Violent Words in a Parking Lot

“You’re an F-ing idiot,” he screamed at the woman, who was obviously frightened at the explosiveness of his outburst. Concerned with neither the woman nor how he appeared to others he screamed the words at her over and over again, gesturing fiercely and menacing in his posture.

The scene played out in the parking lot of a nearby supermarket in plain view of others. The man did not care. It was clear that he wanted everyone around to know that the object of his anger was an “F-ing idiot.” My wife Lisa was witness to the outburst, the man’s words impacting her as she exited her car. She was stunned to see that the recipient of the man’s wrath was an elderly woman who was fearfully standing next to her parked car. Shocked at the intensity of his rage, Lisa waited before going into the store, fearful that the man might do something rash.

As the man continued his repetitive insults Lisa was unable to remain silent. Hoping that the awareness that others were listening would give him pause, and to let the woman know she was not alone, she said, “Excuse me?”

The man turned to her but his anger did not diminish. My wife became a secondary target. He had F-bombs to spare and was apparently willing to hurl them at anyone who did not agree with him. Lisa found herself plotting escape routes if he approached and pondering whether to dial 911.

In the course of the man’s diatribe he revealed the terrible deed the elderly woman had done, the heinous act that caused him to respond so viciously. The woman had stopped her car and waited in the lane as another woman prepared to back out of a parking spot. Mr. Angry was one of those who had to either wait several seconds for the parked car to exit or drive around her.

That was it. A momentary delay in the parking lot. The loss of a few moments of time were enough for the man to unleash his fury, enough for an elderly woman to be publicly derided as an F-ing idiot.

When Lisa shared this story with me we both marveled at the man’s lack of decency. The elderly woman may have been overly cautious in her driving, she may have made a wrong decision and she may have caused others to waste a minute or two. None of those acts made her deserving of public scorn, none had any bearing on her value as a person. It was clear to us that the man’s problem wasn’t just that he didn’t respect the woman, it was that he didn’t respect people. That absence of baseline respect allowed him to attack others for their mistakes, to condemn them for minor slights.

As we talked I thought of how more and more people are becoming like Mr. Angry, thinking only of themselves without regard for the feelings of others. So many people have forgotten the truth that every person, even those who wrong us, is deserving of kindness and respect.

I don’t want to be like Mr. Angry. I want to be better, speak better and think better. I want to view others with respect, not just in parking lots, but even in the privacy of my mind. I intend to do this by working on avoiding derogatory labels for people, to cease with the name calling that is pervasive in our culture. From now on, if someone cuts me off on the freeway, leaves a bad Yelp review, or in any way offends me I resolve to no longer say, “Look what that idiot did!” or “What a jerk!”

I am going to try and say, “Look what that person did.” No adjective, no defamatory comments. I intend to aim my negative comments at actions, not people, to continually remind myself of the personhood of every man and woman I meet, regardless of the rightness of their actions. I want to remember that everyone is a child of God, that everyone has value. As I do my prayer is that my heart will soften, my anger will fade, and a kinder person will emerge over time.

I can’t change Mr. Angry, or the countless others like him, but I can change me, and I intend to.

- Bart

Thanks for reading and for sharing with others. I can be followed on twitter @bartbarrettmd, and those who wish to receive posts via e-mail can do so by subscribing to the blog. Comments and questions are always welcomed.

Gone in a Heartbeat

In April Paul saw the cardiologist for a check-up. He had an electrocardiogram done and for extra measure a nuclear stress test (A radioactive tracer is injected to identify areas of decreased blood flow.) Both tests were normal. His mind at ease, he looked forward to a relaxing summer.

9 weeks later he was dead from a heart attack. He grabbed his chest, told his wife he was having pain, and collapsed. He was gone before he reached the hospital.

His death is a stark reminder of both the fragility of life and the inadequacy of medical science. Death remains certain and our ability to see it coming woefully inept. People like Paul die when we think they will live while others live far longer than expected. (I currently have a patient with widespread cancer. He was told he had less than 6 months to live, so he enrolled in hospice. That was 14 months ago.)

The certainty of death and the uncertainty of its timing seem to have little impact on how many of us go about our lives. We live in denial, planning to live to be 100 and die in our sleep. We put off vacations or delay retirement, focusing on financial goals. We ignore damaged relationships, telling ourselves we will reach out to estranged family and friends “eventually.” Many spend no time at all pondering what happens in the next life presuming eternity is either non-existent or blindly hoping that if it does exist we have been good enough to qualify for a good after-life.

Paul reminds us of the foolishness of this attitude. Tomorrow may never come, the remainder of our lives may be measured in days or hours instead of years. Now is the time to pay attention to our loved ones, mend relationships, and consider eternity, for “now” may be all the time we have left.

- Bart

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Shooting Congressmen

A congressman is fighting for his life in a Washington DC hospital. He and other Republican members of congress were attacked while they practiced for a baseball game. Their attacker did not know them, had never met them, yet had concluded they needed to die. The shooter appointed himself judge, jury and executioner, imposing a death sentence on them for the crime of being conservative.

How did it come to this?

Several thoughts come to mind-

1-      Politics has become too important. When people blame all of their problems on government or look to government to provide all of the answers to their problems, those who oppose their views can be easily demonized. This is true on both sides. When we assign evil motives to our opponents we provide potential justification to harsh actions against them. Yoda said it well, “Anger leads to hate, hate leads to suffering.”

2-      Human life has lost its value. There was a time when people were valued because they were people. People were defined first and foremost by their humanity. Created in the image of God, all people deserved to be treated with dignity and respect. This was why our founding fathers embedded a prohibition against cruel and unusual punishment into our constitution. Even the worst people were thought to be deserving of some degree of dignity.

This is no longer true. We see people being beaten, bullied and attacked for what they believe. Our rhetoric has lost any semblance of dignity and respect. This week I saw a post in which someone called Jeff Sessions a “F-ing D-bag” (abbreviated for politeness.) The attorney general of the United States deserves more respect. He has served his state and the nation for 35 years. While he has been wrong at times (on many occasions I am sure) being wrong does not make you a D-bag. When we reduce people to epithets, when we ignore the good that is in them, we devalue all humanity.

3-      No one listens anymore. Everywhere I look, from the debates in congress to the comments on Facebook posts, I see put downs, insults and personal attacks. Opposing views are mocked and dismissed out of hand. No one seems interested in the truth coming out as much as they are in winning an argument. The resultant “us vs. them” posturing is damaging to our culture. It breeds anger and contempt for others.

It does not have to be this way. We can be better, we can work to focus on the good intentions of others, on their positive contributions and on common goals.

We need to assume the best in others. Both political parties want a better America for all Americans, a better healthcare system, safety for our citizens, education for our children and a thriving economy. We would all do well to remember these shared goals. We may disagree with others on how to achieve them but we need to stop assigning evil motives to those who disagree with us.

We need to remember that people are more important than politics.

- Bart

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The Doctor Won't See You Now. And That's a Good Thing

It has been 6 months since my practice fully embraced digital medicine. Whenever possible we give patients the option of being treated without coming to the office. Several times a week we review text photos of medical conditions from rashes to pink eyes and respond with treatment plans. On a daily basis we treat high blood pressure and diabetes through secure email. Patients whose blood pressure was poorly controlled due to difficulty coming to the office are now perfectly controlled. Being busy is no longer an obstacle to care and patients are responding.

Thinking I am on to something, I have been sharing our new policy with other doctors. Everyone is interested in the idea but most don't think we are charging enough for the service. Our $120 a year annual fee leads to the conclusion that they would lose money if they adopted a similar practice. My reply that patients deserve this more convenient option is not persuasive.

I expected hesitancy and reluctance from my colleagues but one doctor’s response caught me off guard. When I told him that I was only requiring compliant hypertensive patients to come to the office once every two years he replied, “Sure, but you still have them come in for their annual physicals, right?”

I replied with a puzzled expression, “No, people don’t need physicals every year.”

“I know they don’t,” he said, “but we get paid for annual physicals.”

“But why bring them into the office if they don’t need to be there?” I replied, still not following his logic. 

“Because we make money and it doesn’t cost them anything!”

“It costs them a day off of work!” I replied.

After a few more minutes of debate I gave up. We have completely different views on the business of medicine. I walked away from the conversation with a new understanding of the problems our society faces as we try to address increasing health care costs. Doctors and hospital groups talk about lowering costs but want to make as much money as they can. If they get paid to do something most of them are going to do it, even if it is useless. 

It is easy to point fingers at doctors, but they are responding to basic economic instincts. They do what they get paid to do. Which means a large part of the blame should falls on those who pay for medical care. Insurance companies and government programs are a large part of the problem. Misguided wellness programs require healthy young patients to come to the doctor once a year and pay doctors handsomely for the visits. Obamacare requires insurers to offer physicals every year at no cost to the patient. Doctors know a cash cow when they see one and willingly go along with the program.

While willing to spend millions on unnecessary visits for healthy young people, most insurers do not pay anything at all for digital care. Many patients also fail to see the value in the service. When confronted with our annual fee over half of our patients were unwilling to pay the equivalent of $10 a month for the service. Modern healthcare access is not worth as much as their monthly Netflix or latte expenditures. Physicians who want to make a good living are left forcing patients to come to the office unnecessarily, because that is what they get paid for. 

My hope is that my pilot projectwill eventually catch on. As my patients tell their friends about the benefits of digital care perhaps the demand for such services will go up. If it does, other doctors may eventually follow. Even if they don’t, I will continue to provide these services to my patients. Having seen the benefits of this care for my patients I am convinced it is the right thing to do.

- Bart

Thanks for reading and for sharing with others. To read more about our digital access plan, you can read the explanation on my office blog. Comments and questions are welcome.

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Life Lessons from Kathy Griffin

How to ruin your life, as demonstrated by Kathy Griffin

1-      Firmly take a position held by some and rejected by others.

2-      Surround yourself with people who agree with your position.

3-      Only read news reports and websites that share your view.

4-      In private and with your friends mock and belittle those who disagree with you.

5-      Tell yourself that those who disagree with you are not just wrong, but evil, bad, stupid, and less than human.

6-      Take your views public, assuming that everyone agrees with you.

7-      Blame others for the backlash when it comes.

It is easy to say that Kathy Griffin deserves all of the consequences from her symbolic beheading of Donald Trump, to shake our heads and wag our fingers and say she should have known better. The truth is that we are a lot like her. Almost all of us follow the first 5 steps on the list. The difference is that we do not have as big of a platform on which to display our ignorance and arrogance.

If there is a lesson to learn it is that we should question ourselves more and attack others less, and that we should strive to treat everyone with respect, especially those with whom we disagree.

-          Bart