Notes on French Medicine, with a Red Army Choir Bonus

 

As some of you know, I’ve been complaining ceaselessly for the past couple of days that I’ve picked up a stomach flu. I’ve seen a French doctor. I’ve been assured there’s nothing wrong with me that a few days of rest won’t fix. Nothing to worry about.

Now, it takes a lot to get me to see a doctor in France. If I report having seen one, you know I’m not just malingering. This isn’t because there’s anything wrong with French medical care–French physicians are very competent and well-trained, as far as I can tell. But there’s also no such thing as a French doctor capable of understanding the following words: “I’m not a French citizen. I have a private insurance plan that only covers me in the event of emergencies. You’ve just assured me that this isn’t an emergency. So is there really any good medical reason to order all these tests, given that I’ll have to pay for them myself?”

Do you find that idea impossible to understand? Doesn’t seem too hard to me. But when I say this I’m inevitably met with a blank stare. It’s truly as if this idea–that medical care is not, in fact, free–is too difficult for anyone in France to understand.

This is all the more aggravating when the physician has just checked your vitals and said, “Doesn’t seem like there’s anything to worry about. You’ve got a bug. You’ll be fine.”

So, long story short, I’ve got a bug and I’ll be fine. But I’m still feeling too tired to say anything intelligent about politics. In fact, I can’t really concentrate on the news, and have no idea what’s happening in the world. That said, this came swimming up on my Twitter feed, and I figured it was a must-share. I watched it four times, and it made me laugh more each time.

Is this as hilarious as I think it is, or is my delight with it a sign that I’ve gone a bit loopy from the medication? (Not exactly sure what I was given, but it works. I’m guessing it’s some kind of synthetic opiate, and it either crosses the blood-brain barrier or the placebo effect is even stronger than I realized.)

If only the Russians weren’t insane. It’s just so hard to dislike them.

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  1. The King Prawn Inactive
    The King Prawn
    @TheKingPrawn

    Many, many Americans are experiencing under Obamacare the exact same thing you experienced in France. They go to the doctor when necessity finally dictates it and pray the doctor won’t find any reason to run a bunch of tests just to cover his basses because all of that is coming out of their pockets thanks to much higher deductibles. We’ve become more medically insecure under the new regime, and all we really have to show for it is more people on Medicaid.

    • #1
  2. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Claire Berlinski: (Not exactly sure what I was given, but it works. I’m guessing it’s some kind of synthetic opiate, and it either crosses the blood-brain barrier or the placebo effect is even stronger than I realized.)

    Then it’s tramadol. Hits your μ-opioid receptors and  inhibits reuptake of serotonin and norepinephrine. (But why would you get it for a stomach bug?)

    I spent the month of May popping in and out of hospitals here in the States, most of it a post-seizure state (meaning cognitively impaired, the chief symptom apparently being inability to locate pants). I ended up practically live-blogging the experience on Ricochet’s Divine Help thread. Having Rico-peeps around during (and a working internet connection at the hospital) made the ordeal much easier to deal with. Maybe I should write a post about it.

    • #2
  3. The King Prawn Inactive
    The King Prawn
    @TheKingPrawn

    Midget Faded Rattlesnake:

    Maybe I should write a post about it.

    If that’s a question the answer is always yes.

    • #3
  4. Claire Berlinski Member
    Claire Berlinski
    @Claire

    The King Prawn:Many, many Americans are experiencing under Obamacare the exact same thing you experienced in France.

    I’m sure they are. I don’t know if you saw this piece I wrote about my experiences with health care in India, but the difference made a huge impression on me.

    They go to the doctor when necessity finally dictates it and pray the doctor won’t find any reason to run a bunch of tests just to cover his basses because all of that is coming out of their pockets thanks to much higher deductibles.

    What infuriates me particularly is being patronized about this. Of course I understand that yes, there’s a very remote chance that I could have something more serious, so in some Utopian world in which none of these tests cost money, sure, it would be nice to rule that out. But I’m more than able to decide for myself that I’m willing to take the risk of not knowing, for now, because clearly: I am not dying, and not even close.

    Unless I fail to recover in fairly short order, it is not worth it to me to know exactly what kind of bug it is. (Especially because the odds are so high that no matter what kind of bug it is, the treatment would be the same: rest and rehydration.)

    I saw a doctor because I knew I had some kind of bug, was dehydrated, and needed a strong anti-emetic lest I get even more dehydrated. Not because I want to spend three or four hundred dollars of my own money to know the name of the bug.

    I’m 47 years old–why should I not be allowed to decide for myself that yes, I’m willing to live with the exceedingly remote chance that it’s something more than a common stomach bug? If I’m still sick a week from now, I’ll reconsider. But being told, as if I’m a child, that I have no competence to make this decision just infuriates me.

    There’s two things going on: first, the assumption that these tests are “free,” which they’re not, even if I don’t personally pay for them. Someone does. Second, the infantilization: I loathe being told that medicine is such an ultra-special, ultra-elite competence that a layman such as myself is incapable of deciding how much health care I want or need.

    The other thing that annoys me is that I don’t ever remember being told–anywhere–what I do think anyone who presents with my symptoms should be told, and under no uncertain terms: Go home and keep your bug to yourself. I know this, but I’m continually astonished by people who think it’s no big deal to walk around crowded urban areas with URIs, hacking coughs, etc. The way to keep these things from spreading is to keep sick people away from healthy people. I don’t know why doctors fail to stress this. Whatever I’ve got, I’ve got (probably) because someone else had it and didn’t stay home.

    We’ve become more medically insecure under the new regime, and all we really have to show for it is more people on Medicaid.

    • #4
  5. Arahant Member
    Arahant
    @Arahant

    Yes, Claire, that is hilariously funny. I laughed from the very start. Love those hairstyles they’re sporting. Also love how they ended it. And yes, I loved the middle, too.

    • #5
  6. Kozak Member
    Kozak
    @Kozak

    Well okay. But if they start singing “Georgia On My Mind”, it’s usually followed by tanks.

    • #6
  7. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Midget Faded Rattlesnake:

    Claire Berlinski: (Not exactly sure what I was given, but it works. I’m guessing it’s some kind of synthetic opiate, and it either crosses the blood-brain barrier or the placebo effect is even stronger than I realized.)

    Then it’s tramadol. Hits your μ-opioid receptors and inhibits reuptake of serotonin and norepinephrine. (But why would you get it for a stomach bug?)

    It’s not tramadol. Looking at the box, I see that it’s French-manufactured imodium–(loperamide). In principle that doesn’t cross the blood-brain barrier, so I don’t know why it’s making me feel so sedated.

    I spent the month of May popping in and out of hospitals here in the States, most of it a post-seizure state (meaning cognitively impaired, the chief symptom apparently being inability to locate my pants). I ended up practically live-blogging the experience on Ricochet’s Divine Help thread. Having Rico-peeps around during (and a working internet connection at the hospital) made the ordeal much easier to deal with. Maybe I should write a post about it.

    Sorry to hear that. Being sick sucks, doesn’t it?

    • #7
  8. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Arahant:Yes, Claire, that is hilariously funny. I laughed from the very start. Love those hairstyles they’re sporting. Also love how they ended it. And yes, I loved the middle, too.

    Okay, then maybe I’m not just feverish.

    • #8
  9. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Claire Berlinski:

    It’s not tramadol. Looking at the box, I see that it’s French-manufactured imodium – (loperamide). In principle that doesn’t cross the blood-brain barrier, so I don’t know why it’s making me feel so sedated.

    OK, sometimes it can cross the blood-brain barrier. But more likely, having drastic GI upheaval is simply exhausting, so when it’s finally calmed, of course you feel sedated :-)

    (Also, God made you slightly loopy by nature (as He did me). It’s one of the things Ricochet loves about you.)

    • #9
  10. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Kozak:Well okay. But if they start singing “Georgia On My Mind”, it’s usually followed by tanks.

    I know. I felt so conflicted watching this. I don’t want to like the Red Army or think of them as sweet, funny, and human–because I know what has to be done to keep them from, you know, invading Europe.

    Anyway, for anyone who missed this classic–this one may rival the first one I posted as the best Red Army Choir cover ever:

    https://www.youtube.com/watch?v=BYbtAZjB8QM

    Tough to decide.

    • #10
  11. Ricochet Contributor
    Ricochet
    @TitusTechera

    These videos are like one of those terrible parodies of foreigners one sees in a certain kind of American comedy. The vulgarity is arresting. If this did anything to make these people less dangerous…

    • #11
  12. Kozak Member
    Kozak
    @Kozak

    Claire Berlinski:

    I’m 47 years old–why should I not be allowed to decide for myself that yes, I’m willing to live with the exceedingly remote chance that it’s something more than a common stomach bug? If I’m still sick a week from now, I’ll reconsider. But being told, as if I’m a child, that I have no competence to make this decision just infuriates me.

    Don’t know about French medicine but I can tell you without hesitation that American Medicine is broken, and was broken before Obamacare.

    As an ER physician most of what I do is a waste of resources. First because the patients don’t belong in the ER for their complaint and the ER is the most expensive place to seek care. Second because much of what I do is providing documentation that I considered every significant posibility so  that in the rare case something unusual or dangerous happened, I can go back to the record and say, “I did what I could to rule that out” when the patient complaint, or the case review or God forbid the threat of a lawsuit raises it’s ugly head.

    There’s two things going on: first, the assumption that these tests are “free,” which they’re not, even if I don’t personally pay for them. Someone does. Second, the infantilization: I loathe being told that medicine is such an ultra-special, ultra-elite competence that a layman such as myself is incapable of deciding how much health care I want or need.

    I can’t tell you how many times I have patients argue with me about the need for a CT scan or antibiotics, based on something they read on the internet, or a friend or relative “in medicine” (frequently an LPN or a physical therapist or a Chiropractor).  I’m nobodies mom and a huge believer in free will and autonomy, but if they really want to ignore my 30 years of clinical experience which is what they are paying for, fine, they just need to accept the consequences, which the system is NOT set up to do.

    The other thing that annoys me is that I don’t ever remember being told–anywhere–what I do think anyone who presents with my symptoms should be told, and under no uncertain terms: Go home and keep your bug to yourself. I know this, but I’m continually astonished by people who think it’s no big deal to walk around crowded urban areas with URIs, hacking coughs, etc. The way to keep these things from spreading is to keep sick people away from healthy people. I don’t know why doctors fail to stress this

    Unfortunatley people are frequently contagious before they realize they are sick.I always tell people to stay home when they have infectious illness.  That and wash their hands compulsively.  It should be right there in your discharge instructions. 

    • #12
  13. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Kozak:

    I always tell people to stay home when they have infectious illness.

    Once you have at least one non-contagious condition that routinely mimics infectious disease, this becomes effectively impossible, though.

    No point in telling an allergy sufferer to stay home because of a sneeze or a fever – or an asthma sufferer to stay home because of a bad cough or a wheeze. Most infections our lot get (sinus, bronchitis, etc) aren’t contagious, anyhow, from what I understand, but opportunistic.

    • #13
  14. Kozak Member
    Kozak
    @Kozak

    Claire Berlinski:

    Kozak:Well okay. But if they start singing “Georgia On My Mind”, it’s usually followed by tanks.

    I know. I felt so conflicted watching this. I don’t want to like the Red Army or think of them as sweet, funny, and human–because I know what has to be done to keep them from, you know, invading Europe.

    Here’s Michael Palin singing with the Russian Pacific Fleet Choir.  Of course this was back in the days when we thought had finally shed her bad old ways….

    • #14
  15. Carey J. Inactive
    Carey J.
    @CareyJ

    Claire Berlinski: Is this as hilarious as I think it is, or is my delight with it a sign that I’ve gone a bit loopy from the medication?

    It’s pretty funny. But the first time I watched this video, I laughed so hard I could barely breathe. Never, in the history of YouTube, has a Downfall parody fallen so far down.

    • #15
  16. Ball Diamond Ball Member
    Ball Diamond Ball
    @BallDiamondBall

    Kozak:Well okay. But if they start singing “Georgia On My Mind”, it’s usually followed by tanks.

    Good Lord, that’s funny.

    At customs:

    Nationality?

    – Russian

    Business or pleasure?

    – Business

    Occupation?

    – No.  Just visiting.

    • #16
  17. Ball Diamond Ball Member
    Ball Diamond Ball
    @BallDiamondBall

    Truly, this marks end of Cold War.  Is on my яфон.

    • #17
  18. captainpower Inactive
    captainpower
    @captainpower

    Claire Berlinski:I felt so conflicted watching this. I don’t want to like the Red Army or think of them as sweet, funny, and human–because I know what has to be done to keep them from, you know, invading Europe.

    There is a romantic notion that the truly evil are somehow different than us. You can tell by looking into their eyes. Then you look at pictures of serial killers and they look like normal people. It’s more comforting to think there is greater distance between us, or that they are easily identifiable.

    When it comes to humor, it can be illuminating or it can be obfuscating.

    Some of it is funny because it highlights reality, like the subversive jokes about Soviet Russia.

    In Soviet Russia the future is known. It’s the past that’s ever-changing.

    Some of it is funny but distracts from reality, like the jokes about Kim-Jong Un being stupid/hungry/misunderstood.

    • #18
  19. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Kozak:

    Claire Berlinski:

    I’m 47 years old–why should I not be allowed to decide for myself that yes, I’m willing to live with the exceedingly remote chance that it’s something more than a common stomach bug? If I’m still sick a week from now, I’ll reconsider. But being told, as if I’m a child, that I have no competence to make this decision just infuriates me.

    Don’t know about French medicine but I can tell you without hesitation that American Medicine is broken, and was broken before Obamacare.

    As an ER physician most of what I do is a waste of resources. First because the patients don’t belong in the ER for their complaint and the ER is the most expensive place to seek care. Second because much of what I do is providing documentation that I considered every significant posibility so that in the rare case something unusual or dangerous happened, I can go back to the record and say, “I did what I could to rule that out” when the patient complaint, or the case review or God forbid the threat of a lawsuit raises it’s ugly head.

    I’ve heard this repeatedly from ER physicians.

    I can’t tell you how many times I have patients argue with me about the need for a CT scan or antibiotics,

    I’ve also heard this a lot, and I understand the weariness it must provoke.

    if they really want to ignore my 30 years of clinical experience which is what they are paying for, fine, they just need to accept the consequences, which the system is NOT set up to do.

    I’m entirely willing to accept the consequences. If it turns out that this is anything more than a common and self-resolving gastric flu, then I have no one to blame but myself.

    Unfortunatley people are frequently contagious before they realize they are sick.

    Yes, and as I understand it, in the case of respiratory infections, most contagious before they’re highly symptomatic. But I can’t blame people for sharing germs that they don’t know they have. I can–and do–blame people for spreading these things when they know full well they’ve got them. I had a bitter argument with friend about this, once. I can’t see much difference between knowingly exposing people to illness and assault. If you understand that what you’re doing is apt to make others ill, it is obviously immoral to do it. Or so it seems to me. It’s not such a huge deal to make me sick–I’m basically healthy and won’t die of it–but it’s a very big deal to make the elderly or the immunocompromised sick.

    I always tell people to stay home when they have infectious illness. That and wash their hands compulsively. It should be right there in your discharge instructions.

    I agree. I’m glad to hear that you do that. But I’ve never once heard that from a doctor. And it really doesn’t seem to be generally understood that this is essential. People come to work or get on the subway with hacking colds all the time. They clearly think this is just fine. I think people who do this should be treated like drunk drivers.

    • #19
  20. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Claire Berlinski:

    Kozak:Well okay. But if they start singing “Georgia On My Mind”, it’s usually followed by tanks.

    I know. I felt so conflicted watching this. I don’t want to like the Red Army or think of them as sweet, funny, and human–because I know what has to be done to keep them from, you know, invading Europe.

    ….Tough to decide.

    I feel less conflicted. People are people, even when they’re part of an evil regime. Nothing about these videos makes me feel warmer toward the Red Army. All I find out is stuff I probably could have guessed, if I thought about it: that people the world over, even in noxious circumstances, enjoy singing and hamming it up.

    Russian  choral music has a rich tradition. To the extent the Red Army choir helped preserve that, fine. Doesn’t change the fact that the Soviets found themselves deliberately curating remnants of tradition because they were so busy smashing up tradition (and everything else) in its natural habitat.

    • #20
  21. Claire Berlinski Member
    Claire Berlinski
    @Claire

    I wish it really had.

    And perhaps it’s curmudgeonly, but that didn’t make me laugh. They don’t have the right to that one.

    • #21
  22. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Ball Diamond Ball:

    Visa application form at the US Embassy: Do you plan to subvert the Constitution of the United States by force or guile?

    Confused, smiling, polite, Japanese tourist pauses. Struggles to figure out the right answer. Finally, circles “guile.”

    I’ve heard this is a true story, but who knows.

    • #22
  23. Ball Diamond Ball Member
    Ball Diamond Ball
    @BallDiamondBall

    Claire Berlinski:I wish it really had.

    And perhaps it’s curmudgeonly, but that didn’t make me laugh. They don’t have the right to that one.

    Eau contraire.  I view this magnificent song from our Civil War, about salvation bot here and hereafter, and played prominently at Reagan’s funeral,  as a cultural triumph *for everybody* when sung by the vanquished (but stylish!) Red Army Choir.

    This, on the other hand, is full of “don’t have the right”.

    Roughly, “Several train lines will bring you here,

    Just outside the west exit of Shinjuku station,

    Don’t miss Yodobashi Camera,

    You’ll find what you need!”

    • #23
  24. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Claire Berlinski:

    I can’t blame people for sharing germs that they don’t know they have. I can–and do–blame people for spreading these things when they know full well they’ve got them. I had a bitter argument with friend about this, once. I can’t see much difference between knowingly exposing people to illness and assault. If you understand that what you’re doing is apt to make others ill, it is obviously immoral to do it. Or so it seems to me. It’s not such a huge deal to make me sick–I’m basically healthy and won’t die of it–but it’s a very big deal to make the elderly or the immunocompromised sick.

    Nuisances are jointly caused, Claire. And the burden of avoiding the nuisance most naturally falls on the least-cost avoider.

    Which in many cases is the guy, like me, whose pre-existing condition makes him more vulnerable to other people’s germies (or tobacco smoke, or whatevs). So we lost the genetic (or temporal) lottery. It’s just not efficient to ask the world to revolve around us.

    • #24
  25. Kozak Member
    Kozak
    @Kozak

    Ball Diamond Ball:Truly, this marks end of Cold War. Is on my

    Well, at least those b@@@@@ds don’t sing “Dixie”.

    That would be too much to bear.

    • #25
  26. Ball Diamond Ball Member
    Ball Diamond Ball
    @BallDiamondBall

    Kozak:

    Ball Diamond Ball:Truly, this marks end of Cold War. Is on my

    Well, at least those b@@@@@ds don’t sing “Dixie”.

    That would be too much to bear.

    The Farewell of Slaveryanka?

    • #26
  27. Ball Diamond Ball Member
    Ball Diamond Ball
    @BallDiamondBall

    Kozak:

    Ball Diamond Ball:Truly, this marks end of Cold War. Is on my

    Well, at least those b@@@@@ds don’t sing “Dixie”.

    That would be too much to bear.

    I see what you did there……..^^^^

    • #27
  28. Sabrdance Member
    Sabrdance
    @Sabrdance

    I saw the Red Army Choir live in concert in, what was it, must have been 2002.  That was back when they were still the vanquished who were being reformed as our friends.  I loved it.

    As Peter could tell us, the Russians are a great people who have borne a lot -not the least of which was the Soviet Union, and now Putin.  The British were a great people (we could have been a great people together), but that didn’t stop us killing them.  Same with the Germans.  I look forward to the day when Russia and the United States are great people together.  We can hardly begrudge them those things that make them great today.

    But perhaps we can begrudge them this:

    • #28
  29. Kozak Member
    Kozak
    @Kozak

    Claire Berlinski:

    I agree. I’m glad to hear that you do that. But I’ve never once heard that from a doctor. And it really doesn’t seem to be generally understood that this is essential. People come to work or get on the subway with hacking colds all the time. They clearly think this is just fine. I think people who do this should be treated like drunk drivers.

    Ah, if most of my patients were like you I might have another 20 years of practice left in me.

    • #29
  30. Claire Berlinski Member
    Claire Berlinski
    @Claire

    Midget Faded Rattlesnake:

    OK, sometimes it can cross the blood-brain barrier. But more likely, having drastic GI upheaval is simply exhausting, so when it’s finally calmed, of course you feel sedated :-)

    Could well be. According to that link, it can’t cross the barrier, but I suspect you’re right that I just feel loopy because I’m tired. Whether it’s that or the medication, though, it’s had a weird psychological effect. This afternoon I spent an hour weeping at the Beau Biden funeral coverage. Don’t get me wrong–his death is genuinely tragic, and there’s every reason to feel compassion for his family. But I did not know Beau Biden personally, so that was a bit … strange, let’s say.

    • #30
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