French Friday: Alien with Preexisting Condition

I was surprised the first time I heard an American dad call his child “pumpkin.” But after all, an American would be surprised, too, hearing French parents call their child “ma puce,” which would be “my flea” in English. More pumpkins will illustrate this post, to honor babies, young children and the season. 

 

As heated debate about health care in America is once again raging and dividing people, I bumped into one post that I wrote seven years ago. I revisited the post and slightly modified it for my weekly French Friday. Si vous préfèrez me lire en français c’est ici. Une version plus courte et aussi plus récente puisque le billet remonte à 2013.

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Our second child was due only five months after our arrival in the States. Most recent immigrants wouldn’t have bothered with health insurance, but we were French and it didn’t occur to us that we could raise a toddler and give birth without some health coverage. So we searched for our plan.

We found an agent, accustomed to people like us, young foreigners who spoke funny but armed with unlimited optimism. When we left his office, we had health insurance and I had become an Alien with Preexisting Condition.

I could now search for a pediatrician and found one in our neighborhood. One morning, my one-year-old woke up crying, her cheeks red and her small hands stuck to her ears.

Bobo, Maman, bobo, Maman,” she said.

I had no doubt she was in pain and took her temperature: 38.6. I called the clinic and rushed her in as soon as they gave me an appointment.

Colorful bulky chairs and a climbing structure for the children – there was even a matching one in a small yard outside – replaced the “Louis XVI style” chairs at my Parisian doctor’s office. The nurses wore tunics printed with teddy bears above pink cotton loose pants and they walked in rubber clogs. Nametags like the checkout clerks at Safeway were pinned on their pocket-chest. My little girl’s pediatrician was dressed in a crisp, long white coat above his polo shirt and khaki pants. In Paris, her doctor wore elegant suits and ties.

“Are you running a fever, sweetie?” The nurse sat my daughter on the exam table.

“She has 38.6,” I said.

The nurse gently slid a thermometer in my daughter’s mouth, less invasive than the barbaric French kind. “101.4,” she read.

“Oh non!” I exclaimed instinctively in French.

“Fahrenheit,” the nurse said, kindly patting my arm.

For a while I panicked when nurses announced that my children were not ill because their temperature was only 99F. And I would also feel much warmer when outdoor temperatures reached 100 F and not 37.7 Celsius.

“Nothing too serious,” the pediatrician said after he had fully examined my little girl. “Regular BM?” he asked

“BM?” I repeated, parrot-like.

French aren’t embarrassed when it comes to body functions, so it took me a while to refer to the contents of my daughter’s diaper as a BM. After many years in America, I would also say UTI, PMS and IBS, and learn that stomach for Americans covers a much larger territory than the organ used in the human digestive system.

“Here you go, sweetie,” the nurse said, presenting my daughter with a small basket overflowing with colorful stickers. “You can have one.”

My daughter picked a sticker that the nurse applied onto her T-shirt while the pediatrician scribbled a few words on a prescription pad.

“Antibiotics for a few days will do,” he said with a gentle pat on his young patient’s head.

“Do you do house visits?” I asked. “And do you take new patients?”

“I don’t do house visits. Unless your child is too ill to be taken to my office – then you dial 911 – you must book an appointment for checkups and immunizations. But yes, I take new patients and I would be very happy to meet your new baby after she’s born.”

“What about my daughter’s diet?” I asked when he slipped his pen in his pocket and handed me the prescription.

He smiled warmly. “She’s healthy. She can eat anything. Just avoid too much fat and sugar. Frozen yogurt is better than ice cream.”

I remembered the detailed instructions related to food that our Parisian pediatrician provided. He would have come to our apartment to check on my daughter, but he also expected his patients’ parents to obey his rules.

This new pediatrician, I thought, is cool. Like all doctors I’ve met here, actually. Way less intimidating than their French counterparts.

I had also immediately noticed how being pregnant in the States had nothing to do with the special status I received in France. With my first pregnancy, I entered the magic world of pregnant women. Perfect strangers of all age and gender would open the door for me and offer their seat on the bus or subway. I could cut in line since French pregnant women receive a priority card. After my daughter’s birth, I was entitled to free postnatal workout at a physical therapy office. No excuse for not having a six-pack after giving birth in France.

Far from my native country I became aware that French pregnant women had advantages and I missed the extra attention, yet I also questioned the rationale behind. Was it, for example, the role of a government to decide of its female citizens’ appropriate waistline?

In France, I had also read alarming articles about the high rate of Caesarian births in the US. My French obstetrician admitted that my chances of having a C-section were much higher than in France. I convinced myself that a Caesarian wouldn’t be the end of the world.

Being pregnant in the US turned to be a totally different business than expecting a baby in France. At my first American prenatal checkup I had, à la française, fully undressed. With an embarrassed smile, the nurse handed me the strange-looking paper gown she had left neatly folded on the exam table before leaving the room. I had dismissed it but now slipped on the thin material. In my haste, I mistook the back for the front, which offered limited body coverage.

In France, nobody cared about me being naked, but I was weighed every single month during my pregnancy, and sternly reminded to gain only a reasonable amount. Once my OB scolded me for two extra kilos. In the States, I couldn’t fully undress, but it didn’t matter if I got fat. My American physician, unlike my French one, didn’t obsess about my weight, but he urged me to take prenatal vitamins and seemed a little obsessed with my due date.

“Vitamins are very important,” he argued when I said I was eating lots of fruit and vegetables. “Also we cannot go beyond early May,” he insisted. I asked him if he had any specific concern.

“No. But we cannot wait indefinitely.” I reminded him that the baby was not late, not even due yet. “Still,” he said.

I had noticed that Americans ran on a faster clock than the French. Was it why American babies, unlike the French, couldn’t be late at their first rendezvous with earth?

Although it felt less theatrical to be pregnant the American way, one aspect worried me. My parents and in-laws had told us that they wouldn’t be able to take any days off at the time of the delivery. We had to find a babysitter who would take care of our daughter while I would be at the hospital. We were a few years away from the arrival of the Internet, so the Bay Area still relied on good old phonebooks. After many unsuccessful calls, I found Laura, a young woman who worked in Oakland with newborns whose mothers were crack addicts. Laura was also a masseuse and a babysitter. All positions fully accredited. Through Laura I discovered that many Americans worked two, three, or even more jobs. Laura was also kind and smart, and we immediately got along well.

Relieved to have secured someone, who could stay with our daughter when needed, lifted a weight from our shoulders. I spent the next two months soaking up California sun either in our backyard or at the playground, which had become our second home. This pregnancy seemed likely to end on a more relaxed note than it had started in France.

Still, on my way to the San Francisco Children’s Hospital, on a busy Saturday night, I wondered if delivering a baby in America would be as surprisingly different as the prenatal visits had been.

“Please, hurry up, it’s an emergency!” my husband begged the front gate attendant when we showed up at the Emergency Room entrance.

He wasn’t a first time father, yet he acted like one. He had zoomed through a red light, honking across the intersection while cars and buses pulled over. I suspected that he was living one of his secret dream moments: being Dirty Harry roaming San Francisco. Now that we were at the hospital, he was as anxious as I was to welcome our baby safely.

“Can we see your insurance card?” was the guard’s reply.

“Can’t you see it’s an emergency?” repeated my husband.

“I’m okay,” I said, breathing in and out like a pro as a young man pushed my wheelchair to the maternity wing of the hospital. In France you walk to your delivery room, unless you really can’t walk.

Our new baby took only a few minutes to travel from the dark cocoon of my womb to the brightly lit American world. It was such a fast delivery that the doctor didn’t even make it. I had delivered the year before in Paris, surrounded by my obstetrician, an anesthetist, the midwife who had taught me the tricks of the sans- douleur accouchement or the painless delivery, and two nurses.

In my San Francisco room, the word “delivery” was different. Only a nurse and a resident assisted me, giving to the event an intimate atmosphere I had missed in Paris. Yet it would have been somehow reassuring to see the obstetrician. Also since I hadn’t eaten anything since breakfast I was starving. A vision of a delicious tray came to my mind and my mouth watered. A warm vegetable soup, then a tomato and mozzarella salad, a piece of crusty baguette and a slice of brie, and to end on a sweet note a mousse au chocolat would have been perfect. I envisioned a sparkling Perrier with lemon zest to appease my thirst. After all, last year in France, the food had been close to that in a four-star restaurant.

The nurse read my mind. “You must be hungry,” she said kindly. “But the kitchens are closed now. Let me see what I can do.” She returned with a huge grin. “I have something for you!” she announced cheerfully, handing me a can of freezing cold Coca-Cola.

That’s how my husband and I toasted our newborn. If the Coca-Cola didn’t taste like the Perrier I dreamed of, it was, however, cold and sparkling, and I polished off the can with the ferocity of a marathon runner.

“Congratulations and Happy Mother’s Day!” the nurse said. Our baby was born less than an hour before Mother’s Day. The nurse smiled and peeked at her. “She’s gorgeous and healthy. You can go home,” she added.

“In the morning, yes,” my husband said.

The nurse looked puzzled. “Now,” she said.

“Now?” my husband repeated. “You’re kidding, right?”

“Your wife and baby are doing well. You can return to the comfort of your home,” the nurse said with another warm smile.

I was tempted. I had done my grocery shopping the day before and I pictured the loaded fridge and stocked cupboards.

“No way,” said my husband.

I felt fine now that I was wrapped as tightly as a mummy in warm blankets and my baby had already returned to sleep, but my husband with his pale face and red rimmed eyes didn’t seem ready for another ride on the One-O-One at two in the morning, with a newborn and her mother in tow.

So, that’s how I spent my first American Mother’s Day in the company of my satiated baby and my roaring stomach.

The morning cereal, whole milk, and weak coffee were close to the French first class service after the forced diet I endured until breakfast. Calliope was healthy and I was well, but I wondered why the only edible thing I had been offered had been a can of Coca-Cola when a French hospital had fed me for a week with gourmet meals. Yet I slurped my soggy Raisin Bran in a few spoonfuls as I had savored my grapefruit juice, yogurt with granola, croissants, and fancy tea across the Atlantic. Nothing better than a nap for a new mother, but I wasn’t allowed this small luxury.

“You are good to go!” the doctor decided cheerfully.

I expected some kind of French checkup but I only received a maternity bag filled with lots of goodies for baby and mom in place of the long list of recommendations the French doctors and nurses handed me when I left the maternity.

About an hour after I got home, my mother called.

“What are you doing here?” she said, expecting my husband to pick up the phone.

I told her that I had returned home after being instructed to leave in the middle of the night, a couple of hours after giving birth.

“I know that you like it over there,” she said. “Over there” sounded like a bad word. “But do you think it’s the proof of a great country to treat new mothers like that?”

I skipped the Alien with Preexisting Condition status and the Coca-Cola episode; she would have called the French embassy to require an emergency rapatriement.

My mother-in-law was as shocked. “What in the world are those American doctors thinking?”

It would have been a complete lack of etiquette to mention the Coca-Cola toasting to my mother-in-law having been born in Champagne, and her mother living in Epernay, the capital of the most renowned French Champagne brands.

I listened to both of them, sitting at my kitchen table as the fragrant scent of the eucalyptuses wafted through the open windows. France was so far. How could I tell my family that I was now living in a country where the cost of health care was so expensive that new mothers are sent home – escorted in a wheelchair to their cars – as soon as possible?

How could I also tell, without hurting them, that if I had only stayed for a few hours at the hospital, everybody had been supportive and kind, and that I had felt much more in charge than I had in Paris, where the medical staff had decided for me what was good or not?

The French social security system was only a word to me anymore. My mother and mother-in-law had lived for too long with the reassuring feeling of being taken care of to understand my new life.

I reflected on the paradox: in France being pregnant is not a pre existing condition but a pregnant woman receives extra attention and care while in the US expecting a baby is not a big deal yet health insurers providers are allowed to tag pregnancy as a preexisting condition.

In 1991 nobody would have thought that the American health care system would some day go through significant changes, the most important regarding the impossibility for health care insurers to deny treatment to anyone with preexisting condition. In 2017 nobody with a heart would want to go back to those days.

****

P.S. I couldn’t miss the single Like I received on the original version of this post 🙂

I was new to blogging and started as an exercise to improve my English, but someone stopped by.

Wow, Mona, my blogger friend, we’ve known each other for seven years! Thank you for your visit and your Like.

 

 

Comments

  1. So interesting to hear the differences between delivering in France and America. Thank goodness I didn’t get pushed out of the hospital so quickly!

    To seven years and beyond! I really enjoy reading your posts. 🙂

    • Thank you, Jennifer. I also love really your posts. You know that your Foodie Friday gave me the idea for my French Friday:)
      Differences aren’t as striking in 2017 than they were back then, but I still notice what separates the two countries that sit next to each other in my thoughts.
      Yeah, it was pretty rushed in SF! Empty delivery rooms when I showed up, packed when my baby was born. Which explains why they wanted me out 🙂
      That was a quick intro to the American fast-paced lifestyle for sure.
      See you on your blog!

  2. What an adventure for a new mom. I laughed at the part about not mentioning “toasting” with CocaCola. I hesitate to think what health insurance like that would cost today. I’m am happy it all worked out well.

    • I’m glad you laughed reading this post, Dan.
      It’s always an adventure to have a new child, but I must say that this #2 baby was quite special in many ways. She’s by the way doing really well in also many ways. This Coca Cola didn’t harm her 🙂

  3. Very interesting, Evelyne. And what a difference! Checking to make sure you can pay before providing care is so American. I hate to think about medical care here. It is so broken in so many ways and yet continues to function. I can only wonder for how long. –Curt

    • What is too bad, in my opinion, is the difference between the excellent care that so many physicians, surgeons, nurses, and health providers at large give to their patients and the disfunctional insurance system that creates so much inegality between people. I still fail to understand why people disagree that health care is a human right. But that would be too much for one blog post to discuss that 🙂
      As always I thank you for stopping by and commenting, Curt. All the best.

      • I think that education, health care, and a basic living standard should be guaranteed or at least affordable for all, Evelyne. I think we have allowed greed to be the primary factor in setting so many of our critical policies in this nation. –Curt

      • Cannot agree more with you, Curt. American entrepreneur spirit should not exclude these kind of necessary affordable tools that would allow a more equal access to a slice of the great American cake.

      • I know that there are good business folks out there, Evelyne— people who care about their products, the people who work for them, their communities and the environment, and can somehow meet these obligations and still make a profit. But when your only motivation is how much profit you can squeeze out of anything as quickly as possible, things go south quickly. –Curt

  4. Posted this a couple of places. Great article and very apropos.

  5. I love this, even though — or maybe because — I’ve never been pregnant anywhere. It’s not God or the devil that’s in the details, it’s the story Your parallel stories are so vivid, your observations so clear (and often humorous), that it’s impossible to make grand generalizations about France vs. the U.S. It’s enough to savor the details and let them take up residence in my memory.

    • Wow, coming from someone who makes a living as an editor, I’m blushing 🙂
      Of course, differences between these two countries are no longer as drastic as they used to be. In the health department they are still quite strikingly different. In any case, welcoming baby #2 was quite an adventure and I’m pleased to announce that she is a very well balanced young woman who still enjoys a Coca Cola once in a while although she favors hard cider these days 🙂

      • Funny thing: Felicia, a character in my novel in progress, drank coffee when she was pregnant with her first child, and wonders if this is why her 11-year-old daughter loves coffee ice cream. 😉 I just read your account of your first U.S. Halloween — what I love is coming at familiar events from a whole new angle. Time does that too. These days adults control Halloween much more than they did when I was a kid.

  6. This is absolutely fascinating Evelyne, I like that you got to experience the process both ways and you were able to share the experience in such an entertaining way!

  7. I found all this fascinating. Great post!
    I had the c-sections, and spent three days in the hospital each time. I would say I had excellent care. I enjoyed the meal trays because they came with broth, tea, milk, and juice and I am a thirsty person 🙂
    I had to laugh at how you were “allowed” to get fat. Don’t you know, I lost weight in pregnancy, and was constantly scorned?!? Every appointment was “EAT MORE!” and I was eating well, I swear! LOL
    There are many Americans who would always hold doors for pregnant women, and I have been taught to give up my seat or my spot in line for expectant mothers, so I’ve taught my kids to do the same.
    The insurance thing, well, don’t get me started. I live here with my socialist ideas waiting until the country is ready for progress.

    • And your comment makes me smile if not laugh on so many levels. Funny how for some of us it’s too much weight gain or not enough. I’ve also met tons of courteous American people who opened the door for me when I was pregnant. But I liked it that it didn’t feel like I was not well. Being pregnant is special but we aren’t ill when we are.
      And I will follow in your steps and don’t start on the insurance thing either. But reading your words makes me feel less lonely and also hopeful for our future.
      See you on your blog.

  8. This was a fascinating post. American healthcare is intriguing to me a foreigner, and this provided a lot of insight!

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