On Fairness and Respect

Sister blogger Lesboprof is out protesting California's Proposition 8 this weekend. She explains in today's post that the nationwide protests are about a lot more than "gay marriage":

It is about calling out people's rejection of LGBT people... the idea that you can say you love us individually and vote against us as a group. We are your family members, your teachers, your students, your friends, your neighbors, your partners in faith, your elected officials, and your compatriots. We deserve fairness and respect.

She's right. That vote was an awfully painful slap in the face to LGBT people everywhere, not just in California. The message is that however much it may feel like you are accepted and respected by society, you really aren't. It's all lip service. And when your students, your friends, your neighbors, your family, and your fellow congregants can vote in secret, the truth comes out. A vote like California's serves only to demonstrate straights' hate and disgust and fear. And that is what it is. During the Civil Rights era, you used to always hear "Some of my best friends are Negroes, but..." and then would follow some right or list of rights that Blacks should be denied. Despite what people say about not being racist or homophobic or sexist or whatever, their behaviors say otherwise.

Maybe we ought to reserve the term "marriage" for the religious ceremony that takes place in churches, synagogues, and other houses of worship. Maybe we ought legally to refer to it as "partnership" (with some adjective to distinguish it from a business license) and make it accessible to everybody (adult), everywhere. The official status of what we currently call "marriage" confers not only numerous legal and financial benefits--which there's really no logical reason to deny LGBT people--but also a certain social standing and psychological meaning. When your coupleship is official, it gets much more "glue": Other couples support it, singles respect it (by which I mean it cuts down considerably on "poaching"). A state license grants a personal sense of permanence, stability, and trust in the relationship--that it really means something, that it will be there for you. All of which there's also really no logical reason to deny LGBT people.

When I was growing up, it was illegal for people of different races to pair off, never mind marry each other. It was called "miscegenation," and it was a crime. There were laws against it. (I know I just said the same thing three times, but I'm betting there's young people out there reading this who won't believe me the first time.) That looks so quaint, backwards, racist, and downright silly to us now. Why are we holding on to the same ugliness with regard to LGBT people? It does not become us as a nation. What it says about "the content of our character" is not pretty.

It's time we grew up.

Courtroom Antics

I have two cases going to court in the next couple of weeks, one civil and one criminal. And it's got me to thinking about past forays into the justice system and how weird it can get.

Used to be, we were the only private practice up here for miles around, and we had folks drive from as far north as Dalton and Copper Hill for therapy. As a result, we were occasionally in courtrooms just about anywhere in the Blue Ridge circuit. Judges and attorneys varied wildly in quality. On one memorable occasion, I drove all the way up to Calhoun to testify in a divorce case in which I had already warned both parties that I had nothing to say that would be good for either of them. But one of them subpoenaed me anyway, so off I went at the crack of dawn to the wilds of north Georgia. No sooner had I been sworn in than the judge asked me if I wanted to waive privilege. I said "No," he excused me, and that was that.

Now I am no lawyer, but it is my understanding that, in the first place, the privilege is not mine to waive. It is the client's, and the soon-to-be-ex-wife, by subpoenaing me, had already waived hers. (Not to mention that, under Georgia law at the time, communications with me weren't privileged in the first place.) But whatever. I didn't want to be there so this suited me just fine.

Even some counties close in to Atlanta were pretty back-country when I started my practice. I was in Dallas one day for a child sexual abuse case. This Court liked to assemble all the parties, including witnesses, before beginning trial and was calling roll. The child victim was female, and was accompanied by her mother. The mother had brought her divorce attorney, who was female, as there was also a modification of custody action pending. I'm a woman, of course, as was the pediatrician who was going to testify to some physical evidence. A female police officer was there to testify as well. At about this point in his roll call, the judge, clearly exasperated, turned to the (female) ADA and asked, "Is everybody in this case female?" to which the ADA, straight-faced, replied, "No, Your Honor, the Defendant is a man." The courtroom broke up. Even the bailiff was laughing.

Veterans' Day

For those of you who like to write but are occasionally stumped for a topic, check out The One Minute Writer. Today's prompt, appropriately enough, is "write about a war veteran you have known of, or known personally."

The first vet I ever knew was my Mom's Dad, whom we called Boppa. He was in the infantry in World War I. I don't know much about his service, because he had a repertoire of three funny stories and that's all he would ever say on the subject. My father-in-law was in the Navy (Pacific) in World War II and was reportedly much damaged by the experience.

One of the best clinical supervisors I ever had served two tours in the infantry in Viet Nam before he went to medical school. As a therapist, it has been my honor to work with veterans as well as active duty personnel and military families. Some have seen combat, others have not, Some were officers, others grunts or noncoms.

Today, and every day, I would like to thank them all for their service.

RateMyProfessor.com

One of my students told me today that I already had a good rating on RateMyProfessor. This surprised me, as I have only been back teaching since January. But I went to look tonight, and sure enough, there I was.

There's good news, and bad.

One of the ratings was from 2002: "Awesome. Really knows her stuff, makes it interesting." I got good ratings on helpfulness. Unfortunately, I'm also rated as "easy". (I'm not easy: I flunked somebody last Spring, fer cryin' out loud!) So of course my overall ratings were good.

But the worst part, worse even than being described as "easy", was that I got zeroes on "hotness". Now I realize that at 56 I can't look very hot to most of my students. But zeroes?

Obama wins!

"Change has come to America."

The Mental Status Exam

MDOD has a new post, complete with CT scan, on a fella who came into ER c/o (complaining of) altered mental status. Of course in the outpatient private practice of clinical psychology, one rarely--if ever-- sees such dramatic cases. Nevertheless, it's a good reminder that whenever we do see a really whack MSE (Mental Status Exam) we should always, always have the patient seen by a physician to rule out physical causes before we assume that they are "just" being paranoid, or are schizophrenic or whatever. Talk therapy won't work on tumors.

Mom once lost a friend that way: He'd been in treatment for months for "depression" when what he actually had was a brain tumor. This happened when I was still an undergrad (yeah, yeah, I know--back before the Flood), but it's remained in the forefront of my mind whenever I am doing an initial assessment or when an ongoing patient's status changes. Mom's friend had never been depressed before, even though he was by that time in middle age, and there was no family history of it. Furthermore, there were no apparent environmental causes (e.g., illness or death in the family, work stress, etc.). Which should have been big ol' red flags right there.

In a practice like mine what we are more likely to see is someone who is physically quite ill, but the medical folks, having failed to find the cause, refer them to us for psychotherapy for imaginary or manufactured illness. One such fella I had certainly had an altered mental status--he kept passing out!--but there was no discernible psychosocial causation, no family history of anything remotely similar, and his personality profile from psychological testing was completely inconsistent with any sort of histrionic or psychosomatic disorder. And a friend's son was once referred to a psychiatrist before it was finally discovered that he really was having trouble breathing: The poor kid had tuberculosis!

Point being, I guess, that mistakes get made on both sides of the professional aisle. Medical people should listen to us when we tell them we don't think the problem is psychological, and we must consult with them, too.

Wood's Rules: #2

Rule 2: I never wait for anyone, not even God, for more than 20 minutes.

The Mister and I went to vote this morning. Lines have been long, but Mr. had called ahead and was told that we could go to the front of the line because of my disability. So we turned up promptly at opening time this morning (8 am). It was a madhouse. The parking lot was full and there were lines of cars snaking up and down the aisles looking for a spot. Which of course they weren't going to find because no one had voted yet and therefore no one was leaving. Ever the optimist, Mr. dropped me off at the front door and I went to the front of a very long, very fat line--only to find that handicap voting didn't 't start until 9:30!

But it all got me to thinking again about disability rights, which we talked about in Ethics class on Wednesday. Going to the front of the line is not a privilege. It merely evens up the playing field. I could wait in line all day, and have done (Jimmy Carter's election comes to mind) but a lot of handicapped people can't maintain for that long. So they could not vote the way things are this year. Point is, "privileges" like going to the head of the line enable us to do things we could not otherwise, things the able-bodied take for granted.

The dean of my graduate school told me once that my fellow students envied my special parking space. At the time we were moving through a buffet line: I picked up a carving knife and told him that anyone who wanted one could bend over and I'd qualify 'em for special parking right here, right now. He did not get the message that he had it all backwards. Curb cuts, special parking, wide doors, grab rails, ramps, all that stuff is not a privilege to be resented by TABs (Temporarily Able Bodied people) like him, but assists that we need so that we can attend graduate school, travel, get to a job, go to the store, stay in a hotel, see a movie, and partake in community life in general. His facial expression clearly said that he thought I was the one being inappropriate.

Anyway, to get back to Wood's Rule #2, which is where we started, I wasn't inclined to wait an hour and a half for special voting privileges. Why, if everyone else can start voting at 8, can't we? Mr. and I have things to do this morning, so we came back home. We will try again later. Maybe we will be able to get a parking place.

But it did occur to me that every rule has an exception, and this rule is no exception to that rule. I would wait in line ALL DAY to vote, if necessary. In fact, before I found out about my disability getting me to the head of the line, I had planned to take Tuesday off if standing in line all day today didn't get me to a voting machine before closing. It took all night to vote the year Jimmy won: I went to the polls after I got off work at 4:30, and they closed the doors at 7. There were so many people already inside that gym that it was after 10 before I finished. Boy was I bored! There's only so much you can chat about to the total strangers in line with you, and you can only study your ballot for so long. Somebody had a paper, and we read it about seven times each, then that got old, too. But voting is so important that it was ok. I would have still been standing there at daylight if that's what it took. I'm just glad the pollworkers were willing to keep at it until we had all voted.

Generally speaking, however, I consider my time valuable, and I hate late. If you are my last client of the day and you aren't there by 20 after, I'm gone. If you are meeting me for lunch and you aren't there within 20 minutes of the agreed-upon time, I'm ordering without you. If you're my doc and you aren't ready for me within 20 minutes of my appointment time, I'm leaving. And I tell my classes that if I'm not there within 20 minutes of the scheduled start time, I'm not coming and they are dismissed. I once had a professor whom I never actually met because he was late for every single class the first few weeks of the semester. The fourth time this happened I went to the Registrar's at 20 after and withdrew: I made them give me every penny back, too. No withdrawal fees, or late registration fees for the new class I signed up for either. I felt disrespected, and I worry that, when I'm late, no matter the reason, that I am communicating a disrespect that I don't feel to the person cooling their heels waiting on me.

Why is this such a big issue for me? Possibly because my mother was late everywhere she went. When I was a kid, I don't think I ever saw a movie from front to back. We would arrive late, stumble around in the dark looking for a place to sit, then climb over people in the middle of the movie. I was always so embarrassed! We'd watch the last half of the show, then sit through the previews and the newsreels and the cartoon and watch the first half of the movie. Mom would announce, "This is where we came in," and we would get up and leave, climbing over everybody again and stumbling out of the theatre in the dark. My mother-in-law was the same way: The Dad-in-Law used to always tell her things were starting 45 min. before they actually did in order to get her dressed and out of the house in time, and even that didn't always work. Mr. is prompt, thank heaven, or we never would have made it as a couple.

Part of promoting Rule #2 to patients is that so often they--especially the women--do not hold themselves in high enough esteem. They are willing to be kept waiting endlessly by people who obviously are disrespecting them by making them sit. One of the faculty at the Internship From Hell pulled that on me once, deliberately, and when I left after 20 minutes he went ballistic. (It turned out that he had not arrived for nearly two hours!). In business and politics, apparently, keeping people waiting like that is a deliberate ploy to establish dominance: What made the guy so mad was that I didn't demonstrate the expected subservience. I won't play that game, and don't encourage my patients to, either.

Anyways, that's Rule #2.

Postscript: The second time was the charm. There were no handicapped spaces available, so Mr. had to drop me off, take the car across the street to the drugstore, and walk back, then repeat the process in reverse afterwards to pick me up. But except for that we were in and out with no problems. The guy in front of us, who had come through the regular line, said he'd been there 4-1/4 hours. My hat's off to him and to every one of those other good people so determined to vote. You go, America!