Dr. Empathy – Or How I Stopped Judging and Learned to Love the Millennial.

I talk a lot of smack about people who dis millennials or “kids today”. My low opinion of that attitude is well documented. What I don’t talk about is if I sometimes struggle with my perception of youth or youth culture, and the answer is: I do.  “You little twerp” has crossed my mind on numerous occasions. In some instances it’s because I’ve interacted with a little twerp (being a kid doesn’t exempt one from being a jerk), but more often it’s because I have a set of expectations that aren’t being met. This is a story about one of those times.

Before I left my previous job, I made small bags of holiday candy and gave one to everybody. For the people who weren’t there, I just left it on their desk. They went over well – almost everybody said they enjoyed their treat, or thanked me for thinking of them. The gratification filled me with holiday cheer. Except that one kid, the senior college student who worked for the vice chancellor. I left his bag on his desk when he wasn’t there and that little shit never once even acknowledged that I gave him anything!

Ugh, rude! How dare he ignore my hand crafted gesture of holiday goodness! What a little twerp! Boy, if I was still going to be working here, I’d never give him anything again!

I had those thoughts for two days. The cognitive dissonance was really fucking with me. I couldn’t reconcile my affinity for millennials with the voice in my head that kept telling me he was rude and (Zeus help me) “entitled”. What follows is a transcript of the conversation I had with that Voice.

Voice: This is why people call millennials entitled, you know. He doesn’t even think he has to say thank you.

Me: I know! Although, maybe he wasn’t brought up to have those kind of manners.

V: So? He’s an adult living in the adult world and that shit is basic. Ignorance is not an excuse in adulthood.

Me: Exactly! It’s just basic good manners to say thank you.

V: Besides, we’ve heard him say it before – it’s not like he doesn’t know how. Remember when you brought donuts and hot cocoa? He thanked you twice!

Me: I remember. I made some kind of joke about bringing them and he was laughing and talking with the rest of us. Um, actually…

V: Right! Now here is, just ignoring you. So rude. He should be acknowledging your gift! That’s why you gave it to him!

Me: Wait, what? No, that’s not why…

V: But didn’t you feel awesome when everybody else specifically came to you and thanked you for your gift? Didn’t it make you feel all glowy and validated? Isn’t that why you gave them gifts??

Me: (whispering) Sort of?

V: Of course it is. So why don’t you just march right over there and take away his gift?

Me: Because that would be horrible! And rude! You don’t give gifts with the expectation that the recipient is going to make you feel good about it! You give gifts because you want the recipient to have it.

V: Are you sure? Because I bet you’re related to a lot of people who would disagree.

Me: This is not the time for that conversation. Look, hold up. The point here is that I gave him a gift and I feel bad that he didn’t make me feel better about giving it to him.

V: And you’re not taking it back because…?

Me: Because if it comes down to it and I can only have one or the other, I’d rather he have the gift than I have my thank you.

V: But that doesn’t excuse his behavior!

Me: Only if I’m operating on a very specific mode of social etiquette.

V: Everyone operates in that mode.

Me: No, they don’t. If I really wanted him to acknowledge my gift, I could go right over there and ask him if he likes it. Better still, I could have waited until he was present to offer it to him, instead of sneaking it onto his desk like a reverse thief. Santa leaves presents in the dark when nobody is looking and nobody thanks him! Maybe he’s respecting MY boundaries? Ever think of that?! Maybe he thought I left it for him because I didn’t WANT to interact. Otherwise, wouldn’t I have said something by now? You know, millennials are really sensitive to introversion and boundaries on personal interaction, it’s part of what makes them so great. Maybe all this time I’ve been listening to you call him rude, and from his perspective, he’s being super respectful!

Voice: (a little quieter now) It still feels rude.

Me: Yes, it does. Because I’m functioning on an unspoken set of rules of social interaction that date back to the Victorian era and I’m too full of myself to just go over there and talk to him about it. That’s my failing, not his.

And that’s when the voice shut up, my cognitive dissonance disappeared and I felt even better about giving gifts at work.

I’m not saying social niceties aren’t valuable or that we should all abandon expressions of gratitude. What I’m saying here is that sometimes empathy is hard work. Sometimes anger feels better than understanding, especially when that understanding only comes after a lengthy struggle. Sometimes overcoming social programming and what is “normal” is a lot of goddamn work and we don’t want to do it. I have found however, that it is nearly always worth it.leftridgepick-strangelove-650

An Open Letter to My New Primary Care Manager

It was busy the day I met you. You were the only nurse practitioner in the office that day, and I was trying to fit in an appointment in my own busy schedule. Since this was a disadvantage to both of us, it sort of cancels out. I only mention it because it may have had an influence on your approach.

I didn’t choose you, but you undoubtedly knew that. I was assigned to you because my own doctor left the practice. Such is the nature of our health care system. Due to a confluence of scheduling issues and timing on my prescriptions, I was forced to take a next-day appointment, squeezed in among patients who were able to make their own appointments well in advance, as well as acute care patients with urgent medical needs. Not an ideal situation, but the best I could do to take responsibility for my own health care.

The intake nurse was pushy and condescending. She told me to get an eye appointment because I was -“Don’t throw your purse at me” – 40, as though she was delivering unexpectedly bad news to a toddler. I tried not to take it personally, though her attitude did set my teeth on edge. I know nurses and medical assistants at that level are over-worked and underpaid, and I’m sure she thought her advice was medically sound, so I made a concerted effort to forgive her thoughtless and trite delivery. After taking my vitals and checking off the list of meds I was asking to be refilled, she left and I waited for you.

It wasn’t a long wait, but sadly, that’s the best I can say about our time together.

After introducing yourself, you sat down across from me and began telling me that the prescriptions I was taking were ineffective for the symptoms I was taking them for. That threw me back. Is this guy for real?? was my thought, but even had I wanted to voice it, you didn’t give me a chance before moving on to your next item of business, which was to tell me that at least two of my medications were narcotics and carried very high risk factors for addiction. You spent the next four minutes lecturing me about my medications, telling me how you wouldn’t have prescribed them yourself, how ineffective and risky they were, how I wasn’t taking them properly, and how the way YOU practice medicine is to establish a “partnership” with your patients. I confess that the rest of the four minutes is now lost to my memory, but you did repeat yourself a lot so I doubt I missed much.

Tell me, sir – what kind of “partnership” is it when one person does all the talking, lecturing, and condescending while the other person is held hostage to the first’s profession? But let’s set that aside for a moment while we deal with the facts that were missing in your extremely one-sided “discussion”.

Had you bothered to ask me how I was coping with my symptoms, I would have told you that in the six weeks I’d been taking these particular medications, my quality of life had improved immensely. That I was relieved and calm for the first time in almost a year, and that in addition to the lifestyle changes I had implemented, I felt that my symptoms were finally manageable. Then, I could have told you that I spent no less than 12 years as a pharmacy technician, so I am well aware of what the medications I am taking are for, their dangers and inefficiencies as well as their success rates. Perhaps I would have lectured YOU for telling me that an anxiolytic, particularly a seratonin receptor agonist, isn’t effective for anxiety, or that the particular norepinephrine reuptake inhibitor I take isn’t effective for depression. I could have told you that when I was in my previous doctor’s office, suffering from sleep-deprivation-induced psychosis, near constant panic attacks, and had to use nicotine as a self-medicating aid, she rightfully concluded that the best medications for me would address all my symptoms and have the fewest number of adverse affects.

Maybe that would have slowed you down for half a second, and I could have reiterated that one of the narcotics you referenced was NOT part of my refill request, as that had been a short term medication only, and the other one was a rescue prescription that I only used for emergencies. Instead of freaking out that I was trying to hoard benzodiazepenes and telling me that I was abusing it, you could have asked how often I was taking it. Then I could have told you I still had over half my original pills in the bottle, but as it is highly effective as a rescue rx, I didn’t want to run the risk of not having any while I was without a provider for 30 days (or longer, since it’s not unusual to wait even longer for a non-emergent appointment).

I doubt we would have had time to go into why I needed these drugs in the first place, what my medical and psychological history was, but at the very least you could have asked me what lifestyle changes I was implementing before jumping to the conclusion that I was ignorant about my own health care. Literally asking a simple question was the very least you could do, and you failed to do it. If I am very generous, I could allow that your intention is to practice medicine in a reciprocal way with your patients, but I can assure you that was not the end result of our visit.

After listening to my lungs and heart, and grudgingly allowing my prescriptions to be refilled (after referring me to the wrong pharmacy, by the way), you finally asked if I was seeing a behavioral health provider, which I affirmed. Then you had the unmitigated gall to tell me “You rock!” and shake my hand while patting my back, not unlike one would do to a Little League player who just hit a single.

As a woman and as an American, I have a long history of receiving inefficient and belittling “health care”. Of being told that I don’t understand my own body, that I am generally ignorant about matters of health, and/or that I am deliberately misrepresenting my symptoms. You managed to hit all three, and even at “don’t throw your purse at me” 40, I’m honestly surprised enough to almost congratulate you. But having had an insider’s look at our health care system, and having a spine made of stiffer stuff than a wet noodle, I won’t. Instead, I am holding you accountable for your actions, and seeking a provider who will put into actual practice the idea of a health partnership. Someone with at least a basic understanding that such a partnership entails two-sided conversations, and a modicum of sensitivity to a petitioner of health care. You appear to be capable of neither. I was told that you are retiring from the first phase of your career while you transition to the second. Perhaps that is something you could work on.

Most Sincerely,

Your Former Patient.

The Painted Heart, part III

My heart is painted over with the lacquered armor of more battles than I can now count, more love than I was ever entitled to receive, and more sadness than is polite to discuss. My painted heart is both broken and solid, heavy with reality.

It’s a trinket, I’m realizing now. A novelty to everyone who’s seen it. A sentimental treasure only to me. That’s human nature, isn’t it? We each have to find the glue to put the pieces back together again, chips and holes and new paint all part of the “charm” until you can either cherish it or can’t stand to look at it. But certainly you can’t expect anyone else to love it in the way you do.

My painted heart is in pieces. I don’t know how I will look at it ever again.

The Painted Heart, part II

You see it there in the window, all glossy cherry red and plump to bursting. In your hand, it fits like it was made to go there and oh the weight of it! You just know you could feel that forever – no forgetting it was in your pocket, not ever.

The paint is hard and shiny, and layered on coat after coat. The most recent application hides the imperfections of the last – dings, nicks and scratches all easily filled in with another coat of paint. There’s a flaw in the side – a place where the material is malformed, but it’s hardly noticeable, you see. And the overall effect is so very lovely. You just have to have it.

You slip it in your pocket. It pulls your jacket just a tad off center. You were right – you never forget the weight of it. Not once.

The Painted Heart, part I

When I was younger, a breaking heart felt like a rend in the universe. I could feel my heart cracking down the middle like a great boulder, the echoes like thunder in the wind.

Now, though, a breaking heart feels more like an old abandoned barn. Peeling and crackled paint flaking off and falling, silent, into soft, loamy earth. The creak and whine of withered boards straining against rusty nails, struggling to maintain a shape as outdated and antiquated as anything from the last century. Lonely and bleak, a skeleton of a frame waiting for the next storm to blow it down.