Bottom of the Totem Pole, Top of the World

An army of doctors. A consultant, three registrars, two interns, two student interns (S.I’s) and six third year students. The students are the only ones in white coats. It seems symbolic of their relative innocence and naivete.

A woman who had surgery to remove a tumor is told that her abdominal discomfort is probably just heartburn. Her eyes tell the story of disbelief. If the consultant really believes it’s just heartburn, why is she surrounded by the army? There are too many white coats, too many curious eyes.

The white coats talk the least. They are practically mute this morning. Why? Were they not talkative and eager before the un-coated doctors arrived?

“Shifting dullness,” a registrar mumbles as the sea of white coats parts too slowly around him. The white coats look confused. The patient doesn’t have ascites, so how could she have shifting dullness? Why are all the senior doctors laughing?

Shifting dullness…


When the doctors are all together, the white coats are unseen. The whispered conversation excludes them. The terminology used exceeds their knowledge.

But when the white coats are alone with but a few doctors, there is learning. There is practice.

The white coats take bloods and request labs.

They put up drips. They give injections.

They take histories and conduct physical examinations.

They perform and interpret ECG’s.

They clerk and present patients. Their opinion is solicited, their existence acknowledged.

They bag critical patients; these patients live.

Plankton in the sea of big fish, they feel like soldiers on the front-lines. Bottom of the totem pole–top of the world.


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