First Month of Patient Care Technician Training.

1/12/2014 PCT Training. 


Phlebotomy. It literally means “puncturing the vein.” It was also the starting unit of a Patient Care Technician training program that I began on the 16th of December, last year. Now that the new year has arrived and I’ve been through the first part of training, I can tell you all the names of the three most commonly used veins for “venipuncture.” Without missing a beat, I can illuminate the complications associated with both venipuncture and “dermal punctures,” why healthcare workers and visitors want to wear n-95 respirator masks in the presence of a patient suffering from TB, or how to locate a temporal, brachial, femoral, and a” posterior tibialis” pulse.

However, the things that really concern me about this fascinating, grueling, and ultimately rewarding learning experience are psychosocial in nature. The deepest impressions made by this training have more to do with people’s motivations and worldviews than anything medically related. For example, the reasons that students chose to put themselves through this schooling are fraught with controversial political, cultural and economic implications. People’s attitudes toward class participation seem to mimic the same ones I encountered throughout my high school experience. Finally, my own patterns of learning and interaction with others say plenty about the ways that I have evolved, and the many other ways in which I have remained the same throughout most of my adult life.

Inspiration is a term tossed around like a hackey-sack among hippies, especially when it comes to what to do with one’s adult life. Career seminars are replete with motivational speeches and pamphlets that discuss the notion of “following one’s dreams,” and “finding your passion.” But when it really comes down to it, there are many adults who would argue that for one reason or another, the notion of an “American Dream” has become more of an American Myth. Some of the program participants I’ve talked to on this matter are simply trying to raise a family, and they appear to have put aside what they consider the lofty delusions of their youth and the dreams that came with it.

Others have had trouble adjusting to the growing disparities between the rich and the poor. Even on a cold winter morning, the disenfranchisement and indignation that burns like an invisible fire through inner city urban neighborhoods just slaps me in the face. I have found some students for whom the numerous training options here simply represent an opportunity to become more marketable in a society where a job search has become a nightmare, and gainful employment seems to be as hard to attain as a buried pirate treasure. Still others tell me that they were convinced to make themselves more “employable” by seeking out more training in various skills. But the ones who advise these students in such a fashion are the Admissions officers for the training program. Fear drives the point home to us all. I secretly cringe at these reasons for participating in such accelerated education, but the Samurai in me can’t deny that I’ve squared off against this same specter of poverty and frustration.

Relating this bit of information to my wonderful and supportive girlfriend reveals another scary possibility that patient care has been forever changed by this type of training. Who, after all, would want to be treated by someone on whom the very meaning of patient care has been lost in the struggle simply to survive? Is there room in that healthcare worker’s heart for the empathy and thoughtfulness needed to provide the best quality of care to patients? Or would they have been just as likely to reap the same internal reward in another industry?

Is it really that easy to exchange one cog in the machine for another?

But the meaning of “why” deepens the more I explore the motivations of all involved, including myself. Another older classmate speaks to me with an almost paternal air, seeking to understand my motivations for undertaking this challenge. The discussion comes the day before our final class exam for phlebotomy.

“You should study,” he says.

“I do study.”

“No No. Some people sacrifice their time and their families to pursue a higher education.”

At this point, I know what he’s getting at, and I have to fight not to roll my eyes. I happen to be among the top students in the small class, and I am always called upon to lead group discussions of the material. But there are some things this man clearly doesn’t know about me, and I don’t know how to go about explaining them without  reliving some of the more bitter parts of my adult past. But I am also not one to shy away from truth. Ever.

“My friend, I have a degree already. It happens to be a Bachelor of Arts in Psychology.”

“You do?” he asks, his eyes sparkling with wonder and what I can only guess is dawning comprehension.

However, this is the moment when I decide to drive the knife in and twist. “How easy do you think this has made my job search in the years since my graduation from college?”

“Oh …”

“Oh,” I mimic, almost sneering with the power of my statement. I find my head spinning at the reminder of how the promise of higher education has settled like lead into my stomach. It’s one thing to reap the benefits of both graduating with a lucrative degree and forming powerful social connections. It’s quite another to realize that your life is forever altered by the realities of balancing a checkbook and having to pay rent while utilizing your marketable skills in an underfunded and oft misunderstood field of study. Philosophy students might have gone through this pain in the eighties and nineties. Psych students who weren’t willing or able to become researchers, professors, or professional emotional scratching posts went through it with me in the 21st century.

Yet it wasn’t just psych degree holders who underwent a fundamental shift in their higher education paradigms. I can scarcely think of five friends of mine from the same alma mater who have jobs that relate remotely to their fields of study. Most, in fact, are still trying to figure out what it means to be middle class.

I’ll have to get back to you on that one when I finally get there. I’ve been trying for more than ten years.

The older student’s comments, however, may also reveal deep cultural divides, even among those who share a common ethnic background. Picture the same conversation in your head somewhere in a small cafeteria area of a small training program. This time, instead of two faceless people who’ve left their ethnic and cultural backgrounds and perspectives at the elevator door, imagine two Hispanic men with very different ideas of what it means to succeed and adjust to the perils of a shaky US economy. If you’re still wondering why this matters, you’ve never been shamed into admitting that you’re a Puerto Rican man who doesn’t speak Spanish as well as he would like. Moreover, the perpetrators of this blame and shame game have never been “your people.”

Case in point. The same man with whom I’ve had the elucidating cafeteria conversation is part of a yet another study group I’m asked to lead in preparation for the final. The group happens to be made of other Hispanic students as well. The fundamental difference between myself and the others becomes clear when my cafeteria colleague and another group member begin to have a fluid conversation in Spanish. Then, the oft dreaded question of my professional and social adult life comes not from the group itself, but from the teacher behind me.

“Do you speak Spanish, Angel?”

“Not as well as I would like. ”

“Yeah, maybe,” says the young woman in front of me, but you understand it, don’t you?”

Now at this time, I’m forced to sound a bit like Bruce Campbell in the Army of Darkness movie when he talks about not having said “every single tiny syllable,” but basically saying the secret incantation to stop the Army of Darkness. To test my “basic” understanding, the bespectacled young lady rattles off something in Spanish so rapid that I only hear about two thirds of what she’s said.

Naturally, a little something called “orgullo” kicks in. “Orgullo” (or-goo-yo) for those who neither speak nor read the language translates into “pride.” In Hispanic culture, “orgullo” is rather large and in charge. Me llena de orgullo ser Latino, pero when you ask me to speak Spanish, something like what I just typed might happen. “Spanglish,” a broken form of what some would call the “original” language that is becoming more and more common with each passing generation.  And like a growing number of second, third and fourth generation Hispanics in this country, la idioma del Español has had to take a back seat to English for educational reasons.

This program proves no exception to me in that regard. It is taught in English by a Russian doctor who has taken command of Western medical terminology, proudly pronouncing the terms with an accent thick enough to make me think of Bond villains.

Yet when I go to translate what the lady has said back to her as proof of my membership in the Hispanic lion pride, I don’t pass the sniff test. To further punctuate the point, the paternal Hispanic man leans toward the rest of the group and says “Pero el no entiende Español.”

“Que carajo cree, maricón? Que soy estupido?”

This is what I want to yell at the group at large, not just to the kind, yet painfully unaware man before me. I’ll leave you to your Google translators to figure out the meaning of those bitter words. Regardless, the gauntlet has been thrown down, and the judgments have already been made, fair or otherwise. I know enough to understand that he said “but he doesn’t understand Spanish.” That’s bad enough, but the group suddenly begins to look at me like a lost puppy dog, and now I want nothing more than to flip my desk over, and scream two words at them in perfect Spanish.

“Unidad Latina!”

Ears burning, face flushing faster than the toilet I used moments before this useless conversation began, I continue to help the group, but the damage has already been done. I didn’t rise to “mi hermano’s” bait, but I’ve continued to help “my people” through their constant frustration with medical terminology and the concepts behind certain procedures. It’s bad enough not to fit in, but now I’m helping my rejecters not to become the “rejected” when it comes to seeking employment with bosses who need them to understand how not to infect or possibly kill the patients with whom they will work. to gain this understanding, they need a command of the English language.

They need me to help them, and they’ve already judged me as unworthy to be among them.

I admit all this to a concerned girlfriend one night after a few too many drinks. It’s not enough to make it right. The situation seems more like a setup to me. But if I’m to believe what another Hispanic student said to me weeks before when I told her I don’t speak the language as well as I want to, “all Puerto Ricans are like that.”

I’d like to meet those Puerto Ricans. It seems that in my family, I’m the only one who has to endure this ridiculous public shaming ritual every time the issue of speaking Spanish even comes up. It’s an utter insult to be belittled by people who have not had to learn the English language in order not to be considered “remedial” in a public school system that still has difficulty with their Hispanic students. My personal life story might leave these judgmental fools suddenly breathless. But if I have to stop and reveal my history to everyone who shakes their heads in my general direction, I won’t get anywhere in life.

I’ve got better things to do.

Needless to say, after some coaxing from my girlfriend, I decide to save my energy during the next few in-class study sessions by ignoring my peers and reviewing my own notes.

The day of the final, I am the first to finish the exam. My grade is a 97. My overall grade for the class is an “A.”

Soy Americano. Soy de la raza humana. Si no le gusta, vete al infierno.

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