In Buddhism, there is a middle path. Siddhartha Gautama, the historical Buddha, was born into a life of indulgence. Later in his life, he practiced extreme asceticism and deprivation. When he sat meditating under the Bodhi tree, he became enlightened, and he found a middle path.
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Some of the worst times in my life have turned out to be the impetus for some of the best times. When I was diagnosed with cancer, I examined my choices in a close way. I didn’t make a lot of changes immediately, but I planted seeds that led to improvement in my lifestyle and my health. It led me to become certified in Hospice and Palliative Medicine in 2013.
When circumstances combined so I wasn’t able to maintain my private practice, I found my way back to the compassionate, supportive team at the HIV Clinic. Though I wrote several escape fantasy poems, I clung fiercely to the life that I knew. It was the only way forward that I could see. It’s only in retrospect that it became clear: what seemed like a destructive process was really a deliverance, (more…)
Some of the worst times in my life have turned out to be the impetus to begin some of the best times in my life. When I was diagnosed with cancer, I stopped to examine my life in a close way. Although I didn’t make a lot of changes immediately, that thoughtful examination planted the seeds that led me to a marked improvement in my lifestyle and my health.
When circumstances combined so I was unable to maintain my private practice, my current life began. Though I had written several escape fantasies, I clung fiercely to the life that I knew. It was the only way forward that I could see. It’s only in retrospect that it becomes clear: what seemed like a destructive process was really a deliverance.
You may have noticed that I haven’t posted in a while. I made a public commitment to post monthly, and a private commitment to post twice a month. I succeeded for three months, then I fell off my schedule.
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I could say that life got in the way. That’s believable for a busy clinician. The truth is, I simply lost my way. I didn’t have a depression, it was more of a dis-ease. I felt out of balance, and not just my regular lack of work-life balance. (more…)
This week, our hospital again held Schwartz Center Rounds. The topic was organ donation, and we discussed the families of the donors, the pride in the legacy of passing life onto others through death. We discussed the unbearable waiting for the transplant recipients and their families, waiting that ended with either grief or gratitude, sometimes both.
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The panel was made up of both Gift of Life and hospital employees, all with very personal stories to tell. (more…)
Here’s a paradox. People actually respect you more if you say no to them. Well, actually they respect the fact that you know your goals and are willing to fight for the resources to accomplish them.
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I’m at a phase in my career when I want to cut back on clinical hours, but I want to continue helping patients and their caregivers. I want to expand my influence in a train-the-trainer sort of way, to leverage my experience beyond my hour-to-hour, appointment-to-appointment life. Clinicians and caregivers, people who take care of people in both professional and non-professional capacities, can benefit from what I’ve learned. (more…)
If you’ve done any reading about healthcare recently, you know that medical culture can lead to burnout. You know that depression and suicides among physicians are rising at alarming rates. You know that work-life balance is practically nonexistent and self-care is almost impossible.
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In the last 10 years, doctors-in-training have been enabled and empowered to limit their work hours, to limit the number of patients they see. Older doctors scoff, saying the younger ones are being babied, that they’ll never be well-trained if they don’t continue at the same grueling pace that physicians have always worked at. The macho culture is long and deep. Recent changes in the system, especially electronic medical records (EMR’s) have exacerbated the crisis by decreasing flexibility and autonomy for all clinicians. (more…)
This past Monday, I had the privilege of helping to facilitate Schwartz Center Rounds at my hospital. In 1995, Kenneth B. Schwartz, at age 40, was diagnosed with metastatic lung cancer. Before he died, he set up a foundation at Massachusetts General Hospital to strengthen the compassionate bond between patients and their caregivers. Today, about 375 hospital organizations in the US and Canada are members of the Schwartz Center along with 120 in the UK.
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The member organizations of the Schwartz Center participate in rounds to discuss cases in a way they are usually not discussed. Instead of talking about what was done or not done in a case, members of the healthcare team talk about how the case made them feel. In the words of one rounds participant, “Rounds are an opportunity for dialogue that doesn’t happen anywhere else in the hospital.” (more…)
Here’s the main thing, the essence. People become the victims of their own success, because if they do something well, they get asked to do more and more. This ultimately dilutes the original greatness. If everything is a priority, then nothing is a priority. You can spend your life moving one step in 360 different directions, with the net result of never moving at all, or you can move 360 steps in a single direction and make a significant contribution.
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That’s the main message of a book by Greg McKeown titled Essentialism: The Disciplined Pursuit of Less. I’m now consciously trying to incorporate this philosophy into my life. In my next post, I’ll talk about my personal experiences with this process, but for today, here are the main concepts. The basic process is to Explore, Eliminate, and then Execute effortlessly.
To be an Essentialist (as opposed to a Non-Essentialist) you start with the ability to choose. A Non-Essentialist’s motivation is “I Have To,” while an Essentialist says “I Choose To.” Subtle reframing of life’s priorities as choices undoes the feeling of entrapment and loss of control. (more…)
Work life in health care is filled with stress. There’s time stress, lack-of-sleep stress, role stress, and computer stress. One of the most challenging stresses for caregiver professions, though, is people stress.
Every student at her medical school interview will say she wants to be a doctor to help people. That remains true at some level for all doctors, but sometimes we have to help people who are trying to control or manipulate us, who are making demands on our limited time, who are being defensive or hostile, who don’t follow our good advice, or who don’t seem to care about us and our feelings. There’s no way to avoid these people, and it’s unprofessional to be rude or hostile or aggressive in return.
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So, what’s a healthier way to deal with unpleasant encounters? Several years ago at a Humanities in Medicine retreat, I wrote about this encounter. I was called to do a consult for a patient who was in isolation for MRSA. When I got to the floor and asked the nurse about the patient, she just rolled her eyes.
I pulled on my yellow isolation gown and then my blue gloves, left first, then right, always in the same order. The patient sat with arms crossed answering my questions with mono-syllables. I sat on the fake leather sofa across from him. Experience and intuition prompted me to ask him, “Do you know why you’re in isolation?” “No,” he said. “They told me I have MRSA, but I don’t know what that is.” (more…)