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Rated: GC · Essay · Other · #1847781
This is a piece describing how I feel about losing another case manager.
Case Manager #2.  Trudy.  Our first interaction began with me saying, "I don't need a fucking babysitter."  This, in front of Case Manager #1, Angie.  I had told Angie the same thing.  The only reason I was even entertaining a case manager was to cooperate with my doctor, whom I highly respect.  He wanted me to have a broader support base than just him if something went wrong.  So Angie, who was moving on to a different position within the center, was passing me off to Trudy.  I resented the idea of having to go through this again.  And what if this one was worse?

I guess I should start with Case Manager #1.  Angie was a good case manager, but she asked too many questions.  She often pried a little bit and I actively resisted that.  At one point, she offered me the opportunity to be a client of hers once she hung her own therapist shingle out.  That was a direct threat to my relationship with my doctor.  We had it out about that after two weeks of strained relations.  She did not mean it as a threat, merely an offer of help should I ever need it.  But I did not see it that way because my position was that I was only seeing her to alleviate my doctor's concerns about me not having enough support.  Angie was only a few years older than I was.  The fact that she was not younger was very important.  She is now an independent counselor.  Good for her, and I mean that.  I have referred several friends to her and they have had good experiences and successful outcomes with Angie.

Case Manager #2.  Trudy was older than Angie, had three kids, and was a part-time case manager with the center.  She is a positive, happy, down-to-earth lady who does not pry much and is sensible about the difficulties I face and how to help me deal with them.  She has helped me with many situations that I would not have been able to deal with as effectively alone, especially with the VA.  It seemed like she always knew when to call my doctor - she always knew when something was seriously wrong.  Trudy met me out in the community, as Angie did, and not in the office.  We would have coffee or lunch and visit about everything under the sun.  This one was not worse.  I really like Trudy.  But now she is leaving.  Another employer made her an offer she could not refuse, and it should work out better for her and her family.  Here again, though, now what?  Case Manager #3?  What if this one is worse?  Trudy said she is having trouble determining which case manager would be a good fit for me.  And she is asking the VA if I could meet with Angie instead.  Tomorrow we meet to discuss the options.  Thank God I meet with my doctor after I meet with Trudy tomorrow.

So, meeting with Angie.  The VA would have to approve that.  And that, again, I feel is a direct threat to my relationship with my doctor.  If it comes down to a decision between my doctor and Angie, I will not do anything to endanger my relationship with my doctor.  Period.  Ever.  I can just see the VA saying that, since I have a "therapist", I do not need my doctor.  I will not allow that to happen.  My alternative to this worry, though, is yet another case manager.  One that may not be all that compatible with me.  Case Manager #3.  Some jerk-in-the-corner twenty-something with no real life experience to draw on working with me, the combat Vet with PTSD and depression who is undergoing ECT and decompensates quickly when all hell breaks loose, resulting in hospitalization in the inpatient psychiatric ward for suicidal ideation.  Great.  What wonderful alternatives to look forward to.  And, of course, no one sees these things the way I do.  They do not understand where I am coming from.  They just say, "Aw, don't worry about it.  Nobody would do that to you."  My ass, they wouldn't.  My past experiences are of trauma and the least likely horrific outcomes under circumstances no one could ever imagine.

I feel like no one understands me.  Nobody understands the pain and the suffering and the anxiety and the depression and the anger - the pure raging anger - that rule my life.  My doctor helps me through these things.  All I have left is him.  I am so glad that I see him tomorrow after I see my case manager.  He will not allow anything bad to happen if he can help it, and that I trust him for.  I do trust him.  I trust Trudy.  Now I have to start over trusting someone else.  Or not trusting them.  Trust is earned, and not easily with me.  It takes time and it takes proof.  I do not just take it at your word that I should trust you.  I have no reason to trust others with my past experiences being what they are.  Why do I trust my doctor?  We have had a solid relationship for eight years.  We have had crises in our relationship and we have had it out over various things, but he has proven himself trustworthy.  It has taken a long time.  And a new case manager, especially a young twenty-something whose frontal lobes have not even fully developed yet, will not understand that.  So here's to Case Manager #3...a person whom I fear will think they are by rights my therapist, are entitled to know every last bit of my history in horrific detail, and have absolute authority over me and my decisions because I cannot manage life independently.  Guess what...you're wrong.  I don't need a fucking babysitter.
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