I am a master procrastinator! It’s starting to show on this blog, but oh well, now you know me better. In high school I always wrote my English papers at the last minute, up late in the basement office, typing furiously, feeling giddily anxious under the pressure. In the end I always knew it could probably be better had I started sooner, but it was always good enough.

This time, though, I surprised and alarmed even myself.

Two weekends ago, while hiking happily through golden aspen groves in Silver Plume, Colorado, I realized my presentation to the American College of Surgeons Annual Clinical Congress was only ten days away. Rather than work on my slides that weekend, though, I spent my waking hours trekking through beautiful trails of my home state, with dear friends and family. I returned to the routine of life in Chicago only to realize that my blog post deadline had snuck up on me, too. I had every intention of writing on the camaraderie of friends, sharing stories, questioning, and challenging, all in loving, mutual respect and curiosity. I spent that weekend steeped in tribal love! No presentation slides materialized.

The trail to Pavilion Point, Silver Plume, Colorado

Last weekend I was scheduled to present a poster on physician wellness at the Society of General Internal Medicine, Mountain West regional meeting in Denver. Darn, I had to go back!  But as if my Unicycling post had foreshadowed, I overslept, missing my 6:00am flight and the poster session. The presentation was flung from my lazy Susan, thudding gracelessly to the ground. I felt terrible, as my colleagues in New Mexico had toiled to get the poster done on time, and because of my mistake, their work could not be presented.

You’d think the guilt from Friday morning would motivate me to get working on the ACS slide deck, but no. I spent that evening and the next day with my parents, seeking yet more autumn aspens among which to commune. This took us to the blue skies, crisp air, and vibrant foliage of Vail, and then back to Silverthorne, where instead of working I then proceeded to make greeting cards and bookmarks with my brilliant new leaf collection. I had come prepared with cardstock and packing tape, and I basked in procrastination heaven.

It wasn’t until 9:30 Saturday night that I finally opened PowerPoint. I chose a design and color scheme. I scoured files and Pub Med for data and citations. I consulted my outline, framed weeks before, and sifted through photos to represent main ideas. As usual, I felt an exhilarating mixture of, “Why do I do this to myself,” and, “Man, this could be really good.” By 4:30am, with eyelids of lead and a fair bit of pride, I could finally go to bed, 35 hours before the scheduled presentation.

Along I-70, Eagle County, Colorado

So holy cow, what happened? This was a very big deal, I was going to speak to an entire audience of surgeons, for Chris-sakes, and they are no easy crowd! How could I put off preparing for THIS long? For my last original talk, at the Chicago Medical Society Midwest Clinical Conference in March, I had prepared weeks in advance, even allowing time to practice in front of friends before the big day. That was pretty uncharacteristic, but it was also a very big deal. For the first time in my professional life, I was not only presenting data and evidence, but also my own personal thesis on physician resilience—practices that I myself assert as fundamental to our professional well-being. WHY did I not take the same solemn approach this time?

Here’s the answer: FEAR. While not paralyzed, I certainly felt stymied. In my experience, surgeons tend not to think very highly of internists, as a group. Our training is shorter (think, ‘easier’), our hours often more forgiving, and our acute impact on people’s lives less (concretely) measurable. We are deemed less worthy, or at least that is my perception of surgeons’ perception (based on personal experience). So the idea of talking to this group on the ‘soft stuff’ of self-care and overcoming personal adversity made me feel more than a little vulnerable. On top of that, I lack the credentials we all look for in academic speakers: research publications, professor status, institutional titles. Who was I to speak with any authority to people who literally hold our patients’ lives in their hands every day?

By the time the slides were first done, I had determined that everything would be fine if I could just be myself behind the podium. After all, they invited me for a reason—someone had seen my CMS presentation and thought I was a good speaker. I’d better be, after nearly 30 years of practice! I’m relaxed, passionate, and articulate. So hopefully, the audience would just forget about my thin credentials and simply be awestruck by my superior presentation structure and style. Oh and I thought the content was pretty good, too.

I finally discovered my core confidence, of course, through writing. On the plane back to Chicago, I took out my freshly crafted aspen leaf notecards to write to my friends. Having just spent such quality time with them, I wanted to stay connected. It’s what I do. They knew about my upcoming talk, and I wanted to thank them for their encouragement and love. I also needed to confess my apprehension—get it out where it was safe. And I found myself writing, “I may not be the one designing the studies, and I may not have the fancy titles. But I’ve dedicated my whole professional life to helping people find their own agency, no matter who they are or what their circumstances. I know this shit; I live it. I’m the perfect person to talk about this, to anybody!”

Aspen leaf notecards and bookmarks, Vail, Colorado, 2015

Thanks to my remarkable tribeswomen, who hold me up even when I’m 37,000 feet in the air, I no longer question my own worthiness among colleagues in the American College of Surgeons, or anywhere. As long as I am my authentic self, and I do my homework, I can speak to anyone. In the hours prior to the talk I did a fair bit of power posing, just to be sure, and everything went swimmingly. I should also mention that three other women spoke at our session. They told personal stories of adversity and how they overcame. It was truly a privilege to be among them.

I sincerely hope that the ACS will invite more speakers from the ‘cognitive’ fields. I encourage the leadership of the American College of Physicians, the internal medicine professional society, to reach out to our surgery colleagues and collaborate on physician wellness initiatives. I read recently, “The only way to survive is by taking care of one another,” attributed to Grace Lee Boggs, 1915-2015.  Just as nobody overcomes personal adversity alone, and no physician can care for patients without an entire team of dedicated staff, no one specialty will hold the patent on physician wellness. Surgeons’ needs differ from internists’, to be sure, but we can all learn from one another, and the sooner we recognize that, the better for us all.

So, I procrastinate. It’s who I am. And I trust myself to get the job done–well, even. I have a chance at redemption for the SGIM blunder. I will represent my UNM colleagues at the podium of another conference in Washington, DC, in 10 days. I have the outline… Planning to create another PowerPoint file in the next day or two…