Definition found in the Dictionary of the Dashboard of my MacBook: A loud sharp cry, esp. of pain, surprise or delight; a shout. An organized cheer, esp. one used to support a sports team.

Pain, surprise or delight?  I think most of the yelling I hear throughout the day is in the “pain” category.

The other week, around 4:30pm, I’m sitting at my desk, talking on the phone to a patient about how he couldn’t have any more narcotics.  He took the information quite well and did not yell at me.  Towards the end of the conversation, I heard someone yelling. Loudly. In my lobby.  I couldn’t hear the patient on the phone anymore, so I told him I had to go. The voice was familiar.  She has done this before.  She is a small, slight woman but has the lungs of a lion.  She was yelling “Mother F***” etc, etc, etc.  at the top of her lungs. She had her reasons for yelling profanities and we had our reasons for calling the police.

The other week I was in Ross, standing in line with a suitcase I wanted to purchase-minding my own business, as well as, carefully analyzing the two women, guy and child in front of me who were all together.  Some random guy, not in line, starts yelling at the guy in front of me.  They all start yelling back (Except the child).  They’re trying to calm each other down, trying not to start a fight, I’m slowly backing up because they are getting loud.  The policemen, nearby, in the store, just watch.  Don’t do anything, don’t say anything.  People in line are like yelling for the police men to come over and do something.  Nope.  Soon, the random guy leaves and the others stay in line, discussing how terrible he is, etc, etc, etc.  And the child?  The child was silent, with tears streaming down her face.  She couldn’t have been more than 4 years old.  It was the saddest thing to watch.  No one paid attention to that sweet precious girl caught in the middle of some stupid argument that could have easily escalated to violence.  The poor girl will, though hopefully not, grow up to be like her 3 closest mentors who at one point in their lives, were also children with silent tears streaming down their faces.

Once I was on the phone to a patient who wanted her bus pass form filled out.  She had turned it in 2 days prior and we tell people that paperwork takes time for the doctors to get to because they are with patients all day.  She started yelling on the phone at me, “I want my bus pass!!!” It was quite shocking and then comical.  Really lady?  I’ve called 911 twice today for people knocking at death’s door-pretty sure your bus pass form is not priority today.  But yes, I will kindly let the doctor know you would greatly appreciate an expedited signature on your very important bus pass form-If I didn’t forgive you the moment you were yelling at me on the phone, I would find your bus pass, rip it up, and deny ever talking to you in my life. I am the nurse and not that my word is always taken over the patient’s but one of us is acting crazy and it’s not me.

I remember one patient screaming (not yelling, not cheering for her favorite sports team, but SCREAMING) “I want a dermatology referral! Why won’t you give me a referral!!!!!”  You may be wondering the same thing.  Just give the lady a referral to see a skin specialist.  What’s the big deal?  The big deal is that you can’t send someone to a specialist for no reason or the specialist will think you are crazy for sending them and plus, it’s your tax dollars that were going to pay for the visit.  She had some bumps on her face.  Tiny tiny bumps.  Like 3.  Like, not even visible.  Seriously.  No one could see them without an imagination.  I have an imagination so I could kind of see something.  I recommended facial cleanser/exfoliation.  And then she started screaming. Really?  My patient died yesterday of liver failure and you want to “talk” about some invisible bumps that just need some St. Ives from Walgreens?  “I’m sorry you are imagining bumps on your face. I’m sorry you think everyone can see them.  I’m sorry you have nothing better to do than examine your face.  I will kindly let the overworked, exhausted, sweet doctor know that you kindly called to sweetly request a referral to see a specialist for your hallucinations, I mean, skin bumps.  Thank you and have a nice day. Merry Christmas! Happy Birthday! Happy Cinco de Mayo!”

I had one patient who called consistently.  She never took my advice.  Never content with anything I say.  Never satisfied with any care given to her.  I can get her yelling just by pressing a few buttons.  I really don’t like getting yelled at so I do everything possible not to push the buttons.  Sometimes, though, the buttons get pushed by accident.  The conversations can get long and because they tend to be one-sided and my input is not necessary, I put her on “mute” and go about my business and every now and then, pick up the phone and say, “uh-huh” because we’ve had this conversation before.  I know her.  I could tell the story myself.  If she can tell her story, she will be happy.  So I let her talk.  The more she talks, the less she yells, the happier I am. It’s not the best use of time but it’s getting better.  What?  You don’t like the passive aggressive approach?  You think we need to be firm and lay down the law?  Oh, I didn’t think of that!  What a grand idea!  Go ahead, you first.  We’ve done it.  We continue to do it.  I weave every trick in the book into every conversation and I still can’t figure out the best method.  I did start one thing though that seems to help.  I start writing while she is talking.  I start writing the following:  Dear God, please help me help ________.  She is driving me crazy.  Please let her know it’s all going to be fine.  Please help her to trust you.  And please do it soon because I don’t know how much more I can take on this already 30 minute conversation.  Thanks. Love you, Your Favorite Girl, Rhonda.

And wouldn’t you know it-it helps!