I ask myself every time I leave Centennial, on my way to Silverthorne. If I have time and nobody in the car who will complain, I always choose 285. It takes at least 45 minutes longer, and it’s a much prettier drive. Thanks to dear friend Rachel who took me this way the first time in 2012, I have now stopped at state parks I never knew existed and passed through beautiful valleys and plains that take my breath away. Less traffic also makes for a more relaxing, even contemplative ride, which I appreciate more and more. Fun turns that open up around the bend to expansive landscapes never get old, and depending on time of year or day, and of course weather, I never know what I’m going to get. Every time, I am richly rewarded with yet a new perspective on the path, the journey–this iteration of the way. I get to explore and learn, to savor and revel. I learn what exits lead to which trails, where to get gas, and where to stop for the best views.
I have the sweetest gig any primary care doctor could hope for. With 5% of a typical full time patient panel, I have the greatest luxury in all of medicine: time.
When someone presents with classic signs and symptoms of a well-described and well-understood condition, it’s okay to take the highway of standard testing and conventional treatment. When the story and picture are less clear and straight, we need to slow down, look around, listen harder, wander the side roads. What’s rustling in the bushes? What path was taken to get here, and what roadblock(s) encountered along the way? What equipment do we anticipate needing as we proceed, and will we know how to use it?
Sometimes even the clear and straight path turns icy, muddy, or otherwise unexpectedly obstructed. This is when knowledge of alternate routes really pays off; even better if those routes are familiar. So often I take extra time talking to patients, even when I think I know what’s happening. I ask more questions to flesh out the story fully, to learn more. Have you had this before? What’s same/different about it this time? What was the context? What made you call me about it? How much is this bothering you? What are you worried about? What’s going on in your life now that may have triggered this? What else is happening? What do you think is going on, what story are you telling? Anything else?
I never know what I’ll learn in these meandering exchanges; most of the time I just get to know my patient a little better. That’s worth so much in itself. And eventually, I have learned, all of this accumulated familiarity matters. My ‘impression and plan’ for any given problem can evolve quickly over a history and physical exam, sometimes taking sharp turns. And it’s the best feeling when my patient and I can look at each other and say, “Wait, remember when…?” and it sheds light from the past on what’s happening today.
Today’s objective may be relief of pain and discomfort. Depending on the severity and urgency of the problem, we may race to that end speeding on the freeway. Our journey together as physician and patient, however, is more like a long and winding road trip. We have much to explore, if we travel together long enough. When you’re not in pain and have some time, we can take the scenic route together, get to know each other better. All of the photos, wildflowers, stories, and memories we collect along the way just make the trip, and our connection, that much more beautiful.
Another day of threaded media to reinforce my personal biases. Thought I’d share since it feels so cosmic. 😉
Often I find myself with an acute urge to connect with one or a few of my friends. I have long since learned to act joyfully on these urges; in college I wrote letters on pretty stationery and mailed them with confetti (100 in my first year alone). As life got busier that evolved to cards and postcards. And now it’s often an email or text, these days with attached memes or songs, and most recently the 8 minute phone call… I still indulge in the luxury of snail mail often, though.
Today I looked for something touching to share. Scrolling through photos, cartoons, and memes on the phone and laptop, nothing felt quite right. Then this appeared on my Facebook feed:
So unassuming yet poignant, down to earth and still profound. Perfect. I sent via email and also saved the image for myself, before sharing on my own FB page. The more I read it the more it resonated. “Mostly, we don’t want to harm each other… We want…For the waitress to call us honey… We have so little of each other, now…” So I shared with a few more friends–ones who I know practice making the “fleeting temples” (whom I admire and wish to emulate) and ones for whom I wish to meet and feel deeply the “true dwelling of the holy.”
One of my friends then shared the image on her own page, and one of her friends commented on the significance of “So far from tribe and fire,” before referencing a recent gathering of exactly ‘tribe and fire.’ YES. Tribe members take turns tending the fire that keeps us warm, leads us home, holds us together, connects us. So I had this lovely and loving idea swirling around my consciousness all day.
Sarai left her eloquent comment on my last post, reinforcing that anchoring–tribe-and-firing–is a reciprocal activity, between ourselves and those we know, both intimately and apparently not at all, though in reality I am convinced that we all know one another on a cosmic level. “I like your hat.” I must call her soon and relight our shared fire. It’s been a long time, and I’m confident that the embers still glow.
Then I came across Daniel Pink’s post on the book The Good Life, which is now on my 2023 wish list. “Friends are medicine.”
Again, YES! I feel validated asking every patient, every year, about the strength and depth of their emotional support network. It’s not my job to help them cultivate it, the way I advise on ways to lower blood pressure and cholesterol. But I point it out so it’s on our radar, to reinforce the paramount importance of this aspect of whole person health.
A fellow physician mom posted on the FB book club group page about Chasing the Scream by Johann Hari. The Amazon page references his viral TED talk years ago on how wrong we are about addiction, which rang a bell, so I watched it again. It’s only 14:33, well worth your time and attention. We think substances themselves are the problem. Turns out, it’s context. Loneliness and disconnection are far stronger drivers of addiction–to substances and other things–than the things themselves. Hear about ‘rat park’ at 3:30 where rats with toys and friends do not prefer drug-laced water when given a choice, compared to their stimulus- and companion-deprived research counterparts. Continue watching to learn about the unintended human drug addiction study that was the Vietnam War, where only 5% of the soldiers who used heroine in company relapsed upon returning home. His lovely conclusion: “For 100 years now, we’ve been singing war songs about addicts. I think all along we should have been singing love songs to them, because the opposite of addiction is not sobriety. The opposite of addiction is connection.“
Recently I started asking patients to categorize their alcohol use patterns among three overlapping motivations: social, self-medication, and habit. That middle one is a flag, though it’s often camouflaged by the other two. Identifying, accepting, and addressing our demons may be one of the scariest things we do in life. No wonder we avoid it so desperately–even more so when we feel we must do it alone.
Our relationships kill us or save us, I often say. More and more I think it’s not actually the toxic relationships that kill us, not if we have other strong, loving, thick relationships, communities, connections, and meaning to hold us up. No, it’s the lack of relationships, that absence of connection, that kills us. It doesn’t have to be many friends or connections, it just has to be enough–close enough, deep enough, tight enough.
Who’s on your mind today? Why not reach out and let them know?
From the top of Schoolmarm, Keystone, Colorado, December 2018
Friends!! Happy Happy Old Year!
So many excellent essays and posts everywhere for the New Year, are you soaking them in? Do they lift you up? What stands out for you from 2022?
I have to say, I’m ready for things to be easier and lighter. These last two years were pretty damn shitty for a slew of reasons… and I don’t necessarily wish for anything different. What doesn’t kill us often does make us stronger, and not always. Some of it just maims and scars, and we could be just as strong and well without it. Whatever, it all just is.
Love and gratitude stand out for me… Also commitment, resilience, and of course connection. Connection, actually, is both the beginning and end of getting through hard times, no? The trust, love, strength, respect, and attention we share hold us all up, bond us closer through crucibles of crisis, and magnify themselves, don’t you think?
Three posts resonate in particular with me this week, which I share below. May they lift or ground you, whichever you need. May you notice and receive whatever else you need as well, to start 2023 in peace and confidence, and to sustain that sense of “I’ Got This,” no matter what comes. Oh and as usual, I’ve included my list of books and notable media at the end. Books in [brackets] are yet to be finished; entries in bold are my favorites. My home Word file denotes romance novels in blue, but I think you can figure it out based just on the titles. There is a theme emerging among the romances I love; maybe more on that later. 😉 I created ‘Inspo’ on Spotify soon after writing the Playlist post last month, along with separate ones for writing and workouts. That subscription is well worth the cost!
ONWARD, my friends. All we have is this one life, with one another. Let us make the most of it all, ya?
Let It Be So
Donna Ashworth wrote the poem “When I Go,” which inspired my post of the same title. In her message for 2023, she reminds us to treat ourselves with a little more acceptance, compassion, and generosity. I wholeheartedly concur–if we can do this better for ourselves, then we are much more likely and able to do it for one another:
“Why do we start a new year, with promises to improve?
“Who began this tradition of never-ending pressure?
“I say, the end of a year, should be filled with congratulation, for all we survived.
“And I say a new year should start with promises to be kinder to ourselves, to understand better just how much we bear, as humans on this exhausting treadmill of life…”
Holding ourselves in acceptance and compassion can manifest in specific practices; we can frame them as resolutions, intentions, hopes, or whatever. For me right now, it all still comes back to self-awareness, self-regulation, and community building… Mindful, peaceful intention in action and interaction, or something like that.
I only recently found Rachel Marie Martin, and her work resonates so far, especially her 23 ‘rules.’ I choose to hold them loosely, some more than others, and I look forward to seeing which ones recur in my psyche over the months to come. If the excerpt here speaks to you, check out the entire list on her Facebook page.
1. Stare fear in the face. So often fear stops us. Instead live fearless – knowing when to stop and when to move and when to be brave.
2. Invest in your friends. Good friends listen and show up. Do the same. Friendship is give and take and give and take. Friends are the ultimate gift.
3. No excuses. You must take care of yourself: heart, body and soul. There is no excuse for forgetting you. Your family needs you to love you with the same tenacity that you love them.
4. Guilt doesn’t need to dictate choices. Don’t let guilt stop you from taking care of yourself. Guilt keeps one stuck.
5. Read real books again. Watch a mini-series. Start jogging. Do something that is not work, not chores, but simply that makes you happy.
6. Love your body. Your aging body. Yes, that. And stop lamenting the wrinkles, but embrace them as another year lived.
How many times do ‘relationship’ and ‘connection’ occur on this blog, I wonder? More times than most other nouns/ideas, I bet. They are my Why. And yet, they are inadequate words to truly express the depth to which I mean them. So I was especially grateful years ago to find John O’Donohue’s explanation of anam cara, ‘soul friend’ in Celtic. That direct translation hardly captures the meaning, either, and his book of this title is a bit dense and esoteric. So I thank Maria Popova for her long form delve, “Anam Cara and the Essence of True Friendship”. Her essays read slowly in the best way–leisurely yet intense intellectual consideration, like sipping the smoothest bittersweet Belgian hot chocolate. I picture the cafe where my best friend from college (an anam cara, for sure) and I always sat, with all the time in the world, enjoying each other’s company and whatever random wonders occurred to us. Read her post in a warm, comfy chair, including the most eloquent quotes from O’Donohue’s writing:
“With the anam cara you could share your inner-most self, your mind and your heart. This friendship was an act of recognition and belonging. When you had an anam cara, your friendship cut across all convention, morality, and category. You were joined in an ancient and eternal way with the ‘friend of your soul.’ The Celtic understanding did not set limitations of space or time on the soul. There is no cage for the soul. The soul is a divine light that flows into you and into your Other. This art of belonging awakened and fostered a deep and special companionship.
“A friend is a loved one who awakens your life in order to free the wild possibilities within you… The one you love, your anam cara, your soul friend, is the truest mirror to reflect your soul. The honesty and clarity of true friendship also brings out the real contour of your spirit.”
And she puts his words in 21st Century context with crystal clarity of their profound, countercultural importance:
“…being an anam cara requires of a purposeful presence — it asks that we show up with absolute integrity of intention. That interior intentionality, O’Donohue suggests, is what sets the true anam cara apart from the acquaintance or the casual friend — a distinction all the more important today, in a culture where we throw the word “friend” around all too hastily, designating little more than perfunctory affiliation. But this faculty of showing up must be an active presence rather than a mere abstraction — the person who declares herself a friend but shirks when the other’s soul most needs seeing is not an anam cara.”
It’s all so much, isn’t it? So much stimulation, emotion, tragedy, possibility, uncertainty, profundity, incredulity, and so much more. *deep breath*
Maybe one of the more important life lessons, that can only come with living it longer, is to hold it all with stronger yet looser conviction. To realize my own mission and have it validated gives me confidence. It also frees me to let go those who can’t see, don’t come along, or even reject it. We all walk our own paths; you don’t have to come on my journey. If our paths cross in a ditch or other obstruction, or your trail looks more interesting or efficient than the one I’m on, I can change directions and choose a new route for a while. There are infinite ways to get to where I’m going. I can just really enjoy and revel in the view as I walk.
To the New Year. Another cycle begins. Bring it.
Books
Pathways to Possibility by Rozamund Stone Zander
Liminal Thinking by Dave Gray
52 Pep Talks for Writers by Grant Faulkner
Useful Delusions by Shankar Vedantham and Bill Mesler
A Little Hope by Ethan Joella
The Wisdom of Your Body by Hillary McBride
Be Water, My Friend by Shannon Lee
Summary of Why We Sleep by Matthew Walker, by Readtrepreneur Publishing on Hoopla Digital
Curious by Ian Leslie
The Icepick Surgeon by Sam Kean
The Other Dr. Gilmer by Benjamin Gilmer
The Upside of Irrationality by Dan Ariely
[The Mindful Therapist by Daniel Seigel]
Plays Well With Others by Eric Barker
[Atlas of the Heartby Brené Brown]
High Conflict by Amanda Ripley
The Lightmakers’ Manifesto by Karen Walrond
Power Moves by Adam Grant
Mentors by Russell Brand
I Am Spock by Leonard Nimoy
I Must Say by Martin Short
Sparks Like Stars by Nadia Hashimi
Be Quiet, Be Heard by Susan Glaser and Peter Glaser
The Midnight Library by Matt Haig
Buried Deep by Margot Hunt
Dirtbag Anthropology by Kate Willett
The All or Nothing Marriage by Eli Finkel
[The Year of Magical Thinking by Joan Didion]
Welcome to Your Teenager’s Brain by Abigail Baird
The Way Out by Peter Coleman
Remarkably Bright Creatures by Shelby Van Pelt
A Republic, If You Can Keep It by Neil Gorsuch
The Egg and Other Stories by Andy Weir
The Fix Up by Kendall Ryan
Playing For Keeps by Kendall Ryan
Part-time Lover by Lauren Blakely
The Ruthless Gentleman by Louise Bay
Delayed Gratification by Lauren Blakely
Instant Gratification by Lauren Blakely
Kismet by Lauren Blakely
The Dream Guy Next Door by Lauren Blakely
Never Have I Ever by Lauren Blakely
Private Player by Louise Bay
Not Until You by Corinne Michaels
If I Only Knew by Corrine Michaels
Satisfaction Guaranteed by Lauren Blakely
Consumed By You by Lauren Blakely
One of Those Flings by Lauren Blakely
Your French Kisses by Lauren Blakely
P.S. It’s Always Been You, Parts 1, 2, & 3 by Lauren Blakely
Special Delivery by Lauren Blakely
Lucky Suit by Lauren Blakely
Cocktail by Lauren Smith
Bossy Brit by Kendall Ryan
One Hot Scandal by Anna Durand
Melt For Him by Lauren Blakely
Portrait of a Thief by Grace D Li
Lethal in a Kilt by Anna Durand
The British Bastard by Anna Durand
Irresistible In a Kilt by Anna Durand
The Pretending Plot by Lauren Blakely
One Hot Christmas by Anna Durand
One Hot Crush by Anna Durand
One Hot Chance by Anna Durand
One Hot Roomie by Anna Durand
Heired Lines by Magan Vernon
The Bromantic Comedies by Erin Mallon
Royally Endowed by Emma Chase
Brit vs. Scot by Anna Durand
One Hot Escape by Anna Durand
The Duke’s Twin by Lauren Smith
Forever Be Mine by Lauren Smith
Royally Screwed by Emma Chase
Royally Matched by Emma Chase
Rory In a Kilt by Anna Durand
One Hot Rumor by Anna Durand
Sweet Liar by Laurelin Paige
Sweet Fate by Laurelin Paige
Incendiary in a Kilt by Anna Durand
He Loves Me, He Loves Me Not by Iris Morland
My Rebound by Carrie Ann Ryan
Devastating in a Kilt by Anna Durand
Two Pretty Lies by Kelleigh Clare
Rivalry by Laurelin Paige
Ruin by Laurelin Paige
Revenge by Laurelin Paige
[Tomorrow, and Tomorrow, and Tomorrow by Gabriel Zevin]
Healing Through Connection 