It’s a busy Tuesday, so I grab a chart and speedwalk to the next patient at the homeless clinic. On the table sits a woman
with this huge stiff tent of hair and a bad case of body lice. She’s rocking with her arms across her chest. She’s hearing voices. She hasn’t bathed in three months, she’s got a cough, and there’s a lot of ground to cover here, so I’m asking questions, things are clipping along. It’s like a groove you get into, a kind of tango where the doctor takes the lead and the patient’s job is to spin and turn when they’re supposed to. But then, like a hard heel on my instep, this patient suddenly blurts out, “So, where did you go to medical school?”
There’s a silence and then I say, “Harvard. I went to Harvard Medical School.” Which is pretty rare, here on the Left Coast.
She stares at me, dumbstruck, and then she says, “Aw Jesus, couldn’t you get a better job than this? What’s wrong with you?”
Suddenly, everything is turned on its head. It’s like we were Dancing with the Stars, and I thought we had the routine down cold, but with a sudden screech the music is dead, I’m standing in the spotlight all alone and I have this awful feeling my skirt is tucked into the back of my pantyhose.
My patient is upset that I went to Harvard. She wants me to defend what I think I’m doing here, working in this homeless clinic. So what did I do? Did I laugh? No, I did something weirder. I start to babble, trying to fill the spotlight of silence. I start with “but I like working here,” and then I say, “I mean I wanted to work here,” I tell her, “I mean I get paid to work here. I applied to work here. This is my job because I want it to be my job, believe me, I’ve had some jobs that were horrible, but the people who work here are great,” and before you know it, I’m explaining all my career choices to this poor woman, who can’t exactly escape.
Let’s just say it wasn’t my best moment.
See, being asked where I went to medical school by a patient was a shock. I don’t get asked that. It’s not because I work in a homeless clinic, I’ve worked enough places to know it’s actually because I work urgent care. Urgent care, for those who’ve never experienced it, is a kind of watered-down emergency room. The motto seems to be: you get what you get, so don’t have a fit. There’s a different doctor on duty every four hours. There are no framed diplomas hanging on the wall. When you’re a patient, you’re sick and you have to sit on those tables, waiting half naked for hours—after that, no one ever feels like they’re in a position to demand anything by the time I walk through the door. So when someone asked me to explain myself and what I was doing there, it was like everything turned on its head. Anything was possible. The mind boggles: Maybe it is bad to have a doctor who went to Harvard. Maybe I should get another job. Maybe I ought to stop leading when I’m dancing the tango.
So, after I finished babbling, I sat down. I asked this woman why she wanted to know where I went to medical school. She stared at the far corner of the room for a long time and then she finally said, “My sister’s a nurse. She says I ought to ask.”
She’s right, of course. You should ask. Everyone should ask, even in the emergency room. Asking is a way to remind yourself that you have a right to know. Nowadays, with healthcare so rotten, it’s easy to settle for whatever you can get, sometimes without even realizing that’s what you’ve done. We compromise ourselves and give up what we deserve in tiny steps. The lights and the noise and the person leading distract us from what’s really going on.
So the next time you’re sitting in a small room, half-naked, on a paper-covered table, pretend you’re my patient. Turn things around, be bold, and ask for some credentials—because when you’re sick, and needing help, no matter who you are, no one should have to feel like you get what you get.