Do we call them patients or clients

"We tend to think the way we speak, and we tend to act the way we think.” A philosophical way of seeing the emotional side of a person and the behavior they exhibit to us and the rest of the world. Lately though, I’ve noticed the nature of it to be as prophetic in what it says, as much as what it does not say. In medicine there is absent a debate today, about how we address or reference an individual who needs medical treatment. Do we call them “Patients” or “Clients”.
That’s the question we ask ourselves, those of us who have seen what was and what now is. It strikes back to George Orwell’s “Animal Farm”, the nature of one social shift to another, the process being the same, if not the specific ideals. Those in power do not work the farm nor do the work. They calculate, they manage, and they create social morphisms of our lives by which they control the “bottom dollar”, but take away that by which we have always been known, “care-giver.”
Words are subtle things that carry power within the effect of what in our minds they bring together. We are bombarded with the rendered chaos of thoughts not our own, words defining the nature of how we look at things, at people, what the paths are that we choose in life. Words bombard us with their energy from conception to death, creating and building the very pathways to the complexities of our minds. They are the rhythms, the music that defines the cadence of the dance we all move to, that transforms us to the higher mind of who we want to be, who we can be or it transforms the spirit of who we are, to that of the trapped beast; marking time, devolving into the purity of our biology and becoming all that our imprinted instincts will push us to be.
Epistemologically we approach the sense of words as a sense of knowledge and the need of words to absorb the nature of that same knowledge. History is full of such words that convey action, take away hope, and scuttle the nature of empathy for the hole we metaphorically hide within. We wrap ourselves in our language as much to express our feelings and ideals, as to hide from them.
The children’s idiom “Sticks and stones may break my bones, but names will never harm me”, is an excellent way to teach children to avoid taking verbal attacks to close to heart. To develop a thicker skin; so to speak, and find points within themselves that build their self-esteem, their character, finding ultimately the nature of a more stable and happier person.
The truth of this is seen every day. We constantly avoid certain words that carry so much emotional and generational baggage; that to use them even innocently, automatically guides some individuals to verbal or even physical violence. We see words take on definitions that collectively cause others to stereotype, to abuse, amuse and in general destroy the essence of truth that they originally had.
“Sticks and stones may break my bones”, but in truth, words do hurt. Not in the sense of a child’s feelings; although that happens as well, but in the sense of loss, when truth escapes the nature of our discontent. A discontent where we find that we have lost the sense of ourselves in the nature of our growing literary ignorance and the knowledge lost, that we once sought within the thousands of words that brought to us the sage wisdom of those who came before.
In today’s world where reality is either funneled into sophomoric techno-fads, with the skills to use, but not the knowledge to understand or in the “win-win” business parlance of saving a penny for a business model to the point of their own self-destruction, we find ourselves working for individuals and corporations defined by those individuals, who have lost the sense of reality beyond the common electron, or the common penny.
They use their monetary dominance to lobby, change attitudes, create new paradigms that repackage the emotional heuristics that once led to individualism, to self-possession, but to which now skews the nature of our whole civilization through the windows of other people’s lives.
We’ve become the dysfunctional narcissists, the virtual gladiators of Rome without the physical danger that once drove a person to be free, that once drove a person to learn, to seek, to value the hard won wisdom of our evolutionary trails. The dangers of a Darwinian life still exists outside our door, not driven by the forces of old, the lions at the gate, the dragons at the door, but by the subtle smiles of the common suit, the sociopathy of a spreadsheet rational, that now guides our life to the stochastic limits of a number line, moving and shifting within the new logic created by the words of our time.
It is easy to see the effect of a word when it is imbued with the collective acceptance of its nature, but not always easy to see the far reaching affects it has when we are besieged through a lifetime of its use. Within the vagaries and vicissitudes of life, there are always those whose needs far outreach their ability to help themselves. A short walk or a well-worn path for some of us, given the ordered-randomness of genetics, the world around us that we try to control, but by which the pressure of our control breeds the nature of our own destruction.
Our history is replete with the fullness of sociopaths, martyrs and those who plod through life finding that they are caught between the two. Through it all the hope that there is hope, was always provided by the “care-giver”. Those whose hearts followed the trails of the weak, the infirm, the innocent, seeing somehow the truth of a spiritual life in the expression of the goodness they brought to others.
The “care-giver” took many names, through many ages, the nature of what they were called solidifying into a collective acceptance, a seating of power in the words themselves. There calling, to be the care-givers of their age coalescing into the recesses of our minds, within the words of “healer”, “midwife” “priest”, “Nun”, “Doctor”, “Nurse”, but always with the same spirit, the same need to be the one in life that heals, even if the only healing left to them were in the words they used to sooth the pain of a ravaged spirit.
On rare occasions some care-givers seem to be given a spiritual understanding that is as natural to them, as music was to Mozart. An intuitive feel for the nature of things, mixed with that rare ability to express it so well, that we are entranced with each word, each note within the devotional aspects of their lives.
Sad to say; that for most of us, the path to that spiritual nirvana, that spiritual balance we seek, requires that we see the ravages of our time in our own lives. Becoming simultaneously the masochist or sadist to our own self-worth, enduring the pain of loss, of depression or with the physical limitations that challenge us to be more than we thought we could be. It is the nature of the victim, the patient that is our life for a time, that we live until the rendering of our spirit shows us who we can be, over that of who we were.
Good-bad, up-down, light-dark. Life is always a contrast of the balances we define in the words we use. The word patient has its recorded origins in Greek, Sanskrit, Indo-European with the meanings of “suffering” and “want”, the trail of its power to subjugate, transformative from “one of suffering” to that of “enduring suffering”.
The word “patient” is as synonymous with suffering as is “care-giver” in its many forms, is to an altruistic heart. Some call it the “Christ Complex”, some just call it the truth of being a civilized human. The power of the words defining the focus of the developing medical arts, capturing the minds of those in search of the Holy Grail, that ultimate prize of finding out who we are by the nature of what we do.
It has been said that “love” is the only aspect of ourselves that we can give away and always have more to give, the miracle of the five loaves and two fish, the feeding of the multitudes by Christ comes to mind. You don’t have to be Christian to understand the nature of what we see every day in our children, in the eyes of those we love. We just have to be able to step away from ourselves and see the essence of what is in every heart, the need to be needed and the need to give our souls up to that need.
It is by definition this aspect of empathy that grows stronger the more we push ourselves to express it. At some point the critical mass of choosing which end of the “Dahmer – Gandhi[1]” bridge we step onto, becomes the higher or lower moral path we find ourselves on.
There has been a loss of understanding into the nature of words, in knowledge and the wisdom gained in the efforts of expressing our lives through the words of our beliefs. There has been an attempt, sad to say, successfully so, in finding politically correct or misogynistic words, phrases or concepts that undermine the nature of medicine, undermine the very stability of our way of life.
There is a dichotomy in our personalities, in our natures. That aspect of ourselves that defines the masculine and the feminine, the balance of our strengths as “father” and “mother”, the twin aspects of our single soul that bonds “protector” and “giver.” The blending, the process of becoming one, finding in ourselves the love that makes us greater than the sum of our parts.
Women brought to medicine that “mother” instinct to give of themselves, to nurture, to support their patients in their time of need. Their strength always inherently there, even when not appreciated or understood in the male dominated world that existed for so long.
Men, the “father” found themselves stronger for accepting there role, but also respecting and honoring the role of “mother”. The two working together so that they each learned to share their strengths, the “father” finding in himself the strength of giving, the “mother” finding in herself the strength of protecting.
The strength in the art of medicine has always been found within the balanced nature of those who bring to the “patient” their love of giving, of protecting. To lose that sense of who we are, both “mother” and “father” in that aspect of our careers as doctors, nurses, care-givers, is to lose ourselves to the nature of what we belief, when we change how we look or describe the nature of those we help.
Our growth comes from how we connect to our patients, how they connect with us. Calling a “patient” a “client” changes intrinsically how they subconsciously see themselves, how we subconsciously or otherwise react to them as something other than care-giver.
The term “client” is one who receives benefits, services i.e., social welfare, or something from the government. It is a patronage under another, a dependent giving up their individuality. The very nature of the word defines a connection of subservience, defining the care-giver as something less than they are.
Treating a patient has always been the validation of our existence, the strength of our character coming into existence though the strength of our love to those in need. In the corporate world, the industrial world, our existence has become the nature of the “parts” we shuttle though our office, through our treatment rooms, the “tale wagging the dog” instead of the “dog wagging the tale” in the action of our work.
We can no more separate the term “care-giver” in ourselves, than the “patient” can from the need they have of us. It is a world of symmetry defined by the words that connect us, over time making that bond stronger in the action of who we historical are, or making that bond weaker in the corporate drive to control even that innate morality we know is the only path we should walk.
You have to ask yourself, when you are in need, do you want to be a client? Or do you want to be a patient? Do you want to be the care-giver? Or do you want to be a factory worker watching the parts goes by without regard to their humanity.
When we use words, we define the direction our mind takes us. “We tend to think the way we speak and we tend to act the way we think.” The nature of our collective future is in the synchronicity of our words; be they well chosen, or ill-chosen, they are a choice of need and a need of choice.
Ultimately, when the confusion of our thoughts becomes the nature of our actions and our actions fall short of the nature of our hearts and we’ve lost that center or balance of ourselves that defines the essence of any objective truth, then we have no recourse, but to look at those basic truths that define the nature of the path we have come to walk.
What word of truth will you challenge yourself with today? Will you be “Orwell’s” intelligent but amoral “pig” or “Benjamin the donkey[2]” revealing the changes that no one else sees. Will you conform to “All animals are equal, but some animals are more equal than others”, or will you sing the friendship of Boxer and challenge the world to remember and walk the higher road. The easy path is never the right path!

[1] Dahmer – Gandhi Bridge (Military Review “Psychoanalytic Profiles and Modalities of Sociopathy”, L. Campbell M.D. PhD et al)

[2] In George Orwell’s Animal Farm - Benjamin reveals that the Commandments now consist entirely of the message "All animals are equal, but some animals are more equal than others". For all his age, he is never given the option of retirement. The only outrage that inspires him into action is the pigs' betrayal of Benjamin's best friend, Boxer, after which he becomes more cynical than ever.