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Oscar, please
The luxury of stepping out of character
I am sitting on the edge of the examination table, my skivvies covered only by a ratty gown that ties in the back. I’m here because my husband has punched me in the stomach and the pain has been excruciating for two days now. My name is Rochelle.
The door to the examining room opens and in strolls an eager beaver third year medical student, clean cut, slightly nervous, sent from central casting to play Young Male Doctor. I shake his hand somewhat timidly and begin answering a barrage of questions. For the eighth time today.
Before you start combing the streets of St. Louis for my sweet, unsuspecting husband, ready to deliver a swift round of vigilante justice right to the boys, I should probably clarify something. He hasn’t really punched me. Not ever.
So what am I doing here with these medical students? I’m lying. Or, as they call it here at the university clinical simulations department…acting.
I’ve signed up to do this, to memorize a script and the particulars of a fictitious person’s traumatic existence and come to the campus of this local university and let med students work me over, so to speak. The purpose of these clinical simulations is to let the med students practice their bedside manners and diagnostic skills.
The purpose for me? Yeah, that part I’m not sure about even as I head into my first performance. Probably because I will try anything once, because I am intrigued that this even happens and because $100 for eight hours work is nothing to sneeze at. (Especially if you get to keep your clothes on, which…Oh. Wait. I didn’t.)
Now, despite my many dazzling performances in print, I haven’t really had much acting experience, unless you count a small but stage-stealing role in a high school Thornton Wilder play called Childhood. (Oh, like you even knew he wrote anything other than Our Town.) Or, I suppose, unless you count every other time I open my mouth, but I don’t really consider that acting as much as…deceiving.
Thus, it stands to reason that I am nervous arriving on campus early this morning, my handy file folder filled with facts about a life which, for the next eight hours or so, is my life. I reach the building at the same time as another participant. It’s also her first day and she’s every bit as unsure where to go and what to do as I. Oh, glory be to the pack mentality. There’s nothing so comforting as not being the only one completely clueless.
This girl is young, probably a college student herself and I start to worry that maybe she’s an actor. NO, an Actor. Like, in the thee-ay-tah, all hand gestures and pretensions, prone to tossing out Arthur Miller quotes and Shakespeare-isms.
If I’m going to be drastically out-talented and out-performed, if my stage time is to be stolen by professionals, I think it best to know right now. That way, I can turn and run. Much to my relief, it turns out that she’s a student/waitress. Not an actor/waitress or even and actor/student/waitress. Just a good old, honest-livin’-earnin’ waitress who probably would quote Cher before Chekov. (Not that that’s a good thing, you understand, but for my selfish purposes, it works.)
It turns out that the clinical trials pair us with another "actor" for the day. One of us will be examined while the other writes up an appraisal of the students’ performances. Out of four or five clinical studies going on that day and the eight or ten women participating, only one is an Actor. And it is, of course, my partner.
As if I’m not under enough pressure. I have to paired with the only person in the building who wouldn’t guess that Stanislavsky was a great internist. I don’t know if I can handle the scrutiny. What if I buckle? What if I get examining table fright? Can I turn to her and plead for my line…my line?
My worry, it seems, is for naught. None of us – my Actor friend included – is actually here for the theatrical experience. We’re not thespians today. (But then again, neither is Catherine Zeta-Jones and she got a goddamn Oscar.) We’re not here, either, because we’re helping to shape the future of medicine and train a new generation to be compassionate and thorough for the good of mankind. No, we’ve all given up our day to come in here for one reason only: the money. As long as we understand our motivations. In character, people!
As part of our case study, the Actor and I need to give ourselves the appearance of having a huge dark bruise on the stomach, where our fictitious spouse has punched us. There’s a very high-tech approach to this: rip a page out of The Riverfront Times, douse it with water and rub across your stomach. Of course, I can’t help but think my partner could method act her fist right into her gut but apparently someone’s not that dedicated to her craft.
I watch first, since the Actor has done this before and I’m grateful, for once, not to be the one talking. As the first student comes in and the exam gets underway, I’m watching my partner field the questions, her eyes darting hither and yon, hands wringing in her lap and thinking two things: one, this is pretty convincing stuff and; two, I don’t think I can pull this off. Would anyone notice a woman in a natty hospital gown sneaking off campus?
But the next thing you know, it’s my nearly-bare ass on the edge of the table and in strolls a strapping young Noah Wyle-esque youngster. He washes his hands, like a good boy, then sits down in front of me and says, "So I understand you’re having some kind of abdominal pain?"
I nod silently. I’m clearly not the most talkative patient on earth. He continues: "Can you tell me a little about that?" And I do. I respond to his questions, revealing only as much as I’m supposed to, according to the script, making him work for the information, read the signs and my body language. As he asks me questions, I can practically see the checklist in his head running down the possibilities, churning out items to be explored, symptoms to be assessed.
I explain to him that the pain in my stomach is constant, that it doesn’t radiate anywhere and that it came on pretty suddenly two days ago. Only once he’s run down a number of highly unpleasant queries about my GI tract and has me reclining for a physical exam does he pause and say, "Do you have a history of abuse?"
And what I feel is shame. Embarrassment. I nod wordlessly until he draws the details out of me, nodding compassionately. In a slightly awkward manner, he tries to make me understand that what’s happening to "me" isn’t okay, despite my protestations that it’s always my fault. I feel sad, confused and scared and I’m almost in tears by the time the voice over the loudspeaker announces that it’s time for the students to move on to the next case.
I’m not too surprised that I get into the part as much as I did. I’m sort of an all-or-nothing chick, after all. What does surprise me was how easily I get into it. How quickly I forget that the things I’m saying aren’t actually mine but the details of a case study culled from dozens of similar cases.
I’ve never been hit before, thank God, so it certainly isn’t personal experience I’m suddenly drawing so strongly upon. Maybe it’s the experience of the victims I’ve watched during domestic violence training for my volunteer work on a crisis line.
Or maybe, and I think this is more likely, it is just the fact that I’m a person and I simply don’t want to be hurt by anyone. The desire not to be violated, not to be the object of anger rises effortlessly to the surface, bubbling there with enough reality that the tears in my eyes come as a complete surprise.
This is how my day goes, over and over again. For hours they come, these medical students, one after another, all different (yet somehow very much the same) dressed up in their eager youth and hip-but-comfy footwear.
Most are good, with a bedside manner still crude enough to be charming, polished enough to be comforting, complementing their sharp diagnostic instincts. Others are sluggish, skirting around the problem and dancing close to it a few times before coming up with the right truth. I feel for them. Then I remember that when they graduate, they will make more money than God, so I suck it up.
A couple of the students – poor things – not only miss the boat, but the entire friggin’ ocean. It’s tough to watch. You can see in their eyes that they want to solve this puzzle, that they want to get the answers right and for a moment you see them not as your physician but as a desperate medical student dying to know the name of the game. I can’t help but think that if their desire to know the patient was as strong as their desire to know the answer, Rochelle might wind up getting the help she needs.
By the afternoon session, it gets harder. The novelty of prancing around in a flapping hospital gown has long worn off and if I get palpated by another set of freshly scrubbed hands, I’ll start showing them what real abuse looks like. Plus it’s draining, this constant stream of questions, sort of the same but never enough that you can sail through.
At just before three o’clock, I’m examined by the last student for the day. My answers are becoming slightly more rote, my intonations no doubt less readable. When the voice on the loudspeaker calls "cut", I’m ready to retire the hospital gown and get back into my own clothes.
I spend a great deal of time wanting to be other people. Or, more accurately, wishing I could taste their lives for just a moment or two. A day in this person’s shoes, a weekend in another’s. What’s interesting here, I think, on the elevator back upstairs, is that when I finally got to step into someone’s else’s pair, they weren’t Manolos or fancy Jimmy Choo boots. They weren’t the rubber-soled clogs of the medical students or even the pumps of the clinic’s staff.
The shoes I tried on were tired and worn and, quite literally, beaten down. They were sad and lonely and difficult and tiring. And they made me more glad than I have been, in a very long time, that I, at least, have the ability to take them off, put on my real ones and stroll freely out the door.
Copyright 2003, Julia Smillie. All rights reserved.
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