Saturday, April 16, 2011

Retrospectology #2 : Catch me if you Can

By 1993, I’d learned that my ice-cream-man white coat brought a privilege I hadn't imagined:  access.  I could walk into a hospital with a clipboard, stethoscope slung over shoulders, and walk right into a nursing station.  Like walking into the Superbowl and down to the field. “Hey, Mr Montana, watch for Frank, he’s beaten his defender on the last three downs.”

I wore a medium-length coat at first, like the residents. 

“Are you house staff?”  asked a nurse.

“Am I what?”

“House staff?”

“I don’t know.”

“Student,” she muttered, walking off.

Later, another student explained the short-coat, long-coat rule.  Who cares, I thought.  Buy another one of these?  Who’s taking measurements, the chief resident?

Turns out, the interns take measurements.  Having worn the shorty for four years, they zoom around the hospital with their extra inches flowing like superhero capes.

“You can’t wear that coat, you know,” an intern tells me.


“Medical students wear the short coat.”

“Okay.  Do you think I should buy a new coat?  A short one?”

“Yeah.  You have to.”

I bought a shorter white coat, and felt the decrease in status immediately.

However, I could still strut into a hospital anywhere and open charts I couldn’t read with total immunity.  So many white coats and scrubs, nurses, docs, techs and transporters.  Nobody knew who anybody was.  I could summon a patient down to the operating room and take out a parathyroid just for practice.

Clock forward seven years, and I’m third-year surgery resident.  I spend two hours a day at the same nursing station, checking labs, talking with nurses, eating soda crackers, answering phone calls, sleeping, writing orders, drinking old coffee, running the patient list with the chief.  White coats and scrubs scramble everywhere. 

Then a med student walks up to the nursing station.  His coat is white as snow.  His stethoscope is more expensive than any other on the ward.  The weight of the Washington Manual in the left hip pocket is not balanced by the hammer and calipers in the right pocket, pulling the coat into a slight hunchback configuration at the shoulders.  The student looks directly at the ward clerk on approach, nods and smiles slightly.  He saunters around the counter, mixing among the other white coats, and takes a seat in front of a computer.  He is showered and unpreoccupied.  He sneaks a look at a 5 x 8 card under the clamp on his clipboard.  Computer codes.  He taps the keyboard with leisure.  He is well-shaved and looks rested.  He is pleasant to everyone.  He is totally incognito.

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