Greetings from Mono, Ontario. I’m taking time off from my writing retreat to tell you about one of the presentations I attended this week. We are quite a diverse group, yet we have this vital thing in common, that we want to help other people write and heal through their writing.

photo by svintus2010 (licensed under CC BY 2.0)

A fellow AWA-trainee talked about how she’s applied what she learned from therapeutic clowning, about how the clown rules apply to facilitating writing groups and to life in general. Apparently, they apply to being a doctor, too.

The structure of her presentation was based on four rules for life given by Angeles Arrien, a cultural anthropologist and author. The rules are: Show up. Pay attention. Tell the truth. Don’t be attached to the outcome.

The presenter spent ten years working at SickKids, a children’s hospital in Toronto. She went to every unit in that hospital, so she saw children and their parents in crisis. The crises ranged from trauma and cancer to severe burns. These four steps helped her to approach these situations and helped her to transition from one patient to the next.

Show up

Before she went into any room, she would breathe and center herself before she knocked on the door and asked for permission to enter. She would show up with her whole self, undistracted by the child she had just seen or the child she needed to see next.

In her words, being centered allowed her to listen for the silence under the chatter. She encouraged all of us to contemplate what works to center us, whether it’s yoga, meditation, mindfulness, or something else. She talked about the value of centering in helping to co-regulate a relationship to effect positive change in the other person.

People unconsciously mirror each other, so it’s easier to relax into a lecture when the lecturer is relaxed, with the parasympathetic (rest and digest) nervous system activated rather than tense, with the sympathetic (fight or flight) nervous system activated.

Pay Attention

By paying attention in an encounter, one is able to enjoy the deliciousness not only of serving, but of being nurtured in return. Paying attention allows one not only to serve, but to experience joy in the service of others rather than feeling drained.

Tell the Truth

By telling the truth, the presenter meant authenticity, or making the true self visible. She modeled this behavior by opening the presentation by admitting that she was nervous. By making the true self visible, she meant not only dropping shame and embarrassment about oneself but also reveling and delighting in what makes each of us human and endearing.

This can be a good strategy as a clown, to be able to emphasize one’s own clumsiness, nerdiness, or insecurity. It sounds like it would be harder for a physician, but that’s what she is suggesting as an essential life skill. Celebrate what makes you different without judgment.

The payoff is affirmation of the true self when you find acceptance. And if you find rejection, there is confidence of a hidden value; one doesn’t take it personally. And the hardest rule of all…

Don’t Be Attached to the Outcome

This is a hard one in the world of scorecards and dashboards and evidence-based medicine, but what’s meant by this is: do the best you can; work to the best of your ability, but don’t worry about things that are out of your control.

All these rules are simple, but in no way are they easy. Think about it, though. Wouldn’t it be great if every doctor followed even some of these clown rules? The next time I’m standing outside an exam room door, I will try breathing and centering before I knock.

Question: Which of these four simple rules seems the most impossible to you? Show up. Pay attention. Tell the truth. Don’t be attached to the outcome. Leave a comment below and let me know.