#AtoZChallenge: More Fun, Less Frazzle

“Rule #6: Don’t take yourself so Goddamn seriously.” From The Art of Possibility, by Rosamund Stone Zander and Benjamin Zander.

This can be a hard lesson for physicians. We do such serious work, after all. There is always another patient to see, another result to review, another call to answer—now! But I have to pee, when can I pee?

In my first year of practice, I remember a particularly hard day. I was running late (I’m still always running late) and the patients that day were all complicated. No simple UTIs or colds to give me some air. I huffed and grunted my way through the visits, occasionally buzzing by Rose, my medical assistant, to answer messages in between. My bladder felt like it might actually explode, but I could not stop to go to the bathroom—there was no time! I was so afraid to fall even more behind, to fail in some way. Eventually, Rose posted a sign above my workstation: “TAKE A DEEP BREATH.” It was an instant reality check:  I couldn’t go on like this, I’d burn out before my career even started! Immediately I realized how unnecessary, and downright silly, was all the rushing and grimacing—and I laughed out loud. Since then I have never again reached that depth of anxiety and sullenness in a workday. I am forever grateful to Rose for her sign, her loving reminder to slow down and take perspective. God bless her.

If we’re not careful, we physicians could all easily drown in the drama and strain, over and again, every day. And is that really what our patients need from us—to be Frazzled balls of tension and urgency, bouncing haplessly from one task or person to another, barely holding it together (and in)? Is that what we want for our colleagues and staff, to have to put up with our irritable and pressing demands?

It doesn’t have to be that way. In my third year of medical school, on my inpatient internal medicine rotation, Chip Dye was my senior resident. The service was busy; we always had a full census of sick patients. But I never felt harried or anxious because Chip set the tone for the team. Always smiling, always willing to answer any question, and finding any opportunity to laugh, he made it safe to learn. He exuded confidence without arrogance, calm without sloth. After rounds he led the team to attend morning report (daily educational conference and community gathering).  He always made sure we ate.  And there was always time to pee.

It’s not that he underestimated or ignored the work that awaited us. He just knew that we would accomplish it all better in a lighter, happier state of mind. When it came time to buckle down and divide tasks, Chip prioritized them with realistic expectations and we all got to work. No muss, no fuss, no stress. It would all get done because we laid out our plans in advance.  We self-respectfully reserved time and space for meeting basic bodily and communal needs. Thanks to Chip for leading by example.

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From Facebook, I can’t remember where or when!

We can always have some Fun at work, no matter how hard the day gets. Whether it’s telling a silly joke, watching a ridiculous viral baby video, or posting a fun meme on the workroom bulletin board, lightening the mood helps everybody get through a little easier. Laughing relaxes us. Stephen Colbert is quoted as saying, “Do you know what I like about comedy? You can’t laugh and be afraid at the same time—of anything. If you’re laughing, I defy you to be afraid.” And if we can overcome our fears of not getting it all done, of not being enough, we will all be better off—physicians and patients alike.

potheads

Also from Facebook…

 

 

Setting Intentions For 2016

Happy New Year, Friends! Was 2015 not a wild ride?  However you experienced it, we can safely call the past year eventful, if nothing else.  The violence and the tenderness, the destruction and the connections—how can we hold it all at once?  I used to think myself an optimist, but now I often wonder if the world will actually end in my lifetime—whether we humans will obliterate one another in a rapid succession of escalating violence, or somehow see the light and work harder toward mutual understanding.  Nature will go on, though, with or without us.  I’m still an optimist, then—for the Earth, not necessarily for people…

This year I realized my body’s inevitable march toward menopause, a stark and sudden awareness. It came to me sometime in the spring, and I felt a keen jolt of motivation to prepare.   After 13 years of practice, I recognize two characteristics of women who suffer the least through this dramatic hormonal transition.

First, they accept it. They have made peace with this phase of life, letting go their reproductive years and embracing their elder position in our human tribal order.  They see menopause as a rite of experience and advancement, rather than a loss.  They move with confidence through this segment of life, and make the best of whatever happens.

Second, these women almost always have well-established habits of good health long before their hormone levels start dropping. Nutrition and physical activity come to mind first, but the practice of  ‘being at peace’ must also be included among the ‘habits.’  They have, whether innate or learned, effective mechanisms for overcoming adversity and maintaining balance—physical, mental, emotional, and relational—they are resilient.  I aspire to be like them.

So, until such time as humanity actually annihilates itself, I pledge to persist on the journey toward my best self. The more I read and share with contemplative friends, teachers, students, patients and others, the more I see how we make our lives out of small, daily choices.  As such, I propose below my intentions for the coming year.  I will fail, over and again, I know.  But as Ben Zander would say, these are not expectations to live up to.  They are possibilities to live into.

 

Choose to Train

I started working with Melissa, my trainer, in January of 2014. It was slow going that first year, with only a vague goal of exercising for its own sake, because I knew I ‘should.’  Now, my pursuit of fitness has much more meaning.  I have a finite amount of time to get in the best possible shape before ‘The Change.’  It’s an exhilarating challenge now.  How fit could this body get?  Every week since July, except for one, I have managed to exercise at least three times.  I set this goal on January 1, 2014, and it’s only since my Menopause Epiphany that I have truly owned it.  I think of myself as an athlete again, training for the ultimate marathon of living well in old age, by getting off my butt and moving, each and every day.

 

Choose to Fuel

*sigh*

I need to manage better what I put in my mouth. Eating is one of the hardest things for me to control.  I know exactly how much my patients struggle to include more vegetables, avoid sugar and starches, and eat less overall, because I fight the same battle every day.  After my daughter was born, at age 35, I successfully lost 25 pounds in nine months by simply cutting my portions in half, getting down to my wedding weight.  I had neither the time nor the interest to exercise, nor the energy to police my food choices.  Though I have kept the weight off for the most part, 7 years later I find myself wondering if I’m pre-diabetic.  I see every day how insidiously a persons’ glucose metabolism changes, and it’s ever clearer to me that ‘trying to eat healthy’ is not enough.  I need to set goals for eating, just like for exercise.  Is it food, or is it junk?  If it’s junk, is it at least junk that I really, really enjoy?  Will it be worth the cost to my body after eating it?  Does it align with my highest goals for health and a sustainable ecosystem?  Will it help me age well?  A body in training needs appropriate fuel.  The training piece feels established by now.  In 2016 I will strive to discern and allocate my energy resources better.

 

Choose Curiosity

It always amazes me, and scares me a little, how easily I slip into assumptions and negative storytelling about the people around me. I play old scripts in my head about other people’s intentions, based on my own fears and insecurities.  These thought patterns reinforce themselves over time, creating perceptive realities that are hard to distinguish from objective truths.  This phenomenon is well-described in psychology research, and contributes to misunderstanding at least, disconnection and isolation at worst.  My heroes Rosamund Stone Zander, Brené Brown, and Elizabeth Gilbert, all propose curiosity as the core antidote to assumptions, judgment, and alienation.  First, I can get curious about my emotions, whenever I feel triggered or agitated. What am I feeling? Where did it come from?  Then I can ask myself, “What story am I telling about this person, and what assumptions do I make about their thinking or perspective?”  If I can get this far, I’m already doing pretty well, and on a good day, I can take the next step, asking, “What other story can I tell, one that could cause me to suffer less?”  Last, I can always engage the other person from a place of vulnerability.  I can ask questions, confess my inner stories, and clarify what’s happening between us.  I’ve been practicing this for the past year, too, and it is hard.  But I’m getting better at it, and the results are well worth the effort.  Mutual understanding and deeper connections are only the beginning.  Curiosity may well be the best approach to world peace.

 

Choose My Family, My Tribe

We are each born into a family, for better or worse. And throughout a lifetime, we can also choose our connections, both inside and outside of our genetics.  I wrote recently about my friend Yakini.  My son had been to her daycare for months, and morning drop-offs were happy and smooth.  Then we went on vacation for a week, and when we came back, he was suddenly distraught every time I left him.  Immediately, Yakini knew what to do.  “We need to come to your home for a meal,” she said, as if it were the most obvious thing in the world.  “He needs to know that we are part of your family, that we will take care of him the same as you,” she continued.  Of course, it was a no-brainer.  We had to validate the sacred contract, as she called it.  Her whole family came over with their guitar.  We ate, we sang, we bonded.  After that the boy was happier than ever to see them every morning.  We had officially claimed Yakini’s family as our own.

My family of origin has its complexities. Culture, generation, and sibling rivalry have all contributed to my repeating scripts and stories.  I have learned with age that these patterns can and do change, and it serves all of us to hold space for the evolution.  I can practice curiosity, allow myself to be vulnerable, and choose deeper connections to the people I might otherwise take for granted or let drift away.  My siblings and I have also chosen our spouses.  We need also, then, to acknowledge each of their families of origin, their patterns, scripts, and stories.  I feel very lucky that my husband and my brothers-in-law all seem to accept our family’s quirks and dysfunctions—I can certainly learn from their example.

Lastly, in 2016, I intend to continue nurturing my ties to my tribe. These are the other family members I have chosen over the years, my friends.  They come from all stages and places of my life, and all offer unique perspective.  They accept my imbalances and love me anyway, and always challenge me to live in my integrity.  They hold me up on my quest for self-actualization.  They invite me to do the same for them, and together I honestly believe we make the world better.

2015 comes to a jumbled end for me, full of intensity, volume, texture, and possibility. I’m grateful for this blogging platform to explore and share ideas.  Thank you for reading to the end of this, I think my longest post yet.  I look forward to more growth and exploration in the coming year.  Nothing matters more than our relationships, first with ourselves and then with one another.  Let us cultivate connections that promote peace, love, and harmony, this year and beyond.

 

The Fabulous Fizzle of a NaMo

November Gratitude Shorts, Days 25-30

Hello Friends, I have missed you!  I hope you all had a wonderful Thanksgiving weekend.

I find it funny that I stopped posting on Gratitude the day before Thanksgiving—how ironic!  Believe me, it was not from lack of thankfulness or desire.  I had to make some decisions about how to spend my time and energy this past week, and I chose to forgo posting each day.  It doesn’t feel too bad—I did make it 24 days, after all!  It helps that I set out on this NaBloPoMo challenge with high hopes and low expectations.  Looking back, some of the posts this month make me pretty proud; others I’m happy to forget.  As Ben Zander would say, “How fascinating!”

I felt validated this weekend by Elizabeth Gilbert’s Facebook post on quitting versus surrendering.   Quitting, she writes, is when you just plain give up.  Surrender, on the other hand, happens when you come to the end of your power.  I kept up my daily posts, for the most part, and it cost me time and energy, both finite resources.  Over the month, I finally had to admit that I was overextended.  I started to worry about neglecting my family—that was a sign.  This holiday weekend was a great chance for us to spend all kinds of quality time together, and I think I made the right choices.  Yes, I committed to post daily gratitude.  It didn’t work out.  Meh.

What were the underlying goals and drivers of this challenge?  It was an exercise to practice intentional gratitude, and articulate it.  It was a chance to confront my perfectionist tendencies, the ones that keep me from trying new things because I fear doing them, well, imperfectly.  I now have a clearer view of my abilities, limitations, and priorities.  I came to the end of my power for posting in this format and frequency, and realized that it’s more than I thought I had in me, yay!  I did not quit my posts.  I surrendered to the realities of life and learned important lessons about myself.  Gilbert writes, “There is always grace in surrender. There is always truth in surrender. There is always a great deal of human dignity in surrender.”  I agree.

On this final day of November, as we move well into the holiday season, I feel truly grateful for so many things.  Our holiday weekend was both relaxing and productive.  We slept in, saw family, ate too much, and purged our closets.  We spent time together all four of us, and the hubs and I managed to get in a date night, too—thank you, sister-in-law, for babysitting!  I wanted to write about all of it, but sometimes you just have to live in it first.

With all the hostility exploding around the world, some of it in my own backyard, I am reminded that every day is a gift.  Each day that does not visit tragedy on my front door is a day to be truly appreciated.  And while I cannot myself affect positive change on a global scale, I can do my part in each of my human interactions.  When someone cuts me off in traffic or behaves rudely at the store, I can choose to tell a story of compassion and patience, rather than personal affront.  The outcome of all this gratitude should be better behavior on my part—more love and light directed outward, indiscriminately, driven by an internal flame, fueled by the realization that I have everything I need and more.  My NaMo may have fizzled this last week, but it was an awesome fizzle indeed, and I am proud to own it.