Insight

“Discipline should not be practiced like a rule

Imposed on oneself from the outside, but that

It becomes an expression of one’s own will.”

-Erich Fromm

I met her twenty years ago. I forgot who referred her to me. When I met her she was in her mid- forties and looked ten years younger. Bright, shiny hair that changed colors at every visit. Very well dressed, but there was always an element to her choice of wardrobe or accessories that seemed to me a bit inappropriate for her age. Let us say she was a tiny bit loud, but she was the kind of person that could get away with it. Funny; bright; boisterous; never seemed to take anything seriously.

She had been divorced twice. There were no children. She had a clerical job that she did not seem to take very seriously. Every available night she was off somewhere with one of her numerous friends, having a whale of a time.

Medically she was well. I began to look forward to her visits because she never posed any problems and she had many party stories and jokes to tell.  One day she seemed particularly happy and extroverted. She had met a gentleman at a bar; a successful and introverted engineer who owned his own business. They had gone out half a dozen times, and she told me that he wanted the relationship to be exclusive. I asked her how she felt about this, as free and outgoing as she was.

“He seems to care for me. He has money; you know I’m not the kind that saves anything. He’s kind of quiet, but maybe it’s time for me to settle down…”

She agreed to date him exclusively. She cut down on her parties. He proposed six months later.

At the next visit she told me that she had quit her job. He had asked her to help him with his business. She did most of the bookwork. Even though there was a lot to do I felt that she was smart enough to do what was asked of her. I was happy for her; I did not think she was serious enough about her prior job and planning for her future.

A few years went by. She toned down a bit, but there were times that I felt that she was not happy, or was maybe preoccupied. I blamed it on her lifestyle change and maybe on added responsibility. One day she came in; totally unkempt, to ask for a tranquilizer. Her husband had asked for a divorce. She would have no job, and soon, no medical insurance. She had not saved any money.

Almost ten years went by. One day I saw one of her friends in the office. I asked about her; why she had not come back. The story was not pretty.

She did well for the first year of marriage. So much so that her husband allowed her to do all of the bookkeeping. It seems that boredom, or an innate compulsion to self-destruct, took over. She developed a gambling habit.  She spent many nights at the local casinos. She got involved in a friendly relationship with a man twenty years younger than she was. One thing led to another; soon she was “in love” with the young man and was subsidizing his gambling addiction. When her husband placed her on a strict allowance she began to embezzle money from the office. She would deduct taxes and FICA wages from the employees’ checks, but she did not make the corresponding deposits at his bank.

It took the IRS 18 months to show up at the office with a subpoena. Tens of thousands of dollars were missing. He lost his business and his reputation.  She lost him.

I told her friend that I’d like to see her again. At no charge, of course; she had no insurance. To my surprise, she accepted. A totally different person.  Still well groomed but very subdued, like a puppy who knows he has done something wrong. We did not talk about her past behavior. I found out that she had developed a form of arthritis. The pain was overwhelming her; this was the only reason that she swallowed her pride and allowed me to help her.

After I wrote a couple of prescriptions I sat facing her, not saying a word.  There was literally a minute of silence. Then she opened up.

She felt horrible. Here she was, in her early sixties, having to work two jobs and barely making it. She had no hope and no future. And she was in pain.  Something about bad breaks.

All of a sudden it hit me. She has no idea that most of this misfortune is of her own doing, I said to myself. Or if she does, she’s suppressing that guilt pretty darn well. She thinks this is life.

Part of me wants to roll a newspaper up and slap her real hard over her head (like we do to puppies). Then I begin to think. Aren’t we all in the same boat?

We have a chronic cough and we keep smoking…

We have uncontrolled diabetes and several pounds of candy and snacks in the pantry…

We have a devoted partner that we seldom acknowledge and that we never say “Thank you for everything” to…

Yes, it’s life, I say. Bad breaks.

I stand up as she leaves; I give her a hug. Of course I will see you free of charge, until we can find some form of coverage for your visits. We will try to get you free samples. Here are some charities that may be able to help.  Keep your chin up. Next visit I want to hear some jokes like you used to tell me. And see a pair of oversized and loud earrings. Hang in there.

She leaves; at least she’s looking straight ahead. Ready to face life.