Sex, Drugs, and Public Health

September 17, 2012

Med School Culture Shock VII

Filed under: Uncategorized — cbmosher @ 3:55 am

VII Into the Real

I signed up for a class on writing, once a week downtown. If it ate into my studies, I could drop out. Meanwhile, I was doing something other than Med School. A diversion. I was unaware that another diversion had already been planned into the Med School curriculum.

A little man in a wool suit and a bow tie took the microphone.

“I’m Dr. Bottie,” he began. “Welcome to Preventive Medicine.”

No one even tried to muffle their groans.

“I know you aren’t all that interested in Preventive Medicine right now…”

… Snickers and snorts …

“… but it’s an important branch of Medicine.”

Guffaws …

“And to start the class off, we’ll be doing a field trip. The buses will be here Friday at this time. It’s not a vacation, so dress like professionals,” he warned us, providing a little insight into past field trips. “And no smoking on the bus.”

Hand up.


“Where will we be going?”

He smiled with his thin little lips. “Harlem.”

I was a little nervous about the field trip, and I could tell, by the snippets of conversation, that I wasn’t alone.

“My parents don’t have insurance on me for death by gunshot. Make it look like an accident, OK?”

“Never been this far north in Manhattan before. Does Santa Claus live in Harlem?”

Out the bus’s left side windows, Central Park’s expanse of grass flashed my memory to my father’s farm, where he had once held a Civil Defense drill: dozens of people lying across the big lawn, pretending to have been burned by the Atomic Bomb. They tried to convince me it was a fun afternoon. Mushroom cloud: what fun.

So I forced my mind to conjure, instead, a grassy hillside from my long ago bicycle summers: where I lay back in a meadow like Central Park’s to look down onto cornfields; where I was immersed in the bizzing of insects hidden in the grass; where I watched crows slowly circle in the warm blue above me on an afternoon that felt like forever and was light years from this New York Med School craziness; where a puff of breeze had brought me the perfume of chlorophyll, late flowers, and just a hint of cow poop.

“Graze around me, cows,” I said aloud.

And the cadence of the bus’s tires fell into the rhythm of Grazin in the grass is a gas, can you dig it?

But, unlike that forever afternoon, Central Park abandoned us at 110th Street. Brick apartment buildings gave way to empty lots and century-old tenements. The faces of the pedestrians outside changed color.

We followed Dr. Bowtie off the bus.

“These people have invited you into their homes,” his eyes swept across all of us. “Be respectful.”

“Homes? These are slums,” Dolen sneered.

“Disrespectful,” Ralph observed.

Dolen snorted.

Then Ralph added, “unprofessional.”

“Yeah, go back to where you came from Weirdo. You don’t belong in New York.”

We followed Dr. Bowtie into a dank hallway, then climbed three flights of decaying stairs which creaked, threatening to decompose with each step. We waited while the Doctor knocked on a door.

A black woman, small child on her hip, opened up.\

“Mrs. Moore, these are the students. Thank you for letting us in.”\

“Yo’ welcome, Doctor. Ah jus’ got back from da Urgency Room. My boy done got his finger bit off.”\

“Bit off?” Bowtie sought clarification as we squeezed into her dark apartment. Three mattresses on a floor of peeling linoleum. Trash heaped up in the corners. Filthy windows admitting little light.

“Grayson!” she called.

A boy, maybe four years old ran over to her and grabbed her skirt with his unbandaged hand. He peered up at us in fear. The rest of us stepped back slowly, trying to dissolve our white faces into the shadows.

All except Ralph. He squatted down to Grayson’s level.

“Hi,” he smiled at the boy. “I’m Ralph. What’s wrong with your hand?”

The boy held up his white bandage.

“Did you hurt your finger?” Ralph continued, softly, his voice a pitch higher than normal.

“It bit me,” the boy mumbled.

“Oh, I’m sorry,” Ralph soothed him. “Who bit you?”

“Da rat.”

“Rat?” Ralph’s voice betrayed surprise.

“Las’ nite. I was sleepin’.”

“Oh. I see. Where do you sleep? Can you show me?”

And Grayson let go of his mother to run over to one of the mattresses, stand beside it proudly, and declare:
“This one mine.”

Ralph walked over, squatted down to look closer at the mattress on the floor. “What a nice mattress you have,” he praised the boy. “Do you help your mother by making the bed?”

“Ain’t no bed,” Grayson educated him. “It’s a mattress.”

Later, as we boarded the bus, I heard Dolen sing song as he passed Ralph. “What a nice mattress.” Then his voice switched to its familiar sneer. “Fairy!”

I made a point of catching up to Ralph in the corridor of the school.

“Sorry about what Dolen said.”

He shrugged. “That’s his problem. I feel sorry for him.”

“You do? You’re the only one in the class, then.”

“Really? That’s sad.”

“Where are you from?” I took the most direct path to the answer of this human enigma.

“A little town near San Francisco. Why?”

“You seem more – – ah, – – – relaxed. Doing stuff other than studying. As if you were – – – I don’t know – – -.”

“Mellow?” he offered. “More laid back?”

“I don’t know what that means.”

That smile again.

“What’s your specialty gonna be?” I veered the discussion for my own comfort. “Preventive Medicine?”

“Pediatrics. But now that you mention it, Peds is pretty close to Preventive Medicine. You?”

“Internal Medicine,” I fear I may have puffed out my chest. “I’m gonna be a Diagnostician. A Detective. Preventive Medicine’s definitely not for me.”

“Uh huh.”

“I hate bowties.” I braced for an argument.

“Good. Do what feels right for you. That way, you’ll be really into it. But, for me, I’d rather prevent illness than clean up after it.”

Shock may be the most accurate explanation for why, in spite of what was a clear opening for obvious and easy rebuttal, I was briefly speechless. The whole purpose, after all, of going thru the torture of Med School and becoming a Doc is to treat sick people. Well people don’t need physicians. When I did respond, it wasn’t too clever.

“Bullshit,” I said.

Smile to laugh to smile again. “You ever see a kid with a finger bitten off by a rat before?”

I held my hands out, palms up.

“Me neither. Now, what was the cause, the etiology of that – – – disease?”

“Rat,” I smirked.

“Nope. It was,” he paused – – – “Poverty. Wouldn’t happen in our homes, huh?”

“Oh, I get it. You’re gonna cure Poverty.” I lost control of my sarcasm.

“No,” he spoke quietly, gently. “Poverty – – – AND War.”

“Ah HA! ” I exhaled my satisfaction at finally fitting one piece of this puzzle neatly into its vacancy. “That’s why you’re against this war!”

He shook his head. “Against all War. It’s just logical. Can’t imagine any physician thinking otherwise. Well, gotta go.”

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