Intents and Means

Saleh Abdel Motaal
Oct 19 · 12 min read

This week I had a waking moment… I was kicked out by my doctor on account that I “had an agenda”… because apparently we would not.

I woke up the next morning, feeling a sense of relief I had been missing for far too long. My sense of confidence.

I was confident in myself once again, because I had handled a narcissist, abusing his position of power, with nothing but my best intentions, and without means that are justifiable (but to regret — ie parentheses denoting thoughts for clarity).

I was fair, I did not cross the line, I was rational, I was afraid, I was right.


Intent

I hope by reading this you will come to appreciate, in detail that:

  1. There is a lot of confusion on how we read people.
  2. Patients can be misunderstood.
  3. Some (not all) professionals can be poisonous to their patients.
  4. Patients feeling not in control of their progress, have the right to want to be.
  5. I needed to wrap my head around what happened when I left my house this time.

Backstory

Starting off with the moment of derail, mid-way through our speed session (this doctor only offers walk-in days for his patients, ie does not make time for appointments). I was asking him (a member of the community of those who are entrusted with studying the mind) that since there is a surge in new ASD research, that I would like to volunteer for a case study, should something related come to his attention.

Things started to get awkward earlier on though, when he rudely insisted that “I had to listen to him”, instead of letting me finish expressing what I was there for; what I am seeking as a patient. So, I clarified that “I did not have to listen, but I will…”, then bit my lip as he went on and on about the same things.

As he was about to segway to yet another “will not work” tangent of my options, close to 10 minutes now, I said “before we move to another one, please help address a couple of things for me…


Skew

To summarize, according to him, my problem is that I have “average IQ” and so I do not qualify for “disability” or any support beyond a handout good for starving while covering part of my medical expense.

Not just that this is far from what I was trying to inquire about, but that this is about the tenth time he said this.

In all those words he spoke for 10 minutes, he is unable to appreciate how I can and “need” to sustain a “positive spin” on life to retain control with all my struggles.


Reality

I have since been forced to call (slow but successfully) to find the “support system” I need, least of which is, until I am able to resolve issues affecting my chances for “fair” employment, my financial troubles.

I have, like many, accumulated enormous expenses to get my degrees, and I did a damn good job in spite of my odds — and the grandfather cynicism of some who were paid by all this tuition to “educate” — because of a few who had and continue to have faith in what they saw possible, and one who saw more than most (and in whom I saw a rare nature that continues to inspire my resolve).

I really struggle with secondary things. But absent a right diagnosis, I developed layers of unresolved stresses on the dumbest of things, that most people just think I ought to brush it off because that is typically how people are able to. But for me, such advice only compounds my stress.

And so while he clearly skewed his accounts of the (clearly underscored to be just barely-) positive, he omitted all the (very real) negative things I am actually dealing with (equipped only with a monthly refill for side effects of my bare existence and some coupons when in good graces)… And, as a patient, this only helps short term.

Asking an ASD person to summarize his worth (fairly) in a few bullets. Or asking them to make an impression, good eye contact, and (yup that one) good handshake (firm but gentle and room temperature please, right with toast)… All that highly superficial junk spewed in university-level courses gearing us for employment.

But on the long term, beyond seeking good reason to want to survive those miserable times, until I break-through on things we ought to address, all that is not going far at all.

To end up seeing those who plagiarized, who fudge, all get hired, the more typical outcome, apparently, all secondary things, while I return home empty handed, just debts, and overbearing sentiments of exclusion.

What I am talking about is issues I need to be in control of, regardless of material dilemmas. Because those dilemmas are mine to workout, and their outcomes are not (always) in my control. And so, on my mind are only things I can, things I know I lock up and cannot overcome, that are trapping in the torment of needing his services, and he won’t hear of it.

Those are not things to put in articles. They belong in the privacy of notes kept by my doctor. But they could not, and so they are here.


More Skew

On me wanting to participate in ASD research, he claims, I needed to “first get better, before saying [crazy] things like that…” like somehow when I am no longer an actual living case to be worth study, I would go and paint skewed pictures of times where details are best forgotten (or forged, who gives a hoot about validity).

But he said that more like “I need to take care of myself first, before I can be any good… for others” and that was my cue, and he saw my face picking up on that. And here was the divide.

I picked up on the fact that this was the best motive he could fathom in his own mind, the selfish one.

That subtle expression would be unnerving to an adult who gets by tucking away selfishness from the eyes of those he charms.

His hope to assert onto his patients a safer mindset like his own.

But two years now, and I am constantly failing to submit to his mindset. All coming to a dreadful moment for him, in one facial expression.

I am no longer just stubborn, I am clearly of a mindset of mine own, that is threatening to his own.


More Reality

He is consumed with his assumption that I suffer only a perspective problem, like somehow staying positive is why my depression will never go away.

I am convinced that my depression is caused from seeing too many such details that I need to find a way to reconcile with the accumulating overhead of those discrepancies between different types of personalities… many good… some triggering… let’s start there.

Discrepancies where certain people would justify what is not fair to others, to be their due right, and are getting away not because of anything but the fact that most others will confuse this with being a driven contributor to society.

And discrepancies where certain people are resolved to thinking that it is not socially acceptable to admit struggle. And to address it actually being a due right on account of one’s existence.

We don’t just go in a box until the next appointment. We need to live with the consequences of what takes place in those sacred offices, not least the morality (or not) of it.

Because such folk will always look at life with a skew of their own injustice, that allows them to charm the rest, into justifying their façade, the singular intent, of being more.


Means

So, as I tried to explain a second time… “my 2 reasons for wanting to participate in studies”… but he interrupts very rudely… “I don’t need to listen”… and I politely responded… “Yes, you do”… and that was that!

He got up in somewhat vialed fury and opened the door, working hard to make it appear to those on the other side that this patient is going mental… like I was lashing out…

But since I remained in my seat and stayed composed, it made his efforts unconvincing enough and no one took him seriously, and so he tries to course correct.

I was inclined to behave so because my intuition had shown me a sense of peace with the facts, this is a (childish) game for him, aka being an adult.

That my doctor is bullying me in the most unethical sense possible. He is trying to mindfuck me into a pecking order of my own submission. He is a narcissist. And, he lost control.

He saw what he could not understand. Someone else able to see too much cues, and yet reasoning about life like he does not need to sacrifice what matters.

Finally, when the words stopped coming out of his mouth, I got up, slowly, took my bag, and walked to the door. I was now in view of everyone else, as he stated with subtle hints of his fading confidence… “you should think if you want to come back here”…

Once again, I was intuited to remain calm, clearly upset, but not loud, not furious, not threatening. I then responded… “I will… because I need access to health care… I don’t have a choice”…

Certainly, that was my move too, because I needed to assert, with good intention, that he has no control to assert on me personally, there is no submission, this is his choice, to be doing this job, as a doctor. Just like I need to get better, as the patient.

We’re not playing games.

All those words were not said, but clearly communicated in the heat of the moment. Clear to anyone with his sad affliction, the worst intent, the most disgraceful means, but not likely to help them reconcile with their own deceit.


More Means

As I was about to exit the offices, I remembered they forgot to give me my prescription. I took the opportunity to compose myself before I walked back to the receptionist. I then asked for it, politely, with a positive smile, not a fake one, but one of certain peace with uncertain duress.

As she was turning to my perscription from the printer, I asked if she saw me being out of control or threatening, her honest read. She turned back with a very assuring look of sincerity and compassion (only a slight second of calculation to consider her outcomes of the unexpected), as she replied… “no, you were just upset”…

This was the waterfall at the end of the rapids. I fell head first. With a teardrop. An intense feeling overtaking me for a moment. I made it back, to the calm waters of the more sensible humanity. I was safe.

No matter how hard my struggles are, or how aggressive and unfair some can be, to retain the façade that they need, for greed, for title, to forge. No matter how long it takes for me to work through my issues. I am doing it, as sensible a human I as can aspire to be.


Intent

There are two reasons to want to be part of new ASD research efforts:

  1. Helping to better understand the nature of atypical minds, it improves the odds, not just for those who are like myself, but anyone who is struggling in all aspects of the mind, because we don’t understand enough, and we are not sure where relationships lie ahead as we continue to explore.
  2. By getting closer to a segment of the mental health community of professionals that are positively hopeful and motivated by it, I will no longer need to spend weeks of the inflicted agony of trying to reconcile with the bleak views of my doctor. It is practical, not selfish.

This is the kind of thing that a trained professional should be able to relate to, but not if they are there to prove something to themselves and are distracted from actually listening. This one was there to prove that I had an agenda. That I was playing games. All true from his side at least. But clearly, this is a luxury he can afford, what he needs to see.


Conclusion

In the past months, I was struggling to find the confidence to see things more clearly. I was subconsciously battling with the shameless mind games he was wheelding, to cover up his shortcomings. That he fails to catch up on literature. Or even worse, that he does not buy it. And, seeming like I was questioning it was something he was not prepared to deal with, to control.

Certainly there are doctors out there that are good. But clearly, a few are stuck dealing with their own sickness, at the expense of patients. Those struggling to reconcile with irrationalities of life. With all the unintended effects of medications. As well as the material aspects. Those struggling and desperate enough, to seem too easy to submit. But some won’t… I won’t!

My account of all of this is not something to take for granted. But my intentions, and means, by account of feedback… You can take to the bank.

I hope by reading this came to appreciate some aspects that would help you to appreciate in more detail the intents of this article.

1. There is a lot of confusion on how we read people

There is a lot of skew on how we think others think of us. But that the sad reality, it all matters enough, at least for some people who might just be wired different, to be affected differently. And that (for some seemingly immature) response can be both by nature of design, or through re-enforcement taking hold in the absence of adequate health care support to necessary treatment.

That some people, like those who are ASD, will not be able to reconcile with what most will consider typical wisdom that works for most.

That such wisdom being in overloading offer from everyone around them, with only very rare moments of being able to explain things looking different from their end.

That it does not help, to hammer, where there are no nails.

That it’s appreciated, that they are not just seen as stubborn. That typical wisdom can just be adding fuel to their constant feeling of “feeling resented” and not for what they are “able to express”. That they cannot just switch to being more typical, ever, and that can be “okay”.

2. Patients can be misunderstood

Those often come from a general lack of understanding that goes along with stereotypical labels on so called mental conditions, like ASD.

And when some fight very hard to beat the odds of getting good education, they will likely not be able to magically overcome the hangups of their one constant, always ASD.

But they will struggle even more to access support on account of arbitrary assumptions, like somehow because of those degrees or IQ, they are not expected to be struggling. Especially that since for most, when they graduate or relocate, they will suddenly find their support system pulled from under their feet.

That this support system allowed them to be functioning in society, and now they are shocked with dealing with a reality that is unfamiliar, without support and will drown trying to put the next one together.

And that because of misdiagnoses, wrong treatment, and a lack of a continuum in their records, they will sometimes be old once they are classified, irrespective of the medical fact that they were born that way, and that they have screamed for people to help them, and that they had no control on how more or less lucky that help came to be.

That all simply means… they are alone, but not okay.

3. Some (not all) professionals can be poisonous to their patients

That professionals can be at odds with a school of desirable by the patients, or be ignorant of their responsibility to be caught up on recent efforts that can benefit their patients.

Some professionals can be hidding their own need of treatment themselves… how does that pan for their patients, and for them.

That professionals can sometimes opt for more passive aggressive means, because of good intent, or deceivingly bad ones, to abuse their authority, with mind games, on patients not in a good mental state.

4. Patients feeling not in control of their progress, have the right to want to be

That patients need to feel they are being farmed out to doctors who are not able to meet certain standards of treatment, or feel without means to be able to do anything but continue to suffer.

That it is the duty and auth of the community of medical professionals to offer “qualified” service, with respect, and without doing harm.

And where this is part of the national health care coverage (in Canada and others), there sadly is often a lacking oversight.

5. I needed to wrap my head around what happened when I left my house this time

I have struggled for the past 5 years (not to lay blame) with the underlying condition left untreated, hoping to feel like I can be out in the world, to find a safe place for belonging.

It requires a lot of monologue, to do what I can to stay rational, until the right trained professionals can help me through.

Some I found already, on my own. In spite of being told they “don’t not exist”, or they “would not deem my case suitable”, which they did. But this is only a start, it is merely a few appointments, in pursuit of a solid plan, to treat side effects and to be able to put together a support system.

Until this all pans out, I am not thrilled to be here, I am suffering, and I am hoping the suffering comes to end (not one of a desperate impulse), hoping for some mercy, of turn of fate, of belonging, to society, of a more sensible humanity.

To be continued…

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