Navigating Narcissistic Relationships

Remember when we women first started out in the dating world? We used phrases like, he’s so nice, or he’s so kind, but occasionally we would say, he’s so conceited. Well, some of those conceited men have a new name now. It’s called narcissist. Women can carry this title as well, but for today, we’re going to focus on men. What is a narcissist? The simple definition is someone with an excessive interest or obsession about themselves. In more basic terms, it is someone who talks about themselves incessantly, whose opinion of themselves is arrogant, who thinks he is the smartest person in the room on any subject, and who believes that their needs come before all others. Well, that certainly should be easy to identify, right? Not so fast. Remember, I said they are intelligent. That also means manipulative, cunning, and crafty. They get what they want, usually all of the time, and their timing is dead on. If they can’t manipulate someone, they simply walk away from situations and more importantly, from people who they believe are of no further use to them. They can inflict enormous emotional pain, because they speak their minds, and don’t mince words. They are judgmental and opinionated, even to the point of shutting down anyone else’s ideas. They speak without a filter, once they have a strong footing in the relationship. Those people must not have any friends, or spouses, you might think. Think again. They have a strong magnetic pull from the opposite sex, and use their craftiness to make their potential mates feel special, in a way that no one else ever has. That might go on for months, if not years, but it won’t go on forever. By the time the woman is hooked, it is almost too late to pull back. It becomes an addiction that is difficult to break. They will win every discussion, turn simple differences into arguments, and scramble even the most sensible person senseless. What do they gain from all this? Hard to say. Power and control, for sure, but also, some deep need to have the attention all of the time, from everyone. Those who find them out, who call them on their character traits are banished from the kingdom, never to be heard from again. They prey on woman who they deem to be defenseless, women who are kind, nice, sweet, and giving. Women who perhaps once had decent self-esteem, but over time, in this man’s spell, begin to doubt everything they ever knew or believed in, and finally, doubt themselves. These men are usually good-looking and intelligent. They are often in a powerful position, physicians, lawyers, CEO of companies. They are successful and often wealthy. They probably have had women in their lives, childhood, for example, who they are angry at, or may even detest. So the question becomes, are narcissistic character traits inherited or learned. Are they from getting too much attention or not enough in the family or other childhood areas. Were they rejected by women in their high school years because they weren’t tall, athletic, or popular? Were they left out of social groups, or were they the center of attention from a young age. Who knows? There are as many theories as there are narcissistic men, but know this. If you are in love with one, you will have to be very strong to stay balanced. They have the ability to hurt you in a way you have never been hurt before, and make you think that you are the reason they have to teach you a lesson. If any of this rings true, I have a book I have often recommended to people, and I’ll pass this on to you. The title is Men Who Hate Women and the Women Who Love Them. It is at least several decades old, and easy to find in paperback. This book is an easy read, and it comes with a check list to help you identify red flags before you become involved with a man who has the ability to make you wonder how you got into this mess, or how to get out of it. For What It’s Worth, most men are terrific, most couples are happy, most men want to love and protect the women they’re with, but if you find your self on an emotional rollercoaster with your man on a regular basis, you might want to rebalance your sense of worth and give this book a try.

Why Men and Women Have Different Needs and Expectations

I’ve been thinking a lot about the whole dating ritual thing, that begins for us girls about 15 or 16. I remember how important it was to have a boyfriend, even if back in the day, that only meant having somebody “like” me, and if I was lucky enough to be “going out” with a guy who was on varsity sports, to dream about wearing his letter sweater. Yes, I know this dates me, but what the hell. In this column, it all comes out, lol. Anyway, usually this dating consisted of walking in the school halls together, telling all your girlfriends every detail of every sentence your guy uttered, which usually consisted of something like this. “Hey, what’s going on?” Still, we put facial expressions in the details, how he stood, whether he looked into your eyes, whether he shifted his weight from one foot to the other, or seemed confident, and therefore, we would all conclude, he was “experienced.” Experienced at nothing, but nonetheless, we were smitten, writing his name on your arm in ink, writing your first name paired with his last name on a notebook, standing by the phone waiting for him to call, and immediately reporting back to your girlfriends if he did.

High school crushes moved on to college crushes or work crushes which were a lot more serious, and often, there was a world-exploding first love which would not be forgotten until decades later, unless of course, you married your first love. Now, I’m all about romance and optimism, and I know that some of these first loves turned into sensational marriages that spanned the years, but let’s face it ladies, a lot of these were doomed to failure. It is very difficult to sustain the fireworks that accompany first love, or any love, until years, and I’d like to know why. This is my theory. Women are adept at fantasy relationships which means that there is a real human male involved who has no idea what his role is supposed to be in the mysterious fictional relationship which she has created and he is not privy to. Many women believe that their mates adore being with her every possible second of the day, which of course, makes until a myriad of disappointments. Most of us women want our men to be protective, but not overly so, to be available, but only when we want them to be, to be romantic, but not first thing in the morning or in the middle of the night, and to be enthusiastic about taking out the garbage, mopping the floor, running the vacuum, and watching Hallmark movies together.

Most men initially go along with this fantasy, confused, but willing to give it a try, but it is not in their DNA to want to rehash emotions for hours on end, patiently explaining why they didn’t pour out their feelings of love several times a day, and finally, after months of frustration, say something stupid that makes us women feel that they don’t love us as much as we thought, they don’t desire us, or they wish they hadn’t married us. We have the sheer willpower to discuss this infraction for hours if not days, amidst crying, sobbing, and yelling, until we are certain our man has learned what our needs are. That, of course, is wishful thinking. And so we go on, with the same partner, or perhaps another partner, or perhaps many other partners until finally, when we are exhausted from expressing our needs, when mid-life turns into twilight years, we all finally get it. Women are women and need emotional fulfillment and security more than men. Men, for the most part, are quite happy if the bills are paid, the dinner is on the table, and the television is working. We all want the same thing, but we want it differently, and maybe, if someone had explained all this to us back in high school, we wouldn’t have expended so much energy wondering what is wrong with our partners, or ourselves.

For What It’s Worth, it took me all this time to understand that men cannot be women, and that’s just that. Men never got the manual for understanding women and we are complicated creatures. Kiss your husband, if you are lucky enough to have one, and feel a little bit sorry for him. He’s trying to navigate a world he’ll never figure out!

Lessons in Humility

Sometimes we may pre-judge strangers without any evidence whatsoever as to who they really are.  I almost always try not to make instant opinions as to whether or not I like someone until they give me a reason to decide, but today, well, things went remarkable sideways. I went for a manicure and pedicure, and across the room from me was a woman who I vaguely recognized. She was pretty, slim, and seemed by the way she was perched in her chair, to be completely confident in life. We happened to be the only two customers, and I couldn’t help but overhear a conversation she was having on her cell phone. She was gushing all over the person she was speaking to, in such a way that I quickly decided she was nothing but a fake.  After all, how else could anyone go on for at least twenty minutes being supportive, kind, welcoming, and inviting to someone who I gathered, she hadn’t seen in quite some time.  Yes, I thought, she’s not a genuine person, and I’m happy she’s not a friend of mine.  I wondered what her game was. By now, I was glued to her conversation.

After another fifteen minutes or so, her tone never changed.  She was more than gracious, and in fact, offered her house for a month to this woman and her boyfriend for a visit, stating that it would be such fun to reconnect, and they would be able to spend time catching up with the changes in their lives.  For an entire month!  I was beginning to second guess my original opinion, and had to admit, I was intrigued by her apparent sincerity.  How, I wondered, could she continue this charade for nearly three quarters of an hour, unless she was not a fake.  Her facial expression matched her words.  She looked kind and genuine, sensitive and forgiving.  I was beginning to like her.

 

At the end of nearly an hour of eavesdropping, (for which I am ashamed) I had two wishes.  The first wish was that I could be her friend.  I wanted her to live in my neighborhood, to ask me over to her house for coffee, to spend an afternoon in her company.  The second wish was that I could learn to be as sincere and kind as she seemed to be, not just some of the time, but all of the time.  I believe myself to be a nice person, but in her presence, I paled in comparison.  Maybe, I thought, I could be nicer, maybe I could be more patient and give of my time more freely.  When my nail session came to an end, I reluctantly got up from my chair, paid for the services, and walked to the door, but not before turning around for one last look.  I wanted her to stop me, to talk to me, to ask me to be her friend.  I wanted her to get to know me, and to like me. I wanted to be her.

For What It’s Worth, I learned something today that I fully intend to put into action beginning tomorrow.  None of us are so important that we shouldn’t take a lesson in humility from strangers along the way.  After some serious soul-searching, I know that I still have a lot to learn.  How about you?

FOOD FOR THOUGHT

I’m the last person who should be giving you any advice about food, but after listening to the news this morning, I have decided to tell you what I’ve learned, but with this caveat.  I love food, mostly anything that contains sugar and zero nutrients.  I’m not proud of this.  I respect people who read ingredients, shop in the outside aisles of the supermarket where fresh and healthy foods exist, and watch their calories, protein content and otherwise take a positive attitude on what they eat.  I’ve heard that our body is a furnace, that what we put into it directly affects our energy levels and wellbeing, and I want to be that person.  I really do.  I have a stack of magazines to prove it.  I have magazines that tout the Mediterranean diet, the sugar free diet, the gluten free diet, the vegan diet, and the dairy free diet, and when I purchase them, I am earnest about changing my food life. 

However, I was brought up to believe that breakfast comes in the form of donuts, and lunch is topped off every day with a huge pile of french fries.  Nothing says it better than a glass of coke, and of course, what would a meal be without desserts?  I’m not blaming New Jersey in the 1960’s, or my parents who loved junk food, but my point is, that when push comes to shove, I’m not going to change, and I know it.  All of this is to explain that generally, when information about nutrition and health show up on my television, I find a way to run out of the room, but today, I actually sat down and listened to three things I thought I would pass on to you. The first is chicken.  According to WPBS News, until the law is changed, and we all know how long that might take, chicken is allowed to be butchered and sold in your local markets with the full knowledge that some chicken has been proven to have salmonella.  What?! How can that be, you might ask?  I don’t know, but I can tell you I now understand why the thinking has changed on rinsing chicken before cooking.  I always thought it was a good idea to wash away any possible bacteria, but that old standby of thinking has changed.  Do Not rinse chicken in the sink, because it spreads the salmonella over all the surfaces it comes in contact with. 

As if that isn’t disgusting enough, the second thing I learned today is that onions, yes, that’s right, onions, are something to be cautious of while shopping because they do carry salmonella!!  Especially the raw onions on your burger. It seems that it is best to buy an onion whose skin is visible to the naked eye, such as a white onion, so that any yellow bruising can be easily viewed.  If you find one of these potential pesky salmonella carriers, do not purchase it!  Last but not least is packaged salad.  This is not news to me, but it might be to you.  These leafy greens also can be infected with salmonella, just waiting to give everyone at your formal dining table diarrhea, if not worse.  How do they get salmonella, you might ask?  Well, apparently the machinery that cuts the lettuce can be infected with the germ, and it gets passed on to the lettuce in a less than polite way.  If you must have salad, and let’s face it, we do have to try to eat healthy with at least salad, the powers that be suggest, washing the leaves carefully (I don’t know why this should be any different from washing chicken, but apparently lettuce gets a free pass) and pulling off the outer leaves where the salmonella might have taken up residence.  So if you’re serving salad tonight, or stopping in a local healthy food establishment, you might want to forgo the lettuce wrap, since those leaves are probably the outer leaves that are large enough to contain the rest of your meal.  (They didn’t mention cabbage cut and packaged for coleslaw, but I’m going to go out on a limb, and say that might be something to think about).

So, there we are folks. For What It’s Worth, I never heard of a box of donuts or a bag of M&M’s contaminated with salmonella, so maybe, just maybe, I’ve been on the right track all along. 

GENDER & RELATIONSHIPS

Men don’t have a chance.  That’s what I’m hearing from men who have spent most of their lives attempting to understand what women want.  They’re not the only ones.  Women don’t always know what they want either, but that’s a story for another day.  Men are hardwired differently from women.  That’s a fact.  They are drawn to murder mysteries; intrigue; horror movies; fantasy heroes; war and hand to hand combat.  They have to try to understand their sisters at an early age.  Why they cry when they are hit, why they spend so much time longing for things just out of reach, why they’re so moody.  Just when boys think they’ve mastered the female psyche, they hit puberty, and they want the very thing that has caused them so much angst.  They want the girl, but they do and say stupid things which pushes the girl away.  They are insensitive, they say the wrong things, they cheat.  By college, men have realized that they can’t decode the mystical female creatures, so they do the best they can by bypassing those things that have pushed women away, and start over, giving compliments, paying attention to subtle changes, like their girlfriend’s haircut or new clothing.  They know they have to give their girlfriends their full attention, be an open book with their emotions, temper their sexual appetite for loving words instead of just jumping into the sack.  Then one day, it hits them.  They find the woman who wants to spend the rest of their lives with them.  They propose, but instead of the relationship taking off on a whirlwind adventure for two, the newly engaged woman gathers round her girlfriends and family, and plans for months the “perfect” wedding.  She reads magazines, consults wedding planners, makes a wedding registry at department stores, and otherwise is “busy” planning their future.  She plans for the perfect guest list, the perfect honeymoon, and eventually, perfect children.  Where is the guy?  In the backseat of a fast moving rollercoaster, wondering what happened to the girl he couldn’t get enough of. 

Then it happens.  Marriage. Children. Responsibility.  Work.  Money.  Future.  It’s no wonder he checks out mentally, some faster than others.  Television programs such as Hallmark, and the Bachelor don’t help.  He’s searching for the Time Machine that can rewind his life.  He loves his wife, he loves his family, but he wasn’t/isn’t equipped for a life that didn’t come with a manual. He’s tired.  He’s confused.  He can’t do anything right.  As a bachelor, he rarely washed his clothes or complimented anyone for any reason.  Now he’s stuck in unfamiliar territory where his wife compares him to the actors on love story movies, and accuses him tearfully of not wanting to spend time with her.  He nods and promises to do better, but in reality, what he’s thinking is, “but I am with her, nearly all of my free time, and the rest of the time I’m working in a dead end job that I hate.”

Men cannot fathom the role we as women want them to play, even though we tell them over and over what our needs are.  Their seeming inability to process our words cause anger and resentment, as if we are plotting against them, when all the while, we are on the same team.  The answer, you might ask?  Not sure, but I do think women are emotionally braver than men; we verbalize our needs quicker and easier, and we expect them to respond accordingly. 

For What it’s Worth, this is not a general scenario of all couples, but it certainly isn’t an oddity either.  I think women try harder, stick it out longer, and are more optimistic that things will change if only they find the magic words that their partners can understand.  I think men are quicker to mentally check out, and do whatever they have to do to keep peace.  When you think of it, it’s pretty amazing that most of the time, it still works out.

THE USE OF AI

I know I’m not the sharpest tack in the box, but I must have been living under a rock not to have appreciated the full magnitude of AI.  For those of you who do not know what those initials stand for, they are Artificial Intelligence.  You know those little boxes with the pictures in them, that you have to click on to make sure you’re not a robot.  They ask you to identify the squares with the motorcycles or trees or school buses?  Well, apparently AI’s cannot think for themselves so they get stumped at the pictures because they have not been programmed to respond to them.  Not yet.  Thankfully they can’t think for themselves. (I use the word “they” as if they have taken on a human form, but to date, they are just computerized machines as far as I know). You know what else they can do?  Rumor has it that they can apply for jobs, on sites such as INDEED, which makes life easier for the applicant.  But what if they could think for themselves?  What if they evolve into a thinking and acting machine one day.  The reason I ask is because I understand that people such as Elon Musk are asking for a “pause” on further development of AI’s because these people are “concerned” about what they might be able to do in the future if the rapid rate they are evolving continues.  Now I don’t know about you, but when I hear the word “concerned,” it freaks me out.  To me that is a code word for “what until you see what happens next”.  Imagine if AI’s could actually think for themselves and begin to run amok.  I have friends who say that is impossible.  I’m sure Orville and Wilbur Wright were told the same thing when they took their first flight.  Besides, AI’s don’t have to think for themselves to do damage.  All they have to do is get programmed some whacko who wants to do harm to people or the country at large.  And I don’t think I have to tell you we have bad people living among us.

Of course the other side of the argument is that AI’s can do so much good in the health care field, possibly coming up with solutions to medical problems and make advances that can save lives some day.  That would be for the greater good, but there is potential to do the greater bad, and I don’t like it.  On a personal level I am discouraged if not downright disgusted by the fact that AI’s have crept their way into the novel writing arena.  If they are given a plot, some characters, and a genre, such as mystery or love story, they can come up with a pretty darn good book, and soon writers like me (who are still waiting to get my book on Amazon, but soon I hope) don’t have a chance, and what’s worse, when you, the buyer, purchase a book, you won’t know whether it was written buy a real author or an AI.  AI’s have also made their way into the world of academia, and are doing homework, writing term papers and book reports, and even thesis papers as we speak.  To me, all that might look good on paper, but it’s just going to make students stupid if they don’t have to do the work themselves.  

Look, I don’t have all the facts, but from what I’ve heard, I’m getting a little nervous about the future.  I mean we already have enough trouble communicating with each other with the addition of texting, and social media substituting for actual phone calls and good old fashion letter writing.  Imagine this scenario.  You want to have a fight with your husband, but he always bullies you into giving up. He can’t win an argument with you because once you start crying, he caves.  But suppose each spouse programs their AI (in the future of course, when they live with you) to fight each other while you both go to bed.  Each of you enter the necessary information, and your AI’s duke it out, without emotions.  Then, you wake up in the morning and find out who wins the argument.  Science fiction?  Maybe.  But what if it isn’t?  For what it’s worth, I like a good old fashioned argument where we say stupid things, and then make up.  It keeps the relationship new and our brains in good working order.  We win some, and we lose some.  If I want to make a point, I certainly don’t want to have a machine take the credit, but that’s just me.  

LOVE WRITING

There are two things you might want to know about me.  The first is that I’m sensitive.  That doesn’t mean I don’t have a backbone, after all I am originally a Jersey Girl, but spending more than half my life in Florida has softened me, and DNA is the rest of it.  I am blessed with an optimistic outlook, much to the chagrin of many people I have met along the way.  I’ve been told that no one wants to hang out with a pollyanna day in and day out, so I try to temper my happy demeanor as much as possible.  The reason I bring this up, is because it has come to my attention that my three latest columns about Cleveland Clinic, beginning with a negative attitude about the untimely medical service, then morphing into another column of those of you who agreed with me, with horror stories of your own in getting appointments, which finally turned into being invited to meet the president of Cleveland Clinic for a sit-down and let it all hang out in his office. Anyway, my last column has invoked angry words in someone.  I have been accused of selling out so to speak, or being less than forthright, and perhaps even getting a long-awaited appointment with my doctor traded for a positive column about my hope that Cleveland Clinic will become the “patient-first” hospital that we all want.  I gave Dr. Singh a thumbs up, with cautious optimism, and I still do.

I have to say it.  My feelings were hurt on several levels.  First, I am not a paid employee of this magazine, and as such, I have no reason to write anything except what I personally think about topics in a truthful manner, hence, the title, For What It’s Worth.  For some of you, it may be worth something.  For others, it may be worth nothing at all. I am all about disagreement, after all, that’s what makes the world go round, but we can disagree kindly.  I am not apologizing for my hopeful attitude.  Most of my columns try to include, wonder, happiness, positivity and optimism.  Sometimes, if something rubs me the wrong way, I may vent, but even then, I am always hopeful.  If we don’t have hope, what do we have, after all?  I understand that I cannot please everyone all the time, and that is not my reason for writing this column, but it saddens me that it seems we can no longer have any optimism in an open forum, without hostility and anger toward the writer.   To set the record straight, I am not a journalist, I am a nurse.  I also did not major in English grammar in school, and at times there have been typos for which I apologize.  There is an editor at the magazine who I count on to save me from myself, but sometimes she gets busy and lets me go under.  My topics are varied.  I am not trying to uncover hidden agendas or cast shade on people or places for the general public.  I am just sharing a piece of myself and my thoughts through my column.  If you like what I have to say, please keep reading. I am humbled by your positive messages and the time you have taken to email me.  If you don’t like what I have to say, that’s fine too, but please skip over my column rather than wasting your time reading it, and making unkind and personal comments.  We’re all just trying to do the best we can.  Commenting on Cleveland Clinic was gutsy on my part.  I thought long and hard about it, but I hoped it might lead to change.   I think it may open up some positive avenues for all of us.  It was never meant to be the explosion that it caused, but I hope that all of your emails will help to change the situation there, (no, I never disclosed your names) and I appreciate your input, as does Dr. Singh, President of Cleveland Clinic.  To be clear, I am not and have never been, paid for my columns, I was not given any incentive to write a positive third column after my meeting with him, I was not given an earlier appointment with my physician, (still waiting until August!) and I am not an investigative reporter.  I can’t do anything more than share my stories, and hope you will still share yours.

The second thing you should know about me is that I am writing under a pen name.  This column was started six years ago as kind of a lark, to be short-lived and I thought anonymity would be best, since I still had an office practice.  I am now retired, but the column continues, lol.  I have written a novel, soon to be out on Amazon, fingers crossed, and at that time, I will have to let you know who I am, in the hopes that you might want to read it.  For now, thank you for all your encouragement and support over the years.  I will try not to let you down.  I love writing, and I love that many of you have given me your kindest words over the years.  It is the reason I keep going.  I am sorry that I wasn’t able to personally write you back, but I couldn’t  reveal my personal email without letting the cat out of the bag.

For what it’s worth, if you keep reading, I’ll keep writing.   

HECTIC LIFE

So, I’ve been doing a lot of thinking lately, about why most of our lives have become so hectic, and lamenting over the good old days.  Of course, I know that in hindsight, it was probably hectic back then as well, but I miss the idle time I used to have, even though my husband and I raised four children.  Still, it seemed as though there was plenty of time to sit at dinner and go over each other’s day, talk about upcoming plans, and maybe sit down for a quiet evening while the children went to their rooms to do homework.  What the heck happened?!

I’m going to go out on a limb here, and blame the internet, and possibly technology in general, but as I write these words, I feel the entire population ganging up on me.  Yes, I use the internet everyday.  Yes, I ask google for answers to questions that I’m too lazy to research, and yes, I’m on my computer as a writer, non-stop, so who am I to make unkind remarks about the internet?  I don’t disagree.  All I’m saying is that I feel like families are losing valuable teaching moments, emotional moments, and yes, even punitive moments because everyone has a device in their hands and are spending an inordinate amount of time that could be spent interacting with others.  I remember when texting first became a thing.  I thought it was ridiculous.  I didn’t see the point of it.  If I had something to say, I could just call the person.  Then, after free time was sucked into the atmosphere, I realized the beauty of texting.  A sentence is typed and received within moments, and the receive answers immediately.  There is no interruption in time management.  In fact, you can be speaking to someone on the phone, and texting someone else at the same time. Magic! I don’t know how we ever lived without texting.

But, I digress.  Now, when my grandchildren come over, they are glued to their iPads.  In restaurants, I see perfectly well-behaved children with their parents, who are free to dine with the other adults free of the inconvenience of their children’s whining or back-talking, because their children are otherwise involved in FaceTime, Tik-Tok, video games and the like.  It seems like a win-win, but sometimes I wonder if it isn’t a lose-lose.  When I was a child eating at a grownup dinner table, I had to sit politely, and endure an hour or more of adults reminiscing about generational stories that were handed down from one to another.  Those stories may be dying at the dinner table as we speak, because children have no interest in hearing them, and are not subjected to sitting there listening.  It feels like our ancestors are begging for a chance to be remembered, but the younger generation has little interest in hearing about anything that doesn’t pertain to them or offer immediate gratification.  Please understand, I’m speaking in generalities, not about your children or grandchildren specifically.  I am simply stating that I feel a great loss of free time, storytelling, family time, and just lazy fun in general. 

But how do we go back?  The sad news is that we don’t. Without technology, we would have to live off the grid, or on another planet to communicate the way we used to.  Everything is done with the internet, and even that is changing so quickly I can barely keep up.  For those of us who are of a certain age, it seems like we are falling behind quickly, with no chance of catching our breath.

For What it’s Worth, I’d like just one more day of being in a family where it was exciting to finish dinner and look forward to putting a puzzle together or playing a good old fashioned game of monopoly, but that’s just me.  A hopeless romantic, and wide-eyed optimist.

PATIENCE FOR
OUR CLINICS

Ok, so here’s the latest scoop on the medical situations regarding my last several columns, having to do with inability to get to a doctor from Cleveland Clinic in a timely manner.  Yes, for those of you who insisted I name the dreaded hospital that I was writing about, it is, in fact, Cleveland Clinic.  The reason I am now going to put a name to the place is because I was invited by Dr. Singh, the President of Cleveland Clinic to have a meet and greet this afternoon.  Just when you think you know how your week is going to go, wham, a personal invitation to speak with the president himself, who read my articles and wanted to talk.  Okay, so I’ll admit I was nervous, anxious, worried, but also armed for bear in the event that he wanted to minimize the situation, but in fact, surprisingly, he was caring, open to suggestions, and transparent with regard to how Cleveland Clinic took over Martin Memorial North and South, and what he strived for going forward. I was impressed, and I’m not easily sold on lip service, but between him and the head of Patient Experiences, Karen Ludwig, who was also present, it was apparent that he knew and understood the frustrations the general public has been experiencing getting seen by a physician in a timely manner. 

I have to give him credit.  His information was forthcoming, addressing my concerns, sometimes even before I had the chance to list them.  Also to his credit, he was young-ish, a physician himself, and has only been the president of the hospital for one year.  In that year, he and Karen had an earful of complaints and they had plans to address all of them by way of hiring almost 60 new physicians, twice as many nurses, and ongoing training for those people on the front lines, who take the calls and make appointments.  I was shocked, in a good way.  He never tried to make excuses, nor did he make false promises.  He said getting things turned around was not going to happen overnight, but he does strive to make this hospital the best it can possibly be, within a reasonable amount of time.  He is there to speak with, to read emails, and to even give out his cell phone number (No, sorry, I can’t pass it along, lol) but from what I understand, he has done that frequently to others as well. 

He loves this community, he loves this hospital, and he loves medicine.  He is not one of those people who sits in their ivory tower, having no pulse on medical practices.  He wants to do better, and promises he will do better, but this is what he has been handed, well, that, and the pandemic, which has seen the resignation of good nurses and doctors who no longer wish to expose themselves and their families to infection.  I get it.  Much as I loved hospital nursing, I have asked myself many times if I had stayed in nursing, would I quit?  I feel like the answer is a hard “no” but it’s easy to say from the sidelines, and not in the midst of potentially deadly chaos.

My point is this. He wants things to change, and he has ideas to change them, many of which it is not my place to share. I came in with a list of suggestions, but before I could get my ideas out of my mouth, he already verbalized them.  We were on the same page! So, the bottom line is this.

For What it’s Worth, he’s young, he’s enthusiastic, he wants to make things better, and he wants Cleveland Clinic, Stuart, to be exactly what we all want it to be, a place we can trust with our very lives.  Let’s be fair and give him time to get it together.  If I was a gambler, I think I’d put my money on him.

FIXING OUR
APPOINTMENTS

It appears that my last two columns regarding the difficulty which many patients are facing when attempting to make an appointment with their physician, or attempting to get someone to call them back regarding their medical issues, from doctors who are employed by the large hospital(s) in our communities have struck a nerve.  I am used to receiving responses (thank you very much) from some of my articles, but never have I received so many at one time, and they keep coming. I thought this was a big problem for me personally, but apparently, it is an even larger problem than I thought. The emails that I have received are upsetting and at times heartbreaking.  Elderly people  without  a doctor, when their physician of many years suddenly takes a leave of absence or retires, with no one to replace them. People who have to wait months, some nearly a year, to get on their physician’s schedule for treatment, some without the resources to know where to turn, and without guidance from the very institution with which they placed their trust. 

In my opinion, and the opinion of others, the system is broken. We all deserve better than this. When people are sick, when people are hurting, when people expect to be treated, and are turned down, they feel abandoned, lost, bewildered, and angry.  What’s worse, many of you have asked me to help.  I wish I could, but like you, I don’t know where to turn. Still, since I have some public voice, and a conscience that realizes we all have to do our part to help, I reached out to the hospital to see if they employed a patient advocate who could field all the calls/complaints and frustrations, and guess what?  I found a department that allegedly can help.  It is known as the Patient Experience Office, and the phone number is 772-223-4995.  After two phone calls and several hours later, my call was returned by a very nice woman who was willing to give me the opportunity to voice my concerns.  She said she understood the frustration of having to wait for appointments for months, or having a doctor who no longer works there, nor replaced, leaving patients without a physician.  She told me her office is open to any and all concerns, and she does what she can to allay those concerns, and will contact individual physician offices to attempt to get earlier appointments.

When I asked her why there is such a long wait to get appointments, even for long-standing patients with doctors of record, she said that with the growth of the community and the large influx in the population coming to Florida, there are simply not enough doctors to see patients.  I find that answer truthful, but frankly, unacceptable. She also stated that many doctors have left this facility, and have not been replaced, but that they are “working on it.”  I don’t doubt what she says is true, but why are doctors’ leaving, and by leaving, I mean leaving our community unattended?  Something has to change.  This should not be accepted as the new normal.  Sick people need to get well, it’s as simple as that. The question is, how can we do that without appointments or physicians? I am all for nurse practitioners. I am a nurse, first and foremost, but nurses are not doctors, regardless of how intelligent they are (and they are!).

As well, I reminded the woman I spoke with that at the least, the front line of staff workers fielding calls should be held to a higher standard of professionalism, by being kind, considerate and courteous, not rude and dismissive, like some of you have encountered.  She agreed. So how much can she help? I don’t know, but personally, I still have to wait until the end of August to see my physician, even though I have been a patient of his for the past ten years.

For What It’s Worth, l appreciated her empathy on behalf of all of us, but it didn’t get me into my doctor any sooner.  Maybe a few letters to the administration would be the incentive for change.  Then again, maybe not.

ISSUES IN OUR
MEDICAL FACILITIES

I’ve received quite a few responses to last weeks column about the difficulty of getting an appointment to see a physician now that the local hospital has its hands in scheduling at a central station.  In my opinion it is cold, unfriendly, and seems to lack empathy of those who field the calls, but perhaps there’s nothing they can do about it, and perhaps those receptionists are sick and tired of hearing how a sick patient needs to be seen sooner.  There can be blame all around, or perhaps nowhere, maybe it’s just the sign of the times.  I do not know of any physicians who are uncaring, although some may be, but I do know that I have heard talk of some of them dissatisfied with the way things are working, so frustration everywhere.

If I ran the medical facilities, I’d have a few ideas to toss around.  For one, I think it’s silly to give a prescription to patients who are leaving the emergency room. If these people were healthy enough to get around, they wouldn’t be spending hours waiting to be seen in an ER.  In hospitals I have worked in, in other states, and in other decades, there was an all night pharmacy in the facility that could fill the prescriptions right then and there. I mean, I know there are pharmacies associated with our hospitals…that is how in-patients get there medications.  Why not help out a few patients who have no one to go to the drug store for them? That would ease their minds, and allow them to focus on getting well.

The next thing I would be thinking about is the need for more convenient urgent care centers in neighborhoods.  There is one in Jensen, one in Palm City and one in Stuart, off the highway, but there are an enormous number of senior citizens who either can’t drive on the highways, shouldn’t be driving on the highways, or are too sick to get themselves help.  If not, then how about a hospital owned transport company, not ambulances, who can take sick people to facilities that will treat them on the spot, instead of having them stand in a virtual line for months waiting to be seen.  By then, they’ve either gotten better, or unfortunately, much worse.  In case the higher-ups haven’t factored in the need to assist people, especially the elderly, widowed and alone, who often can’t or won’t call an Uber.  The elderly are worried about their safety, getting into a car with a complete stranger, and I don’t blame them. 

I don’t know how these issues can be addressed, how much money it would take, who could pay for these benefits, and if anyone even cares to try to rectify our medical situation, but if anyone much more intelligent than I am could tackle these problems, please let us all know. 

For What it’s Worth, no one feels more alone than someone who is sick, and no one has a worse doctor than themselves when they attempt to self-medicate for lack of bonafide, qualified, timely, medical attention.

KINDNESS GOES
A LONG WAY

Happy New Year everyone.  Let’s do our best to make it a good one!  I thought I’d start out this year with some thoughts about our medical center.  This is only my opinion, and the gossip of others that have mentioned this medical center to me over the past two years, so let me preface this column by stating that if you have been a patient in the emergency room, or in the hospital, and had a great, life-changing experience, I’m happy for you.  If you have a physician who you can regularly see whenever you have a medical problem, and they are affiliated with this un-named hospital, you’re fortunate, and again, I’m pleased.  But for many of us, myself included, I am disappointed with my high expectations of what I believed would be medical care at a higher level.  I mean after all, it’s world renowned.   I remember thinking that Martin County was the chosen county, the lucky one, to even have this facility considering our little town.  I believed the already great medical care afforded here would escalate to a higher level, with physicians who delved deeper into the problem symptoms that didn’t necessarily fit the four corners of their medical school textbooks, physicians the like of which I had worked with at Mount Sinai Hospital in New York City, and Georgetown Hospital in Washington, D.C., where it was unheard of not to investigate a patient’s complaints to the fullest, with a treatment plan and follow up that actually worked. That is what I anticipated.

Unfortunately, I have been disappointed.  Perhaps I raised the bar too high.  Perhaps I was asking too much. Perhaps the doctors who have signed on with this facility feel the same way. They now answer, not only to their education, their oath, their own medical desire to ease suffering, but to the institution which pays their salary.  My disappointments are not limited to me.  I have heard the same complaints over and over, but there doesn’t appear a way to make things better.  First, it seems to me, that if your physician is now on staff,  by which I don’t mean have only hospital admitting privileges, but office practices where appointments are made by hospital staffers.  There’s no longer a receptionist who knows you personally, who knows you by name, who asks about your family.  So what, you might say?  Well, here’s my personal experience.  I have been a patient of record at a particular physician’s office for years.  Now that he works for this institution, I was unable to get an appointment with him for four months, but was offered an appointment with his Nurse Practitioner in three months.  I’m all about nurses.  I am one.  But they’re not physicians, and my problem entailed more than a nurse practitioner could address, in my opinion.  Let’s add that up.  I had to endure my symptoms for three or four months, or else go to the emergency department.  Unfortunately, my experience at that department was less than I had hoped, and I was told to make an appointment with my specialty physician, which is exactly where I started.  I thought I could use my “in” with someone who was related to this doctor, to ask for a special favor, and get a message to him that I needed to see him sooner, if possible.  Guess what?  No, he couldn’t do that, because his schedule is set for him by the staff of the hospital.  Now, let me again preface this by telling you that this is my experience, and not indicative of anyone else.  Perhaps he just didn’t want to see me sooner, maybe he was burned out, working too late and too many hours, maybe he just didn’t like me, but what if the message I received is true?  Suppose he actually can’t make his own schedule?  All I can tell you is what my experience was, but maybe it’s also been your experience.  Maybe phone calls should be answered, or at least returned in a decent amount of time, which has also been a complaint of many people.  This is not to say the doctor’s aren’t top notch.  I’m sure they are, and as in all institutions, some are better than others, but if you can’t get to a doctor, how can you decide?

For What It’s Worth, I long for the small town of Stuart I came to years ago, where the population was smaller, where doctors were in solo practice, where one bad review could close them down, but these days, I personally feel lost in the crowd.  I am not targeting this or any other hospital for their reputation or physician talent.  Obviously they are a well respected entity, but I wish there could be more empathy within their staff who are the front line, who must be tired of hearing that we need an appointment sooner than later, but some words of compassion would make the wait for care easier. Maybe the hospitals I once worked for, whose memories are of “patients first”, are wishful thinking now, but all I’m saying is that I think we can do better.  People are sick. They’re hurting. They’re alone and frightened. Our elderly population could use some kindness when they’re told they can’t have an appointment for months, and maybe even a follow up call, to let them know that someone cares to see how they’re doing while they wait.  Kindness goes a long way toward healing. Is that really too much to ask?

WHAT OUR READERS ARE SAYING

René Z. Bunting Hutchinson Island
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Dear L.E. Murphy, I read with interest your latest opinion column about readers' responses to holding Cleveland Clinic accountable and Dr. Singh's subsequent invitation to you. I served as a Vice President for two healthcare systems in the greater Philadelphia metro region, including southern NJ, so I speak to this issue from a position of over 35 years experience. My last organization achieved the Malcolm Baldrige National Quality Award-a rigorous process that requires meeting critical criteria, including among other areas: leadership, quality improvement and customer satisfaction. In the spirit of improvement, you have shown a light on an important issue. Thank you for voicing a concern shared by so many healthcare consumers across the United States, not just in Florida--that is--the issue of not having timely access to care when it is needed (not months later!). Lags in meeting consumer demand has a lot to do with national shortages of some critical specialties, but it may be also due to breakdowns in processes. I commend Cleveland Clinic's Dr. Singh for inviting you in and for listening to your concerns and the concerns of many in our region for whom you spoke up. I hope his leadership team will look earnestly at process improvement as a result. Your readers, even those who critiqued your actions, will benefit from your efforts. I hope they will see the merit in what you have courageously done. I wish more healthcare professionals and consumers will take positive approaches to improving interactions with providers and the health system as you have. And, finally, to your readers: there are so many dedicated doctors, nurses, and other healthcare professionals who most recently have been on the frontlines of a worldwide epidemic. Many left their own families for long days and nights, some became very sick and some died as a result so all of us could have care in the most dire situations. Let's recognize that the last few years have been tough on everyone, including healthcare professionals, health systems and the people who run them. While they are not perfect nor are the systems they work in, they deserve our gratitude, respect and also our honest feedback. And that's exactly what Dr. Melfi has tried to do...for all of us. Thank you Dr. Melfi,
Anita Melfi Visoky
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Dear L.E. Murphy, I am writing in response to the "For What It's Worth" article on technology, which appeared in the recent issue of the Stuart Living magazine. I agree with you that technology is becoming too overbearing. You mention the demise of generational stories that had been handed down through dinner table conversations. I am doing the best I can to preserve the stories of my own family and learn about our ancestry. You and I both share the surname Melfi. In my case, it is my maiden name. I have traced the ancestry of my Melfi family from the tiny village of Faeto, Foggia, Puglia, Italy. Do you know something of your (or your husband's) Melfi ancestry, and where your Melfi name originated? Thank you.
Dorothy Kamm
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Dear L.E. Murphy, I enjoy reading your columns and find them insightful. It was encouraging to read that Cleveland Clinic is striving to improve and hire additional doctors. I truly hope that Cleveland Clinic is an asset to our community. However, I am friends with several physicians and medical personnel who told me that they were forced out of their positions when Cleveland Clinic took over. Cleveland Clinic required a tremendous amount of additional "paperwork" and pressured the doctors to order tests they considered unnecessary so that Cleveland Clinic could benefit financially and "justify" the doctor's salary. When my doctor left last summer, one month before my annual exam, I was provided a list of new doctors as replacements, none of whom had a local track record, and many, because they had limited work experience, had little or no online reviews from their prior workplaces. It is obvious that Cleveland Clinic wanted to force out experienced doctors and hire younger ones for less pay. I've seen other companies do these things as well when they wanted to force an employee to quit, without having to pay unemployment. I, too, had difficulty getting a timely appointment, and I was discouraged that I was not treated as a long-term patient. I decided that I am done with Cleveland Clinic. I have lived in this community for more than 35 years, yet I was treated like a nobody. I have taken my business elsewhere and now consult with independent doctors who are unaffiliated with the hospital or medical offices. The wait time to make appointments is far less, too. I just want you to be aware that there is another side to this issue.
Anonymous
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Dear L.E. Murphy, There are so many obvious solutions. All of which should be considered. None of which will. My family has worked in the medical profession in some ways for years. I will start with a question. Why is big pharma allowed to decide how you can be prescribed a medication? Why can big insurance tell you what they will and won’t pay for said prescribed medication? Why has making an appointment for a Dr or a procedure become so hard? We have become so impersonal that people talk at you not to you. The medical profession has been going paperless for 25 years. Yet every time you go to any place for care. What’s the first thing they do? I need your insurance, drivers license and co pay. Then they hand you a clipboard filled with a thousand questions that they already know the answers to because you have already been there. I am not even allowed to call my family physician now. I have to make an appointment or ask a question through a message service. The simple answer to all of your questions is. To me anyway Let Dr’s be Dr’s. Let them be able to actually see their patients and talk with them. Not a nurse practitioner or assistant that is on a time schedule because they are under the control of some hospital. Technology has been both great and detrimental to the medical profession. Well to everyone really. No one can talk face to face anymore. It’s all texting emails and phone calls from people sitting at home In their PJS. I know that the answers are we more complicated than this. But in actuality not. All someone has to do is say. Im not treating my patients that way anymore. I bet there are more Drs that would love to go back to the way it was. When big government big pharmaceutical and big insurance didn’t control the medical field. Thanks for reading this if you do. I enjoyed your article
R.Hanson
R.Hanson
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Good afternoon! I keep telling myself how I need to write to you! I so look forward to the living media pamphlets in my mailbox and get disappointed if I don’t see an article. I believe I’ve read that you published a book but nevertheless most of the time I feel like you are writing about my own life, or at least a portion of it. I too, am a RN of 43 years now retired but maintain my Florida licensure as I’m not sure I’m ever done or feel the continued power to be an advocate. I recently became a patient of Jupiter Urgent Care, then Jupiter Medical Center Emergency Room and filled out my survey but did not get any responses. Gosh, I truly miss the “ old days”. In any case, just wanted you to know how much I enjoy your articles. They do help me to say “ I’m not alone”, “ I’ve been a great parent”, “ I’m a great wife”, “ I’m a good friend” despite all these changing times in our lives. You should be on a podcast! All the best to you! Andrea Hanson RN BSN IBIS - West Palm Beach 717-856-6244 Sent from my iPhone
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