Hold On Tight Because It Is Going To Be a Rough Ride!

Katie (name changed) was clinging to her mother and would not let go. She had both arms wrapped tightly around her mother's neck and was whimpering, with her face buried in her mother's chest. She insisted on being carried and would scream in fright when anyone tried to talk to her. Katie's mother was exhausted from holding, carrying, and rocking this terrified three-year-old for days on end because she weighed around forty pounds by this age. Katie was just diagnosed with leukemia, and only her mother's arms could comfort her. Even though there were no painful procedures for Katie to endure during the hospital stay (children are routinely sedated for anything painful during leukemia treatment), she was still terrified at all the new faces and unfamiliarity of the situation. I wondered if Katie thought that if her mom kept walking and rocking her back and forth, no one would get close enough to hurt her.

Fast forward two years, and Katie had her last chemotherapy treatment. She was so independent that she insisted on sitting in the big chair all by herself when her port was accessed with the needle used to infuse her final chemotherapy treatment. She jumped up onto the exam table without hesitation and insisted on also using the otoscope to look into my ears after I examined hers. Katie reported that she would be a doctor someday, so she needed to practice at every opportunity. Katie's only cries and whimpers were in protest of having to leave the clinic so soon because she was having great fun. She loved coming to the clinic now because of all the attention she received from the nurses, doctors, child life specialists, and others.

Needless to say, it was a privilege as a pediatric oncologist to watch previously sick and frightened children learn to thrive, even while being treated for cancer. People often ask me if being a pediatric oncologist and working with sick children every day was sad. I actually thought it was a very uplifting career because I witnessed humanity's best every day. Children are remarkably resilient despite so many challenges. This encouraged my soul. If a three-year-old could transform from being paralyzed in fear to an outgoing, confident, and vibrant kindergarten student before my eyes, then it was easy to imagine anything was possible in life. Transformation of character occurs mainly as we endure and overcome hardships. My career provided living examples of this every day in the journey with the precious children I cared for.

Do You Have a Stubborn Person in Your Life? Take Care Not to Exhaust Yourself in This Relationship

Tommy (name changed) was seventeen years old when I met him. He had more difficulties and trauma in his first seventeen years of life than most people have in their entire lifetime. He was a survivor by necessity because of adverse childhood experiences. Tommy wasn’t easy to get to know because of his tough exterior. I attributed his demeanor as a mechanism to protect himself from any more disappointment and pain.

By the time I met Tommy, he had already seen many doctors for vague symptoms over a period of years. Eventually, he had a surgery referral after a mass was found in his chest. The biopsy revealed an unusually slow-growing cancer called a germ cell tumor.

Tommy was alone when I spoke to him the first time. His mother wanted to be there but had to work to pay the bills. Tommy barely responded to my questions. He would not look me in the eyes. Because of the unusual age and presentation of this type of tumor, I asked him about certain symptoms or changes in his body. He proclaimed with exacerbation with every question, “No, I don’t have that symptom. I am fine!” His biopsy did not make sense with the story he was giving me, so eventually, I said that I needed to do a complete exam to sort things out. He was reluctant but finally did cooperate. I discovered that he had a very large, softball-sized testicular mass during the physical exam. Now, this made more sense to me. His chest mass was metastatic from a very slow-growing testicular mass that he probably had for quite a long time, given his symptoms.

I asked him how long he had noticed a change in his body, and he just shrugged and looked disinterested. He had been asked directly about such changes in his body several times, and he had denied any issues repeatedly. He refused to discuss it from that time forward. He refused to allow anyone to examine him again, except for a quick listen to his heart and lungs. He was stubborn about this and remained so going forward.

Unfortunately, the late diagnosis of this particular type of tumor made it incurable. If the tumor had been diagnosed months or years before this, it could have easily been treated with surgery alone because this is the primary treatment modality. By the time slow-growing tumors widely metastasize, they are incurable because the growth is too slow to be affected by chemotherapy or radiation. Chemotherapy and radiation work by disrupting the DNA in tissues that are dividing more rapidly, but they do very little in these slow-growing tumors.

I have many fond memories of Tommy. He spent a lot of time in the hospital and was usually alone, so I had the privilege to get to know him very well. We developed a close bond. His tough exterior was only part of the story. We had long talks about things that he enjoyed, like fixing old beater cars, sports, and food. We discussed spiritual things and what we thought the afterlife was like. He died with the same no-fuss attitude. He was very courageous even when dying at such a young age.

It is easy to get frustrated with the stubborn people in our life. After all, they are often their own worst enemy because they refuse to ask for help. Stubborn independence can literally cost a person their life. However, I was not upset or frustrated with Tommy because I knew he was a survivor. Tommy did whatever it took to prevent himself from ever feeling vulnerable again. Tommy survived difficult situations as a young child rather than giving up. He figured out how to cope, relying only on himself when no one was there to help him.

I enjoyed my time with Tommy and navigating the patient-doctor relationship by remembering that his most significant need was to feel in control, and his biggest fear was feeling vulnerable. We got along well when I focused on his needs, not what I thought he needed. After all, I could not have convinced him to change anyway. I allowed him to be independent and maintain his dignity above all else. Rather than be in constant conflict with Tommy, I spent the time getting to know him. I will always remember and admire his strength and courage.

Are You the Victim of Narcissistic Abuse? You are Not Alone.

Do you have someone in your life who is difficult to get along with? Perhaps you have tried everything you can think of to improve the issue, but the other person just won’t budge? Psychologists may even describe the person as a “narcissist” or “highly toxic,” Ideally, we would all avoid such people. However, sometimes this is impossible because of work or family commitments.

Well, you are not alone. I am in this painful situation. My most recent annoyance involved reading an email where the toxic person capitalized the first letter of all proper names, including his name and everyone else’s name, but he repeatedly left my name uncapitalized. This pattern was not a type error as this pattern continued across many email interactions.

I wish this minor annoyance didn’t bother me, but it reminds me of the apparent dislike and scorn that I have experienced from this person so many times in the past. The constant put-downs somehow make me feel small, just like the small, uncapitalized letter at the start of my name.

Perhaps you pray for God to change the situation, and you desire nothing more than for peace. Sadly, peace often doesn’t come in these relationships.

Many people are in this situation, as evidenced by the numerous podcasts, blogs, seminars, and various learning opportunities that exist to recognize and avoid toxic narcissists and minimize their damage. It is a tremendous drain of energy and causes stress for many people. Chaos is the norm in these unfortunate situations.

There are no quick fixes that I am aware of, but some insights have emerged after dealing with narcissistic abuse for over thirty-five years.

Firstly, narcissists usually only pursue close relationships with caregiving types that are empathetic, warm, and accepting. Narcissists are quite selective of whom they target because most people will not put up with them, to begin with. I found that allowing my nurturing personality to continue to bless others is good medicine for all. I need to continue expressing my authentic self. I have learned to recognize the signs of narcissism to stop being a victim of dysfunctional people. Being a victim the first time is understandable, but repeating the pattern repeatedly means there is something internal that also needs to be addressed.

Secondly, I often remind myself that it is okay when a toxic person doesn’t like me. Although it makes me uncomfortable to be belittled and scorned, I know I need to stand strong. One thing that makes one vulnerable to a narcissist in the first place is wanting to please people at the expense of personal values and self-worth. Someone will be unhappy in a dysfunctional relationship with a narcissist, so I have chosen to make myself happy first and not worry about the narcissist’s anger and unhappiness. This may sound selfish, but I have learned through personal experience that the happiness of a narcissist is very short-lived and is based on control rather than mutual respect. The only person’s happiness I can consistently control is my own.

Thirdly, this relationship burden keeps me focused on my true friends and my true home, which is in heaven. I love and appreciate true friendship so much more now! I yearn for heaven because I know there is coming a time when there will be no more strife, pain, or tears. As simple and child-like as this may sound, it encourages me to strive to become my best self each day despite the unpleasant situation.