The Way

"Be yourself", she said.

"I can't be myself," he lamented without looking up, "it makes them uncomfortable."

They sat quietly for a moment as she thought about this. "They are making you uncomfortable, not being who you really are, doing things how you think they can, should be done. Its exhausting your spirit. I think its killing you."

He sighed, having had this conversation in his head a thousand times, resigned and tired of it.  "They are the power, their comfort matters, not mine. Conform, be what they think a professional in my line of work looks like, speak the proper way, dress the proper way, surround myself with the proper things,"  he said, waving a tattooed arm at the large black and white "Get Shit Done" poster behind him. He waited every day for the corporate email telling him to remove it. "The way as they define it, as if that is what makes all of this work, as if they make this work. There is no room for different colors, different paths, different... visions, in any company that believes it is the one. There is the world as they see it, success is what they say it is, they need to control things, they need people to follow their way, allowing them to assuage their fears. Our fears, mine, my patients, don't really matter, unless it makes for a nice slogan. It makes them nervous allowing their people to have new ideas that are not their own. They expect patients to rise up to their level, instead of coming to where the patients actually live. As if I am supposed to be the shining beacon on the hill, one of the Rescuers, as opposed to one of the people."

"Isn't that their motto, 'new ways of thinking', 'we care about the whole person', 'meeting you where you are', that sort of thing?"

"Believing their cheerleading doesn't make it real. Everyone finds the words to make them look better than the other guy, but they end up all being the same. I suspect at some level, at some point, they really believed it. (That could be wishful thinking...). This is all illusion, none of it is real. Its the theater of medicine. Its a play with a set, a script. It always boils down to business, what works for the business, not patient care. Patient care is a means to an end, a gig." 

He looked up at her and half smiled, she isn't naive. "Someone once said, 'If you want them to listen to you, dress like they do, they will think you are one of them'. I believe that. I believe these troubled, disparaged, and despised people need me to be one of them, or at least not one of them, for them to listen to me, not some starched rod-up-my-ass, supercilious prick, or their "common man" dressed down version of it. I don't see myself as that much different from my patients, just luckier. I don't need to be The Man. I feel it in my heart for them to be able to hear me, to see me, I need to represent their lives to the degree that I can without it becoming ridiculous. I need to show them that I can see them, hear them, understand them, that I know who they are.

"I do recognize that I, to some degree, I need to show them there is a better them in there, to be that example. Patients expect a doctor to look and act a certain way, not because they like it, not because it works, but because they expect it. They expect the system to look like the system because the system told them what it should look like, sound like, be like. The system, expects it to look like the system, they tell all of us what roles to play, dress per the script, stethoscope over my bright white lab coated shoulders. Medicine should taste bad, it should tingle, be in a shiny box, be on TV, thats how you know it works. But there is a point where we take ourselves too seriously, and make ourselves too lofty. We become just another them-not-us voice, just another not them person telling them they are less than, pushing them around, making them dance for their supper. When I do have to push them, I want it to be as one of them, not one of them, doing the pushing. I can't be that person, that them professional person, when I see my patients. I honestly don't think it works well. Fine if they want to be that person, but why do I have to be?"

"Because they have the power."

"Because they have the power...", he reflected thoughtfully. "Do I confrom to keep my job, or do I do what I think is right? 

"You already do. You keep a low profile, keep your mouth shut, more or less, keep your ideas to yourself, let them think you are one of the team, one of them, 'Go team!' ", she said, raising the roof, "buying into the cheerleading."

"Really? Do you not see the poster?"

"I do. I see it as their voice, they see that too, and they appreciate it. Getting shit done is actually the key to their success, and they understand that. It gives them a relateable focus. I like it."

"Hmm... so do they. Took it down once to conform, the patients all complained it was gone so I put it back up. Taught me that I was connecting, I was reaching them where they live.

"Do principles matter?", he asked, as if changing the subject but not.

"Sure," she replied,, "But which ones? The ones that keep you employed, or the ones that make you a better clinician?"

"And that, folks, is burn out." 

"You burned out a long time ago...", she observed with compassion for her damaged friend.

"But I still feel the pain of the scars. Every. Single. Fucking. Day.", he whispered to no one.