Work history

For a meeting today I dressed in an oatmeal-colored tweed skirt and a soft brown sweater. Red suede t-strap heels completed the look, despite their impracticality. Sometimes you need to wear your power shoes.

Those shoes made me think of another pair of red heels--the ones I wore up on stage in front of 900 people. Several years ago I spoke during a plenary session of an industry-wide conference, my hand shaking as it held the mike. Can't even remember what the topic was. Looking good gave me confidence and I knew that once I started speaking my hand would stop shaking; it did.

Almost twelve years ago I went in for an interview for a position I was in no way qualified for. I saw the job listing on Craigslist--Transplant Coordinator. Transplant! Great. I'm a recipient! This is the job for me. I was two years post-transplant and my identity was Liver Girl. I thought a lot about my hospital experience, my surgery, how the whole thing had changed me. Still trying to figure out what I wanted to be when I grew up, I thought about how I could fit myself into this new world I'd been baptized into. I wasn't a doctor, I wasn't a nurse. What could I do?

They only called me for an interview because my surgeon put in a good word for me. Actually, I'm pretty sure he told them they had to hire me. The interview was for an Assistant Hospital Services Coordinator--mostly an administrative role. Absolutely for sure the worst interview of my life. I had no idea how much I didn't know. Recipient! I'm perfect for this job. . .wait, what do you do again? I was unprepared but I also knew I was smart and good at learning. The hiring manager asked all sorts of character-based questions that I had a hard time answering ("Tell me about a time you had to go around someone rather than through them" Ummmmmmmmmm) and I walked out of there cringing. Nonetheless I got called back for a second interview. Back then the CEO interviewed everyone herself and within five minutes of my interview with her I knew I would get the job. We recognized each other right away. She deserves her own post.

My first day at the office I felt. . . wholly alive. Like I had arrived at the place that was everything I'd never known I'd always wanted. People were smart and curious and caring. The office was attractive and full of windows. I started on a Monday and sat in on the weekly morning conference call, during which most of the organization reviewed the cases from the week before. I could not believe I was there, part of this conversation.

I was in that assistant position for less than a year. During one of my many trips back to the intimidating but exciting closed door of the Placement department I caught that team's eye because I was able to be taught how to fill out one of their forms with relative ease and they were desperately under-staffed. I got invited to apply for a job that usually sought out people with science backgrounds. My Spanish-Literature degree was not anything that meant anything to anyone in this role. Training involved learning how organ allocation works, learning to speak to surgeons on the phone where I would describe the medical histories and current organ function of all sorts of different patients. I could barely remember what a normal pH was. Hell, I barely understood what pH meant let alone what arterial blood gases, diabetes insipidus, cardiac output, and pulmonary hypertension were. There was a lot to learn and I had a great many teachers. For at least a year I would occasionally wake up from a dead sleep and feel like I'd almost just remembered this vital piece of information that someone had told me was essential to doing this job, but then it would slip through my fingers and I would sit there in the dark worrying that one day they'd all realize I had no idea what I was doing.

They told me and every other hire it would take at least a year to get good at the job, and that they you would have to worry about being too comfortable. That once you lost the fear of messing up, you really had to pay extra attention to make sure you didn't mess up. It was fast-paced, emotional, exciting, fulfilling work. I carried a text pager and a cell phone and worked twelve hour night shifts. Sometimes twenty-four hour shifts. I made some truly amazing things happen in that job.

As an outsider I was able to notice many things about this new world of mine. How in the medical field people can be afraid to admit when they don't know something. Understandable, because we want our doctors and everyone involved to know all the answers. I didn't have to worry about that. Everything was new to me and I just wanted to learn as much as I could. I learned and learned. Passed the national certification test--one of the first in my department and one of a short list in the entire company. Passed by one point :-)

I often wondered how it was that I'd been allowed into whatever room or conversation I was in. The first time I put on scrubs and went into the operating room to observe organs being recovered from a brain-dead patient. I saw a heart beating inside the chest; the next second it was in a doctor's gloved hand. I gazed at perfect, pearl-like lungs. Inflated with air, held aloft They were so unbelievably beautiful I still catch my breath picturing them more than ten years later. The patient's toes also struck me. Her toenails were painted with glittery, lavender polish, slightly chipped. After the organ recovery was complete I reached my hand out and held her foot to say thank you and to hold her in my heart as she must have been just days before, painting her nails or having them painted. I was awed to be there.

I gave that talk on the big stage. I got invited to give other talks. I led meetings where I was explaining a new biopsy protocol to a group of doctors and they were the ones asking me how we planned to do things. I wrote policies. I had an an article published about kidney allocation. I was invited to join and then head committees.

I became a quality specialist and then a supervisor. A year later I was asked to apply for a new management role in a different department. The Clinical department. If I'd thought the old Placement door was intimidating, this was a different level entirely. These were the people who had been my main teachers. I was going to manage them? I was scared.

That job was the hardest thing I have ever done professionally. It crushed me. I doubted myself. I didn't know how to do a good job and that bothered me so much. I upset many people, many different times. For a long while I lost my ability to admit when I didn't know something. I felt like I had to be the Boss. The person who knows. No good for anyone.

But I learned. So, so much. And I had moments of great success and pride. I had someone ask me to manage her team, telling me "A year ago I would have said no way but you've grown so much now it would be great to have you manage us." I stepped into operating rooms and was the one explaining what was about to happen, the one answering questions. I started asking questions again, starting letting go of my fear of being exposed as someone who didn't know. I needed to know and I needed people to teach me.

The moments of wonder. The pure, acute humanity we get to stand next to when we do this work. The times I got to sit next to a person when his or her heart stopped. To be there, holding space for that moment and for their families. To honor their lives. To be surrounded by such deep grief and to know there is nothing you can do to make it go away. To know this is only the beginning of great pain and adjustment to the unrecoverable loss. And to sit there anyway because that is the one thing we can do for one another. Be present and make room. Be a professional who is not in the grief, but next to it. And work as hard as we can to make the most of the gifts those people have given others.

I'm not the same person I was when I started this work. The work has changed, my role has changed, and I have changed. The future will bring more change--I'm not sure what. I'm ready. I'm smart and I'm good at learning.