Blog Post: 2/26/16

Hello again! I have now been working for over three weeks now here in Puget. It has been really hard and long but thankfully also very interesting and fun.

Now, this week a lot has happened however nothing that I would really want to expand upon for over 400 words. So, what I thought I could do for this blog post is, instead of talking about my week, I could explain a little bit more about how the medical emergency systems work here in
France, especially the rural aspects of it.

So, unlike in America, where for any sort of emergency, you call 911; here, in France, for medical emergencies you call the number 15. Then, on the fifteen, you have a dispatcher. Now, unlike the dispatchers for 911 which have no real medical training but instead training in emotional support and triaging, these dispatchers have actual medical training and really have to understand the calls they are receiving. Now, what do I mean by "really understand the calls they are receiving"? Well, what I mean by that is that the dispatcher needs to take a medical emergency and organize it into three categories: non-emergent, slightly emergent and very emergent. Then, with each category the dispatcher has to then send in a different group of people or do a different action.

For non-emergent cases, the dispatcher just gives medical advice over the phone such as disinfect the cut and cover it or take this medication. That is all that is required and is why the medical dispatchers on the fifteen need to have basic medical training such as first aid. The, for slightly emergent cases, the dispatcher has the doctor in the region on-guard come over and examine the situation. That is what it means to be on-guard. It means that if there is ever an emergency and it is in our region, the fifteen calls us and we must go over there. This also applies for hospitals in that they can call us too. So, when we were on call, we had calls that came in around ten at night that we had to go too; the most dramatic one being two women in a psych ward getting into a fight.

Now, lastly, for very emergent cases, the dispatcher chooses to either send your stereotypical ambulance or a SAMU. A SAMU is a traveling hospital bed, in that a very skilled doctor and two very talented nurses with an abundant amount of medical supplies that set up there and work on the patient on site. The dispatcher must choose between these two types of groups to send for emergent situations. All of these different situations and outcomes are why the dispatcher for the 15 must very well trained and good at what they do.

Now, as a bonus for reading this lengthy post on French medical procedures, I have included a very ugly photo of myself at the local hospital in Puget. Now, if you look in the upper right corner of the photo, you will see that the clock reads 10, it was a fun night! Thanks for reading!

Blog Post: 2/19/16

Hello again,

I have now been in Puget for around a week and am just starting to adjust to the time difference and busy work life of the doctor I am shadowing. We have been very busy racing around town and the mountains for house calls and hospital calls, barely squeezing in time to eat and sleep. However, even though it is taxing and long and difficult, it is, most of all, super fun.

On my very first day, we had a practically full practice in which- in one day- we saw nearly 50 patients. Then, afterwards, we did a few house calls that took a lot of time because it took almost thirty minutes to get to the actual house! Here, I am really seeing another side of France that I really had never seen and that is the countryside. There are some very small towns with very few people and lot of animals and nature.

Then after those house calls and after we finished up at the medical practice, we went home to have dinner. However, we were on call and of course around ten at night, we got a call from a hospital almost thirty minutes away. When we arrived, we discovered that not only was it to assist a death but also that the man who was dying happened to be the father of the last patient who had come into the practice that day. What had occurred was that this 84 year old man was perfectly fine until fifteen days ago when he experienced an AVC, which is the french acronym for an accident vasculaire cerebral which basically means a stroke. Because of this incident, he went from a happy, healthy senior to an impaired, dying man. When we entered his room, we automatically saw that he was in a lot of pain and that his 'pauses' were long, therefore indicating that he was, in fact, near-death. So, in the dark of night, in a room with peeling, pale paint and under a flickering, yellow light, Dr. Godart administered two doses of morphine and we spent that night, with his daughter, watching him slip into the cold embrace of death. And, that was only my first day!

Since then, there has been nothing as extreme and intense but there has been plenty of stuff just as depressing. When we visited the retirement home, I was able to personally give basic check ups, such as measuring pulse, blood pressure, breathing, for several patients and most had severe cases of dementia or Alzheimers. It reminded me of my time volunteering at Hospice but unlike that time, I much more enjoyed it here because I really felt I was helping them and making a difference. To sum it up, even though I am seeing a lot of pain and suffering and undergoing a lot of back-breaking work, I am having the best time and loving every minute of it. This experience so far has definitely reaffirmed my want to be a doctor.

Thanks for reading and I'll post in another few days!

Blog Post: 2/12/16

Hello all!

I have just flown from Scottsdale to France and am now up in the mountains with my aunt, the doctor I am shadowing. The trip has been very long and strenuous because we had several crazy and terrible mishaps. We stayed in this one small, dingy airport in Paris for almost 8 hours! Now, I am super excited to be in the town I will be doing my internship, Puget. Here we are up in the mountains where it is beautiful and cold. Brrrrrrrr....... but it is so picturesque.

I will be starting in the practice tomorrow that Dr. Godart runs herself. What she does is that every day she begins with doing some clinical rounds with her patients from 9 a.m. to 12 p.m. Then, after that she either goes to the hospital, retirement home, or house visits. However, she does multiple of these shifts a day! Then, we go back to the practice for another six hours finishing around 7 or 8 and then we go either back to the hospital or more house calls. What this means is that we usually are working from 9 a.m. to 10 or 11 p.m.

I am just starting to learn the stressful and difficult job it is being a rural medical professional. The hours are crazy, the people are rude and the driving is insane. However, she says it is very rewarding and she is able to make a good living. One thing that really strikes me is the personal toll that weighs on the rural medical professional. She says that if she does not set breaks for herself then she will go crazy just thinking about what to do and if she made the right calls etc. She always says that being a doctor is difficult because if she makes a mistake someone dies or is seriously injured. People definitely rely on her.

She gave me a tour of her practice and while she was on the computer, I asked her how many patients she might have. She typed a few buttons scrolled down and told me 2,000 as on the computer. All these people that she either travels to or has come in need her to give them medical care. Most of them are very old and frail and are lost in the vast, bureaucratic mess that is the French Medical system. She has to sometimes drive for over forty minutes just to get to some small, rickety home to help an 94 year old woman. That day I also asked her how old was her oldest patient was and she said somewhere around 100. Yet, because she is one of two doctors in the immense region of the mountains in the South of France, she also takes care of children and newborns. Its a crazy job and life!

Thanks for reading! Ill keep ya'll updated. Bye!