On Journeying Together

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NaBloPoMo 2016, Letters to Patients, Day 30

To Patients Who Journey With Me:

It is my privilege and my honor.

Well here we are, my friends, we made it!  30 posts in 30 days, woooo hoooooooooo!!

I had 30 topics all lined up on Halloween, and I think I used 6 of them.  How fascinating!  Looking back, I’m pretty proud of the content this month.  It all came from places of true feeling and contemplation, and I tried my best to make it relevant to the physician-patient relationship.  I meant to write more cogently about policy and operations, maybe illuminate more of the physician’s experience, to help patients understand our perspectives.  I wonder if that is more appropriate for long form writing, or even not writing at all, more like panel discussion or podcast?

Some of you have followed, liked, and commented all the way through—thank you so much.  After all, what is a blog if nobody reads it?  The feedback has held me up and kept me going.  It’s not so different from my relationships with actual patients.  Some are superficial and short-lived.  But most have a true human connection, and potential for integrative growth over time.  My heart is warmed whenever you inquire about my children with genuine caring.  When you remember my extracurricular projects and congratulate my successes, I feel respected.  Heck when you just notice that my hair is longer, I know you see me!

Believe me, I’m not in this just for the science, or the money, or the prestige, or the teaching.  I’m in this to know you, my patient—and for you to know me.  I know there are some who see me as expendable, exchangeable.  Their interactions with me feel purely transactional.  And that’s okay; everybody needs something different.  But I could not long survive a practice of only such relationships.  No, that would kill my soul for sure.  I live for the connections, I say.  I learn from every one of you, and you make me better.

So thank you for journeying with me.  It’s a long, strange trip, eh?  The path winds, the weather shifts, and times change.  But as long as we go together, I’m all in.

 

On You, the Elite Athlete

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NaBloPoMo 2016, Letters to Patients, Day 28

To All Patients:

What would happen if you thought of yourself as an elite athlete?

I present tonight the first phase of the presentations I have given this fall to physicians, corporate executives, and tomorrow, a corporate design team.  See how it applies to you:

***

What makes you exactly the same as Pat Summit, Martina Navratilova, Michael Jordan, Dana Torres, Peyton Manning, Serena Williams, Wayne Gretzky, and Walter Payton?  You are an elite athlete.  You have a specific skill set which you spent years training and honing.  You continue, through practice and discipline, to refine it.  It’s an upward striving, just like an Olympian—Higher, Faster, Stronger!  And, you’re part of a team.

So how should you take care of yourself—your very valuable, elite athlete self?

Fuel & Train

  • “Regular people diet and exercise. Athletes fuel and train.” –Melissa Orth-Fray
  • Our bodies are our vehicles. Elite athletes’ vehicles require premium fuel and meticulous maintenance.
  • We all struggle with the same challenges—time, motivation, discipline.
  • Each day we have an opportunity to walk the talk, and practice what we preach. Every good lifestyle choice, no matter how small (apple instead of candy, stand rather than sit), is a step of intention toward health.

Rest & Recover

  • Chronic sleep debt increases risks for diabetes, obesity, impaired immune function: GET MORE SLEEP.
  • Rest and recovery are integral for sustaining long term performance and injury prevention—ie burnout. This applies for both physical and mental exertion.
  • Take your allotted vacations and really disconnect.  The world will still function (temporarily) without you.
  • Broaden your methods: 15 minute walk, 10 minute meditation, 5 minutes of journaling—unwind, unload.

Manage your stress

  • How do you know when you are ‘stressed?’ How/where does stress manifest in your body?
  • What are your existing resilience practices? How quickly do you abandon them when things get busy?
  • Exercise mindfulness: Live in the moment; breathe deeply; speak and act intentionally, not incidentally.
  • We are no different from toddlers—easily emotionally hijacked when tired, hungry, over-extended.
  • Elite athletes use the disciplines above to manage their emotions and stay focused.

Cultivate positive relationships

  • Coaches, teammates, trainers, psychologists, equipment managers—no athlete succeeds alone.
  • We thrive when we feel seen, heard, understood, accepted, loved, and safe.
  • It is only when our relationships are strong and we feel connected, that we can truly care for ourselves and our teams.
  • Who is your support network, and how do they hold you up?
  • Who do you support, and why/how does this fulfill you?

 

What is your sport?  Who is your team?  How does caring for yourself benefit those around you?  And finally, what can you do today, tomorrow, next week, next month, and in the next year, that will elevate your own health and well-being, and that of your team?  Please share your ideas in the comments!

On Happy Movies

 

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NaBloPoMo 2016, Letters to Patients, Day 26

To Patients Getting Into the Spirit:

What movies do you recommend?

26 days and… writer’s block.  So duh, the obvious solution was to take a shower!  According to Shelley Carson, PhD, the defocused mindstate of showering allows for creativity and innovation.  I noticed the sullenness that envelopes me so often lately.  I wished for a mental uplift, and the gods obliged—they reminded me of “The Internship.”  Vince Vaughn and Owen Wilson play a couple of recently unemployed Gen-X salesmen who land coveted internships at Google.  They lead a dejected team of Millennial misfits who, of course, overcome all odds to win in the end.  It’s admittedly full of cheese.  But the endearing characters and uber-nerdiness get me every time.

Post-shower, I came down to movie night in progress:  “Music and Lyrics,” starring Hugh Grant and Drew Barrymore.  Grant, an 80s pop ‘has-been,’ falls in love with his substitute plant waterer and incidental lyrcist, played by Barrymore.  Once again, current-event melancholy yielded to drippy-sweet romantic comedy.  You just can’t sustain a sour mood in the face of all that adorableness.

Other movies that come to mind, and that I plan to watch in the coming days:

Love, Actually

The Holiday

White Christmas

You’ve Got Mail

While You Were Sleeping

It would really be nice to get fully into the spirit again this year.  Why not aim for joy, after all?  Vacation days, family gatherings, gift exchanges and excuses to shop with abandon…  It could all be good, and I can exercise more control over my mood than I have until now.

So, the feel-good, holiday-mood-elevation movie marathon begins tomorrow, yay!  Please feel free to make your suggestions!

On the Golden Positivity Ratio

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Courtesy of Bryan Jorgensen, Las Vegas, NV, 2016

NaBloPoMo 2016, Letters to Patients, Day 25

To Patients Seeking Positivity:

Aim for the Golden Ratio!

As many of you know, I have recently undertaken to re-evaluate my Facebook usage.  Not long after I established my account c.2008, I decided to make my page a monument to positivity.  I realized that after I die, it would be the most visible and accessible legacy I leave, and I have total control over what I post.  I minimized complaining and ranting, and when frustrated I would try to write with an attitude of learning, of moving forward.  Lately I tend to leave off the latter.

Somewhere along the way, I think over the past year, but I’m not sure, pessimism and cynicism snuck in, no doubt related to politics.  The layers of consciousness infiltrated by the negative campaigning this time around extend deeper than any other election cycle in my memory—but maybe I just don’t remember.  I think humans have evolved to forget pain as a survival mechanism.  If women remembered all the pain and anxiety of pregnancy, delivery, and caring for a newborn, we would never do it more than once, are you kidding me?

I used to review my Facebook posts and feel elevated.  Today they often bring me down; it feels terrible.

Thankfully, I have some tools to resist the negativity.  I was reminded recently during my 3 Question Journal Shares with Donna over at A Year of Living Kindly.  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 relationship with ourselves.  It’s not a far leap to see how this idea pertains to news, social media, and any other human interactions.

Business researchers have discovered a 5.6:1 ideal ratio in highly functioning organizations, whereas low-performing teams’ ratio landed close to 0.3:1.

For more information on the science behind the theory (and motivation for practice), I highly recommend Positive Psychology in a Nutshell, by Ilona Boniwell.  For a brief overview, check out this PDF.  The book summarizes the origins of positive psychology as a field, and the research and wisdom of its study and application.  For example, psychologist Barbara Frederickson has described how positive emotions contribute to our personal growth and development (taken from Boniwell’s text):

  1. Positive emotions broaden our thought-action repertoires
  2. Positive emotions undo negative emotions
  3. Positive emotions enhance resilience

So hereafter, I will pay more attention.  I will likely continue to share articles that illuminate my concerns for the future.  But I will aim for the 5:1 positivity ratio.  Holy cow, can you imagine if that’s actually what we saw on the news and social media?  And why not aspire to 5:1 in my personal interactions, too?  That’s taking charge of my own happiness, yes.

On Experiencing and Expressing Gratitude

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NaBloPoMo 2016, Letters to Patients, Day 23

To Patients Seeking Words for Gratitude:

I found them!

As we head to gatherings tomorrow and seek words to honor and express the occasion, I’m particularly grateful today to see the post below by David Whyte.  Where, you ask?  Why on Facebook, of course!  Back tomorrow with my own original words.  Until then, peace and gratitude to you all!

***  ***  ***

GRATITUDE

is not a passive response to something we have been given, gratitude arises from paying attention, from being awake in the presence of everything that lives within and without us. Gratitude is not necessarily something that is shown after the event, it is the deep, a-priori state of attention that shows we understand and are equal to the gifted nature of life.

Gratitude is the understanding that many millions of things come together and live together and mesh together and breathe together in order for us to take even one more breath of air, that the underlying gift of life and incarnation as a living, participating human being is a privilege; that we are miraculously, part of something, rather than nothing. Even if that something is temporarily pain or despair, we inhabit a living world, with real faces, real voices, laughter, the color blue, the green of the fields, the freshness of a cold wind, or the tawny hue of a winter landscape.

To see the full miraculous essentiality of the color blue is to be grateful with no necessity for a word of thanks. To see fully, the beauty of a daughter’s face across the table, of a son’s outline against the mountains, is to be fully grateful without having to seek a God to thank him. To sit among friends and strangers, hearing many voices, strange opinions; to intuit even stranger inner lives beneath calm surface lives, to inhabit many worlds at once in this world, to be a someone amongst all other someones, and therefore to make a conversation without saying a word, is to deepen our sense of presence and therefore our natural sense of thankfulness that everything happens both with us and without us, that we are participants and witness all at once.

Thankfulness finds its full measure in generosity of presence, both through participation and witness. We sit at the table as part of every other person’s strange world while making our own world without will or effort, this is what is extraordinary and gifted, this is the essence of gratefulness, seeing to the heart of privilege.

Thanksgiving happens when our sense of presence meets and fully beholds all other presences. Being unappreciative, feeling distant, might mean we are simply not paying attention.

© 2015 David Whyte
from ‘GRATITUDE’
In CONSOLATIONS: The Solace, Nourishment and Underlying Meaning of Everyday Words.
© David Whyte and Many Rivers Press 2015

On What Helps

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NaBloPoMo 2016, Letters to Patients, Day 22

To Patients Preparing for Uncomfortable Holidays:

Seek what helps.

What did I write recently about staying off of Facebook and minimizing my social media exchanges?  How fascinating, look what I just did—spent the last two hours on Facebook!  I also write about trying, falling down, and trying again…  So this is me both falling down (in my attempt to stay off) and trying again (to engage meaningfully).

The holidays are coming, yay!  …And, not so yay!  The conversations we have with friends and family in the next 6 weeks or so have enormous potential—for division as well as connection.  Personally, I feel optimistic.  I plan to evoke my core values of open-mindedness, empathy, and integrity.  I want to look back on the gatherings with gratitude and deeper connection.  So today I share with you all the things I have read (today—see?  I endure Facebook for your benefit! teeheehee) that have helped me.  These pieces validate, challenge, reassure, alarm, question and motivate me to Hold the Space, Stay on the Path, and Seek Love.  Please share yours, also!

A fellow physician’s acknowledgement of the humanness of bias, its potential for harm in caring for patients, and a reminder for self-awareness and –management.

Posts by Michelle at The Green Study, reminding us that internal conflict is normal in the face of world events such as ours, with concrete suggestions for actions that align with core values:  “We cannot strengthen our character unless it is tested. We cannot defend our freedoms unless they are threatened. We cannot become better writers or artists or humans unless we have obstacles to overcome.”

An article from The Guardian that points me to reputable sources of alternate points of view, so I may understand better.

A call out from the Wall Street Journal—to help me own my shit before I call out others on theirs.

A gentle message from fellow blogger John Pavlovitz: “Friend, however you choose to navigate these holidays, know that it’s the right way. Give yourself permission to pretend or confront or abstain as you need to, and forgive yourself later if you decide you chose poorly. You’re probably going to get it wrong or at least feel like you did.

“But remember too, to save a little of that mercy for those who sit across the table from you or those who choose not to. They’ll be doing the best they can too.”

And finally, the Prayer of Maimonides, the twelfth century physician and philosopher:

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These holidays, wish me persistence and ‘stubborn gladness,’ as Liz Gilbert calls it.  I wish you all the same!

On Trudging the Road Forward

img_4456NaBloPoMo 2016, Letters to Patients, Day 21

To Patients Who Doubt Your Ability or Endurance:

Don’t give up!  Stay on the path!!

Holy COW, Day 21!!  That’s three whole weeks that I have managed to post every single day!  So it really is true, the more times you try, the more likely you are to succeed.

I tried NaBloPoMo last year with “November Gratitude Shorts.”  It felt scary at first, then stressful, then deflating.  Then this past April, I did my first A to Z Blogging Challenge.  I had the insight to warn my family that I would be busier, and then halfway through announced that I would basically stop cooking until it was over.  It was not nearly the slog of NGS, but I did feel quite overextended and anxious for many days that month.  I submitted the last one with 30 minutes to spare on April 30.

The evolution here is worth examining, as it parallels other endeavors in life—exercise, parenting, the cultivation of other relationships… When I counsel patients around health behavior change, I often hear, ‘I tried that before, it didn’t work.’  This is usually when I point out that ‘before’ was a very different time.  Then they concede that since then, their experience, circumstances, and priorities may have evolved, sometimes drastically so, and maybe ‘it’ might work this time, who knows?

If we live consciously, observantly, and mindfully, I believe that all of our experiences make us stronger.  Trials and learnings in one realm of life inevitably pertain to all others.  If we can manage to see and appreciate this, then the potential for application and personal growth expands exponentially.  How much more could we accomplish if we just allowed ourselves to pick up and keep going, not only expecting to fall along the way, but anticipating it with gladness for the learning?

So let’s lighten up on ourselves, shall we?  Even if you have tried many times to quit smoking, establish an exercise routine, ‘eat healthier’ (whatever that means for you), and then consistently gone back to old habits, don’t give up!  Stay on the path!  Keep moving forward!  Try something new, learn something new, integrate, and continue!  Life is so much more fun when we don’t take it all so seriously, no?

So now that I have bragged on Day 21, what do you bet things will fall apart as we approach the Thanksgiving weekend?  Oh well, we shall see!  Even if that’s the case, I already have some valuable lessons stashed away:

  1. Try not so schedule so many conferences and presentations during NaBloPoMo.
  2. 500 words and 60 minutes are very reasonable limits for daily posts.
  3. Definitely warn the family; set expectations in advance.
  4. Protect the sleep!!

Happy Monday, all—and here’s to trudging the path together!