Chapter 35 Exercises: High-Stakes Confrontations — Legal, Medical, Financial Disputes

Section A: Conceptual Understanding

Exercise 35.1 [Conceptual] ★ In your own words, define what makes a confrontation "genuinely high-stakes" as the chapter uses the term. Give an example of a confrontation that is emotionally difficult but NOT high-stakes in this chapter's sense, and an example that IS high-stakes. What is the difference?

Exercise 35.2 [Conceptual] ★ Explain why the chapter says the paper trail is "not optional" in institutional confrontations. What specific risks does the absence of a paper trail create that are not present in personal confrontations? Give an example of how a verbal agreement that seemed solid could fall apart without documentation.

Exercise 35.3 [Conceptual] ★★ The chapter argues that escalation channels — supervisor, formal appeal, regulatory complaint — are not last resorts. Many people treat them as such. Why do people resist using escalation channels? What is the psychological or cultural reason for treating escalation as a nuclear option, and how does the chapter's argument push back on this?

Exercise 35.4 [Conceptual] ★ Define "BATNA" in the context of institutional confrontation. How is the BATNA analysis in high-stakes institutional confrontation similar to, and different from, the BATNA analysis described in Chapter 25?

Exercise 35.5 [Conceptual] ★★ Dr. Priya Okafor — an experienced physician — felt "small" in her own medical appointment. Explain why this happened using the power analysis from Chapter 33. What specific types of power were operating in the physician-patient encounter? Why didn't Priya's own expert power protect her from this experience?

Exercise 35.6 [Conceptual] ★★★ Research on "white coat syndrome" suggests that medical settings generate anxiety and diminished self-efficacy in many patients. How does this dynamic interact with the communication demands of medical advocacy? What does this tell us about the structural design of medical encounters, and who bears responsibility for making those encounters more genuinely collaborative?

Exercise 35.7 [Conceptual] ★★ The chapter includes a sequence for contract disputes ending in "small claims court." Many people have never considered small claims court as a realistic option. What are the specific barriers — knowledge barriers, psychological barriers, practical barriers — that prevent people from using small claims when it would serve them? How could those barriers be reduced?

Section B: Scenario Analysis

Exercise 35.8 [Scenario] ★★ Marcus Chen receives an Explanation of Benefits from his health insurance company denying coverage for a doctor's visit, citing "out-of-network provider." Marcus saw an in-network provider and has documentation to prove it. He calls the insurance company and is told, after forty minutes on hold, that the decision is final. Using the escalation ladder from Section 35.2, write out Marcus's complete next three steps, including what he says in each and what documentation he needs.

Exercise 35.9 [Scenario] ★★ Sam Nguyen's operations team hired a contractor to renovate the office break room. The contractor was paid half up front ($4,800) and has now disappeared — no work done, not responding to calls or texts. Sam checked and the contractor is not licensed in the state. Apply the contract dispute sequence from Section 35.4 to Sam's situation. What are his options at each step? What additional facts would significantly affect his options?

Exercise 35.10 [Scenario] ★★★ Jade Flores is meeting with a financial aid officer who says: "The system shows you dropped two courses mid-semester, which changed your enrollment status." Jade knows she did not drop any courses. The financial aid officer shows her a system printout that says she did. Jade does not have documentation with her — she did not bring her enrollment record to the meeting. What should she do in this moment? What should she do after the meeting? Write out her words in the meeting and her action plan for the next forty-eight hours.

Exercise 35.11 [Scenario] ★★ Dr. Priya Okafor, as a patient, wants to ask her physician for a second opinion referral. She is worried that the physician, who has been treating her for two years and whom she likes, will be offended. Using the specific approach described in Section 35.3, write out exactly what Priya says to request the second opinion and how she handles the physician's initial response of: "I think we have a very clear picture of what's going on. Are you not confident in my recommendation?"

Exercise 35.12 [Scenario] ★★★ A hospital has sent Marcus a bill for $2,800 for an emergency room visit. He reviewed the itemized bill and found two charges he does not understand and one charge for a service he is certain he did not receive (a respiratory therapy consultation he has no record of). He has insurance, but they say the charges are his responsibility after deductible. Write out Marcus's full action plan: what questions he asks the hospital, what he requests from the insurance company, what documentation he needs, and what his escalation path is if neither the hospital nor the insurer resolves the disputed charge.

Exercise 35.13 [Scenario] ★★ Jade Flores is being discharged from the hospital after a brief stay. She does not feel ready to go home — she is still in significant pain and cannot manage independently. The nurse says discharge orders have been written. The attending physician is not available. Jade does not know what to do. Using Section 35.3's resources, what specific steps should she take immediately? Write out what she says and to whom.

Section C: Applied Practice

Exercise 35.14 [Applied] ★★ Identify a real or realistic situation in your own life that involves a dispute with an institution (past or current — medical, financial, educational, government). Complete the full BATNA worksheet from Section 35.5. Then write the one-sentence statement of what you need and the brief narrative of facts (maximum 150 words) you would use to open the confrontation.

Exercise 35.15 [Applied] ★★★ Complete the full High-Stakes Preparation Checklist from Section 35.5 for a real or realistic institutional confrontation from your own life. All five phases. Where gaps appear (you are missing documentation, you don't know the right person, you don't know the applicable regulation), identify what you would need to do to close those gaps before the confrontation. Be specific about what research you would do and what documents you would gather.

Exercise 35.16 [Applied] ★★ Write a formal demand letter for the following situation: You hired a contractor to paint your apartment ($1,800 paid in advance). The contractor did not complete the work, and when they did work, the quality was unacceptable (documented with photographs). You have given them two opportunities to return and complete the work; they have not responded. The letter should include: specific description of the breach, documentation references, specific remedy requested, deadline, and your stated next step if the remedy is not received. Make the letter professional in tone.

Exercise 35.17 [Applied] ★★ You are accompanying a family member to a significant medical appointment. They have been told they need surgery; you both want to understand the alternatives before agreeing. Using the medical advocacy scripts from Section 35.3, write out at least five questions you would ask during the appointment. Then write the question you would use to open the second-opinion conversation.

Exercise 35.18 [Applied] ★★★ Research the consumer protection laws in your state or jurisdiction that apply to one of the following areas: (a) landlord-tenant security deposits; (b) debt collection practices; (c) insurance claim handling; (d) deceptive trade practices. Write a one-page summary of: what your rights are, what the institution's specific obligations are, what agency enforces these rights, and how you would file a complaint if those rights were violated. Cite your sources.

Exercise 35.19 [Applied] ★★ Practice the medical advocacy pause sentence: "Can we slow down? I want to make sure I understand the decision before we talk about next steps." Write three versions of this sentence that you would be comfortable saying naturally — your own language, not the book's. Then write the two most likely physician responses to this sentence and how you would proceed in each case.

Section D: Synthesis

Exercise 35.20 [Synthesis] ★★★ The chapter argues that individual assertiveness in high-stakes confrontations is "necessary but not sufficient." Build the case for this position. What does assertiveness do? What does it not do? What structural conditions would need to change to make the power asymmetry between individuals and institutions less severe?

Exercise 35.21 [Synthesis] ★★★ Dr. Priya Okafor is both an expert in medicine and a patient who feels the full weight of the physician-patient power dynamic. Write a 600-word essay analyzing what her experience reveals about the nature of expert power in interpersonal and institutional contexts. When does possessing expert power in a domain not protect you from the structural power of an institutional encounter in that same domain? What does this tell us about the difference between individual expertise and institutional power?

Exercise 35.22 [Synthesis] ★★★ Design a one-page "High-Stakes Confrontation Quick Reference Card" that someone could carry with them and use in a moment of institutional confrontation — medical, financial, or legal. It should be brief enough to fit on one page, clear enough to use under stress, and comprehensive enough to include the most important points from this chapter. Consider: what are the five things a person most needs to remember in the moment?

Exercise 35.23 [Synthesis] ★★ The chapter argues that knowing your rights is a form of power in institutional confrontations. But there is significant inequity in who knows their rights: people with more education, more income, and more institutional familiarity are more likely to know what they are entitled to and how to assert it. Write a brief analysis of this inequity. Who benefits most from the skills in this chapter? Who faces the biggest gaps? What would it take to address those gaps more broadly?

Exercise 35.24 [Synthesis] ★★★ Compare Jade Flores and Dr. Priya Okafor as people navigating high-stakes institutional confrontations. What resources does each have that the other lacks? What structural disadvantages does each face? What strategies from this chapter are most accessible to each? What does this comparison reveal about the relationship between social position, institutional knowledge, and the ability to advocate effectively in high-stakes confrontations?

Exercise 35.25 [Synthesis] ★★★ The chapter closes by connecting to Part 7's focus on chronic conflict — when high-stakes issues recur without resolution. Consider: what happens to people who repeatedly face high-stakes institutional confrontations and lose? What is the psychological, financial, and practical impact of sustained institutional power over individuals who cannot effectively confront it? What would a systemic response to this pattern look like — and whose responsibility is it?