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Monday, April 28, 2014

High-heeled nurses, and others who have gone to the Dark Side

Many times in this last year I have breathed a grateful sigh that I only have a few more years left before I can retire, not from writing, which I still enjoy, but from this world of medicine.

Now those of you who know me might be asking yourselves, "is this Tim Cook speaking?" It is sad, but the world of medicine, as I have gotten to know it, is now all but gone. I still enjoy my real work, interacting with patients and their problems, but unfortunately that is becoming less and less of what I do in my job. Now, what is the distinction between my work and my job?

To put it in perspective, let me share something of myself, and where I came from. I am the son of medical parents, and I knew that medicine went back several generations in our family. But it was not until my father's funeral, that I found out that I represented the seventh generation of physicians. That gave me pause to stop and consider.

Now when my father died I was a young doctor, fresh out of my internal medicine training. I was practicing medicine at that time in southern Ohio, and I was eager and happy with my profession. I looked forward to getting up and going to work. Even when I got called out in the middle of the night, I did so with a real sense that it was very necessary. It was a time of great professional fulfillment. And it was a time in which there were very few folks on the Dark Side. At the hospital I worked in, and even the clinic where I had my office, there were but a very few persons whose job was not directly related to the medical care of people. As a physician, I felt free to practice medicine. There were few persons who had the timerity to act as judges. And I do maintain, to this day, that it was good medicine that I practiced, and I was proud of my colleagues, who also practiced great medicine. In short, it was a fun and engaging profession.

Not so today.

Now I work shifts in the hospital. I do still try to bring something of this pride and joy in my noble profession to work every day. But I tell you it is getting harder. My colleagues are wrapped up in their own worlds, and conversations with them no longer carry the same weight as in previous years. And the shallowness of the emotional contact with them is distressing to me. We can no longer just sit down and confer, discussing interesting cases which mean something to us. We're too busy, and by that I mean too wrapped up in getting the stuff into the computers, which now control our very lives. And the relationship with nurses, pharmacists, lab and x-ray people has become distressingly superficial. When I leave my work at the hospital, I'm drained, and not in a good way.

I keep asking myself, "what happened?"

And I keep coming back with the same answer: health care has become big business, and is no longer defined by the patient-doctor or the patient-nurse relationship. Is it any wonder that patient satisfaction with their "health care" has hit the skids? And I keep seeing the high-heeled nurses, and the doctors who have gone to the Dark Side as the enemy. These are the folks who now run the show. They tell us how to practice, how much to practice, how to "say it in the right way" so that insurance companies (mostly run by high-heeled nurses) will pay. And rarely does a day go by (except weekends) when a small parade of "suits" is not seen going up and down the halls, doing nothing but formulating opinions about "how we can do a better job (i.e. cut costs)."

Not to mention, I now get very regular e-mails from my "boss" informing me of things that become "effective immediately," or how I should have done this or that differently. I really feel that I'm being micromanaged into retirement.

So, this is what defines my work (i.e. my profession) as being distinctly different from my job. I realize that I may be the last generation of physician in my family, but you know, perhaps that's not such a bad thing after all.

And besides, I still have my writing - which is becoming ever-so-steadily my work.


  1. A nurse only 3 years into this game and having never experienced anything other than the way it is, I can say that this is not what I had in mind when I decided to become a nurse. I can't care for my patient and interact with them using common sense, good manners, and a spirit of empathy--I am told how I am expected to introduce myself, what words I should use, how often I should use them, and how I should chart them. Perhaps the hospital would be better off training used car salesmen to do the job.

    1. Oh, I do empathize with your plight, Josh. Nursing has become another profession that has come under the gun of the "business of health care." And that is why, in large part, Judy Morrison, and her colleagues do play a very prominent role in The Book of Drachma. As a physician, I am dependent on good nurses, who are getting scarce.