Shoots in the Poop

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It’s December 4th… Time to look back?  Honestly, I’d rather just get this year over with and move on,  because I have already been looking back all this time.  Since January I have counted—weeks and months since the knee injury, months since starting the new job, since surgery, since a spring crisis, since the last this or the first that.  What was it all for?  I think I was just reminding myself that there’s been a lot going on, reassuring myself that I’m not just whining, not being weak for letting my personal health habits slip.

I’ve felt like a relative slug for the last 6 months, despite my best efforts.  I think I must have eaten a pint of ice cream every two days for most of the spring and early summer.  Looking back on the calendar, I stopped using smiley stickers to mark workouts around July—their intensity was only worth hand-drawn smileys.  By and since August they aren’t worth smileys at all—I just jot down what I did in shorthand.  Some weeks it was barely anything.   I judge myself every day—perhaps less harshly than I might have a few years ago, and also less compassionately than I might a few more years from now.  I still struggle with the fear of self-indulgence if I allow myself too much self-compassion.  I am still learning self-compassion.  I know it takes time to rewire our limbic brain patterns with knew learnings from our cognitive brains.  So I will keep trying, because I know it’s helping.  And I’m modeling for the kids.  We can do our best and still fail.  The key is to keep moving.  We can practice admitting we need help, seek it from the appropriate sources, lean on it heavily, and stand back up eventually.  And then we remember those who helped us, and prepare to be helpful in return.

I have leaned on so many this year, I feel almost speechless at the outpouring of support and love.  The only way I don’t collapse from this weight of gratitude is by storing it like a battery—ready to be discharged, full power, when someone needs to plug into me.  This may be my favorite thing about humanity—that we are wired to connect so tightly, to help one another in webs of mutual love and kindness that can extend ad infinitum.

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So I’ll look back a little.  This week I feel a turning.  Did I say this already recently?  Oh yes, it was November 12.  I was making more room for books, trying to stay off of my phone, off of Facebook.  Being on the laptop every night to post to the blog stymied that last part, but it also bought awareness of how I find loopholes in the best plans for self-discipline.  And the daily writing practice also contributed loads to this internal revolution.  This was my fourth year doing NaBloPoMo.  It was by far the most fun, the smoothest, and the most rewarding attempt yet (I think I also said this last year?), and now I miss writing every day (definitely have not said this before).  Maybe it was the daily dopamine hit of views and likes.  But I think it’s more than that.  Through the daily discipline, I had a chance to process and synthesize so many ideas and connections that had been marinating for months, maybe even years.  I practiced prioritizing, selecting, and distilling those ideas into about 1000 words each day, more for my own benefit than anyone else’s.  That people read and related to them was definitely a happy bonus.

Besides NBPM, I attribute this turnaround to two books that Donna recommended to me earlier this fall:  Leadership and Self-Deception and The Anatomy of Peace, both by The Arbinger Institute.  I have wanted to write about them for the last several weeks, but I haven’t yet figured out how to prioritize, select, and distill the lessons coherently.  The foundational ideas are not necessarily new, but they are profound.  The books are written as modern allegories, and there is just something about the metaphors and analogies that has unlocked and integrated everything I have learned about inner work, communication, relationships, and leadership to date.  And that is saying a lot.  Because of these books, the daily writing, and all the conversations I’m having (with myself and with others) as a result of both, the two most challenging relationships in my life right now have fundamentally improved—mostly because I have been able to shift my own attitude.  As with all things, this new ‘way of being’ will take practice.  I need to keep the training wheels on for a while yet.  But now that I have made this turn, the path looks straight, and I see light.

The manure has piled on all year.  So much fertilizer, oh my gosh.  It’s done its job, though, because I have definitely grown.  I feel strong, healthy shoots of green popping out through the thick, dark carpet of poop.

We Are Tested

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What a shit week.  I wonder, how are you doing, my friends?  Because I look around and it really seems like I’m not the only one feeling it.  A friend’s young, healthy sister-in-law was diagnosed with metastatic lung cancer and possibly also lymphoma.  Another friend’s cousin died from a drug overdose after recently completing rehab and getting back to her young family.  Patients are sick with mysterious and disconcerting illnesses.  Pipe bombs were sent to a slew of Democratic leaders and supporters.  And today a man commits yet another deadly, hate-driven shooting.  Seriously, WTAF?  And I honestly think we have yet to hit rock bottom.  I don’t see any of it turning around anytime soon.

I have barely made it through—so much psychic energy required to simply move from one task to the next, taking care of many (and not so much some others).  This past year, actually, sometimes I’m barely holding it together.  First the knee injury, then taking on a new big role at work.  Then surgery/rehab, and another personal crisis that derailed all of my health habits for spring and summer.  As I go around the country talking about personal resilience and culture of wellness, I wonder, am I being a hypocrite?  Am I really walking my talk?  Because if I’m not, I had better just sit down and shut up.

I wrote to a friend today, “I hope you are able to take care of yourself and recharge.  The energy in the world is so tumultuous and agitated.  It’s no help to blame and lament (well maybe lamenting can be a bit cathartic—for a while).  I guess this is a time to exercise our best skills—sharpen them against the harsh and jagged surfaces of challenge and trial.  I feel like all year my professed self-care practices have been called out and called forth—TESTED.  And I’m still here…  Still doing some good every day (I think), alongside the mistakes, the sub-par moments, the not-my-best words, actions, and thoughts…  But hey, who’s perfect?  Nobody.  And are we all here doing the best we can?  I agree with Brené Brown’s husband Steve, the pediatrician: It helps me live better when I choose to believe that we are—all visible evidence to the contrary.” (Here is another article that describes well the benefits of this mindset.)

CO fall 2018

Similar to last week, as I consider this idea, I am met with readings and conversations that deepen the exploration.  Friend and author Donna Cameron published an op-ed today in which she, in her typically kind and gentle style, encourages us all to be our best and see the best in others—on November 7, a day full of potential for vehement loathing and gloating celebration.  In her wisdom, Donna urges us to think ahead and decide in advance how we will choose to think, speak, and act.  How can we be our best on that day, to ourselves and to one another, no matter what the circumstances?

Recently I have had conversations with trusted friends, my coach, and my therapist, focused on my own most cavernous arenas of personal self-loathing and shame.  How lucky that I have such generous, loving, wise, candid, and brave people holding me up.  With their help, I can move past shame, take a step back, and recognize that I simply have some dysfunctional patterns, just like everybody else.  I slide into these deep grooves when I’m stressed, exhausted, and distracted—they are the default. They are part of me, and also subject to change—to intentional modification, gradual evolution.  These days I meditate often on the distinction between perfection and healthy striving, and I’m also reminded daily of the benefits of cultivating a growth mindset.  These days, instead of berating myself for falling into the same deep hole in my sidewalk, I can hold it more lightly, laugh, and exclaim, “How Fascinating!” climb out (often with a little help from my friends), and walk—ever onward.

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Today as I walked outside, slowly (I’m so tired), I noticed the leaves again.  I think autumn is my favorite season.  It reminds me of the wholeness and beauty of transitions.  They are inevitable.  They are temporary (or constant?).  They are unpredictable, at times prolonged, at other times sudden and acute.  They can feel at once painful, joyous, terrifying, shocking, enlightening, overwhelming, confusing, awe-inspiring (or simply inspiring).  It occurs to me that the best way through them involves practicing some combination of mindfulness, self-compassion, empathy, generosity, deep breathing, sleep, connection, self-awareness, magnanimity, and of course love.  The only way out is through, and if we do it well, we can grow a little at a time in the process.

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Who knows what shit will be flung our way and hit the fan next week?  How will we cope?  I know I will be leaning on my tribe and looking to make our ties ever stronger and thicker.  Thank you for being here to share the journey.

One Cheek in the Saddle

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Hello friends!  I live!

The blog is now two years old (celebratory post forthcoming).  Looking back, I have strayed often from the declared theme of patient-physician relationship and communication.  I have yet to figure out my optimum writing practice and discipline.  And every day the thing I long for most is to write for fun!  *sigh* Life.

If my world were a horse, happily trotting along a winding dirt trail in the Rockies, oblivious to my riding its back, then I would have fallen off multiple times from confusion, inexperience, fear, overreaction, awe, inattention, and impulse.  Sometimes I roll a ways down the hill, too.  The past two months or so have seen all of these and more.  Thankfully, as dust-covered and disoriented as I stand at times, the horse always allows me to remount.  At this point I’m about halfway back in the saddle again—one cheek on.  The next few posts will document my return to two-buttock riding.

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So much inner work done to date, and so much yet to do!  And I am infinitely grateful for the dense, strong, and unfailing network of support that surrounds me.  2017 could be my most productive and effective year yet, and I need help organizing.  So a couple weeks ago, I scheduled a session with my life coach of 12 years.

Her pre-call questions for me, and my spontaneous answers:

What do I want more of?

Connection, understanding, civil discourse.

To see people being kind to one another.

For people to truly listen to one another and try to understand each other’s points of view.

For us all to hold our shared humanity above all else, and see one another as fellow humans, all trying to make our way through an uncertain life.

Inner Peace.

Time outside, preferably in Colorado, in the mountains, but pretty much anywhere is good.

To write with purpose, discipline, and impact.

Integration—of everything I do, even the small things—for my Why to show up everywhere I go, with everybody I meet, most of all with my kids—to model the Why for them, in person and out loud.

To read primary literature, writings of the great thinkers and contemplatives, past and present.

Discernment—what is worth my time, contributes to my purpose, vs. what detracts from it?

Focus on what I’m for, rather than what I’m against.

Focus in general—to channel my energy to activities that align most with my central mission.  See Distraction below.

 

What do I want less of?

Rage and seething.

Repression of rage and seething.

Time wasted for lack of discernment.

Distraction.  I feel like Doug, the dog from the movie “Up”—Squirrel!  It all matters, but I cannot do everything at the same time.

 

What thoughts are uppermost in my mind these days?

The daily shit show that is our government and how it vexes me (see above, rage and seething)—sooo many squirrels.

I need to do something useful, to help, to contribute.

We are all in this together, we have to get through it together.

This is a test.  We can pass, and with flying colors, and only if we work together.

Every time I get angry, sarcastic, etc., I contribute to the negativity and morass.  I need to be better.

Why have I so much trouble walking the talk?  Why have I not achieved inner peace althef*ingready?

 

I present thusly to my trusted coach. The process always brings new insights, connections, and openings of mind and heart.  I plan to emerge on the other side of 60 minutes with increased clarity, confidence, and drive.  I’ll let you know! 😉

Oh yeah, and the Rules of Engagement also live, just taking an unplanned hiatus.  More of those to come, also.  Like I said, I’m only one cheek back on right now. 😉

 

 

On the Golden Positivity Ratio

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Courtesy of Bryan Jorgensen, Las Vegas, NV, 2016

NaBloPoMo 2016, Letters to Patients, Day 25

To Patients Seeking Positivity:

Aim for the Golden Ratio!

As many of you know, I have recently undertaken to re-evaluate my Facebook usage.  Not long after I established my account c.2008, I decided to make my page a monument to positivity.  I realized that after I die, it would be the most visible and accessible legacy I leave, and I have total control over what I post.  I minimized complaining and ranting, and when frustrated I would try to write with an attitude of learning, of moving forward.  Lately I tend to leave off the latter.

Somewhere along the way, I think over the past year, but I’m not sure, pessimism and cynicism snuck in, no doubt related to politics.  The layers of consciousness infiltrated by the negative campaigning this time around extend deeper than any other election cycle in my memory—but maybe I just don’t remember.  I think humans have evolved to forget pain as a survival mechanism.  If women remembered all the pain and anxiety of pregnancy, delivery, and caring for a newborn, we would never do it more than once, are you kidding me?

I used to review my Facebook posts and feel elevated.  Today they often bring me down; it feels terrible.

Thankfully, I have some tools to resist the negativity.  I was reminded recently during my 3 Question Journal Shares with Donna over at A Year of Living Kindly.  I remembered something about healthy relationships maintaining a 3:1 ratio of positive to negative interactions.  Turns out it’s actually 5:1, widely attributed to observations by Dr. John Gottman, renowned marriage and relationship psychologist.  I think the same thing applies in other realms, too, such as self-talk—a reflection of our relationship with ourselves.  It’s not a far leap to see how this idea pertains to news, social media, and any other human interactions.

Business researchers have discovered a 5.6:1 ideal ratio in highly functioning organizations, whereas low-performing teams’ ratio landed close to 0.3:1.

For more information on the science behind the theory (and motivation for practice), I highly recommend Positive Psychology in a Nutshell, by Ilona Boniwell.  For a brief overview, check out this PDF.  The book summarizes the origins of positive psychology as a field, and the research and wisdom of its study and application.  For example, psychologist Barbara Frederickson has described how positive emotions contribute to our personal growth and development (taken from Boniwell’s text):

  1. Positive emotions broaden our thought-action repertoires
  2. Positive emotions undo negative emotions
  3. Positive emotions enhance resilience

So hereafter, I will pay more attention.  I will likely continue to share articles that illuminate my concerns for the future.  But I will aim for the 5:1 positivity ratio.  Holy cow, can you imagine if that’s actually what we saw on the news and social media?  And why not aspire to 5:1 in my personal interactions, too?  That’s taking charge of my own happiness, yes.

On What Helps

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NaBloPoMo 2016, Letters to Patients, Day 22

To Patients Preparing for Uncomfortable Holidays:

Seek what helps.

What did I write recently about staying off of Facebook and minimizing my social media exchanges?  How fascinating, look what I just did—spent the last two hours on Facebook!  I also write about trying, falling down, and trying again…  So this is me both falling down (in my attempt to stay off) and trying again (to engage meaningfully).

The holidays are coming, yay!  …And, not so yay!  The conversations we have with friends and family in the next 6 weeks or so have enormous potential—for division as well as connection.  Personally, I feel optimistic.  I plan to evoke my core values of open-mindedness, empathy, and integrity.  I want to look back on the gatherings with gratitude and deeper connection.  So today I share with you all the things I have read (today—see?  I endure Facebook for your benefit! teeheehee) that have helped me.  These pieces validate, challenge, reassure, alarm, question and motivate me to Hold the Space, Stay on the Path, and Seek Love.  Please share yours, also!

A fellow physician’s acknowledgement of the humanness of bias, its potential for harm in caring for patients, and a reminder for self-awareness and –management.

Posts by Michelle at The Green Study, reminding us that internal conflict is normal in the face of world events such as ours, with concrete suggestions for actions that align with core values:  “We cannot strengthen our character unless it is tested. We cannot defend our freedoms unless they are threatened. We cannot become better writers or artists or humans unless we have obstacles to overcome.”

An article from The Guardian that points me to reputable sources of alternate points of view, so I may understand better.

A call out from the Wall Street Journal—to help me own my shit before I call out others on theirs.

A gentle message from fellow blogger John Pavlovitz: “Friend, however you choose to navigate these holidays, know that it’s the right way. Give yourself permission to pretend or confront or abstain as you need to, and forgive yourself later if you decide you chose poorly. You’re probably going to get it wrong or at least feel like you did.

“But remember too, to save a little of that mercy for those who sit across the table from you or those who choose not to. They’ll be doing the best they can too.”

And finally, the Prayer of Maimonides, the twelfth century physician and philosopher:

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These holidays, wish me persistence and ‘stubborn gladness,’ as Liz Gilbert calls it.  I wish you all the same!

On Rest and Recovery

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NaBloPoMo 2016, Letters to Patients, Day 19

To Patients Who Feel Tired:

Take a break.

It’s the home stretch.  9/10 presentations since August are completed, last one in 10 days.  I feel positively exhausted.  I drove 2.5 hours to Champaign Thursday night, arriving around 11:30.  Sleep was not great that night… not for a couple weeks now, actually.  I presented at a conference yesterday morning, then attended other presentations the rest of the day.  I made new connections, re-established old ones.  I received an award, so humbling and touching, and engaged in lively conversation with colleagues at dinner.  I left Champaign by 10:30pm, and swung by to pick up my daughter from her sleepover just before 12:30am, because she wanted to come home.

I got out of bed at noon today.  Had some coffee and leftover carrot cake for—well, breakfast, I guess.  Folded laundry, paid some bills, cleaned off my desk.  The only things I have to do this weekend are write, work out, attend the middle school play, and maybe cook something.  It’s a weekend for much needed rest and recovery.

It’s been four months of intense learning, processing, sharing, and integration.  It’s maybe also been a year of angst, trying so hard to engage with ‘others’ in the personal political arena—mostly online.  Curiosity, probing questions, reading for understanding and hoping for others to do the same—I engaged in good faith.  Now I’m finished.

I have gone back on Facebook since my 24 hour fast this week, very occasionally getting sucked into reading diatribes about one thing or another.  I have minimized posting my own tirades, however.  I see a friend complaining about ‘the left,’ calling out the whole group as hypocritical.  I’m tired.  Tired of the generalizations and name-calling, tired of the fruitless arguments and echo-chamber goading.

So this weekend I’m resting and recovering.  I have reviewed and renewed my charitable contributions.  I’m trying to be more present to the family.  I’m considering my options for civic participation.  I’m saving my political curiosity and engagement for people I meet in person.  I’m sleeping.  A lot.

My last presentation this year will be to a new audience, outside of medicine.  I feel positively giddy with anticipation.  I need to be focused and my best—not just for them, but for me.  The energy I project can amplify exponentially if I get the resonance just right.  Then it recharges me, too.  And that can only happen if I’m rested and healthy.  So this downtime is my investment in future engagement.

What has you tired right now?  What do you need to recharge and re-engage?  Here’s hoping you find it.

 

On Fasting

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NaBloPoMo 2016, Letters to Patients, Day 15

To Patients Who Are Fed Up:

Try fasting.

That pun really was unintended!

I asked a colleague about fasting once—what are the benefits, why does he do it?  He asked, “Don’t you ever feel like it’d be a good thing, every once in a while, to stop eating for a day?”  Ummm… No, are you kidding me?  That would never and still has never occurred to me, I love food too much!

Tonight, however, I think I may understand a little better.  Maybe fasting is about counteracting overconsumption.   Certainly we have a problem with food glut here in the US.  I have heard the word ‘detox’ associated with fasting, too…  Maybe I just refuse to admit how poisoned I am by the food I eat to consider this remedy—I am pre-contemplative here.

I am finally ready to concede, however, that I overconsume Facebook.  Sure, it provides plenty of material for this blog, and I really do interact meaningfully with a lot of people (but wait, do I, really?).  And, I have let it overtake my consciousness too often.  The time suck is interfering with other tasks and yes, relationships, I must admit.  I rationalize that I am ‘reading,’ that it’s a source of so much interesting information and idea exchange.  That may be partially true, and still, it costs too much.

So I commit to a Facebook fast this day, November 15, 2016.  It’s been a long time since my last fast—actually a year, come to think of it—yup, almost exactly!  How funny…

Is there something you need to take a break from?  Something you do habitually, that’s not all bad, but that may be excessive, a little out of control?  Maybe you don’t need to quit it altogether, necessarily.  But maybe taking a little time away will help put it into perspective?  A little break—a pause.  Test your ability to resist, challenge yourself to notice where the habit shows up, what drives it, what you might substitute for it, and how the withdrawl sensations may evolve…

Now I’m wondering if I could actually apply this to my eating.  No, not fasting from all food (again, are you kidding??), but maybe something a little more manageable:  Fast from dessert for a week—substitute fruit.  From sweetened condensed milk on weekdays (“That’s like dessert!” one of my patients exclaimed once)—substitute soy milk.  This looks more like actual behavior change than just fasting… huh.

I will be back on Facebook tomorrow.  It will likely look very similar to my usual pattern, maybe even a rebound effect—a more intense fix after the sudden withdrawl.  Well, we’ll see.  I feel a lightness to trial and error lately, and this is worth a try.  I shall report back, so stay tuned!