Nothing Has Changed

I have several lab coats. I usually buy a few each year; some gray, some white. I prefer the kind with multiple pockets. The breast is reserved for pens while the side pockets hold my stethoscope, prescription pad, reflex hammer, and various other tools of the trade.

These jackets tend to age quickly. They carry around the residue of my day. Frequently they get caught in car doors, spattered with body fluids, or trampled on. None of these are problems frequent washing and dry cleaning can't fix.

But what really bothers me is the pockets. Maybe its the heft or sharpness of the contents. Whatever the reason, the fabric frays at the edges and holes form. My first indication is when a pen or reflex hammer falls to the ground right after placing it in my coat. I look down cautiously as I hear the plink of the object crashing to the floor.

Of course I learn to adapt. I shuffle the contents from one location to another. However, as more rips occur, I find myself running out of options. I clip my pens to the top of the fabric in order to keep them fastened to my body.

I often marvel at my geriatric patients and their similarities to my old coats. Continuously shifting the contents, they often struggle to maintain the fidelity of an imperfect covering. Some defects we repair, others are ignored. And sometimes we mourn an irrevocable loss.

Is it possible that I'm just projecting? Maybe it's not my patients, but I who more closely resembles these war torn garments. The holes in the breast pocket are more reflective of my internal milieu. I ignore the tears and scars and carry on wounded but still somehow functional.

Until the lab jacket becomes so unusable that I discard it and buy a new one.

And months later as I race through the hospital I hear a plink and turn to find my reflex hammer has again fallen to the ground.

I absentmindedly place my hand over my chest and realize that internally nothing has changed.