200th Post: The Best of Healing Through Connection

Harper Columbine 5-31-14

Happy New Year, my friends!  May 2018 bring us all health, joy, connection, and learning!  And may we all look back one year from now feeling more empathy and compassion, and enjoying better relationships than ever before.

If you are new to this blog, welcome!  I hope you find something that resonates.  If you are an old friend, thank you for your support, feedback, and encouragement the last 32 months.  As I reread the last 199 posts this past week, my favorite parts were the thoughtful and enlightening comments.  I never imagined I could make friends writing a blog and yet here we are, connected, engaged, and holding one another up.

What have you discovered about your own writing when you go back and read?  Turns out I have a pretty consistent theme—it’s all about relationships.  Relationships require awareness, insight, active engagement, negotiation, and adaptation.  This is no less true in our relationships with ourselves than with others.  I have divided my favorite posts below into three categories: Health & Self-Care, Physician-Patient Relationship, and Relationships and Communication in general.  Though I have written pieces on politics and healthcare, I realize that these are critical arenas in which to explore relationships, and not my primary areas of focus in and of themselves.

2018 brings big new projects and responsibilities, yay!  So of course there will be big new challenges, also yay!  Looking ahead, I commit to my self-care practices with renewed motivation:

  1. Get to bed by 11:30 every night—Coach Christine has permission to call me out if I’m caught Facebooking past this time.
  2. Maintain 4+ workouts per week. An aging body needs regular vigorous movement!
  3. Keep up with therapy and resume regular coaching calls—reflect internally and project my best self outwardly.
  4. Maximize intake of stems, stalks, leaves, and fruit; minimize refined sugars.
  5. Nurture my ties to my tribes. They hold me up so I can do my best for those whom I lead.

The coming year will also require pulling back on certain things in order to maintain sanity.  While I refuse to renounce my Facebook use altogether, I have already decreased daily hours spent.  And though I still strive to maintain social/political awareness and activism, I will engage less with opposing voices on social media.  The costs, I have learned, far outweigh the benefits.  I would much rather take a politically oppositional friend out to lunch, or even fly to meet them, and have far more meaningful conversations in person.

For now, I plan also to scale back on the blog.  I’ll continue to write, of course, but likely more in the form of stream-of-consciousness journaling, brain-dumping, and snail mail letters to friends.  I expect that once in a while one of these activities will yield a post or two, and I hope to catch them by the tail and publish them before they escape the moment.  I leave here the list of my favorite posts to date.  Please feel free to dip in and out, leave new comments, and share links.  I suspect I will be drawn back to the page before long, as I already have a list of ideas for future posts.  But in case it’s longer than I anticipate, please know that I appreciate every view, every like, every comment, and every connection.

Thank you for stopping by and taking the time to read.  And may you take something away that makes you glad you came.

Sincerely,

Cathy Cheng


552503_3426810143573_122185844_n

Health and Self-Care

The Sh*tpile  /May 2015

https://catherinechengmd.com/2015/05/01/the-shtpile/

Everybody has one.  We inherit large parts of it from our parents, whose parents passed theirs down, etc.  Life experiences add mass and odor as we grow up.  It sits squarely in the middle of the house of our existence.  For the most part, we simply live our lives around it, walking past every day, careful not to knock any pieces off.  The surface gets dry and crusty; we grow accustomed to the smell.

 

How Health Begets Health  /November 2015

https://catherinechengmd.com/2015/11/07/how-health-begets-health/

As the kids and I sat waiting to get their flu vaccines this morning, I heard someone blow their nose. It was that thick mucus blowing that feels, at the same time, both gross and gratifying. I took a deep breath through my unobstructed nostrils and looked happily at my uninfected children.

 

Setting Intensions for 2016  /January 2016

https://catherinechengmd.com/2016/01/01/setting-intentions-for-2016/

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.

 

So You Want to Lose Weight  /March 2016

https://catherinechengmd.com/2016/03/12/so-you-want-to-lose-weight-the-four-as-of-goal-setting/

We set weight loss goals all the time, all of us—physicians included. We choose a number on the scale—an outcome—that represents our better selves, however we see it.  I suggest today that behavior-oriented goals, rather than outcomes-oriented ones, lead to far greater and more meaningful success.  How much are we really in control of what we weigh, day to day?

 

Never and Now  /April 2016

https://catherinechengmd.com/2016/04/17/atozchallenge-never-and-now/

And, there is another important practice to overcoming the Nevers: Mindfulness, the practice of the Now.  Never is about the future or the past.  Often it’s a shadowy, catastrophizing perspective of things.  But we cannot predict the future, despite our arrogant human certainty.  And we cannot live every day to come based solely on what has already happened or not happened.  Circumstances and attitudes change.  Landscapes change—at times literally, and in an instant.  We evolve, we learn, we grow.  How can we be so sure that Never is real?

 

Yes, And!  /April 2016

https://catherinechengmd.com/2016/04/30/atozchallenge-yes-and/

The goal is to open our minds, allow possibilities, expand our boundaries, and encourage creativity. I can still see her smile, the gleaming light of engagement and anticipation in her eyes.  I also remember my own hesitation and self-consciousness.  What do you mean, pimple on my forehead?  Is it really about to burst?

 

On the Critical Importance of Self-Care  /November 2016

https://catherinechengmd.com/2016/11/06/1638/

Technology and other advances have created a world of 24/7 hyper-stimulation, global comparisons of productivity and innovation, and immense pressures to be perfect, or at least appear so.  Men and women live under constant scrutiny and competition… I see, hear, and feel it from my patients every day—the anxiety, the uncertainty, the angst.  The suffering is real, if not totally tangible.

 

On the Second Arrow  /November 2016

https://catherinechengmd.com/2016/11/11/on-the-second-arrow/

Eventually, breathing, we can let go the negativity, pull the arrow out.  Breathe.  When assailed by another first arrow, see the second arrow coming and sidestep.  Breathe.  Keep breathing.  Practice self-compassion and forgiveness.

 

On Readiness  /November 2016

https://catherinechengmd.com/2016/11/16/on-readiness/

I confess I am guilty of impatience and judgment.  When I see your uncontrolled, lifestyle-related medical problems, and you resist behavior change, I feel frustrated.  I know you feel it, too.  But know that I don’t blame you. The point is: we don’t make changes until we are ready.

 

Walking the Talk  /July 2017

https://catherinechengmd.com/2017/07/09/walking-the-talk/

18 months ago I wrote about my plan for maximizing menopause preparedness.  As with so many missions, this one has experienced both successes and failures.

 

Just Do It My Butt  /November 2017

https://catherinechengmd.com/2017/11/06/just-do-it-my-butt/

Medical systems which include dieticians, exercise physiologists, and health psychologists can deploy these team members to support patients in their health journeys.  But does your doctor’s office have this kind of set up?  Does your insurance pay for these services?

 

Citius, Altius, Fortius!  /November 2015

https://catherinechengmd.com/2015/11/09/citius-altius-fortius/

Every day I live in awe of the astounding miracle that is the human body. It is the quintessential integrated machine.   Almost every part serves a unique and essential purpose in normal daily function, and the parameters for such function are incredibly narrow.  But take something out, wound something else, or trash multiple systems at once, and the whole assembly adapts around the insults, automatically, without any action or awareness on our part.  The body’s compensatory mechanisms exemplify the resilience and tenacity of nature, no doubt about it.

 

Dance For Your Health  /November 2017

https://catherinechengmd.com/2017/11/16/dance-for-your-health/

So basically, dancing activates key areas of the brain and body in an orchestrated fashion, igniting motion, joy, connection, exhilaration, sensory integration, creativity, passion, cardiovascular elasticity, and fun.  How could this not make us all younger?


IMG_3823

Physician-Patient Relationship

The Premise  /April 2015

https://catherinechengmd.com/2015/04/14/hello-world/

Patients and physicians have control over one thing above all else: our relationship with each other.  Relationships live and die by communication.  Barriers on the obstacle course of patient-physician communication loom large and formidable. Our system fails us over and again. And it falls to each of us, not the system, to find our way to connection and healing relationships.

 

What Are You Looking For?  /April 2015

https://catherinechengmd.com/2015/04/22/what-are-you-looking-for/

My mind’s eye saw hers widen with disappointment, then anger, her posture turn aggressive.  My inner conflict escalated quickly:  Sacrifice the rapport I had just established in the name of antibiotic stewardship, or give in to the misguided pleas of a wrung out fellow working mom, and contribute personally to the scourge of antibiotic overuse and resistance?

 

More Than Enough Love  /June 2015

https://catherinechengmd.com/2015/06/20/more-than-enough-love/

Like parenting, the path of medical practice is not paved with lollipops and ice cream.  It’s more like an uphill dirt road with pits and grooves, erratic weather, and hairpin turns that make you dizzy and nauseated.  It can also offer astoundingly beautiful scenery along the way—like parenting.

 

Help Me Help You  /July 2015

https://catherinechengmd.com/2015/07/10/help-me-help-you/

When you feel that disconnect, like I have left Best Me somewhere else and you’re not getting what you need, what will you do?  Will you yell and storm away? Smile to my face and then write a scathing, anonymous Yelp review? What would you do if I were your spouse, colleague, friend, or child? You and I are in a relationship, not unlike these.

 

Closing the Satisfaction Gap  /July 2015

https://catherinechengmd.com/2015/07/20/the-thorn-in-our-collective-side/

This patient gave Dr. K the best possible feedback: An objective observation about a behavior, her subjective interpretation of it, and its consequence for their relationship.  This is how we communicate evaluations to medical students on their performance in clinical rotations.  There is no reason why it should stop at the end of training; it’s just that the evaluators have changed.

 

The Burnout Crucible  /September 2015

https://catherinechengmd.com/2015/09/20/the-burnout-crucible/

Maybe it’s a moot point, whether it’s better to never burn out or to burn out and relight. We’re all here doing our best every day. Maybe it’s more important to just cut ourselves and one another a little slack sometimes, have compassion for aggressors while calling out their unjust behaviors, and offer everybody the benefit of the doubt, especially when we’re all stressed out.

 

What Makes You Think You Can Trust Me?  /February 2016

https://catherinechengmd.com/2016/02/01/what-makes-you-think-you-can-trust-me/

Trust is the cornerstone of any meaningful relationship. The patient-physician relationship is no exception. It takes time and presence to cultivate. These are big investments, and if we are willing to make them, the returns can literally save us.

 

 

I am Edna Mode  /February 2016

https://catherinechengmd.com/2016/02/20/i-am-edna-mode/

Clearly, Edna trained in the School of Tough Love.  Fortunately for you, I have also studied empathy, compassion, and motivational interviewing.  I can help you persist.  I have patience for your journey.  I can be your pillar of consistency.  Edna is nothing if not consistent!

 

Humbling and Honoring  /April 2016

https://catherinechengmd.com/2016/04/09/humbling-and-honoring/

I get to choose when I am willing to donate my time and energy to the free clinic—everything I do there is on my own terms.  The patients there have no such choices.  If they want care, they have to show up—early—on the day the clinic is open, regardless of what else is going on in their lives.  There are no appointments, and almost no continuity with providers.  It’s a completely different world from where I make my living, on the Gold Coast of Chicago.

 

On Mutual Respect  /November 2016

https://catherinechengmd.com/2016/11/05/on-mutual-respect/

To Patients Who Abuse Medical Staff: Let me be clear: That is not okay.

 

No Substitute for Time  /November 2017

https://catherinechengmd.com/2017/11/03/no-substitute-for-time/

“More information about the value of a physician-patient encounter will always be found in the content of their communication than in what they ultimately do. The difference in… physicians’ behaviors will not be found in any database, electronic medical record, or machine-learning algorithm. I have yet to see data on the contextual information from a history of the present illness in any data set or quality improvement initiative.”

 

Dr. Jerkface In Context: Healing the physician-patient relationship  /November 2017

https://catherinechengmd.com/2017/11/25/dr-jerkface-in-context-healing-the-patient-physician-relationship/

Do patients care about doctors’ suffering?  If they knew how the system harms physicians, would they have compassion for us?  What about if they knew how physician burnout and dissatisfaction directly affects their quality of care, all of it negatively?  What would move patients to stand up with and for doctors?  This is my goal for the indefinite future: to help us, patients and physicians, the end users of our medical system, stand up with and for one another, for positive systems change.


546505_3541050719516_553644737_n

Relationships and Communication

Gratitude, Generosity, and Peace  /July 2015

https://catherinechengmd.com/2015/07/30/gratitude-and-generosity/

When I feel grateful, there is enough. I am enough. Even just saying the word, seeing it on the screen, brings me to a more peaceful state of mind and body.

 

Warrior Pride and a Plea for Kindness  /December 2015

https://catherinechengmd.com/2015/12/13/warrior-pride-and-a-plea-for-kindness/

There is no substitute for a face-to-face conversation, and the time and energy it takes to have one. It requires a certain degree of tolerance, and an unspoken contract of civility and courtesy.  We must choose carefully with whom we are willing to undertake such a venture.  And perhaps most importantly, we must be clear about our objective(s).  Do we really expect to change someone’s fundamentally held political or religious beliefs?  How realistic is that?  What other purpose, what other good, could possibly come from such conversations?

 

On Belay  /April 2016

https://catherinechengmd.com/2016/04/02/on-belay/

The interview starts with the two men talking about Hank Williams’ troubled life, his ‘formidable demons,’ as Hiddleston puts it. He expresses compassion for this, as I have seen him do in previous interviews about other characters he has portrayed.  He describes how Williams rose to stardom quickly, but ‘with no real support, no one to anchor him.’  Funny how he uses that word, anchor—like belayer.

 

Opposition and Openness  /April 2016

https://catherinechengmd.com/2016/04/20/atozchallenge-opposition-and-openness/

When I look at the list of definitions of oppose, I feel tired.  When I think of the energy it takes to constantly stand against something, I feel listless and drained.  Fighting, resisting, combatting, Obstructing, standing in the way, hindering, disputing, dissenting, contradicting—it’s exhausting.  I think of times when I meet someone new and all they talk about are the things they hate, that they can’t stand, that they want changed.  I cannot wait to get away and find levity.

 

Every Day a Revolution  /April 2016

https://catherinechengmd.com/2016/04/22/atozchallenge-every-day-a-revolution/

Like the turning of an incandescent light bulb, gently, patiently, and consistently in one direction, the steady work of activists eventually leads to sudden and intense illumination.  Darkness becomes light, cold spaces are warmed.

 

Withhold Judgment  /April 2016

https://catherinechengmd.com/2016/04/29/atozchallenge-withhold-judgment/

After all of this exploration, conversation, debate, research, and observation, once again I conclude that one of the most important practices for inner peace is to Withhold Judgment. Not all judgment, and not indefinitely, but much and for a while.

 

Playing My Part  /May 2016

https://catherinechengmd.com/2016/05/22/playing-my-part/

Given the awesome support network with which I am blessed, I feel an impulse to do something more with my writing—to amplify and project all this love and connection back out onto the world for some positive purpose.  But how can my words possibly make a difference?

 

Holding the Space for Personal Acts of Peace—On Listening  /July 2016

https://catherinechengmd.com/2016/07/11/holding-the-space-for-personal-acts-of-peace-listening/

I know I will not do justice to all the complexities of our issues in one blog post, but I ask your forbearance for my interpretation, as it has led me to greater conviction for what I can do, I, one person.

 

Holding the Space for Our Suffering to Heal Us  /September 2016

https://catherinechengmd.com/2016/09/22/holding-the-space-for-our-suffering-to-heal-us/

For a moment we felt stuck, we connection seekers.  I looked at our leader.  His expression conveyed nothing but humility and empathy.  His posture conveyed resolution.  Despite our deep longing, he refused to lead us into treacherously thorny fields, because he knew he did not have the time to bring us safely through to the other side.  But he also allowed us to process, invited us to consider how else we could collectively resolve our unease.

 

On the Golden Positivity Ratio  /November 2016

https://catherinechengmd.com/2016/11/25/on-the-golden-positivity-ratio/

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 relationships with ourselves.  It’s not a far leap to see how this idea pertains to news, social media, and any other human interactions.

 

Train to Withstand the Discomfort  /February 2017

https://catherinechengmd.com/2017/02/20/train-to-withstand-the-discomfort/

We all know the satisfaction and comfort of echo chambers.  Seeing, hearing, and reading that which validates our existing positions feels so good.  But the farther we regress here, the harder it becomes to tolerate a dissenting view.  We must resist this temptation; we are called to be more disciplined than this.

 

To Train or Not to Train  /May 2017

https://catherinechengmd.com/2017/05/08/to-train-or-not-to-train/

…even if we don’t all talk politics, we all need effective communication skills, especially in the arenas of conflict resolution, negotiation, parenting (which encompasses them all), and the like.  We are social beings—we only survive by cooperating and living well within our tribes, and by tribes living well among one another.  That can only happen if we practice getting along.

 

Tribal Pride and Tribalism  /November 2017

https://catherinechengmd.com/2017/11/29/tribal-pride-and-tribalism/

We all need our tribes.  Belonging is an essential human need. To fit in, feel understood and accepted, secure—these are necessary for whole person health.  And when our tribes have purpose beyond survival, provide meaning greater than simple self-preservation, our membership feels that much more valuable to us.  But what happens when tribes pit themselves against one another?  How are we all harmed when we veer from “We’re great!” toward “They suck”?

 

 

 

I Hereby Commit to NaBloPoMo 2017! Day 1: Shitty First Drafts

DSC_0358

2015 November Gratitude Shorts

2016 Letters to Patients

2017 Field Notes from a Life in Medicine

Day 1:  Shitty First Drafts

I first heard this concept listening to Brené Brown’s book Rising Strong.  It refers to Anne Lamott’s writing process, described in her book Bird By Bird.  Brown uses it as a way to work through strong emotions.  When something hard happens, intense emotions can get the best of us.  Anger, resentment, defensiveness, judgment, shame, and a multitude of other difficult feelings can overcome our senses.  How can we keep from getting sucked into a raging emotional vortex, dragging others along with us?

Write a Shitty First Draft, or SFD for short.  I have done this a few times recently.  I take a pen and paper and let loose.  I vent, rant, SWEAR IN ALL CAPS, draw angry faces, scrawl everything I feel, with total abandon.  This is the first, most subjective and raw version of the story I just experienced.  Man, it feels good, documenting everything from this (self-)righteous point of view!  But it doesn’t stop there.  Sometime later—whenever I’m ready, I return to the SFD to edit and revise.  Curiosity is key here.  What other versions are also plausible?  What am I missing from the other side(s)?  What other story will allow me to suffer less?  What makes me so attached to the SFD?  What core value has been violated here?  What is the most generous assumption I can make about the other people involved? I also learned that last one from my girl B2.

Turns out some SFDs are easier to edit than others.  Seems it depends on the circumstances, relationships, and (inter)personal stakes involved.  In the end, though, it’s well worth the effort.  I realized it this week and posted a musing on Facebook, and my friend offered me a chance to expound:

“CC: Curiosity, Transparency, Integrity, and Openness are saving me right now.

“Friend: I’m glad they are but curious to know how they are?

“CC: They are keeping me focused on the best and most meaningful contribution I can make to the team. As more moving parts get added to the process, I can stand on these practices to respond effectively. In the end, regardless of the project outcome, hopefully I can look back and know that I have very little to regret. …And if I do regret anything, hopefully I will have at least also learned some valuable lessons.”

The more I practice my SFDs, the sooner I can get to healthier iterations of my life stories—ones that allow for forgiveness, equanimity, gentleness (on myself and others), and inner peace.  I used to secretly berate myself for not getting to the peace part faster, easier, more efficiently.  But now I know, the healthiest way out of the shitty feelings is straight through.  The Shitty First Draft is the perfect vehicle for getting to the other side, and I get to drive every time.

 

Two Buttock Riding

 

Continued from last week…

My objective for the coaching session was to figure out where I really want to put my energy for the foreseeable future.  I felt essentially torn between my paraprofessional activities (writing and speaking on physician health, patient-physician relationship, bridging silos in medicine) and my nascent political activism (community involvement, calling and writing to Congress, thinking of running for office someday??).  It felt like I should choose, and yet something told me they could be integrated.

Highlights from the call:

What is your goal for the end of this session?

Clarity and direction; movement.  Readiness to act.

How close are you already?

85-90%

How will you know when you have it?

Hard to describe…  It will be a dual certainty, like choosing furniture, knowing whether I like a person: cognitive and visceral.  It will feel decisive.

How are you feeling now?

Overwhelmed, distracted.  [Recall Doug the dog, in the movie, “Up”—Squirrel!]  OMG there is too much to keep up with: Healthcare, Russia, immigration, refugees, border security, Russia, EPA, what-the-hell-did-he-just-say-and-what-the-hell-does-that-mean?, racism, misogyny, intolerance, Russia, free speech, NIH funding, science, climate change, women’s rights, the Persisterhood, congressional seats up for grabs across the country, and oh yeah, the rest of my actual life.  Every day five new things to look up, articles on both left and right to compare notes, filtering facts from spin, trying to stake independent and educated positions backed by evidence!  GAAAAHH!

What would happen if you didn’t do that?

I do what do, spend hours a day reading and trying to engage in discussion (in person and on social media), in order to be credible in my conversations, to engage from a place deeper than superficial rhetoric or simple emotional reactivity.  My big fear: If I don’t do it, I will become one of those loud-mouthed, uninformed ranters who has no evidence for my broad-brush, oversimplified generalizations and ad hominem attacks.

What is the 98% truth about that?

Not likely to happen.  That’s just not me, I don’t do that.  I always look for evidence to back up what I say, and when I don’t have it, I own up.  If I don’t know what I’m talking about, I listen more and ask more questions, or I don’t engage until I have something useful to contribute.

And the 2% truth?

There is still a risk.  I may spew sometimes—when I get triggered and e(motionally)-hijacked.  I feel particularly susceptible right now, with all of my core values and our generation’s social progress seemingly under attack.

AND, I never live here.  I may wallow a few days (1-2 weeks, max), stewing in cynicism and resentment.  But I always rise up, usually with the help of others, with writing, and with time.  I always come out having learned something, and resolving to apply the learning (usually about myself and my relationships) to whatever comes next.

***

Insights gained:

I’m okay.

In reviewing my time spent on my screens each day, I realize most of it edifies me and connects my mental dots of current events, social science, and personal meaning.  I know not to spend time on baseless rants and otherwise rhetorical opinion pieces.  I choose articles with links to data, history, and primary sources, and ones that challenge my thinking or oppose my positions (sometimes).  I look for nuance, complexity, examples of collaboration and compassionate leadership.  This is what I spend my time and energy on; it broadens my perspectives and integrates the knowledge and ideas I already have.  It fosters my own creativity and philosophy.  This is who I am.

It’s the blog.

This is what I want to spend my energy on.  It’s my platform, my thing.  All the paraprofessional stuff I do was born of this: What gives doctors meaning is the relationships we get in our work—mostly with patients, but also with one another and society at large—status, respect, contribution.  Physician, wellness/resilience, the intersection of health and leadership, bridging silos (physicians, nurses, pharmacists, insurers, hospital administrators)—it’s all about relationships.  And, so is politics.

Therefore, I will use this blog for all of it. I can share my letters to Congress.  I can continue to write about physician-patient relationship.  I know I have written about this before, but somehow it required some reinforcement:  It’s all connected, and it’s all me.

FEAR.

Of course, that’s what really holds me back (yup, written about that before, too).  Fear of attack, rejection, overwhelming engagement obligation and getting sucked into negative, counterproductive exchanges with strangers.  Fear that I have nothing useful to say.  Someone else has already said it better and reached more people.  Who am I to think that my words matter?  It’s all so paralyzing.

I got this.  

I’m ready.  It’s time.  Because: Nothing I say or write, at work or on Facebook or anywhere, is anything I would not say or write in public.  Integrity is important to me—to be the same person in private that I am in public.  I’ve been practicing, and getting better, as evidenced by the civil exchanges I facilitate on my Facebook page (which I will also share more of), bringing together friends from different walks of life in meaningful conversation.  We exchange important ideas, always concluding cordially, all relationships intact and even, I daresay, strengthened.

And, my blog is my space.  I get to manage who comes on (into my house), and I make the rules for how we engage (no poop flinging).  I don’t comment on public sites like Washington Post or New York Times, or large Facebook groups (usually) because that is like leaping into a flash mob of the worst kind.  There is no meaningful exchange or benefit for anyone.  Here, threads can be more personal, meaningful, and transformative.

***

New Goals:

Shift the Boundaries.

I can push my fearful limits and present myself more confidently to the world.  I can choose to plant more color and texture in my front yard.  I can also dig it up and throw it out if I realize it clashes with the house.  It’s all good.  And I must also mind the costs, especially to my family.  So, I can bring them closer by putting the screens out of arms’ reach when I’m with them.  Easier said than done, and definitely worth the effort.

Focus on the WHY.

It’s all about cultivating productive, contributory relationships–first with myself, then with others, and then between all of us, for more peace, love, and joy for us all.

Publish Weekly.

If this is where I want to put my energy, then I want to have something to show for it.  Plus, it’s therapeutic.  Writing calms me, which I need now more than ever, as you can see.  For now I can stop chasing conference presentations, formal leadership roles, Daily Actions to prove I am an engaged citizen.  I can simply write when I am moved—and I am always moved—and share it here.

See you next week!

 

One Cheek in the Saddle

DSC_0662

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.

***

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. 😉

 

 

NaBloPoMo, Here We Come!

919_4331873329587_306774116_n

The Cubs have won game 5 of the World Series.  Halloween is tomorrow.  In two days I will commit to publishing a post a day for 30 days.  Woo hoooooooo, bring it!!  It’s been a year since I tried this the first time, and I almost made it—26, I believe, and a few may have been reblogs of others’ work…  I felt embarrassed about the ‘failure.’  But then I got through the A to Z Challenge by the skin of my teeth this past April (last post at 11:30pm on April 30th), and that was much more fun.  So I’m trying again, yaaay!

I launched this blog 18 months ago to address physician-patient relationship.  I aimed to discuss communication, self-awareness, and emotional intelligence, as tools to rekindle that trusting, continuous bond that so many of us miss in medicine today.  Since then I have come around to the original theme occasionally, but not nearly as often as I had intended.  So I take this annual blogging event as an opportunity to refocus and try something new.

For Na Bo Po Mo 2016, I intend to write 30 letters to patients.  Some will echo routine conversations; others may reflect my musings on this vocation.  I may examine observations on the state of medicine today.  Or other things, who knows?  I will at least attempt to convey my deep love for the work and the people.  Maybe I can help fellow physicians and patients connect, or perhaps lend some perspective and awareness.

There is a lightness to trial and error.  When you try something new, you make a commitment, set an endpoint, and decide how you will measure the outcome.  But you don’t have to attach yourself to a particular outcome, just the process.  I commit to try my best and have fun, and see what comes out, in fewer than 500 words per post.  I wonder where this will lead?  Maybe it will turn into a monthly newsletter for my own patients?  A book?  A column somewhere?  Anything is possible!  I’ll never know until I try, and I like the openness of the adventure.

I hope you will visit often, and leave your thoughtful comments.

Let the journey begin!

 

Playing My Part

IMG_3397.JPG

Hello again, friends! Feels good to be back…  3 weeks since my last post of the Blogging A to Z Challenge, holy cow!  At the end I thought, ‘Hey, I can do this!  One post a week, no sweat!’  …And then crickets…  How Fascinating!

Though I have not posted in three weeks, I have written like mad, mostly journaling. Today I suddenly realized how much I have missed corresponding with my friends on paper.  How long it’s been since I wrote by hand to someone other than myself!  As I sat this afternoon and wrote, on stationery, with colored gel pens and stickers, to some of my best friends, a tremendous sense of connection and gratitude filled me.  Much of this post was born of those spontaneous letters to my fellow conscious, cosmic journeyers.

Given the awesome support network with which I am blessed, I feel an impulse to do something more with my writing—to amplify and project all this love and connection back out onto the world for some positive purpose.  But how can my words possibly make a difference?

The A to Z Challenge showed me that I have the capacity to write often and much—and to produce better-than-crap results! It also taught me that I can take more risks with my writing, in both format and content.  Now I want to take my writing a little more seriously, lend more credence to my own abilities.  In the framework of Simon Sinek’s Golden Circle, I know my Why: to cultivate positive and constructive relationships in every realm of life.  This blog is another What to my Why.  But since the Challenge ended, I struggle with the How.

I think night and day about so many things:

  • My own individual relationships—spousal, parental, sibling, other familial; colleague, patient, student, friend, stranger.
  • Relationships I observe between others, and their impact on those of us around them.
  • Healthcare and medicine in general, and specifically at my own institution—miracles, bureaucracies, opportunities and pitfalls.
  • Leadership and organizational culture—examples of effective and ineffective models, and what makes them so.
  • Social justice and discourse—with an urge for movement toward acceptance, inclusion, mutual understanding, and cooperation.
  • Education, parenting and role modeling—integrity, walking my talk, inside and out.
  • Physician self-care and care of one another—individual and system issues, and their interface.

What am I called to affect? I live a conscious life in all these realms, or at least I try.  I have opinions and positions on various issues, some which I hold with deep conviction.  And I struggle with whether and how to express them—for what purpose?

Finally, I have an idea. Though I have opinions and positions that I hold strongly, I plan NOT to use this blog to promote those views.  There are plenty of people doing that already, a multitude of voices trying to win one another over, or, more precisely, trying to drive one another into silence with ever louder, brasher, and more vociferous language.  My voice can be one of moderation—of collaboration, connection—maybe a bridge for a few who seek one…  Or maybe just one stilt among many others, helping to hold up one such bridge.  I will strive not to criticize or proselytize, not to berate, blame, shame, incite, or inflame; and also not to concede or abstain.  I can, at the same time, hold my positions with conviction and passion, and also listen for the convictions and passions of others.  I can practice curiosity and openness.  I can question, explore, Hold the Space, and stand strong and tall, without feeling threatened.  I seek others who strive to do the same.

Voices of moderation are muted these days. The great orchestra of discourse has lost balance and harmony.  The most strident strings, horns, and drums play for their own promotion, rather than as a contribution to a symphonic collective.  The resulting dissonance makes us want to cover our ears and run away.  In order for a symphony to engage and inspire, each player must not only know her own part and play it well, but also listen carefully for other players and their movement.  Maybe we can all do this a little better: maintain our own distinct voices, while integrating with those around us.  The best orchestra functions as one entity, breathing and moving in a quintessentially integrated fashion.

My instrument is language. The past seven weeks have shown me my part in the online verbal orchestra.  This blog is where I will practice, record, and offer my contribution, not to overpower any others’ words, but to meet, align, and resonate.  The harmony of consonant contrast plays on, somewhere.  Maybe I can help find and amplify it, so more of us may enjoy the music of life among one another.