Lausanne is a gorgeous city. Stretching from the banks of Lake Geneva to the spires of the Cathedral, the city traverses 600 m from sea level to the heart of the old town. It’s a wonderful city to get lost in and that holds particularly true of the old town centre. There you’ll encounter a most fabulous Saturday market as well as endless windy streets and, if you were there one Saturday in June a few years ago, like I was, you’d have met up with an ant-racist feminist protest as well. Walk a bit further and you’ll not only bump into the Cathedral (and the amazing views), but also into the town hall and, across the way, Tissot’s house. Did you know that in Tissot’s final days, a dictate went out asking citizens to remain quiet in the neighbourhood so that he could recuperate?
Lausanne is also full of hospitals. A centre of medical tourism, the city boasts numerous hospitals that treat myriad complaints and conditions. Spas, fertility treatments, cosmetic surgery, neurosurgery, laser hair removal – you name it and it’s there for you, all delivered, I would imagine, with standard Swiss professionalism, efficiency, and cleanliness.
Switzerland has been a centre for medical tourism for centuries. In addition to Tissot, whose fame in the second half the century brought patients from throughout Europe to Lausanne, there were also doctors active in Geneva. Théodore Tronchin, active slightly earlier in the eighteenth century, counted numerous members of the French elite among his clients, among them such women as Madame d’Epinay, who spent a number of months under his care.
Medical tourism provided the elite the opportunity to travel to other countries in order to seek medical care for their various ailments. Many of them had already tried out local doctors (and sometimes very famous local doctors) to no avail. Others didn’t like what their local doctor had to say. And it is certain that many sought the social cachet that a link with someone of Tissot’s stature could offer them. As my son’s fortune read last week: Flattery can get you anywhere. Given the tone of the letters addressed to Tissot, it is clear that many members of the European elite shared this attitude.
Even today, medical tourism remains, by and large, the realm of the elite. It is the elite who, by their very economic status, have the ability to travel. Mobility rights might be accorded to all persons with valid transit papers, but it still costs to travel (and as an island resident myself, this is brought into high relief…). Travel for medical care costs even more. While Canadian provincial health care systems may still pay to have rare procedures done outside of jurisdiction, medical travel remains, for the most part, restricted to those who want to pay for special treatments in extra comfortable, privately-funded environments. Just as Lausanne has become a centre for medical tourism, so too do we see the rise of India as a destination, particularly for those seeking so-called “wombs for rent.” There is also a ‘healthy’ international trade in human organs, something recognized by the WHO (among others) as an issue of concern. The right to a healthy body, it seems, is a right that is, in some cases, guaranteed to the rich on the backs of the poor.
During the eighteenth century, health was a prized commodity. From their letters, I learn that patients suffered for months with fevers, wheezing, headaches… I learn of traumatic birth stories. I learn of quack medicine. For these individuals, health was not something to be taken for granted. It could disappear at the snap of a finger, several years’ healthy living wiped away in the space of one short but damp and cold winter.
Health was capricious. It was something people courted, but not something they could ever rely on. This, in particular, was something Tissot understood. It is, in part, why he wrote the Avis in the first place, so that medical knowledge could be made available ‘on the ground,’ where it was needed most. The book provided practical knowledge that even the least learned lay person could apply. It was the perfect companion, particularly in remote rural areas.
Writing a letter directly to a doctor was, perhaps, the next best option. And from the letters in the Fonds Tissot, it’s clear that Tissot often responded with diagnoses and remedies. But then, as now, the face to face encounter remained the ideal option.
But during the eighteenth century, travel was difficult, even for the elite. From the letters, it’s clear that travel was often taken during spring or summer. Two seasons were closed to easy physical movement. And some patients, given their conditions, were not unable to travel at all. For them, a face to face visit with the doctor was impossible. Finally, the realities of the French Revolution, starting in 1789, also impacted travel and while many French expats found new, if temporary, homes abroad (in such cities as Lausanne, which ‘welcomed’ hundreds of émigrés), others stayed at home. For them, travel was fraught with danger.
Others, however, had an easier time of it. Medical ‘tourists’ were not the only patients that Tissot saw. Numerous letters come from neighbouring communities, among them Morges, just two hours’ walk away (currently accessible through a glorious pedestrian footpath along the banks of Lake Geneva), and the bigger city of Fribourg (further away). Others wrote from Lausanne proper, or even from Geneva. In her final days, Suzanne Necker, one of Tissot’s more famous patients, resided at a family residence at Beaulieu, now incorporated into a suburb of Lausanne.