How do you do your duty for people whose behavior you despise?

In My Humble Opinion
1

As a doctor, my duty binds me to work for the benefit of my patients’ legitimate medical needs. As a prison physician, that means I am frequently obliged to be an advocate for unrepentant killers, rapists, sadistic psychopaths, rip-off artists, etc.

Recently, I was reminded yet again of this while setting up a long and complex (and expensive) treatment plan for a patient with a chronic disease who was busy blaming his victim for his incarceration. The details are moderately heinous, but suffice it to say, his victim is no longer alive.

This caused a small pause in the office visit, and I did quickly proceed to shut the guy’s chitchat down by telling him we were focusing on his medical problems today. Period. But I was surprised at how angry I felt. And afterwards, as I reviewed his chart I noted that his unwillingness to accept responsibility has been a feature of his for a number of years. So this was not just a bad day for him, but a pattern of continuing behavior.

Afterwards, I had to make a conscious effort to let go of my emotions and proceed with planning his treatment (which frankly is better than many non-incarcerated folks can get these days).

I’ve got my own methods for letting go of this stuff so I can do my duty. It mainly involves mental exercises that allow me to get over not only recreational outrage, but even the most righteous anger (which usually leads me astray just as effectively as unrighteous anger).

Generally recognizing that they are already in prison as punishment & not to be punished is a good place for me to start. That thought is generally followed by some reflection on how whenever I fail to act correctly it seems to bring me as much grief as it inflicts on others. At need I’ll bend the ear of select friends who are in or have been in similar situations with their work. And if I’m still unsettled by the matter, I’ll do physical exercise more vigorously than usual.

It seems to be working for me. I sleep pretty good, don’t grind my teeth, and don’t take this stuff out on the family. But I am curious how other SDMB denizens with similar situations deal with it.

So, dopers! Enlighten me. How do you do your duty when your primate brain is screaming things like “take this guy out of the gene pool! Now!!”?

2

I take my ethical obligations seriously. I’ve posted before that I would defend Osama Bin Laden to the best of my ability, if appointed to do so, or if I accepted a fee to do it. I’ve defended drunk drivers, thieves, a teen-aged rapist, a murderer, and more assholes than I can count. I don’t have to like the client to do my job. Some really bad people have walked because I did my job well. (or because the Prosecution did theirs poorly).

Then again, I sometimes have trouble sleeping, and seek blissful intoxication fairly often. Cost of doing business.

3

Thanks, Oak. But do you have a method for detaching your emotions from it, other than the ethanol infusions?

Oh, and this thread is not just for health professionals, etc. Many people face this situation in myriad walks of life. I’m sure that our mods here at SDMB have a lot to offer on the topic too!

4

mostly half-assed

5

Well, it’s never going to be easy knowing some of those people are on the streets and are probably going to do the same or worse in the foreseeable future. I believe in the system. The state must prove guilt beyond a reasonable doubt. The client…even if he is an asshole…has rights that I believe are worthy of protection. During a case, it’s easy enough to deal with the tactical decisions and just put the moralizing on a back burner. After the fact, sometimes it is not so easy to put that aside. One case in particular comes to mind fairly often. When it was over, I have reason to believe two women went home that night and prayed about me. One thanked God for allowing me to keep her child out of prison. The other asked God to send me straight to Hell for defending the guy that raped her child. Being an atheist, I have no recommendation for how God should resolve that conflict. I did my job. My god damned job.

I do not miss criminal defense work one little bit. But, I’d do it again if necessary.

6

Well, personally the concept of unconditional positive regard goes a long way to help me not throttle people in everyday life. I suppose generally people are doing the best they can, even if there best is pretty pathetic.

Mind you, I don’t spend my days dealing with convicted killers (at least not as far as I know). I think your job must be very trying.

7

I don’t come into contact with quite as many undesirables as you do, QtM (although the prison does sometimes bring inmates through the lab), but when I do I like to remind myself that their lives are already pretty much in the shitter. I’m happy, healthy and free to do whatever I want. Sometimes I have to bite my tongue or push my irritation down (which feels a lot like holding my breath as long as I can) or just plain leave for a bit. I sometimes also have to remind myself of my professional obligations and sort of ‘shame’ myself into doing not what’s easiest, but what’s required. Which usually sucks. But in the end, it’s ‘living well is the best revenge’ that carries me through having to deal with fucking dickwads.

8

I don’t think I could do what you do QtM. I’d probably end up staying at work in my off hours if you know what I mean.

9

Then again, there’s the old lawyer’s joke. Jury comes back with a guilty verdict. Client looks at the lawyer and says what happens now? Lawyer looks at his watch, then replies “Now, you’re going to jail, and I’m going to lunch.”

10

I think that I’d have to console myself with the fact that I had to deal with him only occasionally. HE has to live with himself, and I’m betting he’s not a pleasant person to live with.

Having said that, I’d probably also fantasize about doing a little behavior modification with a taser or similar instrument.

11

Gandalf and company met Saruman and Wormtounge on the road, and were gracious to them. Probably would have given them food, if asked. Gandalf, at least, had a very good idea of what Saruman was possibly up to, including murder. And yet, he let them go. Why?

You might take comfort in pondering that passage.

12

As an office manager, I once had to fill out the paperwork and sign weekly for an employee who, at the ripe old age of 25, had 7 children by 7 different women, and who came whining to the plant manager every week that he didn’t have enough to live on after all of the child support was taken out of his check, by court order. At that time, in that state, he had to get $120 per week in take-home pay, per state law. At a wage of about $6 per hour, I shudder to think what his poor kids received.

I restrained myself from leaping over the desk and throttling him, but barely. I filled out the stupid paperwork, but I was pissed off every single week. (And no, I didn’t hold all 7 mothers blameless, either, but I didn’t have to deal with them whining every week.)

13

It’s an understatement to say that my experiences pale in comparison, but I was a mechanic in a former life. Sometimes, I was working for the customer and trying to solve a problem for them. At other times, I was just fixing a machine. Take pride in your work.

14

The fact that I could lose my job is my main motivation to keep me in line. The loss of my job will precipitate other losses, such as my home, my cars, and my toys. And those are all motivation enough to “be nice” to my patients.

15

This is why so many of our colleagues develop God complexes. I had such an inferiority complex to start with that if anything it has brought me up closer to normal.

I don’t know why, but it doesn’t bother me at all to take care of despicable people. I just focus myself, define in my head what my job is, and I do it.

The ones that make me stabby are the ones who actively undermine my efforts. For instance, I had a patient today who has already had a bypass at age 40 who can’t be arsed to check his blood sugar. (He claimed he didn’t have a meter, which means he just doesn’t know where it is.) Then I had another, a member of the Dozen Club (HbA1C > 12) who was in the hospital with a nasty infection last week (the less said about it, the better) who also can’t be arsed to check his blood sugars and who flatly refuses insulin. He was actually shocked and pissed off when I told him I wanted him to come back in a few days with a log of his blood sugars.

With patients like this (and with both of these) I often have to leave the room. I go to my office, close my eyes, and recite my mantra–“all I can do is all I can do”. Then I put everything together in my head, work out exactly what I need to say, and go say it. I’m pretty good at finding the point where I need to step out, but I admit I’ve unloaded on a patient or two.

When all else fails, I just remember that the better I do my job, the less they have to see me.

16

In dealing with an abusive and mentally ill mother, my technique was to simply act in a way that a good son would act. This allowed me to define my actions for myself and not use my mother’s judgment as a standard for my behavior.

I also used what I thought were “professional standards” in the military and as a teacher. Gives you a bit of an anchor in a sense.

I found the same mental positioning to be useful as a high school teacher for thirty years. (Also remembering that they were teenagers and I was an adult helped too)

In a strange way, it is more or less like that old Sinatra song “My Way”…not to be self-centered, but to define myself by my own expectations rather than others meant that I wasn’t tugged this way and that by whatever variations were going on with others and my own circumstances.

Not necessarily helpful, but it worked for me.

17

I came across a saying when I taught at a private Jewish school:

Do not put a stumbling block before the blind.

At first, I took it to mean that you literally shouldn’t play mean tricks on those who have a handicap. The longer I go, though, the more I come to believe that it’s more about not adding troubles to anyone already carrying some.

Your patient is a bad man in a bad place. Whether or not he ever changes for the better is not up to you. Not only do you not get a say, nobody is going to hold you to account for him. So, do your job, and send him on his way without tripping him up.

Then, go stomp some dandelions.

18

I walk home 30 minutes and try very hard to not look at email and turn off my cell phone until i’m back at work early the next morning.

i’m in sales and deal with some world class jerks either as customers or internally. put it this way, i used to work at lehman brothers, who were among the biggest corporate assholes you could ever meet.

For any really bad cow-orkers, i pretend they are clients and don’t sweat it much. Clients can be unreasonable, and thus ignore their BS.

That walk home and the distancing keeps me sane.

19

At my job, the worst category I usually have to deal with is annoying people, not unrepentant killers, and occasionally mean people. So the comparison might be mild at best, but …

I got to the point where I had to realize that it’s easy to be pleasant to pleasant people. The real challenge is to be pleasant to someone who is making you want to punch him in the junk. I started to look at those situations as an opportunity for me to have to work at being a better person. It’s like exercise I guess – no pain, no gain. If I know I’m going to be dealing with one of these unpleasant people, I actually take a few moments beforehand and reflect on it, and visualize myself acting calm, pleasant and professional regardless of what the other person says. Wow, that was so self-helpy sounding, I might be ill. But it works for me!

Anyway, after I took up this outlook, two things happened which made me feel pretty good about it. First, to belabor the exercise analogy even more, it was one of those things like how exercising gets your heart rate up, which eventually leads to improved heart performance when you’re at rest (NB I think I learned that in gym class in the fifth grade, so feel free to translate that into something more accurate and doctorish :slight_smile: ) I noticed that my interactions with everyone seemed to be a little better. Even situations that were formerly “very good” were now “very good + 1.” “Excellent” moved to “excellent + 1.”

Second, there was an intern in the next department over, who made a point of telling me, at the end of his internship, that he had learned a lot from observing how I approached these difficult people. I wasn’t supervising him, so it was like I had helped someone professionally without even realizing it, and it was very rewarding to hear.

So when you’re doing good for people who probably more deserve a slap upside the head, you can benefit:

  1. yourself
  2. other people you will encounter in the future
  3. other professionals who look to you as an example (even if you don’t realize it is happening at the time)

When people get very annoying, sometimes I even have to run through this list in the back of my mind to keep me focused.

20

I work in a service that provides support to vulnerable members of the community, including a contract for MAPPA - Multi Agency Public Protection Arrangement. This means that the service we provide(welfare advice, tenancy support, linking in with law centres etc) extends to people who needs this support because they have just come out of prison after doing a Very Bad Thing(including but not limited to sexual offences, especially to children). Most of our service users have a mental health or drug problem.

Occasionally it gets right on my last nerve that public money is spent at a high volume for those people that have effectively chosen not to be an upstanding member of the public.

But what I remember is this: I have been working in the substance misuse field for a fair old while and I have come across many people who expect the world on a plate despite never having contributed anything to it. The reason I do this work is because I see the good in people and I believe they can change and begin to contribute.

When I see that happen, it’s beautiful. And it’s always worth it.