Monday, March 19, 2012
A French Hospital Story
As far as I’m concerned, my hospital story started on December 1st, 2010 when my Mom passed away in her rest home in New Jersey. I went back to the US for the funeral the beginning of the December and got back to Paris on Dec 18. The day after, Sunday, I decided to go swimming in the municipal pool as I’d done for years.
It was unusual weather for Paris in winter – there was snow on the ground – and ice. What happened is that I slipped on some ice hidden under crunchy snow right in front of the Chinese restaurant that’s next to my apartment building (i.e. I dropped 180° on my rear end). I knew immediately that something was really wrong– I could hardly walk back to my apartment because my left and lower back hurt so much. And it didn’t get better in the next few days, despite a visit from “SOS Médecins” – a French association that sends doctors to your home when you need a home visit. So, after a few days, I went to the emergency room of Hôpital Bichat, the municipal hospital closest to where I live. It was there that I discovered what had really happened. When I slipped, I had fractured my coccyx. There’s nothing you can do for that except lie down and not walk. Which I did. Plus I discovered home aide (“aide à domicile”). Through the town hall (mairie) of my district (arrondissement) I discovered a wonderful association that sends out women who can help you with cleaning and errands. That really helped me get through this period.
When I went for my follow up appointment at Bichat, the coccyx was fine, but my left hip wasn’t. Actually, it had been pulled and hurting since I was in the US. What was going on? The intern who saw me gave me a referral to a “professeur”, a doctor who was not only Head of the Orthopedic Department at Bichat, but a specialist in hips. (In France, professeur means the absolute top level of doctors.) I went in to see him and in the spirit of his title, he examined me in front of an audience of interns. There wasn’t much he could tell me, so he gave me a prescription for a hip scan and after that, I had to come back.
I had the hip scan on February 3 at an upscale radiology clinic near the Arc de Triomphe in the 8th arrondissement, a far cry from the immigrant ‘hood where I live in the 18th. I could tell that the doctor was worried when he looked at the scan – apparently there were holes in the hipbone. “You need to see Professor Massin tomorrow” he told me. I replied, “If I phone him and demand that, basically his secretary will laugh at me and tell me where to go.” “Ok” he said, “I’ll phone him and make the appointment for you.” And he did!
So, the next day, February 4, I went to Bichat for my appointment with Professeur Massion, carrying a load of scans, x-rays and MRIs. His reaction to the scan? “Madame, the holes in your left hipbone could fracture at any minute, even if you step the wrong way. What you need to do is check into the hospital right now so we can do tests to determine where the holes come from.” “What? Check into the hospital right now – with nothing except my purse and a few x-rays?” Well – he was so serious and worried that I accepted. And so began my Hôpital Bichat adventure.
First I want to say that as an expat in France it’s good to have a network of friends and people from groups you belong to. This made my stay in Hôpital Bichat bearable, starting with lists of things to bring me in the hospital. A friend of mine had extra keys, which she handed over to other friends as time went on. The “guardien” (building supervisor) also has a copy of my keys. And I’m real good at making lists. We also developed the “cell phone sur place” technique where someone would enter my apartment and then call me on their cell phone so I could guide them to find stuff I needed. It worked. In the end I had everything I needed, which is pretty miraculous considering how I unexpectedly checked into the hospital after a doctor’s appointment with no preparation whatsoever.
I quickly discovered that the theme of staying in a hospital in France is “interruption”. When you least expect it, a nurse or nurse’s aid enters your room and takes center stage. It doesn’t matter what you’re doing – they just take over and do what they have to do.
The first thing they needed to do was to find out why there were holes in my bones, especially my left hip. This meant tests – lots of tests. Just a sample are: pet scan (really funny in French as this can be translated word for word as a “fart” scan), ultra sounds of the pelvis and skull, x-ray of the vertebrae, eye exam, colonoscopy, MRI of the pelvis, examination of the bone marrow in the left hip, mammogram and it goes on. Leave it to say that 3 weeks after I entered the hospital, they came up with a general diagnosis: cancer. But where did it originate? Don’t know? Ok – do more tests.
Then there was the question of what to do about my left hip which was fragile from the holes. Their solution: I needed to have a hip replacement operation before starting cancer treatments. This would eliminate the possibility of starting the treatments and then breaking my hip which would mean stopping the treatments to have an operation. Not good. I agreed with them that having the replacement before chemo was to way to go. So, on March 8 I was moved from the Rheumatology Department to the Orthopedic Department for the hip replacement operation. It was done by a young doctor (i.e. he looked about 25 years old), so I was a bit hesitant at first. But I would have had to wait too long for Professor Massin, head of the Orthopedic Department, who checked me into the hospital in the first place. And the young doctor worked closely with Professor Massin. So I agreed. And in the end, he did a really good job.
About three weeks later I got the final diagnosis: the cancer came from a small tumor on my left kidney that had metastasized onto my bones. As a matter of fact, the tumor was so small they hadn’t even seen it the first time they looked at the x-ray. What gave them the answer was an analysis of the cancer lesions on the hipbone that had been removed – it turned out they were kidney cells. Voilà.
It was then that I met Doctor Rodier who was to be my oncologist. Since Hôpital Bichat did not have a cancer department, Dr. Rodier was the link to cancer treatment at Hôpital Beaujon just outside Paris in the suburb of Clichy. I liked him immediately and agreed to follow his treatment there.