Sam’s Blog Week 1- A final year student elective experience in “Les Urgences”- Aix en Provence. April 2015

Vous voulez du ping?

 A bit about me…my name is Sam and I finished my undergraduate medical training in Bristol at the end of March. We then have 2 months to go off and do a medical elective anywhere in the world. I set out to do something French speaking as I have a base level of French but have never really achieved fluency. I did AS-level and have been to France for the odd holiday so can order a beer and a coffee, but that was about it really. I’ve somehow been lucky enough (with some help) to end up in Aix-en-Provence for my elective, doing emergency medicine, which is perfect. In preparation for my elective I did some evening French classes to try to hit the ground running, which after the first week I’m glad I did!

 Language

Landing at Marseille on Sunday there was a bit of a heated discussion between two French guys in a queue for bus tickets, I did not catch a single word they said which I found slightly disconcerting. Language-wise the first few days in hospital were a struggle, but everybody has been very patient with me and I received a very warm welcome. I’ve found that I can understand most of what is going on, but need lots of work on my speech. There are a lot of similarities in medical terminology, so if in doubt, try the English disease or symptom with a French accent. By the time I get back to my little flat each evening I am absolutely knackered, understanding and talking French all day uses a part of my brain that doesn’t usually get much exercise!

I hadn’t really prepared myself for how different the southern accent is to what I’ve been taught and know. On the first day I was asked in a supermarket “vous voulez du ping?”, I politely declined not having a clue what she had just offered me, realising on the walk home what she said. Words such as “demain” (tomorrow) become “deming”, “bien” (good) becomes “be-ing” and “pain” (bread) becomes “ping” with the strongest accents.

The hospital

This week I have spend primarily with the infirmières d’acceuil et orientation (IAO), essentially the front door triage service. All patients brought in by ambulance are triaged, have a set of obs before being referred on to the most suitable place for their needs. Walk in patients are also seen here.

Some patients are sent to filière longues (in patient for up to 3 days) or filière courte (dealt with by a duty doctor on the same day). I spent some time with a couple of the interns (similar position to F1/F2 in the UK, I think) doing filière courte. Patients coming in range from twisted ankles, broken feet needing plastering to lacerations needing suturing.  Essentially the aim of the service is to prevent unnecessary admissions. One of the interns I was with on my second day asked if I would like to do the consulting, unfortunately I declined as I don’t think that my French is up to that yet, hopefully will be able to in a week or two.

One interesting case I saw is of a young man with a pneumothorax, he was in dechocage (resus) and had a chest drain inserted. There was a very loud hiss of air escaping when the doctor entered the pleural cavity to insert a drain (as described in textbooks).

One of the most noticeable things as a foreigner (and having never really spent any time in a French workplace before) since being in the hospital is the cultural difference when greeting people. Kisses on the cheek and handshakes left, right and centre. I think it is just a fundamental difference between British and French cultural norms, but to an outsider it gives the impression that the department is very tightly knit.

Sam Gilbert