Being a medical student on clerkships often feels like performing on a stage while wearing a straitjacket. You’re unsure of how your personality and tics might be perceived, and the goal — besides absorbing as much knowledge as possible — is to make a good impression in order to land a good evaluation.
The composition of the team changes often, sometimes weekly. The audience shifts quickly; you must be agile to meet their expectations. Some attendings always like to hear the patient’s vitals on rounds. Others don’t if they’re stable. Some like to hear your plan by organ system, others by problem. Sometimes, your anxiety is assuaged by an attending who makes jokes with the team. Sometimes, you are on edge the entire time. At the end of the week, you feel drained. You dread the change that’s coming.
On the other hand, the non-clinical staff — the floor secretaries, medical assistant and maintenance people — never change. They are not on a rotation. So, they can be anchors as you try to stay afloat, as you are rocked by never-ending waves on a shoreline.
Internal medicine was my introduction to the hospital. After one week, I was still shy in my interactions with the team, figuring out logistic and team dynamics. I made it to the hospital on a Saturday morning, in pain from a stiff neck. The first person I spoke to was Ms. K, the weekend and evening unit secretary. Immediately after we exchanged greetings, she noticed that I was uncomfortable.
“What’s wrong? Come here!” she asked.
I walked to her desk, and she led me to the supply room, handed me a heating pad for my neck and asked if I was enjoying my time on the service.
How kind of her, I thought, pleasantly surprised.
For the rest of my time on the service, we chatted about tennis, music and other common interests when we crossed paths. Ms. K. had played tennis in high school, which her parents and friends thought was an odd choice. She was the only Black girl on her tennis team. Her husband and children were much less interested in the sport, instead preferring basketball. This reminded me of my own experience: I started playing tennis at 11 years old, and quickly grew to be over six feet tall. Most people assume that I am at least decent at basketball. The mismatch between family or societal expectations and our own interests often causes internal conflicts. I was born during the peak of Michael Jordan’s career, and in naming me “Jordan,” my father hoped I would grow into a talented baller. I did not.
Ms. K was just one of many friendly staff members. There was a daytime business associate who went by T. She was jovial, and I often heard her singing Tina Turner songs at her desk. Her favorite was “Proud Mary,” which was mine as well. So, we immediately connected. We’d sing together every once in a while when I walked by her desk:
’left a good job in the city
Working for the man every night and day
And I never lost one minute of sleeping
‘worrying ’bout the way the things might’ve been
Big Wheel Keep on Turning (Turning)
Proud Mary keep on Burnin’
Sometimes, she’d be joined by Ms. S, a patient care associate. When I saw her in the mornings, her greeting of choice was a happy “Good Mornting!” akin to Madea’s, the tough Black matriarch figure played by Tyler Perry. We laughed every time. But when she saw me with the full team during rounds, she switched to a terse “Morning.”
Our interactions in the hallways epitomized code-switching, the scaffold of communication used between many Black people in the workplace. In mixed company, she was “professional” or “workplace appropriate” as some might say. In one-on-one interactions, we used slangs and cracked jokes.
The Madea references, the Tina Turner songs and experiences engaging in non-stereotypical activities are all connected with some highly valued aspects of the Black experience: pillars of music, comedy and a constant inner identity conflict due to societal expectations. In clearly defined hierarchical relationships, I do not approach conversations about race or even pop culture as easily.
Most Black people I have met while in the hospital are non-clinical staff. It is no surprise, given the history of racial hierarchy in the United States. They acknowledge this hierarchy in many ways. For those who are older, it is by being cheerful in subtle ways as these women have been to me. I believe that this is a way to acknowledge and celebrate the fact that younger generations of Black people have a place and a future in medicine. For those who are younger like Mr. D, the patient transport associate who doubles as an Uber driver on the weekends, there is hope that they too can climb the hospital’s ladder. When I rode in his car, we talked about the health care system and his goals. As it turned out, he is currently studying for his MCAT and will apply to medical school soon.
Despite being part of the hospital’s social structure as a member of clinical teams and an aspiring physician, I felt a sense of kinship and togetherness in my interactions with each one of these members of the hospital staff. Hanging with them for a few minutes each time felt like a break from the performance — they weren’t evaluating me. Many of them are natives of New Haven, with a wealth of knowledge about the city and its history. Finding what we had in common, regardless of where we stood in the hospital, is what drove these connections. With them, it was the fact that we were Black in a space where those in powers are mostly White.
Certainly, I have connected with many more members of the hospital staff on a different level. For instance, the unit secretary during my first surgery rotation was an elderly White woman who used to bike to work in her younger days. Seeing me wearing my helmet on my way home sparked daily conversations, which I enjoyed after long days in the operating room. In the cafeteria, the gentleman who works in the burrito line makes me smile every time because of the excitement in his voice and how happy he seems. What do we have in common? We share the same first name.
I have learned that finding what I have in common with people yields great interactions, and that certainly contributed to these relationships I built with staff members of the hospital. They all make the hospital-world go round for our patients and certainly contribute to making my world go round during my clerkship year. For that, I am thankful.
I’d like to thank Drs. Anna Reisman, Danna Dunne, Lisa Sanders, Benjamin Oldfield and Vincent Quagliarello of Yale School of Medicine’s Department of Internal Medicine for their contribution and encouragements in the conception of this essay.
Attending Howard University gave Max a foundation for and continues to inform how he approaches issues related to injustice. Now in medical school, he has made it one of his focal interests to learn about and contribute to progress towards health equity, nationally and globally. Through this column, he will share stories on his experience as a Black man in medicine, and insights on topics of race, class, health equity, and medical education.