Beige Food Seven
Rules as Protection
Do you have rules for social media interactions for yourself and/or your kids? Maybe you never post photos that have the location metadata, or even photos where the background is identifiable geographically. Maybe you don’t use your real name. Maybe if you strike up an online friendship and you agree to meet in person, it’s somewhere distant from your usual places and very public.
Whatever it might be, chances are good that you have some guidelines or rules for yourself, and perhaps many more for your kids, that reflect that you understand parasocial relationships are relationship-esque but are not real relationships. They may develop into real relationships, but key pieces of how we build mutual trust are lacking in the online world.
You need similar rules in any organization or system setting. These rules are much more difficult to set up because there is no inherent “stranger danger,” or “I don’t know you,” if you and your colleague have worked alongside each other for years, or you have been a patient with your current treatment team for years then you do all know each other.
I have already handled the pitfalls as an employee in the Set Shifting series, but I want to address being a patient in a healthcare setting in this one.
It may not be apparent to most, but the healthcare system is designed as an adversarial system, similar to most judicial systems in the western world. Unfortunately, unlike the judicial system, in the healthcare system there are no defense lawyers who will represent your best interests as the patient. Practitioners are the prosecutorial lawyers and the judge is the employer of those practitioners. I go into more detail on these concepts in the series No Before Times to Be Had (Part Two specifically).
It's very important to identify your healthcare goals and your medical mind prior to attending any appointment with any healthcare practitioner. If new symptoms are prompting you to seek out professional attention, then steel yourself for an online search on possible underlying causes for such symptoms. And this is not so that you can speak knowledgeably with the practitioner. In fact, you won’t be sharing the fact that you’ve looked out any information online.
The reason for doing so is to review the limits of what could be done to address the symptoms ahead of time. Very few practitioners will be willing to discuss, prior to getting the results of the screenings they have requisitioned, what a positive result would mean for subsequent treatments. You will usually get a “Well, let’s see what we get back first.” Additionally, very few will give you an explanation of what might be ruled in or out based on the screenings and tests they have requisitioned for you as well. However, this is the kind of information you need to determine whether you want to undergo the screenings in the first place and what possible treatments you would or would not consider for yourself should there be a positive result on any of the tests.
I cannot know what the best rules for you to develop might be because we each have distinct healthcare goals and medical minds. I have a busy brain and a somewhat anxious mind. I also have a very active immune system and a very sensitive interoceptive sense of what’s going on in my body as well. For me, I have a rule that a new symptom has to be present, unrelenting and worsening for two weeks before I seek medical attention. There are obvious exceptions, such as sudden weakness on one side of the face or body, or one-sided drastic swelling of limbs where a two-week wait-and-see would be foolish.
New symptoms could have a serious underlying cause, but there are also very few serious causes that require immediate intervention to save a life. Having a stroke? Dealing with appendicitis? Sure, those things need immediate attention. I would not sit on facial droop for two weeks, for example. However, I do seek to keep my interfaces with the healthcare system focused on things that they can do. I look to have a trendline and not just a novel symptom data point. Just like with glycemic control vs. glycemic trendlines—I don’t want to treat things that don’t require any interference to resolve of their own accord. That is me and my medical mind.
I think people fall into two basic medical mind categories: 1) “I would prefer to risk the negative impacts of every possible intervention being applied rather than risk the possibility of the deep regret I would have that something is caught too late to save my life”; and 2) “I would prefer to risk the possibility something is caught too late rather than take the risks of applying every possible intervention to try to put my mind at ease.” Given my experience in the care experience review field, I can assure you there are an equal number of winners and losers for both categories. Just because we have an inherent medical mind, doesn’t mean that it’s ultimately the best path for us. In the end you need to be true to the medical mind that you have and you need to give yourself the grace and humility to recognize that, whether it does or doesn’t work out in your favour, it’s neither a commendation nor an admonition of the way that you think and act as a patient.
But no matter your medical mind, when it comes to discussing your diet and food choices it’s a good idea to limit that discussion to dietitians, if they are present on your treatment team. And even for dietitians, they are working to standards of care and it’s a parasocial relationship just like any other.
I would not recommend lying about your intake or food choices—lying is cognitively exhausting and will trap you in the end. But it is pretty straightforward to say to any practitioner who is not your dietitian: “Thanks for your advice, I’m working with a dietitian on food choices and I’m comfortable with the path we’ve chosen.” If you’re not working with a dietitian and you have a healthcare practitioner asking you pointed questions regarding the “healthiness” or “nutritiousness” of your food choices, you can say that you’re comfortable with the choices you’re making and that they’re broad and suitable for the recovery process you’re undertaking. And then move on to the topic that you wish to address with that specific practitioner: “I’ve come to you today because I have a concern that I’m really hoping you can help me with...”
Usually that redirect will be enough to get them back in their lane of expertise. If it’s not, and you’re being peppered with questions that are reinforcing their anxiety around cultural “good” food choices, then it’s okay to ask in response to a question, “It seems, from this line of questioning, you are concerned about my food choices (or food amount, whatever it might be), is there something specific that is worrying you?” Using the words “worried” or “anxious” to describe how they are coming across to you will usually trigger a backtrack and likely some defensiveness. That’s not a bad thing because, while their concern over your health status may be predicated on their expertise in interpreting various biomarkers, their understanding that diet will resolve the concern is based on cultural misconceptions based on the desire we all have to have something that is in our control keep us healthy and help us avoid death.
Next installment December 12.
Image in outline preview: Flickr.com Rafael Edward.
