Press Gainey is the death of actual medical care.  

If you think that the satisfaction of patients is the primary determinant of excellent emergency care, you are part of the problem.

Those of us who give emergency medical care actually do care about our patients and do all we can to be kind and compassionate, but if you came to me because you had chest pain, but give me a poor score because the coffee you asked for wasn't hot enough, then none of this makes any sense anymore.

I got into this line of work to save lives of those who are experiencing life threatening medical emergencies.  I have yet to see a bad review from anyone who actually fit that category.

When I read the responses and see "I hate the 0-10 pain score, I couldn't understand it.  Even after they explained it to me, and I'm a reasonably intelligent person."

No.  No you are not. 0=no pain, the number increases with your level of pain.  10 is the worst pain you have ever had in your life.  If you don't understand that, I can't help you.

And yet?  YOU determine if the care I gave was considered appropriate.

What you think of me is none of my business

I work on this every day.


I suck at it, sometimes.  Maybe a lot. But, I keep trying.

Integrity is hard.

But, for me at least, living with the holes in my soul that are created by being false is worse.

Sometimes, I get my feelings hurt (I do TOO have feelings!) and I feel really awkward or left out and I want to say or do things that might make me feel better for a flash, but would probably really hurt someone else.  So, I just keep my mouth shut.

Sometimes, people I really like do/say things that make me uncomfortable.  There are times when it is completely appropriate for me to call them out -- times when I sort of have to.  But, there are times when it sort of isn't my place, so I sit on the sidelines kind of holding my breath, hoping it all comes out ok.

In the end, my goal in life has been (since I was about 13) that I want people to be able to say, "If Mel said it, it's true."  It may have also been wildly inappropriate, but I'm working on that too.  I want to be worthy of the trust of my friends.  I want to be honest with myself, too.

That honesty will include that not everyone will like me.  I'm ok with that.  I'm also ok with others who don't care as much about holes in their souls, those who would say unkind things about me.

Recently, a friend said something to the effect of, "I would just worry about what they're saying behind my back..."

My response was this:

I honestly don't worry much about people who are my friends saying hurtful or damaging things behind my back. I have to believe they wouldn't do that. 

I mean, I'm a realist, I'll bet every (mutual friend in a given group) has been the subject of some private conversation between others in here, dissecting a situation or laughing good humoredly about some thing or other that is only differently weird from them. It doesn't mean they don't still like and even respect each other. 

Sometimes you don't know when people who purport to be your friends say hurtful or damaging things about you and you go on being friends and all is well. Either that means that they spouted off in anger and the person they said it to kept their confidence or it was something they've already pointed out to you was a problem. If it becomes a regular thing for someone to say negative things about me, that will eventually become evident. 

Either way, anything anyone says about me outside my hearing isn't anything I can do anything about. I can only go on trying to be honest and real.

Or, as my good friend is wont to say, "What someone else thinks of me is none of my business."

If you don't like me, and you let that be known, that's ok.  If you don't like me but pretend you do?  That's gonna be ok too, as long as your dishonesty doesn't actually do any harm to me or my reputation.

I'm just gonna plow along and try really hard to be the best version of me I can be.