Balls and Walnuts
more than you ever wanted to know
Prisons, self-built
I had a counselor in junior high who took one look at my aptitude test scores and told my parents (and me): He can be anything he wants. For some reason, I thought that would stick with me for life, and I suppose I still believe it*. I try to reinvent myself every ten years or so. What will it be when I turn fifty — playwright? Bungee jumper? Aging midget porn star?
My counselor and my parents never taught me that as I got older, as I made one decision after another, I would box myself in. Throughout college and med school, I had a vague notion this was taking place. But every single one of those decisions seemed like the right thing to do; and even with Monday morning quarterbacking, it still seems like I made the right decisions.
I’m in a thoughtful mood because of today’s post from Blue Gal. It’s a poem, and the author has given permission for folks to reprint it on their blogs, provided we keep the author’s byline. Join me below the fold for poesy and a bit of discussion.
Quota by Dr. Katherine Ottaway
honestly
I feel despair
when I try
to think about the new scheduleTwenty four slots
Of 20 minutes
See three people
For 40 minutes
Twenty on the schedule
Pray for two no showsUnanswered questions
Wake me Sunday morning
If I am called to a labor patient
Must I make up that clinic face time?
What of holidays?
The clinic is closed.
Night call is nowhere addressed
Will they hire more and more
Who don’t take call
Until I am the last woman standing
Red rimmed eyes staring
Numb with fatigueWhat of my nearly deaf patient
Who reads lips
May we take forty minutes?
All the fairly deaf elderly?
New parents, anxious
Questions pour out like
Coins from a jackpot win
What of the tearful brokenhearted
And anxious?
I shrink at the thought
Of crushing their hearts
Into twenty minutesAnd what if I am sick?
(no paid leave)
If I cancel clinic
For illness
Do I make up those days
A quota of patient face daysI am in the factory
The mines
People are the shirts I must sew
The tons of coal I must load
I must meet a quotaDoctors die younger
Our life is measured out
In patientsI won’t let the quota
Kill my love
My first reaction to this poem was, “Why are you putting up with this? Why did you sign the contract?”
But I can imagine only too well the decisions Dr. Ottaway made which boxed her in, forced her into a position where knuckling under to managed care beat all other alternatives. If nothing else, you feel attached to the community after a while. You wonder who will take care of your patients if you leave.
Docs do leave, of course. I live in a community which has seen about a 75% turnover in its primary care population since I first came to town 9 years ago. Death and retirement have taken their own, but many more have emigrated. So, yes, it is possible to leave an undesirable situation.
I don’t know Dr. Ottaway; I don’t know what keeps her in her predicament. Love, she says. Love, too, is a prison.
‘Kay, that’s it for tonight. I’m going to go sulk over that Doctors die younger line. Will. Not. Google.
D.
*Well. Forget President. Too many porn movie rentals in this boy’s history.
Are doctors any more boxed in than other vocations? Dentists, obviously, have similar constraints. But what about, oh, engineers? Architects? They are boxed in too. Misdiagnose a patient, one person dies. Screw up a bridge…
What about people who work in department stores? I remember my day being broken up into chunks, bordered by breaks. Factory workers, the same: dull, repetitive work until a break. The break too soon over, and more dull repetitive work until the next break.
I don’t think you’ve chosen a profession that is any more boxed in than many others. The poem is a protest against a specific form of care, isn’t it? It’s a rant against the HMO. Ok, maybe not a rant. I’m sure there’s a better word, but it won’t come to me at the moment.
Late last night, I thought, “Hmm. Maybe too overdramatic a title for that post.” Overdramatic for me, but perhaps not for the poet, whose poem (for me, anyway) conveyed a trapped or caged feeling.
My point is that most of us do it to ourselves. I’m content with my situation, but I still recognize there are things I can’t do. The poet, on the other hand, is far from happy.
Hmm . . . Still not coherent. Well, that’s 7 AM for ya.
I’ve been thinking a lot about the “self built prisons” lately. On Sunday old co-worker of mine came told me about one class action suit against my former employer that was settled in the employees favor for 12 million dollars. I also saw a show on TV about a group of people that were sea nomads. They had no word in their language for “want.” They had no concept of time. Possessions were hindrances and could not be transported on their small boats. Seems like these 2 groups of people were the opposites. One, the unhappy self built prisoners, and the others were truly free to the point there were no colleges or libraries. I wouldn’t enjoy be happy entrenched in either camp. Not being a “prisoner” is a trick – of the mind perhaps? “To thine ownself be true?”
I think the trick is not to think of things as a prison. If I think about it too long I will realize that I will spend the next 18+ years caring for 3 kids which will make me pull out my hair, cause me grief, anguish and all kinds of worry. Then there are the years afterwards where you can only hope and worry and wonder if you should do something to help. Life can be a prison, it doesn’t matter the vocation. Children can make you feel constrained. Family can make you feel the same way. It’s all in the perception. My best thought is to make the best of it. Sounds like crappy advise, but I bet even that Dr. has good days – days where she saved a life, brought a child into the world, and caught a close call.
It’s all in the perception.
Every life is the amalgam of the decisions that got us to this point right now. Some nights I would stare at the ceiling and wonder why the fuck I made the decisions I made that got me into this. But the more I learned about myself and the more time that passed, it surprised me that some of decisions I wondered about actually turned out to be the right decisions. There are lives I wish I could have lived, but that would have taken me down a different path from the life I live right now. Yeah, I know I can’t be ANYTHING I want, but I feel pretty good about where I am in this moment and the opportunities that exist for tomorrow. And you should too.
The Future Is Unwritten.
Great comments all.
Please don’t think of this post as a personal cry for help. It’s not. From my POV, though, it really would be nice to experience some of those parallel universe lives.
The more I think about that poem, the more it bugs me. “Twenty on the schedule.” Surely not all of them are new patients. I see 24 or more in a full office day, and 6 to 8 of those are new patients. Does an internist really need more time than a specialist? Admittedly, there’s only so much history to take from a patient with wax impactions, but still — some patients really do require a lot of my time.
Seems to me, the poet needs to be self-employed. Hard work is a lot more tolerable when you know it’s self-imposed and not forced on you from above.
See, this is why I haven’t been able to get myself in to file my school application today, nor have I done any serious work on getting employed again. I’m constantly afraid of making the wrong decisions, which will trap me “for the rest of my life”. The truth is, it’s only me who traps me – I stayed at two jobs I disliked for years too long because I was overwhelmed by choices and fear of failure.
Still, as we get older, it is true that our choices do cut off certain possibilities. I’m certainly never going to be an Olympic athlete, to say the least. And if I do become a vet tech but decide it would be more fulfilled to become a vet or zoologist with a Ph.D., being almost forty with a partner who wants a house and children make that a much less viable option.
As for the poem, I also felt it seemed more a condemnation of the current health care system than anything else. It could just as easily be a poem by a public school teacher agonizing over having 40 kids in her classroom, or a public interest lawyer wondering how he’s going to afford his rent. It’s probably unproductive to ask why they don’t go into private practice. It’s more important to ask: why does our society make doing good things for others so difficult?
DN: re why does our society make doing good things for others so difficult?
Money, which is to say, greed. Truly the root of all evil, if I may be pardoned the cliche.
As for the vet tech decision, to fire you up, remember that NOT deciding is also a decision. Inaction is choice. I think about that every time I delay getting back to my romance manuscript 🙂
Great perspectives. I love the idea of loving and living for the moment. I also loved that poem. It’s a matter of taking any moment, even those of despair, and turning it into art. At least that’s part of it.
So, Doug–what’ll it be? The red sports car or the black one? 😉 I’m not picturing you on a Harley or in a Hummer, but I could be wrong.
Sorry for being flippant. It’s late, I’m tired, we spent an ungodly amount of time at a farewell dinner tonight, and the speeches were really painful (the chief community health nurse is leaving–all her minions were weeping. it was ugly.) I did get some damn good sex when we got home, though, which accounts for the slightly giddy attitude.
Anyway–yep. Every day, every decision we make, we box ourselves in a little more. It’s not possible to avoid that completely: no matter what you do, you just cannot be a child star anymore.
But I don’t think it has to be tragic. What’s tragic is when you make decisions without realizing that they are decisions until you’re stuck in a life you hate and can’t escape.
Which isn’t what I see in the poem, btw. She’s not happy about the situation, certainly, but at the end she reminds herself of why she made the decision to be there.
The key, I think, is just what you said–making decisions deliberately, reminding yourself that it’s all a choice, and whenever possible, making choices that break you out of the rut.
I will be 43 next week and my life is more open to potential and possibilities than at any time in my past. I have spent a lifetime breaking free of the prison that was built around me, the prison I was shoved kicking and screaming into, the prison that almost killed me. I know I’ll never be perfect, lose all my scars, or find myself completely happy, but that doesn’t stop me from pounding on the walls. All potential options in infinite directions aren’t easy, likely, or warranted, but many are still viable. Many more than most people choose to think.
Some of the best decisions I’ve ever made were when I said “Fuck this, I’m done.” Life is too damned short to spend it miserable, locked 8+ hours a day in a job you hate. As long as you breathe you still have a choice. In something.
As I look back at the choices I’ve made, at the chains I’ve rebelled against, some to the point of obliteration, I know there isn’t a single damned one I’d change.
No, strike that. I’d have met my husband sooner, before so much damage had been done, before my prison had been built.
No regrets, Doug. Whatever life throws, whatever paths lay at your feet, live with no regrets.
Other than finding Bill sooner, I wouldn’t change a damn thing. I’ve fought too hard to get this far and I have too many battles yet ahead.
BG, that’s what I love about my readers. They might come around for the yucks but they’re willing to think, too.
Darla, you need to spill some details. This is Balls and Walnuts, after all. As for
. . . I’ll always have that lap dance I gave Ava Gabor.
Tam, you’re exceptional. But you knew that 🙂 In some ways, I feel the same. For me, every decade has been more pleasurable than the one before it. Childhood was miserable (yours was worse, from what you’ve told me, but mine wasn’t exactly a trip to the Catskills). College, med school, for all I reminisce about it, was a bear. Yeah, it keeps getting better.
Maybe all those choices were making me miserable.
Thanks for your comments, everyone!
I’ve only boxed myself in, or felt that way, by my choices a couple of times that I can recall. Twice that I can remember, and both of them were choices I made based on fear. I think sometimes for me, it’s exactly the opposite. I tend to get overwhelmed by possibility and sometimes I freeze like a rabbit in the road at night. Hehe. Most times I unfreeze pretty quick. My motto has always been “Move!! Take a step in any direction” I tend to trust that the universe will knock me over the head with a clue-by-four if I’m going the ‘wrong” way…
I’ve been going back and forth on this… On the one hand, we aren’t necessarily destined or consigned by fate to any one end. To be sure, some ways of breaking out are less savory than others (drugs, alcohol, affairs, abandonment), but we can still change things. At the same time, there exists the potential for tremendous forces to be arrayed against us – “you can be anything you want to be” can be a cruel lie for someone with socio-economic strikes already against them.
Our choices can define us without trapping us – it’s finding that balance that’s tricky, I guess.
Uh-huh. You know, I don’t see you spilling details. Innuendo and fantasy, yes, but not actual details. I’ll just let you use your imagination.
I’m not sure I want to know about the Ava Gabor lap dance.