The Coat
They dressed us up like doctors.
We had to wear a long white coat over our required professional dress attire.
You know the kind. Those white jackets a doctor wears, or a scientist.
I received my coat after my extensive training. It was an official rite of passage. A promised symbol of accomplishment. Hours of training to achieve.
On the top left lapel, the coat displayed the university hospital symbol, very official. On the right, in bright, red embroidered lettering, it announced, “Catherine White" and below that, “Psychometrist." Next and last line, “Neuropsychology Laboratory."
Yuk. Not like me at all.
Within a week of wearing it, though, I discovered the Jacket Privileges.
Patients and other non-jacket wearers deemed me intelligent, worthy of respect. I gained an unspoken bond with all the other white coat wearers.
Were these people actually asking my opinion about medical topics?
I recall the cognitive distortions and mental flip-flopping.
I am in the elite. Huh, this feels kinda good.
Moving on up, Catherine. You made it. You are a member of The Team to restore health, offer hope, save lives.
Wait… Is this trickery?
Don’t over-think your idealistic disdain of symbols of a socioeconomic divide and the evident, forced class system, Catherine. Your principles of equality won’t work here.
Just, please, don’t lose yourself and what brought you here.
Geez, ease up and don’t be so serious all the time.
It is just a white jacket.
The Mess of It
Week two to year seven… I hated the damn coat.
It was uncomfortable, stiff, and incredibly itchy.
It was also bright white, not boding well for someone like me. I’m messy. Maybe a bit of a mess in general. Who knows?
All I knew was that this coat caused serious life problems.
I spent my precious free-time spraying The Coat with stain remover smelling of a chemical decrease in life expectancy.
Adding bleach to hand scrub out the pen stains from rushed work days. Or was it a stress-induced lack of manual dexterity from work?
Air drying to prevent shrinkage.
Madly ironing out wrinkles the night before each workday as if it were my new cardio routine.
Shit. I wanted overtime pay for Coat Maintenance. Not going to happen, though. Only the MD/PhD’s got all allowances for dry cleaning their Coats. Loss of family time and forced insanity were meant only for those paid hourly, you see.
All for naught, though. Sure enough, I inevitably dribbled ugly, brown stains from quick gulps of coffee while running into the hospital, praying I’d punch the time clock before the hour to prevent pending job loss from accruing one minute late punches.
Fuck. How many late punches have I accrued to date?
Coat Maintenance was a useless battle.
I kept trying, though. I had to look good to represent, ya know?
Don’t forget, Catherine, you will get a great retirement if you can make it to 30 years’ time in the system…Is it still week two? Year seven? …
Am I losing a sense of time?
The Good with The Bad
Back to the Coat Benefits.
Doctors like women who wear a white jacket. A common hospital workplace scenario always played out the same…
Me standing in the elevator. A cute young doctor hops in, thanking me for holding the door. He looks at my white jacket; I look at his. Instant connection. We read each other’s titles and he states, “Psychometrist, huh? Sounds very official. What does that mean?”
I respond with a flirtatious and coy smile, the kind that suggests I want a bit of a chase.
I knew you gotta skirt the answer and vowed to myself to never explain the title, cuz there are two reliable principles in this game...
One, everyone with a white jacket looks a bit more attractive. Two, guys always like a little mystery.
Play the game, Catherine. Play the game. The pay isn’t great, but you sure will have a great retirement. You’ve only got 25 years to go, so have a little fun.
Everyone knows that there’s a price to a political process and system.
Something’s gotta get you through.
The Work
Petty things aside, I had an actual problem.
My coat created a demarcation between me and the patients. It eroded away the very essence of the human, person-to-person relationship I wanted to have with them.
As the Psychometrist in the Neuropsychology Department, I administered psychological, diagnostic, and intellectual tests, scored the tests, entered the data, and wrote behavioral notes.
The diagnoses and determinations made in my clinic were usually dire, predicting Alzheimer’s or dementia, showing severe brain deficits from trauma or abuse, showing intellectual dysfunction, or suggesting impaired cognition from serious psychological distress.
My role was to guide patients through a series of four to eight hours of neuropsychological testing in one sitting. The assessments consisted of tests of memory, cognition, intelligence, and more. It was an exhausting process for most of the patients. It was exhausting for me, too.
While my compromised patients struggled to think, reason, and try to do really hard brain tasks, I was to remain extremely objective and professionally detached. If I showed empathy or support, it might have affected their performance.
Each work day, I did everything in my power to do my job well. I prayed my work provided accurate information for the benefit of the patients. Correct clinical information led to diagnoses that potentially improved a prognosis or access to correct treatment. There were times I felt, desperately hoped, it might lessen suffering.
The work was tough for me and, as a sensitive soul, I learned the hard way that such work can be traumatic for someone, like me, inclined more toward supportive, clinical roles.
Hard work. Much overtime. Difficult boss. Ornery co-worker. Sad stories.
There was, though, a lighter and pleasant side to it all. I possessed a unique talent at being able to make the patients feel more at ease. That felt rewarding. Back then, I thought I had a gift of sorts. A talent at calming patients’ anxiety during a painful, sometimes humiliating, process.
Because I’m from Pittsburgh and Italian, down-to-earth friendliness is my nature. A good, light-hearted story before or after the testing helped bring a smile to faces and a sense of comfort.
Truth be told, I think my supervisor questioned my suitability for the role. I had a reputation for stupid jokes or silly blunders. I’m was a frequent giggler, clumsy, often awkward.
As for my ability to make my patients at ease, my patients liked my awkwardness. Seeing my vulnerabilities helped them realize that I, like everyone else, possess quirks and challenges. Some even considered me neuro-diverse, just like them in a way.
Truth is, we are all have deficits. Strengths. Concerns that the former outweighs the latter. Fears that we are failing, maybe declining, albeit physically, mentally, or in character.
My physical lack of grace or atypical quirks mirrored their mental and emotional slip-ups and stumbles.
The Challenge
On one particular work day, supervisors announced my patient for the day was in prison for a serious felony.
It was typical for me to do the tough cases.
Some thought me innocently naïve to have no fear of sitting alone in a room with a forensic client for 8 hours straight. Yet, I learned in life and in previous clinical roles that others usually pose a threat only when they feel threatened.
When we respect another person’s life experience, perspective, or emotional needs, a relationship — working or not — is stable and healthy.
The forensic client I had to test that day was respectful.
He also enjoyed challenging me. He tried to trip me up and interject with brash comments and questions. Deep down, I sensed he wanted a level of friendliness, humor, and levity.
Once, he stopped me and said, “OK, now one intelligence question for you. He wrote, “A, B, C, D, E, F, G, H,” and said, “What letter comes two to the right of the letter which is immediately to the left of the letter that comes three to the right of the letter that comes midway between the letter two to the left of the letter C and the letter immediately to the right of the letter F?”
I was certain that he made up this nonsense question to prove the ridiculousness of these assessments. He knew as well as I did that I’d hate it if I had to endure a series of rigorous questions that most find impossible.
They trained me to redirect the patient under such circumstances, so I tried.
To my surprise, he refused to proceed and asserted, “No. I want you to answer this question. It has an answer.”
“C’mon,” I said, “We both know you made that up. I get your point, but there really is a usefulness in these assessments.”
He looked at me with seriousness. He then wrote out his proposed mental challenge below the series of letters.
“I expect you to try,” he said. “I wish to establish a logical point about the neurocognitive effects of tensity on intellectual brain operations.”
My curiosity peaked. His words sounded intelligent.
“Ready?” he asked. “Let’s see how intelligent you really are. In my opinion, most individuals in the healthcare field, like you, are quite dull.” He grabbed the stopwatch and said, “You have 45 seconds. Get ready… Go.”
I was nervous. Was I really dull? Did this guy have one up on me? Would I be able to handle him for another 7 hours?
He saw me pausing and asserted in an irritated and aggressive tone, “I’m not joking around. I expect you to answer the question. Now focus. I’ll restart the time. Are you ready to see if you have much intelligence? Here we go. Get ready to read the question and give me an answer. 3, 2, 1… Go.”
My eyes blinked several times. I looked down. I felt a dryness in my mouth. The question blurred, and when I read it, the words were a wash over me. I felt frustration and insisted to myself to read it again and determine if there was an answer. I read it again. Then again. I placed my hand on a letter that I chose randomly and counted two to the right of that letter and got stuck when I read the next part, “immediately to the left of the letter” when I heard him say, “Stop! What is your answer?”
Thinking the problem was a bunch of gibberish and that his behavior was unwarranted and not welcomed, I told him I had no answer because the statement made no sense and I wanted to move on with the real reason he was here today.
His eyes softened. He looked at me with kindness and explained, “Now that is the effect of pressure. That is the effect of feeling judged, tested, and analyzed.”
“You see,” he explained further, “a person rarely thinks at their best when forced or when afraid. So, I do not feel these tests are valid. While folks sit in your office, in a clinic, in a hospital, being assessed for what may be the most frightening diagnosis that one might receive, I simply cannot believe that they are at their best to process something mentally.”
With kindness, he continued to say, “Catherine, there really is an answer. I won’t time you. Look again. I know you can figure it out. I see you are not only genuine and compassionate but also quite perceptive and sharp. Check it out. I feel you can determine the answer.”
The softness of his voice and his trust in my ability had an impact. He seemed almost gentle, and I was interested in whether this patient could actually devise such a complicated question that truly had a solution. My body was at ease. I read the question. I worked through it, with a vague recollection of how good it felt to challenge my mind.
“H.” I knew I was correct.
“Yes,” he said with a warm voice and a father-like nature. “Now that is the effect of nurturing positivity, the effect of having someone believe in you. If you give that sense of nurturing to all of your patients, only then will their true abilities come forth.”
I knew that to be true. Throughout my years of psychometry, it was my goal to make my patients feel comfortable, supported, and respected. It was good to be reminded.
Tired, uncomfortable in my coat, and reflective, I questioned whether I could make it through today’s assessment.
“Let’s proceed,” he said. “I’m ready.”
The Conundrum
By the time we reached lunch, the testing process was running behind. That meant little time to take my lunch break, little time to run to the restroom, and no time to grab a snack.
So, after lunch, I held off from going to the restroom for a long time. It then reached the point where I REALLY had to go to the bathroom
Because my patient had a criminal history and was still living in prison, when I finally allowed myself to go to the restroom, a colleague stood watch outside my door to make sure that he did not get up and walk out.
The other psychometrist, pushed for time with her own patient, seemed edgy. So, I felt I had to, well,… pee quickly.
Normally, I took my coat off when going to the bathroom, not only because I didn’t dare wrinkle the damn thing, but also because, for me, there was a high possibility that the back of it would fall in the toilet or something (I am definitely not the most coordinated person).
On this day, though, I was rushing, and I said in my mind, “Screw it, I am just gonna hike up the friggin’ coat.”
Proceeding to do so, I awkwardly held it while trying to balance over the toilet and do all things one needs to do after one goes to the bathroom. It proved to be an impossible juggling act, accounting for the jacket, pantyhose, a long skirt, heels and only one free hand needed for toilet paper.
Ugh.
Leaving the restroom and thinking all was successful, I hurried back to my office to start up the assessments that had several hours to go. After the testing, I possessed an impossibly negligible amount of time to score all tests, write up the results, and drum up notes about the patient’s behavior.
When I sat down, I took a deep breath to regain some energy. I looked at the patient, shared a feeble smile, and said, “Let’s continue where we left off.”
Much to my surprise, he wore a big, cheerful smile on his face and just looked at me for a good few seconds. His demeanor differed totally from the initial seriousness and the kindness that followed.
Looking me in the eye, he said, “Catherine, you are adorable.”
A few seconds passed, and then he said, “You really make me smile. I am enjoying this.”
I braced myself, wondering where this was going.
I looked down, made sure my bra wasn’t hanging out, that I wasn’t showing too much cleavage or something similar.
Finding no reason for his sudden, very personal friendliness, I thought of what I might say if he was going to continue in this manner.
His smile was coy, and he continued to look me in the eye with what felt to be fondness. He then added, “You really are quite endearing. I think I like you.”
I was at a loss for words for a few moments. Looking down to give myself time to think of how to be kind and also firm in my next approach. I took in another deep breath, looked up and started, “I really need you to...” at which point he giggled more and interrupted to say, “No, Catherine. You don’t understand. It is just that… Well… It is just that... You just have toilet paper hanging way out of the back of your skirt!”
I turned in my seat and discovered that a long line of TP hung from the back of me. Worse yet, my jacket tucked up into the back of my skirt and bunched around my waist. It was horribly conspicuous and, to make things worse, it held in a long line of toilet paper that reached off of my chair and out the office door.
Aghast and terribly embarrassed, I started blushing. I announced, “Oh dear God! I am such a dork,” as I awkwardly tried to pull out the line of toilet paper, straighten the white coat that was tucked up in around my waist, and quickly squirt hand sanitizer in my hands.
With painful embarrassment, I told the patient that it’d probably be a good idea for me to return to the restroom, fix my blunders, and wash my hands.
His laughter got louder and turned into a deep belly laugh that brought tears to his eyes.
I found his bright smile and genuine laughter incredibly refreshing. I joined in on the laughter. The shared mirth continued for a good, long while.
The Result
After we calmed down a bit and agreed to start up the testing again, he said, “You originally thought I was hitting on you, didn’t you?”
I sighed, sat back in my chair smiling, and felt myself ease into the levity of the moment.
His face grew more serious, and he then added, “You know, I am probably very different from what you think. Actually, I am an honest and good guy. I’m just a guy who found myself in the wrong place at the wrong time. As a result, the court determined me responsible for the death of a man who I did not kill. And now, after 23 years in prison, my family thinks that I have progressing dementia. Truth is, my mind is still intact; it just does not process correctly when the traumatic memories come to the forefront of my mind. I’m deeply sad, disconnected from everything, and I suffer every day. Your silly blunder gave me a bit of joy. I had not had joy like that in a long time. I feel comfortable with you.”
We both paused and his statement hung in the air. I processed what he just shared.
We stated nothing in the next quiet, thoughtful minutes.
In those moments, I think both he and I felt very human. Purposely not speaking, I let the weight of his comment sink in for both me and for him. Maybe, in sharing his truth, he might acknowledge his need for help.
His smile waned more, and he said, “You know, seeing you with toilet paper hanging out is the only thing that will get me through this day, Catherine.”
I understood him completely. I appreciated his total candor and courage while he allowed himself to be so vulnerable.
Following this, the testing proceeded with more seriousness, concentration, and cooperation. The whole scenario was actually a necessary transition.
At the end of the morning assessments, we exited my office, about to walk together to the elevator to meet his escort, who would take him to lunch. But, when we stepped out of my office door, my two colleagues were standing there — one a neuropsychologist and the other an administrative person who never really liked me.
My patient looked at them, looked at me, and then announced, “Catherine, what you did this morning made me smile more than I had smiled in a long time.” I knew he liked that his statement was both a compliment and also a way to instigate a bit of confusion for my colleagues.
The administrative co-worker looked at him, then me, then him, then me, and finally stated with seriousness, “What the hell were you doing in there?”
The neuropsychologist looked entirely confused and possibly concerned. I just smiled, explained nothing to my colleagues and said with genuine honesty, “You really made me smile too.”
The Undressing
When my patient returned from lunch for the afternoon testing, he noticed I was no longer wearing my coat. He stated, “You look totally different without your jacket.”
I was both pleased and annoyed at his statement. I explained that, after the bathroom incident, I threw the coat in my bag during lunch to take home later.
Right as I mentioned this, I thought to myself that discarding of my jacket was not just a result of the bathroom blunder. In hindsight, I believe that, on some subconscious level, it was a statement — a choice that related directly to the events of the day.
It felt great to be without the coat.
I was finally free from that troublesome jacket, revealing the real me — the woman who entirely loved this job.
With greater freedom, a renewed perspective, and a shared combination of humility and respect, my patient and I worked together as a team for the rest of the afternoon, him grateful that I made him smile and me grateful that the day proved the power of bridging a human divide between a healthcare professional and a patient, between a “good person” and a convict, and between two people who felt humanly flawed and unassured of themselves.
The Truth
Truth to be told, I never wore my jacket again after that day.
To my superiors, this seemed to be a rebellious way to not follow hospital policy. I kept the real reason behind my choice to myself.
Without the jacket, I finally showed my true self and exhibited my deeply felt desire to connect with my patients — connect in a very real and human way when they, too, were at their most vulnerable point.
Once revealed, I could celebrate the connection I had with my patients — a bridge that connected me to their life, their struggle, and the fragility of existence.
This day renewed my dedication to my role.
I remembered, again, to nurture positivity and provide dedicated support to patients who were, in fact, no better or worse than me and had no more and no less of a guarantee for their future.
We are all in this mess of life together.
Maybe giving transparency to our vulnerabilities, giving levity to our blunders, and connecting during the process of life is how we get through the mess of it. Exposing our challenges and revealing our authenticity might allow us to unite in the fight. It might even allow us to overcome.
You see, white linings, unlike white jackets, bear the requisite of stains.
And, healing and health only comes only when we uncover what’s real.
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