Sunday, June 24, 2007


Last week I started reading My Detachment, a Vietnam memoir by Tracy Kidder. It’s a strange war book, in that the author never even encountered the enemy (he was a “REMF”—or “Rear Echelon Motherfucker”), but in a way that is the topic. It’s also fascinating to hear a renowned journalist confess to dozens of youthful white lies, in the context of trying to create some meaning out of his meaningless job in an absurd war.

The peculiar nature of army deployments to Vietnam—in for a year, then home—meant that Kidder’s detachment consisted of a rotating cast of intriguing characters, each of whom starts off as “the new guy”, becomes, in a matter of months, the “old-timer”, then suddenly disappears. When Kidder arrives “in-country”, he encounters a soldier who shouts “I am so fucking short!” I had never heard this phrase before, and at first thought it might be synonymous with “so fucking drunk” or “so fucking high on opium”. But Kidder explained that “short” meant nearing the end of one’s tour of duty. When his enlisted men got “short”, they would start shirking duties around the base, stating “I’m too short for that shit.” When a short man left, nothing much changed. Someone took his place. The war went on.

The whole arrangement reminded me a bit of Green Acres, particularly with regard to the psychiatric staff. There is no specified “tour of duty” at the hospital, of course, but on average docs have stayed for two or three years, then quit, cracked up, retired, been fired, or gone on medical leave and never seen again. The shrinks come and the shrinks go. The war, as it were, goes on. For some reason, though, I kept re-enlisting. When I worked at a veterans hospital as a med student, I sometimes met vets who had volunteered for multiple tours in Vietnam. You sort of had to wonder about them. I wonder similarly about myself, now.

Strangely, as I walked down the hall last Friday morning to start my very last day at Green Acres, an older, seasoned staff member caught sight of me from a few doors down, stuck his head out, and said good-naturedly, “Hey, doc—aren’t you a little short to be going to staff meeting?” A week ago I would’ve been puzzled by the phrase and nodded politely, but thanks to the current reading I caught the meaning. “Matt”, I said, “I am so fucking short.” He laughed. I leaned on his office doorframe a moment. He told me that during his time in Vietnam, when a guy hit the 30 day mark to going home, he was allowed to wear the ribbon from a bottle of Seagrams on his hat or helmet. “When you got that short,” Matt said, “no one would give you any shit.”

But this was not so much the case at Green Acres. The night before my last day, one of my patients inexplicably snapped and “wailed the hell out of” [nursing report words] another much smaller, gentler patient, repeatedly pounding him in the face. I was asked to "do something" about it, but there was little more to be done that hadn't been done already. Another patient had run off while on a pass to his substance abuse counselor to scavenge and smoke cigarette butts out the gutter. And right up to the last I was being asked to write silly orders about headphones, Jell-O, and the Snoezelen room.

A few people wished me well. My medical director organized the traditional Green Acres cake-and-punch farewell gathering (a ceremony that is always announced by Administration as a “goodbye punch”—though I’ll never know if the double entendre is intended, or just another amusing Administration language gaff.) At the Punch, the Superintendent, who is a recreation therapist and not overly fond of doctors, stayed on the other side of the room and did not speak to me, as has been his habit. Back on the ward, a patient asked to see me, curious to know “whether you quit them, or they quit you?” Later the head of housekeeping stopped by my office to say that I “seem like a pretty good doctor”, as far as she could tell. One "patient advocate" stuck her head in and half-apologized to me for some truly egregious behavior over a year ago.

In the end, my hours wound down, and I just sort of packed my duffel and boarded the plane.


Anonymous Anonymous said...

Great blog, great last post from Green Acres. I hope you keep blogging about private practice in the new place!

6/26/07, 6:32 PM  
Blogger ClinkShrink said...

Great post. I often wonder how long my institutional life will last and how it will end. Some folks get fed up and leave in a storm, some quietly taper off and disappear, some get escorted out. I've signed up for more re-enlistments than I can count and goodness knows why. This week I had two patients thank me for my help and burst into tears. I guess I'll stick around for a while.

6/26/07, 7:16 PM  

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