Ralph

Step-wise. It is how I prefer to accomplish tasks. I view most projects as smaller steps that, once taken, will lead to the desired endpoint. I fully understand that this model isn't applicable to all processes, but working in that logical fashion feels right to my left brain.

My desk at work is an example of my preference for steps. My list of upcoming surgeries is in constant renovation. I've found coordination between services to be the most challenging component of a big case, so I keep check sheets to remind me not to miss a vital step. And there are so many. A few months ago I decided to take a week of vacation and discovered (at the last minute) that I was the only one who knew how to set up a particular type of case. I emailed all of my colleagues, the residents and the fellows the check sheet for the case. I received responding emails stating that some had no idea what went into that type of surgery, and some hoped they would never have to coordinate one. They will. I will take more vacations.

Now...the thing about steps. There are limiting factors. Resources available being one. Sometimes staff isn't available, or the patient has to work out insurance kinks. But the biggie, the one that can bring my "I-ride-a-unicorn-to-work-and-I-work-in-a-hearts-and-flowers-everybody-is-so-happy-to-see-everybody-please-thankyou-can-I-help-you-with-that?-day...is the Rate Limiting Factor. Ugh! Sometimes there is one step that simply must be completed, and if not completed, the process will grind to a halt. A virtual standstill. This. Drives. Me. Crazy.

I concede to a small genetic expression of Obsessive Compulsive Disorder. I realize this. I count backwards while I run. I'm crazy about checking and re-checking the prescriptions I write. But not being able to move, not being able to work can make me a lunatic. Okay, lunatic is a pretty strong word. In my head I'm a lunatic. To the observer, I'm probably just a little edgy, maybe cranky. I suppose I should say the I understand a rate limiting factor that is uncontrollable, some things just happen...like, oh I don't know...hurricanes. But if I'm sitting around waiting on someone who is not participating in the process, and SHOULD be participating because it's his or her job, either as part of the health care system - or as the patient, I'm likely to be a little testy. I don't need or want excuses from these RLF's. Thinking of them as "Ralph's" seems to help. It's a name I simply can't take seriously.

As I consider this, there are also RLFs in relationships. I've been in relationships where one party is simply not participating. That's pretty damned rate limiting. Lately, I find myself wanting to make sure I'm walking my own steps. I don't mind walking next to someone through the process, but I don't want to be caught up in his idea of what the steps are and wander too far off of my own path. I have so much going on in my life right now, and I'm still learning. Each person I encounter is a teacher, as I hope am I. Although I will continue to introduce myself as Michelle, I am also Ralph.