Category: Medicine

Day 14 of “le confinement”

Two weeks ago today, President Macron urged people to voluntarily self-isolate, do the obvious: don’t ‘bises’, stay 2 meters away from each other, cough into your elbow, etc. Since then, he has had to resort to draconian measures to get us to pay attention. At last count, France has 29,155 cases of Covid-19 and 1,696 deaths. We have been given a new ‘passport’ to carry with us, replacing the one from two weeks ago. This one asks us to put the time and date when we leave our apartment and adds two more reasons to leave. However, the old is still good, until further notice, as long as you write in the date and time and the reason if it is not on the original.

The weather has mostly been lovely although it has turned cold again. I think that will change this coming week. The papers show us eerily beautiful photos of Paris completely empty of people and cars. The police that have been stopping people and checking their ‘passports’ are backing off as a couple of them have died from the virus. Five doctors have died from the virus. Macron has brought in the military to help out the overworked protectors of the people.

I, and I assume most of you, have been getting e-mails from every service and store that has your e-mail address telling you that they have your best interest at heart, where to get more information on-line and how much they care about you. It has caused me to actually think that this is the perfect time to reflect on all our relationships. Are we keeping connected to the most important ones? Are we reaching out to someone over 70 that you care about just to see how they are? What would we change, if anything, in our relationships to these stores and services? Have your priorities changed in any way due to staying in your home? Like the Count in A Gentleman in Moscow (Amor Towles), do you think that “the endeavors that most modern men saw as urgent (such as appointments with bankers and the catching of trains), probably could have waited, while those they deemed frivilous (such as cups of tea and friendly chats)..deserved their immediate attention.” p. 391. These are life-changing times and reflection is a pursuit worth having a cup of tea with.

In other areas of life, yesterday was Opening Day of Baseball in the USA. The fields of green were empty and baseball fans around the world mourned. Rogers Hornsby, when asked how he spends the winter said,“People ask me what I do in winter when there’s no baseball, I’ll tell you what I do. I stare out the window and wait for spring.” Dan Barry wrote a lovely imaginative piece about yesterday’s Opening Day game: https://www.nytimes.com/2020/03/26/sports/baseball/baseball-opening-day-coronavirus.html My friend, Georgia, told me that her father once said “There are two seasons in the year. Baseball season and the void.” When I lived in California, I felt that way. Starting from the day after the end of the World Series, I would start counting down the days to Spring Training. Most teams had a Fanfest sometime in January and thousands of fans would pour into stadiums around America. When I moved to Paris, friends asked me ‘how can you leave your beloved Oakland Athletics behind?” I don’t have an answer for that. I subscribe to MLB.com audio and listen to all the games I can. The A’s, being on the West Coast, are the hardest. Only matinee games on the East Coast came on at a time I could actually listen. Now there will be nothing, but I still have my subscription. Just in case……

In another part of the sports section, I read that hospital masks are being sewn out of baseball uniforms. Soon health care professional will be sporting the the stripes of the New York Yankees and the Philadelphia Phillies.

I wish you all the best of weekends in our new, organically evolving times. This too shall pass.

A bientôt,

Sara

What to do during a Pandemic or how I spent my Lockdown being happy!

The sun is out in Paris. It’s quite cold. It’s very quiet-except at 8 (20:00)H in the evening. Then we are all out on our balconies clapping and cheering. Day 7 of lockdown. People have been sending me wonderful videos that make me laugh out loud. Others are sending ideas of what to do with my time. I keeping a list of everything because I think that once I do all the cleaning and organizing that I haven’t down since…forever, I will want these pieces of advice.

Here are 450 Ivy League courses you can take online right now for free. https://www.freecodecamp.org/news/ivy-league-free-online-courses-a0d7ae675869/ I grew up in Princeton. When I went to university, Princeton was still boys only. I’m pretty sure I couldn’t have gotten in anyway. But now I have a chance to get that Ivy League Diploma I’ve always wished I had!!!

My friend, Nancy, back in Oakland (and who faithfully reads this blog! Thank you, Nancy) sent an e-mail with many idea to while away the time. The one that jumped out at me was: “Take this time to declutter and reorganize your home or apartment!” I’m already doing that but if I can get advice that will help me get it down faster and make it less complicated, I will use it. Some of these require shopping and I do hate to make Jeff Bezos richer but Amazon is delivering: https://www.goodhousekeeping.com/home/tips/g2610/best-organizing-tips/?slide=3&utm_medium=email&utm_campaign=5e727c0952ce250001ce37cc&utm_source=5bb3df034c091406e33e1941&agent_id=5bb3df034c091406e33e1941

Then, whether we are inside or out, the weather is going to get warmer so here’s how to prepare your clothes for winter storage: https://www.apartmenttherapy.com/storing-winter-clothes-36717824?utm_medium=email&utm_campaign=5e727c0952ce250001ce37cc&utm_source=5bb3df034c091406e33e1941&agent_id=5bb3df034c091406e33e1941

My friend, Marjorie, who also is a devoted fan of this blog sent along a couple of real winners. First resources for free virtual museum tours: http://mcn.edu/a-guide-to-virtual-museum-resources/ She says the Vatican virtual tours are spectacular: http://www.museivaticani.va/content/museivaticani/en/collezioni/musei/tour-virtuali-elenco.1.html Do you want to see Giselle at the Paris Opera: https://www.operadeparis.fr/en/magazine/giselle-in-replay The Guardian has links to the best theatre and dance to watch on-line: https://www.theguardian.com/stage/2020/mar/17/hottest-front-room-seats-the-best-theatre-and-dance-to-watch-online as well as opera and music: https://www.theguardian.com/music/2020/mar/16/classical-music-opera-livestream-at-home-coronavirus

Movies….don’t have or want Netflix, Amazon Prime or Hulu, here are hundreds of free movies on-line: Classics, Noir, Westerns and Indies: http://www.openculture.com/freemoviesonline And while you are there, look at the thousands of other interesting and challenging things you can do.

But Sara, I do have Netflix and Amazon Prime. The New York Times updates its list of Best Of every day: https://www.nytimes.com/article/coronavirus-quarantine-what-to-watch.html I took one suggestion and binge watched “The Stranger” by Harlan Coben while I cleaned out a closet, re-organized my filing system, did filing and then re-organized the closet. The Guardian loves lists. The Best Books of 2020. The top 50 movies of the past decade.

I have to stop here. Everyone in the world must be on their computer. Mine is slower than a turltle in hot weather. So here’s your final tip. The Metropolitan Opera is streaming free every until it runs out of operas. And Neil Young will soon be streaming from his fireside. How cool is that: https://www.theguardian.com/culture/2020/mar/22/standup-sistine-chapel-best-online-culture-self-isolation-coronavirus-live-streaming

Now turn the news off and enjoy this time!

A bientôt,

Sara

Personal Update from Paris

A lot of you in the US are writing me and asking “How is it in our beloved Paris?” Somewhat different and somewhat the same as what you are reading in the papers. Last Thursday, President Macron spent 26 minutes on national tv outlining what has happened so far and what will happen. He was very serious and didn’t try to make this pandemic sound less than it is. At that point, only four days ago, he urged all people seventy and over to stay home unless absolutely necessary. He said transportation would stay the same but hoped that work and people would work from home. As of Monday, he closed all schools and universities. He said this was up to each and every one of us. The virus knew no borders and didn’t carry a passport. That was Thursday.

I’m discovering that the French are very stubborn and obstinent people. They proclaimed that nothing was going to stop them from living their lives. So they were out and about. The metros were a bit less crowded but not by much. So on Saturday, the French administration announced that as of Saturday at midnight, all public places that weren’t necessary for our survival were to be shut down, closed, fermé. That got some people’s attention. By Sunday noon, the markets caught up with the US and all the toilet paper and such were gone. However, the municipal elections were not postponed. On websites, times were posted when best to go vote. A friend went back and forth about whether she would vote or not. Finally she decided to. She went at the last moment, waited till everyone was gone then went in to vote. Everyone was wearing masks and keeping all the voting paraphenalia as antiseptically clean as possible. I went out for about forty-five minutes just to walk, and the streets in the 16th arrondissement were full of people walking with children, with dogs and, since it was a lovely day, filling up the parks and green spaces. That was yesterday.

This morning at 8:45am, I received a notice from the administration that since the French were not doing as asked, we had forty-eight hours to decide where we wanted to spend the next forty-five days. As of tomorrow, there will be a 6pm curfew and the police will be in the streets urging people to go home. I dropped everything and headed out. I was prepared to be homebound for two weeks but not for forty-five days. I first went to the grocery store. Still no toilet paper. Then I headed for Picard which only sells frozen food, absolutely delicious frozen food. They were almost out of food and not taking any loyalty cards for discounts. I then headed for Marks and Spencer who sells my favourite yogurt. They looked like they had plenty of food though the yogurt was in short supply. When I asked, I was told they would be staying open. Picard, on the other hand, said they had no idea. On the way to M&S, I passed a florist. It wasn’t really open but the door was open. I asked if I could buy. They gave me 3 beautiful bouquets for about a third of the normal price. That will be the last of my fresh flowers I’m afraid. Finally, I went to the pharmacy. Not my normal pharmacy on Av. Mozart which had a long line snaking out the door and winding to the corner. I stopped at the one near M&S. I was the third person in line. We’ve been told pharmacies will stay open but…. I had no trouble getting what I needed.

Forty-Eight hours to decide where I want to spend the next 45 days. I knew my friends in Normandy and in Brittany would probably love to have me and my crazy cat come join them. I would love to go to Le Gers where I think my heart resides. But…..I have here, in my small apartment in Paris, everything I need to survive the next 45 days if I never go out. I have Netflix, I have enough books to read for at least a year. I have the expanded tv that has HBO series, Showtime and Canal+. I have the wonderful Zoom. Which allows me to have video conversations one on one or in large groups. I have my work which I do at home anyway. I just learned yesterday that ten of the world’s best museum’s are totally on-line and I can tour it visually. I was even given a jig-saw puzzle with 1000 pieces. That would take some time!

Yesterday, I defrosted my freezer. Something I should have done months ago And thank goodness I did. After shopping at what was left in Picard, I was able to fit for more things in the freezer. I have plenty of ‘projects’ to do. So as long as I talk to friends at least three or four times a day, I think I can do this! And that’s whats happening in Paris.

A bientôt,

Sara

PS As I was about to hit ‘publish’, I received an e-mail saying all non-essential travel to EU is to be banned for 30 days.

Dr. Abdu Sharkawy

Another blogger that I read wrote this on her blog today. She found it posted on one of the ex-Pat Facebook pages available to all of us over here. It is so wise that I have to post it myself:

“I’m a doctor and an Infectious Diseases Specialist. I’ve been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria…there is little I haven’t been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared. I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil.  I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they ” probably don’t have it but may as well get checked out no matter what because you just never know…” and those with heart failure, emphysema, pneumonia and  strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess. I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize.

And well, even that big party called the Olympic Games…that could be kyboshed too.

Can you even imagine?I’m scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession. 

But mostly, I’m scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, open-mindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it.  Stop waiting to be surprised further.

The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and “fight for yourself above all else” attitude could prove disastrous. I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let’s meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.
#washurhands #geturflushot #respect #patiencenotpanic”
By ABDU SHARKAWYdr-abdu-sharkawy

A bientôt,

Sara

Health Insurance: USA vs France

I came to Paris, in 2014, for one year. My intention was to better my french then to return to Oakland, go to baseball games and continue learning civics. It didn’t happen that way. Within six months, I knew I wanted to stay; one year was not enough. Not only was Paris beautiful, inspiring and exhilarating, I’d never lived in a city before. Cities, I learned, pulse with life. In Paris, no matter the time of day or night, life was happening. People were out on the street, having a drink in cafes, walking for pleasure or transportation, going to a myriad of events available every evening. For me, it was intoxicating. I loved it.

Then we had an election in the US. I found it hard to be there but not be living there. All my friends were in various stages of depression. At the time, no one thought it could get as bad as it has, that democracy is actually at stake. Some friends are inured. It’s impossible to watch from over here in France and not be shocked and outraged. The US, always somewhat imperialist, is now cruel and verging on terrorism. That is as extreme as I’m willing to state. In the back of my mind was always the question ‘What would it take to move here, to cut ties to California?’ Two things always jumped up. The first was health insurance. The second was home ownership. The wisdom says don’t sell your home in California unless you are 100% sure you never want to move back. I couldn’t afford my own home if I had to buy it.

Health Insurance: I’m 72 years old. I have Medicare and also a secondary insurance. Until recently I didn’t know if I was eligible to get French insurance. The french system may be the envy of the world. It is a single payer plan. A citizen gets a social security number and then applies for the Carte Vitale. With the carte vitale, every time one goes to the doctor, any kind of doctor, at the end of the visit, you hand your card to the doctor. Then you pay your co-pay. The doctor is paid the rest by the government. Some of my friends have a secondary insurance, which is not expensive in US terms, so as to cover any unforeseen problems. And french medicine is NOT expensive compared to the US. When I had my right hip replaced in February of 2017, I received a statement telling me how much the operation, lead-up appointments and post-op appts cost and what percentage of that Medicare paid. The grand total was $65,000. For the sake of personal information, I googled the price of hip replacement in Paris and the average cost was $8,000-$10,000. Same operation, same skill set, same medicine. It’s one thing to know that there is something very wrong with the American system, it’s another to have the numbers. I once ran out of an over-the-counter stomach aid while in Oakland. It had to be prescribed and my co-payment was higher than I paid over the counter here in Paris.

For five of the six years that I have been in Paris, not knowing what to do about health insurance has kept me from committing to moving here. Last fall, I learned that Macron had decreed that anyone who has lived here more than three months is eligible to apply for french health insurance. As with many things that require dealing with the french administration, I felt paralyzed to take action. Friends offered to help. One sent me the web address to get more info. Another actually translated into English what I needed to do and what I needed to produce, document wise, to get my social security #. Then I finally found someone who would go with me to the office. I needed my hand held. We set up a date and ….. the office had moved two years before. There was no longer an office in my arrondissement. My friend is married to a frenchman who writes beautiful french just the way administrators like. He wrote a letter to be signed by me applying for both the number and the Carte Vitale. Yesterday morning, I sent it registered mail. So now I wait.

https://www.expatica.com/fr/healthcare/healthcare-basics/guide-to-health-insurance-in-france-108848

This is not a political post. All the above raises all sorts of questions (that most of us already know the answers to) about why certain American politicians don’t want to make insurance affordable to 50% of the country. That’s not my fight this week. My fight is to grow old with insurance and the best quality of life I can have. I think the quality of my life is far better here in France. I would like to take the actions necessary to commit to living here. I may not hear anything for a year. Such is the snail’s pace of french administration (especially now when they are stepping up their efforts to help the British who live here, get residency cards, get their drivers license, etc). I have taken the action and it is very satisfying.

My next action is to get a French Driver’s License. Much, much harder than in the US.

A bientôt,

Sara

One foot in Paris and one foot in…..

Christmas time is a season I love….for all the wrong reasons!  I love the fading light as the days get shorter, especially walking in Paris when the sky is a pinkish grey turning to dark purple then to nighttime black.  I love the lights around the Champs Elysees and the Ave. Montaigne.  Many arrondissements have also decked themselves out near the Mairie in an array of colours and blinking tiny little lights that tell you that FairyLand is around the corner.  The windows in the Department Stores are a delight for everyone of all ages.  There are tables set for Christmas Eve dinner with animals prancing around, chasing each other and having wonderful fun.  Mama Bears are serving up a meal and Papa Bears are cutting a turkey.  In another window, there are trapezes with more animals and dolls all sporting the the bags and clothes of the Designer who is sponsoring the window.  I don’t care.  It’s a treat!  In front of the window are families.  The adults in the back and the children up at the windows with their hands out wishing they could touch what is inside. My gardienne put up a large tree with wrapped presents under it.  The lights twinkle day and night.  I’ve never seen an apartment building like that before.  I think I have a very special gardienne.

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I’m not religious so I don’t need all the icons that go along with Christmas.  I don’t go to the Christmas concerts unless it’s Sing Along Carols.  Those I love.  My friend, Meg, is taking me to a Festival of Nine Lessons and Carols at Westminster Abbey when I’m in London.  This is quite religious but at least this year, I’ll hear it in English!  I can be talked in to most kinds of music with the codicil that I can leave early if I’m not happy.

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I even love giving presents.  I’m not the person who shops at the last minute which probably makes a huge difference in how much I enjoy gift giving.  I shop all year long looking at things and thinking “my sister would love that”.   I buy it and put it on my gift shelf to be wrapped at a later date for a birthday or Christmas.  So unless someone tells me that their house is bursting at the seams and not one more thing can come inside, they will get a gift from me no matter how old they are.

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Last summer, when winter and Christmas seemed light years away, a family in London asked if I wanted to do a Home Exchange.  They would spend the month of December at my home in Oakland, California and I would spend at least two weeks at their home in London.  I’ve always heard that London really knows how to throw a Christmas party.   Each time I mention to someone that I’m going to London, I hear “You have to go see the windows at Harrods/Fortnum and Mason/John Lewis, etc”  So more windows to appreciate.IMG_0062.jpg

Yet, while all this beautiful and festive time of year surrounds me, my mind and heart are partly in Princeton, NJ where my uncle Stan still lies in a hospital bed in the Skilled Nursing floor of his Retirement Home.  Very little has changed.  I’m told his appetite is coming back and the hope of everyone that loves him is that this will make him stronger.    And being stronger, his Physical Therapy will go better.  Which means he will become more mobile.  Being mobile is critical as Medicare, the great American social insurance plan for adults over 65, will assess him soon and tell us and him what his future will look like as far as living conditions go.  I feel strongly and passionately that I don’t want Medicare being the boss.  I want to be there and with his family and friends, tell Medicare this is what we can do for him.  We will make it happen.  Stan needs to stay in his apartment, there is no doubt in my mind.  Enid, his wife of 61 years, lived there with him and her presence is everywhere.  His computer, which is his lifeline to the men who are still living and flew with him in WWII, is there.  All his Princeton Basketball paraphernalia is there.  He has tapes of games going back for years.  He still watches them.  His freedom is there.  On every phone call with him he says “I am so helpless.  I can’t stand it”

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Cousin Joan and I are determined to create a bedroom for him that can have a hospital bed and a bedroom for a live-in aide–hopefully a strong male aide.  Joan wrote a letter to Stan’s lawyer asking for some kind of contract that Stan could sign saying he won’t hold Stonebridge responsible if anything should happen to him.  Even if Stan lives less months that he would if he were moved, the months would be as “good as it gets” months for him.  That is what is important.  That he leave this world with the things he loves and the people he loves surrounding him.

Those of you who have read Being Mortal recognise that some of my strength is coming from reading this book, this text for how to humanise the end of life.  And I’m not foolish enough to think that reading is doing.  I think it is going to be quite hard to talk about this stuff with the doctors, with Stonebridge, maybe even friends and family.  We Princetonites are supposed to be intelligent and educated.  So we’ll see.  I have planned a trip back there in January.

Meanwhile, it’s off to London.  It has been a long time since I spent any time in London.   More to come in these pages……!

A bientôt,

Sara

Quality of Life

A number of people responded to my blog about my Uncle Stan.  My friend, Darcy, has been caring for her mom who lives in the same place as Stan.  Her mom has dementia and has a small studio in the Assisted Living side of the Retirement Community.  She wrote this in response to another of her friend’s whose mother is just entering the dementia stage: “that you don’t know who you are when you are taking care of your mom. This made my whole world make sense, finally. Those simple words I don’t know who I am brought everything into perspective for me. Not that I understand all the emotions I went through here in Princeton and all of the emotions I continue to feel now that I have left. This will take years. But coming back, returning to Stonebridge, threw me into the old feelings of emotional chaos and I didn’t expect this. I was quite floored by it all. I felt guilty not spending more time with my mom and yet my body simply gave out on Friday. All I wanted to do was sleep.

I think it’s impossible to know who I am when I’m taking care of her because there are so many different people involved. Internally, there is my little girl, my childhood, adulthood. I am my mother’s daughter, friend, care taker. Added to this is the great unknown, the day to day step to step into aging, the uncertainties that come with this. How will my mother be today? How and where will her mind be? When will she fall again? This alone creates a myriad of emotions. Then throw in siblings and all of their emotions, their uncertainties, the family dynamic surfacing over and over again making us all crazy at times because there isn’t one truth yet we must be looking for that one stability. But it doesn’t exist because we never know what is coming next. The same way we don’t know what our siblings will do next. It’s a constant confrontation of the complexities of the past, present and whatever may be in the future.

It’s not like when we were growing up and we had parental guidelines already established for us. Friendships had their own boundaries, too, ones we navigated on our own. When it came to those friends and the twists and turns in life, we felt we knew what mattered most, even if only at that moment in time. Now there are no guidelines, only the heart. I wonder if peoples’ best and worst qualities come out when caring for an elderly parent.”

Darcy also recommended I read a book which another friend had already suggested I read.  BEING MORTAL by Atul Gawande. Gawande is a surgeon at Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker and teaches at Harvard Medical School and the Harvard School of Public Health.  In his free time!! he writes books.  Gawande poses a question that I’ve never heard said by a doctor–“Do we try to do too much?  Are we just trying to fix the next thing or are we thinking about the ill person in what may be their last years and asking them what they want?”  He calls these the Hard Questions or the Hard Talk.  It is a very provocative and thoughtful book.  He even gives the example of his own father who developed a cancer in his spine.  It is a book all of us should read, to prepare ourselves for the future and to help our elders get what they really want–which may contradict what a specialist doctor wants for them.  We are all going to die but we have choices, up to a point,  where that will be and how it will happen.

I’ve thought of Stan ever since I returned to Paris.  He did not want to be in that bed up on the Skilled Nursing floor.  He didn’t want to be poked and prodded all day long having his blood drawn, helping him sit up or lie down.  What he wanted was to be sitting in front of his computer and doing whatever he enjoys doing.  He doesn’t have to walk to do that.  He has now got an aid 24/7 to help him get his breakfast, shower etc.  But I don’t know if he is back in his apartment or still up in Skilled Nursing.  Being Mortal has given me a whole new way to think about what happens next, what to ask Stan and then to listen.  It’s allowed me to be really honest and say that this fall is probably the beginning of the end.  Gawande says that if he can live the way he’d like to live, in his apartment, surrounded by photos of Enid and all his Princeton Basketball paraphernalia, the end may be further away.  But the Stan that is up in Skilled Nursing doesn’t want to live the way he is living up there.  Neither would I.  A specimen under the light of nurses and doctors and aides none of whom knew him until about 2 1/2 weeks ago.

I recommend this book.  Darcy calls it The bible for caregivers.  Yup, it is the only one I know of that has the questions that we should be addressing now.

And in Paris….Life is cold but at the same time full of activities.  I’m feeling grateful to be here right now, with good friends and activities I love.  Christmas Parties bringing a lot of people all together in the same room maybe the only time all year!!  And the lights!!!! The Champs Elysees is lit up and the Ave Montaigne looks absolutely elegant with lights in all the trees and little tiny blue sparkly lights flashing on and off inside the the white lights.  It’s a wonder to behold.

A bientôt,

Sara

My Uncle Stan

I just finished writing a blow by blow description of my Uncle Stan, age 94, falling in his apartment and breaking his left hip.  I hate what I wrote.  I don’t have the writing ability to keep your attention while describing all the running around I was doing accompanied by intense wildly vacillating emotions.  Some writers can grab you and put you in their shoes so that you feel the sadness, the anger, the helplessness of being the caretaker of someone who has been vital and in charge his entire life.  I had hoped the writing would push me to sort through a lot of my questions of American versus French medical systems as I’m at the age where I’m asking myself “Where do I want to grow old?”

I’m writing all this from my little desk in Paris.  I returned here over the weekend feeling no small amount of guilt for leaving Stan in the hands of Skilled Nursing. These are the things that have stuck to me and won’t let go.                                                                                                                                       Stan was so miserable, so uncomfortable, so humiliated by his powerlessness that he sank into depression and confessed that he wanted to die.  I couldn’t find any fault with that thinking.  The surgeons couldn’t do a hip surgery on him, he was too old.  They opted for two one-inch incisions at his left hip and placing small rods in to hold the hip together.  Then it was up to him to do Physical Therapy to strengthen himself enough to be able to walk again.  What I saw in front of me was an old man who was so thin, so small that he looked like a little boy lost in his twin size bed.  A man whose lack of any fat on him caused him to slip far down in his wheel chair until he became so unbearably uncomfortable that I’d go looking for aides to help pull him up again.  His hearing is so bad that even with his hearing aids, we had to almost yell to explain to him what was happening.  Due to another syndrome, his hands and feet got little circulation and he was cold most of the time.  I would wrap his Princeton stadium blanket around him as if he was a baby in a casket.  It wasn’t difficult at all to step into his slippers and think “I don’t want to live like this.”  He was completely helpless, dependent on me and the nursing staff.  He stopped eating.  He said he had no appetite, that this was the first symptom that Enid had (his wife who died six years ago) when she was sick with pancreatic cancer.  He convinced one of the nurses to include a blood test for pancreatic cancer in his lab work. I knew that he was saying “I just want to die.”

The Skilled Nursing unit of Stan’s Continuing Care Retirement Community was understaffed and underpaid.  I know they were working hard.  But they couldn’t be everywhere at once.  Sometimes when Stan pushed his call button, it would take 15 to 20 minutes before someone came in.  Stan has a primary doctor in Princeton but none of the staff could take orders from her.  They could consult with her.  After the first day back at Skilled Nursing, I didn’t hear about any consulting.  It seemed the right hand didn’t know what the left hand was doing.  When I mentioned this to any friends, they would nod knowingly as if this was an accepted fact of the American system.  Without an advocate, a person could easily be forgotten.  Especially someone like Stan who doesn’t like to make waves because he’s embarrassed to be seen as he is.  He made it clear he didn’t want any visitors.  We had to cook up a plan to encourage his friends to visit as if they were just passing by but not stay too long as it tired him too much.  No way were we going to leave Stan along with his depression.

By the time I left late Friday, the staff was going to put him on an IV to feed him.  My cousin, Joan, was there expertly taking over the reins to insure that Stan didn’t get lost in the system.  She wrote to say that the visits were cheering him up a bit.  Though it was only mentioned a couple of times to me, I couldn’t help but think that so much of this mess is due to our lousy Insurance system.  It was strongly hinted that he left the hospital too soon because insurance/medicare would pay another night.  When he wanted the extra lab work, a nurse took me aside and said that insurance may not pay for it.  The underpaid overworked staff remain so in order to line the pockets of those at the top of the Insurance Food chain.  I’ve had the experience of having to pay more for a medicine with my Co-Pay than the entire cost is here in Paris.  This is, of course, just my opinion but as I watched the week with Stan unfold, it struck me that this is one of the ways the Insurance men and laws deal with our elders–hide them and maybe they’ll go faster.  I don’t feel polite about my dealings with the health care system last week.  I made myself unlikeable to all the staff, sometimes even to me.  But what would have happened to Stan if I hadn’t been there?  It was Thanksgiving week and people were on vacation.

More on this later.

A bientôt,

Sara