Physician as Trainer

“No way, are you kidding me?” I would have said, if asked to do uphill sprint intervals this time last year. I also would never have ridden a bike through traffic and then up a training hill (or ridden a bike at all, really—biking has always scared me), or tried walk/jog/running from the bottom to the top of Ryan Gulch Road in Silverthorne, Colorado, an 800 foot climb over 2.5 miles.

How is it then, that this summer, I did all of these things? I credit my relationship with my trainer, Melissa. I started seeing her in January, 2014. I had thought for a (long) while that I needed to start exercising again, but after 15 sedentary years and two pregnancies, I barely recognized my body or its capabilities. I thought I could train for a few months and be back in shape, doing all things I used to do.

Little did I know what lay ahead in the actual training. First I had to identify some dysfunctional movement patterns I had developed over the years (wait, what do you mean, ‘fire your glutes,’ I’m supposed to be able to do that?), and correct them before loading them with weights and speed. I had to accept how out of shape I actually was, and reconcile the long, uphill path to physical health. And I am not an unhealthy person! I have no chronic medical problems, sleep well, and take no medications. I experience minor aches and pains that are generally attributable and transient. But last year I was afraid to start an exercise program on my own—I knew I needed help.

The first few sessions were fantastic, full of learning and potential. Turns out you can learn to fire your butt muscles in a one hour session—gluteal amnesia can be cured! But as each meeting revealed yet another pattern to be corrected, I got discouraged. How can there be so many things wrong with me, and when can I work out for real, already? After our first interval training session I wound up on the floor, dizzy, nauseated, and disgusted with myself. Later, Melissa demonstrated 14kg kettle bell swings. She told me I would do them, too—yeah, right (smirk)!  And, over time: Turkish get-ups, first ‘naked’ and then with weights, TRX lifting, Rip Stick swinging, planking, running in Kangoo Jumps, jump roping, kettle bell swinging and snatching, hill training on a bike, and, finally, metabolic circuit training that really gets my heart rate up—without ending up on the floor—I have actually done it all.

Why is the relationship key? From the beginning, Melissa has made it safe for me to show up every week, however I’m feeling and whatever is happening. It’s okay to tell her that something we did last week caused me pain. If I feel apprehensive about something she wants me to try, I can say so. She does not judge me, look down on me, or belittle me for what I cannot (or will not) do. She also does not judge herself. That I have pain is not necessarily her fault. Neither is the fact that I push myself to the point of dizziness and nausea. She holds the space for me to bring my concerns, without blaming or getting defensive. She states her observations objectively, of both my movements and how my personality and attitude affect my training. I have a hard time pacing myself, and she helps me monitor for and manage my tendency toward overexertion.

She gives me permission to just bring what I got. We go from there, wherever it is, and see how far we get. I often surprise myself with what I can do! As a result, my confidence and motivation have dramatically increased. These days when she offers a new activity, I say, “Great, let’s try it out!” It’s okay to fail, if that’s what you want to call it, because I always learn something to apply next time. Through it all, I know she is there to coach and support me, without judgment, and always with love.

It takes time and practice to acquire new skills and habits—‘way more than I initially thought! But now I think differently—hills are challenges rather than enemies. I look forward to what I will be able to do next, including uphill sprint intervals at 9000 feet—maybe next time—this time I did them at 5700 feet.

Melissa helps me stay on course in training with knowledge, application, openness and compassion. I can do the same for my patients and their health. When I withhold judgment about patients’ physical and motivational limitations, I make it safe for them to bring their fears and aspirations to every visit. I can meet them where they are each time, and hold space for the inevitable roadblocks: medication side effects, obstacles to behavior change, complications of treatment. We can then find a way through together, because we both know we’re in it for the long haul. Physicians and trainers may have more in common than we think.

14 thoughts on “Physician as Trainer

      • Thank you and same to you & your family! We were on a little getaway in Northern Michigan and I had typed a long response, only to have the hotel wi-fi signal drop at the critical point of trying to post the comment, losing everything I had typed! 😦

        I especially loved this: “She also does not judge herself. That I have pain is not necessarily her fault.” I never really thought about that side of the equation, that the advisor/teacher/parent also needs to cut themselves some slack.

        As a final sidenote, kudos to you on achieving your fitness goals. I have new inspiration now to work on my own (very modest) goals! 🙂

        Like

      • Hi Nancy!
        Hope you had a great vacation!
        Thank you for writing the long comment, I appreciate the spirit. 😊 I wonder what you think of this idea: that physicians’ best advocates are patients. It seems counterintuitive, no? But I feel strongly that if patients knew better the burdens of the system on physicians, and understood fully how that in turn harms patients, then we could all share the same voice to change the system. Does that make sense at all? I’m thinking I need to explore this in a post soon…

        Like

      • That would open the conversation up in an entirely new way, wouldn’t it? But what a challenge too…in the popular mindset, physicians don’t exactly come across as disadvantaged, with their Beemers, Wednesdays off, and calling card “MD” prestige. Yet stereotypes, even over-glorified ones, are limiting and detrimental, esp if, as you suggest, the effects are felt rippling throughout the system and negatively impacting patient care.Yes, definitely sounds like an idea worth exploring! How exciting!

        Like

  1. This sounds pretty much like what I experienced when I began sailing. My instructor agreed to teach me, but set this as the bottom line: I would show up every Monday. We would go out, regardless of conditions, and spend the entire day on the water. The only time we wouldn’t sail would be in blanketing fog. Consistency and working with someone who knows what they’re doing is critical — and I learned.

    Liked by 1 person

  2. Wow! You’re ability to write, be vulnerable and take responsibility for your actions is wonderful to witness. You’re an incredible role model for me. Thank you for this beautiful gift. I will read this again and again as I did today. I value our relationship and am priveleged to be part of your journey as you are a very important part of mine. My wish for you is that your patients allow you the luxury to help them discover their incredible possibilities, as you have given this to me.

    Like

  3. Great connection, Catherine! I think this is the perfect analogy to what you’ve been saying about how great medicine has to involve relationship. The best treatment my mom has ever received has naturally flowed from her doctor holding the space for her to bring her concerns, without blaming or getting defensive. It can be so hard to forge that kind of connection, but when it happens it seems nothing is impossible. Thanks so much for sharing! Keep being awesome. 🙂

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s