Tag Archives: health

Superhero Exploration!

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November Gratitude Shorts, Day 20 (Late entry)

Man of Steel, Ironman, Thor, Avengers, Captain America, Mission Impossible, Jason Bourne, Hallelujah!

In the last several years my preferred movie genre has shifted from romantic comedies to superhero action flicks. I’m not exactly sure why, though I suspect it has something to do with letting go childish wishes of happily ever after and embracing a more, shall we say, assertive form of entertainment.

The story follows a similar arc, regardless of the movie. We meet the heroes, then follow along as some colossal menace emerges that only they can fight.  In at least one scene they narrowly avert some mortal threat at the last millisecond.  No matter how desperate and hopeless the situation, no matter how fast my heart races and I tremble and fret, in the end the heroes win and all is saved…until next time—tune in next summer!

I learned recently about three types of stress:

  1. Threat stress: This is what we generally mean when we say ‘stress.’ It’s the fight, flight, or freeze response, when we sense a threat to survival, or we appraise that we lack the resources to cope with our circumstances. It’s mediated by cortisol.
  2. Challenge stress: We face a challenge that we feel at least somewhat qualified to tackle but it will be hard, test our limits. If we’re lucky, it’s something we care deeply about and we rise to the occasion—I’m thinking this could lead to a state of flow. This stress results in increases in DHEA and testosterone.
  3. Tend and befriend stress: This is empathy. We see a friend in need and we respond with compassion and love. We feel connected through their struggle. Oxytocin rises here. [Addendum, 04/26/16: This is an incorrect interpretation of the tend and befriend response.  Read my updated understanding here.]

This is intriguing to me, and I will study more about this construct in the very near future. I have experienced a fair amount of the latter two recently, and I’m positively exhausted.  So here is what I have learned: Not all stress is bad.  But even good stress costs energy, and we need to recover from it.

So maybe this is why superhero action films appeal to me? The heroes experience a call to adventure.  They, and we, wonder if they are up to the challenge.  They are tested, sometimes to their very limits.  In the end they prevail.  Maybe watching these movies vicariously feeds my challenge stress hunger, helps me believe that I, too, can rise to the occasion of my challenges in life?  None of the heroes do it alone, they all have at least one loyal partner who believes in them and their cause—the partners tend and befriend them—they have connection.  We all need help to get where we need to go.  The true superheroes know this well.

 

 

 

 

Who’s Your Team?

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November Gratitude Shorts, Day 17

As I lay on the table in physical therapy today I thought, how fortunate I am to have healthcare insurance that allows me to come every week and get help for my pain and dysfunction. I always leave feeling better, and my therapist knows exactly what’s going on and what to do.

I also have an incredible trainer. She has a sixth sense for my mood and readiness for challenge each session. She is also a lifelong learner, and seeks new knowledge from reading and conferences, among other things. When I share assessments between these two dedicated providers, they each integrate the other’s recommendations and the results are synergistic.

My primary care doctor has ‘the three A’s’ that matter most to us patients, in order: Availability, Affability, and Ability. He also cares for my children, and manages their hypervigilant internist mom with kindness and patience.

My therapist is a Godsend. I don’t have depression or anxiety, nor psychosis or a personality disorder, that I know of.  But I have my share of emotional baggage, and having an objective professional to help me sort and process has proven invaluable in all aspects of my life. Long-established thought, feeling, and behavior patterns show up repeatedly, wearing slightly different outfits each visit. Through therapy I have learned to recognize the party crashers more easily, and manage them better over time.  Sometimes they are allowed to stay, and I make sure they know the rules. Other times they get thrown out, again.  Therapy helps me keep my inner house in order, so that I may welcome and integrate new knowledge and wisdom.

But my team includes more than just my healthcare providers. I have a strong cadre of close friends upon whom I can call at any time, and who will answer always with love and understanding. I recently had a sudden personal dilemma that caused me considerable angst. I emailed a few of these friends and each of them responded immediately with exactly the wisdom I needed… Not necessarily what I wanted, but that’s what true friends do–they tell you the truth with kindness, compassion, and unconditional love.

I also count my parents, sisters, husband, children, neighbors, some colleagues, and many others, as team members. The NFL comes to mind… Choose your team–each is comprised of literally hundreds of people, all working for the shared purpose of making the team, as a whole, the best it can be.

I cannot think of how my team could possibly be better.  And it’s not just about me. I am a member of each other person’s team, too. We all hold each other up.

An idea came to me in conversation this past weekend, when I spoke to a fellow internist about physician burnout and patient satisfaction: We cannot separate my well-being from your well-being, if we are in relationship. And we are all in relationship. So let us take care of one another.

Lessons From Middle School Drama

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November Gratitude Shorts, Day 15

Grateful for the arts today, and theater in particular. This is unusual for me, as I am generally not a theater-goer. But the middle school’s first production of the year occurred this weekend. My son served on crew, so I was excited to see the show!

The students positively awed me with their performance. They adapted three books in what I would describe as visual narrative. The players took turns speaking and acting lines from the books, with minimal props and costumes. The depth of expression these preteens acheived far surpassed my expectations. 

They chose Brown Girl Dreaming by Jacqueline Woodson, Between Shades of Gray by Ruta Sepetys, and Boy by Roald Dahl. The first two blew me away. As I watched and listened to the autobiographical narratives of one girl’s coming of age during the civil rights movement, and another’s harrowing trauma of Soviet subjugation, I found myself trying to imagine myself in their shoes. 

It makes me wonder, do I do this enough in my work? When I hear my patients’ stories do I try to take their perspective and understand their decision making? I believe I do, mainly because I take the time to ask about their stories. I know this is the best way to counsel them on health behavior change. We make decisions emotionally, and rationalize afterward. So I need to speak to whatever holds meaning for each individual, which I can only know by listening to each person’s story and taking his/her perspective.

A study of medical students by Blatt  et al in 2010 showed that perspective taking can be taught, and can positively impact patient satisfaction. I would argue that it also improves physician satisfaction, and the benefits ripple out to the whole system. 

Where I need to practice perspective taking more is outside the exam room, when I interact with my support staff.  I need to learn more about their workflow, to understand the impact of my frequent and often impromptu requests of them throughout the day.  I need to verify that the stories I tell myself about their behavior at work are accurate (or, likely not–then I need to get curious). I need to ask for and listen to their stories in order to know best how to integrate the team.  I’m so grateful to the middle school drama club and my blogging challenge for helping me uncover this insight tonight. Now to put it into practice tomorrow morning!