All names have been changed to protect my innocent ass.

---

Multi-Tasking: The Psychiatrist as a Disciple.

When I first met Dr Esbe in 2006, I was immediately taken by his charisma. He seemed like someone who wasn’t a psychiatrist — easy going, charming, with a quick and easy-smile; so as far as shrinks go, he seemed relatively normal.

As a comparison, I’ve seen two other shrinks in my life — one would easily fit in the ADHD¹ category, while the other would probably feel at home in the OCD² group. But Dr Esbe seemed more like the LDA³ type to me.

Additionally, since I have no medical insurance, Dr Esbe agreed to take me on pro-bono. Because of that, I wanted to give something in return. Something of value. I knew it would make me feel much better about it, since I was not used to getting stuff for nothing. My botched surgery of a few years ealier has made me see life from vantage points I never imagined.

Since I noticed he did not have a Web site, I offered to develop one for him. When I presented the idea, I told him that I’d give him a state-of-the-art site — a real showcase. He smiled and said it was something he had considered, though never got much further than that.

Dr Esbe said that his “office manager” would be responsible to oversee the project, so he’d discuss it with her. I suggested that he give his office manager the link to my Web site, so she’d be able to see the quality of my work.

Within a couple weeks, Dr Esbe told me that his office manager did have a chance to review my work, and said she felt confident in my abilities. He set up a meeting for me to meet her.

[1] Attention Deficit Hyperactivity Disorder
[2] Obsessive Compulsive Disorder
[3] Landscape Design Architect

The Mystery Office Manager.

After our quick discussion, I realized I still only knew Dr Esbe’s office manager as “office manager” — I had not gotten her name, yet. But since he only refers to her only as “office manager” I didn’t see it as a problem.

At our first meeting, I met Kay, the office manager. We decided on a domain name, and split-up some tasks. Primarily, Kay would get some of my tasks organized for me, such as a time to photograph all the staff, and obtain a bio from each professional staff member.

I recall I mentioned that I promised Dr Esbe a state-of-the-art site, and Kay’s response was one of surprise, “No, we don’t want that!  Our patients are not computer experts.  We want them to use it and not make it complicated.”

That one response drew a fairly clear picture as to her level of understanding, and then she confirmed it, “Personally, I really don’t use the Web much anyway — I find it confusing. I don’t know what people see in it.”

For someone who admitted not knowing how to use the Web, nor even liking it, I was taken by how Kay wanted to control the meeting. When I would bring up issues of things I needed to know, I would sense the sigh of frustration, which was usually followed by, “Is that something we need to discuss now?”  I learned in fairly short order that responding with “Yes”  was the incorrect answer.

When I asked about email forms, I got another clear answer, “No! Are you kidding?!  Why would we want to add email?!  We already answer the phones and read faxes — adding email would only have us wasting even more time.”

Kay’s logic (and don’t try to change it) was that adding email to the phone and fax would increase communication from patients by 50%. She preferred having one of her staff answer the phone and write down a message. Frankly, that logic left me nothing to respond with.

Kay was so adamant about not using email, that she included it in the FAQ section on the site. These are Kay’s own words of reason, even though they don’t really answer the question. To me, Kay’s answer is a perfect, though unintentional example of: If you can’t dazzle them with brilliance, baffle them with bull shit.

Months later, I came to the conclusion that this was but another example of Kay’s need for control. It was confirmed during our first meeting that Kay supervises the administrative staff. Her staff are the ones who answer the phones and pick-up the faxes. Going with email, sent direct to the professionals, would eliminate her control of incoming dialog. Currently, she can view and read everything coming in.

As the project progressed, the picture became clear. Kay was essentially useless, and more often than not, was just an obstacle to work around. Eventually she sabotaged the entire initiative because she embarrassed herself with a ridiculous demand. Kay did none of her assigned tasks, which were few. After four years, she never organized the staff for photos, nor did she ever obtain their bios.

Suspicious Secrecy.

As we wrapped-up our first meeting, I asked Kay for a business card, to which she said she had none. Even her emails listed her first name only with her email address. It only added to my suspicion, since Kay began to sound as if she owned the company … and she spoke down to me.

At my next appointment with Dr Esbe, while we were casually talking, I simply asked, “By the way, does Kay also go by: Mrs Esbe?”

“Yes,”  he replied proudly.

I’d been set-up. Why did they both keep the truth from me?

Deliberately, neither of them told me that the “office manager” was also the doctor’s wife. My instincts told me that my “patient-doctor” relationship had just been compromised. And right after admitting they were married, Dr Esbe went on to tell me how lucky he was … he obviously adored her. I knew there would be no way that I would ever be able to convince him of anything, if Kay disagreed.

I also accepted that I would no longer be able to discuss the Web initiative with Dr Esbe. I was already very disappointed, but felt I was in too deep to withdraw.

TEAMWORK: Kay Sets Obstacles. I Work Around Them.

The situation went downhill from the beginning. Kay was a control-freak, and would lose her temper easily. I sensed that she herself, could do very little, so instead she micromanaged her staff, and she wanted to micromanage me — doing something that she had admitted to having no knowledge of, nor interest in. But that did not matter to Kay, as it was what she did. Kay soon disliked me as I was not able to let her tell me the wrong things to do. Any work I put out is a reflection of me, and since I promised Dr Esbe a state-of-the-art site, I knew what had to be done. Kay was still learning the basics of email.

Most of our communication was via email — Kay’s choice — and something I found ironic due to her stated position, yet she was apparently the only one in the office with email. More control? She struggled with it, none the less. She would be very demanding about stuff she knew nothing of, even though I would be very patient with her and explain everything more than once. I don’t believe she read much what I wrote to her.

Whenever Kay wrote to me, she would set her caps-lock key, and then compose an email. After some time, I carefully explained to her that based on the Web’s own netiquette, using all caps is considered rude, as if you are yelling at someone.

She obviously took that into consideration, since as she continued using ALL CAPS, Kay began BOLDING many of the words. I took that to mean she was yelling at me with a bullhorn. Her emails virtually never included a salutation or a cordial close, either. More often than not, Kay’s emails would not be filed under the professionally polite category. The nasty and rude groups maintained a steady growth.

Only about 4-5 months passed before I sensed that Dr Esbe’s own attitude with me had begun to slide … I knew I was being undermined, but there was nothing I could do about it. Dr Esbe even told me they discussed the Web project at home, [translation] Kay talked about me at their home, which was one of my earliest concerns about maintaining that sacred doctor/patient relationship. Based on Kay’s unique way of addressing me, I can only imagine how she would speak of me when I wasn’t around.

Excellent! Did you study drama?

An unexpected and very telling, eye-opening event took place about 6-8 months into the project. At about 10:00 one morning, I received one of Kay’s choice emails. She was at her nasty best and blasting me for something. Her email didn’t even deserve a reply, nor did it get one. I felt it was all about her making sure I didn’t forget who was boss.

A couple hours later, I swung by Dr Esbe’s office to pick up a script. The patient reception area was empty, but the sliding glass partition was open to the office part. As I walked up, I saw both women in the reception office on the phone, so I slowly leaned forward into the open glass.

I quickly changed directions and backed out when I saw that Dr Esbe was standing in the reception office doorway, to the far left. I doubt that he saw me. At that point, I just stood at the glass and waited.

There was a fourth person in that room who I had not seen, since she was squatting at a filing cabinet on the far right. I saw her the same moment she saw me, and that was when Kay stood straight up — I could tell that she was just as startled seeing me as I was seeing her. Remember, only about two hours had passed since I received that extremely rude email from Kay.   But in a few seconds, everything would change.

 ”Oh!  Hi Larry!  How ya doing?!”  

In an instant, I was speechless. In front of Dr Esbe, Kay had just greeted me as if we were long-time, best friends … instead of what she did every other time: look away and ignore me.  Kay would never acknowledge me. The only difference this time was that Dr Esbe was in the room, too.

I had just seen Kay’s persona. She spewed charm, innocence, and sweetness. Without a doubt, I knew what it meant immediately, even without that red flag whipping me in the face.

I had truly been fortunate enough to see Dr Esbe in the room, so I knew exactly who the performance was for … and why. It was truly an academy-award-winning delivery at its finest.  She was a natural.  I was phuqued.

I stood there frozen in shock as they both walked out of the room. I just knew as they disappeared, that Kay must have taken advantage of the situation further, and said something like, “Did you see that? He couldn’t be bothered to even say ‘hi’ back to me.”

Of course, Dr Esbe was unaware of the supremely-nasty email she had sent to me that morning, or frankly, was unaware that she was doing it on a regular basis. It must have looked odd to him to see my mouth open and nothing coming out.

That firmly planted, in my mind, what I was truly dealing with. Her characteristics were all adding-up and pointing in one very clear, and frightening direction.

Qualified to do the job.

Why do people hire experts and then tell them how to do their job?

I built their site with WordPress as its core to create a dynamic environment, allowing the office staff to be involved with adding posts. I explained the many features and capabilities, and I even set-up an opt-in list so those interested would immediately be updated.

I received no objection from Kay while developing the site. But for some reason, that all changed seemingly overnight — shortly after I pushed the site live. Kay began to have problems with it that I really could not make sense of. More than once, I asked Dr Esbe if the three of us could meet regarding their new site. Each time, he stated categorically: “No.”  No reason, just, “No.” No reason “given” that is. It seemed obvious to me that was a directive from Kay. How could she ever expect to keep her story straight if I were sitting there, shooting holes through it.

That began an almost a year-long effort on my part to convince Kay of why, and why, and why, we needed to use the site as designed. She never did back down, though, as I came to believe doing so would mean just one thing: she’d have to “back down”… hence, lose face. Of course, she was never able to provide a valid reason, though, nor did I believe she felt she needed to.

After a year of attempting to change her mind, Dr Esbe made a rare Web mandate, stating to me, using Kay’s exact words (somewhat elementary in nature) that they wanted me to change it. I knew he had no idea what he was asking. But this seemed to confirm who wore the pants. He did what she said, without even asking me for an opinion.

As mentioned earlier, he had previously admitted to discussing the Web project with Kay at home, yet he refused to permit the three of us to meet regarding Web initiative, or even just he and I. I would have preferred all three, but I tried the “two” just as an option. That made another clear statement to me, how important it was to Kay to keep me from sharing my expertise with the doctor.

Time to Replace the Porsche engine with the old VW.

Within a month, I had removed WordPress from the site, and rebuilt it statically, while maintaining the exact same look. Being dynamic, the site had a log-in area, i.e., a place to enter a username and password. But being static, a log-in area was no longer needed, nor did one exist.

In less than a week after I completed the transition to static, I received an email from Kay telling me she couldn’t find the log-in area. [I wonder what my face looked like when I read that?] I replied with a long, detailed, yet cordial email explaining that I had completed making the requested changes, and how we’d be doing things going forward. I closed by asking her to make a copy of my email for Dr Esbe, since it was very informative.

No more than 30 minutes later, I received another email from Kay, and to paraphrase, she said, “… that’s fine, but where do I log-in?!”

I felt that after a year of trying to get her to understand what she was telling me to do, and then completely missing the message written in my previous email, I had earned the right to compose another email with more candor, and somewhat direct. I asked why they wanted to make sure I had the credentials to create a Web site for them when they were not going to listen to me anyway. And how we literally just wasted a year of no progress, as I wanted to continue development on the initiative, but instead, was justifying my stance against something that I now realize had no logic whatsoever. Even though Kay knew nothing about Web technology, she needed to have complete control of the project; hence, she would not back down.

Although I did not include this, I had never, in my life, worked with someone so arrogant, so righteous, as to stick to a completely invalid argument, just because of her grandiose sense of self-worth. It was difficult to know what happened after that, as most communication virtually stopped.

OK, Now What?

After the realization that Kay had no idea what she was asking for, including no idea how it would change the entire site, she vanished — at least to me. Virtually all communication stopped coming from her. That was about February, 2009. Virtually nothing happened with the site for the next 7-8 months, nor did I see Dr Esbe during that time. So I was a bit in that limbo area, and simply waiting (or was that purgatory?).

In August, 2009, I called in for something, and was speaking with Ann, who I had determined was the most professional woman working the front. And that’s when it hit me, “Hey Ann, would you be at all interested in helping me work on the Web?”

“I thought Kay was doing that,”  she replied.

“Well, she always has,”  I said, “but she seems extremely busy, and unable to devote the time needed. I can easily teach you what you’d need to do — I think you might even enjoy it.”

“That’s what I was thinking, too. I’d like to learn more about it. I would need to ask Kay for permission. How about I call you after I get with her?”

“That would be just great, Ann, thanks. I’ll look forward to hearing from you.”  Although I couldn’t say anything about Kay, since she was Ann’s boss, I felt as if that would be the deal killer.

I expected to hear back from Ann that week, but almost two weeks had passed without hearing a thing. I needed to run by Dr Esbe’s office, and by luck, Ann was at the window just finishing with someone. We both greeted each other, and I mentioned I had a script to pick up.

Something wasn’t right, though.  Ann was looking for the script right in front of me, but she never made eye-contact. She also wasn’t as cordial when she said “Hi.”  Very unlike Ann.

So, while she was still looking down, going through the file, I spoke up and said, “Ann, did you ever get a chance to ask Kay about the Web?”

Never looking up, she said, “Well yea, I asked her the afternoon you and I spoke, and Kay said she’d get back to me. Two days later, she told me about how she contacted you, and how you guys exchanged emails back-and-forth, and how you take so long writing your long emails, and eventually you said you really didn’t need my help … so I didn’t see any reason to get back in touch with you.”

Ann still had not looked up. But not hearing anything come from me after a few seconds, she took a quick glance and saw my wide-open eyes, with my head slowly moving from side-to-side.  All I was able to do was whisper, “Ann, I’ve had no communication with Kay since February.”  [it was then mid-August]

Now Ann was the one with the big eyes.

She appeared to be looking straight through me. It made me think she was going back and reliving the event again. And again. I saw the shock in her face, and how she became speechless … except for the one expressive “Shit!”  that found its way out.

There was nothing else we could do right there. We were both truly stunned. Ann made her way slowly back to her desk. I left with my script.

Less than a month later, when I was again in the office, Ann approached me and said, “I need to tell you something. I turned in my resignation … I’ll be leaving in three weeks.”

“If you hear it from Kay, she’s been telling everyone that I’m retiring. She completely made that up, as I never said such a thing, nor am I. It wouldn’t take you much to figure out why I’m quitting. There’s only one way to do things around here, and that’s Kay’s way … but now, I’m over it.”

I was truly sorry to see Ann go, but she obviously had integrity to maintain … something the others probably didn’t understand.

Can anything make sense on this project? Just a couple weeks earlier, Kay fabricated a finely-detailed lie to make me look bad to Ann, as well as her entire staff. I never did find out if Kay was aware that her deception had back-fired. And apparently all because she lost face.

With what had happened with the fabricated story to Ann, and who knows what else Kay had been spreading, we went from building a Web site, to Kay ceasing communication, and a few other events that told me Kay had targeted me for one purpose — for Dr Esbe to stop treating me so she would no longer need to deal with me, nor even see me. The writing was on the wall, especially knowing the extent taken with Ann.

    Preparing for the End

Creating my Report — An Exercise in Futility.

It was time for me to do something. I needed to get all my notes together, and share the events with Dr Esbe that would be the easiest to substantiate. I knew that Kay had been undermining me with him for years, but I also knew that he was completely loyal to Kay. But what else could I do?

Kay was creating detailed, fabricated lies and spreading them to others. And I had proof. The question I had yet to test was if even solid evidence would have any chance against Kay’s word.

In September 2009, I set up a phone call with Dr Esbe, and we spoke for almost an hour. Strike that: I spoke for almost an hour. He barely said a thing, and neither confirmed nor denied what I told him. But everything I told him was easily substantiated, and I said it very carefully, and strictly factual … meaning I did not speculate, nor use words such as:  “sociopath” … “personality disorder” … etc.  Being a shrink, it would have been quite easy for him to identify the characteristics based on the evidence I presented.

At the end of the call, and after hearing the factual, and provable stories of deception, he decided the best thing to do was to stop working on their Web site entirely. Once again, his response made no sense. Considering the problem was with Kay, I asked him if I could continue work with someone else on the Web site. I got a quick, “No.”

Kay’s Update.

Due to the timing of certain events, and primarily this phone call, I later concluded that he must have shared what I told him with Kay, as to what I had witnessed, even though I figured he would have respected medical confidentiality laws. But beginning within the next 30-45 days, virtually every dealing I had, indirectly even, with the administrative staff — coincidently Kay’s staff — had a problem of some sort. Each incident was based on what certainly seemed like a blatant lie from Kay’s staff, simply passing the blame elsewhere.

Delayed approvals, no response to the pharmacy, and culminating with the biggest one — not ordering my crucial, daily medication. That medication, like so many other meds today, can cause dangerous withdrawals if they are stopped abruptly, without a long tapering-off period. Medication that cost about $500 per month, retail.

My Medical Service Begins to be Purposely Delayed.

There’s a script I need refilled each month, one that I call into my pharmacist, their system automatically sends a fax to Dr Esbe for approval, and Dr Esbe’s office shoots back the approval via fax. It’s a monthly thing and usually is a day turn-around.

In November, I went through the same procedure to request the refill, but when I showed up three days later to pick up the meds, I was told it wasn’t approved. “I’m sorry … what do you mean? That really makes no sense.”

The pharmacist said they just say that when a doctor does not send back the approval. He offered to send it again, and I said, “Please.”  That time it got approved, but I had been out a few days.

December rolls along and time to fill the same med. Same thing happens. But this time the pharmacy needed to resend it twice. It took three requests before it got approved.

When it happened again in January, the pharmacist suggested I contact Dr Esbe to find out why the ongoing delays. So, I called Dr Esbe’s office, and spoke to Em, one of the women in the front office. I told her I had a situation that I would need to talk to Dr Esbe about, and wanted a suggestion on the best way to approach him.

When I told her what it was about, she quickly stopped me and said I didn’t need to speak with him as that was her responsibility. I sensed quick anxiety — like borderline getting busted. I was very surprised by her reaction, as she immediately implied the problem was at the pharmacy. The pharmacy is part of a large grocery chain, and when I spoke with the pharmacy manager, he confirmed the problem was isolated to me and them, and not widespread.

I told Em that I really felt in the middle, as two people were telling me two opposite stories. She replied by saying, “Well, I don’t know what their problem is.”  If I were a betting man, though, I would place my bet on the pharmacy as the one not screwing up.

It was an odd piece of the puzzle for quite a while, and fit no where. But as I was working on another piece, I found its place. Kay has control over the administrative staff … they’re her loyal subjects. Dr Esbe told me years ago that he didn’t want to be bothered with it. It’s Kay’s domain to use as she maliciously desires.

Kay is the only one to report to Dr Esbe. If Kay, did indeed, instruct Em to delay the authorizations, Em would know that it was Kay’s deal, and not Dr Esbe’s. And if I got through to Dr Esbe and told him what had been occurring, it may have easily stirred up unpleasantness for her on two fronts.

My Three-Month Meds.

Dr Esbe’s staff orders a three-month supply of meds for me which I get at a deal. All I need to do is inform my contact at his office with enough lead time (3-4 weeks) so the new supply comes in before I run out. My contact is Em, the same woman who is responsible for my pharmacy refill approvals.

During the last week of February, I called in and left a message for Em. I left two requests on her voicemail: one for the 3-month med refill and the other for a script. Two days later, I called and was told the script was ready. Hence, message received with both requests.

In mid-March, for the first time ever, I had run out of my meds and had not received my call from Em that my resupply had arrived. I called on the morning of the 17th and spoke to another woman who told me Em was out sick. I asked her if someone could check on the order for me, whether it had arrived, or when it would arrive. I made that call before noon.

At 16:45 (just 15 minutes before they close), another woman in the office, Shane, called to tell me that they had not arrived, and then gave me the phone number of the pharmaceutical company. I asked why she was giving it to me, and she made a comment such as if I called them, too, it might expedite the order. It was now about 16:50.

I called the pharmaceutical company, and to summarize, I was informed there was never an order placed during February for me, but on top of that, I was told that no one from Dr Esbe’s office had contacted them since my previous order, 3-4 months earlier. If you recall, I was told, “… if you call them, TOO …” indicating that I wasn’t the first to call. I was lied to.

The rep I spoke with said if Dr Esbe’s staff can fax the order right back, he’d rush it through for me. Frankly, he was quite surprised that I was calling, since he said there was nothing I could do, and implied that I was doing their job.

It was now about 16:56. I had about four minutes until closing. I dialed Dr Esbe’s office, got voice mail, hung up; dialed, got voice mail, hung up; dialed, got voice mail, hung up … and did it until it was after closing. For my last call, I left a long, detailed message directly for Shane, the woman who had told me to call the pharmaceutical company. At the end, I left my phone number and asked to be called.

Still no word by the next afternoon.

By 14:00 (2pm) the following day, I still had not heard from Shane. I wanted to believe that she just forgot to call me, but took care of everything else. But my instincts wouldn’t leave me alone … I called just to be sure. Shane answered, and I asked her if she had received my message. Click to listen …

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

“… I did not … [Hannah] took off the messages … so she did.”

Wrong.  According to Dr Esbe on a subsequent call, office policy states that when someone gets a message, they are notified to come listen to it. Therefore, consider her answer: if she had not been notified, she likely would have been surprised to hear she had missed a message.

Yet there’s not even a hint of surprise in her voice, though there is a change, such as searching for an alibi. Since she did nothing that I relayed, or requested in the message, she apparently could not be honest with her answer. Another, blatant lie. And besides, she has fairly bad grammar: “… this is her.” [sic]

So after Shane stated she did not get my message, I immediately dove into overdrive to give her the message she claimed she never got. But if she never got the message, why did she not want to hear it? She continually cut me off, and interrupted me to say that she would give a message to Em when she returned the following week.

The following audio is a series of clips from the same phone call with Shane. In the very first sub-clip you’ll hear Shane say, “… alright I’ll leave Em that message and she can call on Monday …”  — except there was no message. I had only begun telling her what I left on the voice mail for her, the VM she claimed she never got. But as soon I began to tell her what was on the message, she immediately started jumping-in attempting to end the call.

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The length of this entire clip is about 1:40, though the last sub-clip you’ll hear was from about 20 minutes into the call, and I still had not been able to get through the 3-4 minute message that I had left on voice mail.

Shane continued to interrupt, and I continued asking her to stop. She finally replied with, “No, I won’t.”  If interrupting is considered rude, what would that be considered? I can’t imagine they would talk to just any patient like that. Shane told me at least three times that she was leaving messages for Dr Esbe to call, and for Em to call. Neither ever did.

Actually, there was someone there who could help.

After telling me multiple times that only Em could help me, and Em would be back the following week, Shane once again said, “Hold please” while I was in mid-sentence. When I was taken off hold, I was greeted by another voice. Dr Esbe’s nurse, apparently overhearing Shane, must have assumed (or was told) I was being a problem, so she took the call. When I heard her voice and introduction, my first two words were, “Thank you!”

Within minutes, the nurse fully understood the gravity of what I had been attempting to get across to Shane. In less than half the time I wasted on the phone with Shane, the nurse had resolved everything. At least with the administrative staff, it only continued to support my assertion that my character had been pretty well trashed by Kay, and worse.

      Why is everyone so lame?

Let’s not forget Kay, a.k.a. Mrs Esbe.

To clarify, it is not “everyone” but only those who work for Kay — the administration staff. As a psychiatrist, Dr Esbe told me years ago that he does not like to deal with the administrative issues, as he just wants to be a shrink. So Kay has built her domain of manipulation and control, and only she reports to him.

Ann quit as soon as she saw the depth of the Kay’s deceptions. It was my discussion with Ann that opened both of our eyes. I knew Kay was trashing me to her husband, but it was Ann who allowed me to see the much larger picture. Kay not only controls and manipulates her staff, but her husband as well. Kay definitely wears the pants in the family, and at the office … and I’d bet Dr Esbe helps her pick them out. He’s turned control to her.

Kay lives for control. I certainly was not supposed to question her when we began the Web initiative. She micromanages the office staff. If they want to stay in her good graces, it would be extremely wise for them to go along exactly with what she says. Why is Kay even at the office with two kids at home?

I’ve concluded: control and jealousy. Kay is a fairly attractive woman in her late 30s, or early 40s. Everyone she’s hired is well below her level of attractiveness … to the point of some being grossly obese (about 20-30% of the staff). Hence, when it comes to job security and staying in Kay’s good graces, I’m easily disposable.

Being such a controlling micromanager, no one did anything without Kay’s approval. What this made me realize was that Shane, and the others, were treating me exactly as instructed.

Kay would not have had the ability to control the professionals, though she probably tried.

Medical Ethics: When is the Line Considered Crossed?

When Em got back the following week, she never called. She had not done her job, she had not ordered my meds, and she was not going to return my calls. Neither did Dr Esbe.

A friend of mine, Alicia, who lives near Dr Esbe’s offices, often swings by and picks up those scripts for me. It’s very kind of her, since it’s way out-of-the-way for me. That week, when Alicia picked up my script, she brought back a little bonus.

It was Em who handed her my script, but when Alicia brought the script to me, she said, “Oh, by the way, Em said you need to give her sufficient lead time to get your refills, like everyone else does.”

“Alicia, did Em leave you with the distinct impression that I don’t do that?”

“Yea … why, do you?”

“Always.”  What Em pulled would normally be called a CYA (cover your ass).

Considering who it came from, though, and the purpose was to maliciously pass deceptive blame onto me — covering something she failed to handle — I’d say it was clearly character assassination. Especially since Alicia didn’t ask.

But Em still had another task to complete. My three-month med supply had not yet arrived, which meant I was still waiting for Em’s call to notify me when I can pick them up. Apparently, she had no intention of doing that, either.

March finished-up and rolled into April. Still no call. Dr Esbe’s office is officially closed on Fridays, though unofficially it’s always open Fridays between 09:00 to 12:00. None of the regular staff is there on Fridays, just the very sweet Friday lady, Nix.

At just before noon on Friday, April 9, I was in the area of Dr Esbe’s office and decided to check and see if my meds had arrived. Nix greeted me by name, and handed my meds to me.

Em had left the UPS tracking information on the package, so with nothing else as interesting to do on this Friday when I got home, I logged into UPS.com, only to discover that my meds had been delivered to Dr Esbe’s office the previous week. My service had come to an obviously malicious stop.

Now what?

It seems fairly clear to me that, since last year, my service has been deliberately and continuously delayed or ignored anytime it involved the administrative staff — Kay’s domain. Kay has a plan in the works for me, with her staff deeply involved, and generally speaking, covering-it up does not seem to be a priority.

A year ago, I shared all my substantiated proof with Dr Esbe, and now seeing where he fits in, he likely shared it all with her. From that discussion, Kay was made aware that I know much more about her than she’s comfortable with. I was a liability to Kay.

One likely scenario is a typical sociopath characteristic — to place blame on the victim for all the malicious deeds done to them. Considering that they made me run out of meds by simply not ordering them, and then Em told Alicia that I messed up, when it was actually Em who deliberately did not place the order. Or, by not sending back the refill authorizations to the pharmacy on the first request, so the pharmacy was forced to make additional requests, and thereby making me wait for my refills.

So what is going to be their next move. A quick look at my calendar seemed to answer that: in about three weeks, I had a scheduled appointment with Dr Esbe — 10:00, Wednesday, May 5. The strategy that Kay had been working on was probably intended to culminate at my appointment.

I needed to have all my evidence nicely organized, even though I knew it would have no effect on the outcome … that being that the doctor would resign from treating me. Truly, I wanted to hear how he’d work around the clear evidence I would present, considering he had no reason based on anything I had done.

What is interesting to me is he did not need a reason to stop providing his services to me, since his services were pro-bono. All he had to say was something based on the pro-bono aspect, such as having too many patients, etc. So, why didn’t he just do that, instead of what he did?
 

My appointment with Dr Esbe

May 5, 2010  Via phone. At the very beginning, I asked the following two questions so I wouldn’t forget them, and before Dr Esbe was made aware I recorded conversations with his staff …

1.  I asked Dr Esbe about messages I left for him requesting that he call me … did he receive them? (since he never called me).

“Let me see …”  he stated slowly, as if looking it up, or thinking back … then eventually said: ” No.”   It seemed odd that he began with “let me see” essentially saying that just because he received them, didn’t mean he’d necessarily call. Later, he heard on the recording, more than once, that Shane stated she would leave him messages for me. Which one lied?

2.  Then I asked Dr Esbe about his office procedure in handling after-hours voice messages, since there is only one voice mail box. Specifically, when a message is left for someone by name, how would that person get their message?

“[The front office staff] would play the message for the person it was left for.”  Shortly after he stated this, he heard the recording of Shane denying that she got her message.
 

I covered the details of the following topics (as above).

• I reminded him of the call he and I had Aug-Sep 2009, in which I described, for the first time to him, the actions and events primarily surrounding Kay … all of which I had substantiated evidence of — solid proof. I did not raise any issues that would be based on my word alone. I included the incident when Kay stood up and greeted me with persona-perfection after the extremely rude email … an event he witnessed. I shared in detail the events surrounding Ann, and how she was told a detailed fabricated lie about me, which also was intended to trash my character. Considering medical confidentiality laws, I expected the discussion to go no further. I believe, based on timing alone, he shared it all with Kay.

• Beginning in October or November (just 30-60 days after my discussion with Dr Esbe), delays of my script re-fills began. The pharmacy would have to submit the re-fill request multiple times before they received the approval. I would be without my meds for a period of time while waiting. This continued through January, in which time I called the office and Em lied blaming it on the pharmacy.  [Kay's staff responsibility failure]

• I discussed the message I left with two requests (late February, a script and my 3-month meds) — one request was filled, and one was ignored.  [Kay's staff responsibility failure]

• On March 17, Shane instructed me to call the pharmaceutical company to check on my order, too, strongly implying that the office already had. When I called, I discovered that no one from the office had contacted pharmaceutical company, nor did they place my order from February, the message I left with the script that was ready within a day. Em apparently deliberately did not place that order, and then lied about it.  [Kay's staff responsibility failure]

• I discussed (in detail, along with playing the recordings above) the call I had with Shane (March 18) regarding the pharmaceutical company call, providing proof of her blatant rudeness and her unwillingness to offer help.  [Kay's staff responsibility failure]

• I discussed how I received no return phone calls the week of March 22 (either by Dr Esbe or Em).  [Kay's staff responsibility failure]

• I discussed how Em lied to Alicia about the three-month order not being placed — she stated it was my failure, not hers. Another lie.  [Kay's staff responsibility failure]

• I discussed how I picked-up my meds on April 9, only to discover they had been delivered the previous week, and Em never called as she always does.  [Kay's staff responsibility failure]
 

Dr Esbe Responds to the Undeniable Evidence Presented

After hearing the deception and rudeness of his staff, as well as exposing the ongoing deliberate lack and delay of service, Dr Esbe completely ignored it all.

Never did Dr Esbe acknowledge his staff’s ongoing deceptions, deliberate lack of service, or lack of medical ethics, even though he was just presented with undeniable evidence, including recordings of his staff — more recordings than were included in this post.

Instead, he was unhappy that I recorded the discussions, though he ignored the fact that those recordings proved how unprofessional his staff had continually treated me. Hence, I translate that to be he was unhappy that I created and presented undeniable proof of what really occurred — a.k.a., the truth.

Loyalty vs Honesty

Blind loyalty is what’s important to a sociopath (i.e., those ‘loyal’ people who will do anything requested of them without question) … honesty matters not.

Dr Esbe argued that the entire problem was with my completely substantiated reporting of the events,  and not the events themselves — ignoring the fact that I had provided undeniable proof.

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DIALOG KEY: To help make the following conversation easier to follow … my dialog is indented and black,  … Dr Esbe’s is italicized and blue.  This is taken directly from a transcript … edited for length, not for substance.

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Closing Discussion

Dr Esbe: “I’m sorry for whatever went on that upset you. I don’t see how we can help you therapeutically when on every other level you’re upset with the process.”

Larry: “Are you saying that what I’ve presented here is not credible?”

“I’m not saying that, and that’s why I apologized to you at the beginning, but each and every appointment you talk about what hasn’t worked well for you at this practice.”   [That's a completely false statement — the first, and only other time was last year's phone call.]

“Well you know why. And I’ll be very candid. I already told you. I even gave you substantiated evidence — there’s someone that works in your office that is undermining me. And, she has an incredible amount of pull with the office staff.”

“Larry, I have to tell you that’s not true.”

“It is true. She just doesn’t allow you to see it. And as a psychiatrist, for you to say because you don’t see it, it can’t be true …”

“It’s not that I don’t see it, and that I’m not aware of what goes on in the office … I can’t make this be about every issue you have with the staff.”
[that looks suspiciously like an admission]

“Oh no, don’t get it wrong. I’m presenting very solid evidence here…”

“Even the taping of the conversations … I don’t believe it’s right”

“If I had not recorded them, it would have simply been my word against there’s — and who would you likely believe?”

“I’m not able to work to figure out your therapeutic needs because of these issues in the office.”

“What have you done to resolve the issues in the office?”

“That’s between me and the office staff. We cannot continue to treat your therapeutic needs with these other issues.”

“So you are allowing Kay to get what she wants.”

“This has nothing to do with Kay.”

“It does to.”

“This has nothing to do with Kay.”

“You actually said to me that you can separate this fully between home and office.”

“I thought you and I could, but it’s clear that we can’t.”

“Wait a minute, is it because I began talking about Kay that we can’t?”

“It’s because it’s always about the staff … I cannot continue to treat your therapeutic needs when we always talk about the staff.”

“You’re copping-out on me.”

“This is not about copping-out, this is about me trying to tend to your emotional and therapeutic needs, and we can never get to that point.”

“It’s because of what I keep telling you, but you don’t want to hear that, and when I asked how you dealt with it and your office staff, you say that’s between you and them.”

“Larry, we can’t keep doing this.”

“I know we can’t!  What do you think I’ve been trying to do?  I’m trying to open your eyes.  You’re either an enabler or you’re in denial. Either one.”

“Well, in either scenario, you’re clearly not getting your needs fulfilled, either.”

“Well, why are you letting it continue?”

“Larry, again, clearly you are not getting your needs met here therapeutically.”

“Even early on, I asked you if the three of us could get together for a Web meeting, and you refused.”

“That’s right, I said, No.”

“Why?”

“Because that had nothing to do with what you and I were trying to do here.”

“How can you say that?”

“As I told you several appointments ago that our business relationship ended.”  [it was actually on last September's phone call he told me to quit working on the site ... never did he say "ended" until this discussion.]

“You cannot just leave a site online ignored.”

“You can shut it down, you can do what you need to. I’m trying to address your emotional needs, and I’m not able to do so.” [The outgoing message on their voice mail system, as of today, refers people to their new Web site for "additional information"]

“But why can’t you listen to what I’m saying …”

“Because that has nothing to do with the care I’m trying to give you.”

“How come I’ve pointed out your staff’s deception and lies, that I have substantiated, and you’re saying it’s my problem that I have with your staff?”

“Larry, I’m going to have to cut the appointment short.”

“Not unless we can continue this sometime soon.”

“There’s nothing else I can do. I cannot treat your needs because of this hurdle you are unable to cross.”

“Hurdle I can’t cross? Where your staff is lying to me, and to other people about me.”

“Again, I’m not going to talk about the staff issues.”

“It’s very difficult for me to have a psychiatrist who has someone at his office who’s undermining me.”

“There’s no one at this office who’s undermining you.”

“I have proof of that and gave it to you a year ago.”

“There’s no one at this practice who’s undermining you.”

“Are you in denial? How is it that I gave you substantiation a year ago, yet you’re telling me that no one is doing it.”

“Larry, there’s no one undermining you at this practice.”

“I gave you proof.”

“There’s no one undermining you at this practice.”

“You’re in denial.”

“There’s nothing more I can do for you.”
 

I think he actually meant “will” and not “can” — though we cordially finished the call.

A Bungled, yet Successfully-Executed Plan.

As I had suspected, this was all a carefully and successfully-executed plan. Their replacement Web site was already online.

Their new URL used the exact same domain name as before, but now ends with .org instead of .com — a big mistake in itself.  Even though not as closely adhered to as intended, a domain ending in .org implies an organization primarily such as a non-profit; while a URL ending with .com implies a commercial company.

Hence, it went from something like: Example.com -to- Example.org

The Big Oversight.

They probably thought that keeping the same domain name was important, though they failed to understand that most people naturally use .com to complete a URL — so most people will still be looking for the old .com site.  A proverbial shot in the foot.

Their “new” site went online already-filled with staff photos (i.e., unprofessional snapshots). The entire design is a huge step backwards: cluttered, very un-classy, low-tech, and completely amateurish.

Apparently, Kay got what she wanted.

I find it amazing how many people seem to miss the truth of the old adage …
“You never get a second chance at a first impression.”

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All names have been changed to protect my innocent ass.

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