Maps and Barriers

I have always loved maps—everything about them. I love looking at all the little dots that represent towns and the roads that connect them. I love wondering what all those towns are like, what treasures they hold, what dreams they hide. I love laying an atlas down or spreading a map out on a table and planning an adventure with it—dragging out a ruler to use with the legend, finding destinations using the grid, calculating distance and time to travel. I love multicolored ones, black and white ones, even topographical maps and nautical charts. I even love figuring out how to fold them back the right way.

I suppose that is why it struck me deeply when one of my mentors said in reference to goals, “It’s like a road trip from North Carolina to California. You can probably get there eventually without a map, but it’s going to take a lot longer and be a lot harder, so why would you?” Since I heard this, any time I contemplate action plans for my goals, the initial image in my brain is a map of the United States with a little dotted line and hand drawn car being animated across it.

Considering one’s plans for obtaining a certain objective seems like a no-brainer, really. While I had never actually visualized my plans as road maps, that is certainly what they were. My lists were directions, turns to be made along the way.

Tonight, though, I was thinking about not the path but the barriers in that path, and I realized that understanding them is just as important as knowing the route. Barriers to advancement, some just and some unjust, will always exist, but if we know what they are, we can formulate a plan to circumnavigate them.

For instance, if I have a patient who comes in with an ear infection, my goal, of course, is for the ear infection to heal. The path is (most often) antibiotics. Potential barriers are myriad—medication allergies, no prescription coverage and lack of funds, transportation issues,… apathy. If the patient is not honest with me about those hindrances, and I cannot foresee them, knowing the path to healing just might not be enough.

Sometimes these days, I feel like we have two wildly separate factions, those who feel like the whole world is out to get them and those who believe the cosmos will make everything all glitter and rainbows and deliver their wants and needs on a silver platter. As is often the case, the truth lies somewhere in the middle and to fully understand that is to fully understand one’s barriers and one’s path.

We live in a world where how we look affects how we are perceived. Period. It’s not right, but it’s true. We can wail and moan all we want about it, and I will continue to do so, but in the meantime, I will also recognize it as something that will always be taken into account. Sometimes it will be a barrier. Sometimes it will be a ticket to the expressway. Ignoring this fact altogether does me no good.

Sexism is a thing. Agism is a thing. Racism is a thing. Class discrimination is a thing. Unfortunately, endless forms of bias influence our thoughts and decisions and those of others. We should rage against these biases, but we should also quietly consider them. Biases are born of ignorance and fear and sometimes eons of evolution. What knowledge gap or fear influences your thoughts? Which ones influence the thoughts of the person holding the keys to your next goal? What hurt has so imprinted their heart that they are irrational about their decisions? From what do their fears stem? How narrow is the world that has made them the way they are? Please don’t mistake my empathy for excuse. At some point, we must be bigger than our shortcomings, and we must always be willing to listen carefully and openly to other points of view so that we may broaden our horizons to other possibilities.

The empathy, however, will help us circumnavigate the human barriers along the way to our goals. I have a thick southern accent. (Or so they tell me.) It is a part of me that explains a lot, like why I say “ma’am” and “sir", “please", and “thank you.” It’s why I respect my elders, am kind to others, and feel guilty because I don’t go to church. And it’s why I have passive aggressive down to an art form when need be. Unfortunately, of late, a number of patients have taken it to mean that I am also somewhat dim witted. Realizing this took me a few weeks of working with New Englanders, and miscommunication, and maybe even some mistrust, resulted. I am aware of this barrier, now, however, and I have developed ways to allow them to be comfortable with my knowledge base. Their prejudice isn’t one of which I am fond, but it is one with which I must live. The best way to change their minds is to be the antithesis of their expectation. I must know the barrier to my goal. Denial will not make it go away.

I feel like so many people these days charge toward their goals with a battering ram leading the way, doing their best to scatter the barriers with vehemence and self-righteousness. Certainly, the headlong run at the enemy has its place. Often, though, the more productive route is, in truth, the harder one. Being open to discussion with people who hold other points of view is rarely easy, but by doing so, we not only learn about other humans, but they also have the chance to learn about us. Then, we are again each brothers and sisters in humanity rather than obstacles to be overcome.

See, my patients’ goals are to be well, and I might either be a barrier or a thoroughfare. If they come charging at the dimwit with the southern accent, they will miss the damn good physician who wants nothing more than for them to live another happy, healthy day.

(I didn’t start this post with this point in mind, but it developed into this regardless. Also, my apologies to all the youngsters who will never know the joy of planning a trip with paper maps or finally figuring out how to fold one back the way it came.)

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