An excerpt from Yankee Doctor in the Bible Belt: A Memoir.

We work in high-pressure environments, where Dr. Death is often lurking. We can be superstitious. We can protect ourselves with a sense of humor. We can use words as a smokescreen to protect our sanity. See below.

I was a resident working in the NICU. The shifts were long—sometimes as long as thirty hours in a row. I was at times dealing with sleep deprivation, which may have made me more suggestible to supernatural omens in the NICU.

For example: arriving at the NICU one morning, I saw two new admissions in adjoining bassinets. One was named “Angelwing A,” and the other was “Angelwing B.” Twins are difficult to carry and are often born premature. These twins were born at 25 weeks, no more than 2 lbs each. I got a sense of foreboding. Surely the name tags would trigger a sense of doom in anyone. These are NOT good names to have—not in the middle of the high-pressure NICU. The vision of newly made angels winging their way to heaven took hold in my mind.

Nearby was a second set of twin boys. Their bassinets carried the names “Wigglesbottom A” and “Wigglesbottom B.” These were born at 34 weeks and looked vigorous. I thought: “An excellent name for a preemie in the NICU.”

In fact, the Angelwing twins died within a few days. The Wigglesbottom boys did fine. I think I may have met them 20 years later—a pair of identical twins, handsome and healthy young men. The name cannot be that common.

A sense of humor

The expression “celestial discharge”—meaning the patient has died and gone to heaven—typifies the wry sense of humor that doctors and nurses cultivate to survive. That sense of humor is a valuable skill.

Words that obfuscate

We use words judiciously to protect our egos and status. Words that obfuscate (and deflect blame away from the provider) can be both helpful and innately amusing. For example:

• “Your illness is idiopathic.” Meaning: we have no idea what is causing it.
• “Your illness is iatrogenic.” Meaning: it has something to do with the medicines we gave you or the surgery that went awry.
• “You experienced a surgical misadventure.” Meaning: the surgeon cut the wrong tube, or a sponge got left behind.

I hope you have enjoyed this exposé into the world of doctoring—how being in the trenches, bridging the gap between life and death, can lead to moments of superstition. How a wry sense of humor is protective. How the use of big words to create a smokescreen and deflect blame from oneself is useful.

These are all behaviors that facilitate survival in what is innately a challenging profession.

Janet Tamaren is a family physician and author of Yankee Doctor in the Bible Belt: A Memoir.