A relatively young man comes to see me.
Problems, a bit intricate, I type a thorough
history as we talk. I make suggestions
and he is to return in a few weeks.
He receives a copy of the note and plan
spit out by the printer.
He returns. There is a pain component.
He does not bring the journal I suggested.
He seems no better. I add a little to the plan
and suggest that he return again.
And again and again. Fourth visit. No journal.
“What have you tried that I have suggested?”
He replies, “I haven’t read your notes yet.”
“You haven’t read my notes yet? In three months?
I’ll tell you what: how about you return after
you read my notes and try some
of my suggestions. Why come in if you aren’t interested
in trying anything?” I do not go to rage.
It is not my problem. It is his problem.
If he doesn’t like the plan or doesn’t want to read
(yes he can read) or doesn’t want change,
that is his choice. Don’t waste my time.
He does not return.
It is a mystery. What did he want?
Why didn’t he tell me if he wanted something else?
If it was opiates perhaps he asked around
and decided I am the wrong “provider”
since I am very careful about those provisions.
A mystery. I wonder if it could have played out differently. Then I let it go and move on.
This too I want to remember. Discussions of the world together. The mysteries of science and sweatpants strings. String theory and medicine, cabbages and kings. Why the sea is boiling hot and whether pigs have wings. This too I want to remember.
When I first think about divorce, I call my sister.
I say, “I am thinking about a divorce.”
She replies, “YOU don’t want to be a single mom.”
I think, well, crap, that is true. Me: “I AM a single mom. It’s just that one of them is FIFTY.”
My sister proceeds to tell me how difficult it is to be a single mother.
I have to self examine my OWN prejudices against single mothers.
Then I wade in, to solo and couples counseling, for a year. My ex fires our couples counselor after a YEAR. He says the counselor is on my side. “We have been talking to him for a year!” I protest.
“I want a new one,” says my then husband.
I find a new one. I am filling out the paperwork. It asks, what is your goal?
That is the moment I decide: I write “Amicable divorce.”
The two years before that moment, I am not sure. I am trying very very hard to see if it can be fixed. But it takes two to tango and my then husband will not tango. Not one step.
We were each attracted to something specific in the other person. My then husband did not want to work at any sort of traditional job. His father would come home angry from work for years. I loved working, always.
I was a terribly serious child, growing up in an alcoholic family, and I have food insecurity. That is, at some deep level, I always worry about whether there will be food. When I meet my then husband he says that his goal is “To have fun every day.”
This slays me. Have fun? And he WAS fun. Biking, jitterbug dancing, he was a tennis and golf pro, he was smart, well read, divorced from a marriage of convenience to a lesbian to cover so she could be a small town librarian. Really? Yes, really. I demanded to see the divorce papers before we got married. My then husband thought I was very very funny and I thought he was too.
When we divorce, people tell me he will never pay child support. He won’t stay in contact with the kids. There are a lot of opinions.
Wrong, wrong, wrong. My ex returns to school, gets a “displaced homemaker scholarship” because he was a househusband (yeah, I said he was smart). He goes to nursing school and gets an RN. “You’ve yammered about medicine at me for fourteen years, I might as well.”
He gave me hell about us living in an “old person’s” town. Then in nursing school he calls. “Hey, I’m doing a rotation. Guess what it is.”
“Don’t know, what?”
“I LOVE these OLD PEOPLE.” he says. And he DOES. He is wonderful with them. He works in a nursing home for years. He gives scholarships to the medical assistants when they leave for nursing school. He brings coffee to his medical assistants and the other staff. He drives by on his day off because one elderly woman will only take her medicine if he gives it to her. He gets pianos for the nursing homes. He does memory loss concerts, where he tries to engage memory loss folks. We store music as entire songs, or entire albums, so if someone starts a song, they can often go through the whole thing. He can sometimes get someone singing who no longer can string a sentence together. Families love it.
Early in covid he calls me. “I have covid.”
“Sh-t.” I say. “Are you ok?”
“Oh, yeah. Everyone at the facility has it. Two staff didn’t so we sent them home. We are working sick because there isn’t anyone else.”
“Yeah, it’s a little depressing. My memory loss folks can look ok at the start of the shift and are dead by the end.”
A quarter of the patients die. This is before the vaccine. My ex sails through covid, says he doesn’t feel bad, for him it’s just a cold. He says, “I miss some of them.” Yeah, holy crap.
So another hero. And he paid the child support every single month and stayed in touch with his kids in his own odd way. “Mom, he tells me about his golf shots,” says my daughter. I laugh, “Yeah. Well, he loves you.” “I don’t care about golf.” she says. “I know, me either,” I say.
The photograph was taken with my camera by my friend Amelia in 2014, I think. It is me and my ex, seven years after the divorce was final.
I read this to my ex prior to posting. Posted with his approval.
A physician says to me, “You might have had more friends and been more successful in your career if you had been put on medication a long time ago.”
I think, “You f—ing bitch.” Nothing shows on my face. The doctor face is pleasant on the surface and the stone face that guards my feelings is deeper. I could show you the snakes and you would turn to stone but I would go to jail.
Your words don’t go away. They fester, a deep deep wound. I ask my other doctor, “If my only symptom of pneumonia is my mood, no white count, no fever, how would I know if I had pneumonia if I were medicated?”
I think back. Age twenty five with belly pain, emergency room, CT scan and then a sigmoidoscopy. I couldn’t eat, it hurt so bad. The emergency room offers me valium. “No,” I say, “my father is an alcoholic. I won’t take that.” I am sent to counseling. The counselor, smug, blonde, polished, wants to send me to her husband, a psychiatrist, for drugs. “No,” I say, “my father is an alcoholic. I want talk therapy not drugs.” I am very very afraid.
Things get better. I tell the counselor thank you. “You can’t stop now,” she says, “You must continue the counseling. Or you will have problems later on.” I go once more. She says I must keep coming. I speak to a family friend, a PhD psychologist, who encourages me to say no. I cancel. No regrets.
I am not an alcoholic. I don’t smoke. I don’t use pot nor CBD. I never tried cocaine or meth or opioids or crack. I can tell an addict by their charm: the sick people are not charming nor the people in for maintenance. The moment a person tries to charm me I wonder what they want.
The physician is wrong and cruel besides. Valium is addictive and is still overused. I could have taken the path of psychiatric medicine but I chose not to.
I will find another doctor who is less stupid and cruel. They do exist. I know, because I am one.
One thing that makes me gloomy, as a Family Practice Physician: the only person who has read my medical notes from the multiple specialists is ME.
Since March 2021, I have seen Family Practice, Cardiology, Pulmonology, Infectious Disease, Immunology and Psychiatry. I am in a rural area, so this involves three different hospital systems. They all use the EPIC electronic medical record, but they won’t release information to each other. I have gotten two of them hooked together under ONE of my names and passwords but guess what: my primary care physicain can’t see the notes from the other sites. Only I can. “Proprietary infromation.” Hey, you stupid medical non-systems, this is MY healthcare, MY notes, and YOU SUCK.
My primary care physician COULD request the notes from my pulmonologist but she hasn’t. I find this incomprehensible. I have been on oxygen for over a year. I guess my doctor frankly doesn’t care. Has she farmed my lungs out to pulmonology and doesn’t have to pay attention any more? My goal in practice was to have all of the specialists’ notes. If that was five different specialists, I requested them. Ok, it is next to impossible to get psychiatry notes. I keep wondering if psychiatrists really write notes. The patients never seem to know what diagnosis the psychiatrist is using. One hundred percent of the people that I have seen put on an (addictive) benzodiazepine say that it is for sleep. Meanwhile, at the conferences, the psychiatrists say that primary care should not give the patients benzodiazepines for sleep. I raise my hand: “Even when you psychiatrists have started them? The patients all say it’s for sleep. We don’t know WHAT you have them on it for.” When I try to stop the benzo, the patient has a fit and says that psychiatry said they have to have it. And the psychiatrist has retired or left or changed the phone number and there are no notes ever.
Anyhow, I am counting up specialists. I had really bad strep A pneumonia in 2012 and 2014. Since 2012 I have seen 20 specialists. That is counting the three Family Practitioners, because Family Practice is a specialty too. I thought it was about taking care of the whole person, which to me means reading all the specialists notes, but not one of the ones I have been to has done that.
So the medical system is an abject failure. I blame the US citizens. We choose the system with our votes. We need medicare for all, single payer healthcare, and one electronic medical record for all of the United States. Right now, there is a push to privatize medicare and turn it over to For Profit. We need to fight this and we need to demand better healthcare. Hospital organizations should not be refusing to send my clinic note to my primary care doctor. It is stupid and bad care.
Refugees welcome - Flüchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflüchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
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