When you’ve been immersed in biochemistry and the lab confronting patients for the first time is daunting. Many of my fellow students had had occasion to observe an operation and be present at a delivery, and were less intimidated than I. I finally had to say to myself, “Okay, Thorn, just take it one step at a time,” and plunge in.
We could choose where to start our rotation, whether to begin with medicine and end up with psychiatry or to begin with surgery and end up with medicine. Once you chose your starting point, you had to go through the sequence in order. Medicine, I was told, was the most difficult service; nobody wanted to take that first. That made up my mind for me. “Let me take that first,” I said to myself. “Then maybe the rest of the year will seem easier by comparison.” I asked around, to check out my instinct that this was the best thing to do, and got it confirmed: “If you take medicine first, that’ll give you a good basis for getting to the patient, then surgery allows you really to work with your hands, then the rest of the rotation is easy.”
When you go on the wards, you’re braced to hear a patient say: “I don’t want any medical student touching me! I’m not going to be a guinea pig. I want a real doctor.” But it turned out that patients are really very kind when you say you’re a student. My first assignment was to draw blood. Along with my fellow students, I’d been practicing on oranges and a little bit on each other, although none of us was enthusiastic about getting stuck with a needle. Now I was face-to-face with a real live patient, and I was perspiring with nervousness.
“Hello, Mr. Carroway,” I said. “I’m a medical student, and I’m here to draw your blood.”
“Are you, dear? Sit right down here.”
I put the tourniquet on. “This might be tight, but if it hurts, just let me know.”
“No problem, dear. I’ve been here three weeks and I have diabetes and they’ve been drawing blood all the time. Take your time.”
Mr. Carroway had veins as big as Arnold Schwarzenegger’s. I put the needle in, drew back the plunger—nothing; I’d missed the vein. I put a Band-Aid over the needle mark and asked Mr. Carroway if I could try his other arm.
“Sure, dear.”
I tried again. Missed again. After the third try, I said, “Mr. Carroway, you’re becoming a pincushion.”
“That’s all right, dear. You have to learn.”
On the fourth try, blood came through the needle and into the test tube. I felt as though I had struck gold! I am hot now, I thought. I am brave. The chief resident came by and saw all the Band-Aids. “Yvonne, you think you can do a little better next time?”
Mr. Carroway consoled me. “You did fine, dear. If you need to take some more blood tomorrow, I’ll be here.”
As a clerk, I was assigned to an intern. When he was on call, I was on call. My intern would say, “Yvonne, we’ve got an admission coming in from the Emergency Room.” Okay, fine, I’m right behind you. He’d say, “Get the blood pressure, get this, get that,” and I would do whatever he said. That’s how medical students learn. It is basically an apprenticeship.
When a patient came in—say, with gastrointestinal bleeding—we stayed with her until she was stabilized, which might take a few hours or it might take all night. Being on-call means you can’t go to a movie, can’t go to a party, can’t say, “I’m going out to dinner. I’ll be back in two hours.” There’s no going home to your own bed. I’d find an empty bed and grab a few winks until a nurse would come in and say, “This patient needs her medication” or “That patient needs blood drawn.” You get up and do what you have to do, and that’s when you really become a doctor. You have to sacrifice, you have to be inconvenienced, because taking care of patients is more important than your sleep or your dinner, more important than any plans you’ve made.
You and your intern work together as a team, so when I was told, “Stick to this intern, Yvonne,” I’d be like a stamp on a letter. I didn’t intend to miss a thing, not one bit of experience or learning that I could possibly grab hold of. I was following so close on my intern’s heels one day that when he came to a sudden stop and said, “You can’t come in here, Yvonne,” I banged right into him.
“Why not?” I demanded.
“Look at the door.”
It was the men’s room.
What a fascinating time those two years were. I came out of them feeling like no training anywhere was the equal of the training at P & S. I came out of them knowing I was not too insignificant, not too black, not too ugly—knowing now that I was not a person to be written off. I was a graduate of the College of Physicians and Surgeons. I was a doctor.
11
Dr. Thornton, Dr. Thornton…
“I CAN’T STAND DOCTORS,” said Daddy. This was when we were teenagers. “I mean, they’ll find something and they’ll go in there and cut you up..…”
We’d interrupt. “But, Daddy, you want us to be doctors.”
“Yeah, that’s different. That’s good for you kids.”
Good for the prestige it conferred, for the income it provided, for the chance it offered to be of value to other people. But for Daddy to go see a doctor himself? He would have had to be at death’s door with his hand turning the knob. And Mommy had not been to a gynecologist since Rita was born in 1952.
When I was on the obstetrics/gynecology rotation in medical school and becoming aware of the deadly toll of ovarian and uterine cancer, I asked Mommy when she had last had a Pap smear.”
After you kids were born, I swore I wasn’t going back to a gynecologist ever again if I could help it.”
“Mommy, please don’t embarrass me. I’m in medical school. I’m going to be a gynecologist”—I’d found out by now that it was a dual specialty, that in order to be an obstetrician, I had to become a gynecologist as well. “How’s it going to look if my own mother dies of cancer because she won’t go for a pelvic exam?”
“You’re right,” she agreed. “I should go. I’ll get around to it one of these days.”
But before she got around to it, something else happened. I was home on a weekend from medical school and followed Mommy into the bathroom while she was washing her hands and before she had flushed the toilet. The bowl was full of blood.
“Mommy!”
“Oh, yeah. That’s okay.”
“Okay? That’s blood! That’s gross hematuria! It is not okay.”
“Sure, it is, honey. That’s been happening for a long time. When I was carrying you kids, you lay on my right kidney. That’s all it is. If it was anything else…
“Like kidney stones. Like nephritis.”
“Those things are painful, aren’t they?”
“Yes.”
“So, nothing hurts, so I can’t have anything or I’d feel some pain.” She did have a great deal of pain, but in her face. Called tic douloureux, this excruciating pain on the left side of her face often froze her to the spot for several seconds when it struck. Over a period of many years she had been taking Tylenol for it, and since this allowed her to tolerate the pain and we were all used to her sudden winces, we had long since ceased urging her to consult a doctor. I might have been equally casual in my reaction to the hematuria had I not learned in my pathology course about the seriousness of the symptom. After the weekend, when I returned to New York, I called Mommy daily to insist she make a doctor’s appointment.
She grew impatient with me. “Yvonne, you’re still in school. You’re not a doctor yet.”
“But, Mommy, you don’t just graduate from medical school and suddenly you know everything where before you knew nothing. For four years you’re studying, and I already know more than enough to be positive you’ve got to have that diagnosed.”
“Well, I’m not going to, so you can just stop nagging me.”
Since Daddy was a nonbeliever too, there was no use in appealing to him. I called a doctor in Long Branch who had been involved in hospitalizing Mommy for depression, explained the situation, and asked him to call Mommy. He did, and succeeded in persuading
her to come in for tests. Her hematocrit, which should have been forty, was down to twenty-five; she needed an immediate blood transfusion; and one kidney, seriously damaged, apparently in an idiosyncratic reaction to prolonged use of the Tylenol, had ceased to function and had to be removed. After she recovered from the operation, Mommy felt better than she had for a very long time; she had been half-sick without realizing it and without imagining that there was a remedy available. For the first time, all of us became aware that there was a practical, personal benefit to my becoming a doctor. If I hadn’t been studying medicine, I would have accepted Mommy’s reasoning that no pain meant no problem.
I became a doctor—that is, I was awarded my M.D. degree—on May 16th, a brilliant spring day in 1973. There were two graduation ceremonies for the medical students. One was for all Columbia University graduates and was held on the main campus at 116th Street, while the second, at Presbyterian Hospital, was just for the medical students. Rita and Linda, Mommy and Daddy, and Donna with her husband Willis and little Heather were there to cheer everyone except Jeanette, who had something else to do that day.
Mommy, beaming but bemused as though she couldn’t quite believe this moment had arrived, radiated happiness, while Daddy’s chest was so puffed with pride that I teased him that he was going to have to go through doors sideways. Mommy told me later that he grabbed the elbows of perfect strangers to point to me and whisper loudly, “That’s my daughter up there. She’s graduatin’ from medical school.” At the second ceremony at Presbyterian Hospital, he added, wanting everyone to share his awed delight, “She was born right here at this hospital and now she’s graduatin’. Ain’t that somethin’!”
In a quiet moment between the two ceremonies, he turned to Mommy. “Remember when you said all those years back about wanting our children to be educated?”
“And you said, ‘Tass, if that’s what you want, I’ll go along with you.’ Yes, Donald, I remember.”
“Well, we did it!”
“A ditchdigger and a day worker.”
“That’s our daughter up there, and she’s a doctor.” They looked at each other in wonder, marveling that it had happened. “Why’ve you got tears in your eyes, Tass?”
“Same reason you have, Donald.”
They were thrilled and touched when the Thornton Sisters Band came in for a mention in the course of the ceremony at the hospital. The College of Physicians and Surgeons prides itself on its graduates being versatile and accomplished human beings with interests extending beyond the narrow confines of medicine. The graduate who best typifies this well-roundedness, by vote of the entire class, is given the Joseph Garrison Parker award. For the class of 1973, there was a three-way tie: the award went to Sharon Grundfest, who was a concert pianist; to Ed Leahey, who was a gifted actor; and to Yvonne Thornton of the Thornton Sisters Band. I swear I could pick out Daddy’s double-time clapping in the applause that followed the announcement. It sounded like the time he was beating on the floor trying to coach Rita to speed up on the foot bass.
He was only a little less jubilant at the awarding of an honorary degree to Duke Ellington. “This Columbia’s cool, man!” he kept saying, with his ear-to-ear grin.
At the Columbia University ceremony, every college was presented to the president of the university: graduates of the medical school were in one section, of the law school in another, Teachers College graduates in a third, and so on. The president acknowledged the colleges, then said, “Those graduates of the medical school, please stand.” The dean of the medical school stepped forward.
“Bow your heads in accession,” he directed, for thus would we signify our assent to the Hippocratic oath, which he began to read out: “I swear by Apollo the physician …” it was a solemn and impressive moment as 126 newly minted doctors vowed to “follow that method of treatment which, according to my ability and judgment, I consider for the benefit of my patients .…. With purity and holiness I will pass my life and practice my art.”
“How come we don’t have something like that?” the law students and the teachers lamented afterward, envying the oath by which we medical students dedicated ourselves as doctors.
I wasn’t the only Negro woman graduate of the medical school. A light-skinned girl of Jamaican heritage, who had grown up in this country and attended Manhattanville College, was my classmate throughout the four years. We had not, however, become close friends because, as I had quickly become aware, she was somewhat snobbish about American blacks. No matter what their status in the islands, when Caribbean natives come here, it’s: Oh, you’re an American black. You’re not as good as we are.
I wanted to say to my West Indian classmate, "Look, you wouldn’t be getting this opportunity if there hadn’t been black- skinned Americans who were lynched or shot or had dogs and fire hoses turned on them fighting for the chance to get into decent schools." But I knew she would counter by saying that Caribbean blacks have a work ethic that American blacks are deficient in and back up her argument by citing all the islanders who have made it in the United States. If there is truth in this, perhaps it is because the Caribbean blacks, even though they were slaves on the sugar plantations, were allowed plots of land to raise their own food, the surplus of which they could sell if they wished, which gave them business experience, while American blacks, during slavery, were kept in such a dependent position that they never learned how to look after themselves. In honesty, I have to admit that an American black all too often will whine, “You owe me this, you owe me that,” while a Caribbean black will turn to and get the job done. But I didn’t relish having my nose rubbed in this sad fact by my Jamaican classmate.
How many prejudices am I going to get hit with in my life, I wondered when I realized that even she looked down on me. Talk about being on the bottom of the heap. Black. And not just black but a dark-skinned black. And not just a dark-skinned black but a dark-skinned black woman. And not just a dark-skinned black woman but a dark-skinned black American woman. It did seem like a very large eight-ball for just one person to be behind.
As of graduation day, however, I had something to weigh in with on the other side of the scales. I was now Yvonne Thornton, M.D. Was it going to be enough?
The wave of change making things easier for blacks had inched up through the high schools, colleges, and medical schools by the 1970s, but it had not necessarily influenced minds and hearts at the postgraduate level, as I discovered when I applied for an OB/GYN residency at Mount Sinai Hospital in New York.
“What are you doing here?” the interviewer demanded when I walked into his office. “We don’t accept black people. You wouldn’t fit in with our other residents.”
“Thank you for telling me,” I replied, without knowing whether I meant to be sarcastic or not; my mouth was functioning but my head was blank with shock. “If that’s the case, why did you schedule me for an interview?”
“Obviously we didn’t know you were black.”
I left Mount Sinai wondering how many other directors of training programs were going to react in exactly the same way, although I would have been surprised if they were all quite so blunt about it. Was I going to end up having to train at a black hospital because no other hospital would have me? There is nothing wrong with Harlem Hospital in New York, or Metropolitan, or Lincoln in the South Bronx—the training is fine—except that they are dead ends. In private hospitals, where the attending physicians also have private practices, if you have been there as a resident, when you graduate and become a member of the attending staff, the patients you saw as a resident now come to you and you can set up your own private practice. That same opportunity does not exist if you’ve done your residency in a black city hospital.
Telling myself to approach the problem with Daddy-type thinking, I reasoned in this fashion: I was at P & S with the smartest guys. I graduated with honors. Clearly, I could hold my own with the best. I didn’t want to be shunted off to Harlem Hospital, but somehow that’s where all the black P & S m
edical students seemed to end up if they stayed in New York. Why? Because when they submitted a list of hospitals where they wished to be considered for an internship, they included Harlem Hospital as their fail-safe choice, figuring that if all the other hospitals turned them down, Harlem would take them. And sure enough, all the private hospitals did turn them down once they knew the student had ranked Harlem. I said to myself that if I put a black hospital on my list, even just as a safety valve, that’s where I was sure to end up, so I took a chance and only listed private hospitals, none of the city ones.
After you graduate from medical school, if you know what you want to specialize in, you apply for either a medical or a surgical internship. But if you’re very sure, as I was absolutely certain I intended to be an obstetrician, and if your grades and your medical school performance demonstrate that you are capable of advanced work, the hospital will sometimes allow you to skip the internship and sign on as a resident. At least that was true in those days, and it was what I wanted to do because as an intern, you’re at the very bottom of the hierarchy; you’re harried, chivied, and bullied by everybody from the chief resident on down. You survive a year of that, only to go into your first-year residency in neurology or internal medicine or whatever and again find yourself on the lowest rung of the ladder, with everyone teeing off on you. If I could manage it, I decided, I would prefer to get knocked around for only one year instead of two, so I put down an OB/GYN residency for all my choices except the last. This was my fail-safe choice: a medical internship at Presbyterian, which I was almost certain I could get.
When I applied for an OB/GYN residency in the early 1970s, few women wanted to go into obstetrics and gynecology because the training program was, and still is, one of the most intense and demanding of all the specialties, plus the nature of the practice is disruptive to family life since babies are born at their convenience, not yours. Most women either went into internal medicine or into one of the four P’s: pathology, pediatrics, psychiatry, or public health. But I had wanted to be an obstetrician for so long that I never hesitated.
The Ditchdigger's Daughters Page 19