I work in a Canadian hospital as a medical scribe, mostly doing nightshifts in a busy ER. The hospital is integrated into a larger, publicly funded provincial healthcare network, and pretty much every job, from janitor to doctor, is protected by some form of union/order membership. Unfortunately, my job is one of the few – along with security, who arguably has it worse than the scribes – that has been subcontracted to a private company, and I'm not part of any union. Despite us being Canadian, my dad has a weird soft spot for Reagan, talks about the Reagan era like the good old days, and generally has disdain for unions. Recently, he dropped some more anti-union rhetoric in a conversation after a long shift, and I lost it.
I explained to him that non being part of a union is the reason I make 14 bucks an hour, to the main union's minimum salary of $23/hour. I also explained to him that despite being on my feet the entire time, I frequently don't receive any breaks on my shifts – which can last from 8-12 hours – while union employees get an hour. He countered that the law still mandates I receive breaks, which is true. But because I spend my shifts joined at the hip to overworked doctors who run around the ER and rarely take breaks themselves, I rarely have an opportunity to take a minute. He asked why I didn't complain or speak up, and I explained that I LITERALLY DO NOT HAVE ANY LEVERAGE WHATSOEVER AT ALL. There is no union to have my back. The entire industry around medical scribing is built on low wages and high turnover, and exploiting desperate aspiring health care professionals with the prospect of building relationships with doctors and getting a good reference letter. If I complain, to anyone, about anything, I will be fired and replaced with the next expendable desperate premed.
He seemed shocked, and asked me why the hospital would even agree to work with a corporation so clearly evil? I tried explaining to him that my position was not in any way unique, and what he's characterizing as “evil,” is completely normalized. I pointed out that it's probably not a coincidence that the evisceration of unions and the complete collapse of the middle class are happening in tandem. People have their narratives and biases, but it's hard to watch your kid suffer, and I think the seed is starting to take root. He's definitely taken a step back from all the anti-union talk for the moment.
As for the doctors I work with, some are more aware/sympathetic than others. Some are great to work with, some treat me like complete dogshit, and most are somewhere in between. One in particular has a habit of sending me home early when the ER isn't busy enough, to save money. I did have to speak up when this happened, because commuting across the city to work to make 50 bucks for the night was making it impossible to live. Fortunately my immediate bosses in the company I work for are also grizzled veterans of the same bullshit, and had my back through the whole saga.
A few nights ago, I had the pleasure of working with one of the best ER doctors in the city. Just a standup guy who never lost his human touch. He clearly cares about the patients, the nurses, the staff, and yes, even the scribe. He asked me casually about my working conditions, and I let slip that I loved the work, but it wasn't uncommon for me to get snapped at or spoken to dismissively by physicians, and that even though I recognize how overworked they are in our always busy, chronically under-resourced ER, I still found it hard. He seemed surprised, looked up at me, and said “wow, I'm sorry. That seems really hard.”
That was it. Just a casual comment while we were reviewing some charts together at the end of the night. But it was also the first and only expression of empathy I could remember receiving from any physician in all the months I'd been scribing away. I'm not a big crier, but I instantly started tearing up. It was an extremely low-effort act of casual humanity on his part, but it pulled me out of a pretty dark hole I didn't realize I was in. Since then, going to work has been so much easier. The pay is still dogshit, I still can't join the hospital union, and doctors are mostly still indifferent to my existence. But knowing that one dude gave a shit for a second was extremely important to me, apparently.
Currently, I'm working my ass off to hopefully get a decent reference to hopefully get into med school. I have no idea if I can pull it off or where this journey will lead, but I will never forget how much that little bit of kindness mattered to me. My goals have changed too, as has my conception of what makes a good doctor. I know that I will only have succeeded at this whole doctoring thing if I manage to treat people with respect and empathy, and not lose my sense of humanity.