Zip codes.
(aired in slightly different form on All Things Considered January 9, 2003)

For several decades, my father and I and other members of our family boycotted zip codes. Our quixotic little campaign eventually ended if only because these days you just have to put a zip code on an envelope if you want to get it sent. But my father's father was a postal clerk, and being a postal clerk was a trade, a trade he was proud of, a trade that ended when zip codes were introduced.

My dad tells the story of being out on a family fishing trip in Wyoming, and they drove up to some train tracks in the middle of nowhere. My granddad looked at the track and then looked at his watch, and said, "Well, should be the 3625 out of Laramie coming along these tracks in about ten minutes." The kids scoffed: how would he know such a thing? They were hundreds of miles from their home in Salina, Kansas. Challenged, my granddad stopped the car and waited. And round about ten minutes later, here comes the 3625.

My granddad knew which train would be coming down the track because back then, sorting the mail didn't involve zip codes. He kept a detailed knowledge of train schedules in his head, knowing that if he put an envelope in the slot of one train, it would get to its destination city tomorrow, and if he put it in the slot of another, it would get there the day after tomorrow. My dad says my granddad used to have a practice version of his mail slots at home, and a bundle of practice mail. He'd drill for the postal service tests he took, sorting faster and faster, then checking to make sure he'd made the right choices.

My granddad was proud of his work. But he didn't want his kids to do it. They all ended up being teachers of one kind or another, people who didn't have to memorize train schedules or practice a skill again and again to get faster. My granddad himself eventually became a national official in the postal clerk's union.

Still, he hated zip codes for what they did to his trade. The system of zip codes means that the system sorts the mail and the people just help move the envelopes. Computers do all the thinking about train and truck routes and geography. He said work like that would drive people crazy. He believed in skilled labor as an end in itself, even if he wanted his kids to leave skilled labor for the professions.

I think about my granddad and zip codes while I slog through the parts of medical school I find most frustrating. Probably partly because of my granddad's aspirations for his children and the family I grew up in as a result, I value concepts more than crafts, ideas more than skills.

But as much as medicine can be an intellectual profession, it is also a skilled trade. And I chose medicine over academia partly because of that. I wanted concrete skills. So I will learn how to draw blood from difficult vessels, how to do a lumbar puncture, where to listen for heart sounds, how to use my hands to do my work. And there are many things I must memorize-the physiological train schedules of the body. To be honest, I find that frustrating. I'm a child of the zip code era.

But the body is too complicated to be reduced to a system like zip codes, which is part of what makes it beautiful. And in order to approach that complexity with limited-time office visits and standard reliable protocols, medicine still has a set of skills and facts that must be known. And so I have to memorize lists and practice with my hands. When I get frustrated with memorizing and practicing, as I often do, I try to remind myself of my granddad, and the pride he took in his work. He believed in the mail before zip codes, the mail that moved across the country because people knew places and schedules and remembered them.

copyright 2004 joe wright