The setting: an inpatient unit in the Bronx, circa 2005.
I was a resident (and hence was likely disheveled, groggy or exhibiting some other outward display of exhaustion) of the internal medicine program at Albert Einstein University Medical Center/Moses Division, aka Montefiore. The fact that the program was considered “malignant” by those in my industry — mainly due to the strict nature of the training program — likely strengthens the possibility of my aforementioned appearance. Those of you who knew me back then can attest.
I was a third-year resident, to be exact, having been through the rigorous training and long, sleepless hours of days spent on the “inside.” It was sort of like doing time, except that I hadn’t done anything wrong or broken any law. Nonetheless, it was a rite of passage, a ritual that had to be passed. Hazing comes to mind and, though different in its finer points, similar in some of the torture techniques used to ensure loyalty in one and competency in the other.
But back to my appearance, I find it relevant to point out that both vitamin D and vitamin Z (I refer here to the zzz’s crucial to sustaining life itself) were a common deprivation in my days as a resident. And up until that point, my body had become accustomed to living without them.
But here I was, a third-year resident physician in charge of my own team. The team was comprised of both interns (suffering through their first year of training — the worst) and medical students, who were still solidifying their knowledge base. Together, as a team, we took care of the patients on the floor.
I was the boss and we all reported back to yet another doctor in charge, the respected attending. These were the ones who had already graduated, the color in their faces already partially restored. I knew who they were by the glow on their newly exposed skin, bright from kisses of the sun’s rays. They were also easily identifiable by the way in which they walked through the hospital — clicks of pride in their stride — knowing they had made it through residency intact and now were in charge at the top of the food chain.
But the attendings weren’t around when we walked in those early morning hours, through the floors, tending to everyday minutia, checking in on patients and their necessities — I was in charge.
On this particular day, one of my medical students, incidentally a man, was called down to the floor where a nurse had been unable to draw a patient’s blood. He was called on to perform the phlebotomy himself. A phlebotomy being the technical term for a simple blood draw.
This was standard procedure. We were called routinely to patients’ rooms if the nurse was unsuccessful at “getting a vein,” and it then became our responsibility to take over the poking.
Medical students followed their own patients and were taught how to perform said procedures, but they were still just “getting the hang” of things.
I decided to take the team down myself, after seeing fear reflected from the poor student’s eyes as he silently pleaded with me for help at the thought of his inexperience. He was envisioning the discomfort — both the patient’s and his own — of digging, repositioning and again digging, deep into the patient’s arm. It was causing him anxiety.
I would perform the phlebotomy, I announced, show them how it was properly done, and take away any possible inconvenience. I had been through it many, many times before and considered myself quite the phlebotomist by then. I was a pro.
I told them this, and the student became instantaneously ecstatic, beaming at the new vision.
Our team walked down together, where we found the patient stationed out in the hall comfortably in her chair.
We exchanged light banter, as I introduced her to myself and the team. She had already met the medical student, clad in his short white coat (the difference in lengths differentiates an MD from a student, unbeknownst to many).
I was there to draw her blood, I said smiling.
She looked me up and down, thought for a second, her brows furrowed closely together in deep concentration.
“Sweetie, you’re not touching me,” followed by, “I know a medical student when I see one.”
Baffled, I chuckled and explained that I, indeed, was not the student and that I was the resident physician, had experience under my belt and would surely get her vein. Satisfied with my response, I turned to get the supplies, when, in back, I heard her exclaim in my direction.
“Sweetie, I’m not stupid. I know who the doctor is here.”
And as I turned around, a smile crept back on my face, because I knew what she was referring to. As expected, I found her happily pointing to the student, who stood like a deer in headlights. She was oblivious to this fact, of course, and instead focused a self-satisfied expression directly at me, to boast of the success of her detective work.
Except that her detective work had actually failed — massively, at that — and landed far from the truth. She was completely unaware.
The student explained, under his breath, that he was not the doctor and that I was, but the woman just shook her head in disbelief. We were not about to fool her.
So we did as she wished.
This is where the moral of my story comes in, and that’s to never judge a book by its cover.
Especially if that book is me, in doctor’s coat and heels, walking away with a group of interns and medical students in tow, a grin on my face as a medical student in a short white coat behind me re-inserts his needle for the third time in a row desperate to find a vein …
Dana Corriel is an internal medicine physician who blogs at drcorriel.
Image credit: Shutterstock.com