You Can’t Give Me Your Unhappiness: A Mantra for Radiologists in Addressing Negativity in Health Care

To paraphrase Dr. Venkman (Ghostbusters 2), there seem to be an awful lot of completely miserable individuals working in the health-care system.

He said it more colorfully and he was talking about the general population in New York City’s vicinity. However, I have often echoed his sentiment during my tenure as a physician. I even had this perception as a med student and, in retrospect, probably even before that.

There are a gazillion reasons for health-care people to be less than happy. I have touched on some of these reasons in previous blogs, offered some remedies and thoughts on preventive measures. I don’t think, however, that I have specifically addressed what might be my current favorite.

Nietzsche described it as fighting too long against dragons, but most folks have experienced it firsthand without the need of any large, scaly firebreathers. Deal with miserable SOBs long enough and some of their misery, or other undesirable attributes, will rub off on you.

A non-radiologist might fail to appreciate just how much exposure we have in this regard. The stereotype is of us sitting isolated in dark rooms, never interacting with anybody. Meanwhile, the truth is that we represent a final common pathway in the diagnostic world. Anybody who orders imaging potentially has reason to come to us, whether in person, via an underling, or with phone, email, or IM.

That can be unhappy making all by itself. We are trying to get a bunch of things done, many already overdue, and here is yet another interruption. It doesn’t help when we think we already addressed whatever they want in our report, or if they are asking questions to which they should already know answers.

Putting all that aside, their style of interaction might be loaded for bear. Some clinicians come storming in (physically or virtually), expecting us to drop everything and wait on them hand and foot. They might imply, or state directly, that our work is not up to their standards, demanding addenda or complete rereads tailored to their interests.

Sometimes it is more subtle. There may be an attitude that they are “real” doctors and we are not, that they work for a living and we have it easy, etc. It is even less tolerable when their physician-extenders are sent instead. I might be willing to accept some guff from a top-flight neurosurgeon, but not his or her noctor flunky.

A lot of us respond to such negativity with our own. Sniping back usually isn’t the best option amongst other reasons because it escalates things. We don’t come out smelling like roses if we later say “Well, they started it.”

A more delayed tit-for-tat comes about if we react by gradually developing our own thorniness. Folks might then perceive that we are not to be trifled with and mind their Ps and Qs. Unfortunately, that is not something one can easily turn on and off. Next thing you know, you are just another one of the miserable SOBs.

Unfortunately, another reaction is to just sit there and take it, internalizing abuse whether it is real or just perceived. A lot of the folks who bring us this unhappiness aren’t doing it on purpose. They are just awash in stress and other negativity from their own troubles in our mess of a health-care system, and it colors their words and deeds even on a subconscious level.

That doesn’t change the fact that, as a passive audience to this parade of uncheeriness, we are liable to be affected by it. We might take it out on ourselves or other people in our lives, even complete strangers. There is a reason mental health workers, while seeing a bunch of patients, regularly undergo their own personal therapy.

I had a minor “eureka” at some point when thinking about a curmudgeonly ob/gyn who had tried mouthing off at me. Her alleged issue was a stone-cold normal pelvic MR I had read. Unable to cite anything about my actual work (missed findings, omitted pertinent negatives, etc.), she was clearly just looking to heap abuse on someone and decided I was to be her lightning rod.

As tempted as I was to roar at her that she could take her nonsense elsewhere, I knew that wouldn’t help—as stated above, it would escalate things. It’d also waste more of my time, by prolonging the useless phone call and/or if she went and complained to my superiors. I didn’t kowtow, so I wasn’t feeling completely spineless after the fact, but I had a lingering sense of dissatisfaction, and of course anger at the “professional” who’d just acted as anything but.

Then it occurred to me. She had a boatload of unhappiness. Maybe it was from professional dissatisfaction, a crummy personal life, or any number of other things. She had just tried to dump some of her burden onto me. Was I going to let that happen?

Now, I am not going to get all New-Agey here and claim that there is some kind of emotional energy transference when two people interact (although I can’t disprove that and if it helps you to envision that in using this maneuver, go for it). Even if I absorbed every bit of negativity she had brought to me and let it ruin my day, taint my mood for the remainder of the week, etc., I have no reason to think she will stroll away with a spring in her step and feel 100 percent better.

Still, it got my mental gears turning. Not long after, I emerged with a mental shield to raise in such moments and it works like a charm. Whether I am facing a verbally abusive individual or simply someone whose stressors might boil over and add to my own, I just think “You can’t give me your unhappiness.” It is almost a mantra.

At times, I have found myself thinking of it like receiving a piece of hate mail. Don’t bother reading it thoroughly or taking it to heart. Throw it in the trash. Better yet, don’t even open it if you know what is inside. “Return to Sender” and let them keep their bile to themselves.

If you are feeling particularly pugnacious and want to tweak someone who is darkening your door, it has occurred to me that actually telling the person “You can’t give me your unhappiness” might just make his or her head explode. I haven’t tried it (and don’t know if I ever will), but it is fun to think about.