On Readiness


NaBloPoMo 2016, Letters to Patients, Day 16

To Patients Contemplating Change:

You’ll do it when you’re ready.  And you’ll know.

My 24 hour Facebook fast is 90% complete, and I feel GREAT!!  Holy COW, I’ve been so productive, and for the most part I feel liberated and lightened.  The darkness of increasing online tension had spread over my consciousness rather insidiously, like a slime mold.  It’s not that I was totally unaware, or that I underestimated its toxic influences; I was just not ready to stop it.  The cost/benefit balance finally tipped and I was moved to act.  It’s that simple and that complicated.

Today I reviewed my notes from the physician health conference 2 months ago.  I came across an important exercise that illustrates my point.  The speaker had us make two lists: energy-depleting activities and energy-enhancing ones.  My second item on the former list was “Facebook+/-“.  It was the third item my latter list.  She then asked us: If we had 2 extra hours a day, what would we do more?  –Read, write, go outside, meditate, do stuff with kids (outside), plan road trips.  Then, if we had 2 fewer hours per day, what would we cut out?  –Facebook/news, TV/movies.

That was two months ago.  I knew I ‘should’ cut down on my Facebooking, but I was not ready.  Yesterday, finally, I crossed a threshold and the decision was easy.

I hear this all the time from patients.  “I know I should eat healthier.  I know I should exercise more.  I know I should quit smoking, cut back on the alcohol, go to bed earlier, address my relationship problems.”  And, “…I just don’t.”  Both patients and physicians can easily slide into judgment here, thinking, “If you know you should, why don’t you just do it?”  Defensiveness and self-loathing follow closely behind these words.

On the other hand, when patients return having cut out red meat, quit tobacco, and joined a basketball club, I ask them, “What happened?”  Most of the time I hear, “I don’t know.  Something just clicked and I decided it was time.  …And suddenly it was easy.”  Sometimes they identify an a-ha moment—when they first held their newborn baby, for example.  But more often there is no cloud-parting epiphany.  They simply cross the threshold of readiness to change, while walking the journey of life.

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.  If we all did everything we knew we ‘should,’ then—well—you fill in the blank.  The point is: we don’t make changes until we are ready.  Certainly we facilitate readiness—that’s a topic for another post.   Suffice it to say: I see you.  I know you want to live healthy.  You will know when you’re ready, and you’ll move.  Until then, I’m still here with you.