#AtoZChallenge: More Fun, Less Frazzle

“Rule #6: Don’t take yourself so Goddamn seriously.” From The Art of Possibility, by Rosamund Stone Zander and Benjamin Zander.

This can be a hard lesson for physicians. We do such serious work, after all. There is always another patient to see, another result to review, another call to answer—now! But I have to pee, when can I pee?

In my first year of practice, I remember a particularly hard day. I was running late (I’m still always running late) and the patients that day were all complicated. No simple UTIs or colds to give me some air. I huffed and grunted my way through the visits, occasionally buzzing by Rose, my medical assistant, to answer messages in between. My bladder felt like it might actually explode, but I could not stop to go to the bathroom—there was no time! I was so afraid to fall even more behind, to fail in some way. Eventually, Rose posted a sign above my workstation: “TAKE A DEEP BREATH.” It was an instant reality check:  I couldn’t go on like this, I’d burn out before my career even started! Immediately I realized how unnecessary, and downright silly, was all the rushing and grimacing—and I laughed out loud. Since then I have never again reached that depth of anxiety and sullenness in a workday. I am forever grateful to Rose for her sign, her loving reminder to slow down and take perspective. God bless her.

If we’re not careful, we physicians could all easily drown in the drama and strain, over and again, every day. And is that really what our patients need from us—to be Frazzled balls of tension and urgency, bouncing haplessly from one task or person to another, barely holding it together (and in)? Is that what we want for our colleagues and staff, to have to put up with our irritable and pressing demands?

It doesn’t have to be that way. In my third year of medical school, on my inpatient internal medicine rotation, Chip Dye was my senior resident. The service was busy; we always had a full census of sick patients. But I never felt harried or anxious because Chip set the tone for the team. Always smiling, always willing to answer any question, and finding any opportunity to laugh, he made it safe to learn. He exuded confidence without arrogance, calm without sloth. After rounds he led the team to attend morning report (daily educational conference and community gathering).  He always made sure we ate.  And there was always time to pee.

It’s not that he underestimated or ignored the work that awaited us. He just knew that we would accomplish it all better in a lighter, happier state of mind. When it came time to buckle down and divide tasks, Chip prioritized them with realistic expectations and we all got to work. No muss, no fuss, no stress. It would all get done because we laid out our plans in advance.  We self-respectfully reserved time and space for meeting basic bodily and communal needs. Thanks to Chip for leading by example.

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From Facebook, I can’t remember where or when!

We can always have some Fun at work, no matter how hard the day gets. Whether it’s telling a silly joke, watching a ridiculous viral baby video, or posting a fun meme on the workroom bulletin board, lightening the mood helps everybody get through a little easier. Laughing relaxes us. Stephen Colbert is quoted as saying, “Do you know what I like about comedy? You can’t laugh and be afraid at the same time—of anything. If you’re laughing, I defy you to be afraid.” And if we can overcome our fears of not getting it all done, of not being enough, we will all be better off—physicians and patients alike.

potheads

Also from Facebook…

 

 

Coping in a Season of Hope When All the Headlines are Terrible

Friends, please read this post by Nancy Faerber at Practically Wise. Nancy’s words are indeed filled with wisdom, not to mention love, hope, and peace. Happy Wednesday!

*****

San Bernardino. Colorado Springs. Paris. Beirut. The news has been scary and heart-breaking, and worse, seems to know no end. How do we cope? How do we keep our empathy, our hope, our very sanity intact under the barrage of awful, at times nightmarish, news? Especially when there is a pattern of randomness, when it seems that […]

https://practicallywise.wordpress.com/2015/12/12/coping-in-a-season-of-hope-when-all-the-headlines-are-terrible/

Superhero Exploration!

November Gratitude Shorts, Day 20 (Late entry)

Man of Steel, Ironman, Thor, Avengers, Captain America, Mission Impossible, Jason Bourne, Hallelujah!

In the last several years my preferred movie genre has shifted from romantic comedies to superhero action flicks. I’m not exactly sure why, though I suspect it has something to do with letting go childish wishes of happily ever after and embracing a more, shall we say, assertive form of entertainment.

The story follows a similar arc, regardless of the movie. We meet the heroes, then follow along as some colossal menace emerges that only they can fight.  In at least one scene they narrowly avert some mortal threat at the last millisecond.  No matter how desperate and hopeless the situation, no matter how fast my heart races and I tremble and fret, in the end the heroes win and all is saved…until next time—tune in next summer!

I learned recently about three types of stress:

  1. Threat stress: This is what we generally mean when we say ‘stress.’ It’s the fight, flight, or freeze response, when we sense a threat to survival, or we appraise that we lack the resources to cope with our circumstances. It’s mediated by cortisol.
  2. Challenge stress: We face a challenge that we feel at least somewhat qualified to tackle but it will be hard, test our limits. If we’re lucky, it’s something we care deeply about and we rise to the occasion—I’m thinking this could lead to a state of flow. This stress results in increases in DHEA and testosterone.
  3. Tend and befriend stress: This is empathy. We see a friend in need and we respond with compassion and love. We feel connected through their struggle. Oxytocin rises here. [Addendum, 04/26/16: This is an incorrect interpretation of the tend and befriend response.  Read my updated understanding here.]

This is intriguing to me, and I will study more about this construct in the very near future. I have experienced a fair amount of the latter two recently, and I’m positively exhausted.  So here is what I have learned: Not all stress is bad.  But even good stress costs energy, and we need to recover from it.

So maybe this is why superhero action films appeal to me? The heroes experience a call to adventure.  They, and we, wonder if they are up to the challenge.  They are tested, sometimes to their very limits.  In the end they prevail.  Maybe watching these movies vicariously feeds my challenge stress hunger, helps me believe that I, too, can rise to the occasion of my challenges in life?  None of the heroes do it alone, they all have at least one loyal partner who believes in them and their cause—the partners tend and befriend them—they have connection.  We all need help to get where we need to go.  The true superheroes know this well.