Empty Style

When she was five, she wore a purple polka dot bikini, prompting her best friend’s grandpa to christen her Miss America. At a doctor’s appointment, she soon learned of a thing called “fat” and how it made others mean and ashamed. It was a word used to describe her, and she never wore a bikini again. Instead she wore leggings and colorful tunics or shapeless dresses procured from garage sales.  She was a majorette who marched in her small town’s centennial parade wearing white shorts that were too big in the hips and went down to her knees, while her fellow twirlers lifted their knees in time with their skinny mid-thighs bare and proud.

When she was 10, she owned just a few articles of clothing that fit: a pair of jeans, black shorts, and a homemade denim skirt that was quickly going out of fashion. She was able to rotate four tops she had in order to make different outfits. She was still called fat, but now she was also called poor. What she sh0uld have been called was neglected.

When she was 17, she secured her first job and soon, her first credit card. Gone were the teenage years of wearing men’s surf shirts and jeans as she was able to patronize retail establishments with clothes that fit her fat, shameful, poor, neglected body.  She found boot cut jeans, a lace shirt she later wore to a Madonna concert, a purple v-neck top with bell sleeves that she wore until it unraveled.  Soon she bought her first pantsuit- black and pinstriped- and it was in that suit she secured her first professional job and launched her career.

When she was 30, her frame had lost nearly 100 pounds and a size 8 fit her like a dream. She indulged in beautiful wrap dresses, vintage-inspired dresses, a sumptuous purple blazer, and knee high brown leather boots that laced up the front. No longer was she seen as that shameful, ugly, mean thing called “fat” that she learned about from the pediatrician all those years ago. Instead others saw her as a competent, attractive, desirable, well-dressed professional woman, who flitted down the halls of the company turning all of the men’s heads and little else. Her rare style may have beckoned to them, but inside she was still full of walls made from bricks of shame, neglect, and ugliness. The men ran into this wall on the regular, and so she spent her time alone, adorned with style but without the love, companionship, and connections that enrich a life and fill it with joy.

(In response to Daily Prompt: Stylish )

The Purpose

The hospital where I was originally treated reached out to me recently on Twitter after I posted an acerbic comment about their upcoming partnership with a nationally known hospital. They asked me to contact them via DM to discuss why I have a negative view of their institution. This is laughable. For real, I am laughing to myself right now. Why do I have a negative view of your institution? Oh, let me count the ways!

I have chosen not to respond thus far out of fear of identifying myself. The details are in the risk management files and the physician who managed it all those years ago still manages it. We even spoke personally. If anyone cared all that much, and I don’t know that they would, it would snowball from there all the way downhill to Dr. Overinvolved. That’s my overarching concern. Him. I don’t want him to know how deeply he affected me.

However, I do think of myself as an advocate to some extent. Coming from that perspective, I should respond. I think I would skip the details and simply say that I was psychologically injured by medical mistakes and that the hospital and physicians deployed the “deny and defend” method of coping with incidents instead of engaging in open dialogue. The end.

Beneficence

On days when I am burnt out on the gym and it is too hot for me to hike in the mountains, I walk along the beach near my apartment. Sunday was one such day. As I strode down Main Street to the walking path, down the Strand and back, my mine wandered from work, to foregoing graduate school, to whether I should move again or not, to cancer, to Dr. Overinvolved, what it would be like to not be alone, and other mundane topics.

On my way back home, the waves crashing nearby, I found myself replaying the day I had radiation treatment. It’s been on my mind lately as it became a discussion topic in a health advocacy class I recently took about crisis, communication, and informed consent. I meant to tell a different story that day, but as I started writing, something occurred to me. Dr. Overinvolved never provided an opinion about whether I should have radiation or not. He said he could go either way and it was up to me. I was anxiety-ridden and traumatized, so I was most interested in reducing my long-term risk. Of course I pursued it! My tumor marker was a little jumpy, just as it is now, so I said yes, let’s do it. I knew the risks and I had read all the research. But he never said, “You should have this.” or “You should not have this.”

So what was he being paid for, exactly?

In one of the many books I have read about professional boundaries, one of the precursors of boundary violations is a professional who is uncomfortable with his/her power and authority. The professional is either too distant by denying the importance of the professional relationship or tries to be less in charge by denying his own power and authority (equalizing the relationship). Both are for the comfort level of the professional, not for the good of the client and both destroys boundaries that protects clients like me.

On this day, he and I walked out of the exam room together and out into the crowded lobby to take the elevator down to the basement where he would give me the radiation pill. We were out of context and he felt hugely present to me. I could feel him next to me as we stood in the elevator, even though we weren’t touching at all and I felt safe, protected, bolstered, and strong. We arrived at basement level and he pointed at the chair I was to sit in. As I scurried over, he knocked on a door and a man came out of a little room. He was the radiation tech. He confirmed my identity and what dose I was to receive, then told us to wait. Dr. Overinvolved sat in the chair next to me and pretended to read my file, glasses on his nose. I remember glancing over and thinking, “I hope that’s stimulating reading material.” The tech reappeared with a clipboard and a form that asked questions about pregnancy and breast feeding. Dr. Overinvolved sprang into action.

“Why does she have to fill that out?” asked Dr. Overinvolved

“All women of childbearing age have to fill it out,” replied the tech.

“It’s unnecessary,” said Dr. Overinvolved, becoming clearly agitated.

“She has to,” replied the tech.

“Her pregnancy test was negative, you know!” yelled Dr. Overinvolved.

“She has to fill it out!” And with that, the tech went back into his little room, slamming the door behind him. I sat there, bewildered, clipboard in hand and said quietly, “Ooookay, guess I better…fill…this…out.” It took five seconds for me to check off every single “no” box on the form. He didn’t say anything.

That’s not weird at all. Nope. Not one bit.

We finally went into the little room with the tech where he handed me a cup with a dust-filled capsule in it. I swallowed it. We all stood there for a few minutes to make sure I didn’t throw it up, then we got in the elevator. When we arrived at the first floor and the door opened, he said something about when I would have a scan and that someone would call me. I was walking away from him with my back turned as he spoke, since I was going to be emitting gamma rays very shortly. I looked back over my shoulder at him and smiled to let him know I heard him. He was walking backwards very slowly, watching me walk away, and his face just lit up with the brightest, most sincere smile I had ever seen from him. I thought to myself, “Wow.”

I didn’t know it at the time, but that was the last time I would see him.

I felt that everything was finally finished. That was one of my reasons for choosing radiation. It was common for all thyroid cancer patients to have radiation and since I did not, I felt that my treatment was incomplete somehow, that the possibility of something lurking was strong. A lot of my fears that were at play when I chose radiation came true anyway. My tumor marker never went away and it is not stable, making my follow up difficult, which means I have worried about something lurking, though not so much since the second opinion.

As for him, I find it very hard to believe he has acted like this before and it has gone unnoticed. This wasn’t the first time I witnessed him yell at the staff, either. Once he yelled at a nurse for giving him the wrong file and he used patient names in front of me too, like he was giving me a glimpse behind the curtain. At some level I must have given him some relief from the stress and responsibility of his job, or he saw me as someone who could do that for him. I always made a point to tell him that he helped me because I don’t think many of his patients ever got better. But me, I am the former fat girl cancer survivor success story! I was on track to become one of his diabetes patients and instead, I became once of his cancer patients and lost nearly 100 pounds, all at once, and while doing that, I taught myself all of the terminology and standard treatment protocol for my disease. He once said to me, “You know more about this than any of my other thyroid cancer patients!” He sounded impressed and I beamed at him.

As for me, I know that I am “guilty” of trying to equalize the relationship by doing this as well as care taking him to some extent. I had spent a lifetime playing up to authority figures and ministering to their needs in order to garner their approval. I was nobody’s daughter, just a lens that others used to see their own reflection. I was abused, not valued, and I internalized all of it.  If I were just “good” enough, maybe I could get that approval and treatment I deserved.  I attached to him like a barnacle because he validated me, he saw me and I am ashamed of that, of the thrill it gave me.

When I presented a portion of this scenario to my class (me taking the full responsibility for choosing radiation or not), they responded by saying I did not give informed consent and that he was trying to further his own agenda at the expense of my medical care. The word “neglect” was used more than once, a word I would never have imagined using, yet it fits. I can chalk it up to another instance when “the only good one involved in my care” did not demonstrate beneficence. My ambivalence persists.

The Light in the Dark

 

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I don’t remember when I first learned the words “transference” and “counter-transference.” What I do remember is that my therapist did not want to discuss those words or their definitions, and she definitely did not want to discuss my relationship with Dr. Overinvolved in those terms. I wanted to.  I liked those terms because they offered such a convenient and scientific way to explain it, though they offered no way to overcome it.

When he first began paying attention to me, I felt so special and so alive (even as I repeatedly pushed his penchant for frotturism out of mind). Everything was magnified, I felt like I saw all of the colors in the world for the first time, in bright, dazzling detail. I thought, is this what it feels like when it’s real? When someone feels sincere emotions towards you and expresses them?  I used to say he had an open heart and that he wasn’t afraid of feeling. I have been called stoic, bullet proof, indestructible, harsh, and probably, without my knowing, “heinous bitch.”  I saw Dr. Overinvolved as enlightened compared to me, not emotionally stunted or fearful like me.  This was my chance to learn to not be afraid anymore.

When I told him what happened to me, I told him in writing and I purposely bled (hypothetically) all over the pages of that letter. I was trying not to be afraid anymore. The story was too raw to tell completely in person, though I had tried. He told me he had PTSD as well. That he had terrible nightmares and that he consoled himself after waking from these terrible nightmares by thinking, “Thank goodness that was just a dream.”  I remember looking up at him and it was the first time he ever really appeared human to me. It was the expression on his face; he had softened considerably. He wanted me to be okay, he needed me to be okay.

When he received my letter he called me, overexcited and wound up, saying, “I wish I had been there” and I nearly fell out of my chair. Finally. Someone wanted to save me.

There were so many nights, back when I still had my own horrific nightmares, when I would be awake at 3am, staring west into the night sky, elbows on the window sill,  thinking of him and wondering if he was up as well.

This is what I think of when I think of him fondly; all of this is what I was thinking of when Dr. Second Opinion said he knew him and that he was a good guy and I agreed. This is what likely kept my PTSD from being worse than it is.

I thought he hung the moon.

But to believe that, I had to push the sexually overt and covert aspects of his behavior out of mind, the things that he said that were too sexual, the physical examination where he was too close to me and too languid and sensual with his touch. These incursions I enjoyed while simultaneously knowing they were in direct conflict with his proscribed role in my life. That is not an easy place to be as he was still the authority figure; still the one with all the power.

Dr. Overinvolved brought so much light, but so much darkness as well. Far from being an Alaska summer or winter, where one or the other wins out, it was more like autumn, the day filled with equal parts of both. I accept it, but I cannot stop digging for an explanation in the pile of crispy, golden fallen leaves that litters his suburban lawn.