Tuesday, April 7, 2015

Clothes Define the Person

With all our children, we have tried to encourage each to be active participants in their learning and education -- not just passive participants in their formal and informal education. For Jeannine, our dream has been in helping her to discover her strengths so that she develops the skills to do meaningful work.

As it turns out, Jeannine has been the most active participant of all the children when it comes to learning. This is not so much with her formal education as much as it is with the informal. The one thing that is positively certain about her is that she strives to do everything everyone else is doing. It is no surprise, then, that when her father decided to break from corporate medicine ten years ago and go back to a solo medical practice, she was right there ready to help. At first it was just confined to those hours she was in the office before and after school, and she was not so inclined to do much more than greet patients as they came in or left their appointment. She would even sit with them in the waiting room entertaining them with her observations, asking questions and responding to their queries as they waited (sometimes a while) to be seen.

As the years passed and formal school was no longer an option, she would come to the office and really want to engage in the "real work" everyone was doing. Not content with taking charge of the shredding and other mundane tasks, she volunteered to call patients to confirm their appointments. After much thought and deliberation, her father agreed to allow her to make the calls. Why not? Her speech was clear and she knew how to dial the phone numbers. All she needed was a copy of the schedule and she was on her way.

We scripted the calls for her, but very soon she was "winging it" and delighting those she spoke with with her professional phone manner and light-hearted chit-chat. It was fun listening to her, especially as practiced pronouncing patient names before making the official call. If she needed to leave a message there was no problem: she handled that very well, even if she had to start over again (in the same message) several times before getting it "perfect." When she was able to speak directly with the patient, it was heart-warming to hear her conclude the call with a sweet giggle and a "you're very welcome" to their "thank you for the reminder." It was even comical to hear her disgust if the patient neglected to thank her and just hung up..."He (or she) didn't even SAY anything when I called," could often be heard sailing through the office as she hung up the phone in frustration.

What was even more fun was to have the patients want to see her when they came in, especially to thank her for the reminder. Puffed up by the success of her new responsibility, Jeannine suggested that she could run the patient paperwork, highlighting medical services for which the patient may be due, and check for copays for those coming in the next day. After our watching her perform this additional task for a few days, she became defensive about having to be monitored. Again, after some thoughtful deliberation, we cut her loose from direct supervision and merely checked her work when she wasn't around. She was truly a productive member of our staff and fully appreciated by patients and co-workers alike. She was so dependable in the discharge of her duties that she was made official with her own name badge: Jeannine -- Office Assistant. On top of this, Jeannine took great joy in sharing with anyone she met -- at the grocery store, at church, at parties -- how she works in a medical office and what she does and how important her work is. In fact, she was so dedicated to her job that she routinely declined going on errands with me so that she could be in the thick of things at the office.

Well, the novelty of this job wore off after about a year or so and, in some ways true to the disposition of those with Down Syndrome, stubbornness set in and it could be like pulling teeth to sit her down to do her job. At first she would take the entire morning to go from person to person in the office to find out if she "had to call" everyone on the schedule, and then we could see her crest-fallen face if no one was crossed from the list.

Not to be deterred from dodging the confirmation call bullet, Jeannine would conveniently skip some people on the schedule (especially those who "didn't even say anything to her" the last time she called -- apparently she never forgets a slight).  It was interesting to hear the conversations she would have when the patient would come in and lament to her that they "didn't get my Jeannine call" and how much they depended on hearing from her to remind them about their appointment. In spite the cajoling we would do to get her do her work, there were days when she just wasn't interested.

So for what it is worth: While it is thrilling to be able to see her grow in her skills and be a positive force in the office, doing the meaningful work we had always wanted her to do, there are times when I wonder if we just haven't created a "Bride of Frankenstein," because there appears to be no end to her desire to do more and more for our providers. The other day I caught her going through the medical scrubs catalog with one of our medical assistants discussing which styles would be best for her when she becomes a "medical assistant for real."