Not what you say

IT'S NOT WHAT YOU SAY
BUT HOW YOU PITCH IT
Journal of Healing – March 10, 2004
By Mary Koch

A few years ago . . . gosh, come to think of it, a few decades ago, my friends and I were absorbed by "Passages," Gail Sheehy's book about stages of adult development.

I wondered recently if I had just gone through another of life’s passages when I became aware of the tone of voice I was using while speaking on the phone with my mother.

It was my Voice Of Authority, the tone that implies, "Listen to me because I know more than you do." I learned that tone of voice from – whom else? – my mother. When we kids were growing up, Mother was a master at stopping all sorts of nonsense with the fewest possible words. It was all in the tone: This Is Your Mother Speaking. Whatever made me think I could use that tone on the very person who’d taught me? Well, sure. We all go through that stage when we’re convinced we know more than our parents. There’s the old joke about kids going off to college, and when they graduate they’re amazed at how much their parents learned in four short years.

* * *

AND THERE'S A stage later in life when we sometimes reverse roles with our parents. My mother (who reads this column religiously) and her children have not reached that stage.

She still makes her own decisions, and they’re good ones – like the decision to stop driving well before her skills diminished to the point where the decision would have been forced upon her.

Now Mother was on the phone. Actually, I’d called her when she hadn’t responded to e-mails. She reluctantly told me about symptoms that disturbed me. I wanted to get in the car and drive 250 miles to take charge – another trait I inherited from Mother. But my husband requires round-the-clock care, and I can’t just up and leave.

More to the point, Mother has an excellent support system of family and friends right where she lives. She was already in charge herself, thank you very much. She had made an appointment with a specialist and arranged for her friend Jean to drive her.

"I think it would be a good idea for Jean to be with you during the examination," I said. Mother demurred. That’s when my tone of voice changed to This Is Your Daughter Speaking.

IN TODAY'S health care system, every patient needs an advocate at her side. It’s a large part of my job as caregiver for my husband. Even if his stroke hadn’t robbed him of the ability to speak for himself, he would need an advocate. The system is so confusing, the examinations so rushed, the doctors’ language so complex, no one should try to sort through it alone, especially not ill and alone.

Ideally, your health care advocate is your most assertive friend or family member.

The advocate provides an extra set of ears to absorb information and an extra brain to think of questions. The advocate makes phone calls, checks back about test results, ensures the patient doesn’t get lost in the system.

I don’t know whether Mother heard my tone of voice, or if she just wanted to get me off the phone. She acquiesced.

Friend Jean, armed with questions and details about Mother’s symptoms, was allowed in the examining room. Jean took careful notes, cracked a few necessary jokes and carried through with the necessary follow-up, including calming down the Voice of Authority 250 miles away.

Mom’s doing well, and I’m speaking normally again.

(Mary Koch writes about health care issues and her experiences as a family caregiver. Her husband, retired newspaper publisher John E. Andrist, was severely disabled by a stroke in 1993. They welcome your letters at P.O. Box 3346, Omak WA 98841 or e-mail them.)