Trying to Teach the In-laws Assertiveness

Argh!

You'll remember that my father-in-law, A, has been hospitalized because of an infection due to a prostate biopsy and that his doctor discovered that he has prostate cancer.

Earlier today A called D, my mother-in-law, to say that for some mysterious reason, A was being released from the VA hospital today before his prostate had been removed. A, who avoids confrontation and speaking up for himself in every situation, didn't know why he was being released and didn't have any details! Part of his behavior is explainable by his having untreated attention-deficit/hyperactivity disorder (AD/HD).

I asked D a series of questions, while she was waiting to hear from A that he was ready to be picked up, trying to get more information. She said she got nowhere with the receptionist in the A's doctor's office. I said she should keep calling back, asking questions and saying that she needs the information because A is prone to either asking no questions of doctors or asking the wrong ones and to forgetting (no, he doesn't have Alzheimer's or senile dementia; he just has AD/HD) or misinterpreting what doctors say to him. She shrugged, which I took to mean that she wasn't going to do anything more—because she generally doesn't assert herself.

I called my husband Ed and asked him to leave work so he could go to the hospital with D to pick up A. I couldn't go because someone has to be home here with our sons, I'm facing a client's deadline, and at least Ed, because he's not self-employed like me, could get vacation pay for today. Someone had to go with her because she gets flustered when talking to authority figures and so probably wouldn't get enough info either. I asked Ed to channel me—to be firm about not leaving until he got answers. I even printed out a list of questions for him to take to the hospital and ask the docs before he and D bring A home.

But by the time Ed got home (he has an hour's commute) and was ready to go with D to the hospital, A's doc had called and given D the full scoop. This happened only because I pushed her to insist that as next of kin, she be given information. When I asked her why she hadn't insisted, before my urging, that the doctor get back to her with details, she said she didn't want to have him performing surgery on A after having been aggravated with her.

Since when is politely insisting that you be taken seriously a crime and enough to piss off a doctor? I don't understand people who are afraid to speak up for themselves. Many times over the years, I've explained to both A and D that being assertive doesn't equal being hateful. They seem to think the two are the same, so they're never assertive.

Here's the truth about A's medical situation, as told by the doctor and neither misinterpreted by A nor with any details left out:

The doctor had told A, when he first found the prostate tumor, that A would undergo prostatectomy "soon." Allan, in true AD/HD fashion, interpreted that to mean "now, while I'm in the hospital for this infection." But before he can undergo the prostatectomy, he has to undergo several tests. Before he will be released this afternoon, he'll undergo one of the tests: a bone (radionuclide) scan, to determine whether the cancer has spread to his bones. (The doc didn't say this, but if it has spread to his bones, he's f*cked.) After the prostatectomy is done, he can get the knee replacement done. If the time span from when he got all the preop tests done for the knee surgery to when the knee surgery can actually be done isn't too long, okay. If it is too long, he'll have to undergo all of those tests again before he can get the knee surgery.

Argh!

Updated 10:20 p.m.: Ed and D did both go to pick up A from the hospital; it took the pokey hospital staff a good 3 hours to discharge him and do the bone scan. We don't have any idea when we'll get the scan results.

Plus, there's this: Ed and I are strongly urging A to get his prostatectomy—and eventually his knee-replacement surgery—done somewhere other than the VA hospital. Of the three prostate biopsies he's had within the last few years, all have been at the VA hospital and two have resulted in infections requiring his hospitalization. I've found several medical studies that show that the rate of infection from properly done prostate biopsies is 1% or less. A's experience and the lack of communication among staff members at the VA hospital spell incompetence to me. If the doctors there can't get a relatively simple procedure (that's how the research reports describe it) right, are they going to get major surgery right? I wouldn't bet my own life on it. But A, always a can't-see-the-forest-for-the-trees kinda guy, refuses to think about that. He'd rather go through the VA than go to a hospital through Medicare ... because he'd have to pay more money under Medicare. Me, I think living is more important than money. But hey ... what do I know?



sandwich generation AD/HD ADHD self-employed in-laws intergenerational prostate cancer Veterans Affairs EditorMom