Maria Yang, MD

I believe patients are the best teachers in medicine.

As an intern, I told a patient one morning that I would visit him later in the day. Various tasks yanked me throughout the hospital as the hours passed. While packing my bag to leave for the day, I remembered what I had said to him. I wanted to go home. I felt exhausted.

He won’t notice if I don’t come around. He won’t remember what I said. And out the door I went.

The next morning, the patient scowled at me.

“I’m upset with you. You said that you would come back. You didn’t. Don’t say you’re going to do something if you’re not going to do it.”

My face flushed. I learned that a caring physician consistently follows through with her promises.

As a fellow, a patient told me about his experience with Familial Mediterranean Fever. In medical school, we viewed this rare condition as a piece of trivia, not a disease we would ever see.

“My body aches in a lotta places,” he said, pointing at his belly, then his knees and elbows. “My chest hurts. I get fevers that suddenly start and stop. Thank God for colchicine. I haven’t had a bout in years.”

I nodded, more to the memory of myself as a medical student. I learned that patients often give colorful descriptions that are more memorable than the bland definitions written in passive voice in textbooks.

Patients have taught me the power of human resilience. A patient, recently diagnosed with stomach cancer, contemplated how he wanted to spend the rest of his life: Volunteer at the local soup kitchen. Continue to coach the Little League team as long as he could. Help his girlfriend start her business.

“I’m not dying of cancer,” he said. “I’m living with it.”

Another patient shared her anger towards and frustration with psychiatrists. She endured many humiliating experiences while detained in hospitals against her will.

“They didn’t believe anything I said. They talked about me as if I wasn’t there. They took away my rights, they took away my life,” she said, “but they never took away my dignity.”

Patients have taught me that they are people who add joy to the lives of others, possess skills and talents that many of us will never have, and provide useful perspectives about health and illness. They remind me that they are not simply diseased organs, malfunctioning systems, or wordy labels. They correct me when I talk at them as if they are only an illness; they look annoyed when I overlook or undervalue their ways of coping with their struggles.

Patients can teach us so much. We must pay attention.

The clerk in front of them put another stack of papers into a folder.

“You know the George Washington Bridge, right?” the police officer said. The orderly nodded.

“Lemme tell you how strict the policy was. I used to work over there. One precinct covers the area north of the bridge, another covers south of the bridge. If someone jumped off of it—like a suicide—all of us from both precincts would watch the body hit the water.”

“Oh jeez.”

“We’d wait to see which way the tide carried the body. If the body went the other direction, we’d pat the other officers’ shoulders and say, ‘All right, that’s yours.’ Crazy, huh?”

The people sitting in the chairs against the wall were dressed in hospital gowns. They watched the police officer chuckle. The clerk’s phone began to ring.

“Psychiatric emergency room,” she said into the receiver.

You’ve decided to dine at an upscale restaurant in New York City. You and your date walk through the entrance and the maitre’d looks up from his podium. He’s wearing a dark suit, a white shirt, and a conservative necktie.

The corners of his mouth turn up slightly as he greets you. “Good evening. Welcome to The Hoity Toity. Would you like to check your coats?”

A young lady with a dark dress wrapped around her slender figure appears. She helps you both out of your coats and, after draping them over her arm, she gives you a small ticket with a large number printed on it.

As your evening progresses, you notice the cavalcade of people providing the dinner service:

Black Shirts. These men wear black dress shirts, black slacks, and black shoes. They ensure that your glasses of water—”tap, filtered, or bottled?”—are never empty. They also clear away your plates between courses.

Striped Neckties. These men wear blue shirts, no jackets, and identical neckties with bold, diagonal stripes. They take your order and replace your silverware after each course. (After the third set of clean silverware is placed on your table, you begin to wonder just how many pieces of silverware the restaurant owns and if a human or a machine is washing them.)

Gold Vests. These men wear white dress shirts, black pants, and muted gold vests. They place baskets of bread on the table and bring out the dishes from the kitchen. When they place the plates in front of you, your Striped Necktie appears and identifies the items on your plate.

Black Shirts, Striped Neckties, and Gold Vests swirl around you throughout dinner. The maitre’d periodically walks around the restaurant, scanning the tables and customers, but says nothing. Coat Check Girl perches on a small stool by the door, smiling at entering and exiting patrons.

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You’ve worked in several medical centers on the West Coast and now work in a few hospitals in New York City. While visiting patients in different wards, you notice the cavalcade of people providing medical services:

Tan Scrubs. These are the patient care technicians, the people who are rarely thanked for changing bed linens, assisting patients to the bathroom, and wiping vomit off of beds.

Pink Scrubs. These are specialty technicians, the people who record electrocardiograms, shoot X-rays, etc.

White Scrubs. These are the nurses, the people who often know more about patients—their health concerns, their personal histories—than the treating physicians.

Blue Scrubs. The doctors and doctors in training.

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In all the medical centers I trained in while on the West Coast (Sacramento—how about that Delta Breeze?—and Seattle), all hospital staff wore the same colored scrubs. It mattered not what your title or position was. This uniformity fostered equality: Since everyone looked the same, everyone greeted each other with respect. (Add a white coat and things change.)

Perhaps the system of color-coded scrubs in certain hospitals in New York is a “patient centered” strategy. Patients can quickly recognize who is best suited to help them at any moment.

However, this color-coding system, at its worst, could lead to disrespectful behaviors and stereotypes that appear in social hierarchies. Those wearing tan scrubs can disappear; no one acknowledges them or their work. People may feel awe for those wearing blue scrubs, even though their behavior may not warrant reverence.

Apparel communicates information about social status, wealth, and culture. That fashion—colored scrubs—is incorporated into hospital policy is one way medicine in New York is more formal. However, I do not believe that this is a foible of medicine in New York. The hospital fashion, rather, reflects the fashion (and implicit messages about social status) of the city. And that is the subject of a whole other post.