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I have been armour suiting up lately.

Why? Well, various reasons. One is that I am changing. I am frustrated with the treatment by my peers and by the local hospital to the point where I am ending contact. I paid my county medical society dues faithfully for years, I go to the meetings, and then no one talks to me. I send patients to do labs at the hospital, get xrays, see specialists. I have been in the county for 18 years working, yet the patients either say, "They say you are not part of the system." or I get referrals to see me precisely because I am NOT "part of the system."

I had a sudden epiphany right before the last county meeting. The hospital sends out an invitation email, but not to me. They do send it to another solo doctor. He forwards it to me. He once said, "I have given them your email over and over and why don't they send you the invitation?" Good question. I am the bad girl who used to be part of the system, an employee of the system from 2000-2009, and then they encouraged me to set up a private clinic. By kicking me out. So I set up a private clinic.

For this last invitation I thought, why am I banging my head against the wall? These people have treated me callously over and over for 18 years and I am done. I thanked the physician who forwarded the invitation. And I didn't go and I didn't explain. And I don't care.

I am spending time with people who DO value me and like me. My Sunrise Rotary, the UW Telepain every Wednesday, my friends, my patients, my church.

I am wondering when the county physicians will come around. One of the things they don't like about me was that I took the training for treating opioid overuse at the end of 2010. Then I was the only physician in the whole county who was doing that treatment for two years. The county doctors ignore me and treat me badly. But the UW Pain and Addiction Clinic said in 2014, "We want to thank you for single handedly lowering the opioid overdose death rate in your county over the last two years." Now, with those two groups, who would YOU spend time with?

Now we have four trained physicians, the hospital "system" finally has one, and they have a psychiatric nurse practitioner ramping up to be the fifth. I am really glad that the hospital is finally coming around, but I am done with the meetings. Years ago, some doctors said that the only contact with me that was acceptable was to be polite in the halls. Fine. It really hurt. It still hurts. I've come around to agree that that is how I now feel about them too. But I don't plan to spend any time in the hospital halls at all unless there are dire reasons.

I think that I armoured up, fell back into my toughest and strongest armour suit to make this change. I developed this suit as a child and wore it for medicine. It is my science brain, all emotion hidden, all emotion shut away, and only logic present. It is the ice scientist. I do not pretend to be Marcus Welby: no warmth. It is an honest suit, logical, but I shut my emotions away from the conversation.

In part it is because I do not want to lie. My emotions are as important as my logical mind. I am still paying attention to my emotions when I invoke the ice scientist, but there is no emotional connection with the person I am talking to. I don't want that connection. I learned the suit in my parents house, in an alcoholic household. Children can learn to hide emotions if they are punished for "negative" ones. The unacceptable emotions in my childhood were fear, grief, shame, hurt. And others. When I raise that wall, the only people who can see through it are my children. My sister could, but she is dead.

However, the armour suit is NOT good for my body. So my neck is going out and stiffens up and I stiffen in my legs and feet and upper back. So I have been thinking about it. I do not need that armour suit if I don't play with the mean people. I don't need to go to meetings with people who treat me badly. I will stick with the people who value me. If I run into the mean people, the suit does not need to be physical. I can learn to be very gentle and just keep my emotions to myself.

We learn our personas as children. The person that we want to be, want to project, want to be seen as. My father refused a persona as much as he possibly could, and caught hell for it from his father and other men. But I adored him and his honesty. And he was wonderful with small children. He would engage them where they were and they recognized that he saw them and did not require a persona. He never dismissed them as boring or unimportant.

My daughter and my father had a running joke involving a toy phone when she was very small. He asked her who was on the phone. She said, "Nobody." My father then started talking about Nobody as a person and asking her questions about Nobody. My daughter caught on immediately and made up creative answers. They played a conversational game that only they understood.

All of us have personas attached to our jobs. Mine is not Marcus Welby at all. And really, doesn't our culture play lip service to being individuals, to being honest, to being real, to being ethical? Yet do we truly value and reward those things?

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