How have I been able to walk, drive and climb stairs?

Two months ago, my left leg was pinned to the ground by a branch of a felled walnut tree that I was cutting up with a chainsaw. A few weeks ago, I included in my blog a photo taken by my doctor [display]. I seem to have recovered well and rapidly. However, a month ago, during my first and only medical consultation since the accident, my general practitioner Xavier Limouzin decided that I should obtain further images of my knee (ultrasound and magnetic resonance imaging) to make sure that everything was OK. A few weeks ago, the ultrasound image confirmed what the initial X-ray photos had suggested: namely, that there was no fracture anywhere and no thrombosis. Well, this morning, at the hospital in Romans, I was most surprised to learn what MR images revealed.

I've just taken this photo of my legs. I'm still attired as I was for the MRI session: shorts and sandals. Well, although these two rather ordinary knees appear to be fairly similar, there's a big difference. The left knee has in fact been fractured, without my realizing it, for the last two months. (I'll be interested to learn why the X-rays didn't reveal this fracture.) To demonstrate what he was telling me, the friendly specialist at Romans clasped my left kneecap between his fingers and said: "I'm squeezing my fingers at the place where your knee was broken. That's probably painful. No?" I had to tell him that I didn't feel a thing. Maybe I'm becoming an insensitive zombie. I asked him what I should do, to stimulate the healing process. He replied: "Lots of rest. No hard work. Keep off your knees. There's nothing better than long hours stretched out on a sofa watching TV."

While at the hospital, I thought that I might return the brand-new blue splint they had given me on the day of my accident. It's much the same form as the leg-protection worn by cricketers. I only wore this splice on the first night, then never again. So, I imagined that I would be acting as a good citizen in returning it to the hospital. Since the MRI unit is located just alongside the emergency ward, I walked in through the landing where ambulances pull up, and promptly found myself in exactly the same hall where I had waited for treatment two months ago. The staff were handling a fellow whom local firemen had just wheeled in on a trolley, parked just alongside me. It took me a few minutes to realize that the middle-aged fellow, wrapped in a white sheet from which his head and bare feet protruded, and lying limply on his left side, was in fact dead. I was fascinated to realize (for the first time in my life) that the behavior, speech and attitudes of professional people dealing with a corpse are quite unlike situations in which the patient is still alive. Several tiny details (such as the fact, for example, that nobody seemed to be concerned that the fellow's face was pressed hard against the metallic edge of the trolley) sent out messages indicating that the patient was no longer alive. Meanwhile, a secretary informed me that I could hang on to my splint, since they did not seek to recuperate such items. I was happy to jump into my car and drive home.

Checkup

Many years ago, back in Paris, one of my former employers told his assembled staff: "The challenge of becoming rich involves two aspects. On the one hand, you have to earn as much money as possible. On the other hand, you must spend as little as possible."

I've often thought that our health situation is similar. On the one hand, you must have access to top-quality medical services… including, above all, an excellent GP (general practitioner). On the other hand, you have to avoid running into health problems. Elementary, my dear Watson. (Apparently Sherlock Holmes never pronounced this apocryphal phrase in any of the sixty detective novels written by Arthur Conan Doyle.) I consider myself fortunate in the sense that, in my personal case, both these conditions appear to prevail.

I drop in at the GP's rooms in Pont-en-Royans once every three months for a renewal of the prescription for three or four pills that I've been taking over the last six years. The ritual is always the same. The GP tries to imagine what kind of medical tests he might be able to impose upon me, through his specialist colleagues in the nearby cities of Valence and Romans. Since my prostate has been removed, and since I perform regular checks for colon cancer, I've become a relatively dull candidate for tests… but I'm sure my GP will think of something one of these days.

A long time ago, he informed me that my cervical vertebra resembled worn-out parts in an aging automobile, and that this could well bring about fits of vestibular giddiness. Back at the time the GP said that, I didn't really believe his diagnosis. On the one hand, I never have a stiff or painful neck (in spite of sitting upright in front of a computer screen for hours on end, seated on a hard wooden chair). On the other hand, if I felt giddy at times, particularly when I looked skywards, I imagined this as the first symptoms of some terrible form of cerebral decay. Maybe I had inherited it from my ancestor Charles Walker, innkeeper on the Braidwood goldfields, who used to drink too much of a beverage invented by a Scotsman named Johnnie Walker who, I believe, was his brother. If Charles had died in 1860 of delirium tremens, and if his great-great-grandson felt giddy from time to time when he was wandering around on the slopes with his dogs at Choranche, it's clear that this had nothing to do with neck bones; it was the inherited fault of bad neurons.

Reluctantly, however, I was obliged to admit to my GP that, one morning a month or so ago, I woke up with both a sore neck and a bit of giddiness. Later on in the morning, just to see whether or not it might work, I performed energetic exercises with my arms, neck and shoulders. By midday, both the pain in the neck and the giddiness had totally disappeared. So, that certainly proved something… and my GP agreed! I did have the impression, however, that he looked at me with a puzzled expression when I was telling him this story, as if I might indeed have decaying whisky-soaked neurons in my inner brain.

The GP's test for blood pressure always follows a similar ritual. Lying on my back, I tend to forget that he's busy trying to determine my blood pressure, and I carry on talking, in anything but a relaxed state. He frowns because his reading is lower than expected. At that stage, he always asks me the same question: "Do you check your blood pressure regularly at home?" And I always tell him that I wouldn't have the faintest idea about how to perform such an operation. By that time, I'm standing up, and my body is no longer tense. And, in this position, the GP's new reading of my blood pressure reverts to its normal value, which seems to please him greatly.

After that incident, the GP sets his computer in action, so that it prints out a new copy of my regular prescription. He functions in multi-processing mode by simultaneously recording my payment, signing my prescription and talking on the phone with his wife. Besides, this red-blooded lady's man seems to be amused when I say that this kind of aptitude is generally strictly feminine.

At that point in my visit to the GP, the serious part of our encounter can get under way. I'm talking of our regular conversations about books, science, the Internet, etc. The other day, the GP set the ball rolling.

GP: "I bought the two Dawkins books you mentioned, and found them highly interesting."

Knowing nothing of the quality of French translations of books by Richard Dawkins, I had nevertheless recommended that he might read The God Delusion and The Greatest Show on Earth. Parts of the first book, on atheism, had apparently impressed my GP greatly. In particular, he liked the explanations about the plasticity of the minds of tender children, who can be made to believe anything they're told. Meanwhile, the overall American situation was news to him.

GP: "I was amazed to learn that declaring oneself an atheist in the USA prevents you from being considered as a decent citizen, capable of becoming an elected politician."

William: "At least it's not like that in France."

GP: "It's the opposite here. Politicians like to make themselves out to be free-thinking Republicans, liberated with respect to religious bias. But, as soon as one of their leaders dies, they all flock along to the cathedral of Notre-Dame to pray for the soul of their dead companion."

Talking of believers and non-believers, an interesting Harris poll has just been conducted here in France, where we imagine that the faithful continue to flock to Sunday Mass, albeit in dwindling numbers.

Roughly a third of the population say they're believers, and a third, atheists. The remaining third is characterized by the fact that they simply don't know whether or not God exists. Among them, most people feel that this question is interesting, whereas others say it's not. Those results are unsurprising. What amused me greatly, on the other hand, is the fact that a third of the religious folk who said they were Catholics went on to reveal that they nevertheless don't really believe in the existence of God. Now, I like that approach! That's the kind of Catholic I myself might be, if I set my mind to it. Besides God, the Devil and the Holy Ghost, though, I would also refuse to believe in popes, saints, miracles, priests and all the rest of the ugly rubbish, including relics.

Victims of bad water and sanitation

At a first rapid glance, this spectacular photo seems to depict a military cemetery, but it's probably simply a manufacturer's storage yard.

I found this image on the following website:

Now, it's my sister Anne who might not feel happy about the choice of this date, because it's her birthday. Be that as it may, the organizers of this celebration (?) have chosen the above photo to highlight the fact that—as they point out on their website—"the water and sanitation crisis has claimed more lives than all the wars of the 20th century". And this is no laughing matter… although they might have invented a more solemn name for their day. On the other hand, their chosen name and their photo certainly attract attention.

Deadly palm oil

In certain domains, the environmental and well-being awareness of my Australian compatriots is far in advance of the French situation. It's only recently that stickers announcing the absence of palm oil have started to appear, here in France, on certain packets of sliced bread.

In Australia, on the other hand, a dynamic consumer movement opposing the palm-oil industry has existed for quite some time.

The product is potentially "deadly" both for human beings with cholesterol problems, and for the jungle creatures (such as orangutans) affected by deforestation followed by palm plantations in Indonesia, Malaysia and Papua New Guinea.

To be perfectly coherent in the environmental combat against palm oil, we should even abandon a splendid old French product: traditional Marseille soap. Now I have a friend down there, in Marseille, who won't be too happy when she hears me saying that. In fact, Natacha recently gave me a stock of this fine soap that's large enough to keep me clean for years to come.

Public health

Seeing these proud and happy and faces, I feel like opening a bottle of champagne and raising my glass: Amérique, à ta santé! [Health warning: Alcoholic beverages must be consumed with moderation.] But there's still a long road ahead before the bill is transformed into effective law.

Here in France, a major step aimed at reducing the financial deficit of the public health system consists of requiring physicians to prescribe so-called generics rather than the original and expensive brand-name medicaments. For years, like millions of other people, in France and elsewhere, I've been taking the inhibitor of blood thickening named Plavix, in its familiar blue packet.

I would imagine that the giant French pharmaceutical company Sanofi-Aventis must have spent a tidy sum of money in the invention of the name Plavix, which would be fit for a luxury sports car. This product has always had the reputation of being particularly expensive... but this has not prevented it from becoming one of the most widely-prescribed medicaments in the world.

Well, a few days ago, the local pharmacist gave me the generic product that is proposed as a substitute for Plavix.

I almost broke out laughing when I discovered the name of the active molecule, which will be used universally for all generics intended to replace Plavix: Clopidogrel. Really, it rings in my ears like the name of some kind of supermarket soup for hungry horse-sized mongrel dogs that make a clip-clop noise when they canter. On winter mornings, after going out for a pee, I'm sure that Sophia would be delighted to get stuck into a steaming bowl of smelly Clopidogrel: the super synthetic dog food that's guaranteed to make your mongrel puppy as big and strong as a horse. Maybe, to promote the replacement of Plavix by this generic, health authorities might look into the idea of getting a rap group to put together a Clopidogrel-inspired slam, or a country singer could imagine some kind of Dylan thing: "My baby's gone and left me with the Clopidogrel Blues."

Meanwhile, as I finish my glass of champagne, I hope that all the citizens of Barack Obama's new and just society will soon have access, at last, to all the Clopidogrel and other great stuff that they need for their good health. In making that wish, I do not suggest that public health is merely a matter of low-cost pharmaceutical products. It's also, of course, a question of being able to receive treatment from excellent medical personnel, associated with great hospitals.

PS After having joked about the clumsy name of the generic product (which appeared already, in fact, on the Plavix packaging), it's only fair that I should mention prices, indicated explicitly on both packets. A packet of Plavix costs 56.82 euros, whereas the price of a packet of generic Clopidogrel drops to 30.75 euros. That's a huge difference. One wonders retrospectively where all that extra cash went, and why.

Incidentally, if anyone were to inform me that I might be breaking some kind of French law in talking publicly (and naively) about these pharmaceutical products, I would of course delete the present article immediately... but I don't see why this should be the case.

Awaiting the plague

The current swine-flu situation provides an opportunity of experiencing the kind of anguish that must have pervaded societies in the olden days, before the advent of modern medicine. Here in France, though, things appear to be under control, and there are no advance signs of panic. Normally, the health authorities have ordered more than enough shots of vaccine for everybody, and the forces of the nation are getting ready to act.

If the worst comes to the worst, and there are doubts about whether the vaccine is capable of saving us from death, then our spiritual leaders will surely guide us in prayer... which is not a bad tool in times of calamity. Personally, though, ever since Louis Pasteur, I have had more faith in vaccines than in divinities. Logically, since God acts in mysterious ways, the best all-round approach would consist of beseeching Him in our prayers to bring about the creation of an efficient vaccine. In that way, if all goes well, not only will we all be saved, but people of all outlooks will be reassured concerning the essential forces that gave rise to this successful outcome.

BREAKING NEWS: Click the BBC NEWS banner to access a comprehensive article, dated 21 July 2009, entitled World response to swine flu crisis, which indicates what is happening in each corner of the planet.

Gene business

In the fascinating domain of modern genetics, one of the most exciting activities costs next to nothing. I'm referring to the possibility of purchasing and reading a few books on this subject by Richard Dawkins. But other interesting branches of the gene business can be far more costly.

Apart from the fact that they are both celebrated scientists in the field of genetics, what do these two men have in common? Well, they are among the rare human beings whose personal genomes have been totally mapped.

Several US companies are now offering services in this domain, but the fees are rather high. [Click any of the following company logos to visit their websites.] If I understand correctly, it suffices to send them a sealed tube of your saliva.

The Knome company in Massachusetts offers you the same treatment as for the above-mentioned scientists: that's to say, your entire genome will be sequenced, analyzed and interpreted. But the job will set you back a third of a million dollars.

The services offered by Navigenics, 23andMe and deCODE are far simpler.


They are cheaper, too, starting around the thousand bucks level. Navigenics and 23andMe are located in California, whereas deCODE is based in Iceland.


In all cases, the results are supposed to provide you with interesting data about potential health problems caused by the inheritance of dubious genes. In certain cases, you might be able to compare your genetic profile with that of friends and relatives, and maybe acquire genealogical information.

At the low end of the scale, for a few hundred dollars, you can send a saliva sample to the so-called DNA Ancestry Project, but I'm not sure that you can necessarily expect rewarding results.

The ideal approach to the question of the likelihood of inherited health problems still consists of compiling family health data, such as the causes of death indicated on death records. And it's hard to see how DNA analysis could provide us with more meaningful facts than those obtained through conventional genealogical research.

Personally, I'll no doubt take a closer look at the DNA Ancestry Project, in the hope of obtaining enlightenment, if possible, on a genealogical question that has always intrigued me. My maternal background was marked by a striking marriage between a respectable and industrious man, probably Scottish, named Charles Walker [1807-1860] and a younger Irish girl, Ann Hickey [1822-1898], whose father and at least one brother were notorious criminals. [Click here to visit a website about these ancestors.] I've often wondered whether it might be possible, today, to determine how their respective genes were allocated to various descendants, including myself. Sometimes, I end up thinking that I might have received a disproportionately large dose of bad Hickey genes, making me rather different to more respectable relatives with nice Walker genes. Or vice versa. But this reasoning could well be bad science. Rather than a question of bad genes.

AFTERTHOUGHT It would be fitting that my relatives might have their word to say on this fundamental question... but I'm not at all sure that they read Antipodes, and I'm even less certain that these dear folk (who didn't even wish to help me obtain retirement benefits from the supposedly-rich Australian government) might like to get involved in DNA analysis. At times, I feel that I should put a practical cross on my Australian past. Since my French naturalization, I see sadly that this is actually happening.