The Sh*t Sandwich

“I have realized that I really enjoy learning about ***, but I don’t necessarily like studying it and being tested on it.”

And there it is. My mama pride swells at this concise, distilled insight of self-awareness that Son shared with me, about 6 weeks into college. So you really like ***. How much might you be willing to work/tolerate/sacrifice to stick with it? Will you keep *** as a hobby/interest, or can you see yourself making a career out of it? No rush to figure it out! And how cool to know there is a distinction to make?

How much are we willing to give for something we really want? Are we willing to eat the particular flavor of shit sandwich (a la Mark Manson–check out his blog and books!) that’s inevitably served on the path to our goal?

Sometimes we don’t even have to know what we want; clarity about what we don’t want–shit sandwiches we will not eat–is enough to set us on the right path for each of us. Some shit sandwiches I have rejected:

Three Dimentional Calculus and Vector Analysis: Freshman year in college, one problem on the final exam of this class took up 8 pages in the exam book. And why did I have to know it? How did the reasoning help me in life? No more math for me, thank you. I left engineering the following quarter.

Physical Chemistry: Having already gotten a C in physics (which happens when you fail the second midterm because you start dating your husband), empowered with an aversion to math, and knowing already that life is too short for this kind of suffering, I rejected chemistry and embraced biology as a major.

5:30am Rounds: General surgery, my first ever clinical rotation. My intern, the wonderful Gopal Kowdley whom I love to this day, looked at me and said, “You’re tempted, I can tell.” But OMG surgery–the egos, the bombast, the misogyny–AND getting up in the dark every day, forever? Nope.

Lifelong call: I love reading echocardiograms–ultrasounds of the heart, beating in real time. Second year of residency is when internists apply for subspecialty fellowships. That year my cardiology fellow stood right next to me at 10pm, monitoring a dying patient in the cardiac ICU. He had a little girl at home who missed her dad. Later that year, the attending cardiologist, my amazing teacher, sat across from me at the nurses station, in the middle of the night, reviewing the EKG of a lady with a likely heart attack. He had grandchildren already. He had to get up in the dark–in the middle of the night. No cardiology fellowship for me!

I live in Chicago when my home is Colorado. Wut? But Husband is from here, we trained here, and we both found jobs here that fulfill us and allow us to make a difference in people’s lives. WINNER! Love makes us do crazy things, like eat this. huge. shit sandwich. Without hesitation, no matter how it tastes. Every day. For 30+ years.

Through the long hallways of my career, at each door has stood a waiter offering some shit sandwich for me to taste in order to get through. I closed some doors, and walked through others. I wrote last month that I regret none of the work thresholds I’ve crossed to date. Since the beginning, nothing has been be-all, end-all. If I didn’t get into med school the first time I’d decide to try again or try something else. I committed to finish an internal medicine residency and pay back my student loans; those doors swung heavily one way. Other than that, I have always had the privilege of myriad opportunities to use my skills and credentials in new and interesting ways if I wanted to–generalists are needed everywhere. But the older I get, the more selective I am about what shit sandwiches I’m willing to eat. I think that’s normal.

As Liz Gilbert interprets Manson in her book, Big Magic: “So the question is not so much ‘What are you passionate about?’ The question is ‘What are you passionate enough about that you can endure the most disagreeable aspects of the work?’”

So ONWARD, I say to Son. Keep learning about yourself and the world. Try out different things, taste a little of everything as long as you’re sure it’s not toxic. Carve out your space. I am confident you will find your favorite flavor of shit sandwich.

Potential and Kinetic Energy: Onward In Power

Here we are, Day 30 of 30, woohoooooo! What a fun month of reflecting, learning, writing, and sharing! Looking back, I see about eight posts to revisit, ideas to flesh out and expand. I also see recurring themes stretching back to before this blog even started–funny how that always is–I am who I am!

I started this blog in 2015; my goal was to make it a year. After that, I’d decide if I wanted to keep it going. Wow. I love perusing the years and seeing which themes persist/repeat, which fade and re-emerge, and which evolve. And something new stirs now, from the 8th annual 30-day challenge.

After nine years of physical training for menopause preparedness, my vertical jump may be higher today than anytime since I was a student. My balance and core strength are definitely better. I know this because my hang time during burpees and single leg jump lunges feels exhilaratingly long. When I squat, on one leg or two, I feel the tension, strength, and stability in my quads and glutes. When I explode up and my toes leave the floor, it really feels like flying, even if for just a second. I feel confident and powerful, free, and also intentional and in control. I attend to position, landing softly, protecting knees and ankles from injury. I have focus.

The ideas that emerged this month, especiallly the eight, also feel strong and powerful. They have potential. They move. They are, in many ways, the culmination of 8 years–maybe a lifetime, actually–of reflecting, exploring, articulating, synthesizing, integrating, of continuous playing, learning, noodling, seeking. They feel at once like energy stored and released, self-propagating, renewable–light, heat, wind–all of it.

I have lived long enough and through enough challenges now to have pretty good perspective. Nothing stays the same for long; nothing is guaranteed. Hard things happen and I have no control. Worrying and ruminating waste precious time and energy, for no benefit. I can do hard things; I have skills and support. So now I can really, freely, revel in the awesome when I have it. And no matter what hard stuff is happening, I always have something awesome. That clarity shines like the brightest lighthouse from deep in my core, and it orients me–reliably, unassailably–in any storm.

Is this what happens in middle age? Consolidation and magnification, gathering for expansion, the existential equivalent of the strongest and funnest squat jump? If so, I’ll take it! Who knows what’s next, it could be anything! I am ready.

Onward, my friends, there is much work to do!

Water, Gasoline, or Firewood?

Ptarmigan Trail, Silverthorne, Colorado, October 2022, one year after fire triggered by hikers

If you don’t already follow Shane Parrish at Farnam Street, or listen to The Knowledge Project podcast, I highly recommend it. In this week’s newsletter, Parrish describes how he engages his kids when they exhibit ‘ineffective’ behavior (such as picking fights with each other). He coaches them to pause and think about their actions: Is what they’re doing going to make their lives easier or harder? Will it get them what they want? He asks them what things would look like if they poured gasoline, versus water, on their current ‘fire.’ “With water or gasoline, you can start a fire, make it bigger, or put it out. The choice is yours.”

What fires burn in our lives? Which ones warm us, give us light, and bring us together, and which scorch and destroy?

Obviously we don’t pour gasoline on a wildfire, unless we are arsonists or sociopaths. And we all rue the careless camper or hiker who accidentally sets our beloved forrests aflame with an errant cigarette butt or the like. What anaologies to our lives can we make of these events? Maybe the overwhelming emotional hijack of a post-traumatic trigger, a cutting word spoken or argument erupting in the heat of anger and resentment? In these moments, how can we slow down, recognize the gas can in our hands, loosen our grip, put it down and screw the cap on tight? Where did we put that water bottle? Better yet, can we just leave the cigarettes at home next time? ** deep breaths **

That scenario is less interesting to me, though, than the campfire or bonfire. I feel like I’ve written this analogy before on the blog, but I can’t find it. I don’t camp, but I love communing around an intentional, contained flame with good company and comfort food. This is the kind of fire that gathers us, warms us, strengthens our bonds. Right now it’s phone and FaceTime calls, hikes, and generally carving out time to spend together–these are the fires that feed me. The flame of a good, strong hearth requires tending, though. Someone needs to find and bring home the wood; it has to be dry enough but not too much so, and made into the right size. Orientation of logs and branches matters for optimal airflow, so smoke billows skyward rather than swirling and suffocating the gathering. We must stoke and stimulate the flames to keep them going, and fuel them regularly to maintain light and warmth for us all to enjoy. It’s best if we take turns. Like maintaining strong fires, good relationships require us to participate actively, thoughtfully, and regularly.

As our collective care and attention perpetuate warmth and light, the best thing is when we attract others to join. When they hear the crackling flames and campfire songs, the laughter and joy emanating from intentional communion, they want to connect, and we widen our circle of friends. Cold and dark no longer feel so daunting; we feel safe and secure; we belong.

As we enter the coldest and darkest part of the year, I’m gathering my firewood and piling it high. Come to think of it, I must also tend to the forrest where the trees grow… An analogy for another time, perhaps.

Fireweed flourishing in its ideal habitat; nature healing itself