Because This Is Who We Are

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Followers of this blog may know of my interest in and passion for physician health and well-being.  I was immersed in this world the last couple of months, with two amazing conferences and multiple conversations with fellow physicians at work.  As often happens, I was moved to articulate a vision/mission statement of sorts, mostly to solidify my own intentions and also to share with like-minded colleagues.

I love that I enter this arena from the world of executive health.  Corporate leaders, physician leaders, and physicians on the ground share so many attributes that everything I learn from patients translates seamlessly to my own professional development.  This is exactly the right space for me to inhabit today, and I am forever grateful for the integrative experience.  Physicians are care team leaders by default, and we miss opportunities to improve all of medicine when we forget or ignore this fact.  I’m interested to know your response to the words below—the more visceral the better (but please, if possible, refrain from spitting, vomiting, or defecating your own words here):

Why do we advocate for physician health and well-being? 

Because we believe we can only lead well when we are well ourselves.

Because leading can be lonely and leaders need support.

Because leaders need metrics of our own performance, both related to and independent of the performance of those whom we lead.

Because health and leadership intersect inevitably and who we are is how we lead; the more awareness and active, intentional self-management we practice, the more effective leaders we will be.

Because people follow our example, like it or not, so we owe it to ourselves and those we lead to model Whole Physician Health.

What Is Whole Physician Health?

Whole Physician Health is an approach to health and well-being which defines physician as both clinician and leader, both healer and vulnerable.  This approach focuses on the 5 Realms of Health: Nutrition, Exercise, Sleep, Stress, and Relationships.  We explore how these realms intersect and overlap, affecting the individual physician, those whom the physician cares for and leads, and the entire medical profession.  We apply principles from health and sports psychology, communication, leadership, mind-body medicine, and myriad other disciplines.  We value openness, curiosity, critical analysis, and collaboration.  Our mission is to create a resilient medical culture in which all members—physicians, patients, all caregivers and support personnel—thrive and flourish.

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The Whole Physician Health Advocate:

*Values self-awareness and self-exploration.

*Understands and accepts his/her position as role model and culture setter for the team.

*Wishes to broaden the skillset in cultivating positive relationships

  • With self
  • Between self and immediate colleagues
  • Between colleagues themselves
  • Between physicians and staff
  • Between teachers and learners
  • With extended family of colleagues and institutional entities
  • Between institution and the patients it serves

*Sees the physician health and well-being movement as an opportunity to learn, see from a different point of view, connect to fellow physicians, and form new tribal bonds that will hold us all up.

*Wants to contribute to the creation of a global professional vision and mission of the 4 WINS:

WIN 1–You

WIN 2–Those you lead

WIN 3–Your whole organization

WIN 4–All those whom your organization touches

Of note, one need not be a physician to advocate for Whole Physician Health.

Stability is Strength

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The holidays are coming.  People will be bustling up and down Michigan Avenue with large shopping bags and puffy coats, fuzzy hats and determined gait.  If someone knocked into you on the sidewalk, would you be stable enough to hold your space and not get pushed over?

I asked this to a friend today, a woman about my height and twenty pounds lighter, ‘bird-boned’ by her own description.  I swear, she looks like a feather to me.  We were talking about our habits, what seems to be changing as we approach menopause, and how we envision our best selves in old age.  I thought about the elder women in my family, who are all healthy in general, but not necessarily fit.  What if someone knocked into them this holiday season, would I be dealing with a hip fracture over Christmas?  The mortality rate for people over 65 in the year after a hip fracture is somewhere on the order of 25%.  My friend and I definitely do not envision this for ourselves.

So what needs to happen in order for me to stand my ground in the face of some external force?  I need a stable foundation, my feet in firm contact with the ground.  I need a low, massive center of gravity.  I need fast reflexes to contract and relax opposing muscles groups to bear the sudden and unexpected load.  I cannot be rigid and brittle; rather I must exert flexibility, to absorb enough force to move with it and away from it on my own terms.  I need to stand tall and face the force head on, with openness and grace, firmness and self-assurance, ready to assess instantly whether it was inadvertent or intentional, benign or malicious.  And then I need clear-minded judgment to determine how to respond to either condition.

This may come naturally and easily in our 20s.  Today, bum knee notwithstanding, I feel confident that I could meet such a force with appropriate strength and stability.  My friend and I agreed today on a shared vision: STRONG OLD LADIES.  We understand that this will not just happen because we will it; we need to fuel and train, rest and recover, and cultivate our mind-body connections, as well as our connections with others.  Small habits, sustained over time, positive or negative, will yield predictable results.  So the time is now to pay attention and establish some excellent patterns.

It occurs to me that this idea of stability and strength relates our physical to our mental and emotional well-being.  While Amy Cuddy’s research has recently been called into question, I still adhere to the idea that power posing and physical posture can enhance or diminish confidence and self-efficacy. Wide stance, low center of gravity, elongated spine, and open arms:  Stand strong, feel strong, think strong, speak and act strong.  I have practiced power posing before presentations since 2015 and I believe I am better for it.  And if it’s a placebo, I’ll take it—the benefits so far have outweighed the risks and costs.

Lastly, I think we can also apply this stability and strength awareness to our inner lives.  Here I refer to our integrity.  Our world changes ever faster, technology offering capabilities we had not dreamed even a decade ago.  It seems every interaction these days is shorter, more ‘efficient,’ less personal.  That is the default goal—low cost, high speed above all else.  Change is often good.  But we must also exercise judgment, and practice taking the long view, casting light from our core values onto a cautiously optimistic future, attending to and addressing the shadows.  We should gut-check, with ourselves and one another.  What are we really getting here?  How will we use it mindfully? How can it serve us, rather than us serving it?  When we are stable and strong in our shared humanity and collective goodwill, we arrive at the best answers to these questions.  Then we can all be stable and flexible, and stronger as we age together.

 

Granola Blondie Night

Holy cow I am so tired.  This is what one sleepless night on top of 6 weeks of cumulative sleep deprivation will do—ya crash.  I have all these great ideas for a post but I cannot remember any, my brain is so fried.  So, I will tell you how else I was productive tonight!  I got on my Wonder Woman apron and–

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We baked.

My kids have life-threatening allergies to nuts, egg, and dairy, among other things, so it’s not always easy to find portable snacks off the shelf.  My son has committed to crew for the school play as well as swimming this semester, so he is often not home until well after dinner.  Today we brainstormed what food he can keep with him.  He already likes our homemade granola, so we tried to think of ways to make it into bars.  We recently found some bread mixes from Trader Joe’s that taste pretty good, and we are good at substituting for egg and dairy now, so we tried their Blondie mix tonight, too.  I overestimated the one stick equivalent of butter substitute, but overall the results were pretty good.

I have included the loose granola and granola ball recipes below.  Enjoy!  I plan to be back tomorrow night with a post from actual thoughts.

Homemade Vegan Nut-Free Granola (I make a 3x batch to save time since it goes fast!)

2 cups rolled oats

2 tablespoons chia seeds

1 tablespoon hemp seeds

¾ cup coconut flakes

¼ cup sunflower seeds

¼ cup pumpkin seeds

3 tablespoons flour

2 tablespoons maple syrup

2 tablespoons coconut oil

1 teaspoon vanilla extract

2 tablespoons soy milk or coconut cream

Preheat oven to 350F

Combine dry ingredients in a large bowl

Combine wet ingredients in a small bowl (I do it in a glass jar to melt the coconut oil and shake to mix)

Mix wet into dry, thoroughly coat/combine

Spread on parchment-lined baking sheet, single layer

Bake 20-30 minutes until golden; stir halfway through

 

Portable Granola Balls

1 ¼ cup rolled oats

½ cup sunflower seeds

½ cup pumpkin seeds

¼ cup hemp seeds

1 cup dried blueberries

½ to 2/3 cup honey

½ to 2/3 cup sunflower seed or soynut butter

Combine dry ingredients in large, microwavable bowl

In small bowl combine honey and nut butter, microwave until very warm and liquid

Pour liquid over dry ingredients and thoroughly coat

If the mixture cools, chunks, or there are still loose oats/seeds, microwave the whole thing in 30 second increments until it’s all warm.

Wearing knit gloves under food preparation gloves, knead handfuls of mixture into tight balls; smaller than golf ball size tends to fall apart more easily

Lay separated until cooled, then store in airtight container