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.