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.

You Can’t Pee!

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NaBloPoMo 2017: Field Notes from a Life in Medicine

When my son was little we lived in an apartment where the kitchen was a separate room, with only a small window through which I could see what he was doing in the living room while I cooked.  Once when he was about five months old, I looked out and he was lying on the mat in the middle of the floor, playing happily with the toys dangling from arches overhead.  I swear I only turned around for a minute, and when I looked back he was gone.  Empty mat, toys still dangling, no kid, no sounds.  I can’t remember what I was doing, but it felt like a slow motion eternity getting out of that damn kitchen to find him.  Something heavy must have fallen on him or he was otherwise suffocating or dying, for sure.  …He had just learned to roll over, and he had rolled and rolled and rolled himself into the space under the air conditioning unit near the window.  He was turning over a dried jasmine leaf he’d found on the floor.  Not long after that I decided I had to buy food preparation gloves.  Just in case my kid needed me anytime I was handling raw meat, this would save me the infinitude of time it would take to wash my hands—I could just pull the gloves off and bolt!  Because you know, 30 seconds could mean life or death for a toddler in his own living room.

Please laugh—I did today when I told the story to a friend.  It came up as we explored the phenomenon of moms putting everything for their kids before themselves.  We compared notes on how long we had ever held our urine.  What mom has not done this?  You can’t pee!  Because you never know which minute you’re not with your children will be the one during which your neglect will kill them.  Thankfully children grow and become more independent, and we can free our bladders again eventually.

It’s not just moms, though.  One of my teachers in the hospital gave herself a urinary tract infection as a resident.  She had so much to do every day, so many patients who needed her that she felt guilty taking time to pee.  I did the same thing in clinic for many years.  I could not justify making patients wait another minute when I was already 15 (usually more) minutes late seeing them. I don’t do this anymore.  In a fit of efficiency last week, I stepped into the restroom after I set my lunch to microwave for 2:00.  It literally takes only a minute to pee.  I don’t usually run late these days, but even if do, now take care of my needs first.  It’s better for me, and better for my patients, whose doctor is not distracted by preventable physical discomfort and dying to end the interview or exam to get some relief.

Our culture still expects moms, doctors, nurses, teachers, and many others to sacrifice selflessly in service of our charges.  UTIs are the least important consequence.  Over 50% of physicians in the US report at least one symptom of burnout, and 400 doctors kill themselves annually.  That is the equivalent of my entire medical school, dead, every year.  It’s not all because of the job, but the obligatory selfless-giver mentality in medicine definitely contributes.

So whatever helping profession you are in, please take time to take care of yourself.  We need you whole and healthy to take care of the rest of us and our children.

Go pee.  I will wait.

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.