Hospital visits are worrisome enough back home, so it’s understandable that you’d be wary of visiting a medical facility when abroad. But just as you needn’t be an artist or model to visit the Louvre, you needn’t be a doctor or ill to visit one of the city’s historic hospitals and medical museums.

Paris has a rich if sometimes horrific hospital and medical heritage. While exploring that heritage will be especially noteworthy for travelers in the medical field, it offers any off-beat traveler the opportunity to learn much about the history of health care and medical progress in France, of Paris’s treatment of the poor and destitute, and a good deal about rabies, tumors, anatomical pathologies, mental illness, military medicine, radiation therapy and much more.

Furthermore, several of the hospital courtyards described here are so peaceful that visiting them is in itself a form of therapy to the urban pathologies caused by car fumes, noise and crowds of fellow tourists, beginning with an oasis of calm right next to Notre-Dame Cathedral.

The Hôtel Dieu

Notre-Dame Cathedral receives over 14 million visitors per year but only the rare visitor will venture into the Hôtel Dieu, the hospital right beside it, even though their histories are intimately entwined.

Hôtel Dieu, meaning the house where one is welcomed in the name of God, was founded under the auspices of the Church in the 651 and developed as a place where the Church would receive the ill, the poor and pilgrims. Piety, prayer and medical care, as it were, were united. It was more hospice than hospital, nevertheless in Paris as elsewhere in France, the Hôtel Dieu was (in some cities still is) the heart of the hospital system in the growing city. Expanded and rebuilt over the centuries on the southern (Seine) side of Notre-Dame, Paris’s Hôtel Dieu was eventually moved to the northern side then rebuilt as it’s seen today from 1866 to 1876.

The current hospital complex appears from the outside to be an uninviting block. But enter the sliding doors, turn left with no need to ask permission at the front desk, and you will find yourself in a peaceful, flower-filled courtyard. As a sign that the courtyard may actually be too quiet, too ignored, a piano beneath the gallery at between the courtyard’s two levels begs, in English no less, “Play me I’m yours.”

This vast hospital complex is currently underused, and the AP-HP, the organization that operates the city’s public hospital system, is in a quandary as to how to reallocate the space. One day there may be busy shops, a crowded café, lodgings or some other financially attractive tourist-pleasing enterprises. Better to come then before the crowds.

The Hôtel Dieu is alongside the square in front of Notre-Dame Cathedral at 1 Parvis Notre-Dame / Place Jean-Paul II, 4^th arrondissement. Open daily.

As a public hospital there is no longer an affiliation between the Hôtel Dieu and the Catholic Church, yet the name remains as a reminder of its origin. Similarly, other Paris hospitals have their history written into their names. Les Quinze-Vingts (meaning the fifteen twenties), for example, was founded by (Saint) Louis IX in 1260 to house the poor blind, 300 of them (15×20 according to the base 20 counting system). From its original location on what is now rue Saint Honoré, Les Quinze-Vingts was moved at the end of the 18th century to its current site on rue de Charonne in the 12^th arrondissement, where it remains one of France’s foremost ophthalmological institutes.

Pitié-Salpêtrière Hospital and the treatment of mental illness

La Salpêtrière has also kept its historic name even though gunpowder (using saltpeter) was only briefly produced on the site centuries ago.

La Salpêtrière was a “general hospital,” which, in the ancien regime, did not mean that it provided medical care but that it housed, often by force, the poor and the indigent. In the name of law and order, Louis XIV’s royal edict of 1656 established institutions “for shutting up poor beggars of the city and suburbs of Paris” who “live almost all in ignorance of Religion, contempt for the Sacraments & in the continual habit of all sorts of vices.”

La Salpêtrière’s most prominent feature is Saint Louis Church (1678), which can be freely visited along with the surrounding courtyard. In 1684 the complex expanded with the addition of a maison de force where, among others, prostitutes and women and girls who couldn’t be controlled by their husband or family were forcibly interned.

La Salpêtrière may have helped clean up the streets of the capital but it became a sick city unto itself where a mix of beggars, vagabonds, indigents, criminals, the deranged, the “incurably” insane (in many cases chained up for life), the socially disobedient, orphans, the destitute and the aged lived in close proximity, often in ghastly conditions.

In the history of the hospitals and asylums of Paris, La Salpêtrière is above all associated with the incarceration of women and particularly of madwomen (les aliénés). Through them, it is also associated with the evolution of the treatment of mental and neurological disorders (or those diagnosed as such), along with those who sought to improve their living conditions or treat them. A statue by the entrance shows Philippe Pinel (1745-1826), bienfaiteur des aliénés, unchaining a ward of the asylum. Jean-Martin Charcot (1815-1893), a neurologist who used hypnosis among other techniques to attempt understand and to cure “hysteria,” also worked here.

In the early 19th century the notorious “general hospital” was transformed into a civil hospital. La Pitié-Salpêtrière then merged with the adjacent hospital La Pitié in the 1960s, creating the sprawling complex of La Pitié-Salpêtrière, near Gare d’Austerlitz in the 13th arrondissement.

Temporary exhibitions are occasionally presented here, but even without them one can enter within the once-daunting walls of La Salpêtrière is to visit Saint Louis Church and the peaceable courtyard. Fear not, there has been no mental asylum here since 1921.

Hôpital de La Pitié-Salpêtrière. The main entrance to this vast hospital complex is at 83 boulevard de l’Hôpital, 75013, beside the Saint Marcel metro station. However, the historic Salpêtrière portion, including Saint Louis Church, can be entered directly 200 yards downhill at 47 rue de l’Hôpital.

The Museum of the History of Medicine

Even in hospitals more welcoming than the old Salpêtrière it’s difficult to imagine living in a time and place when might have been subjected to the variety of medical tools at the Museum of the History of Medicine, located in the old Faculty of Medicine, now Université Paris Descartes in the 6^th arrondissement.

This old-fashion museum, which appears little changed since the room was built in 1905, presents a sweeping view of medical, mostly surgical, progress over the centuries.

Here we can examine medical techniques and technology as practiced through the ages in Paris: scythes for removing gangrened limbs (ponce patients had been knocked out with sponges imbibed with opium or henbane), prosthetics that may have replaced those limbs in the 16^th and 17^th centuries, 17^th– and 18^th-century amputation kits, 18^th-century surgical kits, 19^th-century bladder stone retrieval instruments, the evolution of obstetrical forceps and much more. We learn about the origins of cataract removal in the 1700s.

The museum displays an original wood-and-brass stethoscope that René Laennec invented in Paris in 1816. Previously a doctor would place his ear directly on a patient’s chest to listen to the heart. Laennec worked at Necker Hospital, which was founded in 1778. The hospital’s originality in Paris at the time was that each patient had his or her own bed. In 1802 it was designated as a children’s hospital, the world’s first. Located in the 15^th arrondissement, it is still a world-renowned pediatric hospital.

Musée d’Histoire de la Médecine, 12 rue de l’Ecole de Médecine, 6^th arrondissement. Metro Odéon. Open 2-5:30pm except Thurs., Sun. and holidays. Entrance: 3€50.

Dupuytren Museum

From the Museum of the History of Medicine, you can cross the street to the Dupuytren Museum, which has existed since 1835 to present examples of anatomical pathologies.

The museum’s display of skeletons, skulls, bones, wax molds, organs in jars, paintings, drawings and photographs is not a pretty sight, but it’s a sight nonetheless, the kind that can either ruin your day or put into perspective the fashion boutiques of the nearby Saint-Germain Quarter. A plaque outside the Cordeliers complex where the museum is located honors the 1800 doctors who “died for France” during the First World War.

Musée Dupuytren, Centre des Cordeliers, 15 rue de l’Ecole de Médecine, 6^th arrondisssement. Metro Odéon. Open Mon.-Fri. 2-5pm. Closed late July to early September. Entrance: 5€, 3€ for students and teachers.

Saint Louis Hospital: The Courtyard and the Museum of Molds

Saint Louis Hospital, near Canal Saint Martin in the 10^th arrondissement, reveals Paris’s medical and hospital heritage at its most architecturally sublime and at its most infectiously and tumorously horrific.

During the Middle Ages and beyond, periods of plague could be devastating in the dense capital. In 1607 Henri IV fulfilled a desire of the Catholic Order of Augustinians, which administered the Hôtel Dieu, by ordering the construction of a hospital that could be activated during periods of plague. Sainted Louis IX, the hospital’s namesake, had himself died of the plague by the gates of Tunis 1270. The selected site was well beyond the city walls of the time. Contagious patients were further quarantined by being placed within a double walled complex, a feature that makes the central courtyard an exceptional oasis in contemporary Paris.

Two years before launching construction of the hospital, Henri IV had ordered the creation of a royal square in the Marais, later called the Place des Vosges. Two of the architects involved in that project, Claude Chastillon and Claude Vellefaux, were also involved in creating the hospital courtyard. Saint Louis therefore echoes the Place des Vosges in its use of brick and stone, but in a sparer, more modest way. Here, patients with contagious disease resided on the second floor.

Created to deal with epidemics, Saint Louis Hospital was used only periodically for its first 165 years of existence. Then a fire that destroyed the Hotel Dieu in 1772 made permanent use of Saint Louis indispensable while the central hospital was being rebuilt. Before long it too was indispensable in the expanding city.

The original buildings of the early 1600s now house administrative offices while patients come to an adjacent complex of buildings as the hospital has been modernized over the past 30 years. Historically specialized in skin diseases, the hospital now also focuses on other specialties as well, including hematology, oncology and organ transplants.

The old buildings meanwhile appear unchanged, except that now there is no sense of imprisonment in the courtyard but rather of security in a secret garden. Such security, in fact, that on weekday afternoon, in the sun or in the shade of the surprising variety of tree species here, this is the preferred playground for neighborhood preschool children, playing on the grass and the gravel paths while a parent or nanny looks on.

Nearby, however, in another part of the hospital complex, it’s another story—and not one for the faint of heart.

The Catacombs of Paris, “the empire of death,” as it says at the entrance, are all the rage for teens and young adults looking for the morbid, giggly thrill of following tunnels lined with millions of bones. But for something truly frightening, Saint Louis’s Musée des Moulages (Museum of Molds, open by appointment and during late-September Heritage Days) is a serious medical house of horrors. It displays wax models of actual tumors, infection and disease, including numerous examples of what has been called “the French disease,” syphilis. Children 12 and under are not allowed in.

Created in 1885 for the purpose of teaching dermatology, the hospital’s historic specialty, the 4807-piece collection is the world’s largest of its kind. The collection and presentation have held Historical Monument status since 1992. One leaves here with a strong will to remain healthy and to wash one’s hand frequently. Here is a glimpse of the museum (commentary in French).

Leaving the museum, some visitors may then want to say a little prayer at the old chapel at the opposite edge of the hospital complex, some may want to return to the courtyard for some leafy contemplation, some may want to flee the hospital complex for a seat in a café by Canal Saint Martin to drink a toast to each other’s health. And we can all rejoice in the discovery of penicillin.

Hôpital Saint Louis – Musée des Moulages. The hospital complex can be entered at 1 avenue Claude Vellefaux or 16 rue de la Grange aux Belles (12 rue de la Grande aux Belles for the chapel), 10th arrondissement. Metro Colonel Fabien or Goncourt, though if visiting the canal area as well you can approach from République. The historic entrance at the end of Avenue Richerand is currently closed for security reasons.

The courtyard of the Hôpital Saint Louis is open weekdays and entrance is free. The chapel is open Mon.-Fri. 2:30-5pm, except for holidays, and Sun. 10:30-12:00am. From late July to late August it is closed except during weekly or twice-weekly mass.

The Museum of Molds (at Porte 14, Secteur Gris) is open by appointment only, Mon.-Fri., 9am-4:30pm, by calling 01 42 49 99 15 or writing to musee.moulages@sls.aphp.fr. Also open during late-September Heritage Days. Visitors must be more than 12 years old. Entrance: 6€ (3€ for students), 7.50€ for visit with presentation in France. Audio-guides available in English for 2€.

Salles de garde: hospital pornography for young doctors

Combine morbidity and sex and you get the salle de garde, the dining room and hang-out for young doctors in their medical residency and other medical staff. At Saint Louis and other public hospitals throughout Paris, salles de garde are normally off-limits to visitors—and it’s probably better that way. Where young doctors may have once dined in refectories surrounded by portraits of the great figures in medicine that preceded them, many now eat among an orgiastic free-for-all of licentious art. This 20^th-century tradition, still alive and well, apparently helps keep the stench of death and disease at bay. In fact, among the codes of conduct of the salle de garde is the possibility to “Laugh at everything, at death, at omnipresent suffering, at religion, at patients. To counterbalance misfortune, the salle de garde becomes a place of pleasure and of boisterous pleasure.” The quote is from a document put out by the Public Hospital Administration of Paris. To see what French interns are contemplating when away from their patients, check out the website operated by the Association des Salles de garde (you must be 18 or older to enter the site). For a State-sanctioned illustrated study on the subject see here.

© 2015/2016, Gary Lee Kraut. An earlier version of this article was originally published in the September 2015 issue of the British publication The Connexion.

Continue to Part 2 of Paris Hospitals and Medical Museums

The post Off-Beat Touring: Paris Hospitals and Medical Museums, Part 1 appeared first on France Revisited - Life in Paris, Travel in France.

The Pasteur Museum: Pasteurization, vaccination and a beautiful crypt

Public health was on the upswing in the late 19th century in part thanks to the work of Louis Pasteur (1822-1895). The Pasteur Museum and Institute, in the 15^th arrondissement, is a reminder of the positive effects of the famous scientist’s work on our daily lives. And Pasteur himself is buried in the basement in one of Paris’s most beautiful crypts.

It’s rare to have a scientist’s name given to a method rather than to an object or measurement, but pasteurization—partial sterilization enabling the demise of undesirable organisms—is known throughout the world. Beyond the reliable dairy products so associated with pasteurization, each time we lift a glass a beer or wine we can toast the great chemist. In fact, Pasteur discovered the benefit of heating wine before the benefit of heating milk when Napoleon III was looking to keep the wine sent to his soldiers from going bad. We can also pet the neighbor’s dog in peace thanks to Pasteur’s work in developing a vaccine for rabies.

Pasteur’s professional work as a chemist who came to practice biology had enormous implications on hygiene and medicine, and the institute that bears his name continues to work throughout the world to create vaccines and to eradicate disease.

The Pasteur Museum is an excellent introduction into his life and scientific times. It is part exhibition about his scientific accomplishments and discoveries through original instruments (explanations available in English), part tour of his apartment within the original building of the Pasteur Foundation. Ten pastels portraits that he drew between the ages of 13 and 20, hanging in his bedroom and in the dining room, unexpectedly reveal Pasteur to be an admirable visual artist before he turned to science. Being able to draw what one saw under the microscope was nevertheless an important skill for a 19th-century scientist.

The unexpected pleasure of a visit here is the chance to descend into the beautiful crypt where he and his wife are buried. For cryptophiles it alone is worth a visit to the Pasteur Museum. Inspired by the 5th-century Mausoleum of Galla Placidia in Ravenna, Italy, the neo-Byzantine curves and remarkable mosaics form an ensemble that one would more likely associate with nobility or with a saint. Pasteur’s dark green granite tomb occupies the center of the crypt. His wife, who died 15 years after Pasteur, is buried by the altar.

The original building of the Pasteur Foundation, in which the museum is located, is part of the vast complex of the Pasteur Institute which includes departments for research, education and vaccination. The original foundation building was funded by “national subscription,” a form of crowdfunding at the time. The Pasteur Institute is a private institution. Nearly half of the Pasteur Institute’s budget comes from income from its own activities, just over one quarter is subsidized by the State and about a quarter comes from donations and real estate assets.

Pasteur didn’t travel much, but he asked his students to deal with local health and hygiene problems wherever they may go, leading to what has been called “scientific evangelization” as his work and emphasis on the scientific method spread around the world. In addition to the Paris headquarters, there are 32 Pasteur Institutes around the world, employing 2400 people in more than 60 countries.

Pasteur left behind a detailed trace of his actions and methods in studies, letters and other documents. Due to the importance and extent of his work, the Pasteur archives have recently been listed in UNESCO’s International World Register of the Memory of the World. Those archives are maintained and have been digitized by the Academy of Sciences and the National Library of France.

Musée Pasteur / Institut Pasteur, 25 rue du Docteur Roux, 15^th arrondissement. Metro Pasteur. Open Mon.-Fri. except for holiday and August. Visits at 2pm, 3pm and 4pm, without reservation for individuals. Visitors must show ID to enter the Institut Pasteur complex in which the museum is located. Adults: 7 €. Students and children: 3€. Reservations required for groups.

Musée Curie and the treatment of cancer

The free little museum at the Curie Institute (5^th arrondissement) provides an introduction to radioactivity, radiation therapy and the life of double Nobel Prize winner Marie Curie (1867-1934) and her husband Pierre (1859-1906), with whom she shared her first Nobel.

Born Maria Sklodowska in Warsaw, Marie arrived in Paris in 1891 to continue scientific studies that she had begun in Poland. She married the French scientist Pierre Curie in 1895. Together the Curies discovered radioactivity through polonium and radium. They shared the Nobel Prize for physics in 1903 with Henri Bequerel for their research into radiation. Marie thus became the first woman to receive the Nobel. Pierre’s life was cut short in 1906 when he was run over by a horse-drawn carriage. In 1909 the University of Paris and the Pasteur Institute joined forces to create the Radium Institute with her at the helm. She later received a second Nobel for chemistry for her work into polonium and radium, making the first double winner, man or woman, in different fields.

Once the scythe of WWI and the flu pandemic of 1918 had passed and the work of Pasteur and others had paved the way for improved and increasingly extensive vaccination, cancer was recognized as a major killer in France. While the virtues of radium therapy had been known since the early 1900s, channeling it for therapeutic value remained a work in progress. The Curie Foundation, which opened in 1922, became the first center in France devoted to fighting cancer with radiation therapy.

Marie Curie died of leukemia in 1934. The following year the Curie’s daughter and son-in-law also received the Nobel in chemistry for their discovery of artificial radioactivity.

The Radium Institute and the Curie Foundation merged in 1970 to form the Curie Institute. This little museum occupies the ground floor of the building where Marie had her office, which can be seen as she knew it. Research, education and cancer treatment are the institute’s aims. About 50% of its research funds come from the State, while medical insurance covers 100% of medical care provided by the institute.

In 1995, the ashes of Pierre and Marie Curie were transferred to the Pantheon, just around the corner from her office and from the museum. She thus became the first woman to enter the Pantheon for her own achievements.

Musée Curie, 1 rue Pierre et Marie Curie, 5^th arrondissement. RER Luxembourg. Open Wed.-Sat. 1-5pm. Closed holidays and August and for two weeks late December-early January. Entrance is free, while donations are welcome.

Val de Grâce and the Museum of Health Service of the Armed Forces

In 1670, 14 years after decreeing the creation of the “general hospital” of La Salpêtrière, Louis XIV decreed the construction of a royal “hostel” to lodge officers and soldiers who were disabled, old or obsolete: Les Invalides. More than 6,000 men were admitted at Les Invalides between 1676 and 1690.

One visits the complex now as the Army Museum and as the site of Napoleon’s tomb beneath the great dome, yet portions of the Hôtel National des Invalides still provide medical services for veterans.

But it’s at Val de Grâce, the military and teaching hospital the 5^th arrondissement, where you’ll find the Museum of Health Service of the Armed Forces (Musée du Service de Santé des Armées). This museum is so rarely visited that coming here you might feel like an intruder in the defense department, or an honored guest.

The central structure of the Val de Grâce complex was originally built as convent under the patronage of Anne of Austria in thanks for having given birth to a son, the future Louis XIV, after nearly 23 years of marriage. During the French Revolution, the convent was transformed into a military and teaching hospital, and it has remained so ever since.

Entrance the museum also gains access to the Baroque chapel of Val de Grace, one of the jewels of 17th-century religious architecture in Paris, as well as to the convent cloister. The museum occupies a portion of the cloister complex.

While covering much of the 19^th and 20^th centuries, the museum is particularly informative concerning the medical needs, care and developments of those wounded during the First World War. The war’s destructiveness brought forth the massive need for medical intervention to deal with the effects of bullets, shrapnel, explosion, mustard gas, horrific conditions in the trenches (rats, malaria, “sick” water), psychological trauma and the flu pandemic.

The State created the museum during that war to show the public the efforts that were being made on behalf of the “poilus,” as the French infantrymen were known. A major display (to be avoided perhaps by children for its grotesqueness) is wax models of the faces of the men were made unrecognizable by artillery wounds, known as “les gueules cassées” in French. The models—considered a medical success story for the army—show faces before and after maxilla-facial surgery, a field with more than ample patients to study and improve their techniques.

Musée du Service de Santé des Armées, 1 place Alphonse Laveran, 5^th arrondissement. RER Port-Royal. Open Tues., Wed., Thurs., Sat., Sun. noon-6pm. Closed Jan. 1, Dee. 25 and the month of August. Entrance: 5€.

George Orwell fleeing a Paris hospital

If, after touring the hospital and medical heritage of Paris, you’d like good bedtime hospital horror story, read George Orwell’s essay How the Poor Die. Published in 1946, the brief essay is based on his experience in the public ward of Cochin Hospital (14^th arr.), which he refers to as Hôpital X, where he spent two weeks when suffering from flu or pneumonia.

“During my first hour in the Hôpital X,” he wrote, “I had had a whole series of different and contradictory treatments, but this was misleading, for in general you got very little treatment at all, either good or bad, unless you were ill in some interesting and instructive way….As a non-paying patient, in the uniform nightshirt, you were primarily a specimen, a thing I did not resent but could never quite get used to…. It was not the only hospital I have fled from, but its gloom and bareness, its sickly smell and, above all, something in its mental atmosphere stand out in my memory as exceptional….For it was a hospital in which not the methods, perhaps, but something of the atmosphere of the nineteenth century had managed to survive, and therein lay its peculiar interest….”

Hopefully what will stand out in your memory as you visit these hospitals and museums is something more cheerful. And we can all toast: Santé!

Return to Part 1 of Hospital and Medical Heritage in Paris

© 2015/2016, Gary Lee Kraut. An earlier version of this article was originally published in the September 2015 issue of the British publication The Connexion.

The post Off-Beat Touring: Paris Hospitals and Medical Museums, Part 2 appeared first on France Revisited - Life in Paris, Travel in France.

Five months after the scandal involving the deflation of Paul MacCarthy’s giant butt plug on Place Vendome, the art collective Adeca 75 has inflated a giant colon on Place de la Republique…

… as Paris explores the fine line between art and fart.

No, actually, what has come to be known as MacCarthy’s “butt plug” was supposedly inspired by his vision of a Christmas tree (you can read more about that here),  while the group Adeca 75 that I’ve referred to above as an “art collective” is in fact an association dedicated to organizing the national program for cancer screening in Paris (you can read more about that here).

Nevertheless, let this serve as a reminder to travelers to not limit your sense of what goes on in Paris to culinary clichés and highlights from the Louvre and the Orsay, for this remains a city where art is still debated and sometimes sabotaged and where the digestive tract is as long and hazardous as it is at home.

March 27, 2015

The post Paris tongue in cheek: From the butt plug to the giant colon appeared first on France Revisited - Life in Paris, Travel in France.

While waiting I heard someone coming up the stairs. It was the woman with the baby in her arms. Rounding the curve of the spiral staircase the baby smiled when he saw me. I wiggled my fingers at him in a wave.

The woman made out the essential of the situation, as women with babies in their arms inevitably do, and asked if the doorbell wasn’t working.

I tried it again and since I neither of us heard a bell ring I knocked, now five minutes late.

The door promptly opened and there was the doctor at the door of his consultation room, just off the vestibule, having released the door with his personal button.

He waved us in as he approached.

“Are you together?” he asked.

“No,” we answered.

“When’s your appointment,” he asked.

“8:50,” she said.

“8:45,” I said, triumphantly.

“You, in here.” His left hand showed me his office. “You over there.” His right hand showed the woman the waiting area.

I shook his hand, put my coat over the chair, and was about to sit down when he looked at his watch, shook his head and said, “No. No. Change of plans. You, out. You’re late. Madame, we’re going to start with you.”

He sent me out into the waiting area and motioned the woman to come in. The baby smiled. Or was it a smirk?

The ophthalmologist’s receptionist-secretary, his sole employee, arrived at precisely 9 a.m. She looked at me as though whatever had brought me there might be contagious.

“Does the doctor know that you’re here?”

“He’s the one who put me in quarantine,” I said.

In Paris a professional’s secretary or receptionist is both the professional’s mini-me and his front tackle.

She looked at the appointment list and said that since I wasn’t Madame Furmane then I must be late.

I said nothing.

When I’d called to make this appointment a month ago we’d had the following conversation:

“I’d like to make an appointment.”
“Is it urgent?”
“No, but I’m on my last pair of contact lenses and it’s been a year since my last check-up.”
“So you’re calling at the last minute.”
“I can hold out until next month.”
“Next month is the last minute. You should plan two months in advance but I’ll see what I can do for you.”
“Can I get an appointment?”
She gave me the date and the time and asked my name. I spelled out my last name then told her the first.

“H-A-R-R-Y?” she asked for verification.

“Gary with a G, like George, G-A-R-Y,” I said.

“You said ‘Harry,’” she said. Not a self-effacing “I thought you said ‘Harry’” or a doubtful “It sounded like you said ‘Harry’” or even a mocking “I couldn’t understand with your accent,” but an actual, accusatory “You said ‘Harry,’” as though I sometimes mistook myself for an English prince.

The doctor now came out of his office and opened the main door for the woman to leave.  The baby ignored me.

The doctor waved me in. He said, “You understand?”

I ignored him.

He repeated, “You understand, right?” Then a third time, no longer as a question, “You understand now,” as I walked into his consultation room.

There was a time when I would suffer through such lessons, French lessons, considering it a cultural trait: live in France, accept that everyone wants to teach you etiquette and put you in your place. But that ended long ago with my first visa: it takes legal status to say Fuck you with the right accent.

I didn’t tell the doctor Fuck you, though, but rather “Why is everyone always looking for a fight around here?”

“Not a fight, you’re just late, throws off the whole schedule.”

A schedule that has one patient at 8:45 and another at 8:50 is begging to be thrown off. I didn’t say that either; I knew that 8:50 is not an appointment time so much as planning for no-shows by overbooking.

My doctor, like his secretary, may have the annoying cultural habit of always wanting to teach a lesson but he also has the pleasant cultural trait of knowing that the best way to diffuse tension is to show that one is vulnerable to beauty and good taste, so after closing the door he said, “Anyway, it’s only natural to want to see a beautiful woman first.”

“I thought you were a sucker for the baby,” I said.

“I don’t like babies,” he said, “but I can’t resist women.”

He then got down to the business of checking my vision, first one eye then the other.

As he honed in on a final prescription I couldn’t decide which was clearer, the first M C T H or the second M C T H.

“This one?” he repeated… “Or this one?”

“I can’t tell the difference. Try again.”

He tried once more but to no avail.

“I hope you don’t have to make important decisions for a living,” he said as he released my chin from the stirrup.

I said, “The decisions I make usually have vowels.”

He asked me what I do for a living.

I told him as best as I could in three words, meaning I lied.

“Do you write about politics?”

“No.”

“You must be a Democrat,” he said. “Every American I meet in Paris is a Democrat. Why is that?”

“Republicans go to London,” I said. “It’s the Americans in Berlin that we’re not so sure about.”

He liked that. We talked a while.

He said, “I used to say mean things about Bush and every American I met in Paris would agree. Now I say nice things about Obama and they all agree.”

“Maybe we aren’t Democrats so much as agreeable,” I said.

Oh, we were having a fine time. For a man with a tight schedule he was now in no rush. We even talked a bit about my vision. Rather, he told me about my vision because he wasn’t the type of doctor to be interested in what I had to say on the subject of my body.

We also talked about French politics. He asked me what Americans thought on the upcoming presidential election in France.

I said if it’s true that the majority of Americans in Paris are Democrats it’s also true that few if any would ever vote for French Socialists.

“That I can understand,” he said. “The only thing that would be good about a Socialist president is that we wouldn’t have Socialist mayor because a Socialist president in France always leads to a Conservative mayor in Paris, and vice versa.”

“Does that mean that you can’t win or that you can’t lose?”

“That’s politics,” he said.

We shook hands as I left, buddies of sorts, and he reminded me not to be late next time.

He’s got personality, that ophthalmologist. He’s cocky but he’s got a sense of humor. I’d get a kick out of sitting next to him on a train to Alsace or at a dinner party for some cross-cultural repartee.

But I’ll never go back to his office.

© 2012, Gary Lee Kraut

The post Republicans, Democrats and the Politics of Vision in Paris appeared first on France Revisited - Life in Paris, Travel in France.

I knew from experience that rental agencies in or near train stations and airports in France simply give you the keys, once you’ve signed the necessary forms, and send you on your merry way to hunt for the vehicle at the far end of the parking lot. And since one of those forms is an inevitably incorrect sheet indicating the agency’s version of pre-rental dents and scratches to your vehicle, your failure to re-inspect may come back to haunt you when you find yourself being asked to pay for someone else’s fender bender.

Having returned to the agency to correct the error, I then set off with a slightly scratched but correctly recorded compact and headed to Royat, the first hot springs/spa town on my list on this exploratory trip to Auvergne.

I assumed that Royat would be bucolically removed from the city, and my assumption had been reinforced by the fact that a tourist official had told me to give myself 30 minutes to reach Royat from the train station. She must have guessed, though, that I’d spend the first 20 minutes correcting the rental car scratch sheet though, because after only a 10-minute drive my GPS told me that I had arrived. But I didn’t appear to have arrived anywhere other than a slope on the edge of the city. It felt like being in Yonkers after leaving the Bronx, suburban yet still city.

Furthermore, my GPS, I discovered by the end of the day, would accept street names but not numbers, so it would abandon me at the start of a boulevard or avenue and leave me to rely on direct sighting to find my actual destination. My first destination, the Hotel Princesse Flore was indeed at the start of the avenue, but I went up and down the full length twice before feeling sufficiently confident behind the wheel on these narrow, winding streets to raise my eyes high enough to see “Princesse Flore” written on the side.

Timeline for hot spring towns in Auvergne

I’d come to visit this 5-star hotel and the adjacent spa and water park because they represent the latest step in the town’s economic evolution, an evolution that began nearly 200 years ago with the discovery of its hot springs.

Though not the case at Royat (aka Royat-Camalières), some hot springs in the region were already exploited during Gallo-Roman time (e.g. Le Mont Dore). Some supplied hot water and even heating to villagers in the Middle Ages (e.g. Chaudes-Aigues). And some were already attracting visitors in the 18th century (e.g. Chatel-Guyon).

For the most part, however, the development of these hot springs medical/leisure “resorts,” as we would now call them, largely occurred during the 19th century according to the following schema.

1. a trickle of visitors following the discovery of the spring (1822 at Royat);

2. the arrival of developers with a vision (1845 at Royat);

3. an increasing stream of visitors including some fashionable French or European aristocrats, who put the destination on the proverbial map (in 1862 the most notable of French aristocrats visited Royat: Emperor Napoleon III, who suffered from rheumatism, and Empress Eugenia, who suffered from his incurable philandering);

4. the construction from 1880 to 1913, the Belle Epoque period, of ever-grander hotels and villas and buildings with furnished rooms to rent;

5. a restyling, after WWI, of water towns and their installations for the evolving high-end curists (patients taking the cure), their entourage and other vacationers; at the same time, further studies were showing the medical benefits of the waters, whether through bathing, drinking and/or inhaling vapors (mostly for rheumatism at Royat);

6. an attempt to keep on a happy face after WWII despite increasing competition from beach resorts and jet vacations;

7. a fall from grace through the 1960s as thermal baths lost their luster and the state health system pays lesser fortuned visitors to come for a 3-week medical cure, and

8. an attempt since about 2000 for local government to encourage the arrival of medical curists while trying to find ways to develop other forms of tourism with or without the thermal baths themselves.

(There are no luxury resorts among the hot springs that I visit in this series, but that doesn’t mean that Auvergne can’t appeal to luxury travelers seeking rural pleasures.)

Royat, Princesse Flore, Royatonic

Royat itself was never a major spa town despite Napoleon III’s visit—the emperor showered most of his imperial thermal favors to Vichy—, but for a time it held its own. Its medically prescribed thermal facility still welcomes about 9000 “curists” per year with a prescription to take the waters for rheumatism and certain cardiovascular diseases.

The hotel across the street from Royat’s medical thermal center entered the scene at Phase 4 of the timeline above. Built in 1883, it was renovated in the 1920s, as can be seen from the Art Deco styling of the public areas, but fell into decline in the final decades of the century. It closed altogether in 1999 (another half-dozen hotels would close over the following decade), took a deep breath when it was purchased by its current owner, Isidore Fartaria, in 2001, and reopened in 2009 as Le Princesse Flore, named for the owner’s youngest daughter. It is now a 5-star hotel, which places it a couple of notches higher than any of the hotels in the Clermont-Ferrand.

As noted at Phases 6 and 7 above, the moneyed crowded increasingly turned away from hot springs such as these in the decades following WWII. Competition from more modern coastal or foreign resorts coincided with moves to include medical water therapy among those treatments to be covered partially or fully by the French public health system.

It was a double-edge sword. Medical coverage of taking the waters meant that certain thermal facilities would continue to function and perhaps flourish by attracting patients of the national health system, but it also led the well-to-do to spend their well-being funds elsewhere. After all, the latter were not about to hang out with the general and elderly population that could now enjoy (or suffer in) the same the hot springs thanks to a doctor’s prescription that meant that some or all of their expenses covered or reimbursed by the state system (le Sécu) and the rest by complementary insurance.

Several times during the course of my stay in the region I would be told that the Sécu killed the high life of the hot springs in France. While that’s somewhat true (as I’ve noted, coastal resorts and foreign resorts also played a role), the Sécu has also allowed helped these towns to survive.

But no spa town wants to live by Sécu alone. For all its positive effects on the well-being of citizens and long-term residents, doing so could a town into a socialist retirement home. (Interestingly, spa towns tend to vote rightward rather than leftward.) So in recent years Royat (pop. 4500) and other towns have sought ways of giving some economic umph to their aquatic heritage by coupling local or regional public investments with private investients.

The Princesse Flore, privately owned, and the adjacent spa and water park Royatonic, owned by the municipality, are a case in point.

As the top hotel in the immediate Clermont-Ferrand region, the Princesse Flore is primarily (at 85%, according its director) a business hotel. There’s no good reason for an upscale leisure traveler to stay here (might as well leave the urban environment altogether) unless transiting as a family through Clermont-Ferrand on an overnight. However, if I were a business traveler who’d just spent the day at one of those French meetings that end with everyone promising to think about the situation some more and to call each other in another week or two, or three or four because vacations are coming up, I wouldn’t mind coming home to this 43-room hotel. In addition to the visible comfort of the rooms and suites, guests have free access to the watery playground of Royatonic next door and can purchase some spa treatments there.

I did not stay the night since I had a chateau-hotel in the country to look forward to that evening. But I took the time to relax for 15 minutes on a hydro-massage bed (Hydro-Jet) in Royatonic’s peaceable Sanhoa-branded spa treatment area and then made the rounds of steam, baths (cold, warm, hot, scented) and basins of its water park. At Royatonic, the water springs from its source at 86F (30C) and his heated several degrees for the indoor pool and several degrees more for the outdoor pool, which is open year-round.

Royatonic is a public project (with plans for expansion), publicly funded and operated, that, according to its director, turns a profit. How it’s public investment and operation is actually calculated with respect to that profit I leave to French journalists to investigate, but the figure that I was given of 165,000 visitors for last year is indeed significant.

Royatonic is certainly a nice place for locals and for business travelers to gather and relax—except when there’s an underwater spin class going on and the music is pumped up in contradiction of the sign asking visitors to respect the calm.

The group was cycling to the tunes from “Grease”: “Grease lightning, go grease lightening…,” “Tell me more, tell me more, did you get very far…”

So much for relaxation.

Anyway, I’d come for research rather than zenitude, and I had a lunch appointment at Chatel-Guyon, the next spa town on my list.

So I plugged Chatel-Guyon into the GPS, with Anywhere for a street name, and drove into the hills.

© 2012, Gary Lee Kraut

Hotel Princesse Flore, 5 place Allard, 63130 Royat. Tel. 04 73 35 63 63. Princesse Flore is the first French member of Best Western’s Premier association of hotels.

Royatonic and Spa SanHoa, 5 avenue Auguste Rouzard 63130 Royat. Tel. 04 73 29 58 90.

Return to Part I: From Paris to Clermont-Ferrand by clicking here.
Go to:  Part III: Chatel-Guyon.
Part IV: Chateau La Caniere, a luxury hotel.
Part V: Mont Dore, Saint Nectaire, Chaudes-Aigues and Yu.

The post 5 Days in Auvergne: Part II, An Introduction to Spa Towns and Hot Springs By Way of Royat appeared first on France Revisited - Life in Paris, Travel in France.

We are so accustomed to being visitors when back in the U.S. that however warm the welcome of family or friends we sometimes want them to go away for a few days. So, having dropped my dear mother off at the airport where she would board the snowbird flight to Florida, I drove back to her house in New Jersey thinking how much I was going to enjoy the next four weeks. It isn’t that I was planning on running around naked or throwing parties, but, well, if there was a time to run around naked and throw parties this would be it.

To make matters even more promising, the threats of winter that had led my mother to flee south never materialized. The weather remained so unseasonably mild that on the afternoon before one of the aforementioned parties I went out and did something I don’t get the chance to do in Paris: yard work. Saw and clippers in hand I roamed the yard like a mass murderer out for exercise, cutting overgrown branches and vines and plants that may or may not have been weeds.

When my friends came over for dinner that evening it was too dark out to see the very neat property line I’d left in my wake, but they did notice a red spot on my neck and, by the end of the evening, another spot on my forehead.

By the next afternoon I was well on my way to sporting a horrendous case of poison ivy, the likes of which I hadn’t known since a teenager.

Poison Ivy
Poison ivy isn’t easy to explain in New Jersey in December and it’s even more difficult to explain in France since it doesn’t exist here. PI is so commonly associated with “three leaves let them be” that it was easy (for me) to ignore that the dangerous resin is also present in the vine, which is where I went looking for it. Furthermore, the weather was so pleasant that rather than shower or change after cutting the vines I continued to do all of the otherwise harmless activities that one turns to after a couple of hours in the yard, such as going for a walk, rubbing one’s neck, talking on the phone, tugging at one’s waistband, and peeing.

For the next four days I lived like a miserable optimist, believing each day that the rash couldn’t get any worse, only to discover the following day that it had. I withdrew from the world like a leprous hermit in woolen underwear and stayed that way for a full week. I ventured off the property only to send an urgent package at the post office, where the normally tight queue of the Christmas rush stretched out to either side of me like an old Slinky as people looked at me—rather, tried to not look at me—as though I were the Elephant Man. The generally kind postal workers at the West Trenton post office typically make their French counterparts look as though the latter had just collectively learned that they suffered from incurable cancer. But this time the postal worker who had the misfortune of having me approach her counter took my package as if I’d written “ANTHRAX” instead of “FRAGILE” on the wrapping.

Staying inside all day might have been the perfect occasion to write articles from the research I’d done at Versailles prior to leaving Paris, but each time I sat at the computer to describe Marie-Antoinette’s private palace I found myself staring wretchedly at the bubbles on my arm, unable to do anything but google “poison ivy” and eventually click on all 1,370,000 results.

After I had eaten all of the veggie burgers, broccoli heads, low-fat waffles, and Egg Beaters in my mother’s freezer, which go surprisingly well together if you add enough teriyaki sauce, and reluctantly thrown out various packages ominously stamped “best if used by Feb 1996,” my sister Lesley began delivering food to my door during her lunch break—and immediately excusing herself for not staying because she had, um, an important meeting. Carin, my other sister in New Jersey, never made it over because she said that just talking to me on the phone made her itch, which isn’t good for the morale of someone who normally lives 3000 miles away.

Sciatica
After a week of calamine, steroids, and self-pity the rash on my neck and face had cleared up enough for me to go out in public again without shocking anyone, as long as I was discreet about scratching myself under my clothes. I then had several very nice days during which I was able to catch up on the dinner invitations I’d had to postpone, go to a cozy new year’s eve party, and, the weather still being mild enough, play tennis outside. In fact, the steroids I’d taken the previous week to get down the PI swelling on my face seemed to be doing wonders for my tennis.

That, a doctor told me a week later, may be what laid the ground for my sciatica pain. I felt a first twitch at the base of my spine while hitting a glorious crosscourt backhand one afternoon. At first the discomfort may have been partially masked by persistent PI itch along my waist band, but it increasingly announced its presence before changing names to outright pain that shot down the back of my leg. Once again I was certain each day that it could get no worse, until the next day proved me wrong.

The pain turned into an endless cramp that was so bad that Lesley, who had now been delivering drugs along with the food, drove me to the emergency room at 4am on a Saturday night. After that, having befriended Percocet and cyclobenzadrine, I lay semi-conscious on her floor for a few days while her 2- and 3- year-old children gleefully stomped on my head, so happy they were that Uncle Gary had come all the way from France to play.

Between December poison ivy and tennis-encouraged sciatica, I need no further proof that global warming will indeed affect us all in unexpected and dangerous ways.

After a week of doctor visits and medical tests I learned that the root of my suffering was a herniated and degenerated disk, which sounds like something one would buy in Paris. I had to postpone my return flight twice because of the tests and treatment (finally had an epidural cortisone shot) and because an overseas flight in coach is bad enough without nerve damage.

HIPAA
I hadn’t had much encounter with the American medical system in a while so these medical visits were my first experiences with HIPAA, the national health information privacy standards adopted in 1996 and in full effect since 2003.

One of the quirks of HIPAA is that you should be called by your first name in the waiting room so as to guard against the invasion of privacy that would come from other patients being able to identify you through your last name. Such a policy in France would be in direct contradiction with its cultural policy of formal distance, where one would be justly horrified to hear one’s first name being used in such a serious setting.

As Americans we are already accustomed to having everyone call us by our first name, so I think the medical first-name policy is just a way of codifying our natural tendency to buddy up to each other for brownie points. Indeed, there seemed to be no similar discretion when I was repeatedly asked to give aloud my social security number in a crowded office or when one receptionist called across the room, “Gary, are you on any other medications right now?” No, I called back, but I could use an anti-depressant.

The Human Voltmeter
Living in France, I have private, European health insurance that serves as a supped up version of France’s national health care system, meaning that my medical expenses in France are mostly reimbursed or paid for directly by the insurer. When in the U.S., however, I must pay upfront for all medical expenses then hope that I’ll be reimbursed once in France. In other words, I’m treated in the U.S. as being among the legion of the uninsured.

I come from a family of doctors, so I won’t spit on the price of American medical care. I nevertheless found it astonishing to be told upon entering one office that I would have to pay the $500 bill upfront and in cash. This, apparently, is the special price reserved for “uninsured” visitors since insurance companies are unlikely to accept such a price. In announcing the price, the receptionist wasn’t the least bit phased that I didn’t have $500 in cash on me; she gave me a sympathetic look as though I’d told her that I’d left home without having breakfast and gave me directions to the WaWa a mile up the road, where I could find coffee, muffins, and an ATM.

The C notes were for a 10-minute test that involved having my leg poked with an electromyogram, which is simply a human voltmeter and relatively cheap as far as medical equipment goes. In order to get me a quick appointment my referring doctor, a friend, had informed the electrician, uh, physician that I live in Paris. So as he zapped my leg the physician told me about his various trips to Europe, the luxury hotels where he’d stayed, the famous restaurants where he’d eaten, and the cases of wine he’d shipped home.

Now, it is a commonly known cultural tidbit that we Americans are quick to talk about ourselves and about money while the French flee self- and financial revelation like the plague, but one would think that the guy could interrupt his Condé Nast narrative to feign interest in something other than my nerve endings. Yet the more significant insight in this experience was my realization that his discourse was actually part of his job since a doctor who can show that he has expensive tastes is apparently considered more trustworthy than a doctor who cannot. Who would want a doctor who’s never been to Paris, anyway, or at least Cancun?

The MRI
Seven years ago I had my first MRI and discovered that I don’t like being placed in a coffin. I only made it through the ordeal because breaking into a claustrophobic sweat was new to me then and because I believed the technician’s reassurance that it was “almost done.”

Two years ago I had a second MRI in Paris for an injured tendon in my hand and knew better. That MRI required no more than sticking my arm into the tunnel with my head barely inside, nevertheless I thought it necessary to tell the French technician that I was prone to MRI panic. She replied as would any good dominatrix: “Listen, I don’t have time for that, just get in there and stay still!”

On this, my third MRI, I hit the panic button as soon as my head slid into the coffin. The American technician immediately slid me out. She spoke gentle nothings into my ear, put soothing if staticky music on the radio, pulled me out between sequences (I hit the panic button again), had me put on a pair of “magic glasses” (frames attached with a rear view mirror so that the small reasoning part of my brain would know that I was not being buried alive), pulled me out again (“you’re doing great, almost done”), and altogether mothered me through the ordeal in a way that is unimaginable in France.

I don’t think I’d have made it through the 20-minute MRI without the technician’s help, though I suppose that the Valium had something to do with it. The Valium also helped make the $425 bill more palatable, at least this time by credit card.

I did however get trapped in HIPAA hell when I called several days later to ask to have the films sent to my brother, a surgeon in California. The receptionist said she couldn’t because she was unable to identify me over the phone. It didn’t matter that I could recite my credit card number, my birth date, my social security number, my mother’s maiden name, and my pet’s name, nor that I could remember the color of the technicians sweet eyes and the earrings she’d been wearing.

Le Docteur
My insurance coverage in France allows me to be reimbursed for medical care in the U.S. for up to 30 days at a stretch, after which I’m expected to be well enough to return to France for further treatment. Were I to find myself on death’s doorstep in France, however, my policy asserts that I must be repatriated to the U.S., where I suppose I would languish on Medicaid.

France has universal health care, and despite its deficit and the countries notoriously high taxes, its health system actually seems to work. What is most surprising is that it works with little complaint from the public. Nurses are perennially dissatisfied with their pay and their working conditions while doctors (particularly divorced doctors) complain heartily about their taxes, but the public is generally well served without excessive waiting as in some countries with universal health care.

Soon after I returned to Paris I called my doctor here to make an appointment so as to go over my spinal issues and any others that he might discover during a check-up. As with many internist solo practitioners in Paris, my doctor doesn’t have a receptionist (or very high overhead), so he picked up the phone himself. He said that he was off the following morning but could make a trip to the office to meet me if necessary. I said it wasn’t urgent. He said, “Do you want to see me or not?”

One thing I like about my French doctor is that he’s always interested in trying to understand whether there may be a psychological component to an illness, which I find appealing because that way I get free therapy just for having an ear infection. I assured him that my degenerated disk was as real as had been the poison ivy (luckily he knew what PI was), though I admitted that some people would consider my distaste for being buried alive in an MRI as irrational.

But I hadn’t consulted him in 18 months and there were no other patients waiting, so we got into a lengthy wide-ranging discussion about aging, about exercise, about sex, about loved ones and death, about travels and home—for him, for me, and for the scientific community. After over an hour of talking, going over my results from the U.S., doing a simple physical check-up, and renewing the prescriptions I’d been given in the U.S., he concluded that I was a sound and healthy man with a bad back.

Then he charged me $30.

And at the door he kissed me on both cheeks.

My intent here is not to argue for a specific health system but to say that French-style universal health care is not the devil-in-scrubs that conservatives in American believe it to be. For American doctors a $30 consultation with a kiss must seem third-world yet they would undoubtedly agree that a doctor can have qualities (or not) no matter what system he works under. American lawyers, on the other hand, would find French health care shocking and despicable since the French systems of health and law leave little room for malpractice settlements that they would find sufficiently motivating. And they would regret the missed opportunity to sue for sexual harassment.

For now my sciatica has calmed down and the poison ivy is a lesson learned. I fear that one day, before long, I’ll have to submit myself to another MRI, but as I write this I’m fully back into the swing of things in Paris. I’ve nevertheless decided to postpone taking advantage of the series of salsa lessons that were a birthday present from a friend. And I’ve turned down the request from another friend to help in her suburban garden. I’m just going to stay right where I am and enjoy that other perversity of global warming: a warm seat in the sun in a Paris café in February.

© 2007, Gary Lee Kraut

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