How’s my desk-side manner?

I have a medical condition that means I need to get regular vaginal ultrasounds – which are about as comfortable as they sound. These ultrasounds make me very anxious, because I worry about what they will turn up; they also frighten me because my past experience has been that the technicians who perform them are not always fully aware of the ways in which their bedside manner affects not just my experience at the clinic, but my entire frame of mind for the day. To be blunt: I’ve had some very, very bad technicians give me very uncomfortable, borderline offensive, ultrasound treatments. And it’s not just the way they wield their probes that grates.

Last Friday I rode my bike to a clinic near my house for the latest of these tests. I was left alone at an “unmanned” reception desk to wait for what seemed like a very long time; I was beginning to worry I was in the wrong place, or had been forgotten, or had gotten the time of the test wrong. Finally, at 10 minutes past the appointed hour, a middle aged, very tired-looking woman emerged from behind the security door to call my name. She sounded, from the start, like she was barely tolerating me.

She ushered me into a large, dim room with all the usual equipment – a big set-up that takes a fair bit of space. Against one wall was her desk. She told me her name, offering a limpid smile (the kind of smile that says: I have been at this all day, and I do not want to be here); then she told me to sit in a chair at one end of the room while she took her place at the other. She asked me a bunch of questions about my condition while staring at her computer screen. I learned that I did not need to have a full bladder for this test, and I asked if I could please use the bathroom before we began; she told me to hang on, that she needed to ask more questions first.

Before we began, she started telling me about how she felt the test she was about to do was useless for my condition; she spoke to me like I was a clinician, rather than a nervous patient about to have a vaginal probe inserted into and moved around the interior of my body. She did not pick up on any of my bodily clues, which ought to have indicated (had she been more perceptive; had she been less tired?) that I was uncertain about what exactly she was telling me (is the test on? Off? Do I need other tests or treatment?). Finally she said: “but we’ll test you anyway.” Same limpid smile, bordering this time on sarcasm.

While she was conducting the test she asked me about my work; she spoke as if by rote, as if she knew this is what she was supposed to be asking at this moment in time. Then, she asked me if I felt that the diagnosis I had received for my condition (the first one more than ten years ago; the second eight years ago, after a battery of tests at the Sunnybrook and Women’s hospital complex in Toronto) had been properly carried out. I found myself justifying the care I had received, by doctors I had liked and respected, while she pushed the probe up and down against my internal organs.

Finally she finished, indicating that kleenex was beside the bed on which I was reclined. (Strangely, this was the most uncomfortable part of the whole experience – to be told “there’s the tissue.”) She drew the privacy curtain, but then kept right on talking to me about current findings related to my condition while I pulled on my pants and trousers. Then I had to ask: am I free to go?

Hurt, still anxious, and, frankly, extremely angry, I left the clinic; I rode out onto the main street and nearly collided with a van while trying to turn back into my neighbourhood. At some point, I think I yelled at another driver. My heart rate was higher than normal. My hands were shaking.

I share all this because, despite the epic fail that was, for me, this particular ultrasound, I’m now, a few days on, rather grateful for the experience. More than any “bad” test I’ve undergone in the past, it reminded me of how important very simple actions and gestures in the office/clinic space can be when putting me (as a patient) at ease. And that made me think, in turn, about my own role as a “clinician” of sorts, during my office hours with students. After I finished steaming at the woman who had conducted my test, I asked myself: How’s my desk-side manner?

Let’s talk about what we do when we meet students in our offices. Do we face them as we speak to them? Do we multi-task while explaining stuff to them? Do we use our body language to communicate something less than welcoming? (Are we too tired for this meeting? are we rushed?) What kind of interpersonal interactions are we modelling when students come to see us? Is our office-hour manner generous? Does it need some attention?

I don’t think directly about these kinds of questions very often. That’s not to say I give them no thought – for example, some years ago I made the decision to rearrange my office furniture in order to place the desk alongside one wall and my chair in the middle of the space, so that students could sit in front of me and we could face one another, without the desk as barrier between us – but I have to confess that, when I have a raft of office hour appointments on my books, I am typically anxious to get them all over with as soon as possible. They take up time I could be using to mark, deal with admin stuff, or just plain get the hell out of the office and back to my research. I have to wonder whether I’m communicating this rush to my students, and how that’s making them feel.

A long time ago now, in the second year of my full time teaching career, I frequently found myself bombarded by students over the lunch period; I hadn’t yet learned how to manage my office-hour time effectively. I would welcome all comers, even if it meant I had to chew my lunch most days while miming sympathy or understanding to the student across the desk (the desk was still in the way at this point). One day, during the spring rush, one of my favourite students came to my door, saw me smiling and nodding while chewing at yet another student, waved and left. Later, he sent me an email; in it, he wrote: “I didn’t want to bother you. There were so many people waiting for you. And suddenly I realised how emotionally draining your job is.”

And that’s it: teaching is an emotionally taxing job. An enormous amount of the work that I do with students is affective labour, and it effects me profoundly (as all affective labour does). I understand this to be an essential fact of my gig, but it is also a problem that is becoming increasingly acute (and, perhaps, increasingly invisible) as governments everywhere download more and more “soft” work – the work of carers and teachers – with less and less support onto an unsuspecting, generally under-compensated body of workers. I’ve been reading a lot about the social, economic, and ethical dimensions of this problem recently; if you’re interested, I’d encourage you to check out the recent issue of TDR on “precarity and performance“, co-edited by my colleague Nicholas Ridout and Brown University’s Rebecca Schneider, as well as the book Cruel Optimism by Lauren Berlant, and the provocative essays “Immaterial Labor” and “Neoliberalism in Action” by the Italian sociologist and philosopher Maurizio Lazzarato.

So how do I deal with this problem, since it’s not going away anytime soon? How do I manage my emotional work, so that it does not wreck my day, while also communicating something about its dimensions, its politics and challenges, in a teachable way to my students? Because, after all, the office hour is a crucial site of teaching and learning, and as an activist teacher I want my students to understand the nature of my work – in both its security and its precarity, both its humane dimensions and its susceptibility to pernicious, increasingly familiar social injustices.

I suspect the woman who administered my ultrasound was, after all, rather a lot like me: her job is a daily emotional struggle, and (insofar as the NHS is also in real trouble these days) she is no longer properly supported. She was taxed, tired, and I caught her not at her best.

The problem is that there was no space within the room she made for me to talk about that (shared) dilemma. The office hour can be such a space. I’d like to make it one.


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