Category: Nonfiction

As my days in New York are ending, the details of terminating with patients, saying good-bye to dear friends, and relocating to the other side of the continent are consuming my time and energy. As a result, I will repost some earlier writings.

Following is the multi-part story of my visit to the jail of New York City. Everything in the account (except for some names and labels) is true.

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Across the street was a large sign advertising the entrance to Rikers Island, the jail for the City of New York. On our side of the street were several check cashing and bail bond storefronts. There was also a jewelry store. A hot dog truck was parked near the intersection.

No buses were approaching. A small crowd of people was gathered on the corner, patiently waiting. They, however, were not at the bus stop.

“The bus does stop over there to go to Rikers, right?” he asked the woman standing at the periphery of the crowd.

“Yes, that’s where the Q100 stops. There’s a van that goes there, too. It’s coming.”

“A van?”

“Yeah. Two bucks to get across.”

“Oh, thanks,” he said. “We’ve never been here before.”

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The empty van, painted blue with E-Z Travel splashed in yellow on the sides, pulled up to the curb. The driver, short and mustached, turned the car engine off and came around to the passenger side. He wordlessly slid the door back and pulled out a thick stack of bills. He looked up.

We were in the back of the line and people silently handed over money to him to enter the van. His thin fingers smoothly sorted through the stack of bills to provide correct change. He did not look at me as he took the two dollar bills from my hand.

We crawled inside and sat down. Every single person in the van belonged to a racial minority group.

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The van rumbled across the two-lane, sidewalk-less bridge. Planes sat in clusters at Laguardia Airport to the right. The waters of the East River below were choppy. A dark, long-necked bird passed overhead.

Not even five minutes later, the van came to a halt outside of an old building painted an institutional shade of dull white. We all crawled out of the van and looked at the chain-linked fences surrounding the cement campus.

“That’s a great way to make money,” I commented. “A mile for two bucks? Nice.”

My companion agreed as we made our way around the building that looked like a terminal for a small airport. Metal barriers guided us to the entrance, which had both a ramp and a set of stairs. A wall of lockers lined one side of the building. A police officer—hair tightly pulled back out of her face, hands on her hips, firearm at her side—shouted: “C33 and C34 are not open today. If you are visiting someone in these wards, you cannot come in today. Everyone else, take a white bin.”

We pulled our bags from our shoulders and walked inside.

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I had purposely removed the small Swiss Army Knife that usually resides on my keychain. The blades on the contraption could do no serious harm, though civil servants often thought otherwise.

“No hoodies, no jackets, no cosmetics, no food items, no electronics,” another police officer shouted. “Put your bags in a bin and then step through.”

My bag and my jacket were already in a bin and rolling along the conveyor belt when I heard this. As I stepped through the metal detector, it beeped.

“Put your arms out,” the police officer on the other side of the metal detector said. He guided the metal detector wand across my chest. “Turn around.” He repeated the motions.

Meanwhile, yet another police officer was digging through my bag and listing all the violating items. “No lip balm, no cell phones, no water, no food, no scissors.”

Still another police officer was also pulling offending items from my companion’s bag.

“Okay,” he said. “We’ll be right back.”

“Where can we get keys for the lockers?” I asked. “We’ve never been here before.”

“You pay with quarters,” the police officer said. “Fifty cents.”

As we turned around to leave the building, I noticed the “Amnesty Box”. The box was about waist high and had a thin slot on top. The words “Amnesty Box” were in faded red and blue hues and the letters were shaped to suggest beauty or hope or joy. The box looked like a tithing box.

Later I would learn that boxes weren’t meant to hold money.

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Only a few locker doors hung open like baby birds crying for food. Quarters were jammed in their slots. There were smaller lockers on another wall, but they were too small to hold all the prohibited items we had brought with us.

“Next time, we’ll just leave all this stuff at the office,” he said as he scanned the wall for functional lockers. His efforts paid off and we soon put our offending items inside: A tangerine, two cell phones, hand sanitizer, lip balm, scissors, water bottles, gum, and keys.

We re-entered the building and heard one of the police officers loudly commenting for all to hear: “What does he think he’s doing? Everyone else is taking off their jackets and sweaters and he walks in here, doesn’t take off anything, thinks he can just walk in like that….”

The young man in question turned around so another police officer could wand him.

The police officers dug through our bags again, running their hands deep into each pocket. Since the metal detector beeped again, I was wanded again.

“Where can we find out where The Person is?” my companion asked an officer. The Person didn’t know of our visit, as he said that he hadn’t been able to speak to The Person directly.

“Go to the information window,” an officer replied, pointing deeper into the building. We followed the queue inside.

When I was a medical student in California, many of my classmates expressed relief that we weren’t in a medical school on the East Coast.

“Everyone is so serious over there,” they said.

The stories we heard about medicine back East!

• “The medical students have to give all of their patient presentations from memory during rounds!”
• “You have to wear a coat and jacket all the time! It doesn’t matter if you are on call! You change into scrubs after 9:00pm and then, before rounds in the morning, you clean up and put your suit back on! The attendings never see medical students or residents in scrubs!”
• “If attendings ask you a question you can’t answer, they throw you out of (rounds, the operating room, the cafeteria)! They scream things like, ‘DON’T COME BACK UNTIL YOU KNOW THE ANSWER!!!’”
• “They have to keep their white coats buttoned all the time! ALL THE TIME!”

These stories must have trickled down from the interns and residents who attended medical schools on the East Coast. Funny, though: I did not hear these tales directly from them.

During my surgery rotation, one of my residents attended a medical school in New York City. This surgery resident had olive skin, dark brown hair, and manicured fingernails. He smiled only once during the month-long rotation.

“Medical students don’t have any respect for the attendings here,” he once complained to the chief resident. The chief was a young man who was almost bald, had grey-purple bags under his eyes, and always carried a travel mug full of coffee.

“Back where I went to medical school,” the resident continued, “everyone called the attending surgeon ‘sir’. We all stood up when an attending walked into the room. If the attending asked us a question, we always finished our sentences with ‘sir’. You only spoke when you were spoken to. And our white coats were always buttoned.”

My classmates and I shot knowing glances at each other.

We then shoved our presentation notes for rounds into the pockets of our short white coats that were hanging open over our green scrubs.

During my time in New York City, I rotated through three different hospitals as a fellow. I visited many wards as the roving consult psychiatrist: I noticed the internists rounding in the hallway, saw the obstetricians rushing to labor and delivery, observed the surgeons dashing down the stairs, peeked at the radiologists staring at films on computer screens, spotted the pediatricians cooing at toddlers, and glanced at the internists still rounding two hours later.

From my observations at these three hospitals in New York City, I can say the following with confidence:

• The medical students do not give presentations from memory. They read from their notes. Their voices are infused with anxiety and self-doubt. They are just as nervous as medical students out West.
• I never saw any medical student, intern, or resident wearing a suit. If they were post-call, they were wandering around in their wrinkled scrubs and sneakers. If they were not on call, many men did not wear neckties! The occasional attending would wear a suit to work, but that was an uncommon sight.
• Though I saw many floundering medical students, I never witnessed an attending throw a student out of rounds or the cafeteria. (I can’t comment about the operating room.)
• Many physicians, regardless of their position in the hierarchy, did not button their white coats.

Nonetheless, I do believe medical training and medicine is more formal on the East Coast. More to follow.