Thursday, July 03, 2014


Since the last Nurse Practitioner who got stuck with the Valier Clinic refused my wish to take a lactic acidosis test on grounds that it was VERY RARE and therefore I didn’t have it, also advised me that my aching arms were either “atypical rheumatism,” “atypical arthritis” or “atypical fibromyalgia.”   No treatment.  To her, I guess I could be “atypical” but not “rare.”  So I waited until the next NP was assigned to the clinic.  In the meantime the arms have cured themselves.

Oh, boy.   Here’s the new Nurse Practitioner -- actually a PA, a Physician Assistant -- on YouTube.  Joni Walton is a “yummy mommy” -- that is, so honeyed, so moneyed, so enviable, so honored, so married to the finest surgeon in town down in the capital, and yet so willing to tell all her little foibles, etc.  My antennae are stiff with vibes.  Some of you will love her at once.

She even knows all about Indians and spirituality.  (By now people who know me are all laughing their butts off.)  In short, she’s a typical UU type.  The Southern variety. (The nurse who did the blood draw -- a new one yet again -- was very skillful.  Ask for Amber.  Local ranch girl.)  
This is not the doc in question.

Frankly and transparently, the management brought in this elite, well-connected woman to counteract a big old bull of an abusive doc who probably could not pass a mental health test.  He’s a leftover from a different era.  But he had money.  For the particulars see  Be assured that when I worked in that clinic as a ward clerk years ago and even in the community at large, I heard stories far worse than bad language.  He’s lucky he hasn’t been punched out -- maybe he has.  But to PA Sugar, Ph.D., verbal abuse is a major sin.  Juries will love her.

I asked for just the blood test -- but got pushed through the BP, the oxymeter, the conference, anyway.  It’s money.  Medicare will pay.  But I take care of my own health, thank you, because there is a steady procession of medical people through this clinic and they vary extremely.  I really liked the woman doc who was an amateur geologist and who cut a little tumor off my forehead.  And I really liked the one who had been a nurse and wore a skirt and apron instead of scrubs.  Both were brisk and businesslike. The best PA was a big bear of a man who was gentle, thoughtful, funny, and did the only full diabetes checkup I’ve ever had, though one instrument had been put away broken so he had to improvise a bit.

My time employed at the “Mother” Marias Hospital in Shelby was a tumultuous one to say the least.  I got the job of ward clerk because I was the only applicant with any computer skills, but even after six years doing data input for the City of Portland, I had a devil of a time with the clinic’s software.  Then they changed to a program even more difficult.  They shared the common management conviction that technology can prevent human error.  All but theirs.

The ward clerk just before me turned out to be only taking time off rather than quitting, so I was relieved of the job when she came back, but the truth is that Mary Maxwell set the bar high by doing a lot for the nurses to compensate for their overloads -- including routinely cleaning the break room and nurses' stations.  She had been a lab technician and had the right temperament for it.  I do not.   She was universally loved. (I liked her, too.)  I was not. My training and probably my temperament were a much better fit as student chaplain in a major regional hospital which was part of my ministerial training.  When this ward clerk quit, she was replaced by two senior nurses who -- the last I heard -- were still struggling with the computer software.

So Dr. Joni is sitting there making oh-so-familiar little speeches about the major importance of exercise (stop laughing, you guys!) and trying to figure me out.  By quitting time she probably knows quite a bit more, since her clerk’s father was a student of mine and the clerk’s father’s mother was a student of Bob Scriver’s, etc.  Of course, it will be an edited version because even that family doesn’t know EVERYTHING, even though they live just across the alley.  But maybe her clerk is more discrete than I think.  What would I want Joni to know?
Maggie on the left.  Lady on the right is from Colorado.

It’s not an info prob -- it’s a life-experience prob.  Nurses around here who are effective are generally a salty bunch.  They’ve likely done as much veterinary care as helping people.  Maggie Nutter was my fav.  She used to bring in ranch animals for the old people to enjoy -- calves, a burro.  The windows looked onto a closed courtyard.

PA Joni, Ph.D., who teaches at Carroll College, has written an article summarized here:“Prayer Warriors: a grounded theory study of American Indians receiving hemodialysis.”  $15 to buy online.  I did NOT want to tell her what my own CV includes.  It would not have improved the dynamics.  At least, like the Indians she recruited, I speak English.  I looked up "grounded theory method."  Very interesting.

I tried to tell her about “Sarge,” who mistook my glasses for my eyes.  I tried to tell her that I seriously blog long-form, rather than write little stories as she assumed, and am in daily contact with some very informed people.  She spent a good deal of time advising me about narcotic abuse locally.  (Never mentioned alcoholism.)  Maybe she thought I was fishing for a prescription.
Very nice lady -- don't know her -- off Google images

This whole thing really bothers me.  I can’t crack the puzzle of Nice Prosperous People who are supposed to be experts who have NO CLUE to the reality of people’s lives, not even those of nurses they are supposed to be teaching.  Or is it me who is clueless?  In my experience such people are intervenors and that makes trouble because they force action on THEIR terms.  Usually, society gives them the power.  Being “helped” adds up to being made a capture victim, so trust is a bad idea.

The kind of writing I do (you don’t see all of it) means rummaging around in one’s interior and ripping off scabs.  I have issues with success and class, money and education, but that’s not it.  She’s making big ultimate mind-blowing subjects into little pillow-fluffing exercises.  (Hear that sneer?  I could censor it, but that would eliminate evidence.)  

There’s also a thing about me being a phony, that my time as a UU minister was somehow a fraud, that I tricked my way into it and then was found out.  It’s in me, not her.  Worse, once "in", I was disillusioned and wanted out.  She could have no idea these things were fermenting in a tubby old white-haired woman with a big mouth.  But that’s the point.  I feel she SHOULD be able to guess such a thing.  I’m not the only person around here with a surprising past -- in fact, mine is better known than some others I could name.  It's an impossible expectation.

In part it’s her sense of entitlement that bugs me.  Maybe she thinks that intending to help me and having been praised as an academic should give her access to my private and personal self.  But it doesn’t.  It doesn’t even give her info she could assimilate.  She's more like a typical doc's wife than like a nurse.  She DID personally call me with my test results, which are within normal limits. I begin to understand that "lactic acidosis" is less a constant condition than a floating figure that can get too high or low, something like glucose.  Balance.  

Crossroads Correction Center

Then I start "replaying the tapes" of the conversation.  (Just memory.  No machines.)  Very little was about me.  Something else was present in the room.  A lawsuit?  Not about me but about the Marias County hospital and the little Valier Clinic? Why is this high-powered woman who operates in a national context treating our local chronics?  What was she really trying to figure out?  Shelby, location of the Mother Hospital, is a major transportation hub, a prison town that shares nurses with the hospital, a place that is not comfortable for Indians, full of nomadic oil field labor, and close to the Canadian border.  In fact, some of the travel nurses live in Canada.  Or is this all paranoia?

Shelby, Sweetgrass Hills in the background -- the Canadian border


Rebecca Clayton said...

This is such a common "type" in Appalachia that I recognized her instantly. Around here, you need say only "big-feelin' Yankee" to let everybody know exactly what you mean.

Since the Civil War, missionaries, natural resource exploiters, social workers, Vista volunteers, folklorists, medical professionals, and Lord knows who-all have come in, told people what they should do, took what they came for (tangible or not), and went back where they came from. They choose Appalachia instead of other impoverished places because they're less afraid of white people.

Some of these visitors swindled people out of timber or mineral rights, others got material for their research projects or street cred in their religious or intellectual communities.

They aren't always intrusive and unwelcome--I think of Rena Gazaway's "The Longest Mile," which your blog brought to my attention. She was an academic nurse who spent several years living in a transient, dysfunctional rural community in Kentucky. Apparently she didn't seem too "big-feelin'" to her research subjects because she was from rural hardscrabble Missouri, and knew how to talk to the people as equals. She provided them with free medical care and any help she could. But she did take away material for her book, which critiqued the social welfare system as it existed in the '60's.

I think this Walton gal pushed your buttons because she treated you as a research subject, which is probably what you are to her. People here would diagnose her as a "big-feelin' do-good-er," and pay her no mind, but you've made me curious about political motives.

Oh, and is it Ph.D. or DNP? A Doctor of Nursing Practice is a professional degree, like a J.D. or an Ed.D. It doesn't involve original research and peer-reviewed publications. Since I've been working at a community college, I've gotten all prickly about this, because some big-feelin' M.A. administrators have been dismissive of my Ph.D. and postdoctoral training, along with my high-profile research pub's. I think you're describing some of the same feelings I've experienced lately.

Mary Strachan Scriver said...

I appreciate your feedback so much, Rebecca! I DO think this woman -- and she really IS very charming -- is part of some kind of cultural trend, another bump of interest in the po' folks. And some of that is truly a feeling of wanting to get close to something real.

I'm remembering another "doctor's wife" at the City of Portland Bureau of Buildings. She was divorced, but equally attractive and diplomatic. The management used her -- rather unmercifully -- as a go-between to keep contractors off their backs when permits hit snags or were just slow. She was an intercessors between male and female, between powerful and disempowered. Very good at it, too. But it was costing her in terms of self-respect. She had no territory that was hers.

I don't know about the degree business. It looks suspiciously like an effort to confuse Ph.D. with M.D. Around here the tribal folks get D.Ed's which they represent as Ph.D's. Of course, the initiated know that one Ph.D. is not like another and will ask who granted the degree and what field it was in. Post-doc is where the rubber meets the road.