Paris, Je t’aime

Name: Allison M. Blatz

Year: Class of 2010

Hometown: Mentor, OH

Major: Public Health Studies

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Paris – the city of lights, the city of love. After spending quite a busy summer in Paris, France, it’s hard to believe the semester is more than halfway over and I’ve been back in the States for over 3 months – wow!

First, a little background – I’m a junior Public Health Studies major (and considering a French literature minor) and preparing for medical school! I wrote another guest blog during my freshman year talking about my research here at Hopkins, and Jackie interviewed me for her blog last year to talk about being Pre-Med, yet this summer was quite a difference experience!

I’ve wanted to visit and study in Paris for as long as I can remember. About this time last year I decided I wanted to study abroad over the upcoming summer so I began to look for programs in Paris. After much online searching and some help from our Study Abroad advisor Dr. Citti, I decided to apply to Boston University’s Paris Summer Internship Program. This program seemed like a perfect fit for me because I wanted to be in Paris, yet do something that was related to Public Health or medicine, which I would have the opportunity to do with the internship component of the program. After being accepted to the program, I couldn’t wait to leave… yet before I knew it, it was here, and I was getting lost on the métro, walking along the Seine and eating crêpes with Nutella in front of the Eiffel Tower!

My program had two parts. The first was a class in the evening studying the French language and grammar… fun, right? There was something exciting about it though – studying French in Paris from the French… Classes were held at BU’s Paris office which was only a few blocks away from the Eiffel Tower. After class we’d often pick up dinner and eat on the Champ de Mars, the park at the foot of the Eiffel Tower. Each time we did this it would be just as exciting as the first!

My internship was truly the highlight of the program. Before leaving for Paris I had prepared my CV in French and had phone interviews in French about the type of position I wanted. Before I left I knew that I had an interview with Dr. Emmanuel-Alain Cabanis at the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (try saying that three times fast!). Quinze-Vingts (literally, 15-20s, the hospital’s name dates back hundreds of years to when the counting was sometimes done by 20s), as the hospital is commonly called, specializes in ophthalmology and is located about a 2 minute walk from the Bastille! A few days after I arrived in Paris I interviewed with the hospital and began my internship the next morning!

My first few days were definitely a little overwhelming. I was expected to communicate exclusively in French and just shadow with some of the doctors on the Neuro-Ophthalmology service, where I would be interning. I had shadowed in multiple American hospitals before, but watching doctors interact with patients in French was a completely new experience. Because sometimes the conversations became hard to follow, I often caught myself closely observing the doctor’s body language and closely watching the patient’s reactions in ways I never had before. When I had shadowed in the past (in English!), it was so easy to get so caught up in the doctor’s explanations or questions of the medical issue that it was easy to forget to stop and watch the patient. This realization really reminded me that medicine is always about the patient and that all the explanations and questions in the world won’t do any good if you’re not considering how they are affecting the patient and how he/she is responding to what you’re saying. Nevertheless, I felt quite out of place and was always afraid of breaking some unstated rule. The staff members were great though, and they were all excited to meet and try out their English on the new American “stagiaire” (French for intern). Right as I sat down that first day of lunch (and no, French hospital cafeteria food is not any better than American hospital food), the conversation was a little slow… until one of the nurses broke the awkward silence and blurted out in French “Do you know Angelina Jolie?! She moved to France to have her babies!” At this I just started laughing, and after that, we usually found something to talk about. Apparently celebrity gossip is the same across the Atlantic.

I was in my department at a very exciting time because Dr. Cabanis had just been elected to the French National Academy of Medicine! This called for a party of course, with champagne in the middle of the day. Dr. Cabanis told me that during my internship he wanted me to focus on working with another member of the Academy who had written an extensive paper on early detection of blood lipid abnormalities in adolescents and how these results could be used to predict risk of premature heart attacks. And my job? To translate from French to English, proofread and get it ready to submit for publication to an American medical journal. Phew! Not such an easy task… I spent much of my time at Quinze-Vingts working on the translation. It vastly increased the speed at which I read French and taught me a lot of medical and scientific terms in French. It was certainly a new experience to collaborate with very respected and renowned French scientists, which was truly a once in a lifetime opportunity for which I am very grateful. I’m actually still working on the finishing touches of the translation and we are still communicating via email and by the occasional phone call.

Because I worked on the Neuro-Ophthalmology service, I got to observe many MRIs and CT scans. This was interesting because the doctors would read and study the MRIs in real-time as the patient was having the image taken, and explain to me what was going on. Everything would be explained to me in French – what the abnormality was if something was there, what a specific blood vessel was, etc – I would become so engaged in the explanations and descriptions that these were the moments when the language barrier would disappear for a few minutes. I’d realize that I was actively thinking in French and comprehending medical concepts. This was so exciting for me, as two of my favorite things are French and medicine… and these moments when the physicians would take time to teach me, I was truly able to watch the two come together… awesome!

I also thought that the French doctors seemed to be more hands-on than American doctors in major hospitals. They were more likely to touch a patient’s arm without gloves on, lift up a child and carry her into the other room or a number of other small things like these. I do want to make it clear that these statements are strictly my own observations, yet something about French medicine struck me as much more personalized and less of following universal rules for dealing with all patients.

While the things I’ve described above were certainly learning experiences, nothing compared to the experience of actually being in a French hospital. One of the reasons I wanted to work in a French hospital was that in some of my Public Health classes, we had learned that some consider France’s system of socialized medicine to be the “best healthcare in the world.” I wanted to know what that actually meant since there is constant dialogue about how the American healthcare system can be improved, especially in terms of providing better healthcare coverage for all. With these questions in my mind, there were a few things that I noticed:

- Quinze-Vingts is considered one of the best ophthalmology hospitals in the country, yet compared to an American hospital it physically seemed much plainer and older. This surprised me, but after speaking with some doctors, my professors and spending much of a night in the ER of another hospital with a friend who developed appendicitis, I realized that this was the case for the most part. It just did not seem to be a priority for French hospitals to focus on external appearances.

- In the MRI room one day, I was reading the referral note from the primary care physician and noticed that it was dated January – but it was June now! Ah, the infamous waiting list I thought. So I asked the doctor in charge about it, and he seemed to think it was a silly question, telling me that the MRI was being done on her knee for a minor skiing accident, and that it clearly was not emergent, so she waited until an MRI was available. I learned that there are a lot fewer MRIs in France to cut costs (which is why we were seeing a knee patient at this hospital). The doctor was quick to explain to me though that if the condition was in anyway urgent, she would have been seen right away. This was proven true later that afternoon as we saw a woman who had visited the doctor the previous week, and it was suspected that she had a brain tumor. Nevertheless, the waiting list remained in my mind, and I thought, hmm, another something America does better.

After reminding myself that I was there to learn and not judge…  I realized that there was actually nothing wrong with either of these things that I had noticed. So, what was the problem in my mind? “Well,” I thought, “American hospitals look nicer. They’re prettier. We have to wait less and they’re faster.” Yet they use more money than any other healthcare system in the world. Americans spend a much higher percent of every dollar on healthcare than does any other healthcare system in the world – even those of country’s whose healthcare systems rank higher than ours!

While these two simple observations in no way account for the excessive spending of the American healthcare system, it started to become clear in my mind that some of the things we have begun to see as essential, like new buildings, fancy lobbies and no lines really are bonuses. And while yes, they are wonderful to have, in America, they are wonderful for those who can afford it – those who are lucky enough to have health insurance. Sure, America has the best healthcare system for those who can afford to pay, but France and other countries may have the better system for everyone, regardless of their ability to pay. I spent a good bit of my final internship paper reflecting on this issue. While it might seem like the better healthcare for everyone is the better option, would this mean a reduction in the highest level of care for those who can pay for it? Surely this wouldn’t be very popular… Clearly this is a loaded issue, but one that is significant in Public Health as it brings up the question, do we have the right to healthcare? I’m very interested in the issue and eagerly awaiting the new political administration to address this on a national scale come spring. Without a doubt, the opportunity to work at Quinze-Vingts gave me the chance to not only see what health issues France is dealing with, but to see how France’s healthcare policies could be used to address American issues. When I eventually become a doctor, I hope to put to use everything I learned.

But… my time in France was not all work and no play! On a lighter note, I made the most of my time in France… spending many nights seeing the Eiffel Tower lit up, exploring little neighborhoods, visiting museums, walking down the Champs Élysées, eating in the Latin Quarter at night and just seeing all the city has to offer. By the end of my stay, I had nearly memorized the entire Paris métro route from using it so much (I was quite proud of myself) and had begun to feel like I belonged in Paris. I also went to Normandy, Aix-en-Provence, Bordeaux, Brussels and Bruges in Belgium, London, and Geneva and the Alps in Switzerland. It was quite a summer!

Au revoir tout le monde! Thanks for reading!

Comments

[Jackie]

Wait, this is an amazing blog for many reasons. First of all, I love your comparison of health care in France compared to America. You are always the expert when I have health care questions! Second of all, your pictures are so beautiful they don't look real. Finally, you mentioned me--so yeah, that's always amazing.

What a great and impressive blog!

[Admissions_Daniel]

I agree with Jackie 100% - this is a fantastic guest blog entry. I feel like I learn so much when I read your guest blogs. I am also so jealous of all that you have done and experienced in such a short time at Hopkins. Thank you Allison.

[Meera]

Hi, I'm going to be a member of Hopkins class of '13. I was directed to this by Admissions Daniel and his blog, and I think it's great! Moi aussi, j'AIME etudier francais et je voudrais etre medicin un jour. That's one of the things I'm looking forward to in college, to study abroad in France, so it's great to see that you had this experience.

(Paris, je t'aime is a good movie too!)

[Jealous]

Wow, what a nice way to study, I am always envious of people who gets to study in Paris, then again I shouldn't be because I get to visit the Paris and the lovely Eiffel tower, about 6 times a year.

[Rebecca]

I absolutely love reading your blog! I am a pre-med student as well and would love to try to do a similiar program as yours. Who can I contact?