Ode to My Dawn Simulator

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NaBloPoMo 2017: Field Notes from a Life in Medicine

Did you notice the photo on my post Gratitude Again?  That was the view out my office window around 5:30pm last week.  These days I appreciate the winter dusk a lot more than years past, mostly because the physically hardest years of training and my kids’ lives (for me) are over.  My intern year I rotated in the medical intensive care unit (MICU, or MICK-you, or just ‘the unit’ for short) in November.  Usual days started by 6am, and finished whenever my patients were stable enough for me to leave, usually past 7pm.  I really never saw the sun that whole month—not from outside, anyway.  Every third night on call, my resident and I covered the whole place.  The longest I ever spent in the hospital was 5am until 10pm the following night—41 hours straight, only to be back again the next morning at 6.  And that was nothing compared to the generation of doctors who trained before me.  Thinking back on it now, I can still feel the saturating fatigue, the utter hopelessness of ever seeing the call room, let alone lying down on a bed.  Thank GOD those days are over.  They weren’t all bad, though.  Residency was one of the hardest things I’ve done, and it was also intensely rewarding.  The friendships I made those years, the unique shared experiences—I carry these with me also.  They made me strong and gave me confidence.

But if I thought getting up in the dark during intern year was hard, somehow doing it as an attending with two little kids was even harder—go figure.  The sleep deprivation of working motherhood is a completely different animal from that of residency, its toll multiplied on family.  The blaring alarm clock, the utter blackness of the bedroom, the contrast of cozy warmth under the blankets with the cold still air above.  They all conspired to make me peevish, sullen, and supremely unpleasant to be around every morning—an additional cost to my soul every time I lashed out at the kiddos out of my own exhaustion.  To borrow a phrase from Vee over at Cute Kids, I might well have died of a bad mood or something worse if that situation continued.

So Husband staged an intervention: He bought me a dawn simulator for Christmas.  It’s an ingeniously simple device: An alarm clock with a built-in light dimmer that comes with its own full-spectrum light bulb.  All you have to do is connect it to a bedside lamp.  Then you set sunrise time, as well as duration of rise (I set mine to 6:45, 15 minutes).  Every morning for the past 7 years I wake up naturally from a steadily brightening, gentle and warm glow from one corner of the room.  It’s infinitely more pleasing; no blaring involved.  Of course now I have my iPhone ‘by the seaside’ alarm as back up, especially for this month as I stay up too late writing blog posts.  And I’m not a morning person in general, so no Mary Poppins songs bursting forth with domesticated mechanical birds on my windowsill.  But life is infinitely more tolerable between Halloween and Easter each year now—for all of us.

Thanks, Husband.  Ya done good.

Gratitude Again

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NaBloPoMo 2017: Field Notes from a Life in Medicine

I generally dislike cold, damp, cloudy weather.  I have survived this in Chicago the past 26 years, somehow, by grace.  Usually the second half of fall just feels dreary, wet, and lame to me.  And yet this season, on this drab day, I feel warm and happy inside more than last year.

Can’t say why, really.  Another year older and wiser, perhaps?  Maybe because the kids seem to have crossed some magical threshold on this side of which they seem suddenly much more mature and self-sufficient?  I’m entering my fourth year in my current practice, which is the magic number for really settling in, it seems.  With the patients I only see once a year, the third and fourth times bring a familiarity and rapport that can only come with time.  It’s like catching up with old friends.  I’m grateful for another year of watching my family grow and flourish.  I’m grateful for my work, and the immense personal and professional fulfillment it affords me.

Two years ago for my first NaBloPoMo, I wrote November Gratitude Shorts.  It was a spinoff from a Facebook trend in which my friends and I posted gratitude for something every day.  Writing a couple sentences a day was fun and easy; converting those ideas to full-fledged blog posts proved more daunting than I had anticipated.  It felt like a slog much of the time, though I did write some pieces that I’m still proud of.  Last year I felt more relaxed, less pressured to write profound things.  This year I’m actually having fun, though I can still only rarely make myself sit down to write before 10pm.  That will be the challenge next year.  I am grateful for the chance to practice my writing and share with a community of readers, writers, and friends.

I feel the holidays coming on, a little more acutely this year than last…  It’s been a tumultuous year, no doubt, in so many realms.  And yet we are all still here, relationships intact for the most part.  And many of us, happily or begrudgingly, have learned a little more about our biases, our emotional triggers, our friends’ and families’ hidden beliefs, and similarities and differences we did not know we had before.  The conversations continue, then maybe stop for a while.  Emotions heat up, cool down, heat up again—and hopefully the connections remain or even grow stronger.  I have hope that we can continue to do better, and I’m grateful that the trials of the past year have shown me what courage and resilience we have.  I am grateful for the holiday season every year, and the chance to reflect and advance.

A friend told me recently about marriage advice he received when he was young.  We get beyond infatuation and on to real love, he was told, through commitment.  This past year I have seen myriad examples of people making meaningful commitments—to their families, to their core values, to their ideals, their aspirations, their fellow humans.  The examples are everywhere, if we are open to seeing them.  I am grateful for the persistence of humanity, and for our innate drive to connect.

The holiday season is upon us, and truly, I wish us all peace, love, and joy.  I’m grateful to have so much to celebrate, so many to celebrate with, and so much to look forward to.  May you feel and be moved by all that holds you up, this season and for all seasons to come.

Mobility is Confidence

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It is Day 11 of NaBloPoMo 2017: Field Notes from a Life in Medicine, Day 10 of Bum Knee Cathy.

So far, so good!  This third time through NBPM is definitely easier and less stressful than before.  It’s not my best writing, but it’s not bad.  I’m spending less time thinking and writing, and having ‘way more fun.  Can’t say that much for BKC, though.  I’ve never had an injury like this and I’m not quite sure what to expect.  The good news is, swelling is decreasing and I limp a little less every day.

I had not gone 7 days without exercise in almost three years, and it was starting to feel a little too comfortable.  It also did not help that we had a bag of Kit Kats left over from Halloween—bad planning.  So on day 8 I decided to see what I could do in the gym.  Turns out, I still need to avoid activities that require me to plant my feet or fully extend the knees.  But there is still a lot I can do, and today I found a full suite of moves, some modified, that were enough to break a sweat, woo hooooo!!  Even though I wrote that I was good about losing my training discipline, I was still worried.

Today, however, I have my confidence back.  Earlier this week I reconciled with the possibility of not playing volleyball anymore, but I have not given up on my intention to get back on the court.  And if that’s not possible, then I can try the other things on my list: martial arts, kickboxing, tennis, and who knows what else?  Still so many possibilities!

The day before I hurt myself I passed a lady on the way to work.  She was older, obese, walking with a limp and a cane.  I came up behind her, slowed down, and passed her when space opened up on the sidewalk.  I suddenly appreciated my unencumbered gait.  How ironic.  My parents are almost 70 years old and they just returned from a month-long tour of China and Taiwan.  He golfs and she still precepts nursing students in the hospital.  Neither of them has ever had a prolonged period of immobility, even after major surgery.  They still move through life confident in what their bodies can do, looking forward to their next trip.  I know many orthopaedic surgeons.  With them I have shared patients who got their lives back after joint replacement surgery—able to walk, golf, and even ski again—without pain, and with confidence.

Tonight I appreciate that much more what my parents have achieved and what my colleagues do.  I appreciate my body that much more, and what is required to maintain it.  I appreciate the importance of conversations with my own patients, when we talk about establishing habits in middle age that will allow us all to be strong and healthy in old age.

How much do we take our mobility for granted?  For myself, not as much today as I did 12 days ago.

Conscience and Ego?

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NaBloPoMo 2017: Field Notes from a Life in Medicine

I’m so grateful for my many friends who make a daily practice of examining and reflecting on feelings, behavior, and meaning.  We see each other often and trade stories of enlightening, demoralizing, enraging, moving, curious, inspiring, dismaying, confusing, validating, and human experiences.  Tonight one of them texted me about a conversation with a fellow cosmic journeyer: “Wise Friend told me that when he’s really wrong is when he’s the most defensive and I thought about it and it’s true for me, too.”

It didn’t take me long to relate viscerally to this message.  I tried reading The Dark Side of the Light Chasers by Debbie Ford some years ago.  It’s all about facing our specific areas of self-loathing and overcoming them with I don’t know what.  Because while I usually take pride in my ability to explore my insides and be with the ugly, I could not make it through that book.  When I got to the comprehensive self-loathing-identification exercise, I had to stop, and my subconscious gnarled such that I picked a fight with the husband that lasted two weeks.  I like to think that I have evolved since then, that my inner life is slightly less gnarly these days. I now choose to work through my self-loathing one small piece at a time, in small doses with my therapist, on and off.

I texted back tonight from my gut, “I think it’s true for all of us, most defensive when most wrong.  Our consciences know better than our egos.”  It was one of those unguarded moments that allows for a new (for me) expression for an old concept.  And now I have a new idea to consider: how do conscience and ego interact, and what are the products of their collaboration and/or competition?  More importantly, how does the interaction (entanglement?) show up in our relationships?  Marriage, parenting, friendship, physician-patient?  How can we manage these relationships optimally through exploring this mental/emotional interplay?  Maybe I’m overthinking…  If it’s mostly true that our consciences know better than our egos, then maybe I can just continue practicing awareness of Ego’s tendency to bully Conscience, and training Conscience to peacefully and firmly Resist.

 

 

To You Who Hold Me Up

 

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October 27, 2017

My Dear Friend,

Thank you so much for hosting me this week!  Your home is a simple and inspiring space—you have clearly arranged and furnished it according to your core values, and its energy is palpable.  OF COURSE you’d orient the sofa squarely facing the big window and rising sun!

I am so grateful to know you, to enjoy welcoming access to your perspective, your experience, your generosity of spirit, and your willingness to explore the unanswered, the uncertain, the mysterious, the daunting.  Because of friends like you, I am a better version of myself.  I hope I can return the favor in your life.

Until next time—love and hugs–

🙂 ❤ Cathy

***

I wrote this to a particular friend today.  Then came the joyous realization that I have many friends to whom I could write the same.  They live their integrity every day, out loud and in person, with clarity, consistency, and discipline.  How lucky am I to be surrounded by such uplifting forces of nature?  Our shared curiosity saves us from cynicism.  Collective love emboldens us to ask the scary questions and stand strong facing the unknown.

None of us can know what’s coming around the corner.  It’s okay to feel afraid sometimes.  Things might suck rocks for a while.  And in the end, because we know we have one another, we also know we’ll be okay.  We walk together, laugh together, wonder together, and learn together.  We are truly stronger and better together.

How can I help but feel hopeful?

Support for the Inner Work

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Things were a little crazy this week.  I have an idea for a post and still have not sat down to write it out.  But I want to share something that came out on my Facebook page (of course) tonight.  One of the reasons I love writing is that insights pop out when you least expect them.  Writing exchanged with others is even better, because those insights are then shared, and their meaning amplifies.

I posted this article from the Washington Post yesterday: “Nearly half of liberals don’t even like to be around Trump supporters.”  It’s a summary of a recent Pew Research Center survey, which finds that 47% of liberal Democrats “say that if a friend supported Trump, it would actually put a strain on their friendship.”  It posits, among other things, that liberals are less tolerant of dissenting ideas because they are clustered in urban areas, lending to louder echo chambers.  By contrast, only 13% of Republicans answered that “a friend’s support of Hillary Clinton would strain their friendship.”

From the survey report:…Nearly nine months after the election, most people (59%) say it is ‘stressful and frustrating’ to talk about politics with people who have a different opinion of Trump than they do; just 35% find such conversations ‘interesting and informative.'”

I consider myself a socially heavily left-leaning, fiscally centrist Independent, but I identify more with liberals than conservatives, by a large margin.  This article made me sad, that my ‘tribe’ shows itself to be much more intolerant and judgmental than I would like.

I posted this comment along with the article:

Ooohh, so much data here, so much potential for blame, and also for self-exploration. Humbling, no question.
“Be extra kind with your comments on this one please, friends. No need to reopen barely scabbed wounds. I mean for my page to be a safe place for all of us to engage. We are all in it together, and the sooner we *all* figure out how to deal with 45 and one another, the better we will all be.
“Also, I’m bummed that Asians are always left out of the data set.”

I got some comments from my liberal friends about how hard it is to talk to Trump supporters, so much so that they avoid talking politics with those friends altogether.  But one friend exemplified my aspiration for all of us.  She wrote:

“… I recently had dinner with a very close friend who voted for Trump. Typically I think I’m a really good listener, listening with curiosity and a desire to raise the conversation and all involved to a higher level. However, when our conversation turned to politics I found myself cutting her off, getting defensive and bordering on being critical of her. I was horrified by my own behavior. I think this article hits on it – the support or opposition of Trump feels like less of a political stance and more of a statement of a person’s values and morals. I don’t think that’s necessarily true- I think a large population of Trump voters (my friend included) were actually voting against Washington more than for Trump. While I can’t get behind Trump I can get behind a vote to change the system. I wonder what might happen if more of us looked for what we can stand behind together?! Thank you for continuing to be a voice for this movement!”

Exactly!  Immediately I felt connected to my friend in a higher calling, and a shared struggle.  I replied:

“(My dear friend), I derive so much of my strength and curiosity from you. How many of us can own up publicly about our own flaws and failures, like you did here? And I know you know I use the word failure in the most empathetic and loving, mutually understanding way. I think that is the first step–complete humility and openness to our own imperfection. It’s so fucking hard. And I’m so lucky to have friends like you, (these four other dear friends), and others… I know now, better late than never, that we cannot do this work without unwaveringly reliable support, no matter how motivated we are.  And for those of us who are already well-supported, I think it’s our responsibility to look outward and support others. You never know when or where someone may be standing on the edge of openness, and when your small gesture of encouragement may nudge them on. Thank you for your loving support, my soul sister!”

It really is true, we cannot dig deep and bring out our best selves by ourselves.  We are meant to hold one another up and accountable, to bring out the best in each other.  It breaks my heart when I interview patients, and learn how sparse and frail their emotional support networks are.  There is no stereotype for this scenario, it can happen to the best of us.  Past experiences, circumstances, timing, life events—they can all combine to undermine our relationships, thereby weakening our capacity for self-awareness and exploration.  So we fall back on default modes of defensiveness, righteousness, denial, and blame.  Whether it’s quitting smoking, sticking to a healthy eating plan, or elevating our political discourse, we are truly stronger together.

I share this tonight because I so admire my friend for owning her whole self.  I am so grateful to her for sharing her imperfections and vulnerability with humility and hopefulness.  She gives me strength to keep going, despite how fucking hard it is.  And I hope I can do the same for many, many others.