Wednesday, August 21, 2013
LIfe at Grady: Dressing the part
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.
“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 brightly 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 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. Hell, I even had a stethoscope around my neck. What could she possibly be--
I figured it out. On this day, I wasn’t wearing my white coat. And honestly, the only reason 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.
“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.
“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.”
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. Johnson, did you know that these lab coats can carry infections? Like, a lot of doctors never wear them at all anymore. 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.
“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.”
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 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.”
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.”
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.
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 at 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. But either way…this? This, my friends, is Grady.
Kimberly Manning, MD, FACP, FAAP is an associate professor of medicine at Emory University School of Medicine in Atlanta, Georgia where she teaches medical students and residents at Grady Hospital. This post is adapted from Reflections of a Grady Doctor, Dr. Manning’s blog about teaching, learning, caring and growing in medicine and life. It has been adapted and reprinted with permission. Identifying information has been changed to protect individuals’ privacy.
Labels: Life at Grady
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