Learn Hardcore French: Quand sa toux empire le soir, elle téléphone au médecin. - When her cough gets worse in the evening, she calls the doctor.

Since toux is feminine and starts with a consonant, you must say sa toux. The fact that the owner is elle (she) does not change the form here—sa toux could mean her cough or his cough, depending on context.

What tense are empire and téléphone, and why are they in the present?

Both empire and téléphone are in the present tense, 3rd person singular:

sa toux empire → her cough gets worse
elle téléphone → she calls / phones

In French, the present tense is used not only for actions happening right now but also for:

habits and repeated actions → Quand sa toux empire le soir, elle téléphone au médecin.
= Whenever / When her cough gets worse in the evening, she calls the doctor.

So although English also uses the present here, note that French present tense very often covers what English might express as “whenever + present” or sometimes even “does / will do” in future context.

What does the verb empirer mean, and why not say devenir pire?

Empirer means to get worse / to worsen / to become more serious.

So sa toux empire = her cough is getting worse / worsens.

You could say sa toux devient pire, but:

empirer is more natural and idiomatic for symptoms, illness, problems, etc.
devenir pire is grammatically correct, but often sounds heavier or less elegant.

Typical French usage favors the single verb empirer in this kind of sentence.

Why is it empire and not empirent?

The verb must agree with its subject:

Subject: sa toux → this is singular
Therefore, you use il/elle/on form of the present: empire

If the subject were plural, you’d use empirent:

Ses symptômes empirent. → Her symptoms are getting worse.

But with sa toux (one cough as a condition), it stays singular: empire.

Why is it téléphone au médecin and not téléphone le médecin?

Because in French, the verb téléphoner is constructed with the preposition à:

téléphoner à quelqu’un → to phone / call someone

So you must say:

Elle téléphone au médecin. = She phones the doctor.

You cannot say téléphoner quelqu’un.

In contrast, the verb appeler does take a direct object:

Elle appelle le médecin. = She calls the doctor.

So:

téléphoner à + person
appeler + person

What exactly is au in au médecin?

Au is a contraction of:

à + le → au

You must contract à le into au in standard French. So:

à + le médecin → au médecin → to the doctor

Similarly:

à + les → aux (e.g. aux enfants, to the children)

Could I say elle appelle le médecin instead of elle téléphone au médecin? Is there a difference?

Yes, you can say elle appelle le médecin, and it’s perfectly correct.

Nuance:

téléphoner à quelqu’un: explicitly means to phone someone
appeler quelqu’un: means to call someone (by phone, by shouting, by name, etc.), but in modern usage, if nothing else is specified, people usually understand it as calling by phone.

In this exact sentence, both:

Elle téléphone au médecin.
Elle appelle le médecin.

can be used to mean She phones/calls the doctor. The original just makes the phone aspect fully explicit.

Why isn’t it Quand sa toux s’empire with a reflexive pronoun?

The verb empirer is not reflexive in normal usage. You simply say:

La situation empire. → The situation is getting worse.
Sa toux empire. → Her cough is getting worse.

S’empirer does exist but is rare and generally considered literary, old-fashioned, or non‑standard in many contexts. For everyday French, you should use the non‑reflexive form:

empirer, not s’empirer, for things that worsen on their own.

How is toux pronounced, and why is there an x?

Toux is pronounced like /tu/ (roughly like too in English).

The x at the end is silent here.
Spelling: toux (feminine noun), but the final x is historical; it doesn’t affect the modern pronunciation.

So:

sa toux → sounds like: sa too

How do you pronounce médecin?

Médecin is tricky for learners. A simplified guide:

IPA: /medsɛ̃/
Roughly: “med-senh”, with the -enh being a nasal sound (like the French in / ain).

Key points:

Don’t pronounce a clear “mé-de-sin” with three full syllables; it’s closer to med-sin (two syllables).
The final -in is a nasal vowel /ɛ̃/, not like English seen.

Can I leave out elle and say Quand sa toux empire le soir, téléphone au médecin?

No, in standard French you cannot normally drop the subject pronoun.

French is not a “null-subject” language like Spanish or Italian. You normally must include the pronoun:

Quand sa toux empire le soir, elle téléphone au médecin. ✅
Quand sa toux empire le soir, téléphone au médecin. ❌ (sounds like an order addressed to “you”: When her cough gets worse in the evening, phone the doctor!)

Without elle, the sentence changes meaning and sounds like an imperative (a command) to someone else.

Is Quand here more like “when” or “whenever”? Does it imply habit?

In this sentence, Quand introduces a repeated / habitual situation:

Quand sa toux empire le soir, elle téléphone au médecin.
→ When(ever) her cough gets worse in the evening, she calls the doctor.

So:

Grammatically, quand just means when.
But combined with the present tense and a general‑time expression (le soir), it often has a habitual or whenever meaning, like in English:
- Quand il est stressé, il fume. → When(ever) he is stressed, he smokes.

Where can le soir go in the sentence? Could I move it?

Yes, le soir (in the evening) is fairly flexible. All of these are possible, with slightly different emphasis:

Quand sa toux empire le soir, elle téléphone au médecin.
– Neutral; emphasizes that the worsening happens in the evening.
Le soir, quand sa toux empire, elle téléphone au médecin.
– Puts more emphasis on in the evenings as the general time frame.
Quand sa toux empire, le soir elle téléphone au médecin.
– Sounds a bit more marked/stylistic; focus on the fact she calls in the evening when it happens.

The original version is the most natural and straightforward in everyday French.