Wednesday, 11 March 2009

Trust me, trust me...I'm a doctor.

I am not allowed to give blood in France because I could have 'Mad Cow' disease. This rule applies to anyone who lived in Britain during the 1980s. But now my dental surgeon wants to transplant a piece of dead cow into my mouth. Now why would I agree to that?

I ask him. He says this is the treatment he recommends. I know the sub-text: he is the specialist, I must trust him. "But what exactly is 'bovine material'?" His secretary gives me a glossy leaflet. It explains that 'bovine material' is harvested bone from the carcasses of dead cows farmed in America, which it claims, is perfectly safe. Excuse me, but as the glossy leaflet was produced by the company selling the bone it would say that wouldn't it? I Google "cow bone jaw dental transplant". I find nothing particularly persuasive or dissuasive but decide: "No way", anyway. I will not be surprised if the dental surgeon refuses to treat me when I tell him.

This highlights a big difference between the NHS and the French health service. In Britain doctors jump through hoops to explain everything in great detail and give patients the choice. In France doctors tell you what to do on the understanding that they went to medical school and they know best. I prefer to think that in most cases doctors, having completed years of studies and exams, do know best. And if not best, then certainly better than the vast majority of their patients. Then again, if you were a haemophiliac given contaminated blood in the 1980s in Britain or a child given contaminated growth hormone around the same era in France, you would not agree.

The whole doctor-patient relationship has been further complicated by the Internet that has made us all armchair specialists. It has demystified medicine, science, biology, our private lives, the world, the universe, even nuclear physics. Well, perhaps not nuclear physics. The information is out there, masses of it, most of it contradictory much of it plain wrong. I can Google 'pain in stomach' and come up with anything from indigestion to cancer. The Internet can tell me what it might be; only a doctor can tell me what it is.

To be honest, I don't know which way to go on this one. For years I had a monosyllabic French doctor who refused to let me leave without a prescription for at least five drugs, several of them over the counter stuff like painkillers that I didn't need and didn't take. At the end of every appointment he would press me to take a sick note from work (useless as I'm my own boss). He never explained anything; I was expected never to complain.

Now I have a wonderful friendly but no-nonsense British GP in Paris. She is very happy to explain and reassure and I am confident she only gives me drugs I really need. In the Internet age trusting your doctor is a leap of faith, but I do think she knows best because she has never given me any reason to doubt it.

As for the "bovine material". There's no way it's going anywhere near my mouth. I'm not that mad.


Nicol said...

I don't think I would go for that treatment either. It would be different if it was from another human, but a cow. No way!

Anonymous said...

Wise decision, I would have done exactly the same!

Louise said...

That sounds horrific - a bit of mad cow in your mouth? Forget it!

Jaywalker said...

You didn't see Envoyé Spécial on dental prostheses did you? It was horrifying. Gah. Never wish to go to dentist again.

Anonymous said...

My neighbour has just popped in to say that as she'd been at the Drs. he asked her to call in and tell me that my blood tests were fine!

That would NEVER happen in the UK and made me laugh.

Enjoying your blog.


Dumdad said...

I have a French woman doctor and she's fine. But, like all doctors over here, you have a slight case of the sniffles and they give you enough medication to serve Zimbabwe for a week.

Iota said...

Scientific progress has never been able to replace the trust relationship.

Henry the Dog's Mum said...

In my view you're absolutely right to refuse to have anything cow inserted into your mouth. As for French GPs, well I still go to the UK to have my breasts monitored by my consultant there, I don't trust my rather slender grasp of the French language and for that reason will always go to the UK for all things medical, including my dentist. I like to know exactly what is going on. And yes, the internet has demystified many things medical, but it has also turned lots of people into hypochondriacs (like me)

Parisgirl said...

Nicol, I'm not sure I'd like another human's bone in my mouth either, to be honest!
Rosiescribble, Louise, thanks for the support.
Jaywalker, no I didn't see ES. Rather glad I didn't in the circs.
NWBD, made me laugh too!
Dumdad, I know, and often the medication is something like Aspirin that you could have bought over the counter. No wonder the Secu is so far in the red.
Iota, I agree, but I think the Internet has made people question their doctor's judgement and weakened the trust relationship.
Henry's Mum, it hasn't turned me into a hypochondriac (yet) but it has made me sometimes think I know better than my doctor, which is not such a good thing!

bonnie-ann black said...

i went to Oxford for one measly summer term and i am forever banned from giving blood in the US. it wasn't always this way. i used to give blood twice a year, and platlets once a year (i have particularly desirable platlets). then, two years ago, the NYC Blood Bank decided my blood was no longer donor worthy because i had spent three months in england more than 12 years ago! no amount of reasoning could persuade them that this is madness.

so, i couldn't give blood, but they wanted me to volunteer to test an AIDES "vaccine". i declined, and it turns out to be a good thing, because 4 people actually got HIV from the supposed "dead" virus.

however, twice a year, i still get pleading letters asking for "desperately needed blood donations." i always return them saying, "read your damned files."

it's very infuriating because i could easily lie on my form and say i wasn't ever in europe, but i won't do that.