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:
- Get to bed by 11:30 every night—Coach Christine has permission to call me out if I’m caught Facebooking past this time.
- Maintain 4+ workouts per week. An aging body needs regular vigorous movement!
- Keep up with therapy and resume regular coaching calls—reflect internally and project my best self outwardly.
- Maximize intake of stems, stalks, leaves, and fruit; minimize refined sugars.
- 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.
Health and Self-Care
The Sh*tpile /May 2015
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
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
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
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
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
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
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
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
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
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
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
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
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?
The Premise /April 2015
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
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
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
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
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
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
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
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
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
To Patients Who Abuse Medical Staff: Let me be clear: That is not okay.
No Substitute for Time /November 2017
“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
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.
Relationships and Communication
Gratitude, Generosity, and Peace /July 2015
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
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
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
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
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
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
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
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
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
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
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
…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
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”?