It’s the holiday season, and while we’d all like to believe that this is a time for generosity, compassion, and common courtesy, the reality is that holiday stress leads to rancor, hostility, and knocking over a crippled grandmother with a pacemaker to get to the last Wii at Toys-R-Us. Although the mental health practitioners of the world attempt to help people manage this stress in both the office and online, many people have clearly not taken advantage of that help.
As we’ve seen, clients can become abusive toward their therapists. It’s not very often, however, that I witness – or am the brunt of – a person’s abuse before they actually become a client.
I received a call recently from a woman who needed to have a psychological evaluation prior to weight loss surgery. This evaluation was to take place in my office in the suburbs of New York City, and because of that, I often give detailed directions to the space itself, instead of simply a city address “at the cross of such and such.” Many clients only want to hear the address and utilize their “flawless” navigational systems, but I strongly encourage them to write down a few directions, as the office is not easily seen from the main road. Additionally, the office building itself is a few stories high with separate driveways and parking lots; thus, if a client parks in the wrong lot, he or she will be unable to find the correct suite and will spend a half-hour strolling around the parking area looking for the office directory. This is especially problematic if I am in session when a new client gets lost, as I am unable to pick up the phone to help find me.
Despite my admonitions to the client that he will likely get lost without just one or two brief sentences to jot down, many flat-out refuse or grudgingly (and purportedly) scratch out the basic instructions. After giving the directions, I emphasize the importance to them of attendance and punctuality for an evaluation of this nature. For years, I had no idea why I always had to wait so long at the doctor’s office. I thought they were late because they were playing golf or buying Ferraris or having sex. But then I learned that many physicians will double or even triple book themselves throughout the day because so many people are often late or simply don’t show up at all for their appointments. Physicians don’t want to be sitting around with nothing to do (i.e., not making money), so punctual clients need to sit around to make up for the irresponsible people who don’t treat their appointment times with respect.
Therapists don’t have the luxury of booking appointments that way. We can’t have three people booked for a therapy session and have two people wait if all three happen to show up. One person, one slot. That’s it. If he or she gives the middle finger and no-shows, that’s lost time and income for the clinician.
Normally, when a client is late for therapy, his or her session is still stopped at the scheduled ending time, as the rest of the therapist’s clients need to be seen in a timely manner. For a weight loss surgery evaluation, however, the opportunity to say “we’ll start up with this next time” is not so readily available. The information needed to approve or reject a client for surgery can normally be obtained in one visit, provided that the client is punctual. I often book extra time for an evaluation just in case, but the client is told that if he or she will be significantly late to please call and reschedule for another time.
After going through all of the details with this potential new client and receiving assurances that there would be no difficulty (due to the navigational system), I waited for her to arrive promptly at noon.
11:55 AM: Dr. Rob takes out appropriate forms for evaluation, listens to clock on wall tick while pondering if he should buy new ink toner today or tomorrow.
12:00 PM: Dr. Rob decides that tomorrow would be the appropriate time to buy toner.
12:05 PM: Door to office suite opens, but it’s the mailman with a credit card bill for Dr. Rob.
12:10 PM: The new client calls. She says that she “just left the house, so I’ll be there pretty soon.” Dr. Rob attempts to remind her of the original phone conversation and that the evaluation might need to wait because he has other patients scheduled, but she has already hung up.
12:12 PM: Dr. Rob reviews credit card bill.
12:15 PM: Dr. Rob practices the nearly impossible “rubber pencil” motion.
12:18 PM: Dr. Rob draws stick figure of new patient and begins stabbing the drawing.
12:25: The client calls again to state that she is “almost there,” but that she needs the address again. Dr. Rob gives directions in a haughty tone. Client hangs up without saying thank you or good-bye.
12:30: Imaginary tumbleweed blows across silent office.
12:35: Client calls again, now officially 35 minutes late.
Client: I’m in the parking lot but I can’t find your office. You said it was on what floor again?
Dr. Rob: It’s on the 2nd floor, as we discussed twice now already.
Client: So where is the elevator?
Dr. Rob (exasperated): Ma’am, I told you that there is no elevator, you need to drive your car to the second floor parking lot and come in the front door.
Client: Why is there no elevator?
Dr. Rob: I don’t know, I’m not the architect or building contractor, I’m just the psychologist.
Client: I don’t like the tone of your voice.
Dr. Rob: I apologize, but I’m very frustrated with you right now. You should probably reschedule…
Client: Oh wait, I have another call. Hold on.
Pause for 1.6 minutes.
Client: I’m back.
Dr. Rob: Ma’am, I am going to reschedule you. This is completely unacceptable.
Client: No, I found the suite now, I’ll be there shortly.
Dr. Rob: No, I have another client in less than 30 minutes, and there is no way that we can complete this evaluation in time. You will have to reschedule.
At this point, the client was right outside the door, opening it and walking into the waiting room, screaming into her cell phone.
Client: Goddammit! Who do you think you are?! Oh. (clicks phone shut)
Dr. Rob: You need to reschedule.
Client: I did not come here to be treated this way. You were rude to me on the phone, probably because I’m black.
Dr. Rob: What?! I may have been rude, but not because you are black, but because you don’t respect other people’s time. How would I even know you are black from a phone call?
Client: Because my name is black.
Dr. Rob: Your name isn’t Black, it’s _______.
Client: No, because it sounds black.
Dr. Rob: This is asinine. I do not appreciate being called a racist, and I’d like you to please leave. I will give your surgeon names of other psychologists who can provide the evaluation for you.
Client: Oh I’m leaving, but only because I’m firing you, not because you’ve asked me to. You are disgusting and ugly. Good day.
I got a call a few hours later from the referring surgeon.
“Did you refer to a patient of mine with a racial epithet?”
“I did no such thing!”
“I should hope not,” he said, somewhat suspiciously.
“She accused me of being a racist because I was curt with her, but I had a good reason for doing so.”
“You had a good reason for being a racist?” he asked, dryly.
“No! I had a good reason for being curt. I was not racist.”
“Fine, Dobrenski. Just watch your tongue around my patients. This hospital prides itself on its diversity and I will not have my good name sullied by some shrink. And if you do have your own racial issues, please address those in therapy or whatever you people do to fix those problems. I’d hate to believe I could only send you Aryan patients,” he added, before hanging up, leaving me alone with my credit card bill, having been branded rude and racist.
I hope everyone is enjoying their Holiday Season…I know I am!