During my years as a patient advocate, I learned a lot about people.   Patients and their families were some of my greatest life teachers.  One of the first things I learned in my days of advocacy was that the term “difficult people” would be more aptly labeled “difficult situations.”  When people are caught in a complex situation, they can appear difficult.  To resolve a problem, you must first understand the situation.

A nurse on one of the neurology floors asked to meet with me about the husband of a patient.  They told me he was writing down things in a little book he carried in his shirt pocket.  In fact, he would sometimes go to where their names were listed on a board and copy them into his little book.  He never spoke a word to anyone and never smiled, just watched.  This had been going on for a couple of days and they found it unnerving and somewhat threatening.  His wife didn’t seem unhappy with her care in any way, so what was going on?  Would I visit with them and see if they might tell me of any problems?

I paid Mr. and Mrs. Pitman a visit.  I introduced myself and what I did for the hospital, and asked how things were going for them.  Just as the nurses had reported, the patient was quiet and seemingly satisfied.  I’m not sure she said a word, just smiled and nodded her head at me.  Her husband looked as grumpy as they had reported and seemed a bit cautious.  I visited for a while, giving him information about the hospital.  He didn’t have much to say other than to ask me my name and then write it in his little book.  I gave him my business card and asked that he call me if either of them needed anything at all.  Not a thing in the visit gave me a single clue.

The next day I met Mr. Pitman coming through the lobby of the hospital.  He was coming from the direction of my office so I asked if he had maybe been around to see me, and if there was there anything I could help him with.  He told me he had actually been to the barber shop to get a haircut, so I complimented him on it, and then asked about his wife.  He told me she was feeling much better.  Then he hesitated for a moment, looked at me and said this:  “I am a farmer and not used to big hospitals like this.  My wife called me a few days ago to come in and stay with her.  I have a lot to do right now and hadn’t planned to come until the weekend, but she was pretty persistent, so I came on in.  I don’t know why she wanted me here as everything is fine.  In fact, if I had any money, I would give it to those nurses who take care of my wife.  They are absolutely wonderful.  I’ve been writing their names down just so we can remember them.” 

I thanked Mr. Pitman for his kind comments and told him I would be sure and let the nurses know how he felt about them.  I felt pretty sure he wasn’t going to be able to do that.  This was a phone call I loved making.  “By the way,” I said to the nurse who answered the phone.  “Mr. Pitman just got a haircut in our barbershop; you might mention how nice it looks and see if that will open up some conversation.”

Mr. Pitman’s face (like mine) appeared rather stern without a smile.  Add it up:  Mr. Pitman’s harsh appearance plus no verbal communication plus continuous note-taking equals a nursing staff convinced he was very unhappy about his wife’s care and preparing to pounce.   But that wasn’t the case; he was a very gracious man in a strange environment, at an inconvenient time, thrust into the middle of people he didn’t know.  He was not a difficult person – just caught in a difficult situation. 

We are by nature, programmed to fear what we don’t understand.  This was the case on both sides:  patient’s husband and nursing staff.  In the case of Mr. Pitman, we did get to know the truth – got to understand.  That made it better for everyone.  When that doesn’t happen, it helps to remember these words from noted psychiatrist, Dr. Gerald Jampolsky:

We do not see people as a whole.  We see just a fragment of a person, and our mind often interprets what we see as a fault.  Evaluating and being evaluated by others, a habit from the past, result at worst in fear and at best in conditional love.*       

*From Love is Letting Go of Fear by Gerald G. Jampolsky, M.D.