Speaking to Power: The Doctor's Office

Two years ago this November, I managed to total my car in the late afternoon. After having it towed and returning home, I took a nap. When I awoke I managed to then slip and fall down the stairs. All of this happened on the same day. The car crash was unsettling. I had never experienced an airbag deployment. I was fine, but the car was definitely not. I miss that car. The fall down the stairs was devastating. I lost it and began to wail uncontrollably.

The timing was terrible for the crash. We were leaving the next day for vacation. We were going on our annual trip to Austin, Texas for the Levitation Music Festival. Lots of walking and standing is involved. And here I was with a hyperextended, deeply bruised knee. I self-diagnosed and medicated. I used my knee brace from a similar injury in 2017 (a week before that year's vacation) and cautioned my husband that I would need to find places to sit and rest instead of standing and walking for hours on end. He was disappointed that I would be limited in mobility on vacation but understood. We found a place in Austin that provided acupuncture treatments and took advantage of that healing treatment on our first day there. Although in pain, the trip was enjoyable and a success.

Fast-forward to January 2020: I had a new-to-me car and still had pain and restricted movement in my injured knee. I needed intervention so I called my clinic for an assessment and referral to a physical therapist. My physician wasn't available, so I went with another doctor rather than wait. I'll call him Dr. X. (original, eh?) Dr. X had me do some range of motion and balance activities. He noted the swelling in my left knee versus my uninjured right knee and so we went on. He affirmed a referral for physical therapy, prescribed an oral medication for pain and swelling, and we agreed through casual conversation that I could stand to lose some weight. That was it. Nothing new or out of the ordinary. Office visit over.

I started the PT and attended for about six weeks, two to three times each week. The physio doc and assistants were great, encouraging, and challenged my fear of engaging with pain. I was able to build some strength and flexibility and in doing that my pain was greatly reduced. It was wonderful. 

As the PT drew to a close, for some reason I opened my patient portal. I was looking at my chart and noticed an annotation from the January visit with Dr. X: Morbid obesity. Yes, I fit the data points for that diagnosis, but here it was in my chart. It was added by Dr. X., not my regular physician, and with no context or explanation around why he felt the need to add that particular point without conferring with the patient. Certainly my primary care physician could have put that in at ANY TIME. We actually talk about my weight and depression at each visit. I was angry. I was hurt. It was a slap in the face. It was unprofessional.

I carried that with me until just this month. Yes, I know, my Zen-master husband would be counseling me to leave that s*!t behind. But my carrying the matter wasn't so much personal, rather I was more concerned about someone else receiving the same deeply personal information without conversation. I had a medical emergency this past weekend which required a follow up (I'm OK and am going to be OK) but the only person within my leave from work that I could see was Dr. X. Seeing Dr. X was likely to help with my anxiety levels if I could bring myself to share the impact of the charting without context. So, I practiced my words, I asked for prayer and support, and girded my "speaking to power" loins in preparation for this early morning office visit. 

We focused on the condition at-hand and once that was wrapping up, Dr. X stood and asked the "is there anything else?" question. "Yes, in fact there is, Dr. X. I would like to ask that in the future when you chart something into a patient's medical record that you have the conversation with them as well." He was uncomfortable and wanted to sit back down, but couldn't quite. When I went on to provide the detail as described above, he had a response that was somewhat hedgy and somewhat apologetic. His PA had the best look on his face which was a bit of, "Good Lord, what's about to unleash here?"  

The explanation offered by Dr. X was that the charted diagnosis wasn't judgmental, but rather a response to a national initiative to track and control the obesity epidemic. He went further to indicate the charting software performs a calculation of weight and height to automatically enter that information. I responded politely, with tears of anger and frustration in my eyes that it still matters that context is provided and that no one going forward have that experience. I stopped the conversation there, and said I didn't need any further response, again stated that this situation should never happen again for other patients, and I thanked him for the response he gave.

In hindsight I need to give Dr. X the benefit of the doubt--it was a January appointment, the software could have updated, he might not have known about it at the time. However, the level of discomfort on his part demonstrated that he must rarely encounter patients who speak back and ask for transparent and quality, caring appointments. His final words were that I would need a follow up on the condition at-hand in a month and that I could have an appointment with him, or certainly could see my primary care physician. Indeed, I will see my regular physician. 

Speaking back to medical professionals who are too clinical, cold, or fast in meeting with us is something we as patients don't often do. Asking questions is our right. Clarifying information we receive and share with our physicians is our responsibility--at the end of the day we are responsible for our health and we can't be so without understanding what our doctors are telling us. 

Here is an example where I needed to ask for clarification during this most recent appointment. Dr. X used some language that wasn't clear to me when talking about a medication I would need to begin. I asked him to clarify, and he skipped way back in the conversation to explain two medical conditions that didn't apply to me. I stopped him again, and said, no, I wanted clarification about the medicine and its impact on my body. He explained and I thanked him. Here, he said, "No, of course. It's my job to explain these things." 

If you are reading this and are hesitant to ask questions of your physician, please work on finding your voice. It is the physician's job to share information in a way you can understand. If you are unable to hear and understand medical information on your own, please ask a trusted friend or family member to be your ears and voice during appointments. You have this right to ask the questions you have. You may feel that you don't have the words to ask the questions, but start by saying that, "I need more information but I don't know what question to ask." is a find place to begin. The doctor or physician's assistant can help you find the words. 

If your treatment during your visit has been unacceptable to you in any way, you must find your voice and speak to power at the doctor's office. Speaking to power isn't about being rude, angry, or loud, but it is about stepping into that space where we exercise our rights when someone holds power over us by position or knowledge.

A question of faith

Today I submitted a letter of resignation to my parish priest surrendering my seat on the parish council. This was long overdue, and I had intended to do so in August following the council meeting that occurred that month. I have been largely dissatisfied with the work of the council as it seems only to be a receiving or affirming group, not one of forming directions and ideas as it should be. From the first meeting I knew that as a woman I would not have a true voice on the committee. The men who were nominated or appointed members all looked to the two women on the council when the priest asked for a secretary. I took the role because I know myself and as the recorder it's the only way I stay engaged in meetings. When invited to be a part of the council I told the priest in no uncertain terms I would stay one year and one year only. It has been three.

In August the blow that came was the resignation of two male council members. I don't have a problem with their resignation, it was the means by which the priest was seeking to fill their seats that bothered me. Rather than making an announcement that seats were available, he started soliciting names at the council meeting. I suggested that he invite participation--people might want a way to serve. He took the two names, said he would talk with the already overcommitted individuals who were recommended, and moved forward to the next agenda item. Fortunately, at the November meeting they were not announced as new council members, but we did have a new member.

At the November meeting, seven months into the pandemic, and on the heels of his own COVID-19 positive status, the priest and two guests at the meeting started questioning the faith and commitment of parishioners who 'weren't strong' and took the pandemic as a way to stop attending Mass. As I sat there, I realized I am in the group who is still taking advantage of not attending Mass. Comments such as "can go other places" were thrown around. And yet, our diocese has given dispensation for not attending Mass until further notice. I held my tongue but realized I could no longer be a part of the council.

While talking this over at dinner with my DH, I was asked if I wanted to find a new church. I responded that I think so. I know that people are the same wherever you go. However, this feels wrong to stay. I've made no decision on this last point. I will hold it in my thoughts, prayers and meditations for the coming weeks.

You are undone- Ode to an aunt

I am that girl. The one you said would hate her parents in a few years for taking and sharing a photo of me, relaxed and at ease. My tummy protruded more than some at age 4. Your thoughts, judgements, and comments whispered shamed me, not the photo or the joy it captured.

I am that girl. The one you disdained for health problems you imagined on me. The problems that didn’t exist as a child emerged only when you judged and reinforced my size was not to your liking. Your observations and from stand against my own medical reports shamed me, not my otherwise vibrant physical and mental health.

I am that girl. The one whose intuition became sharp as a knife over the years, honed by subtle glances, whispers and laughs that people like you tried to hide, preserving your polite society. My institution protected me yet broke my trust in others, and that need to have trust proven rather than openly given to others shames me still today.

I am that girl. The one who sees what you cannot because I live in the life you projected on me of the shame and hurt it brings when I think of these things. Your actions tell how much you hurt from your own imperfections, those shortcomings you lay on others to lighten your load. I share that burden from you and watch while they contribute to the endless cyclic battle with shame that has followed me every day of my life.

I am that girl. I will stand. For her, the one that have tried to send on that same journey of shame. Whether intentionally or not, your shame will not be her burden. You will not hang your hurt, your own shame and your own judgements on her. It is enough. You are undone.

I will give thanks to You, for I am fearfully and wonderfully made;Wonderful are Your works,And my soul knows it very well.—Psalm 139:14

Lent Reflection: Saturday, March 4

Saturday was a day of travel for me. I woke early and could not sleep and spent time watching some television and was in my head quite a bit. The television I watched was The Americans a show set in the early 1980s about a husband and wife who were brought together as KGB spies to serve undercover in the United States. The couple has grown to love one another after 20 years and while the stress of the job and the fact of the 'job' itself seems to create appearances that they cannot show their love, they do have this quality in their lives.

The focus for my meditation on Saturday was Nik, my dear husband of 20 years. We have been together nearly 30 years, and we've seen the better and some worse, and we still love one another. Most of my actions were dedicated to service of him yesterday. I spent time at the knife outlet in Sevierville getting some things that he wanted for himself and others. It's a labor of love for me to do these things for him. While it has material appearances, it remains as a gesture of love.

Hear, O Israel: the Lord our God is one Lord; 

and you shall love the Lord your God with all your heart, 

and with all your soul, and with all your might. 

And these words which I command you this day shall be upon your heart; 

and you shall teach them diligently to your children, 

and shall talk of them when you sit in your house, 

and when you walk by the way, and when you lie down, 

and when you rise. -- Deuteronomy 6:4-7

In my time thinking about and praying for Nik on Saturday, I am astounded by his constant kindnesses to others. He embraces all the best things that people have to offer and willingly sacrifices where he is able and where it will benefit those who need more than he does. His work in the world is service by nature and he seeks to do nothing more than serve others, even me. I found a tweet that he posted last Monday, when I was home ill and unable to function due to a massive sinus infection.

NikHavert My #mondaymotivation is nursing @mandylyn as she deals with a sinus infection.

It's these small but powerful things that remind me how much I am loved here on Earth and that point to the love beyond imagination that God has for us.

Lent Reflection: Friday, March 3

In addition to my nightly prayer, or Compline, I have added a daily devotion of prayer and meditation for those who are in my life. Thursday, was focus on my dad. Friday was focus on my mom. Compline for Friday included Psalm 87: The prayer of one gravely ill. I hope that my focus on this prayer helped release some of the pain I felt at my mom's illness and passing nearly six years ago. Photos from that time are popping up in my Facebook memories, and it all comes flooding back to me.

Lord, you are in our midsts, we are called by your name. 

Do not desert us, O Lord our God! --Jeremiah 14:9

My work at the conference was good yesterday. My anxiety levels were low. I'm in a place where my parents were together in 1982: Knoxville, Tennessee, the site of the World's Fair. I turned 12 that same year. That was 35 years ago and so much is different. That seems strange to say, really, as change happens every moment in our lives.

I like to think that I'm good at handling change. I'm not any better at it than most people. I stress in the face of change and then put on the brave mask to work through or around it. I spend a lot of time fighting things I can give over and let go. The verse from Jeremiah above tells us how to conquer stress and to ask for help when needed.

Lent Reflection: Ash Wednesday

Wednesday was a day of travel for me. I spent much of the day in transit by car or in the air. I was worried I would miss my flight, so I skipped morning Mass and went to an evening service in my destination city, Knoxville, Tennessee. It was the right thing to do.

The All Saints Catholic Church has a school affiliation and the sanctuary filled to capacity for the 5:00 pm service. The children were singing beautifully off-key and the pastor's homily was spot on for what I needed to hear on this day. He reminded me of the three facets of Lent: Penitence, fasting and almsgiving. I've been bombarded with ideas for Lenten commitments and have chosen one for myself. The reminder of almsgiving though gave me pause. I thought of ways I can be always prepared to give and hope that I can add this in.

My commitment for Lent, however, is including the Compline, or night prayers, from the Liturgy of the Hours in my bedtime routine. Really what my focus and intent is will bring a reflection of my conscience and an emphasis on the day. I hope that this is a habit I can form in 40 days, but if not, I plan to keep practicing.

Do not let resentment lead you into sin; the sunset must not find you still angry. 

Do not give the devil his opportunity. - Ephesians 4:26-27

Last night's prayer and meditation helped me to see that I can use some kindness in some of my relationships, and curiosity as well. Conversation has become difficult with some family because of attitudes and things said in recent months. These aren't things that are related to politics like some strained relationships are experiencing. I have been working through my upset, and it's really more about hearing words that are contrary to life-long beliefs I have had about people in my family, particularly my dad, who I thought had been part of my formation in support of equality in how to treat others. Nik says he's trying to stir things up on purpose, that dad enjoys upsetting me. In either case, it's not right and it's not fun for me. And so my response is to shut it down and not engage in the conversations as fully as I might with others. Why would I want to subject myself to that behavior? And when I've tried to engage on why it's hurtful, wrong or offensive, I get that thrown in my face as well. It's truly difficult for me.

The Laudate app on my phone has the prayer available with the daily Psalms. Find the app in your app store (Apple | Android)

Day 3: What My Voting Districts Look Like

When I went in to vote on Tuesday, my State and Local ballots were mostly familiar to me, but I had not done my due diligence for the State House Representative for my district. I had never hear his name. He was running unopposed. I did not cast a vote.

I went to work, then went home, but in the middle of the day I began thinking about why I hadn't seen the name of the person on the ballot. Where in the district did he hail? I located the district maps for both the State House and State Senate on the Indiana Government site. I was aghast at the district drawing for my Senate district. It was the strangest shape I'd ever seen. I'm in that odd pyramid shape at the top, center of the state. The largest city in the southeast corner of that block is Huntington, Indiana. The uppermost goes to the fringes of the City of Elkhart. The block spans sections of four counties. FOUR. The House District map is much more straightforward but still has its oddities in boundaries.

Indiana State Senate Minority Leader, Timothy Lelane (Democrat) is seeking to simplify the district boundaries through his committee work. I applaud this effort which the linked article extols as a bipartisan collaboration. While I don't believe that this will ensure the state becomes more likely to turn blue during elections, it will still go a long way to helping people understand who their candidates are. By having some modicum of regularity to the boundaries, it's likely more people who are 'like' their fellow district voters will be able to see their commonalities and talk more about issues that matter.

I engaged in fleeting thoughts of seeing what it would mean to run for this State Senate seat, and largely have dismissed the idea. I am not convinced that I could do the work and have the same lifestyle I have now related to family and work. Change would be inevitable. I look forward to sharing with my new State Senator and continuing State House Representative my views, which likely will vary from theirs.