This isn’t what I ordered.- Us

Lemon cake was a hot commodity on the unit. Keeping the peace as an often solo provider charged with the care and feeding of twenty people meant occasionally overlooking the particulars of medically prescribed meal plans. Adam, how about trying the meatloaf instead of ordering three deserts? Make me. He was preparing for discharge from our day treatment program which usually went one of two ways; clients showed up with their bags packed to return to inpatient or we’d sing Happy Trails, wait for their insurance to turn over and readmit them in a few weeks. Mel, why the sudden change? Your daughter’s coming this weekend and you were just saying how much you’re looking forward to it. She sniffs, Nope clutching her paper bag, stone-staring at the wall.  I’m gonna kill myself when I go home. Better admit me. My daughter can visit me here. Contrary to the mandates of managed care, broken hearts aren’t cured in 6 to 8 weeks. Insurance policies ensure we stay stuck in a cycle of co-collaborative sickness. Very Important Persecuted; the system teaches people to use pain as power; give or take. In order to prevent the inevitable, sabotaging goodbyes is common. I knew this and should’ve ordered his just deserts but it was my job to set boundaries and take heat. Playing dual roles of clinician and food currier put me in an awkward position, especially regarding anyone  with a condition that could be impacted by what they did or didn’t eat; a difficult kind of authority.

Adam stormed out when his tray arrived with only two of the three cakes he’d ordered. Sitting on the grass in front of the hospital lobby under a palm tree we worked out a repair. Adam, I’m really sorry crossing the lemon cake off your menu hurt your feelings. I don’t want to hurt you. I’m trying to make sure your blood sugar stays within range and we stick to the plan the doctor gave us. But I really wanted it and I felt like you were judging me. I was judging his request, 100%. No one should eat three pieces of cake. In fact, there’s zero biological reason why anyone should eat cake, ever. I hated being responsible for what other people ate. I hated being the one to monitor soda intake and walk the fine line between over-feeding clients who I knew were homeless and having to consider what constituted stealing from the hospital. I hated that my clients got two hot meals before I’d had the chance to eat anything, usually because my boss was late, sick or in the nurse’s lounge…eating. Hospital hierarchies are not hospitable to staff or guests forcing everyone to take rather wait to receive care. How patient does a patient have to be? Underneath all the hate is an ocean of empathy I once nearly drowned in. Skinny bitch aside, I didn’t want him to drop dead from a broken pancreas. I never had to say any of this because Adam, like all people, have a psychic, judgement antennae. He knew part of how I felt and was hell bent on sitting and sulking till I gave him nothing less than the apologetic truth. Adam, I was totally judging your food, but not you. I’m sorry and I don’t want you to die before art therapy cause I know it’s your favorite and we’ve got something great planned. I can’t let you eat three pieces of cake but I’ll swap out the chocolate for the lemon if you want it that bad. Deal? Success. If only all resolutions were this easy.

Leggo My Ego

It was a phrase I created while leading groups to simplify and unify a definition of mental illness. Comparative suffering and resilience are terms I created to describe a  social phenomenon probably born out of capitalism. It’s essentially an attempt to justify or invalidate pain. I erased diagnostic ranking with frozen waffles. Becoming sick in our head, heart or soul is the result of trauma. Trauma is anything we perceive as having the power to separate us from love. A zit can be just as a traumatic as having a stepford mom. We agree on a handful of universally accepted hurts but the spectrum extends out in opposing directions from major to minor and everything in between. Your goldfish dying when you were 5, traumatic. Becoming a prisoner of war, traumatic. Seeing footage from inside a clothing factory in Bangladesh after launching your career as a fashion blogger; Buddha has officially left the palace. What? ‘Leaving the palace’ is another phrase meaning trauma. After living the life of a little prince Buddha is said to have snuck out of his palace one night only to encounter the horrors of humanity which challenged all of his beliefs about the meaning of life and led him to discover compassion which gave birth to his true identity as a deity leading to the creation of Buddhism. Kind of a metaphor for how we heal too, except we’re not all bald and I’ve never met anyone who floats in a lotus garden.

How we respond to various offenses is as unique as we are. Not all child stars become addicts. Not all people living on small incomes feel oppressed. Some people have car accidents and think it’s funny. Some people decline their inheritance. Our reactions are determined by what makes us crumble. As a recovering anorexic I pair many things with food, except my food plan. I pair that with anxiety and cardio. Anything that hooks our ego is a trigger; some condition or event that unleashes all our fears of being unworthy of love. Suffering begins when we not only believe the fears but also remain fixed on the fix and blind to alternatives. If I lose him there’s no one else I could possibly be with out of the 8 billion people on planet earth. I won’t let go till I get justice. I can’t be happy till we get pregnant. I’ll not speaking to her till she admits what she did wrong. Trauma can also be a rational response to having our lives, sanity, dignity and safety threatened either once or repeatedly over a period of time. Some wounds linger and lead us to believe relief won’t ever come. When I find myself stuck I imagine crowds of people running towards and away from each other holding their ego’s over their heads. Mine! Mine! Mine! It helps me remember the answer; let go.

*Adam’s real name isn’t Adam. He was a delight and we did have a food fight which was mostly my fault. I did apologize and I’m pretty sure he forgave me. Also managed care sucks. xo

ps: Have you ever made food art for a post before? I love my ketchup heart.




23 thoughts on “Leggo My Ego

  1. E, I was an RN in Management most of the time for almost 50 years and to compare the difference of care in a managed care environment with how it used to be (sounding like an old fart, now) is so sad. When I began in the 60’s it was all about caring, now it’s all about bottom line. I don’t think I could be a nurse again. And it’s got to be worse in the mental illness/addiction world. If the non-clinical managers of the HMO’s could see how extending a stay could save them money over re-admittance…arrgh. You got me going!

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  2. ketchup, I was certain it was strawberry jam/jelly/preserve. Sadly “insurance” has become “healthcare” Healthcare provides help, insurance denies it. I’m fighting them now for the one and only medication I have to take. And even with a letter from my doctor stating this is medical necessity, that I am suffering long term damage without it, I’m high risk, AND it’s covered under my policy, they said, nope denied. Why, we asked, the answer amounted to, because. My mom said, “it’s going to cost them more in the long run, unless you die first.” My reply, “if I die first, it will save them money” ;);) Enough of that, can I have my cake now?

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    • Margaret I’m so sorry. You can have ALL the cake. It’s maddening. I’ve spent the past five years of my career trying to change the system through trauma-informed care policy. It’s unfair and I won’t pretend otherwise. Also, you’re not allowed to die. You’re worth vastly more than the ignorance of the false power of the system. I promise to keep fighting…and eating all the frosting πŸ˜‰

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      • Oh, I’m fighting. I’ve been doing all the appeals myself, getting the helpful info from the doctor. He said he would do it, but they are so decietful, correction, down right liars,(the insurance, not my doctor) I told him I’d do it. I’ve documented everything. I have all the complaints to all the right agencies filled out. Just waiting for this final appeal. No matter the outcome, approved or denied, I’m filing the complaints. No one should have to go through this, to receive the healthcare their doctors say they need. I did laugh though at you eating all the icing:):):):). I always scrape the icing off the cake, and just eat the cake. I’ll ask everyone if they want it because I don’t want to waste it, and someone always wants it. After eating cake with them once, they always come next to me the next time there is cake. Long story short, if that’s possible at this point, I’ll always give you all the icing off my cake, my friend :):):):)

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      • To the good, life saving fight and frosting! You’re 100% right Margaret, no one should have to go through what you’re going through to receive the care we need. My husband is all about the cake too. Happy to sit next to either of you and share the sweet life. ❀️

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      • Thank you E. Your prayers are worth more than anything. I prayed that God make them do the right thing, and I have been thanking Him for it. “It is a fearful thing to fall into the hands of the living God.”– Hebrews 10:31. ;)Look at me, coming to your comments and sneaking in a Bible verse hahaha :):)

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  3. Fabulous writing. It must be so depressing to be forced into that sort of charade, either as a caregiver or as a client. It’s funny how in the name of economising (and probably other factors, like the tail wagging the dog in policy-making areas), the whole thing appears to become basically useless and doesn’t really address the core of the problem. I’m beginning to think that art and literature have a more important role to play in rehabilitating hurting souls than things that are officially designed to rehabilitate hurting souls. For some reason my brain is now starting to remember things from transactional analysis texts – “I’m OK, You’re OK” and “Games People Play” in particular…

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    • Funny you mention charades. I’ve been composting on the idea of secrets; shades of cultural denial and ignorance. Yes, it is depressing and doesn’t have to be this way. ‘Managed care’ as a concept feels on par with a bread line; here’s your ration of love, now make that be enough or we’ll call you names. Transactional analysis ugh! Haha. I feel mixed about it; logically it should make sense but in order for true healing to take place there must be integration between our head and our complex human heart. I agree this is where the arts become a real life saver; we fill in the gaps with pens and brushes.


  4. Oh and PS: If you think there is no biological justification for cake, you haven’t tried my cake! πŸ˜› It is perfectly possible to make highly nutritious and delicious cakes, although the mainstream cuisine has forgotten how, and you certainly won’t find them in hospital catering (which is sad when you think about it, they should know and do better given this is health care…)

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