“Everything is going to be OK, Mr. Roberts!”  the young man ran in to the hospital room where I was examining Mr. Roberts and just as quickly left.

My first thought was, “Who was that guy?”  My second thought was that Mr. Roberts was most assuredly not going to be “OK” for the near future, maybe never.  I was just an intern, years ago, and had to evaluate the unfortunate man who had a large stroke involving the dominant hemisphere, middle cerebral artery territory, affecting expressive and receptive speech and paralyzing his right side.  At least Mr. Roberts didn’t understand the optimistic words.

The “intruder” was a physician’s assistant for a well-known local internist and was busy writing orders when I returned to the nursing station.  Because he worked for a senior physician, he made himself important by association.  Stripes are what nautical and airline officers wear on their sleeves or shoulders. Stripes should not be transferrable, but a lot of people think they are.

I stayed quiet that day; as an intern, I was at the bottom of the hospital pecking order, and the PA was “wearing the stripes” of the doctor for whom he worked.  My training was more than his, I was working longer hours than he (nobody worked longer hours than interns in those days), but length of training, knowledge and hours worked stood little chance against a forceful, sure of himself individual.  I would see that in spades with the surgeons with whom I would deal.  There was no way I would have told the PA that Mr. Roberts had a long, difficult road ahead of him.

A month later, that longest year of my life, I found that the OR Nurse for cardiac surgery wore the stripes of the two cardiac surgeons for whom she worked.  Every intern had to spend time on the cardiac surgery service. The pair made my 24 day rotation hell.  The two fed off each other, driving me to tears on one occasion, classic physician behavior back then that is slowly dying out as the old guard finally moves on.  I was a physician, not yet licensed to be sure, but I didn’t deserve to be treated as the “hired help,” either.  The two were equal opportunity nasty to everybody; they threw instruments, hit me on the wrist with an instrument if I weren’t holding it properly, demanded I hold a retractor better, when I couldn’t see what I was doing, and thanked me only 5 times on the 12 multi-hour cases which I helped them.  I found I could fight back with my intellect, because I was able to correctly answer every anatomy question they posed during a case, often with a bored tone of voice that was my passive-aggressive way to say, “Can’t you do better than that?”

One day, I finally had one of those rare moments in life where I said exactly the right words at the right time, the “Perfect Squelch.”  I was holding a hemostat, a clamp, and my thumb was too far through the handle.  “SMITTY!” the senior surgeon shouted.  (I hated that name).  “DON’T HOLD YOUR INSTRUMENTS LIKE THAT!!! YOU DON’T HOLD YOUR SILVERWARE LIKE THAT, DO YOU?”

I quietly replied, “Dr. Maloney, I don’t use silverware.  I eat with my fingers.”  Other than Dr. Maloney’s unsuccessful attempt to comment, the room remained silent the rest of the case.

Their nurse treated me as the hired help, too.  While I didn’t like how she looked at me, her mannerisms or her tone of voice. I just told myself that my time as an intern wouldn’t last forever.  Every day was another 0.27% gone.  I wonder how she was treated by the surgeons themselves.  One subsequently had a nervous breakdown, and I actually felt sorry for him.  He was an arrogant jerk, but his life was going south and mine was not.

Wearing the stripes literally came to pass the following two years, when I was in the Navy.  The concept of the wife of the Captain being in charge of the other wives was “wearing his stripes.” Some women used their power well, however, perhaps supporting a pregnant wife of a Navy Ensign, her officer-husband overseas for 8 months, and needing help.  Others tended to act as their husbands, only that backfired if a wife was a professional with her own career and quite capable of living independently from her husband if she had to.  Like mine.

Over the years, I have seen others wearing the stripes.  I’ve seen them on the face or heard it in the voice of an Executive Secretary or a doctor’s nurse.  It was a very clear, “my boss has a lot of power, so therefore I have it, too.”  Had I more interpersonal skills, I would have learned to cultivate these people so that they would look forward to hearing from me and do things that I wanted.  Alas, I did not have such skills.  I called things as I saw them, and that wasn’t always popular.

I came by my attitudes honestly.  My father was once superintendent of schools, responsible for everything in the district. Not everything he did was popular; indeed, we frequently got phone calls at various hours, since our number was in the directory.  One night, I heard my mother on the phone in my parents’ bedroom, a place I never went.  Sound travels, however, and I couldn’t help but overhear her say something along the lines of “That’s not my job, and I am not going to listen to your tone of voice any longer.  Good-by.”  She hung up.  When she left the bedroom, she saw me.  I don’t remember the look on her face, but I never forgot her words.

“Your father is getting paid to do this.  I’m not.”

She might easily have said, “He can wear his own goddamn stripes.”

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