In every argument, there’s a moment when you choose to fight. It may not seem a choice, because the moment is fleeting and the decision may not be a conscious one.
But choose you still do. I call such moments “choice points,” because with awareness, you can notice them and make a thoughtful choice about how to proceed. Unlike, for instance, the doctor in the following story.
My friend and fellow mediator, Vickie Pynchon, has been blogging the experience of her father’s end of life in an emotionally wrenching and deeply loving series of posts, Negotiating Life’s End. The following excerpt, from Part Two, begins with Vickie’s learning that her dad has been taken to the hospital. She rushes there too.
I arrived at my father’s hospital room at the same time Dad’s primary physician, Dr. X was making his rounds. I introduced myself as Don Pike’s daughter and asked about my Dad’s condition. For reasons I didn’t understand, this seemed to irritate Dr. X.
“What do you want to know?” he asked, eyeing me suspiciously. “Your step-mother has already decided what will happen.”
“And what is that?” I asked, not having yet had the opportunity to speak with my step-mother since our cell-phone conversation fifteen minutes earlier. Something must have changed in the interim.
“It’s quite simple,” said the doctor, as if he were speaking to a child. “Your father can’t swallow. His wife doesn’t want the hospital to insert a feeding tube. We’ll send him home with morphine to ease the pain. Without food, he will quickly die of renal failure.”
They say anxiety interferes with the functioning of the brain’s higher “executive” functions. So I wan’t thinking very clearly.
“You’re going to let him die of starvation?” I asked. “I mean,” I was almost stuttering now, “you’re gong to starve him? Why? What is his prognosis?”
Though the word “starvation” carried the most emotional wallop for me, it appeared to be my use of the word “prognosis” that disturbed Dr. X.
“Prognosis?” he asked, glaring at me now. “Prognosis? He’s in the last stages of Parkinson’s disease. That’s his PROG-NO-SIS.”
Did you notice where Doctor X chose to fight, transforming what was about to be a pivotal and important conversation into an escalated, emotionally charged event? It was when he said, “What do you want to know?…Your step-mother has already decided what will happen.” When I first saw that line, I knew it for what it was and felt such pain for what would come next.
Vickie, no doubt very distraught, had asked about her father’s condition. Instead of answering her question, the doctor chose to fight with a message carrying these subtexts, which Vickie heard loud and clear:
- I’m not going to answer you because doing so may open the door for you to think you have some decision making power here.
- You have no legal standing here. Only your stepmother does. So I’m going to point that out first, lest you are clueless.
- I am suspicious of you. Are you one of those people who’s about to make my job more difficult?
Ironically, of course, the physican made his own job much more difficult all by himself — and upped the suffering level for Vickie in the process.
Did he do it intentionally? I doubt it. But benign intention doesn’t sanitize bad impact (with a generous nod to Stone, Patton and Heen for the succinct phrasing). He did it reactively, operating to protect himself and control where he thought the conversation was going. I imagine he did so because of difficult prior experiences with other patients’ families. Families that were not Vickie’s.
What could and should this physician have said instead? The options are almost endless. A few that occur to me are:
- Vickie, you must be upset. Here, let’s sit down a minute…
- Vickie, your stepmother is here too. Let’s talk this through together.
- Vickie, I have an emergency down the hall and promise I’ll be back as soon as I possibly can so I can answer all your questions.
- Vickie, let me give you a hug.
At the next choice point you face, will you notice it? And what will you say instead?
Thank you, Vickie, for allowing me to write about your story. Big, warm hug that reaches from New Hampshire all the way to California, my friend.