Author: BusyDoctorMom

Burning Out and Reigniting the Fire

About 2-3 years ago, I begrudgingly saw that I was not doing well mentally.  In retrospect, I was feeling the tell-tale signs of burnout.   I saw my day as adversity, full of roadblocks and things keeping me from a sense of happiness, peace and wellness.  I of course, refused to see this until it had gradually set in and became my new normal.  I took a burnout quiz on AAFP, the Maslach Burnout Inventory (MBI) and scored quite high.  This, in retrospect, was not a good sign. I was only about 2-3 years into my attending career path at that point.  The long stressful hours were taking their toll. And I predicted another 30+ year career – seeing myself in this role for that long was difficult, and I could see this was not going to be sustainable.

Maddie is displeased
Maddie’s face reveals that sometimes life just doesn’t go your way.

Physician burnout is well summarized and described on various sites on the Internet.  I like the AAFP article linked here that summarizes physician burnout well.  Physician burnout can be likened to a battery running out of juice.  I definitely can relate to this analogy. About 2-3 years ago, I wasn’t quite a dead battery, but I was pretty close.  I was run down, a battery at maybe 10-20%, fizzling out.  I felt exhausted in every aspect – mentally, emotionally, and physically.  This was a slow process over several years, so my recognition of the problem was poor.  It took me time to admit to myself there was something wrong.  My natural inclination was to get more rest.  But in spite of getting more hours of sleep, I felt a constant tiredness.  And I could feel a subtle, diminished quality in my ability to care and feel, both in my job and with my family.   I also went for medical care, and was diagnosed with hyperthyroidism.  I did fortunately get this treated and managed, and felt great improvements, but I still felt twinges of something abnormal in my life.  I often found myself feeling wiped out, way out of proportion to my exertion level or work load.

I began to analyze other things I could change.  I began exercising regularly.  I resumed running.  I tried to rest more.  I resumed hobbies I previously enjoyed (reading, writing).  I analyzed my life, and my life priorities, and shifted things around so they brought me better peace.   I made a scary leap into a new job.  And I am very glad I took all of these steps.  I quit treading along in a pathway that was not good for me.  I currently feel valued, balanced, and in better alignment with my personal ideals.

Kids eating
Take time to stop and smell the roses…and eat carbs.

I still struggle with tendencies toward burnout.  I think this stems from a drive to do more each day than I probably should.  My tendency is to be a workaholic and perfectionist and superwoman.   I have a driving need to prove to myself I can do more.  But, as I grow older, I am learning to recognize and admit I am human.  I have a set “tank” of energy – my battery life is sadly not infinite.  I need to rest, digest, and recharge.  I cannot always go, go, go. It is not laziness or weakness or wrong to rest. It is a necessary and natural part of life to rest. Looking at the human body, there are processes for high octane stressful situations in life (i.e. the sympathetic nervous system, or the “fight or flight” system), and also natural, needed ways to recuperate and simply be still/less active (i.e. the parasympathetic nervous system, or the “rest and digest” system).   Life should be no different – there needs to be balance in life.

When I do too much now, I am getting better at recognizing the tell tale signs of overwork and pending burnout – a nag of irritation at myself or others, a feeling of mental exhaustion out of proportion to my work load, physical feelings of tension in my back, shoulders, and neck.  I force myself now to take a step back.  More breaks.  More recreation.  Focus on my hobbies and things outside of medicine.  More time with family and nurturing relationships.  Looking at the big picture.   Practicing gratitude.  With all of these tools, I am slowly learning how to reignite my fire for medicine and my passion to care for my patients, and I hope to prevent fizzling out again any time soon.

Goals: Breaking Them Down and Taking Some Names

Over the last year or two, I have begun breaking down my long term goals into more doable chunks and shorter term goals.  This has really helped me overcome a tendency to build mountains out of mole hills and procrastinate.  Instead of staying vague, I have forced myself to take my goal and really break it down into doable, shorter term steps.

A useful book that I recommend that describes this idea is  Stick with It: The Science of Lasting Changes, by Sean Young.  I like how this book logically breaks goal setting down into 3 levels: Steps (small tasks, taking 2 days or less to complete); Goals (short term goals, which take about a week to complete; and long term goals, which are comprised of the short term goals, and take up to about a month to complete); and Dreams (goals that take 3 months+ to complete).

Maddie and her champion doll
Maddie’s alter ego exhibiting her power pose – Set goals, perform, and win!

One example is my current financial goal to payoff my student loans.  This has seemed like a very challenging and sometimes insurmountable dream for the last 4+ years.  One helpful tactic for me has been to break down this vague and huge goal (“I want to payoff my student loans as soon as possible”) into something more concrete and specific.  For example, I set goals to reach certain number milestones each month, each 6 month period, and each 12 month period.  I focus on the present (e.g. the present week or present month), estimating my budget of spending and income, and then calculate the extra money I can send toward my student loan.  And then, I analyze my progress at the end of each month and the end of each year.

Another example is setting my goal to run a marathon.  Rather than getting too overwhelmed and giving up due to inexperience, I read several blogs and books to help me.  I chose a marathon training plan, and wrote down the workouts each week on my calendar (doing this really helps me – I hate to leave something on my calendar undone).  And then, rather than continuously seeing the 26.2 miles and getting too overwhelmed, I tried to focus my attention on what was before me: each month, each week, each day, each workout, and each step/stride.

By breaking down a huge 26.2 mile distance into doable chunks (e.g. each workout with a set distance and time goal), I was able to minimize the overwhelm, and instead slowly chip away at my goal.  I was most importantly able to feel a sense of accomplishment with each of my small goals – that is, completing each of my daily workouts.  Then, on my race day, I was able to smoothly and confidently meet my long term goal of finishing the long race.  I had plenty of practice in hitting my daily and weekly goals, and thus, race day, though challenging, did not seem so foreign and daunting.  In other words, I felt read and prepared.

Sliding Through Life
Take Luca’s example – slide through life smoothly, with small, doable goals in mind.

Even in planning out my week each week, I attempt to set 2-3 big overarching goals, both in my work/career and in my personal life. Then, I strategize how to really, concretely, make this happen, e.g. carving out 30 minutes of time on Monday for my goal of reading, or setting aside 20 minutes of time on Friday to exercise.  Instead of rolling through life, letting my life’s responsibilities control me, I feel a sense of focus, having been able to set small doable goals for the week, day by day.  There are 168 hours in each week, 24 hours in each day.  And unfortunately, time is a precious finite resource.  It cannot be brought back once it is gone.  I think goal setting in this logical, step-wise way, i.e. breaking big things down into smaller doable goals, has helped me better manage my time and actually finish more of the tasks I set out to do.

Good Enough: Letting Go Of Perfection

I’ve come across a concept recently via several blogs and podcasts that sometimes “Good enough” really is good enough.  Perfection can be overrated.  I kind of tie in the idea of the 80/20 rule into this.  The 80/20 rule was introduced by Vilfredo Pareto, in 1895, in regards to economics and the idea of income distribution.  In essence, Pareto’s principle noted that 80% of the wealth (in his example, 80% of the land in Italy) was controlled and owned by about the top 20% of society.  This 80/20 rule, though, can be extrapolated to other areas of life.  Including the efforts to accomplish goals and be productive.

Maddie on Piano
Maddie practicing the fine art of piano playing.

Take an example of the work it takes to perfect a hobby, like playing a piano piece. You can spend a manageable amount of time (e.g. 20%)to get to about 80% mastery.  The piece, when played, sounds pretty decent, and you can recognize the melody, but there are some errors.  You are by no means a concert pianist, but the song when played makes you happy and is pleasing to your ears.  The effort required, however, to get the extra 20% of mastery can be huge.

And, in reality, is that extra 80% effort worth it?  With professionals (i.e. the top 20% of performers), I could see that yes, this can make a difference between sounding mediocre and sounding excellent.  And for them, I think the extra blood, sweat, and tears makes a difference.  But for the many (i.e. the 80% of the rest of us who see piano playing as an enjoyable hobby), the extra effort may not really be worth it for the goal we are trying to accomplish.

Another way to interpret the 80/20 principle is in our “to-do” lists. I have found this concept of productivity to be crucial and helpful for accomplishing what I want to do.  Instead of blindly checking boxes off of my list, I try to prioritize tasks with the most lasting impact and things that will truly accomplish goals in my life that I value.  Is the task on my list in the 80% (i.e. accomplish 80% of the effect) or the 20%?

Kids Bowling
Practice, practice, practice.

Going back to the analogy of learning to play a song on the piano, is it something crucial to be able to “hear” a good tune, or is it simply “something nice to have” that cleans up the rough edges and corrects subtle errors?  It may feel good to cross this task off the list and follow the task all the way from 0% to 100%, i.e. from start to finish.   But for the majority of us, that extra 80% of effort really won’t make a big audible change in how good our song sounds.  Instead, we could have spent just 20% of our time and energy to get to “good enough.”

So instead of always striving for perfection, I have tried to instead focus most of my efforts on getting too good, i.e. the 80% mark.  And then, in a select few circumstances, if I feel the extra effort and hours to get the extra 20% is time well spent and important to me or my career or my family, great.  But, if I think 80% is pretty darn good, and good enough for my purposes, then it is time to move on.

I am slowly learning to let go of perfection, and value my time and energy.  Live to fight another fight.  If my current accomplishment is getting me to where I need to go, it is time to put aside my “good enough” project, and move on to the next goal in my life.  My acceptance of “good enough” in my work is a work in progress and I am still learning how to do this properly and consistently.  But it is definitely liberating, and has helped me to get more done, in less time, and with less stress and worry.

Meditation: A Way to Mentally Focus

I have dabbled a bit in meditation over the last couple months.  And I have found this exercise to be beneficial.  I have started to do this before my workdays and I find it has helped me focus better and sometimes perform better mentally.  I unfortunately sit a lot at my job, so by taking 5-10 minutes each morning to do a short mindfulness exercise or breathing exercise helps my mental and physical stamina.   I feel better able to focus my thoughts as I strive to diagnose and treat my patients.  I have also felt less stressed in the evening as I interact with my family members.

Ballet bar
My children exhibit the importance of balance and strength. Meditation can be a way to harness these two concepts mentally, to better tackle your day.

I have used various meditations tracks myself: Audible, Aaptiv, and Breathe.  I think there are dozens (if not hundreds) of other options out there, both free and for a fee.  Of course, just glancing out the window, or closing my eyes, and focusing on my breath for several breaths is another good way to meditate briefly when I get a free moment in between patients, or when sitting in traffic, or sitting in a waiting room.

My kids love to pose.
My kids love to ask me questions. And try my patience.  And to pose. Please excuse the cat toy and garbage can in the foreground.  #RealLife

I think it has been so easy for me to occupy all of my free time with more and more things to do.  Chores.  Reading.  Podcasts. Audiobooks.  TV.  Streaming services online.  I find that meditation has forced me to take a  moment for myself, away from all of these distractions.  To close my eyes or stare off into space for a brief moment, focusing on my body and emotions, focus on my breathing, focus on the moment.

Mental health is easy for me to take for granted.   But when it is out of balance, I definitely feel it.  There are several moments in my busy life when my mind is frazzled and tired.  December can be stressful, when preparing long and hard for the Christmas season.  I get worried and anxious when preparing for my children’s birthday parties.  I also feel wiped out at the end of a long and trying work day, or when I have a “bad day.”

I strive to physically exercise several times a week now as I have become dedicated to my running.  After resuming running several years ago, I would sorely miss this if I went back to a life without regular physical exercise.  Running regularly was not easy at first, but has grown to be more enjoyable after 6-12 months of dedicated practice.  I just started exercising my “mental muscle” via meditation.  As I am a beginner, I often find the practice difficult and challenging.  But in time, I suspect it will get easier and more rewarding.

 

Adversity As A Way To Grow

I was reading a children’s book to my son several weeks ago  – What Do You Do With A Problem? by Kobi Yamada.  I saw parallels in this book to the central ideas in another book I read several months ago – The Obstacle Is The Way by Ryan Holiday.  These books both highlight one premise of stoicism – adversity as a breeding ground for growth and improvement.  The quote from Marcus Aurelius’ Meditations that highlight this idea is as follows: “The impediment to action advances action.  What stands in the way becomes the way.”

Maddie Running
Maddie learning to overcome the cold (and posing in spite of the chill)!

Challenges in life can be disruptive and disheartening. I often which life’s challenges or “problems” would go away. Wouldn’t it be nice if life was smooth sailing?  It seems like a great day when things always go your way.   But by looking at problems via the stoicism lens, I see now that problems and “hiccups” in life give me an opportunity.  An opportunity to sharpen my skills.  A chance to see how far I can go.  Without adversity and problems in life, the world would be a boring, unchanging place.  With problems, we are given the opportunity to make ourselves and the world better.  It is great when I come through an obstacle successfully, and therefore feel myself becoming a stronger, more resilient person.

Of course, things do not always turn out positively.  Sometimes (a lot of the time!) outcomes result in loss or failure.  But again, this can help me gain self awareness about my strengths and my weaknesses.  It makes me honestly assess myself, seeing via examples what I am able to do, and what I cannot do.  I can then focus my efforts on growth and improvement.

Luca Climbing
Luca prevailing by climbing over his obstacles.

Again, if you have a moment, I would recommend The Obstacle Is the Way, a great book to read or listen to.  And if you have a little one, I’d highly recommend What Do You Do With A Problem?  I think these books help reinforce the concept that problems, despite their initial negative appearances and the negative emotions they conjure up, are not always bad.  Depending on how you look at obstacles or adversities in life, they can be seen as catalysts for growth and the starting line for good.

Mindfulness: Learning to Live in the Moment

Dwelling on My Thoughts

Thoughts are powerful.  I am learning through slow but  deliberate practice that mindfulness is a great tool to harness and control your thoughts.  It is easy to dwell on something from your perspective, and fail to see how others may see the same situation.  And it can be easy for me to get stuck in my own head a lot, to the point that a whole day seems to pass by without me living in the moment.  I’ve started some small exercises to be more present.  If I don’t do this, I find a whole day or a whole week speeds by without me really living.

These little cuties are often on my mind.

Practicing Mindfulness in My Day

I’ve tried to be more mindful in little snippets and moments in my life.  When I wake up, I concentrate on my senses.  How the bed feels against my back.  The way my eyes feel as I open them.  The sounds around me.

As I brush my teeth, I concentrate on how the bristle feels, on what the toothpaste tastes like, how my body is able to do unconsciously go through the motor actions to brush my teeth.

As I drive, I try to see how things look around me with attentive eyes.  A person walking down the street with their pet.  Someone walking to the bus stop.  Feeling how the steering wheel or how my seat belt feels against me.

At work, as I enter a patient room, I concentrate on how the computer feels in my hand.  How the doorknob feels. Cold or warm.  How the ground feels against my feet.  Thinking a small mantra, “I am here for this patient. This moment is for them.”

Defining My Meaning In Life

This of course isn’t second nature.  It takes practice.  But doing this has helped me start experiencing more.  And feeling more balanced, happier, and more fulfilled.  I take each day and try to live it more.  God has given me so many gifts and so many senses.  I sometimes forget this.  I worry about little but trivial things.  Paying bills. Finishing emails.  Cleaning the house.  And often these thoughts crowd out the bigger and more important picture.  Why am I on this earth?  How can I make my family members’ lives better?  How can I make my patient’s lives better?

One of my important life goals: creating a happy, fulfilling childhood for these 2 beautiful children.

I think purpose and meaning in life are crucial.  This is a tough thing to define and wrap up nicely in a little bow.  I am coming to realize, however, that life is a journey of discovery, and on this journey, we get to define our meaning.  Life isn’t easy. It is full of struggle, negativity, and challenges.  But I feel that these negative things and challenges can teach us about ourselves and what we are capable of.  And it can make us stronger and a more complete, more fulfilled human being.

Next Steps: Meditation And Nurturing Self Awareness

My next plan in life is committing to small meditation practices every day, each morning, before life gets away from me. I will begin this at the start of next month.  (It always tends to work out better when I start on the first of a month!  Must be something psychological.)

I will try using one of the many mindful apps out there.  (I haven’t decided which one yet. Perhaps HeadSpace or Aaptiv, which are currently on my phone.  I recently read Mindfulness: An Eight-Week Plan for Finding Peace in a Hectic World, by Mark Williams, which also offers some free meditation tracks online.  So many choices).

But to keep things successful and doable, I will commit to a small goal of 5 minutes/day.  I know that I will often want to exceed that, but if I make it a small goal, I will be able to check it off of my to do list. And thus I will feel accomplished and productive (rather than kicking myself for leaving something else for tomorrow).

I hope that by beginning to do this regularly, I will reap both physical and mental benefits of meditation. I have read several articles on how this improves performance. And most importantly, I will be eager to see how it improves my self awareness and nurtures my goal of mindfulness and being truly present in this one life I have been given.

 

 

Perseverance: You are Capable Of More Than You Think

My Second Marathon: Less Than Ideal Physical Conditions, But A Great Lesson In Perseverance

My Pittsburgh marathon experience recently was a success, and I am proud to say I finished!  I think any race finish is a success!  Unfortunately, my time was not what I had hoped (I had hoped for an improvement in time from my first marathon).  My health was challenged by an untimely bout of viral gastroenteritis (stomach  virus) the day before.  Obviously less than ideal conditions.  I am pretty sure I caught this from my cute (but full-of-germs) children, or one of my patients, or a bit of both.  The afternoon before, I recall feeling a little punky, and then slowly but steadily, became exhausted, nauseated, and became a close friend to the restroom for unnatural products from both ends.  I rested for good solid few hours that afternoon, and then slept for 12+ hours the night before.

My little runner and tumbler, one of my motivations when the going gets tough.

Facing Doubt and Learning to Push Negative Thoughts Aside

I awoke at about 40-50%, less nauseated but also unfortunately a bit behind on my fluids.  I ate nothing and had minimal fluid intake the night before, obviously not what I planned to do.  I tried to gently hydrate and ate a minimal breakfast that morning.  And I anticipated a great challenge ahead.  I had several nagging thoughts of, “well, maybe I can stay home and sit this out.”  But 3+ months of work were weighing on my mind.  So many 1-3 hour runs early in the AM 6 days a week spent pounding the pavement.  So much time spent away from other hobbies and pursuits, and away  from my family.   I used this thought of time investment as inspiration, and pushed the negative thoughts aside.  Instead, I strived to think to myself “I worked hard.  I feel okay today, not great, but okay.  I will use this as an opportunity to see how far I can push myself, safely, but I will push myself.”

It was certainly a challenge on my body and mind, but I am glad I did indeed push myself.  I did great the first hour or two, until my early morning Tylenol unfortunately wore off, and some dehydration and discomfort really settled in.   The last two and a half hours was a bit rough, but I took it 1 mile at a time.  And I am very proud to say I made it to the finish line.

I think this was a great lesson to myself on perseverance and seeing how far I can truly go.  And to not limit myself based on perceived notions of what I am capable of.  Stop listening to boundaries and restrictions, both that I set for myself, or what everyone else tells me.

I am so appreciative of my ability to push through the pain and discomfort, and finish.  My finish time wasn’t stellar (4:40:22), or what I expected (I had hoped to set a personal record by about 10-15 minutes), but given all the challenges with the preceding virus/illness, I am proud of what I did.  And proud of my grit and determination to push forward and not stop, in spite of pain and challenge.

I think going forward in my life as a mom and doctor, I feel huge  waves of confidence in what I can do.  I am not perfect, and I don’t have all the answers for my kids or my patients.  And I will never be so overconfident to say I am perfect and all knowing.  But I realize some dogged determination and perseverance can carry me through a lot in life.  By not giving up, I was able push through, improve, and reach a new level of performance and success.

An Unfortunate Injury: Forced Break and Forced Rethinking of My Health Priorities

I also unfortunately suffered a foot injury about a month after my marathon. This was probably a reflection of overtraining, not taking enough time of rest after my race, and not admitting when I need to take a break.  It took a good 4 weeks to recover.  I can tell you, I missed exercise, and missed running.  I missed having my body whole and healthy and pain free.  Just walking, climbing steps, and jumping would elicit a bit of pain.  I missed my solo runs, as this was my time of reflection, my “me” time away from others.  As an introvert, I realize some solo time is crucial for recovery and rejuvenation.  Though I’d hate to admit it, the time away from running was also good for me.  I gained more time with my family.  I was able to fully heal my body. And crucially, I gained more time to sleep.   I am realizing I need to guard my sleep time and stop depriving myself so much.

I read a great book, Why We Sleep, by Matthew Walker a couple of months ago, and I highly recommend this comprehensive review of what sleep is, why it is vital, and how to use it to our advantage.  This book, coupled with my injury and forced break from early morning runs, made me rethink my routine and how I was treating my body and my health.   Sleep is crucial.  It is not for idleness.  It is not for lazy people.  It helps your mind and body recover.  It helps solidify learning and healing.   It improves your immunity.  It improves your vitality and creativity.   The book goes into great detail, but those are some wonderful takeaways I gained from my study of the book.    The book also discusses dreams, insomnia, and why typical insomnia treatment with sleeping pills is not always ideal.  I found it a very interesting read, very detailed and very scientific.

Return to Running, But Learning Balance

I have returned to running this past week.  I craved the activity and ability to get my heart rate up.  My foot hurt slightly but fortunately has gotten stronger and less bothersome as activity is ramping up.   I am learning to adapt my schedule and change things around.  I have tried running later in the day at times, so I can protect my sleep time.  I am unfortunately quite a bit of shape, but I know I can regain my ability.  And given my persistence and success with my “less than ideal” second marathon, I know I can push myself further than I think.  I am learning to look at boundaries and limits, everywhere in life, and analyzing them to see if I can knock them down creatively but aggressively.

Growth Mindset, Thinking of How Many Blessings I Truly Have

I am eager to continue to grow, reinvent myself, and make myself better.  (If you haven’t read anything about a Growth Mindset versus Fixed Mindset, I encourage you to do so.   This is great way to look at the psychology of growth.  One great resource is here.)  I hope I can continue to set an example for my family and my kids.

During my run, I used Aaptiv (a great way to have a trainer in your ear during your workout, breaks up the monotony!), and the trainer described a great way to overcome a desire to stop. And that is: think of someone who can’t exercise.  Run for them.  Exercise for them.  Persist because of them.  Keep running and don’t stop, for they cannot do what you are doing.   I felt like my run was more like a prayer and meditation in their honor.  I found this truly inspiring and a great way to keep going.  And I plan to carry this forward to everything in life, I think that is a great lesson that translates everywhere.

There is so much to be grateful for in life that I often take for granted.  I am healthy.  I have a beautiful, loving family.  I have a roof over my head.  A stable career.   Free time to pursue my passions and hobbies.  I am able to continue to grow and improve.  I have way more to appreciate and think positively about, and a lot less I should complain about and dwell negatively upon.

My family: my priority in life. 2 of 3 smiling faces ain’t bad. (I don’t envy the hard working photographers out there. Getting the “perfect shot” is pretty darn hard!)

Perseverance and Gratitude: Tools for Success and Ways to Battle Pessimism

Positivity and gratitude, I believe, will carry me forward in the future.  I know more challenges and set backs will come up, in my running, in my career, and in my family.  But I will think about my successes in the past, particularly my success in pushing through a painful, uncomfortable, imperfect marathon situation.

I will keep those lessons with me, and they will fuel me with inspiration and hope.  And I will think of all of those I encounter, particularly in my life as a physician, who are so gracious and open to share their own challenges, with their personal lives and with their health.  I think this will help reframe my pessimism.  Instead of dwelling on all I do not have, I will work on focusing on my blessings and all the wonderful things I do possess.

Love: Time Flies When You Are Having Fun

10 Years Have Flown By!

My husband and I will be celebrating our 10 year wedding anniversary this month!  We were figuring out the math, and we have been together since our freshman year in college, 18 years ago.  Half of our lifetimes have been spent together! Going forward, we will have been together longer than we have been apart.  It is hard to believe that much time has already passed.  Just goes to show how fast time can pass us by.

I think we get along well as a team.  Our strength is that we are mature and respectful when making communal decisions together as a family unit. I am also proud of our strong friendship.  We are conscientious and systematic when coming together to discuss big life decisions, e.g. where to live, what to do with our money or possessions, when to have kids.  I am proud of our children, our two little, amazing, miraculous creations.  We are raising them together each and every day.  Parenting is not an easy job, but it is incredibly rewarding.  Our children are adorable and amusing, which definitely helps bring some humor and happiness into our lives.

These two little hooligans are “out of this world” adorable.

Spending Time Together One-on-One

To prevent our relationship from becoming too monotonous and revolving around kids (a common trap I think for young parents), I have been striving to explicitly schedule date afternoons/nights together for the past few months.  Sometimes it is a movie, and/or dinner, sometimes its just going home and sitting quietly for a few hours without little voices intruding into our minds.

Occasionally life gets busy, and we miss a week or two, but having this to look forward to now and then definitely brings some fun into our lives, and helps to nurture our connection to one another.  We do try to get the kids to bed at a decent hour each night (quite a challenge in and of itself). With that, we get an hour or so, sometimes more, of adult time in the late evening.  But by that point, fatigue has set in, so the quality of time together is not always the best.  Getting additional “together time” outside of that, with some fun “dates” is crucial and rejuvenating.

Respecting Our Differences

I think one other thing we do well is spending some time separately, pursuing things that we are passionate about.  I think we have a lot in common, with common goals in life, but at the same time, we are two separate people and we don’t need to do everything together the same way.

One lesson that I’ve learned recently is trying to seek out a viewpoint outside of your own.   Abraham Lincoln is a pivotal example of this in how he selected his cabinet.  He included several of his political opponents and critics to aid in his decisions; instead of looking for constant harmony, he invited differences of opinion with so varied a group of cabinet members.  Being too keen to seek out things that confirm your own thoughts and feelings is a form of bias, and does not always lead to the “best” decision or the most accurate answer.  Often, this leads you to being stuck in your same way of thinking that may be wrong.  And it does not allow you to pursue improvement and a growth mindset, instead allowing you to continue in a fixed mindset, which is not optimal for self improvement.

I think that my husband and I recognize we can have differing opinions, and we still love and respect each other.  And having this difference actually makes for better decision making and more interesting and varied relationship.

10 Years, and Counting…

I think we have been very blessed and fortunate in our married lives so far, without any enormous storms or hugely debilitating challenges.  We have had some, don’t get me wrong, but we are blessed more than others.  But at the same time, if/when a challenge will blow our way, I think we have a strong, loving, respectful relationship that will help to carry us through.  I think that when an obstacle or problem comes up, we are able to approach it in a careful, systematic way.

Our two children are quickly growing up I know parenting is a struggle at times, but I learn so much by being a mom, and I think my relationship with my husband is different, but stronger, because of our children.

I know we are still young in our relationship, but at the same time, we are no longer the newbies and newlyweds we were 10 years ago.    We are more mature, with just a few gray hairs and wrinkles to prove it.  And we have plenty of photographs documenting our memories.  A decade is quite some time to be together with someone.  I feel so much gratitude each and every day for finding and marrying my soulmate and best friend.  I look forward to what the future has in store for us, and will strive to never take our love for granted.

Time Goes On: Learning to Say Goodbye

Life is Short

Learning to say goodbye is never easy.  We are asked to say goodbye in many different ways in life.   Some examples I have seen in my own life: Saying goodbye to my family every morning as we go our separate ways for work or school.  Letting go of items or possessions that no longer serve a purpose.  Saying goodbye to patients after my residency, as I moved on to my attending position.  Expressing condolences for my older patients who have passed away.  Saying goodbye to patients who have moved away, destined to establish with another physician.  Accepting the fact that everyone and everything around me is getting older and time never stands still.  I think the hardest example of this is accepting that my children are growing up.

This little gal is no longer just a crawler but a runner, jumper, and climber.

My Children Are Growing Up

My daughter is no longer a baby.  (But don’t get me wrong: she will always be “my baby” in my heart.)  Physically, she is taller and leaner.  Looking back at pictures from a couple of years ago, I see she has lost her baby fat. She refuses my help many more times than she used to.  She is starting to learn how to read.   She likes to tell me about her day.  She will be turning five in a couple weeks, and will be going to kindergarten this fall.   She still wants me to tuck her in every night and read a bedtime story to her,  and I cherish this. I wonder how quickly the next several years will go.  When she becomes an independent teenager, I will likely miss those moments she needs me so much.

Blink, turn around, and they are already so much older. Hard to believe this was 2 years ago.

My son, too, is a precocious 2 year old.  He is constantly vying for independence. He likes to tell me all that he sees around him.   It is kind of neat to revisit the world from a toddler’s eyes.  Nature has so much beauty and wonder that we adults take too much for granted.  He likes to have as much control of his day as possible, and lays out his demands confidently. This includes insisting on wearing  particular clothing for the day, choosing his own meals, and wanting to turn on and off the light switches himself (though he is not quite tall enough and requires a lift from mom).

I can still recall both of my children being tiny infants, requiring constant care and attention, with their only mode of communication being cries and shrieks.   Now they each have their own little voices and thoughts, and their own emotions and opinions.  Where did the time go?

Being Thankful

Seeing my kids grew up so quickly has made me more aware of how short time on this earth can be. Instead of focusing so much on the past or future, I am trying to enjoy the present. Tied with this, is the concept of gratitude.    I strive at the end of every day to think of three things I am thankful for.   Invariably, my answers involve relationships, my family, and my health.  This mindfulness practice has fueled my desire to be more focused on the present moment.  I see every day in my life as a mom and a physician how fleeting  time can be.

I think looking back on how far we’ve come is a useful exercise.  It is hard to say goodbye to the past, and with that goodbye, to admit that life has changed.  Sometimes I think I forget how quickly time passes and take a lot of things in my life for granted.  Purposefully and deliberately looking back at the past allows me to properly say goodbye to things that are no longer present.   I’m able to express appreciation for how much I have in the present, and take stock of all of my blessings.  And I enjoy imagining how things will look in the future.

Handling Emotions – Nurturing Emotional Intelligence

Emotional Intelligence, EQ

I read a wonderful book, Emotional Intelligence by Daniel Goleman, a few months ago.  This book was recommended during a continuing education workshop I recently attended.  And I greatly recommend it to anyone else who hasn’t read it yet.

I wish I had read it sooner, particularly as it relates to raising my kids, particularly as it relates to toddlerhood. (Terrible 2’s and the classic toddler tantrums are a perfect example of how poor emotional control can manifest when faced with negative emotions.   Not something that adults should really be doing, though I admit sometimes I want to.   And I don’t think I am the only one.  Strong emotions can really inhibit your self control sometimes.)

The book, Emotional Intelligence, outlines what emotional intelligence is, and why is is important.  I admit this was a relatively new concept to me. But one that is intuitive and vital for all aspects of life.

A brief definition of emotional intelligence, or EQ, is the ability for someone to recognize, harness, and express one’s emotions, and recognizing how emotions a person feels can affect relationships and how one interacts with others.  Not easy to do, but something very important to fit in with a society where we greatly benefit from teamwork and working with others.

Two Pathways for Emotions

A concept I found really pivotal in the book is that the brain has 2 pathways when it comes to processing emotions.  One pathway goes through a slower pathway that travels through the cortex, or higher reasoning part of the brain.

The faster pathway, which can be thought of as an evolutionary protection mechanism, goes from the thalamus straight to the amygdala.  This is what makes you have your “fight or flight” response to a perceived threat (which may indeed not really be a threat).  The second fast pathway is what drives me to startle and feel fearful when I hear a loud noise, or feel my cat brush along my leg when I don’t realize she is there.  Afterward, with the help of my higher cortex, I reason out why I had the response I did.

I can see how this drives me to often react unhealthily to stress in my daily life.  Just realizing this has helped me become more self aware of my actions and thoughts.  And forgive myself for occasional bad actions.  I am nowhere near perfect, but I think just understanding emotions and emotional intelligence better helps calm me and drives me to be better.

Childhood Development and Emotional Intelligence

The book also describes emotional intelligence and how it develops in childhood.  I kind of think of this as the key concepts kindergarteners learn.   Listen.  Share.  The Golden Rule – Do unto others as you would want to be done to you. After reading about the concept and analyzing my own life and the lives of my children, I see how vital this concept really is. And how hard it can sometimes be to control.  IQ or “book smarts” as I like to think of is something that is geared toward in our modern school system.

But to really thrive in life, I see that  having just book smarts is not enough. People smarts (and emotional smarts) will actually get your further (and create a happier, more fulfilled life).

I plan to read more in the future about Emotional Intelligence as it pertains to children,  and how it can impact my children as they develop.  I am trying more and more to help my children name their emotions.   And I have analyzed how good my children are at recognizing emotions, in me, in themselves, or others.  The fast pathway of the brain I think can easily pick up on negative versus positive emotion. But it takes a bit more learning, experience, and thought to see what exactly that emotion is, and what to do about it.

My daughter easily reads annoyance or tiredness on my face, but sometimes says “why are you mad?”  This is a good (but embarrassing) reminder to adapt my facial expression (but also my own feelings and thoughts) to better suit my interactions with her.  And I try to take this further when talking with my other family members, coworkers, and patients.

Like I said, I am still a work in progress (but aren’t we all).I plan to continue to develop my own skills in emotional intelligence.   I think I have always intuitively recognized that emotional intelligence is vital to good relationships and success in the real world.  And as I raise my young kids, I hope I can help them better recognize and harness their emotions, so they can be happy, loved, helpful members of society.

Digitalization of Society and Its Relationship to Emotion

Though our society is becoming more digital and fragmented, there remains a great deal of emotion in our lives and that will never change.     Think of how a brash, “thoughtless” comment on the internet can make you feel sad, anxious, or angry.  When you engage your higher learning centers in your cortex, however, and start to look at possibilities of what the other person was feeling, you can realize why you, in reaction, felt how you did.  For me, naming that emotion helps me disengage, and often forgive the comment. And not to take things to heart, particularly if that is more harmful than helpful.

Self Care and Its Importance to Emotions

If I am tired, stressed, or overworked, my emotional reserve to control myself goes out the window.  This fact has made me focus more on self care – sleep, stress reduction via hobbies and time away from work, eating well, and exercise.

If I have a good nights sleep, I think I make better cognitive decisions.  But my emotions are also calmer.  This I think is a good example of how EQ and IQ can overlap and interact.  And how the mind, the body, your emotions are interdependent and intertwined.

Nurturing Emotional Intelligence in Others

Like I described above, I am trying to help my kids navigate the tumultuous world of their internal emotions. But I also hope to set an example, for my kids and for everyone else I interact with, including my patients.  I see a lot how emotions can create rifts in families and relationships  Looking at things from afar, it is easy to judge and think about how sometimes silly these fights can seem.  But delving into conversations with my patients, and truly spending 10-15 minutes walking in their shoes, I see how things get a bit murky and difficult.  I recognize that emotions, thoughts, and facts get intertwined.  And how hard it can be to forgive.  But how powerful and freeing it can be to forgive and let go.

Parting Thoughts

I hope to continue to be vigilant in recognizing emotions, not just in myself but in everyone around me.   To do this well, I believe it first takes recognition of this idea, and self study.  I plan to read more books about this, particularly how it pertains to childhood development.  There is a lot more I can learn about it.  I am steadily recognizing too that good self care (rest, nutrition, exercise, play) is vital in ensuring I have good self control and am setting myself up for success in managing my emotions.

Just like every skill in life,  this takes practice.  I am trying to train myself to not let the fast emotional pathway control my reactions, and instead work constantly to engage the slower, higher thinking pathway.  This will lead to better outcomes and less regrets.  Since learning about Emotional Intelligence and how the emotional centers of the brain work, I  am more explicit in  naming my own emotions and learning how they drive me to act.

As a parent, I am also seeing how this naming of emotions is crucial in helping to calm my children if a tantrum arises and they are not getting their way.  It eases misunderstandings and miscommunications.  My kids feel “heard.”

Happy smiles.

As a doctor, I am striving to use my understanding of emotions to choose words and actions that are more beneficial to everyone around me.    I believe it has helped me better see those around me, particularly my patients, in a new light. I feel better able to comprehend their emotions, and how emotions impact their choices in life.  And I feel it has improved my communication skills and ability to understand what others are communicating to me.  I think and hope this practice will help me to continue to grow and improve, as a doctor, a mom, and a human being.