This, too, shall pass

Preparing for a colonoscopy, à la française

When I scheduled my first colonoscopy, in Philadelphia, the doctor gave me directions for the day before the procedure: Basically, drink chicken broth, eat yellow Jello, then drink gallons of this disgusting liquid.

That’s not quite how it works in the land of more than 1,000 different cheeses. Here, the medical authorities have a slightly different philosophy about how best to prepare for this procedure: three days of an easily-digestible diet intended to lighten the elimination. Couple that with the unrivaled French reverence for dining and you need more complex, nuanced guidance. 

It’s all contained in a folder with little food icons, a prescription for the vile drink, and instructions — in French, of course — for every meal and each step of the process. Every medical procedure has its own “dossier” — a folder of all your important documents, test results, prescriptions and information. You get to keep it. It doesn’t stay at the hospital or the doctor’s office because, as one receptionist told me, “Bah, it’s yours.” The colonoscopy dossier I received is white with colored designs and contains my prescription for the prep and all my instructions. The diet prep is detailed in full. 

In the U.S., a low-residue diet, according to the Mayo Clinic, identifies “lean meat” and “fish” as safe to eat. We need to go the extra kilometer on that in France. After all, the French eat way more parts of the animal and have many more ways to prepare them. Consequently: 

Non-autorisé (which is just what you guess it is) in the meat category are:

Charcuteries

Fatty meats (sheep, pork) or anything cooked in fat

Poultry skin

Internal animal organs

Marinated meat

Game

Autorisé:

Poultry without skin (chicken and turkey)

Rabbit

Horse or red meat if it is lean and cooked without fat

I can have all the lean horse meat I want, but I do need to cut back on kidneys, liver and brains. 

Where the Mayo Clinic says all fish is OK, the French offer the kind of culinary guidance you’d find in a Julia Child cookbook. I can eat non-breaded fresh or frozen fish cooked en papillote, in the microwave or traditional oven. I must avoid canned fish in oil, white wine or tomatoes, and any fatty fish like tuna, sardines, mackerel or herring. While that won’t be tough on me for these few days, the best way to put that rule’s impact into perspective for the average French person is to look at the canned fish aisle in my local supermarket: 

This is just canned fish. Tuna, mackerel, sardines, halibut, anchovies, etc. . .

Now we must tackle the sauces, jellies, condiments and — most importantly — the cheese!

I can spice up my white rice or lean chicken with salt and “other aromatics,” but cannot add capers, onions, curry, paprika or pepper. I also can’t have a French cooking staple: sauce made with a base of wine, mayonnaise or tomato. I cannot add pepper, mustard, cornichons or herbs like parsley, thyme or dill. 

These restrictions do suck the life out of the cuisine to which I’ve grown accustomed, but I can easily live without them for a few days. I cannot, however, imagine how someone born and raised among the subtle flavors of shallots and white-wine sauces might react to this list. 

I cannot eat a baguette or any fresh bread. Wait, what? This one hit me hard. I eat two slices of an excellent baguette tradition every single morning. I must trade that for a dry toast-shaped biscuit. I can’t even slather it with my favorite fig confiture, just seedless jelly.

At least I don’t have to live without the coveted cheese course, but I must be precise in my choices. The colonoscopy rules say I can’t have fresh fermented cheese like Camembert, Brie, Bleu, Roquefort, Munster, Chèvre or the mysterious others signified only by an ellipsis. I can, however, enjoy Gouda from Holland, Gruyère, Cantal, Tomme of Savoie or the Pyrénées. 

Just like in the states, chicken broth is a staple of the pre-colonoscopy diet. It’s such a pure, simple, easily-digested food, yet it may end up being my biggest challenge. Chicken broth, in all its glorious assortments — fat free, low fat, low salt, no added salt — sold widely in convenient, shelf-stable boxes or cans in the U.S., has been impossible to find here. I’m guessing the French assume we all should make our own stock, just like they believe we all must have an espresso after every meal. 

I will either have to make my chicken broth from scratch or use the overly salted bouillon cubes or concentrate from the supermarket. The broth is easy enough to make, but there are a couple hurdles resulting from the dramatic downsizing of a three-story home into a two-bedroom apartment. 

One: I don’t have enough room in my fridge for a big jar of broth. Two: I don’t have a big jar.