National Blog Posting Month (NaBloPoMo) was an annual November thing back in 2015, when I started this blog. Apparently the person who started it no longer claims it or formally facilitates, but many of us still practice. This year a small cadre of women physician writers may join me in the challenge, woohoo!
The theme for this, my 7th year, emerged over the summer. As some of you know, Son is a senior in high school, applying to college right now. On a walk through the neighborhood one sunny evening in August, I ran into parents of two different classmates, kids he’s known since preschool. We compared our respective parental experiences of contemporary college apps—fascinating! In both conversations, I asked my counterparts what they wished most for their kids to learn at college, and then in life. As usual, the question arose from outward curiosity, and before I could finish asking, I really wanted to answer for myself, too.
In short order, three primary ‘adulting skills’ came to mind:
Over subsequent weeks the list grew quickly, as I sought additions from other friends and family. I noticed it was mostly nouns, which started to feel listless and uninspiring. Simon Sinek points out, in Start With Why, that posting static concepts such as ‘Honesty’ as organizational values is too abstract and unmotivating; it doesn’t tell people what to do. He recommends converting such nominal platitudes to verb statements instead: Isn’t ‘Always Tell the Truth’ a much clearer and more activating expression? And bonus: it also makes us accountable.
So this November, I intend to post one ‘action mantra’ each day, that I hope for my children to practice, to live a good life. I have chosen the theme title: Do Good, Kid. I like that play on words, too. 😉
This year’s theme is, perhaps, more personally meaningful and coherent for me than previous ones. I imagine it as the lifelong learning To Do list that could persist as my kids’ ethical earworms when I’m not around to remind them. It’s also a record of my own personal aspirations. How can I ask them to do anything I’m not willing to model myself? I have 30 days, and well over 30 practices to choose from. This could be fun.
So let’s see how it goes, eh? Can’t wait can’t wait!
Do you not just love when insights occur in rapid and acute succession?
I had ‘Rubik’s cubed’ the last post for a few weeks before finally sitting down to write and publish it last Tuesday. The smoke signal idea came to me while typing—it felt almost tingly, like the most pleasant and rewarding epiphanal effervescence. And here just now I’m only describing that sensation for the first time. How fascinating. Little did I know last week that my own smoke signals have long smoldered in the distance. Since musing about the physical sensations of meaning, I’m suddenly noticing my own, left and right.
I’ve had two prolonged absences from in person clinical work these two years. The first was 2.5 months externally mandated by pandemic lockdown in 2020. The second, ending as of 10 days ago, was a 5 month personal leave. In each case I did my homework prior to returning, reviewing charts and schedules, contacting colleagues for sign out (the verbal transfer of care between clinicians who share patients). Both times I felt ambivalent, missing the nearly 24/7 control over my own schedule (or the illusion of it, anyway), and also anticipating the gratifying interactions of in person clinic.
In June last year, the joy of return enveloped me like the warm, welcoming hand of a soft spring breeze. I had completed the interview part of my first face to face visit since March. We got to the exam room and I did my usual head and neck assessment. I put my stethoscope earpieces in and placed the diaphragm against the patient’s chest. That first heartbeat may have been the most soothing sound I had heard in years. The soft, rhythmic, unobtrusive yet vital thudding of the heart of a live person—a person in my care—wow. I can’t remember if I actually got goosebumps then. But I get them now just thinking of that moment. I had not realized how much I missed hearing it, or how much it meant to me. I lingered an extra second or two just listening, feeling a deep joy and relaxation, a settling of my soul even, maybe. It was profound and totally unexpected.
This time it was a conversation. It’s such a privilege to know people in the intimate space of their health, to appreciate them as whole people, body, mind, and often spirit. In executive health we get the bonus of relating our patients’ whole person health to their roles and responsibilities as designated leaders at work. This intersects also with relationships in their families and personal tribes, just as it does for all of us. Toward the end of an interview last week, once again I felt overwhelmed by a deeply grounding, relaxed and yet energizing sensation. My patient and I were talking, engaging, exchanging ideas and observations, relating, as fellow humans. It felt paradoxically expansive and distilled at the same time, like I had dropped right into, and was operating directly from, my core, best self. I was right where I was supposed to be, doing and saying exactly what I was meant to do and say, right in that moment. I could only marvel inwardly and briefly in real time, as the encounter moved on. It was not until later in the day that I was able to name the emotion as sheer joy. I was lighter on my feet, uplifted in my chest, feeling positively buzzed.
Wow, it’s already the end of October. NaBloPoMo is almost upon us (well, upon me, I guess, as there is no longer an official November event–but this will be my 7th consecutive attempt), and I feel ready! The theme this year is personally meaningful to me (stay tuned for the reveal), and I look forward to the challenge. So good to be back, friends. Onward.
I recently had the privilege again to meet with a group of bright, hard-working medical students. Their college mentor, my friend and colleague, invited me to lead a discussion on meaning and stress. She saw them, only starting their second year, already losing sleep and well-being over choosing a subspecialty (they do not have to declare until 2 years from now). I recognize a similar anxious urgency in my own son, who applies to college this fall. My friend and I wish for all of these young people to suffer less and really enjoy the journey of learning and integration, so we sat them down for a chat. As usual, I learned at least as much from our conversation as the students did.
We discussed the Meaning to Stress Ratio, a framework I started using with patients years ago. In essence, I posit that if your experience of meaning/personal fulfillment at work outweighs your experience of stress, then it is likely a sustainable situation. We can afford to pay high amounts of stress if the work has enough intrinsic value to us. Many students seem hesitant to choose certain specialties for fear of stress (hours, responsibility, risk), among other things. Some are even prepared to forgo their true interests and passions, and commit to fields with better, lower stress ‘lifestyle’.
My friend and I, sitting in the circle of students like a couple of Cub Scout den mothers, tried our best to reassure and encourage her students that they, like we who went before them, would figure out their true places in good time. Our goal was to give them both moral support and some concrete tools to navigate the journey more lightly.
“What does meaning feel like in your body?” This question occurred to me while preparing for the session. I had never thought to ask it, to anyone, before now. For years I have asked patients where/how they feel stress in their bodies. The intent is to strengthen self-awareness and identify smoke alarms of sorts, so people can take steps to head off unhealthy consequences of excess stress and rebalance self-care practices. And though I ask patients about sources of meaning and personal fulfillment in work, I never wondered what meaning actually feels like, physically. How fascinating!
I thought to ask now because these students are still searching for meaning in their work (lives), while many of my patients have long since identified and pursued it. If body signs of stress are smoke alarms, perhaps body signs of meaning are smoke signals. They draw us in the direction of what needs us, and what we need. Students reported sensations like ‘energized,’ ‘light,’ and ‘revved,’ and feelings of satisfaction, contentment, peace, and inspiration. They described being in flow.
In the end, we agreed on three practices for my future colleagues to develop as they find their rightful place in our profession. I write this as a message to those students—Onward in solidarity:
Know your body signs. Check in with yourself physically on a regular basis. What body systems agitate and/or crash under stress? How does this manifest in your behaviors and performance? Your relationships? When do you notice the opposite happening, what does that feel like, and could this be a sign of meaning? Once you know your signs, what will you do when you notice them emerging? How can you set your personal marathon course with pee stops and goo stations where you need them? How do you feel at your highest and best, and what helps you get there? How can you get more of that?
Maintain strong boundaries and observe. There will never be a shortage of people, mostly older doctors, telling you why you should or should not choose this field or another. They will project their own biases, disappointments, pride, and traumas onto you, ostensibly to help you, but I suspect it’s a version of self-soothing for them. Do not let them enter your psyche; they may not have your best interests at heart. Rather, look around for the people who exude joy at work. Find the ones with whom everybody loves to work, the intense yet relaxed, the energized, light, satisfied, and peaceful ones. Interrogate them about what makes them click at work, and see if it resonates with you. Observe yourself in their presence—do you vibrate at the same frequency? What does that tell you?
Cultivate relationships with those who/m: 1) you admire, 2) seem to balance meaning and stress well (then probe their practices), 3) sincerely care about you and your well-being, 4) will give you honest and loving feedback/reflections/observations about you/r attitude and impact, and 5) will stick with you through the hard times and hold you up—and whom you would support in kind. These are the people who earnestly call you out and forth, who help your best self shine, sometimes through your own BS.
I’ll find a way to translate these principles for Son, as he writes his college essays. If only I could breathe peace and excitement into his lungs, and suck out the anxiety and pressure. For now I can at least be one of those loving mentors, standing by with Gatorade and cool towels when he swings by me this lap and the next, and the next.
Deep breaths, my friends. Find your pit crew and trust the process. You’ got this.