Thoughts on hierarchy, privilege, culture and equality

[osodecanela]

My morning started today with a stop at the hospital to send mother and child home. My patient, a very lovely Latina, delivered the day before yesterday and it was time for her to go home. I arrived on postpartum and a 8:45, right at the height of the morning 'Rush hour'. Nurses, residents, attending docs, and clerical staff were all darting about, tending to everything that needed tending. Everyone was smiling. Postpartum is generally a very happy place. Even with all the hubbub, people chirp good morning to one another as they flit about.

Several of the staff are originally foreign-born. One nurse in particular, with whom I always have a very warm interaction is originally from Southeast Asia, Cambodia I think, pleasantly called out, "good morning Dr. Bloom!" I smiled.

"Good morning, La." Then I continued, "La, how many years do we know each other?"
"Five or six I think. Why?"
"Why do I get to call you by your first name, but you don't get to call me by mine?" She laughed.
"It's the way it was in my country. It's a sign of respect."
"So then my calling you by your first name is disrespectful?"
"No."
"You know La, in some ways it feels disrespectful to me, if I get to call you by your first name, but you're not allowed to use mine. At the same time, it would feel really strange for me to call you a Nurse La when we've known each other for so long."

She chuckled, and then called me by my first name, which I think may really have been difficult for her. Was I trying to make a statement about equality, or was I imposing my social customs on her? I sat there, pondering that thought as I wrote my patient's discharge note, another nurse I've known for nearly 20 years walked past and chirped, "good morning Dr. Bloom". She's from the Philippines. Slowly shaking my head, I replied "good morning", then looked over to my right, to see La smiling at me benevolently.

Comments

[grizzlyzone.livejournal.com]

I go throught this all the time, 'cept in my case, I'm just a "Mister".

I think it has to do with my advanced age.

[robearal.livejournal.com]

Even in our own culture, as egalitarian as we'd like to think we've become over the past 40 years, there are still tiers of hierarchy. You are the Doctor. You're in a position is perceived to be above that of a nurse. The tendency is to acknowledge that higher position with a term of respect. As a patient, I certainly don't feel comfortable calling my doctors by their given name, even after being a patient for several years. Another option that may be easier for your associates from other cultures would be if you suggested they call you "Doctor [First Name]". That way, the honorific/title that they are comfortable with is still there, with some of the equality you feel lacking.

[oscarlikesbugsy.livejournal.com]

Humm...one thing that is delicious about the world of manners is those nice moments when the lines get transcended, in post-verbal ways...

[shirtlifterbear.livejournal.com]

I LOVE that Nurse La got to show you that it wasn't JUST her!

That must have made her DAY!

[barbarian-rat.livejournal.com]

I think that robearal has a good suggestion "Doctor [insert first name here]"

[pangolin.livejournal.com]

I really can't imagine anyone not referring to a doctor, in a hospital, as Dr. [surname]. That seems more a tradition of the medical field than anything else, though perhaps it is encouraged or enforced by doctors generally. (I didn't go to evil medical school to be called mister!).

[bearquest.livejournal.com]

I actually tend to address friends (non-professionals) with the title Sir or Ma'am and catch some grief for it. But that's what I was taught as a child. Certainly if I ever were lucky enough to get to know you on a personal basis in the real world, I would be hesitant to address you by your first name, even if you gave me permission to do so. It's partly my wishing to acknowledge your status, partly because of my lack of self-esteem and partly because subconsciously I imagine that by doing so I could further ingratiate myself to you and you would like me more, or dislike me less.