May 2010

This doesn’t really have anything to do with the French medical system; I am just putting it in this category because that’s where all my pregnancy-related stories are going.

Because we work for an American company, Jake & I do not participate in the French social security system. The company provides us with real insurance in the States and “insurance” for while we are here. By “insurance” I mean that we pay out of pocket and then the company reimburses us for expenses, at rates based on the the real insurance (for example, labwork at 100% and office visit at 80%). The important thing to note for this episode is that is is not an actual insurance company or plan; in theory I should be dealing with real live human beings, people with hearts and stuff.

So, we had decided that it was very important to us to have Vanina at the birth so I could focus on, you know, HAVING A BABY and not expending a great deal of energy trying to understand and respond in a different language. And we decided it was important regardless of the cost. However, as our company does in some cases move people to a different country to deliver a baby in order to ensure adequate medical care, we decided to ask if they would be willing to reimburse part or all of the cost of a translator. Because that is a LOT cheaper than flying us to a different country and providing lodging for 4-6 weeks. France in general may have adequate health care but due to language I don’t necessarily have access to it. I sent a nice email asking about this, fully expecting that we would not receive any assistance but hoping I was wrong.

A few days later I got an email back. As expected, our request was denied, but the tone in which it was denied really made me angry. It went something like this:

Unfortunately translation services are not covered by our insurance. But I have an idea! Why don’t you just ask a co-worker who speaks better French to go with you?

And my response was something like this:

Because I will have to be at least partially naked to deliver a child, and neither I nor my co-worker are comfortable with that situation.

As if “asking for help” has never occurred to me. Sheesh. What an idiot. I DO ask a co-worker to go along for things like “My knee hurts” or “The bank refuses to change my address” but you don’t ask your co-worker to attend your child’s birth unless the baby is falling out at work, or maybe if they are a super close friend, like close enough that you are both ok with them seeing you naked for hours on end. Anyway like I said I wasn’t surprised by the “no,” I was just taken aback by the flippant manner in which this particular suggestion was offered. I really don’t expect any medical “complications” or anything but the fact that they COULD happen – I think I know more women who have had emergency C-sections than those who haven’t – and I could, in theory, hold the company legally/financially responsible in that event should maybe inspire them to be a bit more cautious and a bit less tight-fisted.

As an aside, we were informed by someone else (with great sarcasm) that translators were not provided for medical situations because they were just SURE we had adequate language training. Remember how I mentioned we got about 96 hours? Yeah. We barely even covered tenses (like “past” and “future”), much less emergency medical vocabulary. Now if the medical personnel want to discuss vegetables, we won’t have too many problems. But beyond that…well, I need help.

So, at this point I am feeling like both  the country of France and the company I work for do not want me to have this baby and view us as an inconvenience. Which makes me both really hurt and really angry, because I know that this is the cutest and smartest baby in the whole world and hopefully someday I will get the opportunity to say, “IN YOUR FACE.”

A few days after the doctor basically told me I would be on my own language-wise at the hospital, I had an appointment at the hospital with an anesthesiologist. In the States, in most hospitals, if you are attempting a natural delivery but change your mind, you just ask for an epidural and they bring it in. Here, you have to meet with the anesthesiologist ahead of time so they can assess your health and look at your back and clear you for the epidural. I really really don’t want an epidural, but with my kind of luck I will be in labor for 72 hours only to be told I’m only dilated to a 2 or something so I decided to have my bases covered. Also, should an emergency C-section become necessary I would prefer an epidural to general anesthesia so like I said, bases covered.

So I went to the hospital and checked in for my appointment. That part went fine. A nurse took me back to a room to fill out some forms before the actual anesthesiologist. And I could not understand her. At all. She had a weird accent, wouldn’t slow down…it has been a long time since I felt THAT lost. And I could tell she thought I was stupid. She decided I couldn’t speak French at all since I couldn’t understand her, and then thought it was unbelievably ludicrous that I didn’t know my height (“In the United States we use feet and inches,” I tried to explain) or pre-pregnancy weight (“I know in pounds,” I supplied helpfully). Finally she gave up and took me back to the waiting room and complained loudly to the check-in girl that I couldn’t speak French, then she poked her head into the doctor’s office and said there was someone out here who didn’t speak any French, did the doctor speak some English?

Then she came back over to me. The waiting room we were in had 2 smaller waiting rooms branching off it, so 3 waiting rooms of people stared as she stationed her face about 4 inches from mine and yelled slowly (in French), “YOU SIT HERE. DOCTOR SAY YOUR NAME. DOCTOR SPEAK ENGLISH. YOU UNDERSTAND?” Ugh. I wanted to punch her.

The doctor was very nice and happy to practice her English, even though I told her French was fine and I just couldn’t understand the nurse’s accent. I got my forms filled out and left, stewing over the irony that the hospital that just got angry at me for not understanding also got angry at me for requesting the presence of a qualified translator…and hoping I could find someplace to deliver my child that would be a little more humane.

In the States, when you do your glucose test, the doctor gives you your glucose drink which you take home and store in your refrigerator. This is because it tastes awful but is slightly less awful when cold. You take it with you when you go do your test, or some testing centers have it there for you, already chilled.

In France you have to go to a pharmacy with your test prescription and ask for the glucose. Then you take this little packet, like a Kool-Aid packet, with you to the lab and they mix it up at room temperature.

Anyway so I showed up for a language exchange a little early, in a part of town I’d never been to before. I noticed there was a pharmacy across the street so I went in with my test prescription, planning out what to say in my head.

me: I need the glucose for this test. (lays the paper on the counter)
pharmacy lady: (blank stare)
me: I’m looking for the glucose for this. (points)
pl: I don’t understand.
me: Glucose.
pl: I don’t understand.
me: Sugar. For this test. (points)
pl: This is a prescription for labwork. You do it at the lab.
me: Yes, I understand that. I have to take the glucose, the sugar, with me.
pl: Is this what you need? (holds up vial for pee collection)
me: No. I need glucose. Sugar. A sugar drink.
(new pharmacy lady walks up behind the other)
pl: I don’t understand.
me: (very frustrated) I go to the lab. They take blood. I drink the sugar. After one hour, they take blood. I need the sugar drink.
new pharmacy lady: You are pregnant?
me: Yes.
npl: You are taking the glucose test?
me: (relieved) Yes! That’s it!
npl: (to first pharmacy lady) Go get her the glucose. (consults prescription, then tells her the size of packet and where it is stored)
(new pharmacy lady leaves to help new customer)

pl: OK…90-something euros.
me: (incredulously) How much?
pl: 90-something euros and something centimes.

I will interrupt this delightful dialogue to say that my comprehension of numbers has increased DRAMATICALLY over the course of pregnancy, due to writing all the checks for doctor visits, labwork, and ultrasounds. DRAMATICALLY. When writing a check I listen very, very carefully but usually ask for a repeat just to make sure; when paying with debit card I listen very, very carefully to the first part just to get an idea of how much it is. So that is why I have 90-something up there; also this was like 2 months ago and I don’t remember the exact amount.  I do know that this was NOT a case of me misunderstanding. It was definitely 90-something euros, not centimes.

Anyway, I gave her my debit card, the French one, but it was declined. I certainly did not have 90-something euros in cash on me so, after all that horrible dialogue, I left without my glucose. When I got home after my language exchange I checked and we only had 80-something euros in our French account. (Lest you be concerned that we are really THAT poor, rest assured that the vast majority of our money is in an interest-earning American account and we move bits over as we need it.) So the next morning I went to an ATM and took 100 euros out of our American account – because of the socialized medicine thing, medications are the same price regardless of which pharmacy you buy them at – and headed to a different pharmacy. This one went much better. I laid the paper on the counter and said I needed the glucose for it, and the lady looked at it to see the size/amount and went to retrieve it.

pharmacy lady: One euro twenty.
me: (incredulously) How much?
pl: One euro twenty centimes.

I dug around for some change and paid for the little packet…and debated marching back into the other pharmacy to wave the receipt in the other lady’s face and tell her I know what a bad, bad person she is.

Now, lest you still secretly think I just misunderstood the first lady, even though I KNOW she said 90(something) euros, I will offer further evidence. Many establishments here do not run a card unless you are spending at least 8 euros. She would not have even tried my debit card if the total was less than 8. And even if that pharmacy DID run cards for any amount, my card would not have been declined for a one-euro charge.

So there you have it. A horrible French woman tried to rip me off but I was saved by being poor. The world makes sense again.

P.S. I don’t know what the deal is with American glucose but I didn’t mind the drink at all, and even thought it tasted kinda good. The only difference I know of is that mine wasn’t flavored like in America. <Shrug>

By this time I had decided that having a doctor who speaks English wasn’t so important, since he/she wouldn’t be delivering the baby anyway, and so far there were no complications to discuss. Tiffany’s doctor said she could “get by” in English so I figured I would just go to her. Here’s how that played out:

Fifth appointment
I don’t remember anything specifically interesting happening during this appointment, except that I got the distinct impression that this doctor did not like me. Even though we spoke French the entire time. A lot of French people are pretty nice about poor French skills if they can tell you are at least trying, but some are incredibly irritated that you’re not completely fluent and I guess this doctor was the latter. Oh well, I told myself, I only have to see her a few times, I can put up with it. She gave me prescriptions for the glucose test, third trimester ultrasound (which she emphasized had to happen in a tiny window of dates, and which I already had an appointment for anyway), and the first part of a detailed blood test required by the hospital. It is a blood typing test, but is much more detailed than what you would consider your blood type. It looks for all sorts of markers and things, and this particular hospital runs 2 of them before you deliver. I have no idea why.

The glucose test happened in between these appointments but it is deserving of its own post so you get that one next.

Sixth appointment
It was a normal appointment – look over all the test results, scribble notes, take off your pants, exam, and then the part where she writes new prescriptions. I took the opportunity to ask a few questions, like verifying that she would not be delivering the baby unless she was on call (because the doctors were still on hospital strike) and a few other things. Upon Vanina’s recommendation I asked if it would be all right if I had an extra person in the labor/delivery room to translate (hospital policy is only one additional person, like the father of the baby; I naively assumed they would make an exception for someone with limited language skills). She looked at me like I was a moron and asked who would be translating (this is all in French, by the way) and I said an accompagnante périnatale. She continued to look at me like I was an idiot. Who? she asked again. I repeated the French words, feeling very self-conscious about my pronunciation of the word accompagnante, and explained that she helps at births. At this point the “you are a moron” look was accompanied by suspicion. “Who is it?” she asked again. This time I try with Vanina’s name, only I can’t pronounce either her maiden name (a complicated French one) or her married name (a really long German one). She shakes her head, like “I don’t know her,” which is why I wasn’t bothering with a name before, and asks again who it is. I was extremely frustrated at this point – even over the course of two very routine appointments we have had several communication difficulties, so I really cannot understand the hesitation to ensure good communication in a stressful medical situation. So I said, “In English we say doula,” and then everything hit the fan.

Jake told me afterward that Vanina had specifically told us not to use the word doula, but I honestly do not remember her saying that. Which is unfortunate, because it is very scary to be yelled at in a foreign language. In general it is more scary to be yelled at in German than in French, but since this lady may literally hold my life or the life of my kid in her hands it was pretty scary. “NO, NO, NO. THAT IS NOT POSSIBLE. ABSOLUTELY NOT. WE DO NOT TOLERATE DOULAS AT [HOSPITAL NAME]. NO. ABSOLUTELY NOT.” Then something about insurance, blah blah blah, and I said we would be paying her, not the hospital, and she continued ranting and raving about how it was absolutely forbidden. I tried explaining, in French, that she would not be there to interfere with the hospital or anything, only to translate, and she went on and on about how they hate doulas at that hospital. I said, as firmly as I could with my vocabulary of a 2-year-old, that I was absolutely not comfortable delivering at a hospital that could not ensure its ability to communicate with me nor allow me to ensure such communication, and she was basically like “Too bad.”

So we left, with me nearly in tears (and I do not cry very often at all) and making plans to return to the States.

At this point – in January – I was starting to get concerned about the language barrier at the hospital. The news that I had a zero percent chance of getting my English-speaking doctor when I showed up in labor was disheartening and more than a little frightening. Somebody needed to do something, and that somebody was me.

While trying to find an English-speaking doctor or midwife several months previously, I had run across the (English) website of a lady named Vanina who called herself an accompagnante périnatale, which is basically just what it sounds like. In English you would call this sort of person a doula. Normally I would not be particularly interested in hiring a doula but the idea of having someone present at the birth who could not only make sure I understand what the hospital people were saying to me but also possibly make sure they don’t do things I don’t want them to without my knowledge was extremely appealing. Plus, I plan to be mentally occupied with things like HAVING A BABY and probably not really into thinking and speaking in a foreign language. I made an appointment.

A few days later, a round, cheery lady with short grey hair showed up, breathless from the 4 flights of stairs one must climb in order to reach my apartment. Everyone, regardless of their physical condition, shows up breathless at my apartment. Anyway so Jake & I talked with her and we all got along famously, and her English was excellent even though she claimed it wasn’t. Even though this was a sort of “complimentary consultation” so we could decide if we wanted to hire her, we learned a lot during this time. For example, the blood test that I didn’t want but was told repeatedly was required/necessary/obligatory was, in fact, not. Apparently French doctors make a habit of telling their patients something is required when in fact they (the doctor) just prefer it. Interesting. Vanina will be a useful ally, I decide. I know my rights in America; I don’t have any rights (to my knowledge) in France so having someone around to explain these sorts of things will be very, very helpful.

Jake & I talked about it off and on for a few days and decided that peace of mind was worth the cost of hiring Vanina, and so we did. A lot of my French comprehension is based on guesswork and context clues, and while I do not expect anything to go wrong during the birth of my child, that is not a situation where “I THINK what they said was…” will cut it. Because sometimes things DO go wrong, and part of my job as a parent is to make choices with my child’s well-being in mind, and I cannot do that if I cannot understand what people are saying to me. A couple hundred euros is definitely a sacrifice for us but I would rather sacrifice euros than my kid’s health, so that is what we decided.

So I had an ally but no doctor…

I just won a book!! Woo hoo!!!!! This is particularly exciting because the flow of books from the publicity group has slowed down. I am still waiting to hear on if the lady can ship it to me or if she needs a US address…but either way, I won!!