This has nothing to do with my ADDled brain … but it’s still important

“The people are the only censors of their governors: and even their errors will tend to keep these to the true principles of their institution. To punish these errors too severely would be to suppress the only safeguard of the public liberty. The way to prevent these irregular interpositions of the people is to give them full information of their affairs thro’ the channel of the public papers, & to contrive that those papers should penetrate the whole mass of the people. The basis of our governments being the opinion of the people, the very first object should be to keep that right; and were it left to me to decide whether we should have a government without newspapers or newspapers without a government, I should not hesitate a moment to prefer the latter. But I should mean that every man should receive those papers & be capable of reading them.”

— Thomas Jefferson in a letter to Continental Congress Delegate Edward Carrington

That famous bolded section of the quote above was repeated recently by the host of a local radio show I recently had the pleasure (and terror) of being interviewed on about the importance of local media. Thankfully, it was not live!

On a chilly gray Saturday, Jeff Milchen and Steve Kirchoff, hosts of “The View From Here” on KGVM brought me and Bob Wall, Operations Manager for the community radio station, into the studio for a lively discussion.

If I sound like I know what I’m talking about, I guess, I do. As a former reporter with the Bozeman Daily Chronicle (among other daily newspapers), a current freelance journalist and a radio DJ on KGLT — a primarily music-oriented local station that intentionally avoids the news — I felt I had a good handle on the subject matter. It helped that I came prepared with quotes and stories from other sources to support the assertions I made.

Here’s a link to the recording.

I’m curious. What are your thoughts about the media and its role in preserving democracy?

Feel free to post your comments. I’d love to know what you think.

The Mighty Doctor: Considering the Power Dynamic Between Patient and Doctor

“I always made a point of telling the doctors I was sane, and asking to be released. But the more I endeavored to assure them of my sanity, the more they doubted it.”

— Nellie Bly

I often ponder the power dynamic between patients and their health care providers. Clearly, doctors spend years gaining medical knowledge that people without this training do not possess. It is exactly this level of education that gives doctors the upper hand.

I have a neighbor, a retired nurse, who refuses to put on a gown or change out of her clothes in any way before she speaks with her doctor. She has a point. Who doesn’t feel vulnerable in those awful gowns? It automatically puts the doctor on higher ground – she’s fully dressed, you’re not.

A 2016 study* found that although current trends in health care seek to minimize this power dynamic through shared decision making, many doctors do not fully perceive, appropriately use or aim to curtail their authority when interacting with patients.

Historically doctors did have knowledge their patients did not. But now, well, now we have the internet, yes? (However, I do caution people to use well-respected sources and check more than one site when looking for answers).

Innately curious (yay, ADD) (and, yes, curiosity may kill the cat, but obviously knowledge is power), when I have a medical issue, I typically research my symptoms and discuss possible causes with my doctor. She listens. She has compassion. She answers my questions. She feels more like a partner than someone with superior knowledge. She respects my intelligence and my preferences.

Many years ago, I had an infection that needed medical attention. I had just moved to Portland, Maine, and hadn’t yet sought a regular doctor. The doctor I wanted to see upon recommendation from a friend was not taking new patients, but there was a new doctor in her practice who had an appointment available.

Dr. Peter Gordon became my primary care physician for nearly two decades. When I moved to northern Maine, I even traveled more than three hours to see him.

The reason?

That infection I had is usually treated with antibiotics. But I was adverse to taking them and told Dr. Gordon so. He wrote a prescription for the drug saying I didn’t have to fill it if I took other less-invasive measures and was able to rid myself of the infection within a day or two. If not, he encouraged me to take the antibiotic. He HEARD and RESPECTED me. In the end, I was able to avoid the drugs and I recovered. And that’s how it went with him and I’m sure still does for his current patients.

If your doctor isn’t treating you this way, you might want to consider finding a different health care provider.

Laura Nimmon and Terese Stenfors-Hayes, the authors of the aforementioned study wrote that although a caring, respectful, and empowering communicative physician-patient relationship is proven to improve patient outcomes, there are barriers to employing this level of care due to the inherent power imbalance by virtue of doctors’ qualifications and training. The authors recommended doctors are educated early on and have opportunities for ongoing professional development to raise awareness of their inherent power and teach them to exercise patient-centered communication “through reflective, effective and professional use of power…”

The following statements were taken from the study, during which doctors were interviewed about their perceptions of the doctor-patient relationship. Which of these practitioners would you be most likely to go to and why? Please leave your answer in the comments section.

A) “There is always a power relationship … Patients, they have to put their trust in you because you’re talking about and doing things that really they don’t understand or don’t have a background in. So they have to have a faith that you’re doing what’s best for them, and so you have to be cognizant of that to make sure that you never ever take advantage of that role.”

B) “There is a power imbalance … I mean, you are empowered by the knowledge that you have and the ability to treat patients. So there is an inherent power imbalance … that power imbalance is in knowledge.”

C) “I think you’re seeing that patients probably think they have more power. I think because there’s more consumerism within medicine, people have a U.S.-style consumerist way/approach where ‘I have all the information, you should do this treatment because I think this is what I need.’”

D) “A lot of patients really want to be an equal partner in the learning. And some of them are very intelligent and they will ask you difficult questions. And that’s fine, I kind of like that.”

 

* Laura Nimmon and Terese Stenfors-Hayes, The “Handling” of power in the physician-patient encounter: perceptions from experienced physicians (BMC Medical Education: 2016) [also posted on the National Institutes of Health’s PubMed Central

It all ADDed up — Part I

You’d think I’d have been upset. But a few years ago, when a psychiatrist told me I had Attention Deficit Disorder,* it was a relief.

That diagnosis — one I’d always suspected — didn’t exist during my childhood. But it explained a lot about my life. Why I experienced so much failure in school, jobs, relationships. Why I’d made so many less-than-ideal decisions. It also confirmed that, like many with ADD, I have dyslexia  my brain sees things differently than so-called normal brains so I had trouble reading and writing.

pexels-photo-278888

So here’s the ugly truth: I struggled in school though I did well enough. My teachers and parents seemed to know I was intelligent but didn’t know how to help me focus. I had to work hard to get good grades.

Particularly in my first few years in college.

You see, I thought I wanted to be a biomedical engineer and the thought still appeals to me. I love the idea of conceptualizing and creating things to help people live better lives. And although I did well in science and math in high school, unlike my college cohorts, I did not take advanced placement courses. Remember bell-curve grading?

So there I was at a midwestern university with more than 100 students in an un-air-conditioned lecture hall. The temperature and humidity were nearly identical at about 100. The chemistry class was taught by an assistant whose command of the English language left something to be desired. Not exactly the best learning environment for even the most conventional of learners.

By the end of the first week of my third semester at this university, I was throwing my shoes at my dorm room door in frustration. I decided something had to give.

Needless to say, I never did get a degree in engineering. Was that a failure? I sure saw it that way at the time.

Skip forward several years. After transferring to Goucher College — a small, liberal arts college that was women-only at the time, I found a new world. More nurturing than the university where a dean told me my SAT scores were the lowest in my class (they were in the top 80 percentile or better nationally). The only reason I got into the school of engineering was because I was a women, he added.

Yes, that really happened. But that was 1979. Although I was aware of gender discrimination, it didn’t occur to me that’s what this was. In reverse. But not really. By accepting a student who didn’t fit the criteria of the school, weren’t they merely setting me up for failure? Probably.

But I don’t blame anyone. It’s just how things were then. And besides, that’s not the point.

After four and a half years of college, several changes in majors and a parental bribe to pay for off-campus dance classes in exchange for not changing my major once again (this time to dance therapy), I graduated with a degree in elementary education. Big whoop. (Apologies to education majors everywhere — a very noble and under-appreciated profession). But before I had finished school, I realized teaching was not for me – not in the traditional sense anyway.

I hate to admit it, but I probably read only half of what I was assigned in college and still managed to graduate with decent grades. I just didn’t have the ability to focus enough to read that much. And I needed more focus than most given the dyslexia.

According to Roberto Olivardia, Ph.D., “About 50 to 60 percent of people with ADHD* also have a learning disability,” he wrote in ADDitude magazine. “The most common of these is dyslexia, a language-based learning disability that affects reading. Eight to 17 percent of the population is affected by dyslexia, and it is vastly misunderstood.”

As a very young child, when I learned to write my name, it would often come out Joby (the legal spelling of my name is Jody, but I changed it because I didn’t like the aesthetics of the J and Y). Turning that ‘d’ around should have been a clue that I had this so-called disability. But again, we’re products of our time.

Although it was 1877 when German neurologist Adolf Kussmaul coined the term word blindness to describe people with reading difficulties, there is still not much known about dyslexia. In fact, it wasn’t until the mid-1990s that scientists started investigating the underlying causes of the condition.

All this to say, children growing up in the mid-20th century were not diagnosed with and therefore not taught how to overcome the challenges associated with dyslexia and ADD. We just learned to cope. Or we didn’t. And we failed. Occasionally.

* I use ADD and ADHD interchangeably.

So many jobs, so little time

So truthfully, my track record with jobs has been, well, somewhat scattered. It’s almost embarrassing. I’ve often wondered why I’ve had so much trouble staying in one job and in one place for very long. I can’t even count the number of places I’ve lived in the last 20 years — four since moving to Montana about six years ago (for example).

In a recent conversation, the reality of my checkered past became too abundantly clear to me.

Sure, I can blame it on having ADHD in a world of supervisors (and you know who you are) who often don’t appreciate a wildly creative mind or know how to usefully focus that energy. But a recent article in ADDitude magazine caught my attention.

In the article, “8 Most ADHD-Friendly Jobs,” adult ADHD experts “suggest good jobs for your unique skill set — creativity, enthusiasm, energy and problem-solving skills,” to name a few. I was curious so I started going through the list.

1) Education

Teacher: My undergraduate degree is in elementary education. I truly love kids as long as they are someone else’s.

So I initially thought teaching would satisfy the joy I felt when I saw a student finally get a concept she’d been struggling with. I loved the creative aspect of teaching, but lacked neither the motivation to deal with the politics of the education system nor the patience to contend with unruly kids.

Nixed that idea.

Day Care Worker: Tried that in Maine for about three months. What was I thinking? Worked in the 2-year-old room. Was sick a lot. Didn’t get paid much. Need I say more?

Practicing high-angle rescue techniques with my former Wilderness Rescue Team members in Maine.

Practicing high-angle rescue techniques with my former Wilderness Rescue Team members in Maine.

2) Medical field

Emergency Medical Responder: Yup, did that too. Before moving to Montana, I was a licensed EMT and certified Wilderness EMT. I volunteered with a local fire department and two different search and rescue teams in Maine. I also taught wilderness medicine to adults (teaching adults was much more my speed).

And I used my enthusiasm for outdoor pursuits to also teach skiing and other basic outdoor skills. But of course, making a full-time living out of that was challenging.

3) The Arts

Where to begin? I was a dancer, singer and actress first. But when people began recognizing me on the streets of Baltimore, I retreated backstage.

I designed and created costumes, sets and exhibits; painted and sculpted scenery; hung and ran lights; constructed sets, costumes, props, furniture and parade floats; set up large and small musical and theatrical productions; and toured with several shows in a variety of roles. In other words, just about anything one could do in the entertainment field, I did. And I did it in Maryland, New York, New Jersey, Maine, across Canada and all up and down the east coast. And I won’t brag here, but let’s just say, you’re likely familiar with many of the places I worked and people I worked with.

The entertainment industry is fickle though and after many years in the field, I could no longer bear freelancing and living in New York. So I all but gave up that career upon moving to Maine.

4) Food

Food Service Worker or Chef: Never had either of these jobs, but as I’ve written about in a previous blog entry, the kitchen is one of my go-to Zen places where time disappears and my focus becomes nearly indestructible.

I’ve considered a culinary career, but I enjoy food too much to make it my job. I’ll settle for superhero home cook, thank you very much.

5) Journalism

Journalist: This is where I had the most success.

Journalism presents something new almost every day so ADDer’s like myself rarely get bored. That’s not to say I didn’t occasionally want to jump out of my seat and run around the room during an overly long government meeting or an attorney’s entirely too verbose opening statement. But of course, that would not have sat well with presiding officials.

Like many ADDers, I’m inherently curious, social and love to learn. So the tasks of interviewing people, doing research or experiencing new things were, and still are, my favorite aspects of the job. I was able to use my creative energy when writing or shooting photos or video.

But it was often a challenge to write some of the longer stories.

Sitting still too long at a computer makes me antsy. I don’t always get up to move to refocus, though I’m sure that would help. Instead I often find myself distractedly surfing the web or reading other articles that aren’t pertinent to the task at hand. Notice the present tense — this is still a challenge.

But working for daily newspapers provided me with hard-and-fast deadlines — something I typically adhered to. In fact, I need deadlines in order to be productive.

And reporting was truly the first job I truly felt I was having an impact and that was very gratifying. I still like to consider myself a voice for the voiceless, which is why I suppose I’m keeping this blog …

Copy Editor: Though I have never officially been a copy editor, I really enjoy the tasks involved in playing with words, making copy more clear, concise and grammatically correct and mentoring other writers as my editors mentored me throughout the years. It is something I am seeking to do more of, as a matter of fact.

6) Small Business Owner/Entrepreneur

Like many with this so-called disorder, I always have more ideas than time or focus to do anything with most of them. I have stacks of notebooks filled with random thoughts and project ideas and an undated to-do list that gets longer even though I occasionally get to cross off an item. However, things have improved in that realm for me and I am finding ways to keep track of and act on more of them. Though I don’t have any interest in being a business owner, as freelancer, that’s exactly what I am.

And though I am never happier than when I am free to schedule my own days, it does take a certain amount of dedication, discipline and commitment. I  keep track of my projects, hours, fees, etc. on self-designed spreadsheets and my calendar and task list are critical to keeping me on track.

Working in journalism was a good compromise despite being at the mercy of scheduled meetings, etc. Much of my schedule was set by me.

Now working from home (or wherever I decide to take my laptop), I have even more freedom and mobility and I am much happier because the only person I have to answer to is myself. I still have deadlines, but they aren’t daily and I can schedule my work around bike rides, lunches with friends or errands. I feel incredibly fortunate to make a living this way.

Other jobs on ADDitude’s list were beautician/hairstylist and high-tech/software developer. Out of the eight job categories, I have worked in more than half of them and have at least an affinity to most of the others.

Does it count that I cut SO’s (significant other’s) hair?

Next up: Change and fear …