Just Like Someone Without Mental Illness Only More So

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Authors: M.D. Mark Vonnegut
they deserved. I wrote orders and discharge plans and tucked people in for the night.
    My first clinical rotation was obstetrics. My first patient was in labor, and what she said to me after I introduced myself was “Cut me. Take out the baby.”
    “You’re making good progress,” I assured her, and she had a beautiful baby about ten minutes later. This doctoring stuff wasn’t so hard.
    I watched other doctors like a hawk. I worked very hard at learning how to examine babies and children. I still carry in my brain high-resolution images of how the doctors I admired listened to hearts and felt bellies. I kept accounts of what worked and what didn’t, when I was right and when I was wrong. Everybody who loved medicine wanted it to be better than itwas, and that meant wanting to be a better doctor than you were.
    Even most so-called accidents could be studied like diseases with various risk factors: teen gun violence required a gun, a grudge, alcohol, and impoverished future prospects. Take away the preconditions and the harm stops. Figure out what goes wrong and fix it. Goodness emanated from Harvard and a few other centers of excellence and spread in a centripetal manner, pushing back the darkness. Good doctors went out and displaced not-quite-so-good doctors. Better medicines and surgical procedures displaced older ones. Medical science and care from World War II till the time when I entered medical school was one success following another, a nonstop steady climb. There was no reason to believe it couldn’t go on forever.

    A surgeon in charge of my surgery rotation said that he knew who I was but that he was going to treat me as if I was normal. I sincerely thanked him and told him I would try to act that way.

    Like other things we do to protect patients from our germs, hand washing and wearing gloves and masks, scrubs and surgical gowns were adopted originally to protect doctors and nurses from the diseases of the people they were taking care of.
    Scrubs were not made to be worn outside of the OR, where they were always covered by sterile gowns, but as soon as the first absentminded surgeon went out of the OR in scrubs, fashion history was made.
    Scrubs have no pleats. Except for the patch pocket over the left breast, suitable for holding three-by-five index cards, theyare exactly like cutout clothes for paper dolls. When they started using scrubs in the OR they were white, but blood on white looks too much like what it is and bright white under OR lighting was not restful. Now they are slightly rumpled, gray, blue, green, or, more recently, pink. They started using pink in the OR under the mistaken assumption that doctors wouldn’t want to be seen in pink scrubs in the cafeteria or elsewhere. Very shortly after the introduction of “OR only” pink scrubs, pink scrubs were everywhere, including neighborhood basketball courts.
    If everyone wore surgical scrubs instead of regular clothing, we could save trillions of dollars. There is no other way to fully clothe a person for less than ten dollars.
    Doctors on call or stepping out of the OR are so important they don’t have time to put on a shirt and tie. Exhausted, unshaven, and wearing scrubs, I was more credible than with a freshly shaven face, pressed shirt, and tie. There was an intrinsic seriousness to what we were doing that made wearing scrubs okay.
    Back in Hollywood Hospital, there were no scrubs. The doctors were very well dressed, and the patients were in pajamas. The doctor in charge of the whole place wore baby-blue alligator shoes, drove a light blue ’59 Cadillac convertible, and wore what I was sure was the button to end the world as a tie clip.

    I wanted to be a good diagnostician. There was a way of touching people that created trust and gave relief from the day-to-day way people treated one another. I was watching and learning from masters. The doctor’s job was to shut up long enough to let the patient be the most important person in the

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