"The system is collapsing": an emergency physician's emotions about the public hospital crisis

Five years after the Covid-19 pandemic , the French hospital system is still in agony: "The health system is collapsing, that's clear and obvious," warns Caroline Brémeau, emergency doctor at the Laval hospital (Mayenne) and author of Etats d'urgences, le quotidien d'une médecin en lutte pour l'espace public , on RMC and RMC Story this Wednesday.

"There are choices to be made. I work shifts without a Smur (Mobile Emergency and Resuscitation Service). Sometimes, we arrive in the morning and we don't know what the organization will be," warns the doctor. "It's the same everywhere, and Laval is no exception."

When she started out as an emergency room doctor , Caroline Brémeau could count on having at least one other doctor with her. But today, "most of the time, I'm all alone," often in critical situations.

"This happened to me while on shift, and for the last two hours there were no emergency services open in Mayenne. We're forced to transport patients much further away, and we're starting to see situations that are detrimental to the patient," the doctor added.

This situation is sometimes the cause of tragedies: "Sometimes when there's a missing Smur team, we go too far and we know that when we arrive it will be too late. We're supposed to be less than 30 minutes from a medical team and that's no longer the case in many places. When we leave for a 45-minute drive for a cardiac arrest, we know we'll arrive too late."

"We feel butterflies in our stomachs before we leave. It's infuriating, we shouldn't have to go through this. It's terrible to have this feeling of missing out on real care," adds Caroline Brémeau, very moved.

Her goal today is to "denounce a system that is collapsing," says the woman who sees herself as a "whistleblower," and that the situation is stronger than her duty of reserve. After each shift, she returns home "exhausted" while her "colleagues are devastated." "Patients give us strength and hope to continue the fight, and I want the general public to realize what a healthcare system can be that can be efficient and collapse."

To reverse the trend, she calls for "a complete reorganization of the healthcare system, not just small measures; we need to rework all professions." Starting with the work of nurses, she says, by expanding the possibilities for starting care. "We need to regulate the actions they are asked to perform so that they don't overextend their workload."