Board-certified in what?!

Bureaucracy is where accountability gets diluted and common sense is quietly asked to wait outside for safety reasons.

You can usually spot it by the signs. Laminated, taped, stacked one on top of another, each announcing a rule that probably once made sense

Arrows point in conflicting directions. Doors are locked “temporarily,” which often means indefinitely. A desk sits between you and the thing you actually need, staffed by someone whose job is to make sure you don’t get there the wrong way.

We may not be able to change systems or bureaucrats, but we can change how they hook us into drama.

Hospitals are particularly good at this.

Clipboards multiply. Protocols overlap. Nobody is quite in charge, but everyone is certain about what you’re not allowed to do. Hospitals tend to amplify a familiar human impulse: gathering in herds, exchanging judgment for the illusion of safety.

Caregivers encounter this constantly. Not because we seek it out, but because care requires proximity to systems that prize procedure over discernment. By the time we reach the desk, our tension is already high and our patience nearly gone.

I found myself at a large teaching hospital with my wife, Gracie, as she prepared for a nine-hour surgery. We were staying with friends nearby. She had already been admitted, and the surgeon was clear about where I needed to enter so I could be with her in pre-op before they took her to surgery.

By now, most surgeons recognize that I’m not new to this. Forty years of caregiving tends to cure naïveté. I can follow the jargon, ask informed questions, and handle graphic medical realities without flinching. That familiarity earns a certain trust once you reach pre-op, recovery units, or the ICU.

The problem is getting there.

Between the parking lot and the patient lies a layered world of desks, checkpoints, screens, and policies, staffed by people who don’t know your history and aren’t allowed to consider it.

Which is how I found myself there with Gracie during her surgery, in the middle of COVID, a season I’ve come to think of as the high holy days of bureaucracy.

It was bitterly cold that morning in Denver. Montana cold I can handle. Denver cold is another matter. I had already made the long walk from the parking area to the emergency room and was not eager to be sent back outside to circle the hospital again in the frigid early morning.

At the ER security desk, I gave my wife’s name and said, “I’m here for her operation.”

The guard checked the screen and said, “You have to use the front entrance.”

“It’s closed,” I replied. “The surgeon directed me here.”

“You have to use the front entrance.”

I tried again, slower.

Same result.

So I asked, politely, “Ma’am, where did I lose you?”

She repeated herself.

Years ago, this is where I would have argued. Quoted instructions. Asked for a supervisor. Escalated things just enough to feel righteous while accomplishing nothing and raising my blood pressure.

Decades of caregiving taught me that nothing useful is changed that way.

So instead of arguing, I chose a different response. I met immovable force with irreverent restraint.

Since I have a full head of white hair, and with great hair comes great responsibility, I adopted my best Leslie Nielsen deadpan and said calmly, “Ma’am, I’m board-certified in cranial proctology. They’re waiting for me in pre-op.”

She blinked.

Her eyes widened.

She waved me through.

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It later occurred to me that my last name may have served as the exclamation mark on the credentials I had just fabricated. Even nonsense, it seems, benefits from proper punctuation.

I arrived in pre-op on time, smiling to myself.

For the record, cranial proctology is not a recognized medical specialty, except perhaps in Washington, D.C., where demand appears chronic and widespread across multiple government buildings. My services, though sorely needed, remain unofficial.

Caregivers live with enough real emergencies. We don’t need to manufacture new ones by turning every bureaucratic impasse into a confrontation. We may not be able to change systems or bureaucrats, but we can change how they hook us into drama.

Not every obstacle deserves a skirmish. Some require restraint, a straight face, and conserving energy for what actually matters.

A little humor, a lot of deadpan, and the ability to avoid getting pulled into someone else’s craziness go a long way toward living a calmer life as a caregiver.

Maybe I’ll give it a try at the post office next.

Or, God help us all, the TSA.