Impressions

Impressions are damaging. They’re mocking recreations of others’ peculiarities and speech habits. And I’ve heard more than my fair share of them in medicine.

Now, I’m not sure why the people doing these impressions are physicians, because they’re so good they could be stand-up comedians. They are pitch-perfect facsimiles and hilarious ones at that. And they’re not always negative or bad. (One resident enjoyed quoting my attending Dr. Rosenow by saying, “Rose like the flower, now like right f***ing now.”) But more often than not they’re done out of frustration or exasperation, when they’re tired and stressed, overworked and underappreciated, without any thought to the person they’re aping.

One particular impression struck a chord with me during my neurosurgery rotation. One of our patients was somewhat of a curmudgeon at baseline. He was also hard of hearing. For a few weeks he had been encephalopathic and there was not much to do for him besides daily exams during rounds and fruitlessly attempting to get him placed at a skilled nursing facility.

He had a distinct personality, preferring some residents over others. His responses to our questions of person, place, and time were oftentimes disoriented. Or they were completely unrelated statements. “Where did BETTY go?” he would shout. When I was removing staples from his scalp incision, he would periodically jerk his head and grunt nonsensical sounds. I grew fond of him as the residents grew weary and annoyed.

During down time in the resident conference room, one of the junior residents did an impression of him that was nothing more than loud grunting. The senior resident commended him, “Hey, that’s actually pretty good.” I laughed, although I wish I hadn’t. I felt embarrassed and ashamed, and found it difficult to look him in the eyes the next day on rounds. I had to step outside of my environment, where it’s okay to say and do stuff because I know I’m not being watched or judged, and assess myself. Is this the kind of thing I can stand behind if someone were to overhear me and confront me about it?