One night in the hospital, I could not sleep. I lay staring at the ceiling, listening to the nurses at their station near my room and the even breathing of my sleeping roomate. I challenged myself to write something in my mind, to play in my mind. What popped up were references to white coats. I’d noticed that the doctors making rounds wore white coats of different lengths. A nurse had explained that the shortest ones, white jackets, were worn by medical students. A medical student further explained the hierarchy for me in terms of who works the closest to the attending/teaching physician, and that he was at the bottom, essentially there to learn. But what fascinated me was the hierarchical organization using the lengths of the white coats, the robes of medicine. Of course, if someone shows up in scrubs, which happens, then it’s difficult to know where that person fits into the hierarchy unless they’d also visited earlier wearing his/her white coat. And my attending surgeon often showed up in street clothes without his white coat.
Why does this society, that of doctors and students in a teaching hospital, need a hierarchal organization? Could it function organized in a non-hierarchical way? Why does this society need a hierarchy?
As a writer, I’ve found it important to think carefully about the society or community of people in which my characters exist. In Perceval, the society, actually societies, required far more work than I’d initially thought. The reason? I’d chosen to create a world in the future, rather than the past or present. The future, however, has its foundation in the past, so I could use the present day world as a basis or beginning. Social organization will affect a character’s behavior and thoughts whether the community is a school, neighborhood, city or country. And I needed to consider America’s social organization in 2048, Europe’s, Austria’s, and various other countries that come into play in Evan Quinn’s life. And then there’s Evan’s professional society, i.e. a professional musician, and how he fits into how that society is organized.
Human beings, like other mammals, like to be organized, whether it’s in the nuclear family unit or a neighborhood, by tribe or nationality. Customs and beliefs tend to evolve within human groups, creating distinct cultures and ways of thinking and communicating. A smaller group, e.g. a family, will have customs and beliefs consistent with any larger group in which its a member, as well as developing its own unique customs and beliefs. So, despite the high level of organization, a high level of diversity and originality can exist within it. In fiction, this information about a character can give him or her depth, breadth and layers of humanity and meaning that a reader can identify and connect with.
Back to the hospital in the middle of my sleepless night, I realized that a hierarchical organization to the doctors and medical students served a purpose more important than simply organization in their society. The hierarchy is based on level of knowledge and expertise, and the white coats’ lengths identify where each coat wearer is in that hierarchy. My surgeon’s white coat (when he wore it) was below the knee and his name and department were embroidered over the breast pocket in black, like all the other attending physicians I saw, but not like Residents below a certain level whose coats were unadorned. These were the professors, the doctors with the highest level of knowledge and expertise. The hem of the coats rises as we tick down the hierarchy: Fellows and post-doctorals, Residents, Interns and Medical Students. Outside of their society, for example, when I or a nurse approached them, we would recognize their level of responsibility and decision-making according to their society.
Sleep finally came that night, but only a couple hours before my Residents arrived on their morning rounds….