Month: March 2015

“It’s Confidential”      

 “Please refrain from talking about…”

“Please be sensitive to others by not discussing….”

“I really cannot answer that question.”             

“I can’t comment”

“You shouldn’t ask those sorts of questions…….you know it’s confidential” 

     Haven’t we all heard things like this?  At work, church, school, organizations with which we are involved, and probably a myriad of other places too.

     Most of the time this isn’t a big deal.  It’s not said with any malice.  It is often a statement of fact and that is the end of it.  However, there are other times when being told something is “confidential” or being told to “refrain from speaking about…” leaves one with an uncomfortable sensation in the gut.  Although I might not be able to articulate exactly what is causing my intestinal distress, I know “something” just isn’t  quite right.  But, what is it?  I have only recently started to gain headway in sorting it out.

      A recent experience in which I was told that I “should refrain from discussing…” has helped me come to some conclusions about why one situation makes me feel disgusting and ashamed and another does not.  So, please bear with me as I try to sort this out in written form.

      In one situation, statements as those above communicate a need to keep something private and are said with no shame in the declaration and no shame or embarrassment made on the person doing the asking.  The statement is just a fact; I can’t talk about it.  I have no need to judge the reason for the question or request and I know exactly who, what, and why the information is being protected and that is easily stated.  If this conversation happens in person,  I can easily look the person in the face, smile, answer honestly, and if possible or appropriate, even engage in small pleasantries with the person doing the asking.  Further, if there is any possible remedy to the situation, it is generally easily visible.  It’s simple.  No shame. No embarrassment. No coercion.  Annoyance is possible,  but even that is generally self-limited.  What does this type of situation look like?  Let me give you an example.

      I am the nurse on duty at the hospital.  I answer the phone at the nurses’ desk and  a man identifies himself as Don Jones .  He tells me that he is calling to check on his friend Bob Smith.   Don asks how Bob is doing.  I don’t have to judge the reason why Don is calling and asking because it doesn’t really matter.  I can’t tell Don anything about Bob.  But, I also have no reason to make Don feel badly that he has called to check on his friend.  In fact, I can easily try to make Don feel better by empathizing with him that he cares about his friend and that I have no reason to judge his intentions.       I can simply and kindly say something like, “Oh, I’m so sorry, but I can’t tell you about Bob’s condition. [initial refusal]. The patient confidentiality rules and HIPPA laws prevent me from giving out patient information to people unless specifically authorized by the patient. [Simple, honest, reasonable, well-known reason.  There is no shaming of Bob involved.  Bob could ask the same question as many times as he wants, my answer will remain the same.].  But, I can connect you to Bob’s room and you can speak to him directly about how he is doing. Please hold. [Possible remedy to situation].

      But, let me give you another possible made-up example of the other kind of confidentiality.

      An employee at my child’s daycare has been placed on a leave of absence with no reason given to explain why.  Is he ill?  Misconduct?  Did his mother die?  What?

     Of course, the leave of absence with no explanation leads to many questions as this daycare provider was well-liked and engaged with many of the children.  So, people start asking questions—-of other parents, of other caregivers, of ancillary staff,  administration.   “Where is George? What is wrong with George?  Will George be returning?  My child is asking about George. What should I tell him/her?”

      Eventually, these questions will be asked of someone who knows something about the situation with George.  When I ask this person, he/she won’t quite look at my face.  The person may abruptly change the subject making as if I just asked who passed the malodorous flatulence thus pretending to save me from embarrassment, but rather it leaves me feeling very embarrassed.  What did I do wrong?  When I ask again regarding George, no matter what the question asked actually  is, eventually the response will be given with a blank facial expression and little eye contact  and will go something like this:  “This is a confidential matter.  I can’t talk about it.  Please refrain from discussing it any further for anyone.”

   Such an answer is given with no effort at connecting with the person asking the question, the answer lacks a full degree of reasonableness, few, if any, reasons are given, and it leaves the person asking the question baffled, embarrassed, sometimes feeling chastised or degraded, or even fearful  for asking a simple question.  It is clear that the person answering the question has judged quite harshly the reason why the question is being asked.  There is no possible remedy given.

     What??!!  What rules say the information cannot be shared?  Can you tell me a law?  Why??  Why am I being shamed for asking?  Why is there no empathy for the reason why the question is being asked?  Why am I being given a coercive directive about what I can ask in the future?  Why is a simple question being judged as “discussing?”  Why is it necessary to place yourself in an artificial position of greater power?  What specifically is confidential???  Why is the assumption that my intent is malicious?  Why is there no possible remedy?  Why am I being told who and about what I can talk with in the future?  The person asking walks away feeling very icky.

       And most importantly, who or what is the intention of the protection???

    To me, I think the biggest differences between the two situations are the motives for refusal to answer and the clarity (or lack of clarity) of who and what is supposedly being protected.  The more I am unable to figure out these two points and the ‘ickier’ the pit of my stomach feels, the more sure I am that the reason I am being told something is confidential or should not be talked about is as malodorous as post-baked-bean flatulence.  And, as such, what might have been asked as a simple and innocent question now becomes something I really want to know.  Now, there are so many more important questions to ask:  Why don’t you want me to know?  Why can’t you give me a rule/law/policy regarding why you can’t answer?  Why won’t you look at me?  Why do you have to puff yourself up into an air of authority which may or may not be real?  Why is there no possible remedy?  Why can’t you tell me exactly who and what is being protected?  What makes you think you can tell me who I can talk with in the future and about what topics??

    For me, the conclusion is:  You are protecting yourself because you are doing something wrong.  Period.  That’s my metric.  If you give me no other ruler to use, then you measure out a devious,  dishonest , and potentially dangerous person.  I now have become the witness to an injustice, until proven otherwise, and I will not remain silent.   Now, the only remedy I see as acceptable is the full light of day on the situation.

* All names and situations are fictional. 

 Hello!

This may seem like a morbid post with which to begin, but really, it isn’t.  Honest.

In his book, “Seven Habits of Highly Effective People,” Stephen Covey states that Habit #2 is: “Begin with the end in mind.” He says this can help guide a person’s actions in a similar way that a mission statement might guide a company or organization.  I took the concept to its farthest outlying implication.  The farthest outlying “end” is, of course, death. So, the implication became, what kind of death do I want?I’m familiar with death.  As an RN, I sometimes care for patients as they near death and I have had a front-row observational seat to many, many different ways different people have experienced death.  I believe it is an honor for me to be present with others–both patients and their families–through the death and dying process.  Some people approach death with grace and beauty and others fight an ugly losing battle with it.  Sometimes my job becomes trying to help people reach some sort of truce with death.  Sometimes I am successful and other times I am not.  Regardless, over the years, I have made a vision of my own of what I want my “end” to be.

This is it:

I stepped out of the shower and immediately knew that everyone was correct:  I shouldn’t have even tried to take a shower by myself.  I’m just too sick.  I sat on the edge of the bathtub breathing slowly trying not to faint.  Finally, the light-headedness began to pass and I opened my eyes and saw myself in the mirror.  I looked old.

“I am old,”  I said out loud to myself.

I turned eighty on my last birthday and no one thought I would live that long after I was diagnosed with malignant skin cancer two years ago.  I hadn’t really believed I would live to be eighty either, but I did and now I can’t even take a shower by myself. 

I was tired of fighting cancer.  I looked at the lesions on my arms and neck which seemed to grow uglier every day.  I was glad I was dying from something  caused from outside of me.  I had always expected to die from something bad from within—-ovarian or breast cancer, stroke, heart attack—-you know, the big ones. But, no, I had the small consolation of being condemned to death by a disease caused by the sun.  I was okay with that.  At least I didn’t have to believe I was dying because of some “toxic waste” or “badness” that I had always believed resided deep inside the core of who I am. 

I took one last deep breath and put on the flannel nightgown with the pink flowers that Greg had given me for my last birthday.  What a good man he has always been.  Even at eighty years old, he was still telling me how beautiful I am despite the wrinkles and the cancer lesions.  Instead of just smiling like I have for years when he says nice things like that to me, I had kissed him and said a simple, “thank you.”  He was surprised I responded this way to his compliment and I jokingly told him, “Even I have a few surprises left, you know!”

Next, I wrapped the big cotton, fluffy, soft white robe around me that Judah had given me years and years ago.  He has always known the meaning of a soft touch and he was good at expressing that softness even with his gifts.  I staggered out of the bathroom and into the arms of Olivia and Joseph and into a scolding from Olivia. 

“Oh Mom!  You know you should let us help you!  You are too weak to be doing such things on your own!”

The two helped me to the living room where the children had moved my bed months ago.  I refused to get a hospital bed.  Even though the children were annoyed by this decision, Greg had quietly and assertively supported my decision.  He knew what I always wanted. 

Joseph guided me to the side of the bed and helped me to lie down.  Olivia fussed with the pillows and blankets making sure they were neat and straight.  I smiled to myself thinking that is exactly the sort of thing I would have done fifty years earlier.  I could hear Nicholas and Teresa in the kitchen laughing and teasing each other.  Nicholas always knew how to push people’s buttons, but at least Teresa seemed to enjoy it and would give it back to him a bit.  Olivia went to hush them, but I held her arm and whispered, “It has been noisy and loud in this house for years, why change it now?”  She smiled and rolled her eyes and I tried to laugh at her. 

I was tired and hurting and she knew it.  Within a few minutes Greg slowly came up the stairs bringing with him the injection of morphine which would ease the pain to the background again.  He was the only person I allowed to give me the shot.  He knew it was more than just an injection of medicine and so did I.  We knew it was my expression of my total trust in him—-something which had taken years to develop.  So now, with so much open and gone from us due to age and cancer and children thinking they know best, it was one of the few ways that trust was expressed between us.  I rolled slightly so he could inject the medicine into my hip and just before he put the needle in, I said, as I always do now, “Don’t poke herself with that needle!”“Oh!!  For heaven’s sake!!  It’s been fifty years since I did that and you are still teasing me about it!” But, when I looked at his face, I could see he was laughing too.

Judah, who had been sitting quietly in the rocking chair, finally spoke, “Tell the story again, Momma.”

They all liked to hear the story:  the story of the fertility shots Greg had to give me every night when we were trying to conceive.  And, about the time Greg, in his nervousness, dropped the needle into the palm of his own hand.  I had insisted the medication was just too expensive to waste, so we changed the needle and he gave me the shot anyway.  They all laughed!  I heard them laughing as the morphine took its effect and I drifted off to sleep. 

When I woke a while later, the shadows had lengthened and it was quiet.  Joseph and Greg were reading on the couch by my bed.  How alike they are!  Judah remained in the rocking chair dozing.  Nicholas and Olivia were in the kitchen making soup.  Well, Olivia was making soup.  Nicholas was getting in her way teasing her.  And, my sweet Teresa was typing at the computer putting her thoughts to paper just as I have always done.  We had gotten a lot of criticism when I became pregnant with her, but she had brought immeasurable joy to all of us. 

Judah was the first to notice I was awake.  He walked to the bed and asked if he could climb in with me.  Of course!

This bed is the bed that Greg and I bought within months of getting married.  The moment I saw this bed with the light oak wood, the high-set of it, and the tall posts, I had adored it.   It was solidly built by an Amish man and I wanted it.  It was one of the first times Greg let me have what I wanted.  Over the years, that bed was my life-boat in more than one storm.  It had always been a comfort to have it as the marriage bed with my beloved Greg.  I could never count the number of times we found comfort in each other’s arms in this bed.  And, how many times there was someone else in bed with us!  For years, it had been our own children who would mysteriously appear in bed with us and later it became grandchildren.  Sometimes, one or both of our dogs would end up in bed with us!  That’s why there would be no hospital bed for me.  I had always wanted to die in this bed and Greg was going to give me that wish. It was right that Judah wanted to climb in next to me even though he is a grown man with a wife and children of his own.  “He needs the touch,”  I thought to myself.  Gently, he lied down next to me.

I could hear Olivia whispering on the phone to the hospice nurse about how labored my breathing was becoming.  I cleared my throat to let her know I was awake.  I raised my eyebrows at her when she came out of the kitchen talking on the phone to let her know I did not want the breathing machine.  She already knew it.

Within a few minutes, they were all at my side. My sweet Greg sat on a chair next to me and put his hands on my forehead as he has always done, spoke sweet words to me, and pressed his face close to mine.  Judah remained next to me, but the others had joined him.  Olivia, Joseph, Judah, Nicholas, and Teresa all found a place on the bed.  I was squished, but Greg knew not to say anything—-That was the way I wanted it. 

He smiled at me and said, “You always said there was room for them all!”

However, when the most recent family dog that I brought home from the shelter tried to jump on the bed too, everyone laughed and shoo’d the poor thing back to the floor.  The dog took his place at Greg’s feet and I saw Greg reach down with one hand and pat the dog on his head. 

I looked from one person to the next thinking about the life we have had together.  I looked at my beloved Greg, tenderly touched his face with all the love that has grown in me for him through the years, and said a final, “I love you.”

I looked at each child in turn and said, “I love you.”

We all knew it was time for me to go.

I could hardly breathe and I couldn’t really feel my feet anymore. I knew it was coming, but I didn’t want this final moment to end without experiencing each sensation of it.  As I gasped for air, the only sensation I really felt was warmth and love from the people I have always loved the most. 

I think that it what they were feeling too because it was so quiet.  The late afternoon sun shown in the window and I knew it was time to go.  I took one last look at my beloved family from this body, shut my eyes, and I was gone.

Death walked in peacefully and I let him lead me from the place and people I loved to a new place waiting for me. 

*Painting by Roger Dellar 

Hello Everyone!

Chances are that if you are reading this it is because I invited you to check out my blog.

Honestly, this is the first time I have ever written a blog and I have no idea if it will turn out well or not.  I have been writing essays, stories, poems, and whatnot for years.  Most of what I have written has only been marginally shared with others; a speech here, a letter there, an essay or poem shared with a particular person or group based on a particular topic.  I have had many people over the years tell me things like, “you should write a book” or “you write well; people need to read what you write.”  I have no real idea if any of that feedback is accurate or not.  Further, I have lots of people tell me things like, “you are so honest” and “you just say it like it is” and that doing so is “so refreshing!”    Well, the reality is that when one agrees with me, I might be refreshing.  But, if one does not agree with me, I’m a pretty big pain in the ass.  So, my hunch is that only the people who like something I have written bother to give me feedback and that the people who think my writing is horrible simply don’t say anything.

Regardless, I have a pile of files and papers and notes written on scrap paper that I decided I better start doing something with it all.  So, I’m going to take a big risk and begin this blog in which I share some of those scribbles, ideas, essays, and general writing with all of you.  It will be you who will decide if what I have to say is worth reading or not.  But, I do have a small request of you, my readers:  Please judge me and this blog slowly and gently.   Although I think I may have some useful little nuggets to share with you or at least some funny stories, I am new at this and I am certainly not a professional writer.  Please give me time to gain some “stride” in blog writing before you dismiss me and my ideas.

And, if you must criticize me or my writing, please do so with the knowledge that my intent is not to offend but to share myself with you; the good, the bad, the ugly, the beautiful, the brilliant, the foolish,  the flawed, and the wise…..the real of me, the authentic me, the genuine me, and the me meant to be shared as fully as I can.  Hopefully, if you realize that, your criticism of me will be tempered by your compassion.