The Comedy, The Tragedy

 

Why are some among us such assholes?

Written on a placard held by a protestor were the words, "Healthcare is a right!". My first thought was that of course it is. Food, shelter, education, to be treated with kindness and compassion... I don't understand why we humans have the need to deny others these things? If we have plenty, why do we argue about this? If we do not, why don't we struggle to share? Why do we create entire systems designed solely to deny these things to one another? Why are we divided along the lines of, "here, you need this" and "I have mine, get your own"?

To be fearless

Her question was a simple one. "How do I find that place where they are more worried about what I think, than I am about what they think?" 

I told her that is the foundation of the greed of wealth.

Small minds with knives

The mediocre with power 

will always preserve their power.

Always.

Cheerleading is sycophancy

Its bad to take one's cheerleading as gospel, and to mistake one's cheerleaders for prophets.

Wolves are not sheep

Do not surround yourself with wolves if what you want are sheep. And do not lament, when the wolves eat your sheep.

The greatest gift

 

The Way

"Be yourself", she said.

"I can't be myself," he lamented without looking up, "it makes them uncomfortable."

They sat quietly for a moment as she thought about this. "They are making you uncomfortable, not being who you really are, doing things how you think they can, should be done. Its exhausting your spirit. I think its killing you."

He sighed, having had this conversation in his head a thousand times, resigned and tired of it.  "They are the power, their comfort matters, not mine. Conform, be what they think a professional in my line of work looks like, speak the proper way, dress the proper way, surround myself with the proper things,"  he said, waving a tattooed arm at the large black and white "Get Shit Done" poster behind him. He waited every day for the corporate email telling him to remove it. "The way as they define it, as if that is what makes all of this work, as if they make this work. There is no room for different colors, different paths, different... visions, in any company that believes it is the one. There is the world as they see it, success is what they say it is, they need to control things, they need people to follow their way, allowing them to assuage their fears. Our fears, mine, my patients, don't really matter, unless it makes for a nice slogan. It makes them nervous allowing their people to have new ideas that are not their own. They expect patients to rise up to their level, instead of coming to where the patients actually live. As if I am supposed to be the shining beacon on the hill, one of the Rescuers, as opposed to one of the people."

"Isn't that their motto, 'new ways of thinking', 'we care about the whole person', 'meeting you where you are', that sort of thing?"

"Believing their cheerleading doesn't make it real. Everyone finds the words to make them look better than the other guy, but they end up all being the same. I suspect at some level, at some point, they really believed it. (That could be wishful thinking...). This is all illusion, none of it is real. Its the theater of medicine. Its a play with a set, a script. It always boils down to business, what works for the business, not patient care. Patient care is a means to an end, a gig." 

He looked up at her and half smiled, she isn't naive. "Someone once said, 'If you want them to listen to you, dress like they do, they will think you are one of them'. I believe that. I believe these troubled, disparaged, and despised people need me to be one of them, or at least not one of them, for them to listen to me, not some starched rod-up-my-ass, supercilious prick, or their "common man" dressed down version of it. I don't see myself as that much different from my patients, just luckier. I don't need to be The Man. I feel it in my heart for them to be able to hear me, to see me, I need to represent their lives to the degree that I can without it becoming ridiculous. I need to show them that I can see them, hear them, understand them, that I know who they are.

"I do recognize that I, to some degree, I need to show them there is a better them in there, to be that example. Patients expect a doctor to look and act a certain way, not because they like it, not because it works, but because they expect it. They expect the system to look like the system because the system told them what it should look like, sound like, be like. The system, expects it to look like the system, they tell all of us what roles to play, dress per the script, stethoscope over my bright white lab coated shoulders. Medicine should taste bad, it should tingle, be in a shiny box, be on TV, thats how you know it works. But there is a point where we take ourselves too seriously, and make ourselves too lofty. We become just another them-not-us voice, just another not them person telling them they are less than, pushing them around, making them dance for their supper. When I do have to push them, I want it to be as one of them, not one of them, doing the pushing. I can't be that person, that them professional person, when I see my patients. I honestly don't think it works well. Fine if they want to be that person, but why do I have to be?"

"Because they have the power."

"Because they have the power...", he reflected thoughtfully. "Do I confrom to keep my job, or do I do what I think is right? 

"You already do. You keep a low profile, keep your mouth shut, more or less, keep your ideas to yourself, let them think you are one of the team, one of them, 'Go team!' ", she said, raising the roof, "buying into the cheerleading."

"Really? Do you not see the poster?"

"I do. I see it as their voice, they see that too, and they appreciate it. Getting shit done is actually the key to their success, and they understand that. It gives them a relateable focus. I like it."

"Hmm... so do they. Took it down once to conform, the patients all complained it was gone so I put it back up. Taught me that I was connecting, I was reaching them where they live.

"Do principles matter?", he asked, as if changing the subject but not.

"Sure," she replied,, "But which ones? The ones that keep you employed, or the ones that make you a better clinician?"

"And that, folks, is burn out." 

"You burned out a long time ago...", she observed with compassion for her damaged friend.

"But I still feel the pain of the scars. Every. Single. Fucking. Day.", he whispered to no one.

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Truth

The truth is, truth is never fully illuminated.

Truth is not fact, though it is based on fact, one presumes.

What is truth for one may not be truth for another, 

yet really, there is only one truth.

We only know our own truth, or so we think.

Our truth explains our fears, ironically.

We defend our truth with fear upon which it is too frequently based,

reaching into the darkness of our unilluminated truth,

grabbing a fear from therein, then wielding it like a sword 

against the fears we have of another's truth,

as if their truth will harm us,

which, sadly, it may.

And we wield it whether or not fitting

for when one has only a hammer, everything is a nail.

This primal need to fight fear with fear

destroys all truths.

Truth is sentience.

It is our greatest strength, our main weakness

that we are blind to this one truth:

all of our fears are the same

that as individuals we flail with our fears,

as family we prevail.

Separate truths ruin everything.

Fear ruins everything.

And this, this is the truth.