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.


On Fasting


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!