“How I Learned to Be a Dick to Patients”

“The Case of Protecting Yourself, Your Community and Everyone's Sanity”

I have had what seems like a fairly atypical start to opening and running my community clinic, Little Bird Community Acupuncture. It has been open for a little over a year and a half and it has been a fucking wild ride. I lost my space that I had my boutique practice in (let it be noted that I loved my patients, but hated the method of practice with a mad passion. It was so boring for me. And I never felt like people were getting what they needed. Common chorus around here, but that shit was not my place to thrive.) I decided to say “Fuck it.” and opened Little Bird with a month's notice. The gods smiled upon me and I found a tiny office space in a community center that I could afford and still be able to feed my husband, my cat, and myself if shit went wrong. I couldn't gamble on going big. I didn't have the time or the financial backup.

So, I opened up all alone. Pretty fucking scared and excited and ready to poke. And holy shit was it a good thing that I stocked up on needles not knowing if I would need them or not. In my first week, I saw over 60 people. The next week was around 70, if I recall, and it just got crazier from there. By the end of the year I was up over 100 patients a week. ( I know all of y'all are telling me to shut up and go fuck myself. But I promise gluttonous feast is is just as bad as famine sometimes.) Also, I had not gotten the memo on the fact that one isn't supposed to see patients for more than 40 hours per week and that is exactly what I was doing.

By Christmas of 2010, I was sweating some big fucking bullets. I was bumping up on being full and thought it seemed totally wrong to close the schedule to new patients. People were starting to get pissed at me and I just put my head down, with my arms and heart wide open, and kept working. Not always the best strategy. After talking to my comrades here, I got the balls to close the schedule to newbies and hire a new punk. Shit should be easier right? Yeah, well. Not so much.

See, I might curse like a motherfucking sailor. I might seem a little gruff, but really it is just the way I protect my tender Mama Bear self. I love taking care of people so much that I will work myself into the ground. I think my patients see me as a tiny cursing fairy of love or some sweet shit like that. And it is pretty true. I often walk my three blocks home at night crying and cursing under my breath. My community is filled with injustice and it breaks my heart. I have patients who are the little annoying go-getters that folks think of when they think of Washington. But mostly the people I see are the ones who serve their coffee, teach their kids, bag their groceries, cut their hair, you get the point. They are normal folks scraping by and it is damn hard to get anywhere in this town if you aren't clawing your way to the Capitol. They are people who just need to feel better so they can pay their rent and maybe eat.

OK, so now you want to know how the Cursing Fairy of Love and Needles segues into learning how to be an asshole to folks. Well, I'll tell you. In August, I let my punk go (another story altogether) and closed the schedule to new patients again. My first inclination was to just pick up the shifts that the punk was no longer working. Thankfully, I have a husband who gently told me I was nuts and that was not going to happen. (I think if I had we would have had a Lindsay Lohan-esqe “collapse from exhaustion” situation, but without the drugs and with a ton of actual exhaustion.) So, I sucked it up and told my fantastic patients that the schedule was shrinking, I was working on finding new punks to fill the void, and that was that. And it sucked. I cried a lot. I got angry a lot. And in the end I realized that I had to hold the line.

I'm not sure if this is a DC or East Coast thing, but a lot of folks here will push to see how far and how much they will get from you. It by far isn't the majority, but it is just enough for you to want to punch them and go crawl in a cave and die. Individuals love to think they are extra special. I'm sure they are. But they aren't that much more fantastic than the other 100 people on my waiting list. Even with two new fantastic punks working we still have a giant waiting list. (I know, I know, go fuck myself.) I have gotten really good at saying no. No to the folks that disregard the “No New Patients” shit that is posted all over the website and schedule. No to the people who ask me to work more. No to the super needy folks who want to take up a bunch of time chatting to fill the void in their lives. No to the chronically late. No. No. No. All of these no's are (mostly) said gently with a smile. Occasionally, it is less smiley and more “I want to choke you out.” But all of it comes from the good place of needing an orderly and calm place that people can come to, be safe, open up, and heal. Without serious and firm boundaries no one here would be happy. Not me, not my patients, not my staff, and especially not Little Bird (who knew that a clinic could become just like a real person?).

So, if you try to jump my waiting list or pull some crazy shit in my clinic, just know when you get my standardized “No, but here are some options for you” email, it comes from a place of love for my community. I have to serve you by being just a hint of an asshole. It is how I protect my community, my heart, and myself and everyone's sanity.

Author: suzzanne.lohr

I was the proud owner of Little Bird Community Acupuncture located in Washington, DC for 6 years and am so happy that the clinic is thriving without me at the helm.

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  1. This is a cussing great blog, you CFLN. It may be the opposite challenge that most of us have, but God bless you for sharing. (and god bless the POCA censors for reminding me of Fantastic Mr.Fox – he resembles a lot of us.)

  2. Suzanne I had no fucking idea that you curse so god damn much.
    Hot fucking shit!
    One of the things that I like about practicing community acupuncture is that I find myself cursing frequently while talking with patients… that is cursing frequently, talking with patients frequently. A good shit or fuck always serve to punctuate. Not surprisingly a lot of my cursing comes up around the acu-profession- the fucking debt load, the stupid ass FPD, the greedy bastards at the schools, etc.

    But I never thought before how cursing might be a really good way to enforce strict boundaries. Or promote the clinic.

    As in “hey folks just grab your own fucking blanket on the way into the clinic,” or “wear your goddamn shoes around here so you don’t get a fucking needles stuck in your toe.”

    When peeps are late I think I’ll try a “where the hell were you, your appointment started 10 minutes ago.”

    And maybe on our business cards “pay what ever the fuck you feel you can–just get your ass in a chair.”

    Thank you for this post.

  3. love this:
    “I decided to say “Fuck it.” and opened Little Bird with a month’s notice. The gods smiled upon me and I found a tiny office space in a community center that I could afford and still be able to feed my husband, my cat, and myself if shit went wrong.”

    So glad enough of us have said fuck it to the acu-establishment and the shitty dreams they sold us that such a thing as POCA requires to be in existence!

  4. You make it seems so simple, eh? Why don’t go fucking, fuck yourself….and hire some more punks while you’re crying about your fucking quick success, why don’t you?

    …he, he…..way to go Little Bird!


  5. I think if POCA produced Tiny Cursing Fairies of Love and Needles action figures, we could probably fund an entire microloan!

    I love this post.

    What I would really like to see on this blog and JRA at some point, is a series of posts about how being a clinic owner and/or a high-volume punk CHANGED people. Somebody could write novel after novel about our various personal evolutions in the crucible of CA. I never get tired of hearing this stuff.

    Also, thanks Suzanne for demonstrating the difference between POCA’s 2 blogs so elegantly.

  6. Those action figures are amazing! We should totally fund loans with those babies.

    And for the record, I don’t actually curse my paients out. Much. I do like the occasional “That is so fucked up.” Or “Holy shit that is wrong.” But maybe more of those fuckers would be on time if I started to ask them where the fuck have you been? 😉

    Thanks for reading my shit. I love you guys.

  7. Thank you for this. Busy was great, until it burned me up and found me crying in my car a lot. I’m just a hired punk, with a lot to learn, but that lesson came fast and hard. It’s great to hear about self-care here, curse words and all. Thank you

  8. The blog is awesome in all its fucking glory, and the comments left me ROTFLMAO. (‘now we know what the little bird is all about’ bhahahahahahahaha). And, I remember Suzzanne in tears at the CAN 101 workshop, at not being able to be 12 punks all on her own. It is all love, every last tear, every single cussword, and every single needle. Love, love, love, love, love. Thank you, Suzzanne.

  9. what a fab post, suzanne. a wise friend once told me, “you can help thousands heal or you can help a few people heal. it all depends on how well you take care of yourself.” when setting boundaries, i often say that to myself.

    thanks for the reminder!