“I Don’t Get No Respect!”

I worked in several non-medical labs – federal, state, and commercial – before working in a hospital. Once there, I spent 30 years in two small hospitals in different states. Six of those I spent as manager – a job I never wanted. In all that time, I never encountered a general disrespect like I did in those hospitals – a disrespect that manifested itself both directly and indirectly.

As a health inspector I could shut down entire kitchens for having no warm water to wash hands in. It’s important, obviously, because there are germs. But in two hospitals over three decades I never had warm water to wash with. Disrespect. “It’s just the lab,” they’d say. Not as important as a fast food joint. The technical reason we never had warm water is because the lab was way down at the end of the line – at the end of all the infrastructure.

And that’s important.

Why? In any organization, you can measure your likelihood of reward or recognition as the inverse proportion of your distance from the boss’ desk. Where is the lab? Down the hall, around the corner (where the floor is going to be redone one day); turn left (where one light is out and the other is flickering); ring the bell to enter.

Respect does not come from speed or precision of work, as we introverts would like to believe. The test that once took six hours now takes 60 minutes. And the doctor is demanding to know why it’s taking so long at 30 minutes. You run a test and get 10.15 mg and the doctor asks you to rerun it and you get 10.16 mg, and they yell: “Well, which one is it?!”

Respect does not come from hard work. I don’t know you, but I know you likely work outrageously long hours that could be considered medical malpractice. Truck drivers, like my father, were required by law to have sleep time; it’s important to stay sharp. And the local Gas‘N’Gulp is staffed 24/7 without the need for callouts or 60-hour shifts. But medical staff are apparently not subject to the laws of biology. We are expected to display perfect performance in high complexity work – without sleep. Medicine is too important to acknowledge medical reality. The doctors assure us that, during training, they all worked six weeks straight without so much as a bathroom break or a single error. Uphill – both ways – so, we shouldn’t complain…I once saw a patient nearly die of a simple kidney stone because a doctor was so drunk on sleep toxins that he failed to diagnose what the nurses and lab people saw – and said – was obvious.

But I can already hear the defenders among you decry: “But we have to work those hours because there is such a staff shortage,” and “Americans just aren’t willing to do the job, that’s why we have to import people from developing countries.”

No! Don’t let that argument slip past you! Americans are unwilling to train for a difficult, high-stress, high-complexity job where they will be tantamount abused for wages lower than they can get elsewhere. That’s not a moral failing, it’s common sense. Immigrants and those from lower incomes work these jobs (and bless our lucky stars that they do) because their alternatives are probably worse.

I did on-the-job training for low wages for years until I was allowed to take the test. I passed it on the first go without going to school. To reflect that I’d become a certified medical technologist, I received a ten cent raise. The message? All that mattered was how low they could go without me jumping ship.

To repeat: respect does not come from working hard for long hours. You have probably witnessed it in other fields of work; think of the doofus who hangs around the boss all day and gets a promotion over the person who actually does all the work. It’s PR. And hidden away in our windowless cave, where our only contact with other people is sticking needles in them, we don’t have good public relations.

In church, when someone is sick they pray that “the doctors and nurses take care of them.” They think the hospital is one part doctors and one part nurses, because that’s what they see on TV. The doctors draw the blood and do the X-rays and the nurses help them interpret the results. Meanwhile, the best that we lab rats might get is: “Are you one of those blood suckers?” Because phlebotomists, bless them, are all most people see of the lab. Even then, phlebotomy doesn’t get respect either.

In truth, none of us ever really leave high school. The doctors are the football team, the nurses are the cheerleaders, and the lab is made up of the geeks and nerds who do their homework. We are the Rodney Dangerfield of the hospital. It is displayed in both subtle and overt ways and it wears on us – mentally, spiritually, and physically. Since retiring, my resting pulse dropped 14 points, I’m losing weight by lack of stress-eating, and I feel 20 years younger.

So, short of retiring, what can be done? Get out of your cave. Sell yourselves to those above you. Use all the big words you know. You are impressive people. Make sure they know it. Why do you think the police insist on being addressed as “officer,” judges as “your Honor,” and my old colleagues as “doctor.” It’s because respect is not given. It’s demanded.