We Are Tested

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What a shit week.  I wonder, how are you doing, my friends?  Because I look around and it really seems like I’m not the only one feeling it.  A friend’s young, healthy sister-in-law was diagnosed with metastatic lung cancer and possibly also lymphoma.  Another friend’s cousin died from a drug overdose after recently completing rehab and getting back to her young family.  Patients are sick with mysterious and disconcerting illnesses.  Pipe bombs were sent to a slew of Democratic leaders and supporters.  And today a man commits yet another deadly, hate-driven shooting.  Seriously, WTAF?  And I honestly think we have yet to hit rock bottom.  I don’t see any of it turning around anytime soon.

I have barely made it through—so much psychic energy required to simply move from one task to the next, taking care of many (and not so much some others).  This past year, actually, sometimes I’m barely holding it together.  First the knee injury, then taking on a new big role at work.  Then surgery/rehab, and another personal crisis that derailed all of my health habits for spring and summer.  As I go around the country talking about personal resilience and culture of wellness, I wonder, am I being a hypocrite?  Am I really walking my talk?  Because if I’m not, I had better just sit down and shut up.

I wrote to a friend today, “I hope you are able to take care of yourself and recharge.  The energy in the world is so tumultuous and agitated.  It’s no help to blame and lament (well maybe lamenting can be a bit cathartic—for a while).  I guess this is a time to exercise our best skills—sharpen them against the harsh and jagged surfaces of challenge and trial.  I feel like all year my professed self-care practices have been called out and called forth—TESTED.  And I’m still here…  Still doing some good every day (I think), alongside the mistakes, the sub-par moments, the not-my-best words, actions, and thoughts…  But hey, who’s perfect?  Nobody.  And are we all here doing the best we can?  I agree with Brené Brown’s husband Steve, the pediatrician: It helps me live better when I choose to believe that we are—all visible evidence to the contrary.” (Here is another article that describes well the benefits of this mindset.)

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Similar to last week, as I consider this idea, I am met with readings and conversations that deepen the exploration.  Friend and author Donna Cameron published an op-ed today in which she, in her typically kind and gentle style, encourages us all to be our best and see the best in others—on November 7, a day full of potential for vehement loathing and gloating celebration.  In her wisdom, Donna urges us to think ahead and decide in advance how we will choose to think, speak, and act.  How can we be our best on that day, to ourselves and to one another, no matter what the circumstances?

Recently I have had conversations with trusted friends, my coach, and my therapist, focused on my own most cavernous arenas of personal self-loathing and shame.  How lucky that I have such generous, loving, wise, candid, and brave people holding me up.  With their help, I can move past shame, take a step back, and recognize that I simply have some dysfunctional patterns, just like everybody else.  I slide into these deep grooves when I’m stressed, exhausted, and distracted—they are the default. They are part of me, and also subject to change—to intentional modification, gradual evolution.  These days I meditate often on the distinction between perfection and healthy striving, and I’m also reminded daily of the benefits of cultivating a growth mindset.  These days, instead of berating myself for falling into the same deep hole in my sidewalk, I can hold it more lightly, laugh, and exclaim, “How Fascinating!” climb out (often with a little help from my friends), and walk—ever onward.

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Today as I walked outside, slowly (I’m so tired), I noticed the leaves again.  I think autumn is my favorite season.  It reminds me of the wholeness and beauty of transitions.  They are inevitable.  They are temporary (or constant?).  They are unpredictable, at times prolonged, at other times sudden and acute.  They can feel at once painful, joyous, terrifying, shocking, enlightening, overwhelming, confusing, awe-inspiring (or simply inspiring).  It occurs to me that the best way through them involves practicing some combination of mindfulness, self-compassion, empathy, generosity, deep breathing, sleep, connection, self-awareness, magnanimity, and of course love.  The only way out is through, and if we do it well, we can grow a little at a time in the process.

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Who knows what shit will be flung our way and hit the fan next week?  How will we cope?  I know I will be leaning on my tribe and looking to make our ties ever stronger and thicker.  Thank you for being here to share the journey.

What If I Slip?

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NaBloPoMo 2017: Field Notes From a Life in Medicine

40 hours out from my non-traumatic, sports-induced knee collapse, I’m off crutches, woo-hoooooo!  The knee is still swollen and stiff, and people still look twice when they see me limping.  I’m thinking of ordering from Peapod–the thought of walking around the grocery store, which I normally love doing, makes me wince a little.

I’m much more afraid, though, of the back slide that may ensue in these next days and weeks.  I’ve worked so hard the last few years, establishing and entraining an excellent exercise habit, and I was just hitting a period of new growth and ability, so exciting!  I was getting lighter and nimbler on my feet, and now I lurch clumsily, Trandelenburg-like (not really, but kinda).  All year I have felt sluggish and tense if more than two days went by without a work out.  I barely moved yesterday and I loved it, which scares me.

The last few months also saw a shift in my eating, recapturing a sense of control.  I was eating less without hunger or feeling deprived, and though my weight had remained roughly the same, my figure was noticeably streamlining.  I liked looking in the mirror again.  Last night I found myself grazing steadily after dark.  …Stress eating sucks.  I only recognized a few years ago that I do it, and I have since had much more empathy for my patients with similar patterns of food, tobacco, alcohol, and other ‘substance’ use.  I know I should not be shoveling tortilla chips, ice cream, cookies, and candy in my mouth at 10pm.  I know I don’t need the calories, I’m not really hungry, and I will feel guilty on the other side.  And I do it anyway.  It comes in cycles, and I have yet to find a healthier behavioral alternative in those moments (drink a full glass of water, get on the elliptical, drop and 20 push-ups!  Ooo, that last one might work…).

The point is, I really worry how this setback with my knee will derail and reverse all that I have accomplished until now.  (hyperventilation) GAAAAAHH!!

But wait, the injury was less than two days ago…  And I continue to feel better, regaining range of motion and limping slightly less with the help of ibuprofen and RICEing.  What did I write the other night about resting and recovering?  And what I have been preaching to patients about mindfulness, radical acceptance, and doing what you can at the time?  About small change steps sustained over time, and about how worry is counterproductive, because to paraphrase Michael J. Fox, if what you’re worried about actually happens, now you’ve lived it twice!?

Okay, I’ got this.  Plenty of movement I can still do with a bum knee (including maybe push-ups when I feel a late-night ice cream hankering).  I’m still the same motivated workout beast I was 60 hours ago, the same person who just got through a 30 day food challenge with only minor transgressions.  And JEEZ, it’s only been 40 hours.

Well thanks for helping me work through that, my friends.  I’m good now.

Love Letter to My Superstar Friends

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Dear Paul & Joanne*,

I cannot tell you how grateful I am to you both for taking the time to meet me last week.  You came out in the pouring rain, not for a lighthearted night of drinks and karaoke, but to talk charged politics with your tortured, melancholic, liberal friend.  I hope it did not feel too burdensome, and that you would do it again.

It was quite the emotional evening for me, unsettling, sometimes uncomfortable, and also dominated by love.  Joanne, we have known each other about 15 years, and I know you are not a fan of politics in general.  Paul, I know you mostly through your witty holiday cards, and your occasional Facebook posts that often touch on politics.  You lean right, it seems, about as much as I lean left.  You gently called me out when I shared a Trump supporter-shaming video, reminding me to hold myself to a higher standard of discourse on all platforms.  That is why I sought you out.  When you engage, you exemplify the attitude toward political discourse that I aspire to.

I described to Joanne over the phone how distraught I had been since November, something akin to “watching the fabric of my generation’s social progress torn to shreds by a maniacally fomenting, double-machete-wielding narcissist.”  You seemed genuinely surprised and curious—why did this election have such a profoundly tormenting effect on me?  What made millions of people pour into the streets around the world in protest?  I was incredulous at your incredulity, and yet I felt a mutual, loving acceptance between friends who only want each other to be happy and feel secure.

At dinner, I could tell that you both cared acutely about my distress, and wanted to help alleviate it.  You reassured me that the worst case scenarios are highly unlikely to actually happen.  You reminded me that hyperventilation and arm flapping are not productive energy expenditures.  You gently encouraged me about the long, jagged, often meandering, and also inevitable path of social progress, and the importance of taking the long view.

I admit that I felt a little defensive at times, as if anything I said about the origins of my distress would be met with, “You’re overreacting,” and “You’re worried about nothing, please…”  We later agreed that it is never helpful to invalidate someone’s emotional response to a stressor, regardless of whether or not we can relate.  Paul, you are so well-read and convicted about your opinions.  I did not see a point in arguing, as you did not seem interested in debate, and I left feeling disappointed that I had not presented a stronger defense of my liberal ideals.  The whole exchange felt lopsided in favor of your position.  But I did learn from your point of view, which was one of my primary objectives.

Most importantly, our conversation revived my mindfulness practice.  You’re right—energy spent catastrophizing about a hell-on-earth future is energy wasted.  As Michael J. Fox says (I paraphrase), “Don’t spend your time worrying, because if what you’re worried about actually happens, now you’ve lived it twice.”  My energy is better spent in the present, attending to what is, rather than what I fear might be.  And I feel justified in my shock and dismay at what is.  In my opinion, Donald Trump has defiled the presidency and brought our politics to a new moral low that I could never have predicted.  I don’t need to ‘go apeshit’ over the future, as there is plenty of wreckage to confront right now, not the least of which is our collective refusal to engage one another in civil discourse.  I can center, ground, and focus, breathe deeply and engage, one step, one person, or one loving couple, at a time.

Last week Dan Rather wrote my heart on his Facebook page:

The threats, the lies, the willful disregard for the rule of law should be limited to the world of Hollywood caricature. To see this played out each night on the news, to read about ramblings and inconsistencies in justifications for actions that should never have been taken, is to see a moment of great peril for our nation.

I remain, however, an optimist. I see the swellings of civic engagement and action. I hear the voices of those who demand that this subversion of our national ideals shall not stand. I have covered social movements of the past, and never have seen one where so much power and numbers lie on the side of the opposition. This is a clash for the values of our nation. Our destiny is in our hands.

Our nation’s patchy, irregular social fabric may be strained to its limits today, and even torn in some places.  But the threat of real disintegration has brought forth multitudes of weavers and quilters to repair and protect its integrity.  I can acknowledge this ‘collateral beauty’ and contribute my part, through conversations like ours, to help mend the tapestry, and bend that moral arc of the universe more toward justice.

Thank you, my dear friends, for helping me train for this marathon.  You hold me up and make me stronger.  I hope I do the same for you.

Sincerely and with love,

Cathy

 

*Not their real names