Back Me Up

Comic Jim Gaffigan says being a dad is like being a backup QB in the NFL - that you’re not the star, and on the rare occasions you get called in, “people are nervous.” Same goes for the backup OB in labor delivery, like that doctor who delivered one of our kids who told me “don’t worry, this is my first birth but I have delivered goats.” I had a back up barista this morning in training at the local deli - she was sweet when she handed me the vanilla latte. “Sorry, I’m pretty sure it shouldn’t be green.” As back ups go, I’ve had my fair share of horrific incidents. I once backed up into the basketball hoop on the way home after asking Shelly Hughes to prom in 1990. Knocked the hoop right over, which is not a great look. In my defense it’s the genes - dad backed the chevy scooter into the lamp post a year earlier….Some of us scoff at the idea of the backup, but the backup itself is actually the most important person in some professions - the understudy on Broadway to give the lead’s vocals a rest on a Saturday matinee or in baseball, like Mariano Rivera who saved more games in a 5 year stretch for the Yankees, when candidly no one was nervous. Enter Sandman, we’d say. Healthcare is used to back ups - back up nurses called travel nurses or doctors, called Locum Tenens, are becoming more necessary as the starting docs retire or need a break from the rigor and pressure of long shifts in hospitals. They are no less important to families in crisis. Mental healthcare is increasingly relying on backups. They’re called clinicians on their way to a license but if you’re dealing with anxiety or trauma, let’s face it—you’re in crisis more often than you’re not, so having a back up in those occasions can be an issue, requiring supervision, guidance, trust. It’s an interesting problem - stigma is dropping for people with anxiety and depression and addictions, but to staff the need, the nation needs help from the bench, and that can mean unseasoned therapists who need lots of training. “We have a quality problem in mental health therapy,” a psychiatrist source told me. Some say AI is the answer to our over reliance on back ups. But I disagree —we need these backups, it’s healthcare’s way of replenishing.  It’s humanity to have personal touch. Sort of like parents: Have children, teach them well, make them leave the house, hope they have kids who will take care of you when you can’t remember to eat. Not a robot, but a grandchild. My wife the teacher is nervous when she taps me to back her up. “I assume you didn’t use that same knife for the chicken as you did to cut these oddly slimy vegetables.” My wife isn’t so much nervous about me showing up as much what I will say and who I will say it to. “Do you have to ask everyone in the elevator what street they live on?” At dinner out with the kids, I once ordered the chicken marsala but the waiter told me to try again, “what’s your back up?” “Try again!” - he had rejected my order, even though he let the guy at the table next to us get the marsala. “Maybe he was doing you a favor,” my wife laughed. Maybe, I’m skeptical, and the risotto was a B-. There are a lot of other back ups in life: the back up order, back up plan, back up girl, back up job, going back up stairs, of course being backed up and being told by the doctor “you need to get your HDL back up.” These days, backups tend to be underpaid and often underappreciated if you ask me. Take teachers, who play the back up role at a whole other level: they are therapists, police, traffic cops, nurses and educators from 8 to 2:10 every day, angels if you ask me—filling in for parents to keep society going forward. It takes nerves and nuance and the patience of a saint, and if I was in charge, well I’d double what teachers make. Just back me up here…