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I recently cared for an elderly woman with a serious wound infection. Her hospitalization extended for weeks, and so, cautiously, I became friendly with her and her sister, who often came to sit with her. I wasn’t sure who was older: Both women had brightly dyed hair (one copper, one blue) and a wise-acre tone. They passed the long hospital hours chatting softly, playing cards, reading the latest issue of Vogue.
Once I entered the room, however, they sat straight up. Bifocals came off, purses clicked shut, hair was touched. And without fail, the sisters flirted with me, flirted like schoolgirls fighting for the attention of the lifeguard. They spoke at the same time, contradicted each other, and dismissed each other’s comments with a bored flick of the wrist.
“Oh, look who’s here,” said the patient. “Have you met my doctor?”
“Of course I met him,” answered her sister. “He was here before. He’s the cute one.”
Let's be very clear—I am not cute. Perhaps once, as a kid, like any other kid. But please, not now. “Well, well,” I said to the patient, “let’s look at your famous wound.”
“Oh sure, very famous. From all over town they want to see my beautiful wound.”
“Doctor,” piped in the sister, “you have the strangest sense of humor. Did anyone ever tell you that?” While I peeled off the bandage covering her 85-year-old sister’s large abdominal wound, she crinkled her nose and smiled winningly.
“It’s looking better than ever,” I said of the wound. “A true wonder.”
“You know, I think he’s being fresh,” said the sister.
“I wish,” said the patient.
And so it went for days, then weeks. One afternoon, as I was writing a note in the chart, the basic weirdness of the exchange—my chatting up (or being chatted up by) two octogenarians while giving medical care—started to bother me.
Why? Low-level, ineffectual flirting probably goes on in hospitals more often than any place this side of a high-school mixer. There is, among hospitalized patients and staff, an unspoken code of conduct: cheerfulness first and foremost, at all times, against all odds, no matter how false or corny. And often, the simplest, most pain-free form of cheer is the mild flirt or its kin—the lingering smile, the wink, the hand on the shoulder. All this thrives in a hospital because of the ambient severity and chaos of the place. A hospital can blister the sexiness out of any exchange, no matter how suggestive. And it works in different combinations of age and sex—young male patient, older female doctor; young female patient, older male doctor, whatever.
This collective deceit all sounds very congenial, but I’ve come to think it creates its own problems. First, the charming, chipper doctor bouncing on his insoles often comes to see the world as a hospital and he as its live wire. This is a problem for anyone who has to live with said doctor. Not to mention the way “Hey there! Where’s my smile?!” will grate at, say, the hospital president’s grim annual cocktail party.
Worse, though, is the troubling social implication within the hospital’s walls. The flirting of the particular sort I conducted and describe (aging female patients and not-as-old male doctors) slams the door on older women even as it appears to humor them. The message is that the possibility of sexual involvement is so remote that there’s no risk of a referee’s flag or even a raised eyebrow. And this for the group of women who may be the biggest (only?) fans of the middle-aged man. Older women long have provided us some of our greatest solace; they usually are willing to be amused (if also bored) by our last howl of hormones. It is painful to see them summarily sidelined, excluded from the meat market of daily life.
And so, in the case of the sisters I started by telling you about, I decided to stop the flirting. I dealt with my patient like the robot doctor I was trained to be. It made sense—she was getting worse every day. Perkiness seemed particularly out of place.
Yet as the patient deteriorated, her sister soldiered on: She redyed her hair as dark as her mascara and continued to dress crisply. In the small room, she straightened and sorted, stacked and folded. And when we spoke, she gave me her brightest 80-plus smile and even started calling me by my first name. “Kent, don’t you look sharp this morning!”
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