April 22nd, 2022

Dr. Good Girl

by Davy Ran

“I like her,” he states approvingly, nails digging painfully into my shoulder. “She’s a good girl.”

I flush in humiliation as my classmate makes worried, deliberate eye contact with me. Are you okay? their stare is asking. My body and my mind battle with each other to answer: NO!… Yes! I have to be!

It’s not the first time this has happened with a doctor, this infantilizing praise with a too firm touch. It’s happened in the ER, in the OR, in the hallway, in the stairwell. A little comment, a little prod. An appreciative murmur as I turn to help a patient. A heavy hand on my waist placed a little too long..

“He’s just being nice,” one resident laughs, while another scowls at me skeptically. “He’s showing you off. You should be grateful for such support.” Nods all around.

He’s important. He’s powerful. He has a hand on my shoulder. What’s the big deal?

You’d think my male classmates didn’t have shoulders at all. But then again, they weren’t good girls. Then again, neither was I.

*      *      *

My classmate Theo and I do a late night run to the supermarket to break all the healthy diet advice we give to our patients. We’re still dressed in our dark blue scrubs and Dansko clogs, med student IDs swinging from our necks. The grocery clerk looks delighted. “Thank you for your service,” she recites, the odd turn-of-phrase ever more popular in the COVID-19 pandemic. Her eyes are resting strangely above me, and I realize she’s talking to Theo, who stands several feet behind us, pulling groceries out of our cart.

“…Theo,” I murmur, and his head jerks up.

“What– I- uh… thanks,” he responds, as caught off-guard as I had been.

The clerk asks him with a large smile, “What kind of doctor are you?”

Theo doesn’t look at me as he places ice cream on the belt. “We’re both medical students,” he answers, and I want to hug him. But it doesn’t work.

“Oh, good for you, young man! You already look the part. You’ll make a wonderful doctor, I’m sure.”

“Thank you,” Theo says politely, and then, a little more deliberately this time: “We are both looking forward to being good doctors.” A stalk of celery is aimed pointedly in my direction, and at last her eyes flick over to me. I’ve been holding out my card to pay this entire time, and it feels terribly awkward now.

“Oh!” she exclaims in recognition, and I let my shoulders drop a little. “It’s so nice of you to support him. What kind of nurse will you be?”

*      *      *

I get mistaken for a nurse more and more as the days go on. It never happened to me when I first began.

“You walk with such confidence,” my friend had said.

“You’re too intimidating,” the doctor had said. I learn to perfect my humble spiel, explaining to each patient—and then resident—and then attending—that while I have an incredible respect for the work nurses do, I’m not one of them, and I never have been. Word still seems to spread that I’m not anything like a doctor, though, or maybe I start holding their words inside of me, good girl, until I’m the one that’s pushing them out into the world. My white coat, a symbol that had once held the weight of the world to me, feels far too light on my increasingly hunched shoulders, a barely-there wisp of meaningless cloth.

*      *      *

The problem is, I’m still feeling out the margins of this job, not knowing my duties yet, where they start and where they end. I help my patients drink and I help them eat and I help them use the commode and I do it all with eager enthusiasm, half out of a willingness to please and impress, and half out of genuine excitement that I get to do anything with patients at all. No one ever told me the in-depth details of what third-year medical students get to do. I assume if any doctor gives me an order it’s one that’s appropriate, and necessary.

I buy my residents drinks and I watch them eat free lunch I can’t have, and I fetch them toothbrushes and lotions and IV bags and iPads. I schedule patient visits and interpreter visits and family zooms. I restock shelves and I make up beds and I clean up rooms. I present my patients but I’m talked over through it all and when new patient assignments come I have to insist, again, that they be divided up equally. I wake up early, and then earlier, and then am far too tired to study at night. My male classmates are thriving. Why aren’t I?

My classmates don’t know where the coffee stand is. They don’t know where the iPads are. I show them the way to the supply closet and one of them remarks gratefully that they’d never have found it without my help. One of their patients has fecal incontinence and they panic, frantically calling out to the nurse, who rushes in and gestures at me to help.

Because I have more experience, I tell myself later, even though I’d never met that nurse before.

*      *      *

“I just wish I didn’t have to take patient calls during dinner,” I complain one night when my phone lights up with a worried relative on the line.

“You have to take patient calls during dinner?” Theo asks in surprise.

“Well, yeah, the doctor told me to give out my number. . .” I start, and then it registers. “They didn’t tell you?”

“No. Of course not. When I’m off, I’m off. That’s what they told me.” There’s a tightness to his voice.

I’m filled with an abrupt sense of foreboding as I realize where this conversation is about to go. “And they don’t ask you to set up the clinic rooms, or get their drinks ready in the morning, or prepare the lounge for lunch, or. . . ” I trail off. The look on his face is answer enough.

 *      *      *

“Go get the bitch,” the attending orders, and several people hop-to. A minute later the chief surgeon comes striding into the OR, tucking her long blonde hair under a scrub cap which proudly proclaims, ‘At your cervix!’

The air abruptly gets thicker, tenser. The friendly background chatter fades away. The attending gestures roughly towards the patient’s body, opened and bloody.

“There,” is all he says, and she gets to work without a word. The room is silent with her. I watch the male residents and the male attending and the male scrub tech swap glances with one another, the one of them actually rolling their eyes in the Chief’s direction.  A few quiet minutes pass, and then: “Come over.”

I look around, but no one moves.

“You,” the chief surgeon says, half-turning towards me and jerking her head towards her hands. “Come over. Do you want to see how to do a vertical mattress stitch?”

Eyes follow me across the room as I step to her side. I can see her smiling at me in my peripheral vision. She places her hand over mine, guides it to a pair of forceps. “Don’t be nervous,” she says softly. “We all start somewhere.”

We’re both double-gloved but I feel her warmth emanating. She’s patient in a way I’m not used to and it’s hard to be nervous knowing she is watching me carefully—not to call me out when I make a mistake, but to catch me in case I do. As it turns out, she doesn’t need to. She lists each motion step by step, explaining the tension my fingers should have and the twists my wrists should make, and the world narrows to just the two of us and the patient’s spotlit skin beneath our fingertips. I do the best suturing job I’ve ever done.

“Why not have the student do a pelvic exam, so long as the patient is out?” the attending suggests, and I become hyper-aware of all the men staring at us. The back of my neck tingles and goosebumps shiver down my arms as the full implication of the attending’s proposal settle in. I’d heard horror stories of women’s genitalia being examined under anesthesia, without their knowledge or their consent, but they had all felt so far away. I had hoped that one of the many terrors doctors used to inflict on patients in hospitals was something we had long since grown out of.

In a room of twelve people there are three women present, and one of them is the patient. We all deserve better.

“I… I think I’m okay,” I manage faintly, stepping back from the operating table.

The attending looks unimpressed. “Okay, then you’re done here,” he tells the chief, voice tinged with impatience. I’d never seen anyone talk to a chief surgeon like that. My legs feel wobbly with shock, but she sweeps out of the room with the exact same confident step that had carried her in.

The chatter resumes the moment she steps out, and I hear several more “bitch” comments spill from around the room. I sit and listen until I can’t stand to sit and listen anymore. I step out blindly and almost crash into the chief surgeon by the door, already scrubbing in for another operation.

“Oh, I- sorry- thanks,” I stammer, thinking of how nasty the people just behind the door were talking about her. I feel guilty and complicit for having overheard.

Concern draws her brows in close, the corners of her lips pulling down. “You okay? That was a big surgery.” …What? Oh. Oh. She thinks the surgery got to me. Already I barely remember it amidst the heavy haze of judgment clouding the room.

“They were referring to you as ‘The Bitch’ in there,” I blurt out ungracefully, wincing at the ease with which the moniker sneaks out between my strained, flattened lips.

She laughs out loud. Sardonically, I assume at first, but my ears soon correct me: this laugh is genuine. I search her for signs of discomfort but find none. My body wants to fidget on her behalf. “Doesn’t it bother you, after all the hard work you’ve done to get here?”

“After doing twice the work they all did,” she agrees, and then shrugs. “But I know I’m good at what I do. I don’t need friends to do my job.”

I do, I think, and feel a little ashamed. It’s chilling to think that I could work so hard for so many years to get through the dark tunnel of medical school only to find that there is another longer, darker tunnel on the other end. There’s a part of me, I realize, that has been quietly preaching a mantra all this time, a part that says, Just get through this, and it will get better. Once you’re better, things will change. I always assumed that at some point, all the touching and teasing and testing would end, and I would finally be treated just like one of the guys, having earned the respect my male classmates claimed freely.

She picks up on my solemnity, reaches over and places her hand over mine again, though there is no patient beneath us now. “This is why we have to look out for each other, or the guys will walk all over us. I’ve always had a tough skin. You need to have one too, if you want to make it.”

It’s hard to have tough skin when it feels like her words are flaying it off me, when every day in the hospital is a new day of being pinched and pulled and poked before my skin has had time to heal over. Surely there’s room for sensitivity in medicine, and if not that, then outrage – righteous, demanding, professional outrage that insists I be called my name, given my space, recognized in my job…. right? I swallow, hard, because my heart has suddenly jumped up to my throat, and is threatening to spill out on my sleeves. I will my heart to keep itself together, to hold in the weight of these words as it has so diligently held in all the others.

One of my favorite nurses turns into the hallway, smiling as she catches sight of me. “You guys working together?” she asks. Without waiting for an answer, she continues: “You’re lucky, you’ve got a good med student working for you.”

“Yes,” the chief surgeon answers absently, taking her hand off mine. “She’s a really good girl.”

Davy Ran Davy Ran, MSc MPH is a rising 4th year medical student at the University of Rochester School of Medicine and Dentistry. They have been involved in global and public health equity work for over a decade with specialized training in working with the LGBT, Latinx, and disabled communities. At the moment, Davy is writing and illustrating a book of short stories about being a multiple-minority medical student as part of a year-long Medical Humanities Fellowship. Their overarching goal is to help recruit, support, and mentor other minorities in medicine and ultimately make healthcare a more accessible, inclusive, and equitable space. (Twitter: @DavySRan)