Working: A Smile Kills the Pain

In 1974, Studs Terkel published Working, a book of interviews that described work as “a search for daily meaning as well as daily bread.” Since then, work has changed. I’m trying to write an update.

Bernard Perlin — Hospital Corridor, 1961

Fifty years ago, Studs Terkel’s book Working described work as “a search for daily meaning as well as daily bread.” Since then, work has changed—and I’m trying to write an update. I’m interviewing people about what they do all day and how they feel about it. If you’d like to talk about your work (anonymous or not), please DM me!

A few weeks ago, I met Rafael at five in the morning. He’s a lead admitting clerk at the hospital. He’s worked at this hospital for over three decades. I was there signing my friend in for surgery. She was scared and in pain. But he was very cheerful and had both of us laughing before she finished the paperwork. I had a few hours to wait, so I asked if I could talk with him about his work. He agreed and asked me to come back on his lunch break, which is at 9 a.m. That conversation is below. I’ve changed the names and left out private details.

---

My day starts early. My work wife picks me up in Queens at four in the morning. That’s what I call her, my work wife, and her husband calls me her work husband, so it’s official. She’s got my wife’s phone number and my wife’s got hers. They talk to each other more than I talk to either of them. We take turns driving, so nobody goes broke on gas. Coming in at four thirty, there’s no traffic; twenty minutes and we’re here. Going home, it’s an hour. She sits next to me for eight hours in between. Add it up. I spend more of my life with her than with the woman I married.

I like starting early. By one o’clock I’m out, and in the summer I can be at the beach by two. I’ve had these hours for twenty-five years. I’m not giving them up.

Every day before my shift, I get my coffee and my corn muffin on First Avenue, and that’s it; that holds me till I get home. I lost forty-five pounds, and I’m not gaining it back. I take my lunch break at 9 a.m. And instead of eating or napping, I walk. The other day I walked all the way down to Canal Street and back. People think I’m going to sit down at lunch. No. I’m going to move. I’ve always been like this. I sleep three, four hours. Last night the game went till almost midnight, and my alarm went off at three. I take my grandpa naps when I can, but mostly I’m just up, moving.

Forty patients come to my window on a normal day. Somebody’s scared, somebody’s crying. Somebody is having a piece of themselves taken out or put back. Knee, hip, shoulder injuries. And I get maybe a few minutes with them before they go in. So I crack my stupid jokes. A smile goes a long way. Sometimes it kills the pain, not my wife though. Unless she dies laughing, and dying laughing is the best way to go. I’ve had patients tell me they forgot they were even in pain. The doctors know it too. They come by and thank me, because a patient who laughed on the way in is an easier patient once they’re inside.

I can’t turn it off. I don’t want to. My mother told me my whole childhood, stop joking, stop joking, and I didn’t listen to her, so nobody after her had a chance. One time I dislocated my shoulder, and my other hand caught fire the same day, and I walked into the emergency room with one arm in a sling holding up the burned one, calling out: “Hey, I needed a hand”. Somebody in the waiting room stood up and clapped.

Not everybody wants the joke, though. One patient wrote that it was inappropriate to joke with somebody about to go into surgery and that I should be fired. I got written up. A year later, she comes back through my line, recognizes me, and says, “I can’t believe you still have a job.” Then she wrote another one saying I was snotty, and I got written up again. I pulled her chart. She had complaints against half the staff. I was just the only one she named twice. She is the only one who complained about me in the last 36 years.

Oh yes, I forgot to say that. I got this job 36 years ago! Back then, to join the union, you had to have family already in it. My sister was already in, so she wrote me a letter for the union, and the union helped me get here. They hired me initially for three months. I was twenty-two. There was a room full of boxes, loose lab reports and doctor’s notes, and my job was to put every paper with the right patient. The pile vanished, but I stayed.

Everything was paper then. A patient came out of surgery, and I put the chart in order: the OR report here, the discharge summary here, the lab work here, so when the doctor or the billing people opened it, they knew exactly where everything was. Then I moved to correspondence, copying records and sending them out to the lawyers for workman’s comp, to the insurance companies, to the patient who needed them for another doctor. One time, I had to pull up a chart that went back to 1905. Somebody came in, trying to find a relative to see if a disease runs in the family. When (big company) acquired the hospital, I think they purged all of that. Now there’s no physical chart at all. When I started, the computer looked like a suitcase. Then we went through a series of systems and technologies. The latest is the useless kiosk you used this morning.

Back in the day, this place used to be a family. Before (big company) took us over, it was (small hospital), and when the shift ended, ten, fifteen of us walked out together to the restaurant, then to a bar in midtown with dancing till eleven, then to another club after. Some nights I went straight from the club back here, showered in an empty patient room, and started my shift. You’d be fired for that now. But that was the hospital then. I miss the old days; a bunch of us are still here, but they are all retiring.

Whatever I’ve got in me, keeping a job a long time, that came from my mother. She worked in a factory, and she stayed at it for close to forty years. My father drove a truck for Rolls-Royce. If you bought one, he was the man who brought it to your door. But when I was a teenager, he got into drugs, and he lost the job, and after that it was my mother who held the whole thing together. My little sister’s the same as my mother; she’s been at hers thirty-something years. Most of us keep things. My father was the one who didn’t.

I’m glad I kept my job for as long as I have. But I think it will soon be replaced by AI. They are trying this kiosk now, and it isn’t working, but it will eventually. The young kids I train, first thing I tell them: get your degree, don’t stay here the way I did. I raised my stepdaughter to care about education. When she was little, everybody gave her toys. I gave her books. She does mortgages now. She makes double what my wife and I make put together, double.

I’ve always wanted to continue my education. In 1999, I enrolled in the College of Staten Island, but never finished. I used to take the ferry over from here; it let me off right by the school. It worked well with my work. Then 9/11 happened, and after that the ferry wasn’t running right, and getting there by train the long way around was too much. So I dropped out. I got A’s in psychology and sociology. I still use it every day. It taught me to read a person, to look at somebody walking up to my window and know whether they want the joke or they don’t.

I’ll keep this job until November 13, 2029, the day after I turn sixty-two and a half, the first day the union lets me go. My daughter wants me home now for the grandkids. But if I leave before that date, I lose my medical for the rest of my life, and nobody knows what medical’s going to look like down the road. So I give it three more years.

And then I want the road. Before I met my wife, I used to just get in the car and drive down to Texas or Florida, sleep in campsites. That’s what I want to go back to. Maybe I buy a truck and do deliveries, something, anything that keeps me moving. I like the road. I’ve liked it my whole life. I love to drive in Manhattan. Even cab drivers can’t deter me. Sometimes the cab drivers stick their fingers out at me, and I stick mine right back.