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Sometimes the answer may simply be a ‘stem failure'


There is nothing you can do to help a person modify his or her behavior, or to modify a clinic behavior, if the person simply does not see-or will not acknowledge-this behavior within himself or herself.

Putting It In View 

“Reality is merely an illusion, albeit a very persistent one.”  -Albert Einstein

GravesI had a discussion with a technician once that did not go as I had planned-for either one of us.

I was trying to get the technician to understand that there was a perception that she was being difficult to communicate with, short natured, and combative. Basically, people were spending a lot of time trying to avoid contact with her. While this same technician was very skilled and performed an excellent exam when focused, the interpersonal skills had progressively worsened.

The aftermath was incredible. I wish that I could say we had a great discussion, worked on a mutual way for these issues to improve, and all ended well. But it did not, and the technician left the practice. In the long run, it probably was for the best.

That night, staring at the ceiling and reliving the conversations of the day, I spent time examining the discussion from all angles to determine if there was any other way it could have gone. By the end of the night, the answer was still the same.

“Everything happens for a reason,” is the rationale my mother continues to use when there really is no answer to a given question or problem.

A case of stem failure


A case of stem failure

The way we view our role and behavior in the clinic is a perceptional issue that continues to rear its ugly head.

There is nothing you can do to help a person modify his or her behavior, or to modify a clinic behavior, if the person simply does not see-or will not acknowledge-this behavior within himself or herself. Then it becomes a “they are against me” mentality and a battle where all involved will lose in the end.

Why do I call this behavior “stem failure”?

Because when faced with a conundrum for which I simply have no answer, no solution, or no idea why something occurred the way it did-I think of leaves in a tree.

One day I had a physician trying to find an answer to why a certain behavior was occurring in the clinic.

The behavior he was seeing was organized chaos and it had finally dawned on him that this behavior occurred every time he was in that particular clinic. He was passionate with trying to find the answer, and beseeched me to explain to him why this was occurring.

I started slowly, and tried to explain the extrinsic influxes that occurred.

The technicians were motivated to perform in a given manner either to earn a reward-being able to work in that clinic with him or being able to perform those tests they were doing and enjoyed doing-or to avoid punishment-being banished to a clinic where they did not want to be. Sometimes extrinsic influxes caused them to perform in a by-the-book fashion and they did not always think things through because they were regimented to perform in a given way. Blank stare.

Intrinsic factors


Then I tried the intrinsic influxes.

The technicians were working at a high level of expertise and enjoyed their roles in the clinic. They did an excellent job because they really cared and wanted everyone to be treated well so they would be happy with the service and clinic. More of the stare. This was not helping.

I tried to explain the patient behavior. We had zero control over patient behavior and/or interpreter behavior and patterns. Again, no help or show of acceptance.

I tried throwing the physicians in the mix and gently telling him that their practice styles could sometimes cause much of this organized chaos. This was met with a frown, and a somewhat cold stare.

I then paused, exhaled, and stated that the answer is a “stem failure.”

"You are asking me why a single leaf fell from a tree in the forest. I have given you physics, explaining that a wind gust came along and dislodged a weak leaf. I have given you real-time and logic-a squirrel jumped on the branch from another tree and broke the stem and the leaf fell. I have given you weather patterns-it is fall and the tree is beginning to go dormant and the stem is not as sturdy as it was in the spring. You have not bought any one of those explainable answers. So, all that is left is stem failure. It obviously had a defective stem and the leaf fell for no other reason than stem failure!”

Believe it or not, he sort of appeared to understand. Simply put, there is not always an answer for why people do what they do or behave as they behave. It just “is.”

Long and short of it


Long and short of it

The long and the short of it is: People’s perception of how they are behaving is their perception. It is not always real or couched in truth, but it is as impenetrable as a concrete wall. No amount of rationalizing is going to compromise it.

If I go back to the discussion with the technician, we have some “longs” and some “shorts” of the conversation. In the end, neither of us agreed with each other’s conclusions. And the cement wall remained.

Breaking it down, the “longs” of the conversation were:

  •  Each of our perceptions of the situations was vastly different and immovable.

  •  The memories of the situations had now become entrenched and elongated.

  •  There were grudges and bad feelings regarding these encounters and the final encounter.

  •  The organized chaos it created: every time someone called, it became a pattern of behavior that people came to expect, and thereby created detours around, even though that created more problems in the long run.


The “shorts” of the matter were:

  •  Again, perception of the instance while it was occurring. “It was them, not me.”

  •  Involvement of social media and the repercussions that created before it was quickly removed from general population.

  •  Initial chaos of each encounter.

Analyzing the problem


Trying to analyze the problem and coming up with a workable solution to the problem sometimes is not possible.

Life is not a sports event that you either win or lose. Sometimes there are ties. Sometimes you have a situation where you agree to disagree. Not the best of solutions-but in most cases workable.

And life does not always have an answer to why your world is the way we perceive. It just is. And the only answer you can muster up is “stem failure.”

It is what it is, and externally, I am not going to change the tide.

On wild and crazy days, I can live with stem failure. The thought of being a squirrel in a tree, bounding through the branches, and causing one leaf’s chaotic flutter to the ground seems clear enough to me.

Why the leaf fell, I don’t know. Nor does it matter because you aren’t going to put it back on the branch.

It happened-move on! 


Dianna E. Graves, COMT, BS Ed

E: dgraves@stpauleye.com


Dianna Graves is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983.


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