All my life, I wanted to be an actress. As a kid, I would pretend the gold wool carpet in our living room was the Yellow Brick Road and that I was, of course, Dorothy. And I would make my parents watch. For DAYS, because I was super into the concept of real time. Often, I would narrate my day to day actions under my breath, because I was certain that splitting my head open running into the console TV while hurrying to change the channel to Scooby Doo or feeling very strongly that I ought to be allowed to wear my dance recital costume to Montessori school were incidents that would definitely figure into the movie that would eventually be made (starring me, as myself) of my life – a movie that was already running more or less constantly in my head. My mom was kind of concerned that I seemed to be constantly talking to myself, but then she figured out what I was doing and realized that I was just a deluded narcissist and probably wouldn’t snap and burn the house down one day. You may recall that I lived in West Virginia. Behind a truck stop. There weren’t a ton of other kids for me to socialize with, so I was basically feral.
Believe it or not, this is not a background that ideally prepares one for normal 9 to 5 employment as an adult.
I did try, though. My first “real” job was during the summer of my junior year of high school. I was working in the Juniors Department at an anchor store in Hanover, PA’s center for intellectual and cultural enlightenment – the North Hanover Mall. Let’s call it “The Bonbon.” My duties at The Bonbon consisted of:
1. Ringing up women who had stopped chain smoking just long enough to run into the The Bonbon to buy spaghetti strapped tank tops two sizes too small five minutes before closing time. Sometimes I would even get to explain to them that a topper above a 50% off rack that reads “Take an additional 50%” off does not mean that the tank top is, in fact, free. However, I did have to concede that, yes, 50 plus 50 did equal 100.
2. Hanging and rehanging JNCO jeans up to ten times an hour. JNCO jeans, as you may recall, were designed to house a refugee Bosnian family of eight in each leg and weighed about as much as an AMC Gremlin. The store’s clamp hangers were just not equipped to deal with the weight and sheer bulk of fabric. You don’t know teenage despair until you know the quiet pop of a breaking clamp hanger followed by the slithery sound of a pair of JNCO jeans pooling in a pile of denim on the floor from somewhere deep within a round rack.
3. Cleaning out the dressing rooms of Bonne Bell spackled pre-teens who had taken approximately 47 items of clothing in to try on face first, before emerging to purchase a single novelty scrunchy to distract from the fact that they were shoplifting three bras and a baby tee under their clothes. And Christ knows what they were smuggling out in their JNCO jeans.
This last got me an official reprimand one day when the store manager gathered together the store’s associates to ask us what we thought we could be doing better to combat “shrinkage.” “Shrinkage” is the pro term for “shoplifting shitbags.” I offered up that perhaps we ought not let people take dozens of items into the dressing room at one time, and that perhaps we ought to require an associate to unlock the dressing rooms for people who wanted to try on clothes, especially on account of the needle and spoon I found in there that one time. The manager looked horrified and said, “We certainly don’t want to treat our customers like criminals. No, I’m asking you where YOU, as an associate, are failing to combat shrinkage,” and I laughed in her face and then she wrote me up, and my official reprimand from the North Hanover Mall Bonbon is probably in my permanent record somewhere and that’s why I can never run for public office.
I was elated when my parents said I could quit my job when school started to focus on my studies. I was already on thin ice for taking off my blazer one day in July when the mall’s air conditioning broke down, exposing a slutty, slutty sleeveless sheath dress from 1964 below. I have it on good authority that the eight or so old people who were hanging out in The Bonbon on a Tuesday afternoon have all since died of shock from the appalling sight of some teenage shoulders. Not to mention that I’d already had to twice retake “credit card training” for failing to foist the requisite four successful store card applications (at only a 27.99% APR!) a month on an unsuspecting public.
I could definitely add “retail” to a mental list I was starting to keep called “Employment Avenues to Avoid.”
The next summer, I added “temp” to that list. The agency I had signed up with for the summer somehow translated my request for “light clerical” employment to mean “trying to identify what bodily fluid caused the stain on these pants in the ninth circle of hell.” Or, as uninitiated fools called this: “Processing Return to Vendor Items at Every Nineties Girl’s Favorite Catalog Store’s Distribution Center.” I promise that you would recognize their catalog in a nanosecond. Souvenirs I picked up during this experience included:
1. A weird skin rash that left only the right side of my face looking like patient zero in a bubonic plague outbreak and required a trip to the dermatologist – just in time for my first day of college!
2. Watching a Charles Manson doppelgänger drop a huge box of platform sandals off a fork lift and then burst into, greasy, blubbery tears. I think I can safely say that Charles Manson is probably an ugly crier.
3. A solemn vow to myself to never, ever have the kind of job that requires waking up before sunrise to disappear into the bowels of a warehouse.
And that, actually, is more or less the extent of my attempts at “normal” employment. (My stint as a substitute teacher took a turn for the decidedly bizarre and is a subject for another day). Part of this is due to the fact that I earned a bachelor’s degree in theatre and film, which is not exactly a field known for churning out accountants and insurance adjusters. (Barnes and Noble associates and baristas…that’s another thing entirely). So I suppose its not really all that surprising that my first profeshunal post college job was as a standardized patient at Johns Hopkins Medical School.
If you’ve watched Seinfeld, you probably already have an inkling as to what a standardized patient is.
From personal experience, I can tell you it’s like this, and yet, not at all like this.
I got an audition for Hopkins’ SP program through one of my professors at college. It was maybe the third post college audition I’d gone on, and I was thrilled to tell my mother, “Yes, it pays!” when she called for an update in the one woman soap opera I was living called “Will Lipstick Get Her Shit Together, Or Will She End Up Living in a Box By an Underpass?” I was hired the same day as my audition and promptly sent off to get the TB test required of all hospital employees.
“So what are you going to be doing at the hospital, sweetheart?” the kind nurse administering the test asked me. She’d probably seen dozens of incoming secretaries, candy stripers, and pharmaceutical rep snipers that day, and I had the strong feeling that she was trying her very, very best to be interested.
“I’m going to be a standardized patient,” I replied.
She stopped, a freshly unwrapped TB titer held like a small dagger. “Working with the students?”
Her eyes widened and she shook her head back and forth a couple of times as she bent to administer the titer. “I know they got to be students before they get to be doctors, but…”
She didn’t finish her sentence, but the short, sharp prick of the titer said it all.
The SP process is set up like this: you get a packet containing all the vital particulars of your character, or “case,” as the pro lingo has it – their name, how old they are, marital status, and what illness they are complaining of, or “presenting.” I specialized in two areas: abused young wives who had “headaches” and “bruises” from “running into doorknobs” and troubled teenage girls who wanted birth control because their boyfriends didn’t like the way condoms feel. After training on your case, you would be assigned to a four to six hour session, where you would sit in a mock exam room and present your case to upwards of eight medical students. The sessions were videotaped for later review, and SPs were also expected to grade the students’ performance by a standard checklist we would fill out after each session. The questions were pretty basic – stuff like, “Did the student wash his/her hands?” or “Did the student use too much medical jargon?” or “Did the student act like a complete pompous ass?” (Paraphrasing).
These are some of the things I learned during my stint as a standardized patient:
1. How to use clown blue and clown red to create realistic looking bruising on my wrists and temples. Sure, it could have been caused by carrying heavy grocery bags or running into a door knob, but let’s see if you can dig a little deeper, Mr. Medical Student!
2. Elevators are a weird place to be when a hospital goes into lockdown. I was in one with a surgeon once when the victims of a major gang brawl were rushed in, and the surgeon took advantage of being stuck in an elevator for a few minutes to whip an economy sized bag of Skittles out of his scrubs pocket and suck them down like a self aware Roomba. He did not offer me any.
3. After several hours of pretending to exhibit symptoms like migraines or severe abdominal pain, you will begin to experience symptoms like migraines and severe abdominal pain. You will also experience sudden irrational anger toward your spouse, because you have also spent several hours pretending that you are covering up the fact that they are throwing you into walls and stuff.
4. Medical students who do not intend to pursue gynecology should not be made to do the gynecology module.
Seriously, y’all, there is nothing more awkward then pretending to be a 15 year old girl requesting birth control while getting a fake pelvic exam from a visibly uncomfortable medical student.
First off, I should state that pelvic exams were not performed on me physically. My cases were mostly for 1st and 2nd year medical students, and also, that was beyond my pay grade. (The SPs who were assigned to cases involving invasive procedures were paid very, very handsomely). So what happened was, I sat sideways behind an anatomically correct rubber model of a pelvis that we nicknamed “Rubber Ruby.” If you want to get an idea of what Rubber Ruby looks like, go here.
Working with Rubber Ruby was a surreal experience for everyone involved. It’s incredibly disconcerting to have this disembodied rubber pelvis sitting in front of you. It’s even more disconcerting to realize that everyone in that room is supposed to be pretending that that rubber pelvis is actually your body. For instance, a doctor would use something like KY Jelly as a lubricant during a real pelvic exam, but this is not possible with Rubber Ruby. The gel would cause her materials to break down. Therefore, students must use powder to help facilitate the exam. Sometimes they don’t use enough, and the speculum makes a kind of popping sound on insertion. Sometimes they use too much, and a little puff of smoke emerges along with the speculum upon removal.
I never knew if I was supposed to react to this. Ostensibly, if this is, in fact, my pelvis, these occurrences in the proceedings would be extremely alarming. I never said anything, though, except for one time when the student dropped the speculum on the floor, picked it up and blew on it, and then jammed it on in like he was plunging a toilet. That time, I said, “Ow.”
Rubber Ruby takes a lot of abuse. To quote that nurse I met my first day at Hopkins, “I know they got to be students before they get to be doctors, but…”
Sometimes I would think about my friends, with their office jobs that had perks like “wearing clothes” and “not saying the word ‘discharge’ on an hourly basis” and I’d get a bit jealous. But you know what? I have acquired many a free drink by telling a Rubber Ruby story. Good luck trying that with a story about that time you accidentally deleted column D on the Henderson spreadsheet.