# 3 The Life Lesson, or Why I Will Not Yell at Old Ladies

Another phone call, same day. I had a 9 am appointment scheduled with a diabetic patient to teach her how to use insulin vials. She’s been using fancy-new-technology insulin pens (easier to administer than vials), but her insurance won’t cover those frills any longer. The patient did not show up for her appointment, and when I called her to reschedule, this was our conversation:

Patient: “I’m not coming in. I’m not switching insulins.”
Me: “But your insurance won’t cover these pens anymore so this could get expensive for you.”
Patient, voice rising: “You tell that doctor that I’m not switching.”
Me: “Ms. Doe, the doctor is the one who asked me to call you and teach you about the new insulin administration method.”
Patient: “I’m. Not. Switching.”
Me: “Would you be willing to come in and just talk? I can show you how it works – it’s really not hard, I promise. We’ll try it together.”
Patient, forcefully: “Why aren’t you telling the doctor what I told you to tell him? You need to go tell the doctor that I won’t switch. I’m not talking to you anymore.”

At this point, I actually lost it. I lost control of the tone of my voice. I said – and I was dripping sarcasm:
“Oh, OK, Ms. Doe, yes ma’am. I will go tell the doctor, right away.”
Patient, barking: “Then you call me right back.”
Me, with a sudden-onset Southern drawl: “You bet I will. Buh-bye.”

And I hung up. That last goodbye was the most sing-song, saccharin farewell I have ever in my life said, and I did not mean her well. I have never lost control like that before. I’m lucky she’s hard-of-hearing and thick-of-accent because I doubt she caught my scathing intent. I’ve always prided myself on being able to meet sour with sweet, kill with kindness, and all that. Lately, I just want to get in a yelling match and be done with it: “OH, YEA, OLD LADY? IF YOU SPENT HALF AS MUCH ENERGY EATING RIGHT AND EXERCISING AS YOU’VE SPENT BEING A BITCH TO ME, YOU WOULDN’T NEED INSULIN!!! Lazy bitch.” Am I a terrible person that I find that rant to be so satisfying?

I do realize that this woman is scared and overwhelmed. She’s poor, she’s isolated, she can’t drive; even something so simple as stopping by the doctor’s office is a daunting task. All these things added together probably mean she feels attacked by this change. She has this one thing that she’s comfortable with, and though it seems small to me – it’s maybe two extra steps to change to this new form of insulin – it’s huge to her. It disrupts her entire sense of order and control. And maybe she’s so exhausted from her life and from her illness that she can’t distinguish between feeling angry at her life situation and feeling angry with me. I’m just the life situation that pushed her over the edge today. I know all this, but in the middle of that phone call, I also felt attacked and overwhelmed, and I reacted just as aggressively as she did. This tells me something that you could’ve probably already told me years ago: I should no longer pride myself on my control over my emotions. Maybe that wasn’t such a great thing to feed my ego on, anyway. Maybe it’s time to admit that I am not a bot, that I have feelings that come in all shapes and sizes, and that they all – good and bad – need an outlet.

I promise I won’t take up yelling at old ladies as my outlet.