Dehumanization

First of all, let’s look at the definition:

dehumanize: de·hu·man·ize | \ (ˌ)dē-ˈhyü-mə-ˌnīz, (ˌ)dē-ˈyü- \ to deprive (someone or something) of human qualities, personality, or dignity: such as

a: to subject (someone, such as a prisoner) to conditions or treatment that are inhuman or degrading“… you treat people with respect, you get respect back. You treat them like animals, you strip search them, you dehumanize them, you lock them up, you don’t feed them … you are going to get that back … “— Adelina Iftene

b: to address or portray (someone) in a way that obscures or demeans that person’s humanity or individuality propaganda that dehumanizes the enemy; I’m always struck by the way language is used to dehumanize others.— Anna Lind-Guzik; Treating Chicagoland violence as merely a tally necessarily dehumanizes its victims, but it also obscures so much of the larger story about that violence.— Gene Demby;

But that approach ignores the fundamental dynamics of racism, which is

c: to remove or reduce human involvement or interaction in (something, such as a process or place); Nurses are also fearful that the use of technology will dehumanize patient care.

https://www.merriam-webster.com/dictionary/dehumanize

I’ve been thinking a lot about the habitual treatment I receive at my cancer center. While the majority of the doctors (with a few notable exceptions) are amazing, the vast majority of the staff treat me with a mildly disguised contempt, as if they are irritated at having to be in my presence.  In other words, the treatment I receive at my cancer center from many, if not most, of the staff is dehumanizing.

Let me cite a few examples from just the week before last … since I’ve been treated there for over 27 months, just think about how many incidents have occurred.

First up, the pharmacy tech who acknowledged that the answers to all the questions she was asking me were readily available to her in my file and she was simply asking me and taking up my time because it was easier for her.  She then told me that my cancer medication would be withheld from me until I capitulated to her demand that I regurgitate the details in my file rather than her taking the time to look it up. In essence, this employee felt it was fine to threaten my life (since the cancer medication is literally keeping me alive) unless I made her life easier. I’m still amazed that I was able to keep my conversation with her devoid of f-bombs.

This is an example of dehumanization/degrading in that the pharmacy tech put me into the position of doing her job as if I report to her. She didn’t ask if I had time to answer the list of questions or if I had access to my calendar at the time she called. When information is readily accessible to a front desk person, attempting to withhold medication until a patient performs the job that the front desk person is being paid for is completely inappropriate. In fact, I’m pretty sure there’s one or two laws that would apply as well. Pretty sure there could be an argument for a charge of attempted murder, just so she could save herself a few minutes.

Coming in second place was the scheduling person who left me the following message … “Hi Ms Johnson, this is (first name only) calling from (cancer center) with an urgent message. Please call me back at (main number to cancer center) as soon as possible.” This message may not seem like such an issue until you also have the context that my cancer center is huge and there are probably 20 people working there who have the same first name, rendering it impossible for me to return the message. After over 45 minutes of being transferred around the cancer center, becoming more and more panicked, I finally figured out who called me. The explanation for leaving such a vague and non specific message … HIPAA. Clearly, these people have never read HIPAA. Also, I can HEAR it when people leave the “t” out of my name.

This is an example of dehumanization in that the person leaving the impossible to return message created a panic attack and took hours out of my day that I can’t get back. She was entirely unconcerned about that and didn’t make any effort to understand why I was panicking and also because HIPAA has nothing to do with the cancer center employees’ information. Her leaving her last name or the name of her department was necessary for me to return the call and there was no reasonable reason to withhold that information from me. In this situation, I was treated as if my feelings and the affect on me was entirely inconsequential and without value. In essence, that I am without value.

Third and the absolute worst is the scheduling person who came up to me at the end of my infusion on Valentine’s Day, when I was already late to my next appointment because, as usual, I wasn’t brought back on time for my appointment, to hand me three pages of scheduled appointments. Those three pages were appointments this scheduling person had made for me without checking with me or my doctor to see if I needed any of those appointments or if I was available for said appointments on any of the dates. THREE PAGES!!!

This is dehumanizing in that it assumes that I will simply follow instructions and show up whenever they demand. It is also dehumanizing and condescending to my doctor in that the scheduler was behaving as if she knew more than my doctor by scheduling appointments no medical person who actually knows anything about my care told her that I needed. She was not apologetic or understanding when I asked her how she knew I was available for the appointments. Her assumptions skipped over the fact that I’m a person, a wife, a mother with responsibilities and treated me as if I am a widget to be placed as they desire.

I am fond of telling people that my treatment must fit into my life, not the other way around. Cancer is a big part of my experience and will be for the rest of my life, but cancer is not my life. People in the healthcare system have a responsibility to treat patients as people and to make a concerted effort to ask questions to understand how what they are recommending to me done fits within that patient’s life.

In each of these situations, I spoke with the patient’s supervisor. Two out of the three were completely dismissive and only made the situation worse. The culture of dehumanizing patients is something both set and perpetuated by the leadership of any organization. In this situation, it’s pretty clear to me that the culture of my cancer center is to blame.

So, are the relationships with my doctors sufficient enough to overlook a culture of degrading patients?

That’s a question that I’m still trying to answer.

Before anyone thinks I’ve not been proactive, I submitted a five (5) page spreadsheet of concerns and proposed solutions to the leadership of my cancer center last year and I’ve been involved with a working group since that time attempting to address them. While it seems that some of my concerns may be addressed, there is still so very far to go.

 

31 thoughts on “Dehumanization

  1. The scheduling thing happened to me! I asked the woman if she had access to my personal and work calendars. I was so angry! But the worst thing – for me – is when they all call me sweetheart, honey, etc. I feel like a little old lady (and yes I have told them not to call me those names. It does no good).

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  2. Good grief, Abigail! I, too, am amazed you held back on the F-bombs! But then you would probably have been viewed as an overwrought woman who’d simply “lost it.”

    Perhaps in your working group efforts, you can add an item that compassion can be taught. (I refer to the Tania Singer, et al research on changes in the brain that I cited in my post about the world needing more anger management.)

    And maybe the buttons would actually open some eyes, perhaps combining the two above: “I’m a human; treat me with compassion;” or possibly “Compassion can be taught; ask me how.”

    And now I’m thinking you need to write more than an Op Ed; we’re entering book territory! All these episodes need a wider audience.

    Liked by 2 people

    1. Ooohhhh, the buttons are a great idea!! Thank you!! I love seeing these situations through different eyes. My first inclination is always to try to figure out why something is happening so that a solution is easier to accomplish. Thank you for reading and commenting!!

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  3. I often wonder, after hearing these stories and looking back on my own, why these people are allowed to work in their field. And why they chose it, in the first place. And its the same in any of the care fields. It’s almost as if they forget the very point of the whole thing.

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    1. Yes! Very different if one is working for a paycheck or working because the work itself is meaningful. Everyone can get burned out and the culture of an organization needs to correct for this type of behavior. Thank you for reading and commenting!!

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  4. This smacks of corporate culture dysfunction. There’s a world of difference between saying “we care about patients as people” and actually caring about patients as people, which involves backing that up with the kinds of systems, training, incentives, and appropriate action that consistently delivers caring. I recommend sending that spreadsheet to someone at every level of the corporation involved, starting with the CEO and every member of the Board of Directors. Because the buck stops there.

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  5. I’m so sorry that your experience is so far from best practices. It makes me very grateful for the compassionate and truly uplifting care my husband is receiving at Mt. Sinai Tisch Cancer Center here in NYC. People from top to bottom could not be more thoughtful. We felt like cogs on an assembly line in the DC suburbs during his first go round, except for the radiation oncologist and his team, so I know what it feels like.

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  6. I am really so amazed by the way you have been treated. The contrast between the way I was treated, and am still being treated, here in Ballarat is so diametrically different. My doctors and nurses have been exemplary in the way they talk to me. For example, after being discharged I got a call from one of the doctors telling me that a recent message may have been a bit difficult to understand. So she explained it all again and clarified all of my concerns. And to emphasise my situation, I am a public patient and all it has cost so far is a few Dollars for one of my medicines.
    Also, the lady who brought me my coffee was so bright and cheerful she should get a medal.

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  7. So frustrating, and yes dehumanizing! Some where along the way doctor’s offices have become robotic. We expect ‘care’, we expect people to care, but often that’s simply missing. One of my last appointments the Dr said schedule a follow up to go over labs, when checking out the nurse said nope we’ll call you. My case is complex. This isn’t sufficient but I’m so generally exhausted and beaten down by the whole system I just went with it. It seems petty on my end but it’s one of those walk a mile in my shoes kind of things. Good to see you giving a voice to the issue of the loss of care in the health care system. 💙

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    1. I have days, weeks and sometimes months of being exhausted and beaten down by the system as well. It’s exhausting. Bright spots are sometimes few and far between. It helps me tremendously to write out what I think and feel. I am also trying to effect change at my own cancer center. But it keeps happening. It’s frustrating and demoralizing at times. Writing helps me with that. Thank you for reading and commenting!!

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  8. Oh, my god, Abigail! This post left me speechless! How anyone could be so heartless is beyond me! It’s obvious none of them has ever had cancer or had a loved one suffer from it.

    I’ve never had cancer so I won’t insult you by telling you that I know how you feel. But I’ve lost many family members and friends to it and watching them suffer left me feeling helpless.

    No one should be treated that way, especially someone battling a terminal illness. They suffer enough without the degradation heaped on top of it!

    Honey, it sounds like you handled it a heck of a lot better than I would have! My mouth would’ve gotten the best of me. I would’ve lost my religion and dropped F-bombs like nobody’s business!

    I’m so mad for you right now!

    Know that you do matter and that we are behind you. Bless you!

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