Commander of the Devout
Like all good medical students, I await the arrival of the Mother Ship as promised and foretold by the Prophets in whose names we have dedicated our lives. But I have begun to doubt. The world goes on beyond the walls of our medical school. I catch brief glimpses of it over the razor wire that our robed masters say is to protect us from The Deceiver. Sometimes it’s an automobile of an unfamiliar type. Occasionally it’s just a snatch of sound, a few notes from what I once remembered as an ice cream truck although the taste of ice cream eludes me. It is haram, or forbidden, to the disciples and I have not tasted it since my parents handed me to the Guardian at the gates of the adminstration building whose threshold I have not crossed for these many long years.
I was not destined for medical training. Some even doubted my dedication during the selection process. My grades and test scores were good, of course, as are everyone’s who is chosen to follow The Way. And it goes without saying that I had a medical degree from a third world country. Everybody does. It’s considered the bare minimum to prove your dedication to the Prophets. But I never really demonstrated my desire to be a physician, at least not where it counts. I amost cured small pox. I almost implemented a Single Payer System (Peace Be Upon Its Holiness) during one whirlwind summer in Tajikistan. I almost did this and I almost did that, never gaining a foothold, something that could convincingly show my dedication to medicine.
Even my admission novel wasn’t as long or as original as it should have been. I only worked on it for five years and the final product, while servicable and the recipient of several literary prizes was not considered Nobel material.
So I sometimes catch the disapproving glances of my fellow medical students. They whisper that I had some help gaining admission. Perhaps a relative on the admission comittee, maybe a few well placed donations to the High Professors.
“Empathy and Caring” Intones my novice, a first year, breaking me from my reveries.
“For the Underserved, now and forever,” I reply automatically, the words of the ritualistic greeting coming easily to my lips though I no longer believe them.
Even during my first encounter with one of the Holy Underserved, though carefully supervised, the brief glimpse I had of her through the Hippa curtain did not inspire the pure thinking in which I had been instructed. She was incredibly fat and reeked of cigarette smoke. Neither had she bathed in a very long time and she smelled like a piece of rancid cheese. I knew on an intellectual level that this wasn’t her fault. After all, are not the secrets of soap kept from the Underserved? And yet I resented her and fought with all of my training to keep from betraying my revulsion to the Guardians.
My novice looked at me suspiciously. Have I betrayed something on my face? Have I allowed my carefully cutivated external serenity to slip?
“The Commander of the Devout wishes to see you, oh my Fourth Year Brother,” says my novice softly, barely concealing his anger to have been assigned a Fourth Year who is fallen from the favor of The Prophets.
“So it shall be done.” I dismiss my novice who scurries away to his empathy prayers and begin the long climb to the chambers of the Dean of Students.
The Commander of the Devout turns from the window and motions for me to sit down.
“I have had complaints,” he says quietly, looking at a thick file laying open on his desk, “Some even question your faith.” The Commander is known for coming quickly to the point. During rounds he once cut short a resident who had only been discussing a patient’s potassium for thirty minutes.
“I serve the Holy Underserved in the wilderness of health care access,” I blurt out, hoping to buy time to collect my thoughts.
The Commander waves his hand inpatiently. “Let us dispense with the scriptures. You obviously don’t believe them, or at least that’s the impression I get from reading your weekly evaluations. Did you not roll your eyes on several occasions during your primary care appreciation meetings? Have you not said to several of your fellow students that you had considering radiology? Don’t deny it. I can produce witnesses if required.”
“I try to think pure thoughts, Emminence, but of late my mind wanders and I wonder what it would be like to have some time to myself, to think of other things besides medicine.”
“Time for yourself? You blaspheme here in my presence? Is it not written that our fathers fled into the wilderness to escape the uncleanliness of the eighty-hour work week?” demands the Commander, making the the warding sign, “Did not the infidels match into dermatology and consort with opthalmologists jeapordizing their very souls and keeping the Pure from the Rendevous With the Primary Care Mothership in the End Times?”
I have never seen the commander so angry.
“Do not fall for the traps of the Deceiver and his Arch-Devil, the Dark Lord of PM&R whose task it is to lead the Faithful astray and deny the Holy Underserved free access to health care and their just absolution from all earthly responsibilities.”
“I have in my hand the results of the match and I could not help but notice you have matched into Emergency Medicine,” the commander spits out the words as if they taste bad, “But I say unto you that even at this late hour it is not too late to withdraw and fall into the welcoming bosom of Family Medicine, the One True Specialty. To sojourn among the unclean, and certainly their are none as unclean as the Emergency Physicians who as they know not empathy and make cruel jests must surely sit at the right hand of the Deceiver as chief among the damned, to sojourn among them is to fall away from grace precipitously and permanentely.”
I shift nervously in my chair. I have been discovered. My involvement in several primary care interest groups and the oaths I have sworn have been in vain. Have I been so transparent? I say nothing.
“Go then,” intones the Commander of the Faithful, “But know now that you are shunned and for any to speak to you is haram.”
Graduation can not come soon enough.