09/30/07

Thoughts \ Developed Thoughts \ Rants \ Raves \ Writing

09/30/2005 16:15 -0600 GMT

Piddley Little Problem

I don't like to complain unless it's important. There aren't too many rants in this Blog, with notable exceptions about the world's inadequate response to AIDS and Bush's invasion of Iraq. (You know, I struggle with those two. Bush's administration has given more to global AIDS than any other country anywhere. That's a huge plus. However, the deceitful Iraqi invasion and the small trillions spent there when they could have been spent more profoundly elsewhere is a damning flaw. I digress.)

Today I'm going to break that habit, and rant about a piddley little problem that I imagine may be a common occurrence for U.S. medical students. It's inconsequential, it's nasty, it's festering, and it's gotta be let out.

I'm sure it will be in far greater detail than necessary.

Here goes.

We're in the ER doing our Sunday best. It's a busy day, and that portends an even busier afternoon, post-game day, after the beers, after the car wrecks, and so on. I was fantasizing about a rib eye sandwich. I hadn't eaten yet, and I had a special spot reserved in my gastronomy.

Two thirds into my shift, I walked near my resident (hereinafter known as the Rez) to hear what else might be going on. What will I be able to help with? I noted biohazard baggies with money in them at my Rez's fingertips. The Rez is collecting them. They're making a lunch run somewhere, I surmise. That's nice, I went on. And in my internal dialogue, I wish I were invited. I inch toward the feeling of crestfallen at not being included. Unfortunately, that's how the first week of this rotation has been.

The ER residents, with one exception, have been less interested in allowing for students' autonomy than the last time I rotated through this ER. Another fourth year, a visitor here, mentioned the same thing. That student described being granted less autonomy than expected. I was surprised to hear that, and I was disappointed to experience the same thing.

So not being included in the lunch plans was an unfortunate consistency of this rotation thus far. I've been treated as if I were invisible, not as a consequence of my lacking anything, but by default. That, my friends, is a part of the bullshit that makes up a minority of being in medical school.

Then the Rez, all smiles, grabbed my arm and told me that I had been volunteered to go get lunch. The Rez laughed. I offered a tight-lipped smile in return.

"It's Surin. Is that OK?" asked the Rez.

"Sure," I said. What else could I say without looking like an asshole? I went to check a chart, and returned. As an afterthought, the Rez asked if I wanted anything.

"No," I answered, still tight lipped, thinking of nothing, feeling annoyed.

"The order'll be ready in twenty minutes."

"No problem. It might take me that long to get to my car," I answered.

I took the baggies, got my keys, and left.

The whole way walking, driving there, waiting, sorting out seven transactions for ER staff, driving back, parking on the ER ramp, delivering the food, re-parking my car a half-kilometer away, and walking back, I brooded.

My first thoughts were of self-assessment. Was I irritated or pissed off about something else? No.

I wasn't asked to get food. I was volunteered! And my personal resources, time taken away from learning, my gasoline - all were used for this effort. And I wasn't asked if I wanted food except as an afterthought. There's an unwritten rule that students get food if the team is busy. It's often the unwritten corollary that the student earns a free meal if s/he makes a run for the meals. There was no mention of that.

These were my broodings.

The same Rez had complimented me during my last shift, albeit in a condescending way, on my assertiveness in asking for a hospital bed for a patient that needed to be admitted. Now I was thinking of how I could apply the same assertiveness to this situation so the Rez would not make the same mistake again.

After a myriad of thoughts that were at least partially embarrassing to the Rez, or that were passive-aggressive, or that did not address the issue, I came up with this:

"The next time you volunteer me to go get other people's food, ask me first, OK?"

I thought that statement, delivered quietly, one-on-one, would get the message across clearly enough, without unnecessarily embarrassing my superior.

Unfortunately, the ER filled with acuity in the remaining two hours, and the opportunity to speak to the Rez never arose. It's such a small complaint, and it takes a far back seat to an acute stroke or a chest pain work up.

An email would be too passive, and too easy to delete.

Then there's that background fear that a poorly placed complaint could make my remaining weeks on this service miserable, if that Rez decides that my complaint is out of line - a minor rumbling in the back of a student's mind.

I need an eye-to-eye conversation.

A few things I won't say will be:

"I didn't come to Med School to get your lunch," or better;

"I'm not paying for medical school to get your lunch."

A good medical resident once told me this. There are two sets of people who are paying to be here in the hospital. They are the patients and the students. What that means is that this is my education. I am paying for it, and I get to shape what kind of educational experience this is for me. This is mine, and you, the Rez, can't take it away from me. And you won't do it again. That's the take-away message to myself.

And that, my friends, is that.

There are a few more bits to put this puzzle together.  I don't want to be the medical student who is a complainer. I get the impression that we privileged med students are known to be complainers about the little things. I don't want to fit that mold.

I also know that an apprentice must pay his or her dues, and on that score I am one hundred percent game. I'm the team player, and I complement my shortcomings with this strength. But there were no shortcomings in play here; I was simply scutted inappropriately.

Another bit is my own baggage. I'm closer to forty years old than thirty-nine, a fact that I milk for my advantage at every chance. I think that many late-20s residents forget that an atypical, late-30s medical student has been around the block a few times. The Rez has no way of knowing that I worked for three years in a trauma unit in Cali, doing all manner of work, likely nearing the level of a second year ER resident in that regard, and this while the Rez was in middle school. So cast your assumptions aside, and take a minute before you treat me like you would. I'm not your equal here, and I grant that. But I'm sure not here to run your errands either.

No other culture in the world that I have experienced would tolerate this kind of behavior.

I wasn't a fast enough thinker to respond immediately, and a later response would have been too late. I'm too nice. So here I am, ranting to the world, to my ten readers. The only consolation, apart from broadcasting my frustration through my keyboard, is to know that I am armed with ready words for this situation if it should occur again.

I can't wait.

"The next time you volunteer me to go get other people's food, ask me first, OK?"

Now let's get back to the important problems.