The first hospital I worked in after residency was an academic medical center.  It was a hospital located just outside the city limits of a major metropolis that held at least 10 large hospitals, ranging from community to research-oriented, teaching and non-teaching, university-affiliated and non-university affiliated.  There were other hospitals, too, small and medium, specialty, for veterans or native people, etc, etc.  The reason I make all of these distinctions?  They all have different feels, different personalities.  
Now, an academic (or university-affiliated) hospital typically employs a lot of teachers, researchers, and learners.  They teem with teams that are about the size of a junior varsity basketball team, many times clogging the hallways outside of patient rooms or crowded around a computer at the nurses’ station.  All are clamoring for understanding and knowledge of not only diseases and medicine but also of approaches and behaviors.  

I grew up in a small, rural town (population ~ 10,000) and never really knew if I would leave it, but as I progressed through my education, the collective ambition of my encouragers propelled me to see more than what my small town or state could offer.  Away I went to one of America’s 5 largest cities.  Of course there were cultural, economic, and atmospheric differences, but I was up to the challenge.  What does “up to the challenge” even mean, anyways?  Must one be successful at the challenge or just blissfully ignorant of the difficulties that lie ahead?

Aside from the personality of a city, I was excited for the bustling nature of a self-contained powerhouse that makes up an academic medical center.  I generally expected to be intimidated just by being there—not many people with an education have an inferiority complex, but I did.  I do.  There were commanding people, knowledgeable people, good teachers, condescending professionals, good attitudes, and bad attitudes.  This is everywhere though.  

My naiveté, that I would be embraced and utilized to the very limits of my professional knowledge, training, and expertise was quickly injured.  I didn’t give up, though.  I was told I’d have to prove myself, make myself an asset that they would soon see they could not live without.  The thing about academic medical centers, knowledge and expertise are commonplace.  I was commonplace.  I was disposable.  I was also young and not as experienced.  It showed, I’m sure.  The truth was that what I offered wasn’t appreciated, to put it politely. 

Perhaps I could win on a social level.  I learned and begrudgingly accepted that it’s not really what you know; it’s who you know.  And it’s not what you say, it’s how you say it.  I chose to say it with donut holes.  That worked for the few hours we were in rounds and maybe for a few precious minutes when I had to page the resident later to give a recommendation on a patient, but it was fleeting.

Every day when I ventured across the hospital to a meeting, to the cafeteria for lunch, or to the coffee stand for an afternoon break, I’d cross paths with the physicians I’d rounded with that morning.  My hopeful eyes would search for contact, I’d prepare my smile and turn my head slightly in their direction…but nothing.  No acknowledgement.  We’d be the only two people in the hallway for 40 or 50 feet, and their eyes that were once straight ahead, searched the floor.  I clearly had done something wrong, I hadn’t charmed them, hadn’t impressed them with my expertise.  My clothes weren’t fancy enough, my sense of humor wasn’t funny enough, I wasn’t pretty enough. 

It took me a long time to figure it out.  Some of my colleagues were more successful at crossing the invisible line.  They had traits that were deemed more attractive or at least local.  I was an alien.  I didn’t belong.  I began to accept it.  At some point I became more confident in my professional abilities and started not to care as much.  I had surpassed the limits of knowledge and had gained experience that none of the residents and many of the attending physicians had.  I vacillated between bitterness and graciousness when considering their snubbing of me.      

Alas, the time had come for me to move on.  Things always have a way of working out for me at the right time, after a lesson has been learned or the next situation has been readied.  After a small, but very meaningful pit stop, my home started calling.  A job back in my home state, the only position I would have accepted, came open.  It was time for a new personality.

The new hospital I went to had a simple rule for its employees:  Make eye contact and say ‘hello’.  I was no longer an alien.  Everyone smiles and is helpful.  It’s not a large, academic medical center, but it is a teaching hospital.  I don’t have to bribe people with sugar anymore.  In fact the food I brought in the early days didn’t impress anyone, but I didn’t need it to attain a level of respect and acceptance.  Acceptance both as a professional and as a person came simply because I was there, doing my job.  I won’t discount my earlier job because it did teach me.  It provided me an invaluable experience.      

Comparing and contrasting the two hospitals is a ready-made tale of the golden rule and loving your neighbor.  Both hospitals are affiliated with the same religious order—both have a motto that implores its professionals to heal and to treat others, both their body and spirit, as Jesus did.  I laugh at the torture I endured, tearing myself apart and doubting my abilities, my personality, and my looks, when it wasn’t my personality that needed inspection.  

The personality of a hospital has many influencers–the people, the administration, the culture of the surrounding people.  My personality was influenced by the first hospital, and my life suffered.  I had to learn to be myself again and what God intended for me, and eventually, the right hospital found me.    

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