Trust.
The election is coming. The news is full of contradictory information. I get emails citing incredible events daily—one included a segment of The View that has a man of color dressing down President Biden who looks blankly into space as F bombs are falling all about him. I googled to see if this video or a news story about such an overt confrontation on national TV could be found independently and got benign segments from that show; it appears the controversial video sent to me was likely fabricated. It was pretty convincing.
Trust in the news, in what we see and hear, all of it is open to question. The sensation and immediate response to it requires a pause and some reflection. Have you ever gotten an email that suggested you had been billed a lot of money but to check on that, click this link………I suspect we have all done that at least once.
If not, you have resolved your issues around trust in a successful manner and I congratulate you. My path to this has been long and tortuous.
I was born with an apparent genetic trait that calls for a default to belief—in what I am told with the interpretation being fairly concrete. By concrete, I mean I take the words and interpret them in as literal a manner as possible. This is how I start with every assertion made to me—to this day.
My brother does not share this trait.
As a child of six years, I lived in a two story stucco house in California; the patio had a stucco wall around it. My older brother, a few months following the annual Disney three-week extravaganza celebrating Davy Crockett confided to me that in fact, our house was the Alamo. I was pretty excited. He embellished, his room being where Jim Bowie had been laid up and died. My parents thought this was charming, my excitement about this news. Not long after, my brother discovered a loose floorboard and when I helped him lift it, we found a wrinkled and stained old paper with a map drawn on it. Following the directions on the map (liberally interpreted by the brother) we discovered a buried chest filled with Confederate money. I was rich! My obsession regarding the storage and plans for this money finally found my mother giving clear directives: we were to take that money and throw it out. She messaged that it was not real, none of it. My pride was hurt. My dream was dead. I learned something, and soldiered on. Or did I?
Halfway through college, I was doing an oil change in my back yard. The oil cap on the engine valve cover was destroyed and my friend Bruce went to get me one while the oil drained. He returned, and I asked, “what the damage?” Without hesitation, he said, “Seven Dollars.” I got my wallet out. We made eye contact. He shook his head and held out the molded rubber piece. “Actually, 99 cents.” I would have paid the seven dollars and been angry with GM—which brings up another point related to Trust. The oil change was on a Chevy Vega which had won Motor Trend’s “1971 car of the year.”
Medical School (and adulthood) provided the environment that would allow me to develop strategies around Trust. I dutifully recorded that someone had “dark stools” in my third year write up on a patient in the surgical unit. On reading this a day later, the lead resident noted that no one else had elicited that history and it would have been nice for me to have brought that forward at rounds. He needed to trust me.
And there were patients. The emergency room was full of people who’s described reality merited skepticism: the 16 year old who, at two in the morning, “was just walking down the street and someone shot me.” There were people, down and out, who looked tired but OK and would then claim 11/10 on the pain scale. There was the couple earnestly trying to get pregnant who had gone through thousands of dollars of testing. I suggested an inexpensive test—the female would be scheduled at 9:00 AM after they had intercourse sometimes between 6-8:30 AM. The intent was to see how many and how active sperm could be found near her cervix. There was nothing there and she insisted intercourse had proceeded as normal.
I was ashamed when a lovely Mexican woman’s record was full of recurring traumas and her visit with me was for a fall down some stairs. She would be admitted to the ICU a month later and it was clear she had been brutally beaten. I had taken her explanation for her injuries at face value. Her husband, one of the most gentle and sweet men I have ever met was in fact a wife-beater. Her injuries and subsequent history were such that the social service department scored bus tickets for her and her child that would take her anywhere she wanted within 700 miles of Salinas. Her life was in danger. No one, not even the social worker knew where she chose to take herself and her two children.
Crowning this Odyssey of mine was a junior high student with a two day history of a painful and swollen knuckle after falling over his bike’s handlebars. The xray showed no fracture. I was explaining to the mother how they should take an antibiotic for possible infection, elevate the hand and come back in forty-eight hours when I had an epiphany, “……unless of course,” I stared directly into the eyes of the boy, “what actually happened is you hit someone in the mouth two days and ago and cut your knuckle then.” The look on his face told it all as did that of his mother. The Orthopedist doing his surgery that evening told me the next day that the infection was pretty dramatic; good call!
The nature of taking medical histories was exactly the right treatment for my bias to simply believe. Asking a middle aged man how much he drinks each week? Whatever he responds, consider doubling the number. Are you taking your medications regularly? Whatever they say, check the timing of the last refill. Many Diabetics don’t want to disappoint their doctor, look foolish, or be confronted by their relative poverty and don’t purchase the medication needed—but they can’t tell you that directly. A teen aged diabetic boy had a log of his well controlled blood sugars except his long term test showed poor control. “Can I see your fingers?” Not a sign of pricks used in the day to draw a bead of blood for testing.
When I apply this kind of thinking to the everyday world, I am generally rewarded. A special deal, too good to be true? These don’t take a lot of time to sort. A call with bad news and a solution to be done now over the phone? I am tempted to make a game and eat up lots of time without giving satisfaction but my peace of mind requires a shorter path: the quip and hanging up. Not opening emails is a problem—this is not just a matter of trust but cleaning house. I now assume lots of people I don’t know with varying needs of me have access to my address, contacts, and demographic information.
It is election time and it is the Wild Wild West with respect to what people are capable of saying, seeing, or believing. If you are like me, take a breath, don’t rush, and consider what you know, before you do - or want to- do because of how you want to feel. If you smell bullshit, take your time and reflect on what you really know as opposed to how you feel.
Which gets us back to the election. If the information is impossible to sort clearly, what do you observe in the candidates as people when interviewed or giving a speech that gives you confidence or makes you skeptical?
Pieces of my Alamo at my feet. The bruise on my face is from a baseball bat, carelessly tossed by my brother in a little league game. Or was it so careless?
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