Bonjour ça va ?
Firstly, je m’excuse pour le rétard: it’s been more than a hot second between newsletters but a lot has been happening. It was my birthday! I was vaccinated (Pfizer, baby)! We welcomed a puppy named Disco into the family! And yesterday, 19 May, we began the process of deconfinement!
E-Mac has seized the occasion to establish himself as a bit of an influencer with a series of stagy Instagram posts announcing the three steps of deconfinement. As a follower comically commented under one of Macron’s posts, “I never believed that I would see a trailer for life returning to normal.”
Truth be told, my absence from Café s’il vous plait has predominately been due to my battles with endometriosis. If you don’t know anything about this little-discussed yet all-too-common women’s health issue, educate yourself swiftly with this piercing profile in The New York Times of MIT bioengineer Linda Griffith and her pioneering research into the disease. Coverage of women’s health is so often tied up in pink bows and pattered with powdery terms like ‘invisible’ and ‘mysterious,’ so it’s energizing to read such a gallant and gritty article.
Tout ça pour dire, I am now intimately acquainted with the French healthcare system (known in local lingo as la sécu, short for la sécurité sociale)—and let me tell you, there is no better way to understand the inner workings of a culture than by delving into their Aesculapian attitudes.
France has a notoriously generous and accessible healthcare system once you have your hands on the little green-and-yellow card known as la carte vitale. A little-known gem of a rule for foreigners is that if you stay in France for at least three consecutive months, you are entitled to a carte vitale under the PUMa scheme. And once you have the card, you have it for life.
The actual workings of the healthcare system are pretty straightforward; where the ambiguity begins is with the French themselves and their quizzical relationship to all things medical.
From anti-vaxxers…
Despite being the home of Louis Pasteur, France has revealed itself, in response to the COVID-19 campaign, as a nation of anti-vaxxers. An article in Le Figaro went as far as to crown the French the ‘champions of the world’ in terms of their contrarian attitudes towards the vaccine (at the beginning of this year only 44% of French adults expressed their intent to get vaccinated).
Although this number is rising, those opposed still hold tight to their conspiratorial fears that the vaccine is some sort of medical Trojan Horse designed to subjugate the French population to Big Brother-esque group think (duh). So hot-headed is the anti-vaxxer campaign in France, that figureheads leading the pro-vaccine campaign, Les Vaxxeurs, often operate under pseudonyms or avoid disclosing their last names out of fear of receiving death threats.
And you know who are big anti-vaxxers? French natural winemakers. Pas de sulfites, pas de vaccin.
… to antibiotics.
What I find so at odds with this generalised vaccine hesitancy is the fact that the French are also prolific pill poppers. In the early 2000s, the French were, once again, champions of the world: this time for consumption of prescription medication (they were notably the highest consumers of psychotropics; in second place was the USA). Whilst they’ve dropped in rankings in recent years, one study I read still placed them in third place in Europe for antibiotic consumption. Such is the level of the French obsession with antibiotics, that there is an ongoing national campaign, hallmarked by the slogan “Les antibiotics, ce n’est pas automatique,” to try and curb the nation’s consumption.
One only needs to visit a French doctor to understand their heavy-handedness when it comes to prescribing medication. No matter what my health complaint, I am almost routinely prescribed paracetamol each time I visit a French doctor. Perhaps the most questionable prescription I ever received was for vials of lithium to combat insomnia—an antiquated cure that seemed better suited to treat to a 19th-century French flaneur’s morbid case of ennui rather than a mild bout of insomnia suffered by a stressed university student.
And this is only prescription medication. The local French pharmacy is a treasure trove of all kinds of over-the-counter meds at bargain prices—a box of 1000mg paracetamol, Doliprane, will only set you back €1.20. (And a tube of Lexomil, a prescription anti-anxiety med is only €1.85). I remember being scolded by a professor at university for missing class as I was sick. “In France, there is no reason to be sick with all the medications available at the pharmacy,” he retorted. You take a Fervex, a mélange of various flu and cold medications that effectively knocks you out for 12 hours so by the time you wake up, you’re no longer sick.
The great paradox
It truly baffles me that the French have such an aversion to the vaccine yet will munch on whatever meds are prescribed to them sans question. But as several commentators have pointed out, this disjoint is perhaps a translation of deeper cultural cumbers.
I sense that the French are stuck in this constant bind of distrusting politicians—and the ruling elite in general—and at the same time fearing losing the hand that feeds them. The anti-vax campaign is perhaps more symptomatic of a disillusionment towards the government, and of a nation fed up with having their beloved principles of liberté, égalité, franternité chaffed at during a year of on-off confinement than of a baseless hatred for Bill Gates and his capitalistic modus operandi. Some commentators trace this mistrust of power all the way back to the French Revolution.
Yet I don’t think the French would go as far as to turn their backs entirely on the government—the hand that feeds them—and reject a very generous universal healthcare system. It’s similar to the nonsensical revendications of the infamous Gilets jaunes: they wanted minimal government intervention in their everyday lives, but maximal protection in the form of laughably high minimum wage guarantees and unemployment benefits. (Nowadays, the Yellow Vests have jumped on the anti-vax wagon; they believe the virus was just another way for the government to cow its citizens.)
I’ve read some accounts that entangle the high use of medication in France with this same system: because medication is so heavily subsidised by the government, it is very cheap—so there’s no pause for reflection before taking it. It’s perhaps for this very reason that French people fail to see that it’s the same evil big pharma behind the hated vaccine that pumps them full with medication.
In her collection of essays, The Secret Life of France (a glittering read for all you Francophiles), Ludy Wadham relates the high consumption of medication to the:
“various myths and fantasies that seem to inhabit the French and condition their approach to suffering. All the values that form the bedrock of France’s collective unconscious—the Cult of Beauty, the Tragic (rather than Comic) world view, the Cult of Reason—leave French people particularly ill-equipped for the harsher aspects of reality. French culture, with it’s rigid founding myths, is particularly ill-suited to the hurtling flux of globalisation.”
This coupled with the growing pertinence of the collapsologie movement—a fatalistic, and very real, movement in France that believes our capitalistic, consumeristic habits will cause the collapse of modern society—could explain why the French are so ready to shun the vaccine yet rely on medication as a crutch to just simply everyday life.
At the end of this newsletter, I’m still not sure what my personal resolve is but I do hope that these cultural cleavages are softened by deconfinement so that the French don’t do something silly like vote Marine Le Pen into office.
As a parting gift, I’ll leave you with an excerpt from my Rolodex of medical resources in Paris in case you require medical attention (and to save you from any traumatizing experiences with French doctors… more of that to come in Part II of French medical mysteries).
Dr. Julia Bache: A British GP who has a holistic approach to health. I couldn’t recommend her more.
Dr. Nancy Salzman: A Canadian GP. Very thorough but very cher. Expect to pay €75-120 cash only with no reimbursement from the sécu.
Dr. Julia Pariente. The best gyno in town. And she speaks fluent English.
The American Hospital + The British Hospital: two hospitals with English-speaking staff. A slice of home away from home, you could say.
Centre de santé sexuelle at Hopital Dieu : a one-stop-shop for all things women’s and sexual health-related run by some of the warmest French people I have ever encountered. And it’s free!
Oh, and the number to call an ambulance is 15 (something I only learned this year).
A la semaine prochaine !