An assertive dandelion

What does it mean to be assertive? (Or not.)

Being assertive is a challenge for me, but apparently not for my appendix, which chose Memorial Day to demand its freedom. That evening, I happily complied, and a surgeon put my appendix and me out of our misery.

My hospital room.
My own version of Memorial Day fireworks

The day after my surgery, an interesting dilemma presented itself–to speak up for myself and risk offending my surgeon or stay quiet. I chose a middle ground, and I’d love to know what you would have done.

To be assertive may risk causing offense.

In my memoir, I explore the roots, manifestations, and consequences of my excessive agreeableness. I own the sad truth that my inability to stand up for myself made it difficult to stand up for my son Matthew during his long rumble with a childhood brain tumor.

For many years, I was well aware of my reticence toward speaking up. There were times I tried to be assertive, but mostly I stayed in my comfort zone where others’ needs took priority over mine.

Being assertive is outside my comfort zone.

But with my uncomfortable truth ready to be laid bare to the world on the pages of my memoir, I’ve been making a concerted effort to be stronger, more assertive, to speak my truth.

Part of what makes it hard for me to speak openly is my fear that I’ll offend someone. That’s what happened with my surgeon.

The morning after my appendectomy, the diminutive man with thinning hair, square glasses, and nutmeg skin stopped in to check on me, and give me my discharge instructions. In a thick accent, he sped through the dos and don’ts. I caught a few snippets–showering was OK, swimming was not, no lifting, call his office if I had any problems.

“So I don’t need to schedule a follow-up appointment with you?” I asked when he finished.

“Yes, you do!” he said with a laugh, “I just told you that.” His laugh didn’t hide his derisive tone.

What I wanted to say, also with a laugh, was, Well, you have a very heavy accent and you talk too fast, so don’t blame me.

But that seemed rude. I was afraid I might offend him. I didn’t want to sound racist.

So what I said, with a smile, was, “Well, you gave me a lot of information, and I’m just trying to take it all in.”

This was growth for me. In the past, I might have said, I’m sorry, I must have missed that. Or I might have been too embarrassed to say anything.

I took a step in the right direction by not taking the blame, and not feeling the shame. But I regret not being more assertive, and I don’t know how I could have responded without offending the person who had held my life–or at least the life of my inflamed appendix–in his hands.

I regret not being more assertive.

The dilemma is knowing what to do when you want to stand up for yourself, but don’t want to offend someone in a way that is antithetical to your beliefs.

Since I’m learning to navigate these new waters of assertiveness, I’ll ask you–

What would you have done?


  • Karen DeBonis

    Karen DeBonis writes about motherhood, people-pleasing, and personal growth, the entangled mix told in her memoir "Growth: A Mother, Her Son, and the Brain Tumor They Survived" forthcoming in spring 2023. Subscribe today to receive Chapter 1: A Reckoning.

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  1. Claudette on June 15, 2019 at 12:28 AM

    You handled it well. I would have done similar unless I was cranky in which case I may have said something a bit more blunt, borderline rude.

    People in the medical field know that they are dealing with patients or friends and family who are not at their usual, because of pain, medication, worry etc and repeating instructions patiently is part of their responsibility. :)

    • Karen DeBonis on June 16, 2019 at 3:39 PM

      Thanks for your thoughts, Claudette. True that doctors must understand that, after surgery, a patient is not at their best. Maybe I should have taken advantage of that, and pointed out to the surgeon that his accent was a problem. In some ways, I wonder if I’ve done him a disservice to not mention it. What do you think?

      • Claudette on June 16, 2019 at 3:48 PM

        I don’t know…we do what we can under circustances like that. It really should be more about the patient in my view. Even if a medical professional has to repeat him/herself, that comes with the territory.

        It’s good to reflect though. :)

  2. Sheba on June 15, 2019 at 1:19 AM

    Karen: every situation is different. However, I would have done the same….no sense arguing as It doesn’t really solve anything. Anyway the timing is not right when you just come out of surgery. You barely have the energy or strength. When ever I had surgery I barely remembered anything the surgeon told me…so I was happy that I received written instructions. Occasionally I just called the following day or two and asked the doctor’s nurse any questions I might have…but now I find they just call you the next day to check on you…so you can ask them anything then. Surgeons have many patients scheduled for the same day…. so they get rushed.
    We truly need to thank our heavenly father that today we have such great medical care and procedures & medications that our parents and grandparents never had … most just suffered in wheelchairs &/or died.

    • Karen DeBonis on June 16, 2019 at 3:45 PM

      Sheba – I agree about the advances in medical care. My scars are so tiny, I don’t know how he got any kind of instrument through them! lol! I actually felt very good the next day. What I’m wondering is, if I commented on his accent, would he have been offended, and should I have cared?

  3. Gail Boenning on June 15, 2019 at 7:07 PM

    Hi Karen–I’d like to believe I’d handle the remark and response as you did. Your left the door open for the doctor to consider his communication techniques with patients in the future. Perhaps he will, or maybe not. Everything that happens is an opportunity for us to learn if we open ourselves–as you did with your body and words. :)

    Glad to hear you are beyond the procedure and feeling better!

    • Karen DeBonis on June 16, 2019 at 3:50 PM

      Thanks for your comment, Gail, and your good wishes! Regarding future patients, I wonder if I should have specifically mentioned his accent, because then he could be open to communicating with them more carefully. Or, maybe he’s heard it before, and he’s doing the best he can. I guess I’ll never know.

  4. Laura on June 15, 2019 at 10:56 PM

    Yes, I agree with the other posters who say you handled it well. I’ve be in a lot of medical situations the past several years and the best providers leave their ego out of it and are just there to be of aid to the patient. That only happens a small percentage of the time though! Also, don’t be so hard on yourself. Perhaps you’re not, but it reads like you are. Be kind to yourself. I learned that from years of being hard on MYSELF.

    • Karen DeBonis on June 16, 2019 at 3:55 PM

      As soon as I saw your name, Laura, I thought about all the docs you must have seen in recent years. And, of course, a TBI makes communication even more difficult, not to mention your hearing loss. I’m really not being hard on myself, although that certainly is my modus operandi, but I wonder if being more honest about his accent would have actually done him a favor. What do you do when you have trouble understanding a doctor?

      • Laura on June 16, 2019 at 4:47 PM

        Good. Glad you’re not being hard on yourself in this situation. It’s hard to monitor that part of yourself (I know from ample experience). Yes, communicating with doctors is a challenge for the patient because you’re not at 💯. I just had an experience with an eye doctor that was not great because of my TBI and my hearing and he was not understanding and awful. Without getting into it try thinking of an eye doctor appointment if you can’t hear and your comprehension and decisions are slower: “What’s clearer, 1 or 2, 1 or 2?” It was over a month and three rounds of glasses before I got a prescription that was useable and I still don’t feel like they’re the best!! So needless to say I’m still working on communicating with doctors in my new condition.

  5. Karen DeBonis on June 17, 2019 at 11:13 AM

    I hope it gets easier, and better :)

  6. Don on June 19, 2019 at 2:09 AM

    Here’s one definition of assertiveness from the internet

    Assertiveness is a skill regularly referred to in social and communication skills
    training. Being assertive means being able to stand up for your own or other
    people’s rights in a calm and positive way, without being either aggressive, or
    passively accepting ‘wrong’.

    This definition uses “rights” and “wrong”. To avoid a long debate on what these are let’s just agree that whatever my definition of your rights and my rights, assertiveness on my part consists in standing up for those rights.

    So regarding your question – what would I have done? I don’t know for sure, but here are some thoughts.

    First, I would feel somewhat disrespected because it wasn’t my fault that I didn’t understand. I’m not slow witted. Perhaps the doctor doesn’t realize that his accent, coupled with my not being at full capacity after the surgery, makes him difficult to understand. In any event, his derisive tone when he said “I just told you that” was a put down. So in this case my right to be respected was violated.

    Second, I’d ask myself if it’s worth the effort to try to gain his respect. I know who I am, so does it really make any difference what he thinks? Especially since he and I are not likely to have many dealings in the future.

    Third, I’d wonder if making an issue of this would make him feel disrespected. After all, his specialty is surgery, and based on the outcome in my case he’s good at that. Why make an issue of this shortcoming? I’d rather have a doctor who’s a good surgeon and not so good at human relations than the other way around.

    So on balance, in hindsight, I’m hoping I’d just have said “Oh, okay”. But in the “heat of the moment” who knows what I would have done?.

    • Karen DeBonis on June 19, 2019 at 9:57 AM

      Thanks for your thoughtful response, Don. Lots to think about. I wonder if the greater good would have been served if I had told the surgeon that his accent made him hard to understand. Would that have made him a better doctor because he would communicate better in the future? Would that benefit his future patients by reducing miscommunications? What if his next patient had a more serious health issue, and a miscommunication resulted in a poor outcome? Can not speaking up ever be considered a sin of omission?

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