Originally published in MedPage Today
by Charles Bankhead
From time to time, I hear a “mature” person lament the sad state of affairs of the “next generation.” Sometimes I wonder whether the same concern should apply to the next generation of doctors.
I was at a cardiology meeting, and my schedule included a breakfast program. As I headed toward the meeting, I passed some vending machines at my hotel. I heard a commotion, and turned to see a half dozen or so young men gathered around one of the machines. At medical conferences, as you’re no doubt aware, different categories of registrants wear name badges that have distinctive colors or ribbons. Members of the press usually get gaudy-looking badges that stand out in a crowd, so other people can spot us easily and run. From the color of the young men’s badges, I surmised they were residents and fellows.
As I moved closer for a better look, I saw the object of the commotion: a vending machine that dispensed canned beer. The conversation went something like this:
“Dude, look! A beer machine!”
“I’m not *****ing you! It’s a beer machine!”
“Awesome! I gotta have some of that!”
As I watched, one of young men deposited some money in the machine and pushed a button. The machine made a kind of whirring noise, and I heard something akin to a door opening. The young man bent over, and when he returned upright, he held up a shiny can of cold beer for all to see. He popped the top and took a long swig, as his companions stood around him, eyes and mouths agape.
Much oo-ing, ah-ing, and whoa-ing ensued, followed by a mad scramble among the remaining young men to find alms to offer this deity of hedonism.
One by one, the men repeated the ritual, until each held his very own can of beer. As they drained the cans and vowed to return often to worship at this altar, something told me this wasn’t the first time they had consumed beer before breakfast.
And then a thought occurred to me: One day I might have to entrust my heart to the care of these young men.
I found the thought unsettling.
On another occasion, I interviewed a resident about some good deed he had performed. I’ll remain vague, so as to protect the innocent — namely, me. I asked whether he had had any help with the task. He replied, “No, I was the onliest one there.”
I looked up from my notepad, and to make sure I had heard him correctly, I asked, “You were the onliest one there?”
“That’s right,” he replied, “no one else but me.”
Well, I thought, I guess the verbal portion of the MCAT really isn’t all that important to being a doctor.
Finally, no tale of medical misadventures would be complete without a trip to the hospital. My wife was in recovery following a day surgery laparoscopic cholecystectomy to rid her of a troublesome gallbladder. I was sitting at her bedside reading, when a young man in scrubs and with a stethoscope around his neck strode confidently into the room, clipboard in hand. Without a word, he walked to the bed, pulled back the sheet, lifted the bottom of the drape covering my wife, pulled it back, and peered underneath.
Judging from his gaze, I knew he wasn’t looking high enough to check the incisions for the gallbladder procedure.
“Who are you?” I asked.
For the first time, the visitor looked at me and replied, “Dr. So-and-So, Chief Resident.”
“Well, chief,” I said, “you’re looking in the wrong place.”
“Are you a doctor?” he asked, with the slightest of smirks.
“No. I’m her husband and we’ve had three children together, so I know which end is which, and you’re looking in the wrong place.”
The chief looked back at his clipboard and then at me. “This is Mrs. Jane Doe in Room 307.”
I couldn’t tell whether it was a question or a statement. “No, I said, it’s Mrs. Bankhead in Room 407.”
The chief looked down at the clipboard again and began tapping his pen on it. When the pithy comeback he sought didn’t materialize, he turned quickly and walked briskly out the door without a word.
By this time my wife had awakened, and she asked, “Who was that?”
“The tribal chief,” I replied.
Just as I was beginning to think that I should die before one of those doctors does me in, something happened to restore my faith in the “next generation.” I went to New Orleans recently and found that the city, including its healthcare services, is still recovering from the effects of Hurricane Katrina, more than five years after the fact. I learned about remarkable acts of generosity, compassion, and selflessness. I learned that some of the very first healthcare providers who returned to New Orleans were residents at Tulane University Medical Center. They set up makeshift clinics anywhere they could find the space. They cared for patients who had nowhere to go. Hospitals in the area were closed for weeks.
The residents who staffed these street-corner clinics, sometimes with no more than a table and a few chairs or a tent, were principal care providers for weeks. They handled scheduling, coordinated supplies, performed whatever triage was possible under the circumstances. They did all of this when most of them had no place to stay, no ready access to food or water. By all accounts of faculty members who pitched in, the residents ran the show and did whatever was necessary to provide care to patients in need, and they did it without complaints or self-pity for their personal situations, which were as dire as those of many of the patients they saw.
The clinics provided the impetus for a citywide network of neighborhood clinics to care for people who once received primary care at a hospital ER or outpatient clinic. Physicians, medical students, and students in other healthcare fields have regular rotations through the neighborhood clinics. Though the term has become almost a cliche in medicine, the efforts of those residents in the early days after Katrina led to a new paradigm of healthcare delivery for much of New Orleans.
The story of the Tulane residents is not an isolated incident, I’m sure. I hope I can remind myself of that the next time I see a group of young doctors gathered around beer machine.
Charles Bankhead is a staff writer at MedPage Today and blogs at In Other Words, the MedPage Today staff blog.
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