Live life fully, without guilt or struggle...
How often have you found yourself running into the same problems again and again. New places, new faces, same old habits... You work hard to change but it seems elusive... It doesn't have to be this way...
All photography provided by Gil Grimes
I have been thinking of you lately, how hard. You work on the analytical, mechanical, decisive approach to medicine. How hard you work to get the diagnosis just right so you can prescribe the right cure. I remember how that felt, and I wanted to give you a little taste of how you change over the next 25 years.
‘Is there some secret you have learned that you wish you knew earlier?’
‘Medicine is a jealous lover…’
Working hard is a tradition in medicine. The braggadocio around hours of call without sleep, number of patients seen in the ER shift, numbers on the hospital service all speak volumes to the cult of work that is medicine. By the time you enter medical school, you are already indoctrinated into the cult. You worked hard in high school to get the right university. Worked hard in university to get into the right medical school. Worked hard in medical school to get the right residency. Worked hard in residency to land the perfect job. There is a theme…. Work.
‘What has been the hardest lesson you have had to learn?’
‘Saying No instead of Yes….’
It has been surprising to me that the hardest lesson I learned from Medicine is how to say “No’. I suspected the lessons in school would be the hardest, maybe the ways to have delicate conversations, or to sit with the dying. However, nothing comes close to learning to say “No’.
Letters to a young Doctor… the first in a series
“What do you wish you knew when you first started practice?”
There are so many things that I wish I had known when I started in medicine, things that unfortunately are unknowable until you have spent some time in practice.There are some things that you cannot know until you have walked this path for a while.It is like a pair of shoes you plan to take hiking, you try them on, walk around the store, climb the fake rock to see how they fit going up and down, and make your best guess.The felt good while you walked all over the REI, looking at everything, but when you hit the trail you find they are not quite right.The break is a little too far forward on the foot and so after 20 KM the midfoot is sore, as are your toes.There are so many things like that in the world, they require first-hand experience to understand…..
Can the Health System survive?
It comes down to the people. It is not about their work, but how they feel; feeling valued, feeling your work is valuable to those you serve, and feeling valuable doing the work. It is work as an extension of what you believe, what you love, and how you want the world to be reflected back to you.
For 22 years I have watched systems work to chart their way into the future. It is a difficult future; the Baby Boom generation is such that it is going to be a costly future as well. It is not a problem, problems can be solved. This is a predicament, it is inevitable, it must be managed. To manage a predicament people must bring their best, give it, and do that repeatedly.
‘One of the ways that Gil adds value and makes important contributions is…’ That is the assignment, to reflect upon when we are at our best. We were to solicit opinions from our colleagues, family and friends about moments when they had seen us at our best. Asking for positive feedback from people that know you well, why is that so difficult, why is it so frightening? Yet, here is was, that sense of trepidation as I pressed send, that sense of unease, of disquiet. It felt really wrong to ask for positive feedback from people, really wrong.
They were kind and offered to put me up for the weekend. I did not know them, and they were trusting that this stranger in the house would be alright. That is the principle of Couchsurfing. People generously open their homes to strangers passing through to spend a night. I was coming back to Princeton for another Hakomi weekend, and the place I had stayed previously was not available. I put my name out with my plans for my weekend of education, and I got several offers from strangers to host my stay. Each one was kind, generous, and unique. However, one was on the bus route I used to get to the Yoga Center where the training was taking place, and I was intrigued. A family of four from the French Alps staying in Princeton for a couple of years, and their house was 50 meters from my bus stop. At the end of the weekend with them, my life had been forever changed.
‘I am curious about your use of the word allow.’
My breath caught in my throat, tightness grabbed at my heart, and for a second the sense of vertigo was there, I was on the precipice looking down. What had she seen, what had I shown, and why did she hone in on that phrase.
‘I want to offer you some words… notice what happens when you hear them…. It’s OK to allow yourself to be loved.’
I turned in, felt the instability in my seat, felt myself twisting just a bit as I looked into that place where it felt scary.
‘Well, I guess it is time to go back to reality…” Hearing those words, my heart sank, I felt sad. I heard longing, longing for a different life, longing for change, a desire longing to be met. I heard the voice of someone who did not expect the world to be different than it appeared, and I imagined someone who felt a little powerless to make any difference. Within me, there was a voice of rebellion to this statement, a voice that wanted to call out, to shake them out of their expectations, and it is the voice that speaks to me often.
The moon, large, yellow, rises slowly above the trees, sounds of the jungle can be heard in the early evening, strange and foreign to my ears. Sitting on the cement flooring that marks the porch edge for the school we are building, I have a moment of clarity, my place on the earth. I see it on a globe, glowing brightly, so far away from everything I know. Rising with the moon, an urge in my heart, to walk into the forest, disappearing from all that is known, into a place where everything familiar to me no longer exists. Into a place where everything unnecessary, unessential, is stripped away.