Tuesday, November 6, 2012

The siege

I'm in an institutional building, like a corporate lobby. Two fighter jets land on the ground right in front of the building. Their arrival is ominous, they block the entrance. Behind white vinyl blinds on the windows I watch their progress but for some reason don't try to escape. Where would I go? A female pilot in a military flight suit pops out of the top of one of the jets. It's a very bright sunny day out there. She walks toward the front door, to bring me in.

Why are these interactions with the medical authorities so rocky and unsatisfying? Why do I feel like a hostage in my own life? Why can't I just get with the program?

Doctors go into medicine so they can fix stuff. They listen just long enough to formulate a theory about what's going on, then tell you what you have to do to fix it. You get fixed and are grateful. You don't ask questions or give input. That's the formula.

There are things that fit the formula. Broken bones, clogged arteries, high cholesterol. Certain types of cancer. Erectile dysfunction, thyroid issues, most bacterial diseases. If you have one of these, you're going to be a fan of the fix-it approach.

If you have something else, you will notice the lack of a fix and other things that are missing too. For example, wrong assumptions and flights of logic become obvious. Each time I tell my story it goes through a different filter and something new comes out. It is often suggested that I do not have a head injury. Or caffeine is not a drug. Or this or that symptom is not caused by the head injury, but something else. You become a Rohrschach diagram, a cipher. The interpretation says more about them than it does about you.

To his credit the young guy at Valley Medical knew my head injury was real. True, he did not read my patient record before the appointment. Didn't explain the process. Wasted my time with an exhaustive set of arcane questions. Did not make eye contact but looked down and kept saying "uh huh, uh huh" every few seconds. Waiting for me to stop.

When I explained my job had changed and become undoable, I watched his face and thought well he's never had a real job. Didn't work his way through school. He has no idea about fighting to get through college, fighting afterward to get any kind of job. It would be a miracle if he had any understanding of work in Silicon Valley, what the expectations are. Fighting to hold onto that job. What it's like to fail.

In the process of trying to catalog all the effects of my injury, he asked some very personal questions. The answers would go through the filter. It felt unsafe, as if next I would have justify why the earth has an atmosphere. Then be attacked for my answer.

When doctors are occupied with this game they often forget there's someone else in the room. Someone watching them, noticing their lack of empathy. And thinking, without a fix and without empathy where are we? Why on earth would I spend my time in this way?

At this point it might seem as if the sun has started revolving around the earth, now stationary. You are taking care of the system and its adherents rather than the other way around. If this makes you angry, they will suggest the anger is related to your head injury and offer you medication for it, trying to make it go away.

It will not occur to them that for a hostage, rage and alienation are a completely normal response.

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