Tag Archives: personal growth

#AtoZChallenge: Drudgery and Discipline

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Well this is scary… It’s only day 4 of the A to Z Challenge and I’m already feeling blocked! ACK! I had what felt like a semi-brilliant idea for ‘D’ –a week ago. I even wrote a short draft. But now I’m embarrassed to continue—it feels redundant and self-indulgent. I’m a little paralyzed by fear. What to do now?

I signed up for this challenge partly to make myself sit down and write every day, or at least attempt it. I’ve kept a running list of my favorite words, declared a theme, committed to a program. I am now accountable. It is up to me to practice the Discipline of daily writing.

I can’t imagine that writing this blog will ever become Drudgery, because if it ever does I can just stop. The blog itself is beholden to no one. But it’s something I created, something that I want to cultivate and develop. Quality of the content is bound to vary; I cannot be the perfect culmination of my best writer self every time! So regardless of how I feel about this post, I have resolved to publish something today, and I will have to find a way to make it good enough. It’s hard work, and it’s what I signed up for.

So this gets me thinking… How many physicians think of their work as drudgery? Sadly, the answer is more than we’d like to admit. Statistics abound on the alarming increase in burnout among physicians, physician suicide, and the associated decline in patient satisfaction and health outcomes. The defining features of burnout in any field are depersonalization, emotional exhaustion, and low sense of personal accomplishment. That’s as good a description of drudgery as I’ve ever seen.

Most of us experience some symptoms of burnout at one time or another. How do we get through it? Many of my colleagues rightfully look to operations—promoting streamlined workflows, simplifying documentation and coding, and standardizing protocols. But these changes come slowly, and we must function in the existing, cumbersome and inefficient systems while we advocate for the changes we want. So in the meantime, we forge ahead with gritty discipline.

Medical training remains rigorous, though in recent decades we have made it more merciful. From the premedical curriculum, to clinical rotations, to on-call responsibilities as attending physicians, our professional lives require us to be there for our patients when we’d rather be communing with friends, attending our children’s school plays, or just sleeping. We made a commitment, took an oath. And for the most part, our work rewards us with rich opportunities for lifelong learning, hearty fellowship, and the privilege of caring for humanity in the most intimate ways. The discipline—the commitment to the work—pays off in spades.

In my reflections on physician health and well-being, however, I always come back to another domain of discipline—that of self-care. Medicine attracts caregivers. Sometimes we are also control freaks, and exhibit somewhat masochistic tendencies. When we let these traits take over, they upset the balance needed to thrive in the complex medical milieu. We need to maintain objectivity with compassion and sensitivity, calm and clarity with intuition and judgment. We cannot do this effectively if we constantly run on empty. When we neglect our body/mind/spirit, we get irritable, and our work and relationships suffer. Ever seen a toddler clunk her head on some furniture while walking? If she’s well-fed and well-rested, she’s likely to keep moving, intent on getting to her favorite toy on the other side of the room. If she is tired and hungry, however, the same innocuous thump may trigger a full-scale meltdown of epic proportions. It’s no different for adults. We need regular feedings, rest, and playtime just as much as our children do. For my part, when I speak to colleagues on burnout and resilience, I focus on the discipline of self-care. It’s what we can control now, while we continue the necessary work of systems change.

Fortunately, I have chosen a profession that feeds my soul. It is a calling, a vocation. I have also chosen to indulge in a hobby, writing, that fulfills me similarly. Both require commitment, discipline, and practice to be done well. Both run the risk of becoming drudgery, under certain circumstances.

This post has been an exercise in Disciplined Writing. I wanted to write while inspired, and it just was not happening. So I had to simply sit down and get to work. But as Liz Gilbert discusses in her brilliant new book, Big Magic, inspiration did visit me, however briefly, in the process.  That will keep me coming back to practice. I will continue this exercise all month—thank you for bearing with me!

#AtoZChallenge: Cursing, Curiosity, and Connection

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Welcome to my first attempt at the Blogging A to Z Challenge!  26 posts starting April 1, one for each letter of the alphabet (I get Sundays off).  I’m exploring meaningful words to apply to perceptions, attitudes, behaviors, and relationships. It’s a personal journey, part of my mission of self-assessment and development through writing.  Thank you for stopping by, and please feel free to comment! 🙂

 

Sometimes we get angry, and we need an outlet. But often we need to suppress, get through the situation with grace and smiles.  Sometimes the need for professionalism and control can turn into chronic repression, which can then lead to sudden and violent explosions, often on those we love most.  Psychology tells us that children (and adults, as well) do this because it’s safest to lose it among those who truly love us, and we know this subconsciously.  But the scars left on these relationships can be disfiguring.  It’s dysfunctional, and there is a solution:  Curse It All.

A colleague in mind-body medicine told me once that he recommended to his patients to tantrum. I was incredulous at first, but then I saw the light.  Venting, done appropriately, can be cathartic and liberating.  One day I became abruptly livid, I won’t tell you why, but suffice it to say it was over something small, that represented a chronic dysfunctional pattern in a longstanding relationship (Cryptic is also a word for this post!).  It occurred to me that this was the perfect opportunity to try the tantrum method.  I was home by myself, and I share no walls with my neighbors.  I took a pair of jeans, held them by the cuffs, and proceeded to pummel at the bed, all the while screaming expletives at the top of my lungs, stomping, and flailing wildly.  It took maybe 45 seconds, tops.  Afterward I felt a new calm, a lightness that had seemed impossible just minutes before.

Cursing, or swearing, has some interesting benefits. It can increase pain tolerance, strengthen bonds of solidarity, and help us convey conviction and passion.  So I endorse it, as long as we use these words strategically.  A follow up experiment to the pain tolerance study found that daily swearers, people habituated to the practice, had less analgesic benefit compared to occasional swearers.  We now also have access to adult coloring books, giving us a visual route to unload intense emotions.

sh-t storm coloring book cover

image from Google

But then there is more work to do. Sometimes it’s enough just to have vented, but I think we serve ourselves best when we can take some time and energy to evaluate.  The first step here is to get Curious.  I first learned this from my life coach.  In conflict, it’s so easy to only see our own point of view.  Emotional hijacking causes tunnel vision.  So once the emotions have dissipated by way of swearing and chopping bed with jeans, we can once again see and think clearly.  Curiosity asks open-ended questions:  What just happened here?  How did I get to this place?  Why do I fly off the handle like this whenever (fill in the blank)?  Advanced curiosity is where assumptions can also be challenged:  What story am I telling about the other person that causes me to react this way?  What other story can I tell that would help us both suffer less and get to mutual understanding?  These are well-established techniques in coaching and psychology.  I refer you to Rising Strong, Brené Brown’s newest book, in which she describes the process of using curiosity as the springboard for healing from adversity and living ‘wholeheartedly.’

 

Why is this important? Because humans live to be connected.  Anger can be blinding.  It arises first and so intensely when we have other, more distressing feelings underlying, such as sadness, shame, rejection, and guilt.  Anger serves to protect us from the pain of those emotions, and also keeps us from moving through them, healing them.  The repression-explosion cycle costs us energy and connection (to self and others), and ultimately keeps us from living truly, freely, joyful lives.  Cursing decompresses emotions, allowing us to open the door to relationships with curiosity.  Then, when we uncover the answers to the open-ended questions, we can start to reconnect with what we love about our partners, our children, our friends, our colleagues, and ourselves.

So go ahead, detonate those strategic f-bombs!  Find the padded space to rail and flail.  Then savor the possibilities of newfound clarity of mind and heart.  How much better could it get?  We never know, but it could be spectacular.

#AtoZChallenge: Assumptions and Appreciation

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Welcome to my first attempt at the Blogging A to Z Challenge!  26 posts in April, one for each letter of the alphabet (I get one day off per week).  I will explore meaningful words to apply to perceptions, attitudes, behaviors, and relationships. It’s a personal journey, part of my mission of self-assessment and development through writing.  Thank you for stopping by, and please feel free to comment! 🙂

 

Yoga instructors. Football players.  ER nurses.  Asian college students.  Old white men.

Hold these likenesses in your mind’s eye for a moment. Who do you see?

Was the yoga instructor a man or woman? The football player?  It’s impossible not to make assumptions, to apply stereotypes.  Such constructions help us make sense of the world.  They allow us to move through countless human encounters quickly and automatically.  And, they can limit us far more than we realize.

One spring day my kids and I sat in the car, waiting to exit the parking lot after church. Three men, Caucasian, in their 60s, crossed in front of us.  They were well-groomed and overweight—grandpas, likely.  Their expressions were neutral, absorbed in conversation.  One of them looked a little winded from walking.  They were perfectly unremarkable, and they did not notice us.

I felt an acute flash of fear.  It was visceral, as if, at any moment, they could decide that my kids and I were not worthy of being at that intersection, and that they somehow had the power to impact my life in ways that I could not control or influence.  Three apparently unassuming white men.   Fascinating.

I remembered this story when a friend and colleague recently shared this blog post on our assumptions about surgeons.  I realized that despite being married to a surgeon, having multiple surgeon friends, and trying every day to live with an open mind, I still ascribe to the stereotype of the mean surgeon.  It comes out when I hang up the phone after a pleasant conversation with an ENT fellow.  “Wow, he was so nice,” I think, surprised.  Or when I feel righteously annoyed after a terse and condescending interaction with his attending.  “What do you expect,” I say to myself, “he’s a(n old, white, male) surgeon.”  Nobody would ever say that about a pediatrician.

I don’t shame myself for harboring the mean surgeon and old white men stereotypes. They were born of a certain reality and make me appropriately cautious in new situations.  I don’t think I behave badly because of them, and I readily acknowledge when the stereotypes are broken.  But the realization that I hold these assumptions so deeply—subconsciously—gives me pause.  What other assumptions do I carry, and how do they limit my relationships?  I think it’s fair to say that we all carry shards of racism, classism, and other forms of blatant prejudice.  Here’s what I also think:  It’s okay.  We can’t help it, that’s just how it is.  Denying it just makes it that much more insidious, subversive, and toxic.  I’m prejudiced, you’re prejudiced, we’re all prejudiced.  The more we say it, the less scary it gets.  The first step is acknowledgement without shame.

But we cannot, and must not, stop there. We can’t only say, “We can’t help it, that’s just how it is.”  We must take the next step, which is to manage it better.

I think an excellent antidote to toxic assumptions is appreciation.

Dictionary.com includes the following definitions of appreciate:

  1. To regard highly; place high estimate on: to appreciate good wine.
  2. To be fully conscious of; be aware of/ detect: to appreciate the dangers of the situation.

Let us first fully appreciate (be aware of/detect) the scope of our prejudices: Their cultural, familial, or experiential origins, their subtle influence on our perceptions, and the covert ways they manipulate our thoughts, words, and actions toward others.  Awareness is key.  It is also hard.  It’s hard because we know we shouldn’t be prejudiced, it’s bad.  Prejudiced people are bad, they do bad things, we don’t want to be like them; if we admit our prejudices then that means we are bad, that we are not worthy.  STOP.  The only way to keep from acting on our negative stereotypes and perpetuating racism and xenophobia is to fully acknowledge their existence and confront them, head on.  They do not define us.  They are not all of who we are and what we stand for.  Their presence does not negate all that is good, generous, and inclusive about us.  AND, they are part of us.  We cannot escape them by way of denial.  If we can call ourselves out honestly, lovingly, and with forgiveness, we can then integrate our prejudices, and put them in their place.  Appreciation does not mean approval of, or abject subjugation by, our biases.  It is simply the first step to living wholly, to knowing and owning all of ourselves, and moving with intention and mindfulness.

Then, let us apply the other definition of appreciation to others. Let us regard more highly those whom we may automatically, however subtly, belittle in our subconscious.  How might we do this?  Look for that which we share.  She is a mom.  She must love her kids as much as I love mine.  What are their circumstances, what lessons is she trying to teach them, and what would I do in her place?  Why did he become a doctor?  He must want to help people like I do.  I could never do what he does, so high risk, so much responsibility.  God bless him, we need people like him.

Let us then solidify the process with words, out loud. “I can tell you really love your son.”  “Thank you for caring so much about our patient.”  It may sound trite, even silly, at first.  But we can never underestimate the impact of a few kind words, not just on others, but on ourselves.  When I acknowledge myself in you, I make a connection.  I see you, I recognize you, I appreciate you, as I do myself.  Prejudice thrives in silence and denial.  It cannot long survive being spoken out loud and it certainly withers in the presence of true connection.

We will always make assumptions.  Tempered with some well-placed appreciation, though, perhaps we can get through life with a little more love and a little less suffering.