Am I in a dream?

On several occasions I have reflected that this bizarre world I find myself in is like a theatre – but am I a spectator or in the cast? I said this to Rosalyn, the physio assistant and she laughed and agreed, and said she often wondered if she was in a dream and would suddenly wake up.

The cast is constantly changing: various characters get better (well, enough to boot them out, or send them across the garden to the retirement home), others unfortunately disappear back to Ganges or another hospital for further treatment. I suspect this is what happened to the old woman opposite, who kept tearing off her arm bandages. Some remain only too audibly present, like 95-year-old Mme Héron, Gael (the poor handicapped woman) a man who has had a stroke which makes it hard for anyone to understand him, and a drug/alcohol befuddled younger woman.

New performers make their entrance. Deborah and I escaped down a quiet corridor on the ground floor this morning. From another corridor at the end we heard religious music (all around us on Sundays) and a woman singing along with the recording. Then we spotted the singer, a black woman, marching past – and back, and forth. EVentually she turned off her recorder and passed into our corridor and we got talking. She was a Camerounian who worked for a French boss (as housekeeper, I think) and when he retired to France came with him. At the last moment she discovered that her visa did not include her four-year-old son. Her friends advised her to go ahead and fight for his visa here. I couldnt make out whether she knew she would end up in hospital in Montpellier before she left the Cameroons. but she has had a (repeat) slipped disk operation and returns to Montpellier tomorrow to get the surgeon’s verdict. Her distress at being parted from her son was evident and heartbreaking. I’ll find out her name soon,as she has ended up in the room opposite me after having to share with a poor old blind woman who cried all night and just wants to die. Our new Camerounian friend muttered it makes you think of euthanasia.

Some people find more practical ways of escaping. We were sitting in the garden yesterday when we heard an aide menage rushing towards an elderly patient, complete with bandages,marching towards the exit to the hospital. “Non, non, Madame. Vous n’avez pas le droit de sortir”. That’s the second time we have witnessed a patient being rescued at the last moment.

Perhaps the worst fate I can imagine is to end up in the “deuxième” – the second floor. This is the ward upstairs, with combination lock entrance, for the very, very sick, dying or – I imagine- insane. Curious because sometimes people do come out. There is a batty 59-year-old who pushes his zimmer at great speed down to physio at coffee time in the morning, has his glasses of juice and coffee, and departs. He is seen occasionally in the afternoons, playing scrabble with Mme 114 (she who is constantly asking where is her room 114). We know he is 59 because a couple of days ago he suddenly broke his silence, and in a deep (mainly,to me, incomprehensible) voice recounted his life history. Unless I have got completely the wrong end of the stick, this included the fact that he is homosexual and it is difficult to find partners in hospital. I think I am right because Deborah saw the good Protestant woman lying on the treatment couch next to her raise her eyebrows to her hairline.

References to the deuxieme make me think of that awful scene in “All quiet on the Western Front” when the young men lying wounded in a French hospital are told the rumour that the bandages room at the end of the ward is in fact the dying room – and you don’t return.

On the positive side, today is yet another cloudless sunny day and I’m about to bully Deborah to go outside, which involves waiting for a young(ish) passerby to help push her wheelchair down the precipitous slope just outside the main doors. And I am sitting in a very comfortable armchair which the staff making my bed this morning suddenly thought I needed. Somebody is bringing in some dvds later in the week, so I plan to start watching movies.

Ella’s fifth birthday party

My oldest granddaughter Ella, will be five on Monday. She has been as high as a kite for a week now, waiting for today’s birthday party. She will be wearing the fairy costume (theoretically) my present. I still get angry that thanks to the incompetent management here I couldnt watch her unwrap the present this morning. (I have still not had a reply to my letter, sent to the directeur over a week ago.)

This made me remember my first birthday party (either my fifth or sixth birthday). I was not present. As so often in my childhood I was ill and, that being before everybody had a phone, the party was not cancelled. I can remember hearing the children downstairs, presumably eating something simple like jelly, as this was in the Forties. The next two birthdays were spent in hospital.

French health system creaking

There is no way I would have got the care I am receiving here in Britain. Instead of spending the last two months in hospital or clinics I would probably have been discharged after a week or two and left with presumaby some sort of daily visit to deal with the post op medical care, give me medication, make my bed and wash me and horrible meals on wheels. I certainly remember that after my first hip replacement I was discharged after two weeks with no physio prescribed until I demanded some – and then only got six poor sessions. Perhaps the low quality of operation and after care 14 years ago accounts for why that hip replacement never worked properly and did such damage to the bone of my pelvis.

So, I am grateful for the French health system, but also deeply concerned at the signs I see that it is inevitably crumbling. This is only a little local cottage hospital, caring mostly for the very old, confused or dying. But it also has a small rehabilitation side, with about 20 beds assigned to people like me, and a surprisingly well equipped physo room, albeit cramped, with two physios and an assistant (there is a third physio vacancy which never gets filled because of the shortage of physios and the fact that people don’t want to come and work in the sticks).

I have written before about how much I have appreciated the care of the kinés, Mireille, Marthine (the sadly departed replacement) and Didier (less so…) and their lovely assistant, Rosalyn. Mireille and Rosalyn go round all day long dealing with moaning, difficult, handicapped, deaf, blind – or deaf and blind patients with non-stop kindness, smiles and gentle compassion as well as professionalism. But how do two people cope with a roomful of patients needing help or simply in danger of falling over when doing their exercises? Thursday was a particularly taxing day, when all the patients most in need of help seemed to need it at the same time. It was the day when Madame Héron, who is almost completely deaf and blind, suddenly started to work with determination at walking between the bars and then demanding more attention (loudly, because she lives in her own little world), when new patients arrived who found it almost impossible to move from wheelchair to treatment bed without being virtually manhandled by these two women. At one stage I said to Mireille, who had her usual smile, but I thought it was a little fixed, that she must be very tired. She replied she was ready to keel over – rare for her to admit personal struggles.

There are simply not enough kines and this is a cryng shame. But the same applies to nurses, aides soignantes, and the assistants. At every level the staff here are incredibly cheery and patient. Yet the better I get to know them and the more I eavesdrop, the more I realise the system is only just holding together. The staff have to race to get through their morning tasks, on top of responding to the demands of people ringing for help. Sickness and holidays mean they are stretched so much that sometimes they finish an afternoon shift, only to start immediately on a morning shift the next day, without a break. (The storms didn’t help of course, as several staff could not get to work those weeks.)

The building, furniture and equipment show further evidence of needing an urgent cash flow. The entrance is so makeshift it is positively impossible for someone in a wheelchair to go out to the garden alone, the physio room badly needs more électrode systems – and space, the bedrooms are shabby with paint peeling and scuffed doors (I have contributed to this trying to manoeuvre my wheelchair into the tiny bathroom, and things like the control to raise and lower my bed don’t work.

Sometimes, I have to admit, it is not lack of cash but lack of imagination that creates unnecessary problems. For example, it would cost nothing to move one of the chairs with arms to near the lift, rather than the useless showy, too low for patients, seats. I often see people on walking frames struggling back to their room, badly needing a half-way halt. And the two nice aides who made my bed this morning, propped my crutches up tidily beside the table – out of my reach…

Major milestone

Today I swapped my wheelchair for crutches!

It all happened rather quickly, after a night in which, with some trepidation, I slept on my side, with a  pillow between my knees .  Today was the weekly review by the doctor, Docteur Commeines. I’ now half way through my four weeks of ‘applied progress if’; I may now put 50% pressure on my left leg.

“I’m tired of seeing you in a wheelchair,” said the doctor.  “Time to see you walking.”  I was handed an ambulateur (walking frame) and tried without enthusiasm, saying I would prefer crutches. So in they brought a pair of cannes anglaises, or beguilles, and away I went, or rather, swayed, back to the kiné room next door. There I walked back and forth, gradually gaining confidence, helped tremendously by Mireille, the kiné, and egged on by Deborah. In fact quite a few people smiled with pleasure at this sudden step forward – literally.

Then, unbelievably (a bit scary) I left my wheelchair behind and walked back to my room. It is somewhat unnerving to see no wheelchair beside my bed after six weeks. Instead just a couple of sticks which I have to concentrate on not knocking over; otherwise I’m stranded.  Whoops. As I said that I moved in bed and knocked one to the ground. Luckily I have my grabber beside me.  I wish I had not lost my old portable grabber, but Deb (sister) is trying to remember where she bought it.

The joy of not having to negotiate the door and cramped space with my wheelchair. And hopefully this transition will relieve the increasing strain on my arthritic right knee and shoulder, caused by manoeuvring my wheelchair, pivoting round on my right leg, and having to lean heavily on my shoulders when walking between the bars.

Poor Deborah has to watch on,somewhat depressed, as she realises she needs more pulley work before her scheduled date for starting to put weight on her leg, in ten days time.  Tomorrow it’s back to the pulleys for me too, to strengthen those damaged or weakened muscles. But at least it looks as if I might be out of here earlier than feared.  Maybe even by the end of the first week of November.

Problems for Monsieur le Directeur – hehe

Well the petition failed to keep Marthine here. All the staff know about it and I have heard various scornful adjectives applied to him. But at least, Mireille told me, that there is now a new policy that there should not be more than 14 reeducation patients per physio. I have noticed one or two empty beds in the corridor sand one of the new arrivals told me yesterday that he was kept in Ganges for an extra week because there was not a bed for him here.

Meanwhile I reckon he has a few security issues to address. I have already worried about the fact that any of the lost souls wandering round the garden could easily wander out of the open gates to the road beyond. A few days ago one patient in my corridor wandered out – and off back home, much to the consternation of the nursing staff who had to haul him back.

Last weekend the nurse and aide soignante alone on night duty were disturbed by the sound of banging on the glass front doors of the hospital (no night grillages). It appeared to be a drug addict, presumably planning to raid the pharmacie. They phoned the pompiers, who arrived 90 minutes later – and the man ran off.

The two women were so traumatised by what might have happened if he had broken the door down that they went to their doctors who signed them off with stress, indicating there needed to be reassurance the doors were more solid before their patients were to go on night duty again. So the staff are yet further stretched, and M le Directeur has some problems to address.

Actually he has another little one which landed on his desk on Friday afternoon: my letter requesting he sorted out the firewall which prevents me (and I assume Apple users generally and perhapsothers) from using skype or email on the wifi system. Thank you to Deborah, my neighbour, and yves Jaffrennou, my friend, for improving style and language.

M. le Directeur
Centre Hospitalier
Le Vigan

Monsieur le directeur

Je suis très heureuse d’avoir l’Internet grâce au service wifi. Mais malheureusement je ne peux m’en servir ni pour l’e-mail ni pour Skype (ou son équivalent Apple – FaceTime). Ces deux services sont pourtant essentiels pour moi – et, indépendamment de moi pour tous les pensionnaires qui voudraient en bénéficier. Pour ce qui me concerne, toute ma famille habite à Londres et j’ai beaucoup d’amis loin du Vigan. Je n’ai pu, par exemple, partager avec mes petits- enfants, l’anniversaire de deux d’entre eux.
J’ai deux ordinateurs Apple: un iPad et un MacBook. A l’accueil, j’ai demandé s’il y avait dans l’établissement un pare-feu qui bloquerait ces deux services. On m’a renvoyé à l’informaticien.

L’informaticien m’a informé qu’il n’y avait aucun pare-feu pour le serveur du Centre hospitalier, mais par contre qu’il y en avait un, général pour tous les serveurs de l’hôpital et de la maison de retraite. Quand je lui ai demandé s’il pouvait modifier ce pare-feu pour permettre l’accès à ces services internet (e-mail, Skype) par les ordinateurs d’Apple il m’a répondu que le pare-feu est sous la responsabilité de la direction de l’hôpital et que toute demande de le modifier doit passer par cette instance.

C‘est pourquoi, Monsieur le Directeur, je me permets de solliciter de votre bienveillance de bien vouloir donner l’autorisation de modifier les conditions d’utilisation des services de l’internet dont je viens de parler, y compris pour Apple et ses applications. Vous comprendrez que la communication avec les familles lointaines est essentielle pour le moral – dont dépend pour une part la guérison elle-même des patients.

Bien sûr, il n’y pas encore beaucoup d’utilisateurs d’Internet dans les institutions médicales où séjournent de nombreuses personnes âgées, mais je pense qu’avec la banalisation des moyens électroniques de communication, cette situation va changer rapidement.

Veuillez agréer, Monsieur le Directeur, l’expression de mes sentiments les meilleurs.

Au Vigan, le 16 octobre 2014
Madame Frances Allen

Learning from my elders

As Deborah and I sit it out until our bones or grafts heal, gradually people whose faces have become so familiar move on. Jeanie. the garrulous woman of my age, and Mme Pialot, the gentle lady from the room next to her have gone home, followed shortly by the plucky 89-year-old Mme Cambon. Se told me the day before she left that her only daughter has now gone back to her home in Japan, her son from Bordeaux was collecting her to go straight to a Nimes hospital where her other sone, aged 51, is gravely ill with a smoking related lung disease. In a couple of days her 93 year old neighbour leaves to live with her daughter.

All of these old ladies were silently, uncomplainingly plucky about their recovery and the life ahead. Unlike Mme Héron, whose voice I hear regularly shouting ‘Non’, refusng medication, physio, waiting for physio. But ‘m beginning to feel more tolerant even about her when I reflect that she is very deaf, and therefore isoltated, and 97!

I also have such respect for all the people who help them, invariably patient, smilingly and ready to listen. Above all Mireille the physio and her assistant, Rosalyn, have a genuine compassion for old people which shines through. Rosalyn was telling me the other day that seeing old people suffer or worry about their future was perhaps the most stressful part of her job.

Recovered

It took me ore days than exected to stop feeling ill. But now I have completely got over it and feel energetic and smiley. It makes me realise that even before last Friday’s crise, in fact since the operation, I have not been feeling right. Unfortunately one of the side effects of no longer taking these painkillers is that I have recovered my appetite… Also I feel more pain, but as the doctor said, this is probably a good thing as now I am starting to gently put some weight on the left side, I get warning signs if I do too much. (Unfortunately these are often several hours later. (Ive just been ling flat on my back for an hour to get rid of pain caused by yesterday’s physio session.)

Anyhow it is gloriously sunny – back to summer weather – and, as the French say, ‘j’ai le morale’. Just as well as Debora is now gong through a black patch and it is up to me to make her laugh.

YesterdayI dragged her out to the garden where all the old dears from the retirement home sit. This is not easy as – incredibly- there is an unmanageable slope between the hospital exit and the path down to the garden. I have still not dared try it unassisted. We sat there, surrounded by smokers and a weird man in a wheelchair oblivious to the world around him. ‘What do we do?’ cried Deborah. ‘No problem,’ I replied, we just wait for the first handsome young man to pass – well, at least young…” It’s a bit like hitching, I explained, you have to scrutinise the passers-by to check if they are suitable before making eye contact. We turned down a couple of offers on the grounds they were too old, and then at last waylayed a young man on his way to visit his girlfriend.

It was worth it: it was the first time that Deborah had been outside and she really enjoyed it. Until her leg started hurting too much. I ws surprised that she was quite shocked when I stopped another man, on his way to visit his parents in the retirement home, and asked him to push Deborah’s chair up the slope first. She said today that she is surprised at how anxious she has become since her accident, especially since she has ridden and skied all her life.

Long weekends

The weekends stretch on interminably without the destraction of physio sessions. Luckily yesterday was sunny, I was beginning to feel better and able to appreciate visits, especially Tom and Chantal.

Today it rained non-stop and I was still recovering, so had no energy. There was not the usual stream of visitors, as families from beyond Le Vigan did not dare risk getting stranded in the storms. But they all phoned, and given the Cévenole tendency to shout and a large number of deaf neighbours, I was able to participate. I’m particularly fond of the deaf old dear opposite, who is going to live with her daughter and family when she gets out next week. I listened to her talking to the family this morning. Lots of ‘eh’s as they had to repeat themselves, but she so clearly loved being told about the antics of the dog by her grandson.

That made me remember a sad story Margaret told me about the old woman sharing a room with her after her accident. The son or son-in-law visited just as she had received her food bill from the hospital. Evidentally she had been too poor to pay for a mutuelle, as most of us do. The man who was going to have to pay the bill went on and on, as if it was her fault, querying the price and exclaiming ‘We don’t eat pate at home, we don’t’. The old lady said nothing. After they left, she cried.

Yesterday another son-in-law asked a nurse, in my presence, to help persuade his mother in law, recently arrived, possibly after a fall, that a particular retirement home he had found would be more sensible than living alone – even though I gather she lived on the floor below him.

Two old women who have not got the loving families of the old dear across the way.

Alerte Rouge

That means: do NOT travel unless absolutely necessary. Yet more torrential storms expected. This applies to the whole of the departements of the Gard and Hérault. The scale of damage after several weeks is than in Cornwall last year. The rebuilding cost is going to be enormous. We are talking about bridges and bits of road swept away, buildings flooded often irretrievably, walls and hillsides collapsed. Mud and rock everywhere it should not be.

Amazingly my guests, Tom and Chantal, made it to Nimes Airport without major problems. I think they were luckily because bits of the route will undoubtedly be flooded today if the rain continues.

They were perfect guests: unphased by staying in a house that has not been cleaned for over two months (and therefore has a huge spider colony), clearly enjoying local toddles and even swimming in the nearby river. The weather didn’t seem to bother them and luckily there were one or two days of sun, including an exceptionally fine day yesterday, when they went to the weekly market and lunched out.

Their departure has been super-efficient: toys returned to neighbours’ basement, bed laundry washed and hung up, everything packed. And all this with a baby and two-year-old and thunderstorms outside.