What Brings you in Tonight?

      Not everyone is cut out to work in the medical field. You must have thick skin so when a physician, patient, or family member yells at you, it bounces right off. You also need to have compassion for everybody, from babies to homeless people, a warped sense of humor when patients come in with objects inserted into orifices, and the capacity to clean up bodily fluids without vomiting.

           “I am going to swab the inside of your nostrils for the Covid, Flu, and RSV test,” Susan told her patient.

           “I do not believe in Covid,” the patient responded.

           “Well, it will also detect flu virus and RSV, which is another virus,” Susan explained.

           “That is fine. You know, the Covid crisis was started as a way for the government to control us and run our lives.”

           Susan grimaced and was once again thankful for the medical mask she wore so the patient could not see her entire face.

           Susan, a medical assistant, works in an urgent care clinic. One shift lasts twelve hours in a place that looks like any other doctor's office. There is an employee-only section with desks, computers, and machines that blink and screech, a waiting room with vinyl chairs in muted colors, a room to get vital signs and a patient’s history, and the final destination, the room where the provider examines the patient.

           Now that flu season is in full swing, along with Covid, strep throat, and a whole load of other viruses, the number of patients the clinic checks in every day has doubled. Unfortunately, the staffing has remained the same. Physicians, medical assistants, x-ray techs, and front desk employees are burned out and exhausted trying to keep up with the rising numbers, while still providing excellent patient care and remaining healthy. When the onslaught of patients multiplies rapidly, and wait times increase, the day is long and composure runs thin for patients and caregivers.

           The front desk employee, Brandon, tells the gentleman who just entered the clinic, “Sir, you need to wear a mask please.”

           “I do not need to wear a mask. I know my rights!”

           “It is company policy that all people in the clinic wear a mask.”

           “Fine. Don’t help me because I refuse to wear one,” he shouted, stomping out, waving his hands in the air.

           Brandon sighed and shook his head in disbelief. With all the bacteria and viruses that come in the door, why wouldn’t you wear a mask? He went to notify the other staff members about what had happened.

           “If he thinks wearing a mask for an hour is annoying, try wearing one for twelve hours,” Olivia the x-ray tech said to Susan. Wearing a mask, using gloves, and hand sanitizer, and removing her shoes before walking into her house were a few of the things Susan did to keep herself and her family healthy. She wondered where common courtesy had gone. Was it too much to ask people to wear a mask so that healthcare workers are more protected?

           The clinic doors open and close, with a steady stream of patients. Machines ding and flash, spitting out results. Susan wipes down room five for the twentieth time that day. All day long it’s gloves on, gloves off, and then an application of hand sanitizer, which locates and stings any papercut. Would she even have fingerprints in five years after all this hand sanitizer?

           Six people have been checked in and are waiting for a room, but Susan takes a ten-minute break to eat her homemade sandwich and hydrate with more water. Each caregiver takes turns treating patients while the other cram food in their mouths. She takes a big bite and reflects on how much water she drinks a day in conjunction with the number of times she visits the bathroom to empty an overflowing bladder.

           With her lunch eaten, it is back to the grind. Susan uses her “talking to patients” voice, which is higher than her normal voice and happens unconsciously.

           “I apologize about the wait. What brings you in today?”

           “Long wait indeed. It has been an hour since I checked in. I am here because my right knee has been bothering me for two months!” huffed the patient.

           Susan tried to smile with her eyes by squinching them, although she was never sure if worked. “I do apologize, we have been very busy today,” she said with her teeth clamped tight. “I apologize for eating while you were waiting but it had been five hours since I last had anything to eat and I was feeling faint,” she thought to herself.

           Susan always had an inexplicable desire to help people, even as a child she was a comfort to her friends and had a listening ear, which is why Susan chose the medical field for her future. She finished the medical assistant training right after high school and is on a waiting list for nursing school. However, after two years of working with the public, through the outbreak and aftermath of Covid, she was questioning her career path.

           “Did you get a Covid vaccine?” Susan asked the following patient. She hated asking this question because of the variety of answers and attitudes patients gave her.

           “Nope. Those vaccines are how you all make money off of us. First, the media scares us then we run out to get a shot,” the patient stated with conviction.

           “If they only knew,” she mused. During 2020, the company stopped contributing to the employees' 401K’s for eight months, there were no more Christmas bonuses, and all new hires were not eligible for the pension. “Oh yeah, rolling in money. Maybe the vaccine makers or CEOs are getting rich, but it does not trickle down to us hard-working regular people,” another thought Susan could not say out loud.

           The next patient had used medical websites to self-diagnose and was now telling Dr. Allen what she needed. Susan silently wished the doctor luck. Time and time again, many patients believe they have all the information they require and want the doctor to agree with them. Their information is either from the internet, their own past experiences or from someone’s third cousin who dropped out of college and they think they know better than the provider who spent eight to ten years getting a degree.

           Another patient had crashed on her mountain bike, hitting her head on a rock. Her scalp had a deep laceration and was being held in place by her husband’s shirt, a red stain forming across the Nike symbol. At least they did not argue when they were told to go to the emergency room where they could get a CT scan of her head.

           Another patient, a small child was getting an x-ray because he had swallowed a marble.

           The next patient was normally a healthy young male but had tested positive for Covid two days prior.

           “I want the treatment I heard about on television,” he demanded.

           “That treatment is for people who are elderly, have health problems, are diabetic, pregnant, or immunocompromised. You do not qualify since you are young and without any other health concerns,” explained Susan.

           “That is ridiculous! I cannot miss work! I have an important business meeting out of state in two days.”

           “I am sorry but these parameters are from the CDC. It isn’t our choice.” Susan took a breath and speculated that this person would take medication away from an elderly grandma who requires it to stay alive because he believes he is an important person with an equally important job.

           Susan stood by as the patient argued, yelled, and cursed, till he finally left the clinic. Susan sat down at her desk, shoulders hunched forward, eyes filled with tears, and her chest feeling like a hollow, crushed soda can. Why? Why are people so selfish, callous, and ugly? Susan’s body and mind were drained, with no more energy, no more strength, and no more empathy. She focused on tomorrow, her day off.

“I am sleeping in, waking up whenever I feel like it, binge watch something funny and I am not going to feel guilty about it.”

In less than six minutes, five more patients checked in and the staff felt like they were never going to catch up. Susan forced her legs to move and grabbed the next chart. It was a seventy-year-old man with a cough, and difficulty breathing and he was accompanied by his wife. Susan got his vital signs, which were normal, and his health history, and then walked them toward the examination room. Susan’s eyebrows furrowed when she heard the wife crying.

“What’s wrong? Do you need something?” Susan asked with concern.

“Is he going to die?” the wife questioned, her wrinkled cheeks wet with tears.

“No,” Susan paused. “Not right now.”

“It’s just that we have only been married for a few months and we each lost our spouses last year. I am so worried I am going to lose him too.”

Susan’s empty chest was flooded with compassion. She looked the wife directly in the eyes and said, “We are going to take great care of him, figure out what is wrong and how to help him feel better. I promise,” Susan squeezed the wife’s frail shoulder and guided her to a chair in the room.

“Thank you. Thank you for being so understanding and for being here in this job. It means so much when a person takes the time to listen to an old woman’s worries instead of dismissing them. Thank you for that,” the wife said, her voice was shaky but her eyes had cleared.

Susan felt an instant kinship with this stranger. Maybe the job was worth it after all, if a day filled with grumpy, rude, and cantankerous people, there was one shining beacon of respect and appreciation.

The rest of Susan’s shift was filled with dressing changes, wrestling children trying to get a throat swab, and looking at urine samples, but she did it with a smile on her face and in her eyes. No job is perfect and maybe she won’t know for years if the medical field is really what she wants her career to be, but the satisfaction of helping people was priceless.

It was two minutes to close and Susan was ready to lock the doors, her mind going through the task list of items needing to be checked off before she could go home. In walks a weary mother of three, each child pulling on her, demanding her attention, and coughing like it was a contest. Susan sat rubbing her temples while they were checked in. Then with charts in hand, Susan, using her cheerful voice said, “What brings you in tonight?”