Linda Hewitt

Writing AMERICAN HEALTH CARE has made me think, for the first time in a long time (at least seriously) about my first job, probably because it was in a medical practice, a very large medical practice.

When I was seventeen, toward the end of my freshman year in college, I lost my scholarship because I had refused to continue taking a class with a teacher who sexually harassed me. (Far from being illegal, this was considered a more or less standard job perk for a certain kind of academic jerk - and evidently still is in some schools). At the end of that last quarter of my freshman year, determined to pay my own way back to school, I looked and looked for a job until, thanks to my boyfriend's well-connected mother and a rather bizarre combination of unlikely circumstances, I was hired to be the receptionist for a large, prestigious orthopedic practice located in the Five Points South Medical Arts Building in Birmingham.

There were three orthopedic surgeons, an oral surgeon, a "diathermy" therapist, a registered nurse, an x-ray technician, two practical nurses, an office manager, a secretary, and a bookkeeper. All the receptionist had to do, I was told at hiring, was to sit at the desk in the sizable reception room, answer the office phone and transfer calls, welcome patients when they arrived, take the initial, nonmedical histories from new patients, retrieve the records for existing patients from file cabinets lining one of the long hallways, noting any new information, and show patients to examining or treatment rooms as soon as one of the nurses indicated an opening. In between the time the patients arrived and when I took them to an examination room, I was to remain at my desk and answer any questions from those waiting to see the doctors.

The pay was excellent, the location fantastic, the "official" 8:30-5:00 hours reasonable, the people nice overall, and the job amazingly responsible for someone hampered by youth and no experience. It sounded too good to be true, and it was.

After a few weeks I could understand why several older, much better qualified women had not been able and/or willing in the past to continue in the job. The practice took no appointments. Patients simply showed up, registered, and waited to be called in the order of arrival. On a slow day, fifteen to twenty patients might appear; the highest number I can recall registering was fifty-two. Complicating the timing situation was the fact that the surgeons began their days at one or more area hospitals operating and making rounds, and could make no prediction as to when any or all of them would be able to return to the office. Some days they arrived by ten, some days not until four; and if emergencies arose at the hospital requiring their attention, they left the office, to return whenever. Also complicating the timing situation was the fact that they were among the crème de la crème of orthopedic surgeons, and physicians from around the world would refer particularly challenging cases, cases the referrers thought should be prioritized. Complicating the timing situation still further was the fact that many of the practice's regular patients were prominent businessmen, politicians, churchmen, socialites, and athletes, not to mention just plain rich people, some of them very rich people, not the kind of people who liked to wait, especially not the kind of people who liked to wait their turn. Adding insult to injury was the additional fact that most of these people were seriously uncomfortable, in need of surgery or recovering from surgery. Since food and beverages were not allowed in the waiting room and leaving to eat meant losing their place in line, those waiting also tended to be hungry and/or thirsty, and I recall seeing a long-suffering bishop sneaking a bite of candy bar he was attempting to conceal in his sleeve.

Lining the walls of the large, windowless waiting room, ranged in front and to one side of my desk, were thirty visitor chairs - old-fashioned, spindle-backed, wooden, their seat cushions made of stiff tufted leather; and some days thirty-one of us sat in that room, while others stood, all of us exerting our best efforts to remain civil throughout what might turn out to be seven or eight hours of wondering together when a doctor would arrive. I was supposed to register people until five p.m., and the office remained in full swing, with all employees in attendance, until everyone registered had been seen by a doctor. Most days the last patient wouldn't be done until six p.m., and I can remember one hapless man on crutches with whom I left the office at nine p.m. on a particularly busy day.

Luckily, I had committed to work only a year while I earned the amount of money I needed to return to school. In the meantime, I realized my role was primarily that of entertainer, attempting to keep bored, aggrieved, and often in-pain people from having public meltdowns.

I go into this amount of detail not to bemoan my situation - in spite of everything, it was a great job for a beginner - but rather to give added point to something I realized early and with great surprise: the patients ADORED these doctors. They might gripe, and they might moan to me or other employees about the waits they had to endure, but invariably they viewed the doctors as gods, all-knowing and all-compassionate, with magical skills capable of curing intractable ills and fixing hopelessly broken body parts. A patient so irritated at an hours-long wait that she'd barely been able to say "thank you" when I took her back to an examining room would take leave of her doctor with stars in her eyes, smiling beatifically when in parting he patted her shoulder and told her she was doing amazingly well and to keep up the good work. A business tycoon who'd repeatedly had to change the schedule for his private plane's departure as he waited through a long day would clap his doctor on the back, tell him he'd changed his life, invite him to visit Las Vegas (or wherever) as his personal guest, and limp out, beaming. At least one patient named his son for his doctor. On birthdays, the doctors received cards and flowers. At Christmas, gifts - some surprisingly grand - would arrive throughout December, culminating in the new Buick that, courtesy of the owner of a local automobile dealership, was delivered annually on Christmas Eve to the dealer's surgeon for his personal use throughout the year.

Irritating as I found their schedules, those doctors for whom I worked earned every bit of the respect, affection, and material recognition they received. They cared about their patients. They lived for their work. They clearly found great satisfaction in doing it well, and perhaps even greater in "doing it their way," with no one to tell them that by any sensible measure "their way" might not meet externally set standards.

Now, when I look back at that experience, I realize it was the most-demanding job I ever had. It was probably also the best possible first experience in the job market - after I survived having sixty eyes glaring at me while thirty-one stomachs churned with hunger (mine too), everything else to do with work was a breeze (and I regularly fell into swamps, down mountainsides, and onto busy highways while on video shoots, one of my later excursions into the job market).

More than that, though, I feel privileged to have witnessed the dedication "the doctors" manifested daily, no matter how tired they were, no matter how early that morning the first surgery had been, no matter how long the day. They were heroes, first to the patients and ultimately to me.

The circumstances under which today's doctors practice are very different, of course, and I suspect "my" doctors found it easier to retain their enthusiasm and even many of their ideals throughout long careers because of the autonomy they enjoyed. Even so, hats off to the men and women who are practicing today. From my research on SUCCESSFUL PATIENT, I now realize that you put up with a lot that has little to do directly with patients, and by and large you do a terrific job with the patients as well. So thanks to you from all of us who benefit from your care!