RX for the doc: Take two kindness pills, and don't call me in the morning

By Lisa A. Eramo

"Hello, my name is Dr. [insert last name], your OB/GYN."

[Doctor turns her back]

"Nice to meet you, doctor."

"What brings you here today?"

[Doctor shuffles papers, her gaze focused on the medical record in her hand]

"I'm here for my routine exam and to talk about my joint pain."

"Let me take a look."

[Doctor performs physical exam then heads over to the sink to wash her hands, her back now turned away from the patient]

"Ah yes, you are definitely a candidate for the stomach surgery."

"Um, do you mean gastric bypass? We weren't even talking about that."

"Yes, the gastric bypass."

"But what about my joint pain? Why do I have joint pain?"

[Doctor shares some irrelevant statistics based on studies conducted with nuns]

"What does gastric bypass have to do with joint pain?"

[Doctor shares a personal story about how her diabetic aunt weighs her food and counts her calories obsessively every day]

"I still don't understand why you're dismissing my symptoms. Gastric bypass seems a bit...um...drastic?"

Silence.

Okay, so who isn't a few pounds overweight? It sickens me (pun intended) to think that the above conversation is based on an actual interaction with a physician. How can someone possibly be so inconsiderate (and deaf)? The truth is, if you walk into just about any physician's office in America, the land of HMOs, not only are you likely to wait an average of 15-20 minutes (or more) to even see the doctor, but then once you are face-to-face with the self-proclaimed miracle worker, you're lucky if you get five minutes of his or her attention--only to be unheard, insulted, discouraged, or made to feel less worthy in the end.

Do you ever get the feeling that your physician is from another planet? It's almost as if the doctor follows an 'insert earplugs' command right before entering the room so everything you say goes unheard. But wait, isn't it part of their job to listen and document medical information? Last time I checked, an office visit typically followed this script: Doctor asks question, patient answers question, perhaps doctor makes a notation in the record regarding the discourse. Seems pretty elementary if you ask me.

But let's get real here, folks. At some point in his or her life, today's overcaffinated, pessimistic, worn out physician was on the flip side of the coin--that is, he or she was the patient. What does this mean? It means that instead of wearing a pressed white lab coat and fancy ID badge around the neck, the physician (then patient) was wearing a paper-thing "napkin"...and not much else.

And boy, was it cold in that exam room. Can someone please turn up the heat?

One could argue that because doctors were patients at one point in their lives, they would be more empathic to the patient's plight. Could it be true? As a general rule of thumb, nope.

Our country's medical schools give birth to countless physicians each year who are resilient enough to persevere through some of the toughest academic and residency programs. According to the American Medical Association, there were more than 334,000physicians practicing in the United States. In 2000, there were more than 800,000.

And although these individuals have surely proven their ability to study, pass exams, and perhaps even save lives, there is one element that they lack: compassion. It's as though as soon as they added "MD" after their names, they had a license to strip others of dignity. After all, patients don't really have feelings, do they? They're really just one more subscriber ID on the Blue Cross (or whatever other overpriced health plan to which you throw away money) bandwagon. Patients equal dollars. Yeah right.

So what would it take to make the average patient happy? A little kindness goes a long way. And last time I checked, smiles were free. News flash: a handshake only takes two seconds of a physician's oh-so-precious time.

Patients trust physicians with their deepest, darkest secrets. Patients let physicians exam their naked bodies and stick tubes down their throats. Patients let physicians cut them open during surgery, not knowing whether they've had more than an hour of sleep the night before. And yet despite these intimate acts, many physicians won't even make eye contact with a patient, yet alone show some compassion when giving "bad news" or suggesting difficult lifestyle changes.

For now, I'll just bide my time, knowing that eventually, physician payment will be directly linked to quality performance, patient outcomes, and patient satisfaction. And maybe Medicare will eventually slash the physician fee schedule so docs can lose their "I am God" complex.

In the meantime, every time a doc upsets me, I'll go to wwww.healthgrades.com and share my thoughts. If I could save one fellow patient the aggravation of seeing a pompous and rude physician, then my visit would not have been in vain.

And for the doc with the earplugs and diabetic aunt who insists that "stomach surgery" is the cure for joint pain? Here's my prescription for you: Take two kindness pills, and don't call me in the morning.

Welcome to my office: Sweatpants required, shoes optional

By Lisa A. Eramo

It's 7:00 am and my alarm clock screams "Rise and shine!" I can hear Cannoli (our cat) whistling like a referee who wants to begin a game, so I roll out of bed and don my office attire: sweatpants, a tank top (no bra), and comfy black slippers.

With coffee in hand, I begin my daily commute to work. It starts with ten trecherous steps across the living room floor--treacherous because I've yet to fully "down" my coffee. From there, I swerve around the dining room table to open the sunroom doors. It is here that I stop as if at a traffic light to enjoy the light pouring into the room. My only coworker (Cannoli) makes his way into the room to begin an agenda of purring, sleeping, and chasing dust bunnies. I take a seat at my desk and push the button that unmutes my phone. Goodbye to "do not disturb" (for now). Start up the laptop. Log in through five million websites to access my work-related files. This is how my day begins...working from home.

According to the United States Department of Labor, 2004 Bureau of Labor Statistics, there are lots of us who begin our days in this way...15% of the working population (20,673,000 people) to be exact. Nearly half of these individuals are actually paid to work at home as part of a contractual agreement with an employer or because they own their own home business.

Strange to think that there are so many of us, especially as I sit in solitude listening to the fan blowing and the cat meowing instead of the morning cubicle chatter. Although I haven't conducted any research yet, I bet the at-home worker enjoys his or her freedom for the most part, but also feels incredibly lonely at times. There are no lunches with coworkers, no coffee breaks to gossip about the latest new hire (or fire), no suprise donuts on the kitchen table.

But it's not all bad. I think about the power that we have collectively. Unlike the onsite worker, we have the freedom to wear pajamas all day, watch the Olympics "live" instead of taping them, blast our stereos as loudly as we want, burn some candles to set the mood, order Chinese for lunch. Heck, we could even bake a cake in the middle of the day if we wanted to.

Yet despite these advantages, I still find myself feeling lonely and bored at times. My mind (and body) need constant stimulation. And when I can't "see" my coworkers and witness all of the nonverbal elements of communication, it often leaves me feeling literally remote and removed. Perhaps my coworkers even unknowingly forget about me. Maybe posting a picture of my face on the overhead projector would remind them to include me on the agenda or prompt me for my thoughts during meetings. Perhaps a life-sized doll in my image would remind them to save a virtual seat for me in the conference rooms. Maybe they could hold a lunch in honor of me each week?

Does anyone out there feel the same way? When my laptop crashed this morning at 9 am, forcing me to waste two hours while anti-virus software scanned my files, I brainstormed some questions that I would ask at-home workers nationwide. Maybe the answers to these questions would bring me solace and comfort.

• Don't they hate it when people ask them whether they are more productive working at home?
  
• Do their laptops crash and printers jam so much that they have bookmarked their user help guides? Can they recite the help guides by heart? Do they have favorite chapters of those guides?
  
• Do they find it difficult to concentrate when passersby on the street or the garbage truck seem more interesting?
  
• Do they find themselves raiding the kitchen cupboards at all hours of the day?
  
• Can they predict when the school bus will round the corner each morning?
  
• Do they find themselves talking to inatimate objects (or pets) about the weather and politics?
  
• Are they on a first-name basis with the Dunkin Donuts cashier?
  
• Are they on a first-name basis with telemarketers who call and constantly mispronounce their names?
  
• Is a walk to the post office at lunch almost as exciting as front row tickets at Cirque de Soleil?
  

For now, I'm off to talk to Cannoli as we ponder the answers to these questions, share chocolate cake for lunch, and watch Michael Phelps win gold.

Attention: Mark this box of memories "fragile, handle with care"

By Lisa A. Eramo

Everyone knows the song from Rent, the musical, during which cast members sing about measuring a year in 525,600 minutes--in daylights, sunsets, midnights, cups of coffee, inches, miles, laughter, strife...you get the idea.

Okay, I like the song, but can we really measure a year in coffee? Perhaps Dunkin Donuts or Starbucks would like us to think so.

Ask yourself this question: What warrants a year or a life well-lived? I bet no two people would give you the exact same answer. I mean, I know people who would say that the bottom line of "the company" trumps everything else. Profit. Profit. Profit. I know people who strive to compose the perfect song. I know people who would go to the ends of the earth for a great picture. I know people who teach. I know people who have given their lives in war. I know people who help people. I know people who have left a legacy. Some might say that doing something to make the world a better place elevates one's status in the "life well-lived" category.

Breaking news: I haven't saved lives. I haven't saved a single life for that matter. I haven't helped to solve world hunger. And believe it or not, in my spare time, I have not managed to find a cure for cancer. Does that mean that my drama-filled and ever-interesting life isn't worthy of musicals, memoirs, and blockbuster motion pictures? Perhaps. But I'd like to think that it's at least worth a blog. And if the Rent cast can sing about coffee, I (or anyone else) can certainly write about the incessant stories that pervade every second of our existence.

Regardless of how you measure your year or your life, you don't really realize how much "life" you've lived until you begin to pack up your belongings in U-haul boxes to prepare for a move. Of course, you can't measure a life in boxes (or was that lyric left out of the popular Rent song???), but it does give you some sense of the strange collection of random bowls you've accumulated, the extensive pictures you've taken of your pets, the clothes that no longer fit you, the pennies you saved for a rainy day, the books that inspired you during the darkest of times.

The beauty of packing is that it's like being reunited with yourself after a long absence. I found the thesis I wrote as an undergrad. I found a tape I had recorded of myself singing and playing the piano at the age of 8 (yes, a true Grammy award-winning composition). I found newspaper clippings of articles I'd written during my journalism internships. I found the lesbian movie I watched when I was first coming out. I found the baseball glove I used as a kid to play catch with my dad. I found an old notebook from a high school Latin class that I took. I found wisdom teeth that I'd had removed in college. I found photo albums covered in dust that contained pictures of people I have loved and lost.

Packing up my life has been a bit therapeutic, particularly the process of deliberately looking at each item and then deciding whether to hold onto it or toss it. It's not just about the items. The items, themselves, signify a "version" of me...the "me" that existed a month ago, a year ago, five years ago...the "me" that existed fresh out of college when I took the ever-so-bold bold step of packing these all-too familiar boxes to prepare for my schlep from NY to MA. Now I pack them again to move to RI. There's something about allowing myself to release an item, a memory, or an emotion that makes me stronger in the end.

I measure my life in boxes. U-haul boxes. Boxes that are heavy, dirty, and worn from use.

And I've marked them "fragile" so that movers know to handle them with care.

On a moving train, next stop: life

By Lisa A. Eramo

"Excuse me," I say, thrusting myself into the crowded rush hour train. Two teenage boys take one small step out of the way, rocking to the beat of their walkmans. My bag catches on their coats and they throw me a dirty look. My gaze moves past them and scans the row of seats on either side of the cabin. I spot one ten feet away and head for it.

As I go to sit down, I see why no one wanted this particular seat. Ink stains dot the middle and edges of the seat like rain spots on a newspaper. I grab the nearest pole as the train lunges into the next station. "Ruggles Street. Doors open up on the left" blares out over the intercom. The train comes to a halting stop. Doors click open and swallow those who enter. Five more people pile in and scramble to find something to hold onto. Doors slide shut and the train resumes its groan and hush like a snake woken from slumber.

From beyond the din of conversation, I hear someone say, "Jesus is the savoir of mankind." It is an old man wearing jeans cut off at his knee and a sweatshirt that says "Harvard University." He shoves his bible into the face of a businessman who continues to talk on his cell phone, ignoring the longhaired evangelist. I notice that the woman across from me is watching them as intently as I am watching her. Probably in her fifties, her book lays open on her lap, the crazy Jesus fan more interesting than Stephen King. Her hair is pulled up into a bun and her tortoise shell glasses are falling onto the tip of her nose. Her right stocking is falling down toward her ankle.

My gaze shifts to doors again. Open then close. I read a poster on the wall about free health care. Open then close. Two more stops have gone by. Leaned up against one of the doors, two teenagers kiss passionately, the black boy gently bending down to kiss the forehead of the white girl whose arms are wrapped around him. An elderly Asian man closes his eyes, his head bobbing up and down in an attempt to stay awake. A man in a black suite offers his seat to a pregnant woman and she takes it.

"I fuckin' hate school, dude" explodes from the rear of the train. There is some shoving and loud laughter as three boys get their kicks. They enjoy the attention received from making such a scene. I become aware that most of the passengers on the train are, in fact, students. Surrounded by a generation of middle school kids that curse and yell and talk about subjects I never dreamed of at that age, I am jealous. I am jealous of their books and their bags. I am jealous of their jeans and lunch hours. I am jealous of their schedules and study halls. I close my eyes and pretend that I am carrying a bag full of geography and biology books instead of reports for my department meeting.

The train moves so quickly that the landscape looks like a Dali painting--surreal and nonsensical. The vibration in my legs reminds me that I am alive and moving toward my next destination.

What an orange goldfish taught me

By Lisa A. Eramo

It began with a bright orange goldfish.

I'm not talking about my affinity for fish, nor am I talking about my affinity for the color orange. No, this fish was much more important than that. It was my first pet, and it taught me a very important lesson.

Picture this: I'm 7 years old, fish in hand, ready to conquer the world. I was thrilled--this beat taking care of any stuffed animal or toy doll. I placed the fish in our living room on a small table with a bright orange table cloth that matched its shining scales and fluttery fins. It swam around in its bowl, wriggled its tail when I fed it, and it seemed to exist for me and only me. I was the proud owner of a beautiful goldfish. I faithfully changed its water, fed it like a good mother would, and gave it lots of love and attention.

And as quickly as I had gotten used to the idea of being its most important companion, my fish friend was gone. In the middle of the night, it had jumped out of the bowl seeming to say, 'Hey, I'm too big for this bowl and there's more out there for me.'I was as devastated as a 7-year-old kid who just lost a fish could be. But at least the fish got a proper burial out under a big tree in our yard.

Losing a fish at the age of 7 in no way compares to the losses I've felt since then, but yet I still keep going back to that day--to the sheer confusion and sadness that I felt at that moment. The idea that I could cherish something with my entire being and lose it in a matter of moments was more than I could comprehend. The fish had been mine, and there was a part of me that felt responsible for its strange death. But then again, maybe it really was moving on to bigger and better things.

When you're young, you create stories to make sense of the world. I still do this. My paternal grandfather still visits me in my dreams now that he has passed away. I know that my maternal grandparents slow dance in heaven every night. One of my great-grandmothers who passed away at the age of 99 still writes in her journal every day. My most beloved teacher still teaches calculus in heaven to those who will listen. And my aunt, well, she watches it all as a quiet observer, smiling from the most beautiful cloud in the sky.

The reality is that people and things come and go. Relationships begin and end. It's the rhythm of life, and oh what an incessant rhythm it is. But even when you've got rhythm, there's always a bar or two that will throw you off. You're singing along to a familiar tune, and suddenly you've forgotten the words. You've plotted out how your journey will go, and suddenly you've lost the map.

This is why at the age of 29--after experiencing grief and loss of every possible magnitude and depth--I don't understand this emotion any more than I did as a kid. People like to use the cliche, "when one door closes, another one opens." I tend to think that these people are just trying to justify a loss that they don't understand. But the beauty of thinking positively is that after a while, you really do start to believe it, and next thing you know, a door does open. You walk through it, and low and behold, there are new roads on which to walk and new connections to make. Suddenly, your life is punctuated by deeper and more thoughtful relationships than you could have ever imagined.

Anxiety, anxiety go away...and don't come back another day

By Lisa A. Eramo

Anxiety.

Just the sound of the word makes my heart race. Anx--i--ety. Anx. Angst. I. Anxiousness.

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18.1% of U.S. population).

Think this statistic is scary? Well, it is. And unfortunately, I'm one who suffers with the condition. Put me in front of a group of people and tell me to give a presentation, and my palms sweat, my stomach does flip flops, and I feel as though the sky could fall at any minute. I obssess for weeks in advance, sometimes not being able to sleep for several nights in a row. And it's not only limited to the public speaking venue--it has social implications as well. Tell me to make small talk, and I'd honestly rather be standing over a 500 degree stove flipping burgers in the middle of summer...in Florida...in my winter coat...while standing on my head. Get the picture?

The first time I started talking about social anxiety, I remember that it felt good to have a "label" to put to what I was feeling. It didn't solve the problem, but it was reassuring to be able to say, "oh, it's just the social anxiety at play..." or "it's not me, it's the anxiety...and I'm getting help for it." I "talked" about social anxiety for a long time without ever really doing anything about it. I felt like a broken record, talking in circles until I was dizzy and my therapist was practically falling asleep on me (no lie...it really did happen).

One year and one therapist later, along came cognitive behavior therapy. My therapist (who managed to stay awake, by the way) gave me several exercises to try and identify my irrational thoughts and recognize that they were just that--irrational. This tactic seemed to work for a while, but gradually, those scary irrational thoughts kept creeping in.

Enter the happy pill...Celexa, to be exact. I'll never forget the day I filled the prescription. I wondered whether a little pill smaller than the size of my finger nail (which, by the way, was pretty small considering my anxiety had caused me to bite them all off!) actually help me? That's what was going through my head as I help the pill up to the light for closer examination. Once I swallowed the pill, there was no turning back. Whatever horrible side effects were written on the side of the bottle could be activated at any time. All of this for the sake of happiness and sanity?

Truth be told, the pill did work its small miracles. I felt better about myself, more comfortable in social situations, and far less anxious. I used to be embarressed and ashamed to talk about the fact that I have social anxiety. I think there is a stigma surrounding any type of anxiety or depression. With an estimated 15million sufferers of social anxiety disorder, it should almost be as normalized as the common cold.

These days, I'm past the point of feeling badly for my social anxiety. With time, it has gotten better, and I am no longer on the pill. When I'm feeling anxious, I let myself feel that way. Eventually, the feeling will subside. Deep breath, and I'm fine.