Fast

I eat. Fast. Often, I consume the food I place on my plate before I even make it to the kitchen table. It’s as if I grew up during times of famine, desperate for each and every morsel. On the rare night my family has dinner together, I am usually finishing just as they are starting, and by doing so, send a not-so-subtle message that I value family time together less than just eating.

I drink. Fast. That first beer stands no chance. After my first “sip”, I look sheepishly at my near empty bottle, while others are still using the bottle opener. The joy and satisfaction of a cold beer on a hot day is made all too brief.

I read. Fast. If I like a book, I will devour it in hours. I will keep turning pages until the first light of day sneaks in under the bedroom blinds, signaling me to stop reading and start getting ready for work. The more gripping the book, the quicker my pace and ironically less time to enjoy my escape.

I see patients. Fast. A necessary skill when the hospital is bursting with influenza, the ICU’s are buzzing with patients on ventilators, and my afternoon office is bustling with overbooked patients. I am relieved when I make it through the day without the weight of unfinished charting and unreturned patient phone calls still to be made. But back home, my escape is not without consequence. I feel a gnawing, growing internal uneasiness at the lack of depth and breadth of my numerous interactions.

Slow

I write. Slowly. Frustratingly so for someone trying to create content and build a platform. But I love to labor over sentence structure and word choice. Although slow, it is not painful. When I am able to put to paper the perfect sentence that captures what I see and feel in my head, it generates a soothing and intoxicating internal harmony.

I listen to music. When I do, time slows, regardless of its fast or slow beat. In my car or at a concert. The chords, notes and riffs are felt more than heard, resonating within. Sometimes I get lost within a space that only exists for a brief moment in time.

I cook. Measured and deliberate. I prefer the feel of certain knives in my hand. Cast iron more than non-stick and the warmth of the oven pre-heating behind me. Whether it’s making homemade pizza dough, baking gluten free muffins or smoking a brisket for the better part of a day, I don’t feel that time has been wasted.

I run. Sometimes for hours. Disconnected and separated from phone and home, my foot cadence becomes my mantra as I let go of the competing forces of work, family and social media. I dive deeper into unresolved thoughts and emotions.

Pace

I first learned about the concept of pacing in high school.  Figuring out a “steady” versus “race” pace was a skill needed to survive swimming thousands of yards day after day. I apply the same concept when training for and competing in Iron-distance triathlons. How fast can I push before burning out too quickly? How do I not leave anything in the tank as I cross the finish line? When I think about the activities and actions that bring me the most meaning and happiness, pace is a dominant factor.

Mindfulness often evokes images of yoga, crystals, incense and oils. But the truth is, when the pace is right, mindfulness comes into play without the need for any new age music in the background. Just as I appreciate the cadence of my breathing on a run or the layering of different tracks on a particular piece of music, mealtime can be transformed from mindless to mindful. Tasting the food and enjoying conversation, while being present and in the moment with my family around the table, becomes so much more than quickly ingesting empty calories.

Applying pacing and mindfulness to an otherwise generic patient encounter opens up opportunities to create a more qualitative interaction. Picking up on verbal and non-verbal cues. Recognizing that what is not being said may be more important than what is. Filling in and clicking on all of the blanks and boxes in the EMR might facilitate an orderly collection of important health data points, but it does not facilitate a natural exchange of information, nor does it create a comfortable space that promotes openness and candor.

We make thousands of conscious decisions every day. What should I eat for breakfast? What shirt will I wear? Do I go for a run or a long bike ride?  What will I write for a new blog post? But we rarely pay explicit attention to the pace of our actions. I have lived most of my adult life moving at a fast clip. Transitioning to part-time gives me the opportunity to slow down and be more cognizant about the pace I choose moving forward. By doing so, I hope to reclaim in my work world the quality that has been absent in some of my recent patient encounters. And when outside the walls of the hospital, I hope to capture more often, that internal harmony or resonance that is waiting for me.  If I can just find the right pace.