Role Models

Off to make a house call! Jeff, pay attention!

A first–year medical student has entered our lives, again  transforming us into new parents.

          After 4 years at Brown and one year living just off Manhattan’s mean streets,  son Jeff has returned home.  U Conn Medical School is five miles distant and he has reclaimed his ancestral room.

.   Once again we hear the patter of little panicked feet upon the stairs in the night . He’s scared and needs comfort, as he did when he first crawled our dark hallways in 1991. Nowadays, we reassure him  the trigeminal nerve has both motor and sensory function, and he returns to bed, soothed, ready to face tomorrow’s  anatomy  test. 

         Jeff’s return home echoes his last sojourn here  during Pere Bush’s tenure.  Cyn and I were determined to provide a soothing, stable environment  in which young children would thrive. We fiercely struggled to demonstrate that, in our upper middle class cocoon,  traditional  role models were irrelevant  and  that we could live a non-judgmental, compassionate lifestyle.  Easier said than done.

         We wanted to show  Jeff, Dan and Abby  that  we had moved beyond traditional heteronormative  roles and that  our life style was not  a deadly, crushing  distraction as we waited our first ominous blood tests.

             “Gee Cyn, I had a great day at work! Earning a paycheck  is both rewarding and  imbues one with a sense of self worth.”

            “ Steven, dinner is delicious.! I guess the  stereotype  that men can’t cook isn’t true.”

            We’d  measure  our words  carefully. We  understood the possibility our hostility, boredom or anger might transfer to our children who ignore every plea to clean their rooms, but pick up on the fact that we think X’s parenting skills  left much to be desired. We learned early on: criticize neighbors at your own peril.

            “Hey mom,  X wanted to tell you that  she is an excellent mother, and at least she doesn’t entrust her children’s safety  to a series of  immature, moody  Norwegian Au Pairs.”  

And then there was the whole potty mouth issue:

            “ Jeff was at our house yesterday, and said “ who gives a fuckety fuck. Who talks like that?”

            We tried our best.  We apparently didn’t protect Dan from the corrosive but hysterical affects  of sarcasm:

https://docs.google.com/file/d/0B0a3zabJzWdYcEtvbHkzU0dWLU0/edit

         We were flattered when Jeff asked to live with us this year, forgoing  the  U Conn  college town that sits across the road from the hospital.  We were touched  he’d rather live with two aging, cranky, middle aged Jews than 120 tightly wound, high strung classmates who would  commit unspeakable acts to win the residency of their choice.

         Jeff has always been competitive.  We recall a time, six years ago, when Jeff traveled to Providence  Rhode Island to sit in with the Brown University Jazz Band teacher.  As Cyn and I know too well, med school is a toxic combination of  overwork,  sleep deprivation, and  rote memory.  Jeff’s experience is different because  students are now expected to volunteer for left wing  projects,  teaching sex education  to inner city schools and  participating in Harford’s gun buy back program.  U Conn  Med exists in a culture that now expects medical students to give back to the society that allowed them to  attend med school in the first place.

         But I didn’t want to discuss the miracle that is Jeff. I wanted to write about behavior modeling.

           I don’t want Jeff to regard doctors as a bunch of bitter, burned out, cynical  paper jockeys  who spend most of the day writing notes  liberating patients from jury duty.  I catch myself when returning home late at night before I  deliver a tirade about the hospital’s mindless and random bureaucracy   that  crushes our goodness and compassion into a fine, bitter paste.  I can’t say a bad thing about any of our patients ( not that I would) 

            At least, once again,  I can  say “ pass the fuckety fuck fuck mustard.” And this from an ex English major.

         I want Jeff to know that even in this era of  pay for service and overpriced meds,  we enjoy our jobs. As Colleague J. sometimes says “ All I have to do to feel better is see the next patient.” We honestly feel we were put on earth to be  physicians, and I think we’d all feel vague dissatisfaction if we played any other roles.

         We don’t want to be mere pill pushers, and I don’t want Jeff to become one either. The world is filled with awful, uncaring  arrogant doctors.

  To quote  Say Anything

D.C.: Lloyd, why do you have to be like this?

Lloyd Dobler: 'Cause I'm a guy. I have pride.

Corey Flood: You're not a guy.

Lloyd Dobler: I am.

Corey Flood: No. The world is full of guys. Be a man. Don't be a guy.

That’s exactly right. I have to  role model that humility, that sensitivity. 

 I want him to know that  being a physician is an honor, a gift,  and to do it well is something  almost no one does. You just cant say that. It sounds … well,. It makes one sound like a doctor.

         This might be why I  need to  tell Jeff about my house calls.             I enjoy making home visits. Patients are  more comfortable in their own homes. We sit and sip coffee in the  kitchen. I do what all  good docs do, ask seemingly innocuous questions that  help me make diagnoses ( So, is this the first year you didn’t  shovel snow?”   I want Jeff to know  that our pateints’ time is precious too, and sometimes you have to  grab the black bag and go visit.

Before you get all misty about  doctors no longer making home visits, remember that  home visits were once used to bluff patients into translating a physician’s presumed compassion with his competence.  I remember  Lewis Thomas’s The  Youngest Science

            I am quite sure my father wanted me to be a doctor, and that must have been one of the reasons for taking me along on his visits. He was not always being  honest. he said. One of his first patients was a male complaining of grossly bloody urine. My father found himself  without a diagnosis. To buy time, he gave the patient a bottle of Blaud’s pills, a popular iron remedy for anemia, and told him to come back to the office in four days. The patient returned triumphantly  holding a bottle of clear urine.

I once rounded with the kids at the hospital, the patients ooing and awing at my young charges.  I doubt  Dan and  Abby will pursue medicine, but I am glad Jeff is planning to be a physician, a surgeon. I’m not sure who role modeled the surgical persona for Jeff.  But there he is, a little cocky, a little arrogant, convinced of his own skills and  knowledge.  That’s not me.  Perhaps it’s Cyn. It’s certainly her dad, grandpa mark, who was  a litigator but would have been an excellent surgeon It doesn’t matter, really, Jeff’s on his way. If only we had role modeled the need to do one’s laundry….