Growing up in and around London, I had some grasp of the difficulties people experience when they change cultures and emigrate to the UK. Having lived in France for a year, I think my understanding has grown a little.
I am not thinking about the impact of racism or xenophobia – although attitudes towards ‘les Anglais’ are complex, nuanced and shaped by historical events – but I am thinking about the small things of everyday life.
First there is an overwhelming sense of being somewhere foreign. The language is different, the customs are different and the institutions run in a different way. Often the most disorienting experiences are when a difference that you don’t expect jumps up and slaps you round the face – for me, the most alarming was the totally different style of language teaching. It was my only incident (so far) of total meltdown.
Language, of course, is key. My partner understands and speaks French at a very high level – higher than many French university students. However, when she returns to our home, she is desperate to speak English – her native tongue.
It is not that she dislikes speaking French, refuses to integrate into French society or chooses to disrespect France in any way. Simply, speaking English allows her to express herself with ease and to express exactly what she means and feels without any risk of being misunderstood.
Some French philosophers of language have railed against youth culture and its “corruption” of the true French language. They claim that one can only truly express one’s true self and be a fully-developed human being if you speak French properly, using all the tenses and grammar correctly.
Although I think their argument is elitist and reactionary tosh used in this context, I do think it gives some insight for those living in a country where they do not speak the native tongue. I have felt a huge frustration in not being able to express myself and my ideas to the people I have met. They have not seen or heard the real me.
I can understand how people living in a foreign country can become isolated, depressed and submerge themselves in familiar customs and pastimes from home. This is particularly true for those who haven’t travelled to work or study – those, like me, who are ‘the housewife’.
At all times, it was important for me to put my experience in perspective, to focus on the excitement and opportunities of my year away and to remember that it was just a year. If we had been staying permanently, I would have had to form different expectations and done things differently – like regular work or volunteering.
We chose to spend time with mainly French people. However, when we did meet others from the English-speaking world, I could understand how mixing with others with similar origins becomes an opportunity for immigrant people to rediscover their true selves – a feeling of liberation, mixed in with the sadness and sense of loss that one gets with nostalgia.
Another specific factor for me was having a long-term health condition. Although France has a magnificent health system, it was an unfamiliar one. I believed that I would be well looked after (and I have been), but I was always plagued with the anxiety that something would go wrong and I wouldn’t know how to access the help or advice I needed. That suddenly one of those unexpected differences would rear its ugly head and throw everything into chaos.
Throughout the year, I have had glimpses of how the experience of living in a foreign country could turn into a negative and self-destructive one. Loss of familiarity, belonging and identity is depressing and can turn into an alienation from society and a contempt for these different ways and of the local people.
It’s a sad, but understandable process – whether you’re someone come to work in the UK or a British ‘ex-pat’ gone to retire in Spain or work in some far-flung corner of a former empire.
I think I brought with me some skills that helped me profit from the year and avoid the negativity. Language was not one of them – although a higher level of French would have really helped!
A level of self-awareness and constructive self-criticism was useful to continually re-adjust and re-focus as time went on – because everything changes all the time.
I am quite experienced at setting myself goals and coming up with achievable small steps to reach those goals. Again, with everything changing all the time, small steps are what work – or not, and that’s where the self-awareness comes in to readjust those steps and goals.
Eventually, I devised a routine that, although I wasn’t working, meant that I was using my time productively with a good mix of going out, staying in, physical activities, mental activities and creativity. Without overstretching my rather fragile body, of course.
When I look back on the year one achievement was to survive a year in France, but I achieved a lot of other things too.
At the moment, I believe that I am managing my Crohn’s disease better than I ever have done before, something that is very pleasing. However, I am just a little anxious that I will struggle to take this achievement back to the UK with me.
I need to remember that there will be some reverse culture shock when I return – but I have shown I have the skills and temperament to overcome that. There will not be the issue of language and, for that, I am hugely relieved.
Monday, 27 July 2009
Monday, 20 July 2009
Hands off our butter!
That double dose of Remicade™ really seems to be working. It has, as promised, knocked my Crohn’s back and I feel a lot better.
It feels like a fast-working dose of steroids, but without the side-effects.
I remember when I had a flare-up last November that my consultants were disappointed that I was put on steroids by the emergency doctor. They said I could have had more Remicade™, but I didn’t really understand how. Now I do.
What are the chances I can persuade my consultant in the UK to use the occasional double dose of Remicade™ when my symptoms flare up? Currently, I am more concerned about getting my next infusion booked in on time.
It has been pleasant to be treated in a health system where costs and budgets still seem to be less important that the quality of patient care. However, as I’ve said before, the new French president is very keen to change this.
One of the first skirmishes over cost-cutting has occurred recently in Caen. The hospital management introduced a reduction in the butter ration for patients’ meals from 15g to 10g.
This being Normandy, dairy products are a very sensitive issue.
The reaction from hospital staff and patients’ groups was swift and political – they denounced the attack on patients’ comfort whilst the director of the hospital was given over £400,000 of tax-payers’ money to upgrade his luxury house.
Although it worries me that the French government’s agenda is to run the health service as a business, it is heartening that serious protests are happening now over the first few job losses – and over cuts in butter rations.
The millions of people on the streets during the one-day general strikes earlier this year had the issue of cuts in the hospitals at the forefront of their minds. The French trade union movement have a habit of stopping unpopular government reforms.
In the UK, the symptoms of a market-driven NHS go further than butter rationing. People dying on trolleys in corridors, waiting lists, cancelled operations, post code lotteries and declining dental health are some of the realities that French doctors and health unions see just over the channel and which fuel the opposition to Sarkozy’s reform plans.
It feels like a fast-working dose of steroids, but without the side-effects.
I remember when I had a flare-up last November that my consultants were disappointed that I was put on steroids by the emergency doctor. They said I could have had more Remicade™, but I didn’t really understand how. Now I do.
What are the chances I can persuade my consultant in the UK to use the occasional double dose of Remicade™ when my symptoms flare up? Currently, I am more concerned about getting my next infusion booked in on time.
It has been pleasant to be treated in a health system where costs and budgets still seem to be less important that the quality of patient care. However, as I’ve said before, the new French president is very keen to change this.
One of the first skirmishes over cost-cutting has occurred recently in Caen. The hospital management introduced a reduction in the butter ration for patients’ meals from 15g to 10g.
This being Normandy, dairy products are a very sensitive issue.
The reaction from hospital staff and patients’ groups was swift and political – they denounced the attack on patients’ comfort whilst the director of the hospital was given over £400,000 of tax-payers’ money to upgrade his luxury house.
Although it worries me that the French government’s agenda is to run the health service as a business, it is heartening that serious protests are happening now over the first few job losses – and over cuts in butter rations.
The millions of people on the streets during the one-day general strikes earlier this year had the issue of cuts in the hospitals at the forefront of their minds. The French trade union movement have a habit of stopping unpopular government reforms.
In the UK, the symptoms of a market-driven NHS go further than butter rationing. People dying on trolleys in corridors, waiting lists, cancelled operations, post code lotteries and declining dental health are some of the realities that French doctors and health unions see just over the channel and which fuel the opposition to Sarkozy’s reform plans.
Saturday, 18 July 2009
My last Remicade™ in France
Thursday was my last trip to the hospital for my Remicade™ infusion. The next will be back in the UK in, hopefully, eight weeks’ time.
The blood test taken on Monday showed that I had quite a lot of inflammation, suggesting that the reason for me not feeling great over the last few weeks was my Crohn’s becoming more active.
As usual, I was assessed by a doctor before my infusion. I was then seen by the consultant in charge of the unit. She decided that I would need a double dose of the Remicade™ and that they wanted to “look inside me”.
My heart sank at those words. In the UK that would mean a colonoscopy or small bowel study and a wait of 4-6 weeks – in other words, just before or after our departure.
Then I remembered that we were in France and things happen quicker, but I was worried I would get an appointment the following week while we had visitors.
I was still mulling over all these possibilities when I was told to put on my shoes as the porter would be taking me down to have my scan in a few minutes.
So, I took the lift to the first floor, an ultrasound scan of my bowel was done, the results phoned up to the unit and my infusion hooked up – all within 60 minutes.
The results showed nothing particularly abnormal, with no serious small bowel strictures requiring surgery. I was simply stunned by the rapidity and thoroughness of the assessment. My mind was put at rest, rather than worrying for 4-6 weeks.
I think I’ve only ever had one ultrasound scan of my bowel done in the UK. In France and the US it is much more common. With good training and an experienced eye, research has shown that it is as accurate as other diagnostic procedures – especially in more serious cases. It’s also quicker, cheaper and less intrusive.
I’ve also never been offered a double dose of Remicade™ in the UK, but this appears to be standard in the US and France when symptoms return and the Crohn’s needs knocking back into shape. The standard dose is 5mg/kg of body weight, so the double dose is 10mg/kg.
In fact, there is an almighty battle at the moment over whether Remicade™ should be available at all as a maintenance treatment for new patients. For me, the drug has had a profound impact on my disease and my ability to get more out of life – this year would probably have been impossible without it.
The blood test taken on Monday showed that I had quite a lot of inflammation, suggesting that the reason for me not feeling great over the last few weeks was my Crohn’s becoming more active.
As usual, I was assessed by a doctor before my infusion. I was then seen by the consultant in charge of the unit. She decided that I would need a double dose of the Remicade™ and that they wanted to “look inside me”.
My heart sank at those words. In the UK that would mean a colonoscopy or small bowel study and a wait of 4-6 weeks – in other words, just before or after our departure.
Then I remembered that we were in France and things happen quicker, but I was worried I would get an appointment the following week while we had visitors.
I was still mulling over all these possibilities when I was told to put on my shoes as the porter would be taking me down to have my scan in a few minutes.
So, I took the lift to the first floor, an ultrasound scan of my bowel was done, the results phoned up to the unit and my infusion hooked up – all within 60 minutes.
The results showed nothing particularly abnormal, with no serious small bowel strictures requiring surgery. I was simply stunned by the rapidity and thoroughness of the assessment. My mind was put at rest, rather than worrying for 4-6 weeks.
I think I’ve only ever had one ultrasound scan of my bowel done in the UK. In France and the US it is much more common. With good training and an experienced eye, research has shown that it is as accurate as other diagnostic procedures – especially in more serious cases. It’s also quicker, cheaper and less intrusive.
I’ve also never been offered a double dose of Remicade™ in the UK, but this appears to be standard in the US and France when symptoms return and the Crohn’s needs knocking back into shape. The standard dose is 5mg/kg of body weight, so the double dose is 10mg/kg.
In fact, there is an almighty battle at the moment over whether Remicade™ should be available at all as a maintenance treatment for new patients. For me, the drug has had a profound impact on my disease and my ability to get more out of life – this year would probably have been impossible without it.
Sunday, 12 July 2009
C'est la vie...
I had half expected to be fighting a non-stop battle with colds this year.
I’m not sure if the viruses are any different here than in the UK, but a combination of my immuno-suppressive medication and the low-level stress of living in a different environment was always going to give the little blighters an advantage.
And I do seem to have had a succession of colds since the end of last summer, more than I usually get in the UK. What is typical – especially since I started on Remicade – is that I feel full of aches, with a blocked nose and sinuses and a lingering headache.
I also feel wiped out and exhausted, so it’s not always apparent if it is my Crohn’s playing up as well. Sometimes all this seems to trigger my guts to go haywire in any case.
It’s all rather annoying and frustrating as these colds interfere with me enjoying life in France almost as much as my Crohn’s does. And so it is good to have moan and feel sorry for myself from time to time.
Our French friends and acquaintances have all been very concerned about the ups and downs of my health, all of which has been very genuine and comforting. In the UK, I feel that talk about health problems creates distance between people rather than bringing them closer together – unless the problem is shared, of course.
I think I can support the theory that it takes much longer to get to know people in France than in the UK, but, unlike in the UK, conversations about health problems arrive very early in this process.
Bowels are a particularly common topic of conversation if the opportunity arises. Maybe this is something to do with the importance of food and drink in French life and culture?
Yet toilets are notoriously filthy (although much less than 20 years ago) and often unisex, with urinals next to the shared hand basin. It is still always a good idea to carry toilet roll or tissues too.
Although these differences freaked me out a little when we arrived, they are just normal now. Somehow, avoiding all mention of bowels and going to pristine toilets with piped music and automatic air-freshener seems weird.
Will I be able to re-adjust? Will I be seeking out the most filthy, smelly and overflowing public toilets in Brighton? I suspect the problem will be finding any at all.
As I have said before, I am a little anxious about going back to the UK and the swine-‘flu pandemic – there are still only 400 cases in France, mainly people who have had holidays in Mexico, America and Britain.
I know what to do – get registered with a GP as soon as I get off the ferry and take all the precautions I always do – but I cannot feel 100% relaxed about it all. Especially as I seem to pick up every bug within a 100 km radius.
I’m not sure if the viruses are any different here than in the UK, but a combination of my immuno-suppressive medication and the low-level stress of living in a different environment was always going to give the little blighters an advantage.
And I do seem to have had a succession of colds since the end of last summer, more than I usually get in the UK. What is typical – especially since I started on Remicade – is that I feel full of aches, with a blocked nose and sinuses and a lingering headache.
I also feel wiped out and exhausted, so it’s not always apparent if it is my Crohn’s playing up as well. Sometimes all this seems to trigger my guts to go haywire in any case.
It’s all rather annoying and frustrating as these colds interfere with me enjoying life in France almost as much as my Crohn’s does. And so it is good to have moan and feel sorry for myself from time to time.
Our French friends and acquaintances have all been very concerned about the ups and downs of my health, all of which has been very genuine and comforting. In the UK, I feel that talk about health problems creates distance between people rather than bringing them closer together – unless the problem is shared, of course.
I think I can support the theory that it takes much longer to get to know people in France than in the UK, but, unlike in the UK, conversations about health problems arrive very early in this process.
Bowels are a particularly common topic of conversation if the opportunity arises. Maybe this is something to do with the importance of food and drink in French life and culture?
Yet toilets are notoriously filthy (although much less than 20 years ago) and often unisex, with urinals next to the shared hand basin. It is still always a good idea to carry toilet roll or tissues too.
Although these differences freaked me out a little when we arrived, they are just normal now. Somehow, avoiding all mention of bowels and going to pristine toilets with piped music and automatic air-freshener seems weird.
Will I be able to re-adjust? Will I be seeking out the most filthy, smelly and overflowing public toilets in Brighton? I suspect the problem will be finding any at all.
As I have said before, I am a little anxious about going back to the UK and the swine-‘flu pandemic – there are still only 400 cases in France, mainly people who have had holidays in Mexico, America and Britain.
I know what to do – get registered with a GP as soon as I get off the ferry and take all the precautions I always do – but I cannot feel 100% relaxed about it all. Especially as I seem to pick up every bug within a 100 km radius.
Sunday, 5 July 2009
Le Grand Départ
This is a big weekend in France, with the start of the summer holidays and the start of the Tour de France bicycle race. Both are called the Grand Départ.
As I’ve mentioned, we are staying here in Normandy for our holidays. Temperatures remain reasonably cool here during the summer which is just right for me. Friends on holiday in the south are telling us it is too hot there – nearly forty degrees centigrade last week.
Unfortunately the Tour doesn’t pass through the west of France this year. After going to the Le Mans 24 hour race, I would have liked to catch one of my other highlights of the sporting year.
However, like last year, it will be a treat to watch as many stages as I want, live on TV. Most of the action is in the mid to late afternoon when I am trying to stay cool and resting at home.
I tried to claim that the 24 hours race at Le Mans was some sort of sporting metaphor that could help those of us with a long term illness. I’m not sure if I can make a similar claim for the Tour.
The race itself is quite brutal. The competitors put themselves through three weeks’ of physical torture that would kill the vast majority of people. The overall winner has to rely on selfless teamwork, perfect strategy, high-level psychological warfare plus amazing fitness and cycling talent.
Professional cyclists stand out from the rest of humanity by their extreme physique and their extreme single-mindedness. Everything is focused on winning and the high intensity training damages professional cyclists’ immune systems – so they are more susceptible to coughs, colds and viral infections.
Of course, focussing on winning means that there is an ongoing battle between the sport’s officials and those riders who use artificial methods to get an edge over their rivals. Drug scandals are so numerous in the Tour’s recent history that it is no longer a surprise when an amazing performance on a stage is found to be drug-fuelled.
I’m not saying there are any similarities here with the average person with Crohn’s disease (particular the performance-enhancing drug aspect), but I have been fascinated by the Tour de France ever since I came across it in my teens.
I could claim that cycling is truly a noble sport and shows us what we can achieve if we really set our minds to it. However, despite being a really enthralling and, at times, incredibly exciting three weeks, I think what it does show us is that being obsessed with physical perfection doesn’t actually make you a very nice person.
So, I will continue to follow cycling (see picture below from the Tour of Normandie earlier this year) rather than being tempted to get on a bike myself. I don’t think my body would ever forgive me – a leisurely walk or a dip in the pool is about as much as I can get away with.
As I’ve mentioned, we are staying here in Normandy for our holidays. Temperatures remain reasonably cool here during the summer which is just right for me. Friends on holiday in the south are telling us it is too hot there – nearly forty degrees centigrade last week.
Unfortunately the Tour doesn’t pass through the west of France this year. After going to the Le Mans 24 hour race, I would have liked to catch one of my other highlights of the sporting year.
However, like last year, it will be a treat to watch as many stages as I want, live on TV. Most of the action is in the mid to late afternoon when I am trying to stay cool and resting at home.
I tried to claim that the 24 hours race at Le Mans was some sort of sporting metaphor that could help those of us with a long term illness. I’m not sure if I can make a similar claim for the Tour.
The race itself is quite brutal. The competitors put themselves through three weeks’ of physical torture that would kill the vast majority of people. The overall winner has to rely on selfless teamwork, perfect strategy, high-level psychological warfare plus amazing fitness and cycling talent.
Professional cyclists stand out from the rest of humanity by their extreme physique and their extreme single-mindedness. Everything is focused on winning and the high intensity training damages professional cyclists’ immune systems – so they are more susceptible to coughs, colds and viral infections.
Of course, focussing on winning means that there is an ongoing battle between the sport’s officials and those riders who use artificial methods to get an edge over their rivals. Drug scandals are so numerous in the Tour’s recent history that it is no longer a surprise when an amazing performance on a stage is found to be drug-fuelled.
I’m not saying there are any similarities here with the average person with Crohn’s disease (particular the performance-enhancing drug aspect), but I have been fascinated by the Tour de France ever since I came across it in my teens.
I could claim that cycling is truly a noble sport and shows us what we can achieve if we really set our minds to it. However, despite being a really enthralling and, at times, incredibly exciting three weeks, I think what it does show us is that being obsessed with physical perfection doesn’t actually make you a very nice person.
So, I will continue to follow cycling (see picture below from the Tour of Normandie earlier this year) rather than being tempted to get on a bike myself. I don’t think my body would ever forgive me – a leisurely walk or a dip in the pool is about as much as I can get away with.
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