Tuesday, June 24, 2008

Close the door! And put something heavy against it!

There is definitely something about the full moon. Or maybe it is some other cosmic phenomenon; I don't know. What I do know, and what just about any emergency room employee will tell you, is that there are times when it seems that the flood gates of craziness open and pour directly into your place of work. Yesterday was such a day.

I know that nuttiness is out there somewhere. You run across it from time to time so you know it exists. The law of averages would seem to suggest that you should have a homogeneous mix of craziness throughout the year - some percentage of your total - but that is not the case. They lurk, out there in the world, until the time is right. What I can't figure out is what sort of signal causes them to attack en masse.

Rather than tackle this weighty issue, which is definitely beyond me, I choose to describe these people. I am in the process of creating a sort of taxonomy system so that all of us who deal with the public can simply name them instead of wasting our precious time and energy describing their activities. No one would bother describing how a tiger took down a gazelle in detail - that's just what tigers do. I welcome your input during this process. I think a dictionary or encyclopedia of misfits might be in the pipeline. I will try to add to this list as I am reminded of other types.

Class One - "The squeaky wheel":

These nuts have discovered that they can raise the stakes in a conversation or interaction to a place where no sane person would dare follow. They have become masters of manipulation - using our own common sense against us. They bait us into interaction, usually by appealing to our genuine desire to help others - only to bring the axe down when we are within their grasp. They have discovered the secret of social blackmail - that if they are the most irritating person in the room, they often get served first and best in order to avoid a scene.

Class Two - "The Mr. Wilson":

A little advice - just because you are advancing in years does not give you the right to be a grumpy, uncompromising jerk. I know, I know. I'm not doing my job the way you would. I'm sure I'm not doing it the way doctors used to. And I'm sure that you, like me, disapprove of the majority of what you see going on in the world these days. None of that, however, is the fault of me or my staff. So lay off, dude.

Class Three - "The Over-Protector":

I actually had one of these yesterday, too. It is usually a husband, but may also be a parent. Whether for desire for some sort of secondary personal gain or because they are maniacally self-centered, believing that no one can care for the object of their affection the way they can, this type is disposed to violent outbursts that take on the appearance of legitimate concern. The problem is, their nuttiness drives a wedge between the patient and the person who has the ability to help them. My feeling is, if you could do this yourself, then why are you here right now? Back off and let me do my job. Please.

Class Four - "The Shape-Shifter":

This is one of my personal favorites. This looks somewhat like what we doctors have termed Borderline Personality Disorder. You start out as "the best doctor in the world", then slowly become the Adolf Hitler of modern American Medicine as you consistently fail to live up to the ridiculous expectations and demands of the patient. These people are exhausting, especially if you make the common rookie mistake of trying to reason with them and prove that you really are not the evil anti-Christ they accuse you of being. Listen to the voice of experience, people.

This is so much fun, I really hate to stop. I'll try to add some more later. Thanks for your patience.