This Is How It Always Is

This Is How It Always Is

by

Laurie Frankel

Teachers and parents! Our Teacher Edition on This Is How It Always Is makes teaching easy.

This Is How It Always Is: Part I: Residency Summary & Analysis

Summary
Analysis
Rosie is in the first year of her residency in emergency medicine and doesn’t have time for a boyfriend, she says. Penn asks her why she wanted to date a poet if she doesn’t have the time, and Rosie says that she only meant she “should date a poet. A theoretical one. A theoretical poet.” Most new doctors date other doctors, but Rosie doesn’t want that. She wants someone who “thinks slowly and deeply,” not a doctor who only says long, scientific words from memory. She was only kidding and didn’t really intend to say yes, but Penn was so nice when he called, she decided to take a chance.
Rosie’s desire for a “theoretical poet” implies she is looking for someone who thinks abstract thoughts (someone who “thinks slowly and deeply”) with little application to the real world. Rosie’s life is full of concrete medical facts that must be committed to memory, and she wants to balance that part of herself out with someone who is creative and not reliant on facts and clinical practice.
Themes
Storytelling Theme Icon
Penn is studying creative writing, but that doesn’t really involve a whole lot of creative writing. Mostly, he studies literary theory, which seems like a lot of nonsensical jargon with no practical application. Studying literary theory takes a lot of time, and Penn spends it in the waiting room of the emergency department. There is lots of “pathos” to be found in hospitals, Penn notes. Lots of crying and tragedy. Watching the people, Penn reads and writes for hours, and Rosie occasionally drops in on breaks and reminds him that she doesn’t have time for a boyfriend. Plus, she says, it is weird to read literary theory in a hospital waiting room.  
Pathos refers to a method of playing on the innate emotions of the audience in order to persuade them, and images of people crying in hospitals surely elicit such emotions in most people. Again, Penn is a creative guy, a storyteller, and he doesn’t like the more technical and theoretical side of art. He doesn’t believe theory amounts to much other than fancy language, and he doesn’t use what he reads to write. Ironically, Penn’s reference to pathos is literary theory and was written about by Aristotle in Ancient Greece.   
Themes
Storytelling Theme Icon
One night, Rosie comes into the waiting room just after two in the morning. She wants food, and then she wants sleep. Rosie and Penn go to an all-night diner, where they eat eggs, and Rosie talks about the differences between medical school and medical practice. He has been doing the same the last few hours, Penn says, “Thinking about the difference between school and practice, books and life.” Back at Rosie’s apartment, she asks Penn to tell her a bedtime story. “Once upon a time,” he begins, telling her about a prince he created named Grumwald. Near the end, Penn tells Rosie to go to sleep. He will finish the story in the morning. “Like Scheherazade?” Rosie asks.
As a resident physician, Rosie has likely been on shift for at least 24 hours, with little, if any, breaks. The theoretical basis of Rosie’s education did little to prepare her for what being a doctor is really like. Clinical cases are complicated, and they don’t play out like they do in textbooks. Penn feels the same way about literary theory, so they have more in common than they think. Scheherazade is the female character of One Thousand and One Nights, a Middle Eastern fairytale, who wins a stay of execution every day by telling a story each night. 
Themes
Storytelling Theme Icon
In the following months, Penn sticks close to the hospital waiting room. He keeps the same long hours Rosie does, reading and writing and thinking about literary theory. It is good practice for their first child, Roo, who will later keep them up all night. Penn is always good about getting up with babies, even if he was up late with babies, but this isn’t why Rosie loves him. She loves Penn’s stories, and now, years after her residency, there is no one in the waiting room to tell her stories. She never intended to stay in Wisconsin (Rosie is from Arizona and hates the cold), but the hospital has been good to her. They know that she is talented and worth keeping, even if her family and kids mean that she occasionally misses work or must leave early for various reasons. Other hospitals, Rosie fears, won’t be so understanding. 
Again, Penn clearly does much of the childrearing, since he is the one staying up late and getting up in the middle of the night with babies, which further subverts stereotypical gender roles that assume Rosie, as a woman, should take care of babies. Rosie’s fear that other hospitals won’t be so tolerant of her family responsibilities reflect the discrimination women face in a sexist society. Later in the story, Rosie is effectively punished career-wise for having a family and is made to feel like she has to make concessions or choose her career over her family.
Themes
Gender and Binaries  Theme Icon
Violence and Discrimination Theme Icon
Storytelling Theme Icon
Family Theme Icon
Get the entire This Is How It Always Is LitChart as a printable PDF.
This Is How It Always Is PDF
Rosie thinks back to the first day Claude was conceived. The emergency room was busy that day. She treated a pulmonary embolism and ruled out irritable bowel syndrome in a pregnant teenager. She also treated a young girl with a broken ankle that day, and Rosie comforted her during her X-ray. Rosie knows the X-ray isn’t why, but she always wonders.
The reader can infer that something happens with Rosie’s baby that makes her wonder if she is to blame because she exposed him to X-rays, which can be harmful to an unborn child. Rosie is clearly a competent doctor, and this part of her identity also defies stereotypical gender assumptions that believe important and difficult work like Rosie’s is best left to men, who are assumed to be more capable. Rosie is obviously capable and incredibly caring.
Themes
Gender and Binaries  Theme Icon