Monday, August 19, 2013

Dr. No.



I walked into the clinic room and introduced myself. "Hello. My name is Dr. Manning and I'm one of the senior doctors in the clinic who works with your primary doctor."

This Grady elder sucked her teeth. Hard. She looked me all the way up and then all the way down. Then she suctioned her tongue against her back teeth once more like she had something caught back in a molar. Her lip jutted out and her brow furrowed.

Awkward.

"Your doctor has told me a lot about you. It's a pleasure to meet you." I tried to break up the uncomfortable once over she was giving me. But it didn't work.

"Who you said you was?" she asked. This time her face was twisted up and her nose was wrinkled like a bad smell had wafted into the room.

"I'm Dr. Manning. I work with your doctor." I tried to smile as bright as possible.

She curled her lips and then grunted. "Unnh." Kind of like the way mean girls size up other mean girls at high school basketball games. That grunt was not an approving one, that's for sure.

I decided that I didn't have the energy to try to decipher all of that, so I just came right out and asked. "Is something wrong, ma'am?"

Her response to that question started with a slow roll of her eyes. Her voice came out throaty. Almost like a growl. "Look to me like if you a doctor that you should have on something that makes somebody know who you is."

I thought I'd heard her incorrectly so I sought clarification. "Beg pardon, ma'am?"

"I SAID, 'Look to me like if you a doctor you need to be wearing something that help somebody know who you is!'" That time her voice was loud enough for anyone in earshot to hear. It was still gravelly, but mostly from the fifty plus years of smoking that I'd learned of in her chart.

I looked down at myself to see where all of this was coming from. I was wearing my badge. It was facing forward with my name and title prominently displayed. I was dressed professionally in a dress that hit at the knee and a low heeled shoe. As a matter of fact, that dress was freshly pressed from the dry cleaner and you could tell from looking at it. You could. Hell, I even had a stethoscope around my neck. What could she possibly be ---

Aaah.

I figured it out. On this day, I wasn't wearing my white coat. And honestly, the only reason that I wasn't was because that morning I'd decided that it was too dirty around the sleeves. Just before walking into the primary care center, I decided that it wasn't up to snuff and that my patients--ones like this woman--deserved better.

Aaaaaah. Now I get it.

"Oh, are you saying that because I'm not wearing a white coat?"

"You look like a sec-a-tary. Not a doctor. A sec-a-tary with a step-a-scope 'round yo' neck. Like you some kinda pretend doctor."

Ouch.

I chuckled more because I was uncomfortable than amused. She didn't even crack the tiniest smirk.

Sheesh.

"I apologize if that made you feel less comfortable. This morning when I looked at my coat I saw a little. . .well. . .  grit on it. Kind of like 'ring around the collar' but on the sleeve." I gestured to show what I meant. "I didn't want to come and see you with a dirty coat. Since the other ones weren't readily available to me, I just took that lab coat off and clipped my badge to my dress. But it sounds like you prefer to see your doctor in a white coat?"

"I jest don't want no sec-a-tary coming at me talking 'bout my medicines, that's all. I swear fo' God I thought you was the lady at the front desk. Definitely not no doctor."

Zing.

I nodded and pressed my lips together. I turned up the deference to see if it would help. "Yes, ma'am. I'm sorry for that. I really am. I want you to feel comfortable. Are you okay with me participating in your care? Without my jacket?"

My resident wanted to defend me so he jumped in. "Mrs. Palmore, did you know that these lab coats can carry infections? Like, a lot of doctors never wear them at all any more. And they can scare kids. So a lot of doctors don't wear white coats at all. Or even neck ties. Isn't that funny?"

She was not amused. Or convinced by that argument.

"You know--what what you said yo' name was?" She was talking to me.

Rut roh.

"Dr. Manning."

"Look here, Miss Manning. I'm 'bout to mek ninety next year. And in ninety some odd years I seen a lot. See, in my time, some colored people ain't even want no colored doctor.  Ain't want nothin' to do wit' 'em. That's 'cawse with all the colored hospitals, see,  they ain't have all the same stuff. Or you ain't know if the people in there had all they had credentials."

Damn.

http://ethicsoup.typepad.com/.a/6a00e554e81be38834014e8c1e08ca970d-800wi


I thought about all of the doctors from my alma mater, Meharry, that had come before me. The legions of African-American physicians trained from 1876 until the year I graduated in 1996. I wanted to tell of the excellent medical education I received and that it didn't start with me. That, as a ninety year old, more than likely every single one of those black physicians that she came into contact with trained at either Meharry Medical College or Howard University College of Medicine. And that, I swear fo' God, that every single one of us earned those credentials. We did.

But. Instead, I stayed silent. And just listened.

"It used to be where when I saw doctors here at the Gradys, I ain't want to see no colored doctors. Or no lady doctors, neither. And for a long time it wasn't na'an so I ain't have to even say, you know, that this my preference. But then I start seeing more and more. Colored doctors and lady doctors, too. At first I ain't won't none of 'em. But after time, you ain't always got no choice, you know? But I seen 'em and turn out that they was good. Good as anybody, I guess."

"Hmmm."  That was all I could think to say in response. She went on.

"Yeah, the colored doctors and the lady doctors seem okay. But look to me like I always get particular about how they look."

"How they. . .look?"

"Mmmm hmmm. Like, do they look like a real doctor, you know? And could I mistake 'em for something different."

Like a sec-a-tary, perhaps?

I nodded. "So. . . .  that's what bothered you about me not having on my lab coat. You weren't sure if I was a doctor?"

"Maybe. I think it's jest the times I came up in, you know? Like you always need to prove yourself. See, this young man here? He don't got to worry 'bout all that. But you? You do." She gestured to the resident physician standing next to the examining table, his pale face now crimson. "Otherwise somebody don't know how to feel 'bout you comin' in they direction like you s'posed to be somebody."

See, this young man here? He don't got to worry 'bout all that. But you? You do.
Otherwise somebody don't know how to feel 'bout you comin' in they direction like you s'posed to be somebody.

Wow.

I narrowed my eyes and let that marinate. After a few moments, I decided not to say anything in return. I chewed the inside of my cheek and tried not to look like I was filing all of this to think about more when I had time.

"Do you understand what I'm sayin'?" she finally asked me.

"Umm. . .kind of. I think I do."

And that was the end of that.

She let me examine her body and be a part of her care plan but most of her questions she directed at the resident doctor. And this woman--let me be completely clear--was African-American.

Yep.

I am still trying to pick that whole interaction apart. Her thinking that I was a secretary. Her previously refusing black or "colored" physicians. Or lady ones. Her life experiences that brought her to this place. What this meant about how she felt about herself and her own people. And, of course, how all of this played into her disdain with the absence of my white coat. I couldn't sort out whether or not it embarrassed her that I was without it or underscored some preconceived idea she'd had before I even walked in.

Or both.

I don't know. I really don't. But either way. . . . this? This, my friends, is Grady.

And I swear fo' God that I don't make this stuff up.

***
Happy Monday.

Now playing on my mental iPod. . . . .

20 comments:

  1. After college, when I was trying to get hired in the public schools I worked at Davidson's in Lenox square. On weekends I worked with an african american high school senior who was smart as a whip. When I asked her what colleges she was applying to she told me "none". She said that because of her skin color no one would ever take her seriously, so why bother spending all that money for nothing. The thing is, like mine, her father was a disabled vet. At that time she could have gone to school on the GI bill. I was stunned by the attitude. Nothing I could say would get her to change her mind. She wouldn't even consider a junior college like Dekalb Tech (Perimeter now). Now I wonder if she had people like your patient in her life discouraging her. I think about her a lot. I hope that at some point she changed her mind and did decide to get an education.

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    Replies
    1. I wonder about so many people. I hope that bright young woman went on to work to her potential.

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  2. Replies
    1. Kind of, right? But I did feel bad since I normally wear my coat. What's funny is that I do have some friends who never, ever do. I'll have to ask them what kind of shit they get about it, if any at all.

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  3. This really bothers me. I don't think your coat would have made a difference to her. Sometimes we have our minds made up already and just look for evidence to validate it. It's like she feels less than a white person or less than a man.. Not good at all.

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    1. These deep-seated beliefs come from a lot of years of a lot of stuff. I tell myself that often so that I won't get too bothered, you know? I don't know what it's like to be in the un-airconditioned side of Grady back when it was segregated. She does.

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  4. My mom always said that after slavery, some black folks' shackles were no longer on their feet, but now on their minds.

    Bless her heart. Some people still don't know we're free.

    -Renee

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  5. Wow...what a stunning look into the mindset of someone I'd be unlikely to have any interaction with on a personal level. If I was the physician I would have been thoroughly befuddled by her response, though after some contemplation I can see where it might have originated. As the patient I would be kind of perplexed by a physician who showed up in a patient setting sans the white coat, but it wouldn't matter to me what characteristics they happened to have (e.g., gender, age, race, whatever). I can't remember the last time that happened, and I'd probably query it, too, unless I could read the name badge clearly. But this patient sounded more like she had some preconceived notions about who should be a doctor that went far beyond the white coat. My own experience says none of that matters; only the truth in their credentials, the openness of their heart, and the skills of their training matter to this potential patient.

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    1. Yep. Maybe she just wanted her doctor to wear a damn lab coat! Ha ha haha.

      Seriously, though--this could be highly complex or not at all, right?

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  6. What an amazing and rich encounter. I have had similar experiences in the pulpit, some folk don't believe women are allowed to preach, because of what the Bible says and all. I admit when I had surgery a few years ago and the anesthesiologist came in and looked like a teenager, Kristian and I looked at each other and said after he left, "we are officially old". I had to shift my mindset to feel safe with a younger doctor, especially one that was in charge of knocking me out.

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    1. I didn't even think about what you face in the church setting. Wow. Peoples' expectations are a powerful thing to go up against.

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  7. From the deck of the Poop,

    I swear fo God, I may have been inclined to say a few choice words to 90 year old sister girl. LOL This was an absolute trip. I went to see "The Butler" on Sunday and actually shed a few tears just remembering when I was there. I was a freshman in college during the year when that stuff started. I was working at a steel mill in Birmingham Alabama (my home) the summer following my sophomore or Junior when the White and Colored signs were taken down. The older black men working there, reminded us, younger blacks that we had been drinking from those Colored fountains all summer and the water was exactly the same; so don't go startin no trouble by drinking out of the white folks fountain.
    Of course I went straight to the White Only fountain, had to sort turn sideways to get thru the semi-circle of white men that had attempted to discourage me from doing so. I later realized that the old-timers were simply trying to keep me safe. The other younger blacks followed suite the day after ,when they saw that I had not been attacked??? The sad part for me is that I knew that my father would have given me the same admonishment if he had been in that plant. I didn't understand then but I understood later. They knew what the KKK and other were capable of during that time.

    Great post!

    Poopdeck

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    1. That. That's it right there, Poopdeck. I think she'd lived through things like your Daddy did. And that left her mind in a different. . . mindset. And what can you tell someone who has lived through that?

      Answer: NOTHING.

      Love you, Dad.

      Kimberly

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  8. The "Mis-Education of the Negro" by Carter Woodson (written in the early 1930s) is a powerful (and, I think, greatly under-appreciated) analysis of the forces that have shaped the mindsets of generations of people in our country. The words of your 90-year-old patient are not at all shocking to me in the context and the framework of her upbringing. What is shocking and heartbreaking to me is that so much of what Woodson wrote still applies (sure, it may be dressed a little differently and spun a little more fancily, but the core message is surprisingly unchanged).

    I cannot recommend this book highly enough, especially to people who are in any way involved in the upbringing and/or education of children (particularly, children whose skin is a little richer in melanin).

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  9. She's 90, so you could give her a pass for that. On the other hand my Aunt Winnie is 94, about to be 95 on YOUR birthday, and she is a soldier in this march for equal rights. She educated US. So her age is not the thing. Maybe it has to do with geography? In any case, this made me very sad, especially given that you are the doctor that would see this elder most fully, who would go the extra mile for her, and she doesn't even realize that. My niece started dental school at Howard on Monday! Not Meharry, but a proud and accomplished tradition nevertheless. Has this elder never heard of "twice as good to go half as far?" If she had, she'd have asked for the colored doctor or the lady doctor every time. In any case, you handled the situation with true grace.

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  10. thank God for people like your dad with courage to lead the way. if not, where would we be?

    if the older men keep teaching the young ones not to drink from the fountain, and the men guarding the fountain kept teaching their kids the same, we wouldn't have progressed at all.

    Deep.

    -Renee

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  11. Wow. Intense.

    I have to say though, in all fairness, I strongly prefer male doctors because female doctors don't take me seriously. They always think they can relate and that I just need to get over having a "hard" life. Male doctors don't quite as easily relate but they feel bad for me and therefore spend a little bit more time trying to figure out how to help me.

    Just an honest opinion from a young female who is skeptical of female doctors,
    Abigail

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  12. This is so interesting to me... it just is really not about race at all most of the time...it is the damn lab coat!...I used to be a caretaker for some very rich families (some you would recognize) (sp?)ha! Anywho...when the movie The Help came out I thought to myself..."Am I the only one who doesn't get it"? I am white and believe me if they could have made me use a separate bathroom they would have!

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  13. Unfortunately this is not just the midset of Black patients in their 90s. I am now a 4th year medical student at a medical school that has little diversity in the south. No one in my family went to college, let alone medical school and many only made it to middle school. My mother is in her 50s and during the beginning of my 3rd year of medical school when I starting to wear my short white coat daily, I didn't understand why she was so worried about the appearance of my white coat. She would call me every Sunday night for me to come over to her house so that she could wash and iron that coat! Initially, it would anger me as I couldn't understand why she was more concerned about my white coat then she was about the knowledge I was trying to acquire and the myriad of exams I was required to take on the road to becoming a physician...After numerous interactions with Black patients during my clinical years, I don't get upset anymore. I get it. To many who didn't have the opportunities that I am now afforded, appearance was the one thing you could control that defined what kind of person you were. Uniforms define most of the professions that those in my family as well as those of the Black patients I encounter...so in a sense your patient felt uncomfortable because she couldn't categorize you based off of your appearance as the one who was in charge. Unfortunately this mindset still applies to those in their teens and 20s, but by continuing to see knowledgeable, caring and compassionate doctors like you and that which I hope to become, the uniform in their minds will change.

    PS. Soror, I'm an avid reader of your blog but this is my first post. Keep it up, "WE" are watching and learning...

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