My experience with the French medical system

Only in France for 3 weeks and I've already had a chance to compare how the U.S and the French medical systems operate. Lisa noticed a blotchy brown spot under my right big toe nail shortly before we left home. I had noticed it for at least a couple months, but figured it was a bruise (from skiing, playing basketball, or just being clumsy) that would grow out. After Lisa's comments I started paying more attention and by last week I was convinced it wasn't going anywhere. Lisa was very concerned and raised the prospect of melanoma and how serious that was. Frightening! But here we are in a foreign country, all its citizens on vacation, with an unknown (as of yet, unused) foreign insurance policy with a high deductible, and our dog Maggie was on the way. What to do? Even hearing Lisa describe a biopsy (because of the toe nail) made me nervous and wonder if I would be laid up for awhile, but it was clear we could not ignore it.

First, we called the woman from whom we're renting to see if she knew a dermatologist. She did. We called and got an appointment for Weds. Then we realized that Maggie was hopefully going to finally arrive that day. We waited to make sure and then cancelled the appt., getting a new one for Fri. at 4:45. At least that's how Lisa heard it, and she is the one doing all the hard work language-wise. We showed up to a fill-in Physician as it's August and so most Parisians are on vacation somewhere else, only to find that our appt. was scheduled for 2:45. The Doctor was very nice and saw us anyway. She did an examination of my toe and did not feel comfortable saying it was nothing, or that it was serious, so she called a colleague to make an appt. for a second opinion. She did not charge us for the appt. Again, all of this took place in French, and while I could comprehend enough to get the gist of what was being said, it was Lisa who was under pressure to understand and confirm the proceedings. And, yes, Lisa told her she was a physician too.

Today was the follow-up, at the Hospital Tarnier. A small hospital with one entrance, we walked around 90% of the building and 75% of a small park before finding our way in. Lisa again took charge with her French and for a moment I panicked when I realized I had forgotten my passport. My license did the job. After a short wait we (yes, "we" - everything here is a family experience due to language and child-care issues) were taken into an examination room where Lisa gave my medical history. Then it was time for the exam, and she had me strip down to my boxers. She did an examination of the toe, said it was clearly red blood cells and thus a bruise. Then she examined the rest of my skin and after some discussion with Lisa who was satisfied with her diagnosis..."Viola," we were done. She handed us the paperwork and told us to take it to the Caisse (cashier) on our way out. I was genuinely curious what such a visit would cost (and wondered about that first visit for which we had not been charged). I was charged 23 euros or about $35. I am clearly not a citizen, yet they never asked for my insurance or anything else beyond basic identification. Lisa is convinced a similar visit/examination in the U.S would have run at least $250 because of malpractice insurance costs. An American dermatologist would probably have leapt to a biopsy. This doctor could remain confident in her experience and skills without necessarily wondering "what will the jury think." Healthcare is also government subsidized, a "right", so she gets paid no matter who she sees, no matter what resources the patient has. We just had to pay a little into the system because we don't pay taxes here. At home we pay a lot into the system (Medicare) and don't get to use it at all. Ok, stepping off the soap box now.

I am thankful that it was nothing serious, that I am not sitting here in Paris with a ripped-off toenail, that I didn't go broke finding this out, and that we can now make plans for the weekend :) Most of all, thanks to my wonderful wife for having the French skills to get us through this in a thorough manner so we can enjoy the relief that we now feel!

Odd and Ends in Paris

Sparkling Tour Eiffel at night Sorry about the sideways video, I'd have to buy QuickTime Pro to rotate it, but I’m still trying to figure out a way to correct it. It's still very much worth watching. The Tower is lit blue every night in honor of the EU and every hour, on the hour, they glitter the lights for 10 minutes. It's captivating, you really can't take your eyes off it! We were on a bateau mouches on the Seine River from 10 -11 pm and it's a beautiful way to to see the city at night.

The boat we took, the Vedette de Paris, was small and uncrowded (unlike some of the bigger packed boats we passed)---a good choice! It starts right in front of the Tower so we got the big light show right off the bat. As it cruises toward the two îles that split the river in two for a short stretch, the Île de la Cité and Île St. Louis, we pass under all the famous bridges of Paris. The ages, architecture, and ornamentation of these bridges are as different as the faces in this very multi-cultural city. A few of the bridges are pedestrian-only, regardless people lined them all, some waving or shouting bonjours and hellos, everyone taking in the same sights and scenes that we were.

Meanwhile, both sides of the river are lined with beautiful (and expensive) Haussman-style villas/apartments with steeply slanted roofs, wrought iron balconies and ornate detail. These are interspersed with gigantic famous buildings built in self-aggrandizement by one king/President or another: the Palais du Chaillot; Musée d’Art Moderne; Grand Palais; Assemblée Nationale; Musée d’Orsay and many other current museums or hotels that remain unknown by name. Then the famous stretch off the Champs-Elysées starting with the Obelisque at Concorde, Jardin des Tuileries, and the immense former Palais/current Louvre. Irie can’t believe that a king would build something so unnecessarily big and opulent. We explain that is one of the reasons the people revolted against the monarchy. As we approach the îles, Notre Dame comes into view and you get a magnificent view of the Rose Window on the south side. The bateau turns and goes around the other side of the îles, where the Hotel de Ville and the Conciergeries (where Marie Antoinette, among others was kept prisoner, in the tower? or am I confusing her with Rapunzel?) line opposite sides of the river. On the return trip, we get a repeat of the views and bridges with the Tour Eiffel standing tall over the entire scene. Unfortunately, the combination of the boat cruising along and being a novice at taking night pictures resulted in photos too blurry to share. The views, however, are etched in my head. It was relaxing yet vivid.

The week also saw us beating the crowds at the Tour Eiffel by climbing the first two levels, then buying tickets for the elevator to the top at the 2nd level. In the photo see the crawling line of tourists waiting for tickets--an elevator ride is the sugar for this line of ants. After the climb, Irie and I went back to our apartment while Lisa got some alone time shopping. Take note in the web gallery of the ornate department stores.

Another day found us walking through the Louvre courtyard (though we have yet to go inside on this trip) into the Jardin des Tuileries where we found a carnival of all things. We all rode the ferris wheel (Lisa taking on her fear of this ride) for yet another round of excellent city views, while Lisa and Irie also did the water ride. This was followed by the Musée d’Orsay for some beautiful sculpture and Impressionism.

On Sunday, I headed down to the Champs-Elysées for the end of the Tour de France. Yahoo sports listed the event as 12:45, and I got there after 1 pm. The streets were barricaded and lined with people, but it was quiet and subdued. Where’s the bikers? I finally see them on a large video screen, somewhere out in the country, surrounded by fields, with 140 km to go. It became clear that the race, while starting at 12:45 only ended in Paris, and after enjoying the spectacle for a few hours I headed back home without having seen a single bike racer. C’est la vie. The reason I didn't stay or go back is that Lisa and I had a date (thanks to our landlady for the babysitter link!) in which we went to the famous St. Chapelle chapel to hear a stringed septet perform Vivaldi's Four Seasons. My favorite classical piece in that setting, surrounded by all that magnificent stained glass left us both feeling sated and dazed.

The funniest event of the week had to be our trip to the Paris Plage. Every year, from late July to late August (which just so happens to coincide with our stay) they truck in sand and create a beach along the Seine. They have all kinds of beach-related activities, concerts, and even a temporary pool. It has been hot this week (about 30 C) so we decided to go to the pool in the afternoon, when the schedule said “kids 10 and under accompanied.” It was fairly crowded with a short line and we made it through the first entrance no problem. Then we got to the actual entrance to the pool and one of the guards made it clear (en français) that my knee-length (righteous curl brah!!) swimsuit wasn’t acceptable. After Lisa conversed with him we realized that 1.) we all needed bathing caps, and 2.) that I needed a “european” swimsuit, either a speedo or what we decided to call a “tankini” which is only slightly larger though just as skin tight. It just so happens that they are prepared for people like us and had a vending machine that sold those exact items. Let me just say that there was a bit of blushing, a fair amount of time in the pool up to my waist, and you will not find any of those pics on the web gallery. (Lisa here: He looks hot and buff in that thing and I think he needs to send it to all his middle aged friends). You will find many photos from everything else this week below...

A week in Paris

Musée du Quai Branly (by Lisa)

I highly recommend this museum. It is fairly new, being the legacy of former President and Paris mayor, Jacques Chirac. It is sublime in its serenity. It is located just up from the Tour Eiffel and at first you pass a massive wall of green. One of the outside walls has been vertically greenscaped and in this heavy summer heat the many varieties of thriving plants appear lush, like a carpet you could roll on and steal a bit of dew. You then enter a garden area and immediately the sounds of traffic, of multi-tongued tourists, of cheap trinket hawkers is gone. And on this summer evening (choosing very wisely to go during the extended hours) we are nearly alone. A lone kitty greets us in the garden. The building was inviting in its cool moderness, both inside and out. We specifically went to see a temporary exhibit on Polynesia. We didn't know what the museum was about. It is very much 3D. It contains artifacts and art from various indigenous people all over the world, divided into vast areas--Oceana, Africa, Americas, Asia. The skulls were creepy, the carved figurines with a little door for housing bones interesting, the buffalo skins familiar, the jewelry made with human hair odd.

The Polynesian exhibit was very interesting, covering the far reaches of the South Pacific, and included Hawai'i, which I was very excited to see. We learned that the items came from the collections of the Europeans who were given them or stole them. Polynesians are giving and generous. Despite this it surprised me that a feathered cape and helmet of royal Hawaiian colors (red and yellow) would be given to a European admiral. Many items were "collected" by missionaries, who brought their prizes back as trophies, proving that they had won over the Polynesians who were now giving up their idols in favor of the white man's god. Unfortunately there were no items related to Hula--no ipu heke, puili, ili ili, or kala'au. So I have to wonder--the missionaries did their best to rid the Hawaiian islands of Hula, maybe the Hawaiians didn't so easily give this up and hand over dance implements to them. They kept them when the Hula went underground, thankfully to be revived. Or maybe I just have my history wrong--early Hula was chanted so the key to its survival was survival of the stories and language and the implements were added later. Don't know. In any case, I'd like to bring an image to those of you who have been to Hawai'i and driven the many Kamehameha roads and seen the familiar royalty signs of the robed and helmeted warrior in profile. I've now seen the robe and helmet in person, in France!!

Maggie's odyssey--by Lisa

After a long journey (mentally and physically) Maggie is finally a Parisian dog. She seems to have come through it better than anyone! Months and months ago, after learning the Queen Mary had no more kennel room, we began to explore other options for getting her to France. We finally came up with sending her cargo and picked Northwest because it was cheaper, and because she could go direct from Detroit to Paris, only spending about 8 hrs in the air, and we had willing family in Michigan to care for her and get her to the plane. Cargo, to us, meant she would fly in the plane with other animals, packages, maybe an employee. I was imagining the FedEx cargo flight Tom Hanks was on in Castaway, without the crash. I carefully combed through the French Embassy and Consulate paperwork on the rules and forms. It all seemed pretty simple and straightforward: Rabies shot, exam, international microchip, paperwork signed by a vet, no quarantine. And we had a 4 month window to get it done. She made 2 trips to the Ashland vet to get ready. Paperwork copied for all who would be caring for her. Before we left Michigan we learned Northwest had a tighter window--10 days between exam and flight. The other potential glitch was temperature--they would not put her on if the temp was over 85. The seemingly sane bureaucracy (oxymoron?) takes a turn:

New exam scheduled in Michigan, new papers dated w/in 10 day window. Dog still healthy, good to go. Arrangements made amongst family about getting her to Detroit, all good. She travels to Detroit, refused by Northwest because papers (so thoughtfully researched, completed and explained) are not "stamped". She goes back to Holland. We are informed at 1am, angry and sleepless. Irie informed when she wakes up, cries. It is now the weekend. Michigan vet not USDA certified so papers must travel to Lansing to get "stamped". "Stamping" can take weeks, and we have the 10 day window. On Monday appointment made to get papers stamped, they will be hand delivered. Tuesday is paper appointment in Lansing, then on to Detroit with fingers crossed that papers will be good enough to let her leave the country. Then Northwest warns the temperature may be too high and it's likely to get hotter the rest of the week. Situation getting tight as 10 day window has 1 day left. She goes anyway with positive thoughts surrounding her. We get a call at 4am, she's on her way.

Wednesday in Paris. Commute ourselves to pick up rental car, negotiate Parisian highways including Le Périphérique ("Beltway" to you East Coasters) to Charles de Gaulle airport. Find Terminal 2E where flight has landed, 15 minutes early. Pretty easy parking garage, lovely air conditioned building, equally lovely airline hostess who escorts us back to baggage claim to find dog. Oops, no dog. Another calm and lovely baggage office person tells us since Maggie did not accompany us she is "freight" and has been or will be (which verb tense did she use?) taken to Freight Area where we have to go get her.

Find the car, try to pay €3,50 but can't because machine does not accept change, nor does it accept our American bank card. (We have a French bankcard, it is sitting in Strasbourg at our "branch".) We are sitting behind an exit bar, hoping another car doesn't come behind us and honk. There is a call button! A very nice man helps us pay in the kiosk (what if it had been after hours?), gives a map and reassurance that finding Freight Area 6 will not be too hard. Bien marqué--well marked! Well, the map, with all its winding loops and off ramps looks like a plate of spaghetti with no sauce, and the well marked signs lead us to Freight Area 1. But we inch our way along, never discouraged, even when bien marqué shows us areas to Freight 4, 5 and 7. Where is 6??? We approximate with 5 (which is prelude for the rest of the day) and somehow find 6.

A series of security guards and doors later we finally find "imports" for Northwest. Very nice lady tells me we must go to customs. I'm thinking we have to go back to the terminal and can only collapse my head in my hands. She becomes nicer, says "ne pas problem" customs is only a couple buildings away, we can walk (smart lady not involving us in those one-way spaghetti loops again). It is hot. These buildings are not air conditioned or posh. There are trucks, gates and security guards to negotiate. I feel my French has hit an all time low as we get door after door wrong, all the while seeming to get closer but not really getting there. Like a nightmare asymptote. By this time it is "le chien"--THE dog. Everyone knows there is a dog, but where is the dog? It seems like they know but we keep going to the wrong door! We get to customs at 12:31. Lunchtime! I go back to outside hot (temperature!) security guard, getting tearful as I ask him if this is really the customs office. No, wrong door, it's over there. Trudging on. Customs is buzzing as the young workers are going off to lunch, but sanely and incredibly, the window has not closed for lunch. We are greeted with "bonjour" by every functionere who works there. I have no clue what we did there but we got ANOTHER paper and went back to Imports. Very nice lady still there, maybe she delayed her lunch because we were so pathetic. Our American credit card is accepted for import tax and she says "go through that door and get your dog." We go onto loading dock and there she is, quietly in her crate, surrounded by workers. She barks when she sees us. The workers tell me they weren't sure if she had been drugged so didn't want to give her any water. When I assure them no meds they find her some water. She is alert, fairly clean (just a little poop on her butt and towels and toy) and robust. She is quiet on the way back to Paris and I have to turn and remind myself we have a dog in the car. When Rick originally booked Maggie's flight he was told "it could take up to 2 hrs to process before you can get her." It took us 1.5 hrs.

Maggie and the apartment. She has settled in nicely. She likes the cool concrete floors. She met one of the cats right away and was scratched. She retaliated by drinking all the cat's water and starting to eat the cat's food. She tolerated that flight better than the cross country car ride.

Maggie and the streets of Paris. She gets some looks--many people are taken aback and the few comments we've had I think these Parisians think she is a wolf. Other people rightly admire her as the gorgeous dog she is. "Elle est sympa"--she is nice--seems to do the trick. She also gets friendlier looks when Irie walks her--if a kid can manage "le loup"--wolf--she must be tame. We got kicked out of the grassy area of the park, only little dogs--whatever that means--can go onto the grass.

So, France and the rules, not liking that so much. Again, the lesson that personal relationships carry the day: our family--Rick's parents, Lisa's sister, Randy, and especially Lisa's mom--really stepped up for us; it's ok to show emotion like fatigue and worry to the office lady and she will help out; chat with the guy who has bad teeth and a weird looking dog and he will not be afraid of yours.

What I like about France--by Lisa

I love the French road system. The highways are well marked by the cutest sign posts, pointing you in the direction of a place. The road names (often a letter plus a number for the highways) are small in comparison to the name of the place they end up. Intersections are marked by roundabouts so you could always go around and around if you're not sure, or haven't made up your mind, and no one will honk at you in annoyance. These roundabouts do not stop the flow with lights. It is a system of manners and ceding the right of way. I cannot guarantee this mannerly system for L'Etoile however (the 12 lane roundabout circling L'Arc de Triomphe). The country roads also mark points of touristy interest by a brown sign. The supermarket is marked by a billboard (I remain grateful Ashland has banned these) but the old château in town is marked by a brown sign. In towns many cobblestones remain. There has been debate about keeping these, as they were used to build barricades and as weapons during the Commune uprisings of the 1870s and again by the disgruntled Parisien students in 1968. I especially like the small little pearly grey cobblestones laid in fan patterns.

I like how the guy in the wheelchair on a packed subway got looked after. The riders packed in around him, pretty much ignored him except for the occasional unobtrusive glance. He didn't seem to be verbal, but as his stop approached he hit a button on the panel of his wheel chair and when the doors opened a worker for the subway put up a ramp and he exited the car with more dignity than the rest of us herded cows possibly could. The worker then lifted up the ramp and was on her way. The whole process took very little time and absolutely no drama.

I love how Paris is so proud of itself that it completely lights up at night, shining lights on all its gorgeous monuments, saying "Look at me! You might have missed me during the day but I am so gorgeous!" France is now president of the E-U, a position that rotates every 6 months, and this pride shows up on the Tour Eiffel which glows blue at night and has the 13 E-U stars positioned on it.

I like that culture is promoted and encouraged. Half of the Metro billboards are for museum exhibitions. That is how I get my first inkling I want to go to a particular museum. They also reduce admission rates for the disabled, the unemployed and other categories of those who can't afford it. (As non-citizens the unemployed Bailey/Brownes don't qualify). Kids under 18 are free.

I like the beautiful oldness. During its chaotic history of wars, pillaging, revolution etc many buildings were destroyed. But there are still quite a few left! Paris is old, way old. The Celtic tribe that called themselves the Parisii lived near Notre Dame around 2300 yrs ago. Their ruins were found and that site is a new museum! We had a date last night and attended a concert on L'Île de la Cité, which is right downtown, in between the arms of the Seine. We saw a group of strings play Vivaldi's Four Seasons at La Sainte Chapelle. This is a gorgeous little cathedral and we were surrounded by magnificent stained glass (these are not just windows, the stained glass windows are the WALLS) and some of the original statues. It was build in the mid 1200s. So here we have an 800 yr old chathedral, listening to music that was composed about 400 years later, played by musicians born about 300 yrs after that. That music in that place--spellbinding. The audience, which was small, stumbled out of there. Thankfully we had workers to direct us outside.

La Vie à Paris

We have been in Paris since Tuesday. Our 4-bedroom, 2-bath apartment is spacious and well-furnished with everything we need. Our landlady, an American ex-patriot with 3 kids has been very nice and helpful, and is now on her way to Corsica for a month. She even set us up with (an expensive) baby-sitter. We have spent the first 4 days acquainting ourselves with our area in the 13th arrondisement (which is charming and not touristy), finding the local markets, metro stops, etc., while also being very much the tourists (see photos). We do a LOT of walking, though we finally got Irie some shoes that don't hurt so her mood has improved, and Irie is loving navigating the Metro. Paris photos

We are also starting to live like the French. Lisa's french is flowing and she obviously deals with the difficult transactions like buying week-long metro passes that require passport-type photos, or purchasing tickets to Vivaldi's Four Seasons at the historic St. Chapelle (we're going on a date Sunday night!). However, I have also been making my way around simple transactions alone like grocery shopping, and yesterday I went to the thrice-weekly market alone. I love these open-air street markets! I was able to ask for a piece of Morbier cheese the size I wanted, a European summer shirt, and all the various fresh veggies needed for ratatouille. I had never made it before, and Lisa said it turned out great. We are already accustomed to the daily rituals of bread, cheese, wine...and nutella!

On the downer side, we went to bed early last night knowing we had to get up and get ourselves out to Charles de Gaulle airport to pick up Maggie. Irie was so excited! We were awoken about 1 am with news that Northwest would not let Maggie on the plane because the vet had forgotten to put a stamp or seal on her USDA papers. This after my parents had taken care of her for a month, and Lisa's mom and sister had taken her 3 hours across the state to Detroit to put her on the plane. From what we understand, they drove all the way back home, are going to get the paperwork fixed, and make that drive all over again today. We feel helpless, burdensome, and reliant on others and want them to know that we are extremely grateful and humbled by their sacrifices!!! Hopefully it will all work out this time. We will miss the final of the Tour de France on the Champs Élysée, but we'd much rather our dog arrives safe and sound.

Meanwhile, our Fréjus landlords, who had already offered to help us get Maggie from CDG, are very understanding. Christine, on the phone this morning was very motherly, spoke slowly to a sleep-deprived Lisa and started using the "tu" form with her. We are going over there for dinner tonight and if Maggie makes it in on Sunday they will help us out then. That is the French way, making contacts and mattering to those with whom you connect.

Tides in Normandy

Even though we are now in Paris, I have to write a post about the tides in Normandy.  They call them the "strongest tides in Europe," and a google search revealed that they come in at the speed of 1 meter/second, and are "as fast as a galloping horse."  We experienced this the first time we went to the plage (french for beach) in Granville.  We arrived at the beach at low tide, about 4 pm, and took a walk a few hundred yards out to the edge of the surf where Irie played briefly in the small waves and Lisa did a hula (ka uluwehe o ke kai).  As you'll notice from the linked pictures, when she started her dance she was on sand, and 3 minutes later the water was around her ankles.  We decided we had to get back and ended up having to wade through an area of water that was up to our waists.  Once safely ensconced back on the plage we were able to watch the water rise for the next few hours as it crawled up the beach, waves getting bigger, and eventually the pool disappeared.  We left for dinner and came back for the entertainment (there was a summer festival going on) and the waves were crashing against the ramparts.  What a trip!

Since the weather had finally improved, we went back to the beach the next day to watch it happen all over again after visiting a corn field maze in the morning.  They have been doing a different maze at this sight since 2002 and this year it is in the shape of Mont St. Michel in honor of it's founding 1300 years ago.  The maze has quiz questions on the Mont to help us find our way (en francaise) and it still took some backtracking and teamwork - it was a lot of fun!  Later that night we took a drive to watch the tides rise around Mont St. Michel which we had visited during the day (low tide) earlier in the week.  The tides really are an amazing sight. Granville plage and cornfield maze pics