Curiosity is a Survival Skill
How I got in over my head and curiosity helped me make it back out
By the time I’d finished my BA in Psychology I was flat broke. I’d put myself through school without any outside support since I’d graduated from high school, so I was swimming in debt. My one credit card was maxed out. My car was no longer reliable enough to get me anywhere, so I’d taken to moving it up and down the block once a day to avoid getting a ticket. I had a loose plan to attend law school with no confidence at all that I could make it happen.
Right about that time a woman I’d worked for during my first year of college in another state reached out to me with an interesting job offer. She and her husband had started a non-profit Guardianship Service and they were looking for a Director.
The job paid almost twice what I’d ever made in a single year. She would cover my moving expenses and give me a down payment for a car. I would run the non-profit as its first employee, not including a few contractors who were already handling a small caseload. I literally could not believe my luck. I knew I’d made a good impression on her in that first year. She’d continued to mentor me through college and had seen what I’d been able to accomplish given the odds against me. However from my perspective, I’d been rescued from three more years as an impoverished student. I was so ecstatic I did not spend a lot of time thinking about what my new job would actually be like.
I arrived on my first day and was immediately shown to the first office I’d ever had. It had a tall window and a modular desk with an upholstered swivel chair. On my desk was a green leather-bound book that turned out to be one of many volumes of the RCW, which was the Revised Code of the State of Washington. This particular volume contained all of the laws pertaining to Guardianship. There was a post-it on the cover of the book instructing me to read it.
Much to my surprise, it turned out that being a guardian for another person is primarily a legal relationship. Since I was working for a non-profit, had a degree in Psychology, and a caseload full of clients with chronic mental illness, I thought I would be running a social services organization. I did not realize that I would spend most of my time in the Family Law Court of the King County Courthouse representing the non-profit in its request to be named the legal guardian for dozens of mentally incapacitated people. Up until that point in my life I’d always considered myself incredibly lucky that I’d never had to stand in front of a judge.
I made the two-block walk from my office to the courthouse countless times and never once did I not feel like throwing up from nerves. I knew beyond a shadow of a doubt that I had no right to ask a judge to grant me total legal responsibility for another human being. It did not matter that I’d read the Guardianship statute over and over again until I could outline every detail. It did not matter that I had a great staff of social workers and nurses. It did not matter how hard I worked in order to be sure we knew every little detail of our clients, so that we could always act according to their wishes. What mattered is that I was sure I did not know what I was doing. I had more than conceived of my own ignorance. I was wallowing in it.
I was so afraid that as a young woman with no prior experience, I would be neither respected nor liked by the people I worked with. What right did I have to be there? Did that judge really believe he could trust me? A simple set of statements ran through my head for the first full year:
No experience = Ignorance
I am ignorant.
Ignorance = Lack of respect and a general state of unworthiness
In spite of my ignorance, new clients kept coming anyway. Guardians enter the picture whenever there is no family, or when families aren’t able to care for their own. Court-appointed guardians are an often-used option of last resort.
Most of our cases came to us from hospitals that needed someone to provide consent for patients who were not able to provide it for themselves. Often these people suffered from chronic mental illnesses and had developed conditions like diabetes and heart disease. Other clients had outlived everyone they knew so when it came time for them to be cared for, there was no one to do it.
Our job was to advocate for our clients according to what we determined they would want for themselves. That guidance was fairly straightforward. Actually figuring out what decisions our clients would have made was an entirely different matter.
It was tricky work because people contradict themselves all the time. I found that what you first learn about a person, like their faith or their political views, is not always consistent with the stories that their families and friends and neighbors will tell you. As often as not, peoples’ private words and actions often conflicted with their stated beliefs.
Getting it right mattered a lot. Often, the kind of consent hospitals sought was permission to perform a dangerous procedure. Who was I to make those decisions? The only way to do that job and also sleep at night was to dive so deeply into someone’s life that I could see across all of their past decisions, the arc of their life’s journey, and their personal belief systems.
It takes courage to advocate for someone whose wishes don’t align with what the rest of the world thinks they need. For me to feel strongly convicted about what a client would want, I had to get inside their head. I had to be so curious about who they truly were that I could suspend all of my own beliefs and biases for long enough to see the world through their eyes.
Frank
Frank was an elderly man who came to us through a request from the local VA hospital. He’d had a stroke in his home which caused him to fall and hit his head on a table. He suffered a subdural cranial hematoma which is essentially a giant bruise under his skull. Frank was in a coma by the time he reached the hospital. The ER doctors had inserted a small tube leading from his brain to his abdomen in order drain some of the extra fluid and relieve the pressure it was causing. It was a temporary fix, and a more comprehensive solution would require major surgery. The hospital asked the court to appoint a guardian to consent to the operation they wanted to perform.
Frank had no living relatives other than three nephews in the Midwest who hadn’t seen their uncle in decades and did not know what he would have wanted.
I went to Frank’s house. It was a tiny 1950’s era bungalow with white clapboard siding and a covered porch. It sat amid a long row of nearly identical houses positioned parallel to the runway at a local Air Force base. A tall chain link fence separated the houses from the base, so you could clearly see all of the activity there. Airplanes touched ground just a few hundred yards away in plain view from Frank’s place.
I knocked on the door of the house next to Frank’s and was met by an elderly gentleman. He told me that most of the residents, including Frank, were retired Air Force veterans. He said Frank liked to say that when his time came he wanted one of those planes to miss the runway and take him out. Over and out.
Later I searched through Frank’s belongings and found a business card for a nurse practitioner at another hospital. When I reached her she told me she’d been assigned to Frank after he’d been discharged from the hospital where he’d been admitted after suffering a major heart attack. Someone had witnessed the event and called 911. When the ambulance arrived, Frank was clearly suffering but refused to get in. He had to be restrained to the stretcher and remained that way throughout his time in the ER. When this nurse finally met Frank he told her that there was no way he would ever go to the hospital again. He said he’d never liked doctors or hospitals, and that event seemed to be the final straw for him. He kept telling here that when it was his time to go, he just wanted to go.
The surgeons at the VA hospital had other ideas. They wanted to perform a full craniotomy to detach the top half of Franks’ skull and remove the accumulated fluid plus any damaged brain tissue. Frank’s odds of regaining consciousness were pretty low. His odds of returning to his previous cognitive state were almost zero. I could not imagine Frank waking up in a hospital bed and realizing his fate. I knew that was not what he would have wanted.
Neurosurgeons have a very authoritative air. The surgeon who wanted to perform this procedure was a foot taller and a decade older than me. He was wearing scrubs and a light blue surgical cap. He did not like what I had to say to him. From his perspective, the plan to appoint a guardian in order to receive permission to operate on Frank had backfired. We argued loudly in the cold, empty hallway of the hospital. My hands shook and I could hear my voice tremble, but I did not waver because I knew I was right.
My curiosity about Frank as a person with his own thoughts and beliefs, his own joy and sorrow, and his innate right to determine his destiny, had led me to a place of great conviction. My curiosity fortified my search for the truth about Frank. I needed to be able to see the world through his eyes and I’d arrived at a place where I was confident that I could. Later that day I signed a “Do Not Resuscitate” order and refused all further invasive procedures, as I knew Frank would have wanted me to do for him.
After that experience I was no longer afraid of being ignorant. I stopped worrying about everything I didn’t know. My curiosity had found a purpose. It fortified me with all of the knowledge I needed to go into battle on behalf of people who couldn’t protect themselves.
Ignorance leads to curiosity which leads to knowledge.
Knowledge leads to power.
Power leads to survival.
