On enabling mediocrity, careless health care, and the quiet war on human standards
He doesn’t know it yet, but I fired my oncologist yesterday.
I’ve been on the fence about it for nearly a year, even failing my first attempt after he promised (seemingly in earnest) to improve his behavior—better behavior being directly commensurate with the quality of the care I hired him to deliver.
I didn’t realize I had unreasonable standards until it was brought to my attention in the exam room, after some high temp conversations with a nurse, her supervisor and finally my main man, none of whom could bring themselves to validate or address my concerns.
Those concerns had accumulated en force, the collection comically overflowing in my mind like a thimble in a downpour, as I had watched the first hour tick away waiting for my appointment.
I was told that what I experienced that day and over the course of years now, though acknowledged as ‘less than ideal,’ were universal to any cancer clinic setting, and that I was a singularly unhappy customer amongst a majority of fellow cancer patients delighted to be there.
Huh. Really, though?
So, I’m the only one waiting sometimes hours for my 20 minute appointment, made six months in advance, after being adulterated by email, phone, text and portal reminders to arrive early?
The only patient with a potentially fatal disease that has to remind their physician again (as in every freaking visit) to include, or schedule at all, the same standard lab test I’ve dutifully offered my arm on for the last four years?
The single individual who’s never earned the eye contact of her nurses as she asks the same questions I’ve already answered via e-check in, who’s physician with whom she trusts her life has to remind himself of her particular history, of his own recommendations, while she’s sitting right in front of him? (Well, behind him as he faces his screen vs. his patient, if I’m being accurate. The feng shui of the situation isn’t subtle.)
So I guess my unreasonable standards for my licensed health care providers are these:
- Empathy and compassion
- Operational competence
- Delivery of service as contracted
- And, just to be greedy, courtesy in all of the above
Ever feel like you’re the only one left on the planet with fucking standards?
Take an inventory, if you don’t regularly already, of the number of times per day you feel disappointed by someone or something—of having received less than you were reasonably qualified for.
(insert litany here)
There are obviously a ton of inarguably objective standards, like how many pints in a quart (if anyone even remembers), the safety of a seatbelt, subject-verb agreement.
But we all have slightly less objective and more societally congruent metrics too, for the quality of things, people and experiences pertinent to us both as smaller groups of people (friends and family, communities. cultures) and as larger (global citizens).
Though they shift over time, we have shared criteria for what passes muster with us. Peripheral to social mores and expectations, we have measurements for what is an acceptable return on any investment.
We do differ, of course, in our tolerance for consequence—what we’re willing to lose in order to gain.
Personally, I’d be much more amenable to spending hours of my valuable time in a cancer clinic waiting room and money I don’t have on an overpaid clinician if I was warmly welcomed, as an individual, by frankly any of these mopes.
But, and this is what broke my heart a little yesterday, I believe we’re so bombarded by mediocrity, so inured to the enshittification of our human experience, that we’ve lost track of what we’re reasonably allowed to receive—from products, from people, from our own decisions.
As told by those in charge of such things, I may in fact be the only patient in that clinic who’s brought my frustrations to the table, because to most of us, ‘that’s just the way it is.’
Our needs are explained away, if we’re even given the opportunity to voice them.
Or, more insidious still, we’re being told what we want and how we want it, without having asked or been asked.
The constant badgering, pummeling, beaten into submission by the brute forces of corporate profit, panicking under the threat of what succeeds the inevitable death of capitalism, has weakened us into resigned submission.
Hospitals are no different than Amazon, utility companies are the elders of big tech, and our time, attention and labors are all constant validation of their needs, not our own.
But it’s all too big, too pervasive, too intractable and endemic…
I’ve written it before and with zero risk at beating a dead horse (only sleeping, not yet dead!), will continue to write, speak and generally get hot about this—we can, and MUST, demand better.
Challenge begets change, every. single. time.
Our standards are linked with our expectations—standards being the societal norm and expectations, the beliefs we form from the information we receive.
Expectations, established via historic or new input, can just as easily fortify our standards as they can loosen our death grip on them.
And as goes anything psycho-emotional, the larger consequence of either isn’t always immediately known to us.
We’re reactive creatures, doing whatever it takes to feel safety in the moment. That often looks like camouflaging our needs to fit the situation, and understandably so.
If we raised our voices on every societal slight, every time our food arrived cold in an empty dining room, every time we got burned (again) at the Genius Bar, we’d be that person—and that person is miserable and makes misery.
While I’m no stranger to complaint, both giving and receiving, that’s not what I’m advocating here. It’s of a piece though, and when constructive, is a massively effective communication tool.
What I believe we need more urgently is a sharpening not of our reactions, but of our standards—for ourselves and for each other.
There’s been a lot of good writing on this lately, about how, particularly as we face the either over or under-hyped AI takeover, the key to maintaining our hold on the human reality we want is to double down on what actually makes us human.
Creativity. Empathy. Relationship. Discernment.
My medical team failed on all of the above. They’re also so blinded by their cultural standings, so arrogant in their preeminence,5 that their already compromised patients are drawn to their projection of competence like emaciated pigs to a trough.
But we deserve all of these things! They’re real and reasonable and occur regularly in nature! We’re born with the cogs and gears that make this stuff necessary to both demonstrate and absorb.
Like morels and the elm, we’re built to both give and receive.
The steep incline here is the work involved. Because we ARE so encumbered. What is necessary, and unfortunately just as difficult, is for us to question not just the meeting of our standards but also the origins of those standards.
Do they come from our own internal values, or are they designed and perpetuated by a corporate marketing team?
Do they jive with what we feel our neighbor, mom, auto mechanic deserves, or are they just the most edible garbage in the dumpster of current options?
We CAN set the bar higher, and those that don’t reach it also don’t make it to the next level—of our patronage, our attention, our time.
Our standards, and our continual challenge of them, are the metrics by which we can continue to move forward, to evolve; to not just subsist, but to validate our existence by the value of our contributions to each other.
Bree Stilwell 