Silence of the not-so-sheepish lamb

Silence

Part VI of "Complaint against Dr Alpha and Dr Beta"

Silence is golden, the aphorism says. So does the medical establishment, at least in my experience at Catholic Hospital's Nameless Clinic.

When Dr Alpha expelled me from the Clinic and from all of the Family Medicine Department of the Hospital, he stated his reasons for doing so in terms of my “angry outbursts” (not his causal role in provoking these outbursts, he knowing full well and for a long time my psychiatric profile) and in terms of my “aggressive language.” It was Alpha himself who set the chain of events in motion. I had come to the Clinic for years, quite docile, being ever so careful to concentrate on one thing in a visit, so as not to give the doctor occasion to distract from my priority need at the moment (critiques of bureaucracy and bureaucrats, all recommend this strategy in dealing with them). I had co-operated with supervisor Alpha while the occasional interns were assigned to me and their practice sessions recorded by video (ostensibly to monitor the interns' behaviour, but I wonder). In other words I often enuff was called upon to be a guinea pig for the trainee's practice session on me; I was never recognized nor compensated for this service nor even given a thanks (that woud imply I was a member of the community of patients and doctors at Shameless); I always cooperated in giving this service. So to reduce me to the epithet of just “angry outbursts” on a very few recent occasions, occasions for which I was set up by Alpha's reduction of me because I passionately communicated the hurt and harm he had done me in all the ways itemized, putting me thru the hells of his vacations where I was abandoned to suffer with real pain and then to endure his nonchalant response and refusal of responsiblity when I had to see him in February 2012, and I reacted in real communication by cursing him out. He wants me to be docile? Silent? Well thawt out, sweetly articulate and “scientifically rational”? And he just rises above it in the grandeur of his politesse and megalomania cultivated by bureaucratic scientists within this profession, he establishing the definition and significance of “angry outbursts” from which there is no appeal? Just tosses me into the gutter. He has made all the time thata I have invested in his gaining knowledge of me and the complexity of my illness a worthless endeavour on my part. He just can't acknowledge we're in this process together. There's a community, whether he likes it or not. He's not an individual arbiter of my fate. However dysfunctional the medical community at Shameless has become, he still shoud take co-responsiblity for what has happened between him and me. And, may I mention?, on the same occasion, he flew into a rage himself. He hurts me, I react and curse him, then he reacts, shows emotion, and rages back at me; but he set the whole episode in motion. His own Bad Medicine is the root of my “angry outbursts” and his.

As a taxpayer-patient in poverty I do have freedom of speech just as important as is that of this bureaucrat scientist feeding at the public trough. He wants to run his practice at the Clinic as his own personal fiefdom. But I say: that it is proper for me to rebuke him when he behaves in his potvalient manner, not taking responsibility for his role in the estrangement, hiding behind his scientific mastery and insisting on total control of the dialogue which has to be more than scientific, more than pill-prescribing, more than expert reading of blood-test results. He still has to learn what an inter-human patient/doctor dialogue is, and I take it that his medical training at the University of Toronto Medical School has ill-prepared him for the shifts in theory and practice in medicine that have transpired, and the shifts will increasingly be demanded by the aging population, creating an ever smaller support base in the society upon which to draw in caring for the ballooning population of seniors. He is painfully old-fashioned in his presuppositions about the practice and theory of medicine. So, I reject his effort to silence me by his wording of his “reasons” for expelling me from the community of Nameless Clinic, but I'm still hoping for an inner reformation of the non-scientific side of his practice of medicine. There's a place for “angry outbursts” at the clinic when a doctor engages in harmful practices, including the non-notifications, queuing, herding, and throwing patients into competition to beg for a time slot with him (when he deigns to make himself available to us/them, especially after vacations), when in reality patients' schedules and time-availability are completely their own and require the mutual determination of a date and hour suitable to both, a mutual determination that must be achieved in the dialogue he avoids, in my case a suitable occasion is necessarily due to my well-documented disabilities and the complexity of my illness. Alpha can't dictate when a patient must come in to receive prompt care, especially on Thursday when the patient is in the shower, with a real care-giver at hand to facilitate the weekly cleaning of my body and my subsequent long dry-out of my dermatosic legs so that the new layer of ointment will adhere.

What's more, the second reason Alpha gives for expelling me from the community of patients and doctors at Nameless Shameless Clinic and the entire Catholic Hospital's Family Medicine Department has to do with my “aggressive language.” Look here, now, I survived the orphanage which tried to shut us up from age 6 to 16. I withstood the anti-Semitism of the bullies among my classmates, and tried to protect a Jewish friend whom the bullies wanted to “starve” in the dining room – only to be punished, me punished by the Housemaster (Duke Duncan) who didn't want to upset the anti-semitic status quo. I survived the silencing of women, like my mother, silenced by a brutal stepfather. I survived homophobia which tried to silence all homos and Lesbians. How can I take seriously an accusation that I used aggressive language, when I've been tawt with women and homos to be responsible for myself in the fight against oppression, to be aggressive, stand up for myself, speak out. The language deployed in the letter of expulsion and excommunication without any contextualizing definition of “aggressive language” is disingenuous. It leaves the false impression that I threatened bodily harm. I did not; I cannot threaten such or physically carry out such a thing. So the term used against me is quite false, and intended to convey a false impression. I sent out a cri de coeur, the outcry of the downcast. But Alpha seems so shallow that he coudn't comprehend what he was privileged to hear in all its raw communicative power from the heart, as God is my witness. I will continue to shoutout against the silencers, who seek to kill what little life I have, by excommunicating me from my medical community, then practicing their nitemares of “life” extension whether a patient wants them or not. And thus their paycheques keep rolling in from taxpayers.

So, here I am in the street, so to say, despite all the years I invested in Alpha, his trainees, his residents, the coming and going of the Nameless Shameless doctors looking for a way-station, a stop-gap as they prepare grant applications and look for better jobs in greener pastures. A curse-out and a few shoutouts mostly on the phone, small in number and minutes, are sufficient to just throw me out of the medical system that I inhabit as a taxpayer-patient with a complex illness and a few small special needs, plus a desire for death with dignity. I am not removing my records from Nameless Shameless. I am still a patient there, tho enduring a heart-breaking excommunication and exile; and I have nowhere to send my medical records anyway. The Clinic shoud take me back in, restore me to its institutional community. For the meanwhile, the College of Physicians and Surgeons supplied me a phone number for an agency called MedVisit  (Doctors Housecall Service), from which occasionally a doctor can come to my home and renew Dr Alpha's prescriptions, over the visiting doctor's signature. I don't know how long they will continue to do this, quarter by quarter. An individual doctor can only visit me once. And the MedVisit physicians can never order me blood-tests. So, now, I have no diabetes-opthamologist, no Diabetes Education Initiatve, no Management Committee assistance in setting up a dialogue with the offending doctors, and no blood tests. But I continue to be a taxpayer-patient and still contribute to the incomes of the Nameless Shameless Clinic where I am still part of the patient-doctor community, whether they like it or not. You just can't throw patients away, especially when you've hurt them thru your own fawlty practice of medicine. And obviously I have to do all the work of resisting the Bad Medicine directed against me and of writing this complaint, unpaid. Everybody else is handsomely remunerated, by my standards. They are all protected by multiple layers of unionization, patients are not a party to tripartite negotiations between we patients, the doctors, and the government. We have no union, we are taxpayers-patients with no representation.

Alpha, Beta, and Nameless Clinic's Management Committee can phone me to set up an appointment at a mutually feasible time at my home. I may have to arrange for others to be present as witnesses and even perhaps advocates for my re-instatement. I hope Catholic Hospital's Patient Relations can be present. May the dialogue that never was begin at last. In the mean time, I'm too hurt and insufficiently ambient to try anywhere else for medical help. I'll do what I can to enjoy my last period of life in this society and its pernicious medical culture which refuses to let me die with dignity, by denying me an end-of-life medication to make the transition from life in this world into death (the Interim State before the Ressurection). I'll try to find the pills I need to preserve my dignity at the last moment before I enter the Interim State of Death where, in my “belief system,” I'll have to answer to our Lord Jesus Christ, lousy Christian that I am. I don't want to go searching for the end-of-life medications I will need in the society that has effectively expelled me thru the medical system in the specificity of Nameless Shaneless Clinic of Catholic Hospital and Dr Alpha. I don't want to try to find a blackmarket pill for the needed meds, nor do I want to have to do anything illegal. But I do know that before the last hour, abandoned on every side, cast out as I am, my discouragement will increase, and my energy will decrease. My organs will fail. And one way or another I will die. I don't want to hasten that moment, but I have to set limits on the care-givers who have no care. Insouciance.

I don't want to have to jump in front of a TTC subway train, as did Jane Muller, an acquaintance. I don't want to have to jump off the Don Valley Bridge as did Frank, another acquaintance. I want to die in peace and dignity at a time of my own choosing. I want to get by, for now, on as minimal “care” as I can manage; I regret costing other fellow taxpayers anything (especially thinking of fellow taxpayers-patients). I want perhaps a few more years in which to quietly flourish, aware of the good creation, relishing it. Especially I desire to relish the good creation whereby human society and civilization are possible, where the various societal spheres can conduct their own inner reformations to better fulfill the norms of God's good creation, also in our medical systems in advanced industrial society where the demographics are decidedly against our creating scientific – technological – educated doctors with cultivated inter-human skills in medical dialogue with patients. I've been thru enuff hells on earth to have reason to doubt that the good I envision will happen. But, as Father Gregory Baum, Catholic philosopher of societ,  after acknowledging how deeply pessimistic he'd become, said, “I'm a Christian, so I'm an optimist.”  Hope.

— end of "Complaint against Dr Alpha and Dr Beta" Part VI (6 part series on blog Christian Medical Observations & Ruminations).