The Medi-morphosis: Being Treated Like a Human Under Socialized Health Care

One morning, I woke from troubled dreams to find myself wriggling like an overturned beetle. Each twitch produced a gasp of pain, as if my backbone had morphed into a stem of thorns.

In the United States, you might go straight for the cymbal crash of 9-1-1, but here, in Paris, they prefer their medicine to crescendo slowly, like Ravel’s Bolero. I dragged myself to the phone and dialed my local GP. All I got was his machine, but Docteur Pédron’s brisk voice can serve as a balm, even recorded.

His office wasn’t open yet, so I relaxed on the floor and pondered my lot. My predicament wasn’t altogether surprising. Some time ago, an American college had made the mistake of hiring me to oversee their students in the City of Light. Responsibilities had piled on my shoulders faster than I could shirk them, each day bending me closer to the ground. So, logically, after decades of loyal service, my back had rebelled.

Part of me wanted to commando-crawl to the airport and return home. After all, the spectacle of American medicine wows me like a Broadway show, one where the eye-popping prices promise quality. But it turns out the reviews are only so-so. The US beats everyone on cost, but the World Health Organization ranks us thirty-seventh for quality—just ahead of arch-rival Slovenia. It’s like shelling out for front-row tickets but ending up on the second balcony, with an obstructed view. If you want bang for your buck, the WHO recommends France: They may not make the podium for cost (a measly fourth-place) but for quality they take the gold. And since I was already in that promised land, I decided to try my luck with the socialists.

Handholds on the sofa allowed me to achieve a standing position, and once there I tested my joints like a statue coming to life. In mincing steps, I shuffled to the Metro station to begin my journey.

Docteur Jean-Jacques Pédron is my entry point into the medical system here. For years, I have brought my ills to his office, which is located near the Grand Mosque of Paris—a towering white structure with a first-rate café. Usually, I treat myself to mint tea and almond-paste cookies before medical checkups, but today I skipped the snack and went straight to his door, pressing the button for the bell. A camera allows Pédron to screen new arrivals on the sidewalk, but the latch clicked open before I could even peer into the lens. So much for security.

Frankly, doctor visits in France can seem primitive to Americans. When stateside, I go to a clinic so large that a hostess is stationed by the carpeted entrance. She directs me to the appropriate bank of receptionists, where another young woman swipes my insurance card and my American Express before presenting me with a clipboard. After serving myself a latte at the beverage station, I settle into an armchair and ponder the form. How often do you feel nervous? it asks. How often do you feel hopeless? These probing queries reassure me of the importance of me, an important topic for Americans, and though I’m never sure which answer is considered correct, I appreciate the opportunity to reflect on them.

Eventually, a nurse sings out my name and we travel through various stations, measuring my weight, my height, my pulse, my blood pressure. Then I strip to my underwear and sit alone until the High Priest to whom I report enters. He’s robed in a white coat and wears a stethoscope necklace.

At Docteur Pédron’s, on the other hand, you step straight from the sidewalk into his waiting room. It’s a cramped square space furnished with metal chairs, yellowing wallpaper, framed posters of ski resorts, and a coffee table groaning under back issues of Elle, L’Express, and Santé. In one corner, there stands a plastic houseplant desperate for dusting. Another permanent fixture is the patients, for the waiting room is never empty, even when I arrive at the hour of opening—as though the current occupants were left over from the previous day.

In waiting lounges in the US, I studiously ignore the presence of other people. On the rare occasion a person I know enters the room, I become consumed by the urgency of answering my clipboard questions. In France, however, your arrival is acknowledged by nods or even mumbled greetings, and those already present keep their eye on you. This is to discourage cutting in line, which could technically be possible, for Docteur Pédron has no receptionist to check you in for your appointment—and, in fact, no appointments. Usually it’s just drop-in time. The American in me wants order—at least a number to be taken, like at the DMV. But here, turn-taking is maintained by a subtle play of nods and frosty stares, a practice so terrible in its efficiency that I have never witnessed an infraction.

Visits take a while, for Pédron is a one-man-band. He’s the only doctor, and there are no nurses. When not busy palpating or scoping, he manages the schedule, buzzes people in, produces bills, deciphers the insurance, and replenishes the supply of pamphlets in the waiting room. If specialized tests are needed, he sends you two blocks away to a lab that draws your blood or zaps an X-ray. Your medical information travels in the chip of your carte vitale, or Life Card, and the rest gets emailed via the most secure medical messaging system in the world. Healthcare in France is half MacGyver and half NASA.

Healthcare in France is half MacGyver and half NASA.

An hour or so later, it was my turn. The doctor waved for me to follow him. Docteur Pédron is small and fit in a slender, middle-aged sort of way, and he is usually attired in a snappy gray suit, which makes me fear I’ve pulled him away from a dinner party, or perhaps a funeral.

In his office, I winced myself onto a chair, balancing my vertebrae like a stack of teacups. Settled behind his walnut desk, he lifted his palms in wonder and asked his favorite question: “What on earth are you doing here, Monsieur Carpenter?”

I should mention that Docteur Pédron is perpetually astonished to see me. For him, I am a potential cover model for the Santé magazines littering the waiting room, rather than a pear-shaped guy strapped in a suicide vest of bad habits. He flaps away descriptions of symptoms like pesky motes of dust. No, no, the suave backs of his fingers say, none of that matters. Everything I tell him is both boggling and trivial—indeed boggling because so trivial.

I began my tale, describing how I woke to find myself transformed into an invertebrate. Meanwhile, Pédron looked up my file. He used to keep the history of my visits on small lined cards, but about ten years ago, he converted everything to computer. Because he types only with his index fingers, I had plenty of time to look about.

American examination rooms try hard to impress. In the clinic I sometimes visit in the States, each room houses an altar for the human body—a table-height bed placed atop a movable block of steel. The walls are pocked with electrical outlets and brackets. The only decoration consists of two anatomical drawings of the human body—provided, I presume, in case the doctor needs reminders during the visit. There are also banks of cupboards under the counter. Although my impromptu inspections have revealed most of these cabinets to be empty, their presence contributes to the general impression of seriousness.

I love Docteur Pédron, but his office is worrisome for its lack of medical paraphernalia. The parquet floor is covered by a tattered Persian rug, and most of the furnishings appear to have been acquired at garage sales: a springy daybed, a metal coat rack, a knick-knack cabinet, a mismatched dresser. Most of his equipment—stethoscope, depressors, blood pressure gauge—are hidden in desk drawers. And while his bookshelf does include a few medical tomes, these rub shoulders with a volume about home repairs and even several novels.

It’s not as if French doctors are stuck in the leeches-and-bleeding era of medicine. Hardly. Not far from Pédron’s place of business, you can see the dome of La Salpétrière, the hospital where world-class experts snip tumors from brains, blast growths with ray guns, and splice the occasional gene. Just because it’s socialized doesn’t mean they don’t have the heavy artillery you need when the going gets tough.

But general practice offices tend to be a little homespun. One day, for example, I stopped by because of a pressure in my chest. After asking what on earth I was doing there, Docteur Pédron listened stone-faced to my litany of symptoms. Finally, he sighed and offered to do an EKG. Scenes of self-importance flowered in my imagination: Monsieur Carpenter being wheeled on a gurney to the EKG chamber, Monsieur Carpenter studied by a huddle of experts with clipboards, Monsieur Carpenter immortalized in medical textbooks for self-diagnosis of a rare disease.

But the machine was just a plastic box the size of an alarm clock, stuffed in a drawer of his desk. A few suction cups later, it produced a curl of paper showing peaks and valleys as regular as the Alps. The device looked homemade to my unpracticed eye (was it possible it dispensed pre-printed rolls of regular heartbeat?), but before I could inspect it, he’d tucked everything away and declared me to be in working order. Once again, I was the man crying wolf.

It is inconceivable to Docteur Pédron that any of my complaints should be taken seriously, and because his incredulity is contagious, I always leave his office satisfied. Visits make me feel good about myself. They’re like getting a haircut or buying a new pair of tennis shoes—except a good bit cheaper. A standard doctor visit currently costs twenty-three euros in France (as one euro after insurance), and the price is the same for house calls, which are still a thing here.

Today, I waited for Pédron to mock my complaints so my back could stop hurting. But as I rattled off the details of my story, the doctor leaned forward, his eyebrows sinking below the rims of his glasses. Where was that dismissive sweep of the hand, the roll of the eyes, the astonished protestations about my excellent health? I downplayed my symptoms and up-played my overreactions, laying the groundwork for him to chuckle it all away.

Just because it’s socialized doesn’t mean they don’t have the heavy artillery you need when the going gets tough.

“Well,” he said sternly. “This time you’ve done it.”

I started unbuttoning my shirt, but he shook his head.

“There is no need,” he stated.

I protested. Surely if he examined me, he’d find the bulging Lego piece that had to be shoved back into place. Shouldn’t he run some tests? Wasn’t there a Ronco CAT-scanner in the desk drawer next to that EKG thing?

But no. He just gave his head a shake to underline the hopelessness of it all. For once Monsieur Carpenter hadn’t been exaggerating. Without equipment or test results, without even deigning to touch me, Docteur Pédron produced a diagnosis.

“Your back is bloqué.” It was, he said, was absolutely classic.

“Probably I just need to work out more,” I replied. It was unlike Docteur Pédron to run out of dismissive comments, so I primed the pump. “Strengthen my core. Sit-ups and the like.” Because I couldn’t remember the French word for this exercise, I placed my hands behind my head, like a POW on a death march, and bowed—a little pantomime that cost me a thunderbolt of pain.

No, no, Docteur Pédron’s wagging finger insisted. I wasn’t going to exercise my way out of this one. As he launched into a lecture about spines and nerves, a more terrifying montage of my future blossomed: Monsieur Carpenter lying before a surgeon with a meat cleaver, Monsieur Carpenter unable to wiggle his toes, Monsieur Carpenter wheeled on stage as the poster boy for the telethon. In short, Monsieur Carpenter as the overturned insect, his metamorphosis complete and irreversible.

Docteur Pédron scribbled on a pad of paper, and tore off the sheet, which he slid across the desk. It was a prescription for muscle-relaxants and painkillers, along with what he referred to as a belt—not to keep my pants up, but to keep my vertebrae from clattering to the floor. It was, in fact, a kind of girdle.

If you’re into the self-administration of drugs as much as I am, you should never set foot outside the US. It’s true we can’t tank up on Sudafed the way we used to, but otherwise, Americans have a pretty sweet deal on the drug front. The aisles of a Walgreens or a CVS are like strolling through a pick-your-own-vegetables farm. You harvest what you want, choosing from among fifty different cough syrups or painkillers. Best of all, unless you’re stuck buying prescriptions, you don’t have to tell anyone what you’re up to. You just stash your hemorrhoid creams and foot fungicides under a box of Fruit Loops. In some places, you can even check yourself out via automated cashier. The secrets of your body are safe.

In France, you won’t find so much as a roll of Tums at the supermarket, and you can’t pop into a 7-11 for something to snug up your bowels. Pharmacies hold the monopoly on health, and medications lie in the vaults behind the counter. Whenever my body betrays me, I skulk down the street, stand in line, and speak to a lab-coated woman whose bun of hair has been tightened with a wrench, explaining exactly what fluids are oozing out of which parts of me. For the benefit of anyone within earshot, I provide details about frequency, color, and duration, after which she goes on a scavenger hunt in the back room, returning with a trove of boxes and vials.

Trips to the pharmacy—also government-regulated—invariably cost more than doctor visits, which perhaps explains why there are more pharmacies in my neighborhood (eighteen) than bakeries (a mere thirteen). Also, because people still know things in France, pharmacists dispense actual medical advice. In the countryside, they’ll help identify the toxic mushrooms you’ve collected, and I’ve often seen them patch up minor wounds with first aid kits. They like to get involved.

In line at the pharmacy, my transformation continued: gravity contracted the remaining portions of my spine, and every movement produced a wince. People around me seemed to be showing off—swaying fluidly to the music of their earbuds, turning their head without rotating their chest, even kneeling to tie their shoes. My own future was devoid of bends or turns. I would slowly petrify. Soon I’d be wearing loafers. My shoulders rounded with despair.

The woman behind the counter had a severe nose but large eyes, making her businesslike in a gentle way, as if she were in charge of financial transactions, but sold only kittens. Her name tag identified her as Béatrice.

“Vous désirez?” she said. And although this is a standard shop greeting in France, a way of asking how one can be of service, I was tempted to sing out that yes, I did desire. Vastly. I wished to have my back back. I wanted to feel whole again.

I slid Docteur Pédron’s prescription across the counter. “I would like a girdle,” I told her.

She led me down the aisle and pulled out a bin filled with broad bands of fabric, ribbed with elastic and layered with Velcro. Out came the measuring tape, and soon she was giving me the tailor spin, assessing my waist and hips. Then she helped me wriggle into samples, slipping her fingers behind the fabric to test the constriction, pinching her face when she didn’t like the results.

Thanks to Béatrice, I ended up with a girdle that fit. True, it was ungainly and plain. It hindered my movements and chafed at my skin. But it encased my midriff like a protective shell.

In the US, my doctor would likely have prescribed me an Iron Man suit, or possibly put me on the waiting list for a full body transplant. And because having a back is a pre-existing condition, my insurance would have denied the charges, forcing me to take out a third mortgage or play the lottery. But in Paris the solution was simple and affordable: repairing my body cost a little over a hundred euros. Even that was three times what a local would have paid, thanks to the standard insurance. (Lots of folks have employer-funded supplements to cover the rest.) Maybe this is why France has one of the best life expectancies (ninth)—far ahead of the US (thirty-first), which even lags behind our old rival Slovenia (twenty-sixth).

Medicine in France sometimes lacks the dazzle I grew up to expect, but mostly it works and is available to all. Back home a lot of people seem to find this conclusion outrageous. French GPs, they argue, earn too little (just over half what the Yanks pull down) to be any good. The French restrictions on kickbacks from drug companies are too goody-goody. Moreover, the American medical error rate (nearly twice that of the French) keeps our countrymen on their toes. And to top it off, if we eliminated all the complicated health forms, where would Americans get the practice they need for cheating on their taxes?

These are all valid complaints, but I suspect the main objection to adopting the best healthcare system on the planet is that it’s French.

As I walked home, the sun came out, turning the limestone buildings gold. The chill lifted, and soon the pills kicked in. Finally, my torso began to unclench—tentatively at first, but then with trust, and even relief. I wouldn’t be a beetle forever. Thanks to Docteur Pédron and Béatrice, to my cocoon of spandex and straps, one day soon I might emerge again, transformed into a human being.

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