Monday, October 22, 2012

On Obedience to Authority: A Waiting Room Full of Dogs

Photo Credit: Morguefile by Alvimann

The first thing that put her on edge were the dogs.

When she opened the door to the waiting room, there were poodles. Shitzus. Papillons. Or something else. Both of them were something that stood on their hind legs, yipped, pretended to snarl and then wanted to be petted. Something that nature dictated would nudge her pen while she filled out forms, race 'round her feet in circles and sniff.

She couldn't help thinking there should not be dogs. Not here, in the physical therapy office. And this made her wonder if she was curmudgeonly—a dog-hater, a grouch. I have a dog, she thought to herself.

"Yip," warned one of the poodle-shitzu-papillons.

At first, no one else was there. Just the dogs. It was 12:45 and the air was redolent with the smell of cooked microwave lasagna. A soap opera could be heard in another room. Unsure what to do, she went back out to the car and retrieved her jacket. Having killed thirty seconds, she went back in. This time there was a man. She explained to him her purpose and he provided her with forms, which the dogs assisted her to fill out. Other staff began to emerge.

A woman behind the counter took her insurance card and attempted to copy it, explaining that the desk help was not present, for reasons no one seemed to know. She copied it several times, incorrectly and then returned it.

"The office help is not here," she repeated. "I will try again later."

Several more patients came in. Soon, there were more patients than there were chairs. This, she thought, was difficult. In a physical therapy office, who has to go without a chair? Stubbornly, she sat in hers, despite her outward appearance of health, daring anyone to make her relinquish the relative comfort and stand, muscles in screaming pain, to wait.

At some point, the dogs were put away in another room.

The therapist arrived for her and she went with her into a room. It was a small corner of a place—including an examination table with a face doughnut and a chair. Just beyond that was a large, ugly curtain, like you might find in an emergency room. Loud country music was playing. Schoolroom fluorescent light fixtures blared from the ceiling, flickering and pulsing their sickly light.

"So, what are you seeing us for today?" asked the therapist.

"Headache," she replied. "I've had a headache every day for two months."

It took several minutes to find a light bulb for the light fixture in the corner of the room, so that the fluorescents could be turned off  and, shortly, upon a commercial break, the music was eliminated as well.

"My jaw is in spasm," she further expounded, "so I was told to go to physical therapy by my oral surgeon."

Measurements were taken. She was told to make a funny face and then another while rulers were inserted between her teeth. It was mentioned that her back was too flat and that there was winging of her shoulder blades. This sounded glamorous and strangely gorgeous. She glanced at the floor, expecting to see feathers dropping off.

"Well," said the physical therapist. "I will teach you some exercises to do. But I want you to tell me if they hurt."

Everything hurt. This left both of them soon with few options for making the situation better.

"Just do the two sets of jaw exercises. I won't use the ultrasound or do the massage. I'm going to leave you with some heat around your neck and these electrodes on your face and arms. There is a non-steroidal anti-inflammatory on the pads."

She lay there, obediently. The hot towel felt pleasant and the electrodes caused no sensation. She wondered how much time had passed.

After a few minutes, a door opened. Voices which seemed strangely loud began to fill up the air in the room. On the other side of the curtain, a patient and another physical therapist had arrived. The patient, it seemed, was a teenage boy. She listened. There was nothing else to listen to. They talked about his head pain, about his grades and he explained to the physical therapist, in a somewhat quieter voice, that he was bipolar.

"Take your medication," the PT advised.

She began to feel tense. She was the unwitting eavesdropper on a child. Without thinking, she carefully kept her body still, her breathing quiet. She felt she had done something wrong, just lying there. After a time, something beeped. It beeped again. The physical therapist from the other side of the curtain poked a head into the sanctity of her space.

"You beeped," she said.

At that point, her own therapist arrived. She moved one electrode to the other side of her face, asked her how she was dong and bustled off again.

She continued to lie. She felt ridiculous. She was quietly lying on a table in an office full of dogs, in pursuit of pain relief and having already performed countless exercises which hurt. The prescribed ultrasound therapy and massage could not be used at all due to her extreme sensitivity. She was lurking in the dark while a child confessed his mental illness to a medical professional, and the appointment, which was supposed to be an hour, was clearly taking up almost two.

The teenager did his exercises. She listened as his back popped and he rated his pain. She listened and wished she didn't have to listen.

She began slowly to be aware of a creeping sensation of burning pain arising from her lower back. As this continued, her bladder suddenly felt on fire, and her legs started to cramp. The sensation worked its way up her body.  She noticed that the hand with the electrode had gone numb and shook it awake. It fell asleep again. I am lying on my back too long, she thought. It is messing with everything. I should change position. I should get up.

She didn't.

The hand went numb again and again. The other hand went numb. Her legs spiked electrical sensations that traveled up her spine. What time is it? she wondered desperately. I should just get up.

The experiment requires that you continue.

I will wait for the beep. It will come soon enough. It's not, she thought, as if I can't bear pain.

She stayed. Minutes rolled on. The teenager spoke. The pain increased. The beep did not come until, finally, it did.

She felt at once defeated and relieved.

A woman she had not met before came in and unceremoniously ripped the electrodes from her skin.

"That was horrible," she managed to get out.

"I'll tell your therapist," came the reply, with some alarm. Returning in a moment, the unknown woman assured her that the electrode procedure would not be done again.

"Make an appointment for twice next week," she said, politely. "We'll get you feeling better."

It is absolutely essential that you continue.

"We'll see you Tuesday!" said the woman at the desk, who had returned from wherever she had gone before.

Yes, she thought. You will.


  1. Ouch. That was uncomfortable. I was lying on that table, feeling guiltier and then annoyed and then angry the office personnel weren't doing more to protect patients' rights and confidential conversations. As for the ripping off of the electrodes, I'm torqued about that too.

    Rawr, now I'm riled up. Well done, Tara!

  2. What I'm thinking?

    1. I honestly wouldn't want to be there, and I'm thankful I am not.
    2. I wish I knew what to do if anything for the one that was there.

  3. I don't really feel at all guilty about listening in on conversations. Is that wrong? Even if it is a HIPAA violation. I also do not patronize any establishment that is full of dogs. I was all grossed out from the get-go by the dogs. There's no way I could relax and get physical therapy in such a situation. Ick. And talk about terrible bedside manner. I think the one saving grace of the whole event would be the opportunity to eavesdrop.

    Oh, but you know... bluster, huff... they should be more careful about confidentiality. And hygiene. I totally thought this was about the vet's office.

  4. The story is, of course, based on my actual PT experience, although I took small liberties with the dialogue. Having said I would write fiction in October, I decided to take it and tell it in third person, at least in the spirit of fiction. Telling it that way gave me a very different experience of the event.

    Today, when I went back, they were attempting to convince one of the PTs to set a trap to catch some large animal which had left teeth marks in the fruit. Apparently, this was not unusual. They said, "Glen, you've caught all the other critters! Why not this one, too?"

    This is what they don't tell you about being a chronic patient.

    However, I found it really interesting to think about it in terms of my own submission to what I perceive as authority. I'm still not sure when that is a good idea and when it simply isn't. Is an office full of dogs and rodents evidence that they can't help my jaw? If they can't, what will? What are my options? Am I better just to walk away? So I brought in the notion of the Milgram Experiment.

    Trusting the expert is one of the explanations for that experiment. That theory posits that often it is a good idea to trust the expert, even when it seems it shouldn't be. In fact, in that experiment, the subject was right. Trusting the expert caused no harm.

    Not sure if this is the case here or not.


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Faith in Ambiguity by Tara Adams is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License