Yes, Virginia, It Does Exist: Medicine Beyond Route 128

Photo by Jeff Cleary Tarayn (Grizzard) Fairlie

It’s like waiting for the other shoe to drop. For all intents and purposes, I should be relaxed. My first month of family medicine residency appears to be benign. The other residents are friendly, sane, and have no notable aggressive tendencies. The smallish suburban town itself is great too: bucolic but close to urban amenities, with a nice, thick working-class veneer to keep it from being a little too Stepford-like.

I should be enjoying the moment and eagerly preparing myself for the next three years of training, but I can’t. For the first time, I’m in a community hospital setting full time, and it’s all a little surreal. I feel like I’m in an episode of Scrubs, a show I had previously mocked (while secretly loving the double entendres and copious classic sitcom references) for its complete departure from “real” hospital life. After all, no hospital I had ever been in had board members who interacted with the residents, a cafeteria where residents sat and had lunch while gossiping, or residents who were well known to the local community. I thought it was just wishful thinking on the producers’ part, as fantastic as the ’80s bands cropping up in the middle of surgeries or J.D.’s (Zach Braff’s) apparent invulnerability to pain or injury inflicted by the menacing janitor.

Evidently, I was wrong. During orientation alone, I, along with the other new residents, met the mayor, toured the town with one of the hospital’s longstanding board members, and ate lunch the first day in the small fishbowl of a cafeteria with the other residents. All the nurses know who we are and occasionally also know our names and hometowns. Hospital staff members are often long-term fixtures in the community, and patients and staff alike might be spotted at the local Wal-Mart.

It’s oddly cinematic, save for the lack of quotable dialogue and camera-ready faces, but that’s not what’s been keeping me up at night; after all, glaringly surreal experiences defined medical school for most of us. What has been distressing is my own discomfiture at what should be such a normal situation. There’s no reason why the small, highly commended community hospital where I now work should freak me out so much. I mean, shouldn’t I be part of a community? Shouldn’t I get to know the hospital staff, the community itself, and, heaven forbid, sit down to lunch every once in a while? And, importantly, if I do these things, aren’t I still as much of a doctor as my friends who are new residents at large teaching hospitals back in Boston?

The settings are so different that comparisons are impossible, but my Harvard-acquired bias tells me that here I won’t learn nearly enough: thus, my discomfort is well founded, a warning sign. Rationally, I know that I’m actually likely to learn just as much if not more medicine here as in a tertiary-care facility, where only 1 percent of patients ever end up and rare conditions are often more adequately treated than common but serious ailments. Reconciling what I feel and what I know to be true, however, will likely take the duration of my training. I worry sometimes that I’ll never recover from the shock of leaving the Longwood ghetto or finding out that one can truly practice medicine outside of the geographical confines of Route 128. Until then, I’m taking it one day at a time—and trying hard not to fixate on whether or not my chief resident does, indeed, resemble J.D.

—Tarayn (Grizzard) Fairlie is a family medicine resident
at Middlesex Hospital in Middletown, Conn.

The opinions expressed in this column are not necessarily those of Harvard Medical School, its affiliated institutions, or Harvard University.

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