Two Hearts

Nayla Jiménez Cabezas served as the Guardian of Program for Maple City Health Care Center from 2009 until 2014. In Spanish, Nayla’s last name is a word that means “heads”.

Nayla doesn’t have two heads, but she often accomplished tasks that seemed to require at least two brains and a lot of wisdom.

In 2013, Nayla faced a situation that seemed to spiral out of control despite her skill and experience.

It started with a pregnant patient who wanted a different doctor for herself and her son.

Nayla listened to the reasons that “Alice” wanted to change doctors to see if there was anything that Maple City Health Care Center could do to improve our relationship with Alice.

Nayla talked with Alice about how a healthy relationship is the foundation of health care.

“I asked Alice if she was ready to commit to her new doctor for the long haul, said Nayla. “Some people change doctors haphazardly, which undermines our ability to provide care.”

Several months later, however, Alice wanted Maple City Health Care Center to accept both her and her son back as patients. Alice tried talking with two different people at the center, but heard the same response: stick with your new doctor to try to make that relationship work.

But Alice persisted. She attempted to persuade one of the center’s doctors to allow her to return.

“I faced a very hard decision,” Nayla said. “It seemed that I could either cave in to Alice or enforce our policy.”

“A friend of mine works with runaway youth. He talks about how our society tends to default to punishment as a response to conflict and frustration. So I talked with colleagues to try to imagine another way.”

Nayla decided to call Alice in order to both listen and explain. “I dreaded the call,” Nayla admitted. “I anticipated that a heated conversation would unravel into a slammed phone.”

Alice, however, listened while Nayla explained how repeated requests felt manipulative and sneaky.

Nayla heard Alice explain how a staff person at the Medicaid office advised her to “go up the ladder” and to “not take no for an answer”.

“Alice explained that after she left the center, she discovered that it would be virtually impossible to transfer her son’s Medicaid coverage to the new doctor,” Nayla said. “Alice told me that she was glad I had called. She apologized for her part of the problem.”

By the end of the conversation, Nayla was confident that the relationship between Alice and the center was intact and capable of growth.

“I appreciate Alice’s courage and honesty. It’s hard for people in our culture to communicate about disagreements.”

“Alice and I were able to confirm that Maple City Health Care Center is a community of people rather than a bureaucracy that is all policy and rules with no feelings.”

“In the end,” concluded Nayla, “I felt good about approving Alice’s return.”