There Are No Words

Picture Credit (John Moore/Getty Images)

“…if we forget, we are guilty, we are accomplices.

“we must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Sometimes we must interfere.”

“When human lives are endangered, when human dignity is in jeopardy, national borders and sensitivities become irrelevant. Wherever men or women are persecuted because of their race, religion, or political views, that place must- at that moment- become the center of the universe.”  

Elie Wiesel 

Over the last few weeks, I read the news. I saw the pictures. I agreed with the outrage expressed in op-ed’s, evening news and twitter feeds. I shared and voiced my thoughts and opinions on the heinous actions of my government, separating in traumatic fashion children from their parents. My thinking brain has been shocked, horrified and outraged and did not have to stretch far to appreciate the parallels to the Japanese internment camps.

But my heart remained protected, wrapped up and insulated using the same tools I use to manage the emotional burden of caring for the critically ill.

And then I heard the tapes from Pro Publica.

I can only imagine the trauma that those children and their parents are enduring. I’m sure it falls far short from reality.  Although I cannot draw a direct comparison,  I do know how I felt when I was separated from my child in a way I never hoped to be.

I ached in a way I had never ached before. The weight of worry in every breath. Fear of the unknown fueled racing thoughts. My vision blurry and tired from holding back tears. My hand constantly drawn to my chest near my heart, pulled by a force from my core. A place I have felt only a few times before. This place inside, beneath skin and bone, ached with such weight and depth that it often forced me to the floor in attempt to ride out the waves of pain rolling through me.

I was overwhelmed and felt helpless. Yet I knew where my child was and who they were with. I knew those people cared.

Now, imagine you’re five years old in a foreign country with a foreign language. Cold concrete floors partitioned by chain link fences all around. No parent to squeeze hard and cling to. No family member to hug and hold, to feel their strength and resolve as an answer to your overwhelming fear. Only uniformed strangers with weapons at their side or tin foil blankets to turn to for any potential warmth.

There is no insulation from their cries. And there shouldn’t be. If you have not heard the tape, I ask you to listen.

Immoral. Unconscionable. Heartbreaking. Traumatic. Terrorizing. Those words, as strong as they are,  are insufficient to describe this current horror. There has already been too much rhetoric and not enough action. So I am going to do what I can do.

I am writing. I am donating. I am calling. I will vote in September and will help as many others in my community and neighboring states to do the same.

There are plenty of organizations that need your help. There is a need for lawyers, translators and donations.  Here is a link to a website at SLATE written by Dahlia Lithwick and Margo Schlanger. They are continuously updating the page with places that are helping in this battle.

Not much more to write. It’s time for me and my family to act. I’m asking you to act as well and share what you are doing. I’ll be sharing here over the next few days what my family chooses to do.

Together, we can be better than this.

 

 

 

 

 

 

Balance 2.0?

So, a wannabe author/writer walks in to a writer’s conference…

Sounds like the beginning of a not very funny joke.  But, that was me earlier this month as I attended the Harvard’s Writing, Publishing and Social Media Conference for Healthcare Professionals.  Quite a busy three days. Started at 7AM and  finished after 8PM. A lot to learn and absorb: Improving writing style, understanding the publishing and self-publishing landscape, using social media effectively and with purpose.  During the three days, met some great people that I now know in IRL (in real life).

There were so many take aways but a few things did strike a chord and stand out.

  1. This blog is “static.” Once or twice a month I write something. Probably a little too long and a little too moody (more on that in a minute). Right now, it’s really a one-way communication between myself and you the reader. I would like there to be more engagement and build on what I have started. I would like to provide more content that hopefully YOU the reader find either useful and interesting or entertaining.

 

  1. So I am asking you, the reader, what more you would like to see? How can I  make this more of a two-way conversation? I am looking to post:

 

  • Shorter thoughts and musings on life and themes such as burnout.
  • Write on End of life issues / advance care planning / introduce thought leaders and game changers in this space
  • Timely topics of the day.
  • Interesting book reviews or articles in paper or journals on critical care, end of life care, burnout.
  • Guest bloggers with strong clear voices on interesting and important topics.

 

  1. The last part that threw me for a loop was how morose or weighty my writing must feel to most people. I often dismiss as a joke, when my long-time friends send me a text checking in to make sure I am ok after a typical post. During the conference, it was commented on that IRL I seem different than the “voice” that comes across on the blog (ie: I have a sense of humor, funny/sarcastic and quite social instead of morose, melancholy, moody or morose)

So, to be brief, my BLOG and website is a work in progress (similar to my life in general). But I hope to grow it into something more.  So maybe call it Balance Redux, or Balance 2.0

Come to think of it, lets get this conversation started.  Thoughts on a new name? Anyone….

The pace and path to mindfulness

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.

How Do You Know When Someone Is Broken?

How do you know when someone is broken? When their spirit is fractured? When their sense of self no longer aligns with what once was. When you feel as if you have woken up in a foreign land, but that sense of displacement is coming from you, not your surroundings.

In television shows and movies, that moment for a doctor is obvious. The scene in which a physician cries in the stairwell, knees bent, head hanging dejectedly. A downward spiral into drugs and alcohol that leads to a near-miss in surgery. Or a final, explosive ranting monologue, that alienates the doctor in front of patients and peers. They have snapped. They have broken. At least until the next scene or episode.

Real life rarely follows a Hollywood script.

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