In complete contradistinction to the ambiguity of the long white coat, you, dear patient, are wearing something that tells the entire world precisely who you are: the hospital gown. We’ve already discussed the physical inadequacies of the patient gown. Let us now explore what makes the gown such a truly dehumanizing piece of clothing: once you put it on, you are “the patient.” It’s the great equalizer, really. It doesn’t really matter where you came from or what your background is, because in the hospital, you’re exactly one thing: the patient. If you have any kind of title for which you have worked hard, and sacrificed, and of which you are proud – things like sergeant, reverend, colonel, doctor, professor – and by which you prefer to be addressed, well, get used to “mister” or “miss.” All of the sudden, I was a “mister.” I knew I was going to be in the hospital. I knew it was going to hurt and be a terrible experience, and I knew I was going to be playing the patient role. But, even after everything that happened, the thing that really drove home my new place in the hospital pecking order was when one of the nurse practitioners, someone barely out of school – I’m 9 years down the medical education rabbit hole at this point – and with less clinical experience than a third year medical student was calling me “mister.” And usually, that doesn’t bother me that much. I certainly don’t expect everyone I meet to magically know that I’m a doctor. But this was someone who was a permanent member of my treatment team and someone who I saw almost every day. I think it bothered me so much because it made it feel like they didn’t really know me or my case. I was just another patient on the list.
Another thing you’ll start to notice is that gown completely and utterly changes the way in which you even register on people’s radar of perception. It immediately stratifies you into being “a patient.” It’s like you’re a piece of furniture sometimes, too. People just go right by you without making eye contact, much less acknowledging your presence. If I’m being completely honest, I used to do the same thing when walking by a patient being transported somewhere. Don’t look at them, or look at the ground, or pretend like you’re looking at your phone/pager, whatever. Even after being around sick people for a long time, there’s a part of you that doesn’t really understand what it’s like to be sick until you’ve been through it. People don’t like to look at you, I think, because you now remind them of their own mortality. But it’s not like I suddenly stopped being the person I was before and became some non-human object called a “patient.” So I don’t do that anymore. Everyone gets at least the nod of acknowledgement as I pass by them now, if not a full-on “hello.”
I made that decision after another one of those great “being a patient in the hospital” experiences. Before all of this, obviously, I took call like any other resident. And for whatever reason, this one neurology resident and I seemed to have the exact same night float[ref]“Night float” is an unnecessarily confusing phrase that means you’re working the night shift. That’s it. But it wouldn’t sound as cool if we just called it the night shift. Hence, “night float.”[/ref] schedule. We’d talk multiple times a night for weeks. She would come into the reading room and literally sit next to me when we’d review a case. She and I answered pages to each other on a first name basis. We’d shoot the shit, and make fun of the ER together. And don’t lie, fellow physicians. We’ve all done the same thing to the ER, just like I’m sure all of you have done to radiologists. Correlate clinically.
One day, during my hospitalization, when I was being ferried back to my room from dialysis, she got on the elevator with us. I was kind of surprised, but also excited to see her. I thought it was going to be one of those, “ohmygod I have a million questions” moments. So I smiled at her and was about to say hi, when I noticed she looked right at me, held my gaze for a second, and had absolutely no clue who I was. Now granted, maybe we hadn’t spent a ton of time with each other, really. But I know her first and last name. I have a pretty good idea of what she looks like. Like, if the 5-0 came in here with a lineup and asked me to identify this resident, I really think I could.
The person in the gown didn’t even register to her. She saw the bed, the gown, and that was all her brain needed to place me into the mental cubbyhole of “patient.” The patient gown is, perhaps, the thing that robs you of your humanity more than anything else in the hospital. Not the gown itself. I mean, they’re not particularly great at covering up your butt, but it’s more than that. No, it’s the way in which it makes people see you. Just another patient.
And as “just a patient,” you’re mostly being told what’s happening. What’s happening, to you. You don’t have a lot of say or choice in the plan. They all stand around outside your door talking about what they’re going to do and what they actually think. Here’s a tip guys, I can hear what you’re saying. But then they would come in to explain things to me like they would to any other patient without any knowledge of medicine. Perhaps this particular annoyance of mine is something that only a nurse or physician could appreciate. But it felt pretty disrespectful, to be quite frank. I’m a physician, just like them. I had more time in training than some of the surgery residents, even. Certainly more than the mid-levels. I don’t want to be told what’s happening, I want to be part of the conversation. Part of the decision making. I’m both the patient in question and a doctor, yet I’m not included in the big-boy discussion? If you’ll pardon my language here, what the f**k? I’m sure a lot of my frustration with the situation was due to the fact that things were largely out of my control, something to which, back then, I was not accustomed. Little did I know that the lack of control was just beginning, and only in retrospect can I say that I’m now used to letting go of the proverbial wheel. But, like everything in this process, I had no choice in the matter. So I just went with the flow.
Continue reading in the next installment by Christopher Graham here: Chapter 4 | Part 3: The Unexpected Visitor
Read the previous installment by Christopher Graham here: Chapter 4 | Part 1: The White Coats
