Whenever starting a new job, a piece of sound advice is “don’t complain.” You’re new. The system pre-dates you. You don’t want to get a reputation for being difficult, as the perception will likely haunt you for years.
At the same time, you have ideas of your own. You approach the system with fresh eyes. Being the outsider looking in, you may have useful suggestions. The key is to know when your suggestions will be welcomed, and when you will be poking a beehive.
In my case, when starting a new job as an anesthesiologist several decades ago, I had plenty of suggestions for reform. Fortunately, I had already read some of the great novelists, and I knew when to pull my punches. When something about the workplace culture seemed especially American, I just let it be.
For instance, I noticed that the operating rooms in my hospital were uncomfortably cold—colder than those I had just visited in Europe. This wasn’t just a subjective perception: the difference in temperature between American and European hospital rooms was real, and persists to this day (a point I confirmed through a quick AI review).
Being American, I naturally imagined a conspiracy. In his American Notes, published in 1842, Charles Dickens listened to an American opine: “Every man thinks for himself, and we are not to be easily overreached. That’s how our people come to be suspicious.” Upon asking, I was told that the extreme cold in the operating rooms was not to lessen the bacteria count. Given no other explanation, I suspected it must involve some shady scheme on the part of the hospital to save money.
But this also proved not to be the case. In the end the explanation proved to be quite simple: the temperature was kept low simply for the surgeons’ comfort, draped as they were in heavy gowns.
But as an anesthesiologist, I wasn’t draped, nor was I actively cutting and suturing. Even when I donned a surgical gown it wasn’t enough to keep me warm while I sat quietly monitoring patients. So, I got into the habit of putting a warm blanket over my body and sticking a special hose between the blanket and my body that poured out hot air.
I resented having to do this, but then I discovered that my situation was very American after all. In Little Golden America, the Russian humorists Ilya Ilf and Eugene Petrov already observed in the 1930s that, “In the matter of temperatures Americans are inclined to extremes. They work in overheated dwellings and drink overcooled drinks. Everything not offered piping hot is offered ice cold. There is no middle ground.”
And so it was for me. When I covered myself with the blanket and forced warm air underneath, I inevitably got too hot. For relief, I smuggled cups of ice water into the operating room and surreptitiously sipped at them through a straw under my mask. But then sometimes my mouth got too cold. This moved me to place a heated saline bottle against my cheeks.
Now the situation really was ridiculous—but apparently still very American. G.K. Chesterton wrote of the American: “He has to live in an icehouse outside and a hothouse inside; so hot that he may be said to construct an icehouse inside that. He turns himself into an icehouse and warms himself against the cold until he is warm enough to eat ices.” And that was in 1922, before air conditioning became ubiquitous.
My instinct was to complain. But I was smart about it. This was not a fight to pick. I’d be fighting against the American way. And so rather than demand that the hospital raise the temperature in its operating rooms, I lived like this for the next thirty years.
Another instance of holding my fire involved the business of medicine. Don’t get me wrong, I looked forward to making a high salary as an anesthesiologist. But how to do so, and all the machinations involved, were beyond me when I started my new job. When I saw what was required, I blanched.
Good business often meant getting one’s allies placed in influential roles at the hospital. In one example of such cleverness, my wily department chairman told me and the other young anesthesiologists to show up at the meeting to elect the hospital’s new chief of staff. He didn’t tell us how to vote. On the contrary, he told everyone to keep their choice to themselves. But he did emphasize that we all be present. Only afterward did I discover his scheme.
Our chairman didn’t want the anesthesiology department to publicly announce its support for either of the two candidates because then the department would have been nothing but a pawn in the game and received very little. He simply informed the warring parties that every anesthesiologist would be present at the election. Then, at different times, he whispered quietly to members of both parties, “You have our support.” Thus, whoever won the close election would think he owed everything to the anesthesiology department and its twenty-member voting bloc. After the election the chairman winked at me, cocked his hand in a fist, and pulled down—his symbol for a busy cash register.
The only time the chairman ever lost a battle was over control of the hospital’s respiratory therapy division. Some of the anesthesiologists didn’t fight hard enough, he complained. The chairman shouted at them, “Are you crazy? Do you know what a cash cow respiratory therapy is?” He bemoaned the loss for years, often wondering aloud, and in an accusatory tone, “Who lost respiratory therapy?”—not unlike angry American foreign policy elites in the 1950s asked, “Who lost China?”
To me, the whole game smacked of commercialism, like haggling in a fish market. But it was, and remains, very American. The novelist H.G. Wells observed of Americans at the turn of the twentieth century, “All men [Americans] are equal at the great game of business. You try for the best of each bargain and so does your opponent; if you chance to have more in your hand than he—well, that’s your advantage and you use it. Presently he may have more than you. You take care he doesn’t if you can, but you play fair—except for the advantage in your hand; you play fair—and hard.”
There was no point in moralizing against the system. I just went along like any good, business-like American—and reaped the rewards. In describing that type, Wells wrote, “There appears no aristocracy in their [the Americans’] tradition, no sense of permanence and great responsibility…from the individualistic business struggle they have emerged triumphant, and what is there to do now but spend and have a good time?” So I spent and had a good time.
To get along with others it is important to choose your battles wisely. The great novelists taught me how. As a general rule, when the situation is normal, not just for one’s business but for the whole country, think twice before making a scene.
I should note that the examples of American craziness described above make America seem…a little crazy. But again, as with much American craziness, it is crazy in a good way. For, regarding the first example, what is the spirit of a country where everything must be served either piping hot or ice cold? Answer: a healthy democratic one. The average person in a democracy expects a little extra luxury when buying a product, in contrast with Old World peasants who, when getting their lukewarm, room-temperature product shoved rudely in their faces, were often told by the Old World merchant, “Here, you nobodies, this is good enough for you.” No, in democratic America, even average people expect their service-providers to heat or cool their drinks. Their drinks must seem extra special because they, the average people, are special themselves. The merchants (often average people too) are in full agreement.
Indeed, the piping-hot/ice-cold phenomenon encapsulates the entire animating spirit of American democracy, which is not to build monuments to a few grand people, or to laud some heroic past, but, rather, to make the lives of average people a little easier, a little nicer, and a little more comfortable in the present.
Think about that next time a waitress puts ice cubes in your water without you having even asked for them—and does so for free.
This post is an installment of American Crazy, a series of posts devoted to literary depictions of American national character.
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