Lenny

As I've mentioned, my first medical assistant, Lenny, had an abrupt transition when I arrived. For most of his time with The Company, Lenny had worked with Tyler, a 6' 6" black physician, who was often drunk or hungover and highly unpredictable. I guess I can be criticized for bringing race into it at all, but in a way I think it is relevant as most of our patients are black. Lenny is white and heavy and I am white and skinny. One of my friends said it must be like having the Blues Brothers appear at the door, sort of in the same way they showed up at Aretha Franklin's soul food restaurant. At any rate, it was a very different dynamic than with him and Tyler, even more so because Tyler had a huge, often very loud personality whereas I am on the more reserved side. So it was a change for Lenny and for our patients.

Because Tyler was fired the day I started work, none of the patients had any warning. Afraid of losing customers, The Company asked Lenny to phone all of the patients over the course of the first couple of weeks to inform them of the change. This Lenny did throughout the day. After taking vitals, he would often excuse himself to head out the car and hit a few names while I finished up. Despite his efforts, over the course of three months I think we lost about third of Tyler's group. 

Lenny was very upfront about missing Tyler. They had worked together for over a year, which is to say that they spent the entirety of their work day side by side, either in patients' homes or in the car. That's togetherness. Sometimes they laughed and imitated patients, developing their own inside jokes. On other days, Tyler would sit brooding, not saying a word between stops. Now Lenny is a very nice guy. There isn't a touch of meanness in him. And he's a pleaser. In the jargon of psychology, one would say he is co-dependent, placing the concerns of others far before his own. When the office assigned him to Tyler in order to "keep an eye on him," in many ways it was a match made in heaven. When Tyler tired of coming into the office, Lenny would gather the charts from the office along with all of Tyler's other paperwork, stop-off at his apartment to pick him up, then on the way back to the office drop him off. Never mind that he then has a long commute home at the end of the day. Because Lenny had already told me these facts about Tyler, he would qualify his affection for the man with "despite all of this stuff..." and I completely understood. Most of us have someone in our lives that we adore despite how he or she treats us. We live for the highs and dismiss the lows. And with many of these relationships, alcohol plays into it.

I get the sense that at times Lenny found Tyler's alcoholic craziness rather glamorous. There is nothing like a rebel to draw a person in. If Tyler didn't want to see a patient that had been scheduled for him, he would cancel at the last minute. Or he would ask Lenny to go in alone, take vitals, get the patient to sign the chart so everyone got paid, then come back out. "I don't need to see that patient this month! They can't tell me who I'm supposed to see! I'm the doctor!" If Tyler had grievances with certain Company administrators, he would air them. The lack of formal professional distance with patients and between the two of them along with a bit of fraud served as a measure of their uniqueness. It was the two of them defying The Company and expectations. If at times during an angry outburst, a chart ended up on a patient's roof, it was more funny than horrifying.

So it wasn't surprising that despite strict orders to cut all ties with Tyler, Lenny remained in sporadic contact. They would text and occasionally talk on the phone. Lots of Tyler's communications bore the signs of drunken ramblings. His firing was part of a racial conspiracy. He had been singled out because he was black, never mind that the company owner was also black. Meanwhile things were heating up because The Company had accused Tyler of violating a non-compete clause and poaching some of his old patients. This was a concept that Lenny had a tough time getting his head around. "They should have a right to see whatever doctor they want" he would say. He seemed only able to see Tyler's side of the disagreement. Lawyers were getting involved. Patients were being deposed. Lenny, despite his personal leanings, was being asked to serve as a witness to the fact that Tyler had made photo copies of patient charts as a method for retaining demographic information and Medicare IDs. So it was an ugly moment when Scott, the office manager, called Lenny into his office about a letter their lawyer had been given by Tyler. Apparently, Lenny had sent Tyler an apologetic email explaining that he was being forced by The Company to serve as a witness against him. Oh, baby.

So Lenny was getting it from all sides. The company fucked him by placing him with Tyler. Tyler fucked him by betraying his confidence. As a newly reformed drunk who now had insight into everything, I was probably being preachier than I ought to about the nature of alcoholic behavior. Plus things were chaotic at home. His wife has MS, is dyslexic, and relied on him to hold things together; things being home finances and the management of their three foster children, all of them boys. On an average day, she phoned him 6 or 7 times to talk about how one of the kids was messing up at school, some controversy with a baby-sitter, a late gas bill, or some other way in which she felt overwhelmed or out of sorts. What sustains him, I think, is an abiding faith in God. He is a devout Christian and finds solace in his recognition of the Bible as literal truth.If not a miracle, it struck me as incredible that he was nearly always cheerful, always upbeat, and tolerant of people who often did not have a lot of use for him.

Lenny was not one of the more popular people in the office. Well, that's not quite accurate. Everyone knew Lenny and had an opinion about him. He was, to say the least, a challenge to work with. The door to the office opens, Lenny walks in, and BANG: he's ON! "How's everyone doing?! Hey, buddy! What's going on?!" He's slapping people on the back, inserting himself into conversations, giving sly looks, telling risque jokes, and generally making sure that he is the center of everything. A typical response to him might go: "Lenny, you're too much, boy." or "Lenny, you need to stop running your mouth and get to work." It was much the same way with patients. He was, at times, a bit familiar. He was intensely curious and might, without warning, pick an item off  a shelf to have a closer look. Most patients found him adorable and welcomed this loud though clearly caring and sincere presence briefly into their lives. Every once in a while, there would be a dissenting view. As you might imagine, a common questions we faced was: "what happened to Dr. Tyler? What's he up to now?" Possibly to deflect his own unease about the truth, Lenny would often embellish. "He's working overseas now." "He became a fighter pilot in the navy." Or the answer that became one of his favorites: "He became a veterinarian and is out in the countryside castrating pigs." He said it with a chuckle and I think honestly believed that everyone was on the same jocular plane. Though as we found out, this was often not the case. I would usually intervene and give a cleaned up version of the truth: "He left the company to start his own business." But at least person called the office to complain about the off-color remark. Joking about the fate of a beloved physician, especially with a reference to pig genitals is not necessarily going to go over big. But this was Lenny to a T. He operates on the assumption that of course you would see things from his side.