Category Archives: gratitude

On Community

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NaBloPoMo 2016, Letters to Patients, Day 10

To Patients Who Feel Alone Sometimes:

Who holds you up?

Day 2 post-election, it is still positively surreal.  Monday night I saw Facebook friends post passionate, emotional, sometimes desperate pleas, urging their friends to vote one way or another.  I also saw friends acknowledging the long, strange trip, looking forward to the next chapter, expressing both relief and trepidation.  A cloud of separation hung over my heart as I read some of my friends’ words then. 

Something inside urged me to contact a high school classmate.  We did not know each other well back then, and we didn’t always like each other.  But I always felt a mutual respect.  She does not post about politics; I do…a lot.  I know we differ in many of our positions and views.  I also know her to be thoughtful, kind, ethical, and just.  I know she has a lot going on in her life right now.  Our Facebook friendship has grown the past few years, and more and more I feel a cosmic connection.  I am meant to know this person again and better, in this later phase of life.  So I messaged her privately, just to tell her I was thinking of her.  I sent hope, and wishes that we could sit down over tea, somewhere cozy, and share our lives—slowly, thoughtfully, kindly, lovingly.  Turns out my little message helped hold her up yesterday.  On this day of anxiety and tension, hope and uncertainty, this long-distance connection gives me strength and peace.  It reminds me of a recent article by the Dalai Lama on our need to be needed.

I’ve said and written so often that I’m so grateful for my tribe(s), the communities that surround and support me in everything I do.  When I see patients, I make it a point to ask about emotional support networks. They don’t have to be vast or deep.  They just need to be strong and reliable.  No matter what our station, our illness, our cultural origin, or our political leaning, we live longer, healthier, happier, and easier when we connect with others.  It can be many, often, and deep.  It can be few and intermittent.  It just has to be meaningful and enough.

Lastly, supportive relationships function best when they are also reciprocal.  I don’t mean quid pro quo.  I mean mutual, shared, communal, uncalculated support.  I ask patients, “Do you have enough people you know you can turn to, people who will be there for you, in times of personal crisis?”  I want so much for you to answer without hesitation, “Yes, definitely, no question.”  Then I can relax about your health.  You (all) got this.

On Finding Meaning

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NaBloPoMo 2016, Letters to Patients, Day 8

To Patients Seeking Meaning:

Try the Three Question Journal.

One of my favorite parts of a new patient encounter is when we talk about your work.  Not only hearing about what you do (as I wrote on Day 3), but what it means to you.  I ask you to rate your overall work stress on a scale of zero to ten.  Then I ask you to rate the overall meaning of your work (to you, not to others), on the same scale.  I’m looking for meaning to rate higher than stress, and above 6 in general.  This ratio, I have observed, represents a sustainable and fulfilling work life.  When I hear you articulate your passions and intentions at work, it inspires me, too.

Some of you realize suddenly that the meaning you once felt has faded, and you get pensive.  Or you tersely state that your work holds no meaning whatsoever, other than as a source of income.  This is where I usually pause for a few seconds to feel out where the conversation will go.  Should I screen you for depression?  Should we explore or move on?  My meaning comes from these inflection points.

Given that we spend most of our waking hours, most days of the week, at our jobs, I assert that it’s worth trying to maximize our sense of meaning.  Why not be happy and fulfilled at work, if you can?  I also assert that this is something we can and should choose, for our health and that of those around us.

My friend Liz recently re-introduced me to an exercise that may help.  It’s from Rachel Remen, physician and author of two deeply moving books, Kitchen Table Wisdom and My Grandfather’s Blessings.  It’s called the Three Question Journal.  You can find background and detailed instructions on her website here.  Basically it’s a daily practice of finding three things in your encounters:

  1. Something that surprised you
  2. Something that touched your heart
  3. Something that inspired you

Many of you may think this is a waste of time, frivolous, meaningless.  You have more important and pressing things to do.  I admit, I am not a consistent practitioner.  I feel anxious: What if I can’t find anything?  That must mean I’m mindless, cold, and utterly un-inspire-able.  Remen says this is okay— “DO NOT BECOME DISCOURAGED!!   Many people find that for a little while the answers to all three questions are exactly the same:  NOTHING, NOTHING and NOTHING.”

Wouldn’t it be so much better to be able to answer with, “This, THIS, and oh my God, THIS!!”  Every day?

We have 22 more days of November.  If you comment that you will challenge yourself to this practice every day for the rest of the month, so will I.  And we can compare notes along the way.  Whattaya say?

 

On Training

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NaBloPoMo 2016, Letters to Patients, Day 1

To The Patients Who Trained Me:

Thank you, from the bottom of my heart, and God bless you, every one.

To the elderly lady with heart failure, who donated your body to science so that I may learn anatomy:  You were the greatest gift.  Your heart was literally as big as your head, and at the time I just thought it was peculiar.  Now I understand the extraordinary adaptive capability of the human body, and I marvel at it every day.

To the inpatients who endured hours of repetitive interviewing and clumsy physical exams by us medical students, all in the name of teaching:  Your engagement in the midst of your own suffering testifies to the infinite potential generosity of humanity.  Your contribution to medical education cannot be overestimated.

To the kindhearted artist in my resident clinic, the first patient to page me for advice:  You showed me that I knew what I was doing, even in training.  You had classic of sinusitis, and I called in the appropriate prescription.  In a moment of sudden panic I wondered if I should have called my preceptor first.  No, I can do this, I realized.  I’m meant to do this.

To the articulate, confident housewife whose retired husband drove you to me in acute agitation:  I learned from you that life phases never cease to evolve.  Our relationships, however longstanding, hold infinite complexities that manifest in jarring and also predictable ways throughout life.  You taught me that stability is overrated, and also underappreciated.

To the wonderfully kind man, one of my first patients in practice, who came in with the nasal balloon:  Your patience and trust will humble me forever.  The emergency room doctor had placed the balloon for a prolonged nosebleed.  He instructed you have me take it out.  I had never seen such a device before, much less deflated and removed one.  You let me examine it, think it through, and finally just cut the tubing with scissors.  We bonded over that and you continued to teach me about collaboration and sharing between patient and physician all the while I knew you.

To all whom I encountered in those early years:  There are too many of you to name, too many to acknowledge fully.  But every one of you helped make me the physician I am today.  With each new meeting now, each applied principle and physical exam technique, I thank you and honor you, my esteemed teachers.