Humor: Sunday Ramblings

I’ve been buying more tissues for the office lately. I guess that’s an indirect measure of 2 things: I’ve got more people coming in sick with colds, and more people coming in with heavy-duty issues that evoke lots of tears.

And like the folks who eat a piece or two of the candy that’s always available, the box of tissues beckons all to grab some.

There’s a lot of variability about how people take and use tissues, which Ifind helpfully diagnostic or at least interesting.

Most will take just one or two at a time. That’s ‘normal’ here in Quincy. But there are a few who take 4 or 5, and do so by rapidly pulling them from the box and filling their hands, making a rather nice pillow of my tissues.

From here, it gets even more interesting. The ones who take the most seem to use them for one sneeze or two eye-wipes, and then discard them. They then take 4 or 5 more, and repeat the pattern. During the course of an hour’s session, they may repeat this until they have literally gone through a full box of Kleenex. When they reach the bottom, they toss the box and look at me blankly.

Of course, I go out and get them another box, which they immediately seize and replenish their empty hands.

Then I start wondering...what sort of a person uses so many tissues and tosses them away so quickly, with just a wipe or two in such a sea of softness. Is this what they do in relationships? Do they take huge quantities of whatever is offered and quickly use it up, toss it away, and just expect an inexhaustible supply of more?

Are they just wasteful, or perhaps they’re a little OCD, protecting their hands from nasal and ocular contamination. Is this a sign of anger at having to be at the therapist’s office, and a way of extracting maximum use of non-paid for consumables? Is it passive-aggressive?

Is it a learned behavior? Did their mothers ( come one...you know it’s ALWAYS the mother) do the same with them...using lots and lots of tissues to wipe their noses and other places when they were growing up? And now, they can’t break patterns.

And then there’s my response. A 200 pack of Kleenex costs around a buck. Each grab of 4 costs me 2 cents. After a while, I find myself counting tissue grabs by price, rather than by the piece, and seem to keep a running total in my head as we’re talking about their problems.

I know it’s not a big deal. In a lifetime, the more tissues we use in the office, the more business we’ve done. So I’d rather have a big utilization to be certain. Call it a quirk on my part. I’m entitled, as are each of you, to at least one.

Waiting Room Diagnostics

We’ve all got a way to greet new patients in our waiting rooms. But figuring out who to invite into our treatment spaces is not always clear cut.

If there’s just one person, it’s a no-brainer. When there’s two, the fun begins. If it’s a couple, both usually come in when I ask who will be coming in with me today. But the most interesting is when a mother, or mother and father and 5 year old child are sitting there, and I ask who will be joining me.

About half the time, the mother answers the question by pointing to the five year old, saying with some disdain in her voice, “He will”.

I usually swallow hard, but find the exercise diagnostic.

She didn’t say “we” will. She didn’t say “This is for me/us and my/our child”. Nope. The guns are drawn, and the kid is the patient. The fact that the mother and child have never been here before doesn’t register with mom. The fact that she might need to help her child deal with this stranger hasn’t dawned on her. She’s ready to surrender her child to the doctor, sight unseen, figuring that I’ll be able to meet with her child while she sits in my waiting room reading magazines, and in an hour, a cured child will emerge, ready to obey her every whim.

So then it’s time to do the next diagnostic question. “Mrs. Jones, would it be OK if you and I talk together for a few minutes first?”

I wait for her reaction, measuring the intensity of her facial grimace, and the length of time that it takes her to put down the article she’s been reading and get to her feet. It’s a good indication of the seriousness of her child’s situation, her reluctance to enter treatment with her child, and her feelings about this whole process. A long grimace, coupled with even a moderate eyeroll, coupled with tossing the magazine down in a propelled manner, suggests that this will be no easy case for this mom. The next best piece of information I get is how Mom tells junior to wait for her while she talks to the doctor.

“Now you sit there and don’t move” tells me a lot. So does “Mommy will be in that room. If you need her, come right in.”

Total lack of a goodbye of some sort is also diagnostic.

So mom finally comes in. Child is sitting in the waiting room, watching a video and seems comfortable. We’re one on one now. I already know what she’s going to say about this kid.

Major Sunday Ramblings

Were I to tell you that a major ice storm was coming to Illinois ( which may well be true), you’d wish me well and urge me to take significant precautions.

Or if I were having major surgery, you’d urge me to get my affairs in Order and say a prayer or two. At least I’d hope you would.

If I were having major financial troubles, you’d expect me to work with an accountant or lawyer or whatever, and would be quite worried about me.

It’s that word ‘major’ that alerts us to the seriousness of the issue, and takes the underlying condition to a lofty height that signals alarm

So what about our poor patients who present with some dysphoria ( for 2 or more weeks), and loss of interest and sexual and food appetites, and...you know the drill. And we toss on a label of ‘major depression’.

They’re already down on their resources to cope. Some have an idea, thanks to the commercials for antidepressants on TV, in magazines, on radio, in newspapers, in direct mail advertising, or telemarketers, or airplanes that fly with tail-dragging advertisements for Paxil, that they’re not exactly feeling well. Getting them to a diagnostic session with us took a lot.

Our reward: “You have Major Depression.”

That’s the equivalent of our own verbal ECT. You can see their thoughts, muddled as they might be, trying to make sense of this status. “Oh, shit”, they think. Or “Oh, darn”, or “Oh, something”. Everyone has a word that follows the “Oh”. And these days, with our slippage in language, the word “shit’ is mild.

But I digress.

They’ve now got Big Troubles. This is no wimpy depression. Nope. And it’s certainly not going to go away on its own. This is the big enchilada, the real deal, and supersized troubles.

“So what’s my problem, Doctor?”

“You have major depression.”

“Doctor, that sounds so serious.”

“Anything major is always serious.”

“Doctor, am I going to live?”

Words like major are tough. Most patients are relieved by my spiel, now perfected to a rote patter, that explains that “ALL depression is Major.

You can’t get a minor depression. We don’t allow that.”

The obvious answer? Dump the major. It doesn’t help. Like the patient who saw the abbreviation in her doctors notes about her having SOB (shortness of breath), it confuses and upsets.

Now to have a major Sunday breakfast, followed by a major football game, followed by a major discussion with son Jeff about the condition of his room.

Return to Top