The Rational Argumentator

A Journal for Western Man

Scrubs May be Cool, But Gowns are Not:
Final Adventures in a Teaching Hospital

This is the third in a series of three short stories by Mr. d'Acier. You can read the first installment here and the second installment here.

It is not surprising that medical care is often expensive.  Good medical care often requires direct, intensive, person-to-person delivery of services that involve substantial specialized human capital.  This semi-technical jargon really doesn’t do justice to what happens when you are lying on a bed in the middle of the night, muscles cramping with post-surgery pain that goes off the scale and takes you beyond reason, and a team of skilled, calm, and obviously overworked nurses and aides appears at your side and quickly intervenes to stop your suffering.  Nor does it do justice to the cheery technicians who wake you in the morning to draw a blood sample, check your vital signs, and manage to make it seem like a pleasant wakeup call.  And how can it capture the steely nerve and precise skill of a surgeon who takes a human being from the brink of death and makes them whole again?

From the mundane to the most dramatic activities, the human capital element in medicine is enormous, and consists of raw intelligence, technical knowledge, physical skill, and an emotional component that is far more complex than “bedside manner.”  When such capital is lacking in a medical setting, it is a bad thing.  When it is present, it is a very valuable thing indeed.

Considering this, it is unsurprising that technological advance often does not lower costs in medicine the way it does in some fields.  An advance in technology permits a farmer to increase the number of people he feeds.  An advance in technology often permits a nurse to serve the four patients on her/his shift more ably, and also increases the skill set s/he requires.  Medical technology can give great benefits, but they are often expensive.  It’s not always so, of course; some advances, e.g. computerized record-keeping, greatly reduce costs.  But many new therapies and diagnostics are simply more expensive.  Since they give positive net benefits, this cannot legitimately be called a problem.  At least, I find it hard to imagine that invention of a fairly expensive course of treatment that will make me whole is a “problem,” and harder still to imagine that a new federal bureaucracy should be passing judgment on which treatments should be available to me and which not, as several presidential candidates have proposed.

But if technological and scientific advance is a crucial factor in modern medicine, two small parts of the hospital system seem utterly untouched by it, oddly enough.  On my last day in the hospital, I was enjoying my breakfast: strawberry gelatin, sugary cereal flakes, decaf coffee with artificial sweetener, a sugary pastry, and black pepper.  I was pondering why the dieticians had added a packet of black pepper to this rather questionable tray, and had even gone so far as to mark it on the accompanying menu card.  Perhaps it was to emphasize the absence of salt – this was a low-sodium selection. 

Everything I had seen during my stay convinced me that the dieticians had not yet heard of the existence of food fiber, and were waiting for further evidence of the safety of fresh fruits and vegetables before allowing them near their charges.  Jello, thin gravy, and translucent sauce seemed to be the staples.  If anything has been learned about a healthy diet since 1960, the dietiticians seem blissfully unaware of it.

I finally settled on the pastry, unpeppered.  I had just finished it, and was washing it down with faux coffee, also unpeppered, when my favorite aide, Esmerelda, entered.  She was bearing towels and a fresh hospital gown.  “I brought you some towels so you can clean up.  And I know you are going home and want to wear real clothing, but someone high up sent a gown especially for you.  Better look at it, it’s something.”

On first glance, the gown seemed to be gold and black checks, but closer inspection revealed it to be an Escher-like pattern of intermeshed shimmery gold and jet black roses.  It bustled with gear loops and cell phone pockets, it was Blue-Tooth enabled, it was made of a breathable yet waterproof nanofiber.  It was awesome.  A card with it read “Compliments of Jill.”

“Try it on!” said Esmerelda.  “Model it for us.”

I threw it on, tied up the back, grabbed my trusty walker, and hobbled out into the hall, heading for the nurses’ station.  “Oh, wild, look at that! I’ve never seen anything like it!” cried Nurse Karolina.  Other nurses and patients applauded and whistled.  Even Nurse Klebb smiled.  I felt rather stylish, even proud of myself.

“So what do you think, Esmerelda?”

“You know, it does look kind of cool.  But it still fits like an old bedsheet, and your butt is still hanging out behind.  It is just a hospital gown, after all.  They never really change.”

I stopped short for a moment, and then laughed.  She was quite right.  I walked one more pass up and down the hall for my admirers, and returned to my room.  My student friends had all checked out, I was well on the road to recovery, and the teaching hospital had learned all it could from me.  It was time to go.  An hour later I was on the long drive home.

James d’Acier is an economist and writer who currently lives in the Midwest.  He recently underwent surgery in a major university teaching hospital, and wrote this story while hospitalized.  While the story of the pepper is true, and he was indeed provided a new pattern of hospital gown that none of the staff had previously seen, the gown in this story is pure fantasy.  This is a work of fiction.

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