ExpatWomen Confession:


Dear ExpatWomen Girlfriend,

I live in China and I have been diagnosed with breast cancer. I am very sick, and I am undergoing chemo treatment in one of the international hospitals here. The hospital seems ok, but not all the doctors’ English is very good – and my first language is French. I am wondering if I should stay here, or move back. Separating the family is not an option for us, so moving back would mean that my husband would have to find another job and we would have to take the kids out of school early. I am torn – on the one hand I want to be in a familiar environment with French doctors, but on the other hand, I wonder if the medical care here is better than in France, as my friends here tell me that the hospital I go to is excellent for their cancer treatments and would probably be better than back home. My family is supportive, and they will move for me if I really want to. Can you give me some advice please?

CW

New ExpatWomen Girlfriend:

Dear CW

I can understand that you’re feeling torn – you have a lot on your plate right now. Our first instinct in times of ‘danger’ is to try to feel as secure and safe as possible, which includes a familiar environment and language – and having your close support system around you. In your case, and in general of people that live in a foreign country, these equations are not always balanced. On the one hand you have your immediate family and probably some good friends with you, but on the other hand you are in a foreign country with a different language and a typically-unfamiliar health system.

In most of the big international hospitals abroad, they have translators working either as consultants, or as full-time staff. If you have not already checked, perhaps check if your hospital in China has this service. If they don’t have this, perhaps you have someone who could go with you to the hospital each time. Or you could find and pay an interpreter, in whose language skills you trust, to accompany you and translate your doctor’s instructions for you. Or, perhaps try calling your doctor in France, or finding a doctor online in a familiar French hospital – and ask if they could talk to you over the phone about your condition, when needed, so that you are sure that you understand 100% your scenario and options. This doctor can also give you their view regarding your medical treatment. Your physician can help assess the situation and reassure you that you are receiving proper care and that there’s no need to worry, or your physician may feel that a second opinion is warranted or even that transfer to another facility is advisable.

Because of cultural differences, the attitude of physicians toward their patients in foreign countries are often different than what you are used to. Physicians abroad are often perceived as being more autocratic and authoritarian. This can make patient-doctor communication difficult. The doctor caring for you may not want you to question his or her care and may not be available to answer your questions. This does not mean that your care is substandard. In fact, the doctor caring for you may be perfectly well qualified to diagnose and treat your illness.

When the communication problem is less daunting, and your current medical treatment is medically satisfying, you can focus more on your emotional needs. In your case, this means deciding whether you want to move back to France, or stay in China. That is a tough decision to make and it very much depends on your personal situation. I would suggest making a list of pro’s and con’s to each option, and talking it through with your family. One very important factor will be how your cancer will be treated, how long they estimate the treatment will take and how comfortable you will be in either place. The doctor’s prognoses will play a vital role, and getting a second opinion from your French doctor might be helpful. Other questions to think seriously about would include exactly how much better your support system would be at home. Domestic help might not be as easily accessible (assuming you have domestic help in China), but then again, extended family might be closer by. Medical coverage is another issue not to be underestimated. Check out your insurance and see what your situation is in case of long-term treatment abroad. Lots of issues to consider! There is no simple answer to your question I’m afraid. Your physical and emotional well-being are both very important. I would try to be as much informed about your physical condition and prognoses in both countries, and consult with your immediate family about the options of staying and moving back. Then, try to make a decision and focus on committing yourself to that decision, so that you can then turn your energies back to what you need most – healing your cancer.

All my very best wishes!

New ExpatWomen Girlfriend
August 2007 

Our New ExpatWomen Girlfriend is originally from The Netherlands. She has lived as an Expat Woman in India, Canada, Indonesia, Chile and Thailand – where she is currently a ‘trailing spouse’ to a husband of a different nationality to hers. She is a mother of two children, born in Asia, that have dual nationalities. She has a Bachelor of Arts degree in European Communications (Marketing) and she will soon graduate from her Master of Science degree in Counselling Psychology. She works in a private mental health clinic, plus counsels expatriate women.

Disclaimer: This column is intended to be of general interest to ExpatWomen.com visitors. Its suggestions and/or inferences are generalizations and do not address the needs of individuals, nor should they be relied upon in any shape or form. Please seek professional advice/counseling/therapy if you genuinely need assistance to talk through issues in your life right now.