What's in a Name? A Lot.

Between college graduation and my first day of medical school, I changed my name. Well, not exactly my given name: Catherine, or my last name but my "for short" or nickname. That sweet little name my parents bestowed upon me and which I accepted willingly fell into the deep hole called the past when I transitioned into a new phase of my life. I figured the time was ripe for change. I  had moved from upstate New York to Texas, starting out anew, turning over a new leaf, and maybe becoming someone different when I matriculated in medical school. I introduced myself as Kate to everyone I met.

My parents and all who ever knew me before I turned 22 know me as "Kitty". To my 94 year old Dad, I'm even more than "Kitty", I'm "Kitty Kat". Sigh. It's sweet and he'll never change, nor should he. But, the name "Kitty" didn't feel right to me, nor did it seem to fit me once I reached my twenties. My family still calls me Kitty from time to time before they catch themselves. I suspect when they talk of me (I won't say about me) out of my presence I'm probably "Kitty" all over again.

My birth name, Catherine felt stately and wise but too formal. Catherine also left the door open to others shortening it to Cathy which would never work for me. Kitty wasn't a name for the long haul of life. So, Kate she became; a name that fits my skin, a name I chose for myself instead of the other way around.

I don't think my parents ever really understood why I decided to do this. My siblings and their families indulged me my independence and choice.  My husband, his family, my children, and anyone who has ever met me after I started medical school know me by the name I preferred to be called. And all that is good.

Sometime my colleagues write my name as "Cate" because Catherine is spelled with a "C". Sometimes my patients call me "Katie" or Catherine if they're feeling formal. Whatever.  More on being addressed by my first name in a professional setting by a patient later. That's an interesting issue and has definitely changed over time.

There's no more worrying about my nickname from the past except around those who knew me back in the day. These folks have license as the only ones allowed to use that name in my presence. If I ever hear it slip out of the mouths of others, I cringe (curdle may be a better word) inside and if they keep it up, they eventually learn never to go there again.

Names are important.

The White Coat

Every medical student dreams of slipping on that first short, thigh high white coat and wearing it around the hospital wards. The pockets, weighted down with medical stuff like a shiny new stethoscope, penlight, and small medical books (known as "peripheral brains") made us feel like members of the profession despite our novice status.

The medical student coat looks like this and usually has the institution's emblem sewn on to the breast pocket. We had to buy several our freshman year of medical school but weren't required to wear them continuously until our clinical years (third and fourth years). The short coat set us apart from the doctors whose coats were longer, to mid thigh. The pockets, however are the same in all these coats and what we carry in them is fairly traditional with individual variations.

Some of us were so turned on by the symbolism and perceived status of the white coat that they were worn first year whilst  dissecting cadavers.  I have to admit that I enjoyed wearing mine but thought it a tad out there and arrogant when a guy I dated liked his coat so much that he wore it into a Tex Mex restaurant on a Friday night. Oy. I thought he was pretty much of a jerk  back then and things haven't changed. I've seen him at various reunions through the years. He's just older now but still the guy who craves the center of attention no matter what. He's also a neurosurgeon.

The long white coat back in the day was the sole purview of the full fledged M.D., whether in training as a resident or the real deal. Nowadays, lab techs, Xray techs, the occasional nurse  and others wear long white coats. The change occurred gradually and no one seemed to notice or care. The part that hasn't changed is the requirement that medical students wear the short, dorky coats. A rite of passage this and one of many on the journey.

I've worn a long white coat my entire career as a physician.The stuff I carry in the pockets changed over the years. I now carry no money, less food, and the "peripheral brain" took a hike.. The stethoscope, the sole, absolutely required medical tool stores nicely in the lower right pocket. My I phone slips into the breast pocket along with pens and business cards. Lots of docs use their I phone apps as "peripheral brains" these days; amazing what you can look up in a pinch with a hand held bit of technology.

What I've noticed in the last 5 years is a movement away from doctors wearing white coats. My three male colleagues for example, rarely put on a white coat. They throw the stethoscope around their necks and off they go. I'm not sure patients expect to see the white coat anymore. Again, a gradual shift in the look happened while no one noticed or much cared.

I keep up the habit for more than the convenience of hauling around "stuff". And, if my women colleagues were truthful, they might admit to the same second big reason. What could that be you ask?

Check it out: from the back, most well fitting white coats hide the butt really well.  I shouldn't speak for all of my gender in Medicine but I suspect this is the reason you'll find the majority of female physicians wearing a white coat. I'm just saying....

Phlebotomy Part 2

The summer between junior and senior years of college I found myself back in Houston, working as a slightly more seasoned phlebotomist. The job was minimum wage, about 2 bucks an hour but I was fortunate to work the day shift; some of my colleagues pulled 3-11 PM. I made about $1000.00 that summer and stashed it away in the bank.

What did I learn? What do I remember about that summer job?


1. I am not a very good phlebotomist; the easy "sticks" flow smoothly but veins come in all flavors; probably the worst are the ones that roll. There were many, many times I left a patient's room empty handed, returning to the lab to ask someone more skilled technically to go back and do the job.

2. More patients than I would have predicted called me "the vampire" when I told them I was there to draw their blood.

3. We "blood-drawer-ers" sat around in the back of the lab wasting time more than we worked. No wonder we earned minimum wage.

4. I saw my first dead person that summer. Called to draw blood on her roommate, I saw an old lady in the next bed who must have just passed on. No one was making any sort of fuss; likely she was expected to go. Even then, instead of the lancing fear I expected to feel, I was overcome with wonder and calm, a sacredness that comes again and again when in similar situations right up to this day.

5. I ate in the cafeteria most days; the food was fabulous. The sweet potato pie was to die for.

6. I met a cute guy, also a phlebotomist.  He had no money and was on his own financially even though he was a year younger than me. He dreamed desperately of becoming a doctor and was taking  required college courses and working simultaneously.  Although he was a genuinely nice person who worked  hard, he never made it to medical school. I think he became a DEA agent.

7.  I don't remember that we wore white coats. I did wear a badge that I was very proud to pin on my shirt;  so proud that I still have it along with other badges I've worn through the years. I suppose we all like to belong to something larger than ourselves and carry proof of it on our person. "Miss" C. Thompson; today it would probably be the full first and last name with no marital status marker.

8. To this day, I have warm feelings for (most) phebotomists. They are a talented group of people who take pride in what they do. Whenever I get my blood drawn I think back....

Phlebotomy Part I

I spent two summers during my college years working a low paying job at a hospital in the Texas Medical Center (in Houston, of course).

Writing this, it occurs to me how deeply chauvinistic Houstonions behaved when naming their medical center after the entire state of Texas when there were other great medical centers across the state. But, I digress. To be sure, the TMC rocks. I owe my medical school, residency, and fellowship training to U.T. Houston, one of the two medical schools within the great Texas Medical Center. 

As premed students, we were encouraged to use our summers wisely, pursuing volunteer work or employ in some field of medicine. We were advised the summer activities would look good on medical school applications; demonstrating dedication and passion to the goal of a career in medicine.

That first summer, between freshman and sophomore year, I landed a clerical job in the laboratory of Methodist Hospital. I have no recollection of how I got the job; some connection somewhere. I was fortunate to have a sister in Houston who knew people who knew people.

I worked in "the cage", a central area in the large laboratory where a handful of women spent the day answering phones, filing lab reports, providing piles of paper to transporters,  gabbing about coworkers, our lives, and complaining about how bored we were. I was 18 and impressionable. There was not much to be learned from a medical standpoint but I did get an earful of life and mastered the names of some of the most common lab tests.

Over time, I grew restless with the work, eying a group of very young "blood draw-ers" (we didn't call them phlebotomists back then) stationed at the back of the lab, surrounded by blood tubes with myriad colored stoppers, individual  baskets full of supplies: tourniquets, alcohol prep wipes, needles, gauze pads, and tape. I wanted to be one of them; they seemed so cool, confident, happy, and on the ball.

I remember asking the lab director if there was any hope of a transfer out of "the cage" since I was pre-med and all. Fortunately, he thought this a good idea (never helps to ask) and towards the end of the summer, I moved to the back of the lab where all those cool folks sat with their trays of tubes and needles.

Training for the newbie phlebotomist?  By today's standards, laughable. But again, this was (groan) almost 40 years ago. Today, phlebotomists are trained technicians with a certificate. What I recall was several laborious days learning tips and techniques in an informal sit-around-and-listen session with other recent hires. None of us was any older than 22.  Our instructor was a seasoned middle-aged, overweight, slow moving Latino woman named Bea. Bea could draw blood from a stone. She was the best technically but took her sweet time training us. All for the best, I suppose.

We didn't practice on each other. We may have stuck a needle in a piece of fruit to get the flavor of the poke. Maybe she watched my technique once or twice. After that Bea was quick to assign each of us newbies to a more experienced young mentor at the back of the lab. And, off we went to draw blood on hospitalized patients.

Gloveless.

Who knew about the risks blood borne infections?

Typing Skills

My Dad was ahead of his day. As school superintendent of the Lago School in Aruba, he insisted that every student learn to type. Mind you, this was back in the day when typewriters looked sort of like the one below. This was also the time when young men launched into careers that had little to do with typing skills whereas women, be the teachers, clerical staff, or housewives benefited from knowing how to type without looking at the keys.

My brother learned to type in high school in Aruba and when he went away to college he was a hot ticket amongst his peers who asked him to type up their papers and reports for class. He earned money by the page. He's still a pretty good typist, probably far better than other men his age.

Hands down, typing was the best skill I mastered in school from the perspective of continuous utilization.  Knowing how to type fast and with accuracy paid off. Countless hours saved. Time is money. More time makes way for more rest.

These days we think nothing of younger folks pecking away at their computer keyboards. I'm not sure how people learn to type these days; probably either  entirely self taught or with a typing tutor on line. The learning starts earlier and earlier; I'd predict many begin as grade school students if not before. In Aruba, back in the late 1960's we learned the 'old school' way where the keys were covered over with heavy duty tape.  We learned to touch type as opposed to the "search and peck" style I see some contemporaries of mine utilize.

Although typing wasn't a necessary skill in Medicine until the early 1990's when email hit the scene, everyone in the field depends on the skill nowadays. The electronic medical record, a prime example of how medical documentation changed in the past ten years makes my point. We type constantly; clinic notes, communications, emails, and other updates fill the gaps between seeing patients. Many of us bring work home in the evening; although this may involve dictation, typing is more common.

Typewriters are a thing of the past except in the lives of  'eccentrics' or the technically challenged. Who among us is not a slave to the keyboard?

I'm grateful that my Dad, who at one time practiced his skills at the typewriter, encouraged all of his students to get into that typing class. Now.

The Quest for Straight Hair

On a lighter note, the three young women, the graduating ninth graders mentioned in the previous post, shared another thing in common other than similar career paths.

We all had thick, curly hair; really curly hair. This might not be obvious from the yearbook photos. In the late 1960's and well into the 1970's straight hair was a highly prized feature. If we didn't have it, we made out like we did. There were ways to straighten thick, curly locks and go for the sleek, polished look rather than the fly away wildness imprinted in our genes.

Eventually we all grew into our natural look and embraced the curls. I look at the transformation as part of growing up, as part of accepting who we are.

 

Three Doctors From a Class of Thirteen

In 1969, the graduating class of Lago High School in Aruba numbered thirteen students. Mere freshmen in high school, we were considered "the seniors" because we would all be leaving Aruba to complete the remainder of our education stateside. The American school for children of employes of the Lago Oil and Transport Company in Aruba operated a  K-12 program for decades. In the late 1960's, the company responded to economic pressures by truncating the school program after grade 9. The company paid for employees to send their youngsters to prep school in the U.S. mainland; a purely financial move with little regard for how the decision might affect young students or their parents.

I won't comment here about the effect leaving home at the age of fifteen to move thousands of miles away from home when cell phones were nonexistent and overseas telephone calls and cablegrams were byzantine methods of communications. Snail mail in the strictest sense kept us in touch. Those were rugged days. More on that later.

Back to the graduating class of thirteen students; 6 young men and 7 young women. We studied Algebra I, World History, Spanish 2, Biology, and English together in grade 9.  We hung out after school and on weekends at the beach and the Esso Club. After "graduation", we split up to attend stateside schools. I landed out at St. Stephen's Episcopal School in Austin because of the proximity to my sister, 12 years my senior who lived in Houston, 150 miles down the road. Close but not too close.

The interesting statistic about that class of thirteen students is that three became physicians and all three were women.  Here we are in our yearbook photos from 1969.

The daughter of the physician director of the Lago Hospital in Aruba, she attended medical school and trained as a Psychiatrist. She lives in Santa Fe.

Originally from Canada, she and her family left Aruba shortly after graduation.  She went to medical school in Canada and became a Family Practice physician. After many years in general practice, she pursued an interest in skin care and esthetic medicine. She operates medical spas in Canada  and markets a line of skin care products.











 


And here I am. At the time, I had no clue what I wanted to do with my life. An acute illness and hospital stay several years later would light the fire on my dream.











The three of  us remain in practice.

** photos taken from the Lago School yearbook, 1969 

Neither Fish nor Fowl

Summer 1975

"Based on your cumulative average (we didn't say GPA in those days) and your MCAT scores, you're neither fish nor fowl when it comes to getting into medical school."

-----from a letter received from my college adviser, an Associate Dean in the College of Arts and Sciences, Cornell University July 1975

Her words were anything but comforting. She stuck to a non-committal stance. I wasn't out and I wasn't in but somewhere in between.

And her advice?

"Send out your applications yesterday, get back to school and have a strong fall semester."

"We Are Powerful Beyond Measure"

This blog launches as a sister blog to Ahead of the Wave on this very special, yet sober day in my life; the one year anniversary of my Mother's death. I've been procrastinating for weeks about my first post for Back in the Day, a blog about my life in Medicine. There is no more time to put off what bubbles forth from my heart. There is no excuse to wait for perfection, to stall the process hoping for a smooth ride. My Mom's death from old age and dementia reminds me that she always wanted to write about her life but put off the process endlessly. She left stories untold and that is a tragedy.

The time for me is now. 

Mom was an an enormous inspiration and source of strength in my life. She steadfastly believed in me and always asserted that I could be whoever I wanted to be. She loved deeply and unconditionally. I know she would have enjoyed reading this blog and from somewhere, I feel her inspiration and support in this new project.

I'll begin my blog with a favorite quote from Marianne Williamson. The words come from her book, A Return to Love: Reflections of the Principles of a Course in Miracles. She captures beautifully the simultaneous exhilarating and terrifying truth of our abilities and talents. She admonishes us to shine our light so that others may be encouraged to shine as well.

She says;

"Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us."

How often do we fear our inadequacy when our power is just beneath the surface? How often do we turn away from our strengths to hide in the shadows?

Marianne follows with an explanation.

"We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There's nothing enlightened about shrinking so that other people won't feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It's not just in some of us; it's in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we're liberated from our own fear, our presence automatically liberates others." 

And so it goes.

And so, today I begin my new blog, Back in the Day, a series of posts about my life in Medicine. I'd like to think that this quote of Ms. Williamson is a steady theme, fueling my creativity. All my life I've struggled to find my talents and to transform my uncertainty into light, a light that shines, inspires, and comforts others.

No more delays. Here we go.