Every single morning, battle lines are drawn:
6:00 a.m. I've been up for half an hour. I call upstairs to my 15 year old son who has 45 minutes to get up, get dressed, eat, and get ready for me to take him to school.
6:10 a.m. I call again. "Tom, get UP!"
"I'm UP. Leave me alone." Deafening silence ensues.
6: 15 a.m "GET UP!" I'm leaving in 30 minutes WITH OR WITHOUT YOU."
Nothing.
6:30 a.m. I'm out of the shower, fed, caffeinated and putting the final touches on my makeup, searching for my cell phone and keys, and putting on my boots.
"I'm leaving in 10 minutes!"
Sudden crashing of feet on the floor, a flurry of activity with a smattering of cursing which I pretend not to hear, and IT IS ALIVE and IT is in a foul mood completely directed towards me. IT is mad because IT doesn't have time to eat and we end up in an argument because I'm super irritated that IT has the GALL to be mad at me.
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THIS morning was different. It went like this:
I got up at 5:00 a.m. so I could do some paperwork for work. I decided to make Pillsbury Cinnabons.
6:00 a.m. I call to get my son up. I tell him about the Cinnabons. (yummy!) I figured it would be magical bribery and would rouse him from his sleep. The wafting of the cinnamon-y goodness had already gotten my husband out of bed.
6:10 a.m. Still no movement and now I'm peeved. "Get your butt down here right now!"
Husband intervenes.
"That's not the way to do it. Watch this." He grinned evilly and I swear he said, "Muuahhaawww!"
"Hey Tom. If you don't come down right now, I'm going to eat your Cinnabons."
CRASH. BAM. BOOM! I'll be darned, but it WORKED. Down he came, at light speed, dressed and ready to take on any potential Cinnabon thief.
"You gotta know what motivates your audience!" is my husbands response to my raised eyebrow and query as to how he worked this strange magic.
Now I can hear you thinking, "He wouldn't really eat the Cinnabons, would he?"
"Darned straight, I would!" replies my husband to your well thought out question. "It's the Hereña rules."
Let me explain. Early on in our marriage, I learned that since my husband grew up in family with five children, there were no leftovers--EVER. If you didn't make it to the table in time for dinner, your portion would disappear. Vanish. GONE. Adios. Make a PB and J and call it a day.
If you tried to save something in the refrigerator for later enjoyment, good luck with that because one of the other members of the family would eat it.
"How," you ask, "Did you learn this?"
WELL, early in our marriage, I left some leftovers in the fridge for three or four days, went to retrieve them and--they were GONE.
"I thought you didn't want it. You hadn't eaten it, so it was fair game," stated my husband.
We stored our Anniversary Wedding Cake in my mother-in-law's freezer after our wedding. Juan went to retrieve it and it was gone. Rob, his brother, thought it was fair game and ATE THE WHOLE THING (not that I hold grudges or anything). I was mad. Juan was philosophical. It was the Hereña Rules at work.
It got me thinking. How do I motivate my PATIENTS to do the things I need them to do, like SHOW UP for appointments, take their medications, exercise, cut out salt and sugar?
Heck, How do I motivate anyone to do anything? It was clear, my husband had a leg up on me on this point.
Some of my attempts at improving compliance with treatment included the following:
Education, often met by a glazed sheen in my patient's eyes. Come to think of it, it's the same look Tom and El get when I'm off on a "lecture."
Cheerleading--Instead of fussing at people because they haven't reached their goals, I encourage them to keep trying. Often this tactic works. It makes people more likely to come back too, since it's positive reinforcement instead of fussing at people and making them feel bad. I consider a return visit a coup in and of itself. I actually do a "Happy Dance" if they reach a goal. It makes people smile.
Negative reinforcement or"yelling" at people. I point out all of the bad things that will happen to them if they don't do what they should for their health. For example, the end of the world as we know it, fire and brimstone, cats and dogs living together, etc. Sometimes that works. When I point out to women that smoking causes premature wrinkling, that motivates them to stop. Cancer? Not so much. Wrinkles? Yup. Go figure.
Sometimes, all that will work are the Hereña Rules.
If a patient has not followed up, I threaten to hold their medications hostage. Then, if they still don't come in for follow up, I do it. I won't refill their meds. It's a last ditch effort, after phone calls, letters, and plain old begging haven't worked to get someone in for their follow up appointment.
I HATE doing it. I will do everything in my power to avoid it. I don't WANT people to run out of medications, but I HAVE to monitor their meds, and their side effects. If someone doesn't come in for followup, I don't know if the meds are working, or if their kidneys or livers are in trouble, or ANYTHING! It's really scary. I'm responsible for my patient and I want them to be healthy.
Soon a frantic phone call will come in. "DoctorDiva won't renew my meds!"
I say, "Tell them to schedule an appointment and I'll give them enough until they come in."
Works every time. Take away their Cinnabon, and Voila!
Hereña Rules.
My husband is an Evil Genius.
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