were a visiting dignitary.
“Y’all want to go round now? Doctor Cohen, how about a cup of coffee? It’s fresh.”
Even after the two earlier cups, Leslie accepted the offer. Mary Ellen turned around and went to the break room for the coffee. “What do you take in your coffee, Doctor Cohen?”
Leslie volunteered to fix her own because it was always impossible to specifically define a ton of creamer, and then on top of that a pink, a blue, and a pinch of the real stuff. People were always surprised, and it always embarrassed her. Mary Ellen, giving no indication that she was surprised, said she’d remember that recipe the next time.
Right, Leslie thought to herself, and pigs will fly.
She often simplified the position of physicians in her world in terms of a personal experience she had while she was a pre-med student in college. She had been employed during the summer between her freshman and sophomore year as a ward secretary on the surgical floor of the local hospital. She was required to wear a blue and white pin-striped, drop-waisted dress, of an unfashionable mid-knee length. It had a little rounded collar. She wore Keds and bobby socks, which were equally unfashionable at the time. She was introduced to the head nurse who was totally competent, totally in-charge and striking in her tiny starched white, belted dress, with her white cap and school pin in place. Her silky white stockings with lace-up white oxford shoes completed the picture perfect nurse. Leslie couldn’t even remember her name now, but in her mind, this woman epitomized what would always be her idea of what a head nurse should be. She ran the department. Saw to the care of all the patients. Knew all the patients. Knew what each doctor on the floor wanted for their patients and in their coffee. She gave Leslie her job description, the must-do list, the next-must-do list and the don’t-do list.
But the thing that Leslie remembered most clearly was her instruction on what to do when the doctors arrived on the floor. “You must get up and offer the doctors your seat because they have important work to do.”
Eventually an attending surgeon and his entourage of students and residents came on to the floor. This nurse immediately got up to let the surgeon sit down. She then brought him a cup of coffee and asked if he was prepared to go around and see patients. When he replied to the affirmative, she went over to a rack of metal backed charts which she and Leslie had previously prepared with updated hand written lab slips, extra progress report sheets and doctor’s order sheets. She wheeled the rack around the hall with the group of physicians and reported on every single patient on the floor.
During her training, Leslie often thought of the day when she would be assisted in this fashion, on some unknown hospital floor, by some unknown head nurse like this one.
When pigs fly.
Thirteen years later, on her first day when she rounded at her first hospital, there was no one to greet her. Forget about that cup of coffee. She tried to identify a nurse. Any nurse. By then nurses no longer wore uniforms. They wore various forms of scrubs and sometimes on Fridays they wore jeans. This made it hard to tell who was a nurse, a therapist, a doctor or a visitor. She went around on her own, to see all two of her patients and then sat down to write in the progress notes. There were none in the chart and so she went to the area in front of the nurse’s station to ask where they might be. She was pointed in the direction of some shelves by someone she later found out was the I.T. guy, up working on the computers. She grabbed a couple of progress notes, stamped them herself and returned to her seat where she was promptly approached by a large woman wearing Hawaiian printed scrubs, who said indignantly, “Excuse me. You’re sitting in my seat. I was charting there and went to check a patient’s vitals.” This happened to be the nurse taking care of her two patients.
Leslie, Mary Ellen and Doc then, set off to round on all of his patients. It took an hour and a half. Mary Ellen had the lab results on every patient filed in the charts. In Leslie’s experience up until now, most lab values had to be tracked down, either on the computer, a file box at the nurse’s station or stuck somewhere in the chart. Mary Ellen knew about any ongoing problems, both medical and social. In Leslie’s current experience, she usually had to rely on patients and their families to tell her if dad had a problem today. Only the nurse taking care of the patient had any knowledge of the situation and if they were down the hall or on break, there was no other way to get current information. It could be read in the chart if it was charted. Nurses were overwhelmed and Leslie understood why. They needed help and help was too expensive for the hospitals to afford. The nurses were not to blame. It was a complex problem for everyone involved.
Of course, she never forgot the nurse who asked her to give up her seat, thereby ruining and at the same time cementing her concept of what it would be like to be a contemporary doctor.
Mary Ellen and Doc interacted with patients as if they were neighbors, Doc taking a seat on the window ledge, sometimes helping himself to candy sitting on the rolling bedside table.
“Take more, Doc!” The patients eagerly encouraged him.
“Oh, no, I’m watching my figger.”
Patients were as interested in Doc as he was in them. He introduced her to everyone. “Doc Cohen, my replacement.” Patients then calling her “Doc” too. There was something about Doc’s easy going, good ol’ boy affability that struck a little envy in Leslie. Some guys just have it, and there’s just no point in trying to fake it.
They saw four patients who had just had total knee and hip replacements. There were two elderly ladies with broken hips, one waiting to have surgery today. There was a guy who had a herniated disc removed from between his fifth lumbar and his first sacral vertebrae. They said hello to a patient who had her rotator cuff repaired yesterday and had to stay overnight because she didn’t have any help at home. Her daughter was arriving from Chicago today to take care of her. There was a guy with a broken tibia and an Abilene Christian College coed with a broken ankle which Doc had fixed. Leslie was surprised to see the two trauma cases because she figured Doc wouldn’t be seeing emergencies this close to his leave.
“The fellow with the broken leg is the son-in-law of one of my best friends and Christy is one of the medical floor nurse’s daughters.” He looked at her kind of stupidly and shrugged his shoulders. “When the agency said you could come and you could stay for a while, I figured, what the hell.” Leslie figured the same. Mary Ellen just looked at her, smiled and shrugged too, like, “What’re ya gonna do?”
Rounds were done and for once Leslie didn’t feel like ripping her hair out. Maybe she had died and gone to heaven. Would Chris and the kids come walking around the corner? Mary Ellen would suddenly have angel wings and Doc would be wearing a robe, hold his hand out to her and say, “Even though you stopped believing, you were a good girl and we’re inviting you in anyway.” Then pigs would start flying all around her.
“You wanna give me a hand with a couple of cases after you get your credential forms signed? Let’s see what a lady doctor can do!” Mary Ellen looked at him with stern eyes and tight lips, like a mother getting ready to scold him. Leslie was totally unoffended because there was no malice in his voice. He was innocent of prejudice when it came to her, she felt certain of it. He was just a good ol’ boy and he could have been talking about cattle or surgery, either one. She knew the sound of malice when it came to women in a man’s world and she wasn’t hearing it now.
They headed to the administrative wing of the hospital and met up with Terryl. He introduced her around the office and she was once again struck with the fact that it seemed she was treated more like a permanent fixture rather than the transient locum tenens.
She remembered her arrival at the county hospital in New Paltz. Just having finished her residency and joining the local group of orthopedic surgeons, she was treated nicely by everyone at the hospital. They were desperate for a warm body and she filled at least that job description. The three senior partners were totally beat up, having taken every third night call for the past ten years. No new blood for ten years! They put her to work instantly taking every other night call and the major holidays. The senior partner went into semi-retirement. At Christmas all three took off for a skiing vacation, leaving her alone to run the ship. Of course she didn’t think