Taking a Moment (or a day) to Rest

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As we drown in the overwhelm of modern day health care duties, most physicians I know, including myself, fail to follow their own advice. Far too many of us have become overly tired, irritable and resentful about our work load.  It is difficult to look forward to the dawn of the next work day.

Medical journals and blogs label this as “physician burn-out” but the reality is very few of us are so fried we want to abandon practicing medicine. Instead we are weary of being distracted by irrelevant busy work from what we spent long years training to do: helping people get well, stay well and be well, and when the time comes, die well.

Instead we are busy documenting-documenting-documenting for the benefit of insurance companies and to satisfy state and federal government regulations. Very little of this has anything to do with the well-being of the patient and only serves to lengthen our work days –interminably.

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Today I decided to take a rare mid-week day off at home to consider the advice we physicians all know but don’t always allow ourselves to follow:

1) Sleep. Plenty. Weekend and days-off naps are not only permitted but required. It’s one thing you can’t delegate someone else to do for you. It’s restorative and it’s necessary.

2) Don’t skip meals because you are too busy to chew. Ever. Especially if there is family involved.

3) Drink water throughout the work day.

4) Because of 3) go to the bathroom when it is time to go and not four or even eight hours later.

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5) Nurture the people (and other breathing beings) who love and care for you because you will need them when things get rough.

5) Exercise whenever possible. Take the stairs. Park on the far side of the lot. Dance on the way to the next exam room.

6) Believe in something more infinite than you are as you are absolutely finite and need to remember your limits.

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7) Weep if you need to, even in front of others. Holding it in hurts more.

8) Time off is sacred. When not on call, don’t take calls except from family and friends. No exceptions.

9) Learn how to say no gracefully and gratefully —try “not now but maybe sometime in the future and thanks for thinking of me”.

10) Celebrate being unscheduled and unplanned when not scheduled and planned.

11) Get away. Far away. Whenever possible. The back yard counts.

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12) Connect regularly with people and activities that have absolutely nothing to do with medicine and health care.

13) Cherish co-workers, mentors, coaches and teachers that can help you grow and refine your profession and your person.

14) Start your work day on time. End your work day a little before you think you ought to.

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15) Smile at people who are not expecting it, especially your co-workers. Smile at people who you don’t think warrant it. If you can’t get your lips to smile, smile with your eyes.

16) Take a day off from caring for others to care for yourself.  Even a hug from yourself counts as a hug.

17) Practice gratitude daily. Doctoring is the best work there is anywhere and be blessed by it even on the days you prefer to forget.

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There is Meaning

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Of course, in life there are moments of darkness.
There are periods of discouragement.
There are times when we lose sight of the beauty of the sky for all the clouds.
You may have to bear severe sickness,
or deal with tremendous pain,
or you may be disappointed in this or that.
But remember, whatever difficulty you have to face,
it will not last.
It is only a cloud.
For God has made each of us with a purpose.

We are made for joy.
But this joy can never be fully experienced here on earth.
God’s joy is ultimately realized in eternity.
To be a Christian is to understand that the cross,
and the suffering of the cross, has meaning,
and that suffering is part of our state on this earth.
Don’t expect paradise on earth.
Don’t.
But there is meaning,
and this meaning is the love of God
and gratitude for life on this earth.
Whatever your state,
whatever your situation,
whatever your purpose,
always remember that you are made for joy.

~Alice Von Hildebrand

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It’s like in the great stories, Mr. Frodo.
The ones that really mattered.
Full of darkness and danger they were.
And sometimes you didn’t want to know the end…
because how could the end be happy?
How could the world go back to the way it was
when so much bad had happened?
But in the end, it’s only a passing thing… this shadow.
Even darkness must pass.”
~J.R.Tolkien

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When we feel overwhelmed and discouraged,
when it seems all is in shadow,
we know we are part of a great story and the plot progression is a mystery.

We are promised light and joy at the end, no question about it.
We pass through the shadows, the clouds clear
and the darkness will pass through us.

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Scattered

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The light beats upon me.
I am startled—
a split leaf crackles on the paved floor—
I am anguished—defeated.

A slight wind shakes the seed-pods—
my thoughts are spent
as the black seeds.
My thoughts tear me,
I dread their fever.
I am scattered in its whirl.
I am scattered like
the hot shrivelled seeds.

The shrivelled seeds
are spilt on the path—
the grass bends with dust,
the grape slips
under its crackled leaf:
yet far beyond the spent seed-pods,
and the blackened stalks of mint,
the poplar is bright on the hill,
the poplar spreads out,
deep-rooted among trees.

O poplar, you are great
among the hill-stones,
while I perish on the path
among the crevices of the rocks.
~Hilda Doolittle “Mid-Day”

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If seeds in the black earth can turn into such beautiful roses, what might not the heart of man become in its long journey toward the stars?
—G.K. Chesterton

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We are mere seeds lying dormant, plain and simple, with nothing to distinguish us one from the other until the murmurs of spring begin, so soft, so subtle.  The soil shakes loose frosty crust as the thawing warmth begins.   Sunlight makes life stir and swell, no longer frozen but animate and intimate.

We wake from our quiescence to sprout, bloom and fruit.  We reach as far as our tethered roots will allow, beyond earthly bounds to touch the light and be touched.

There is renewed hope seeded in the heart of man, ready and waiting to unfurl, with a precious fragrance that lingers, long after the petal has dried, loosened, and fallen to freedom.

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The Thoughts We Cannot Say

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A hundred thousand birds salute the day:–
        One solitary bird salutes the night:
Its mellow grieving wiles our grief away,
        And tunes our weary watches to delight;
It seems to sing the thoughts we cannot say,
        To know and sing them, and to set them right;
Until we feel once more that May is May,
        And hope some buds may bloom without a blight.
This solitary bird outweighs, outvies,
        The hundred thousand merry-making birds
Whose innocent warblings yet might make us wise
Would we but follow when they bid us rise,
        Would we but set their notes of praise to words
And launch our hearts up with them to the skies.
~Christina Rossetti

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It is hard work to feel morose in May –
yet with so much blooming blight
and wild reckless tweets and twittering
drowning us all –
Should such din and clatter
weigh heavily,
I seek a lightening of spirit
to rise far above,
launching my heart to the skies.

 

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In a Daze, Dancing

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I go my way,
and my left foot says ‘Glory,’
and my right foot says ‘Amen’:
in and out of Shadow Creek,
upstream and down,
exultant,
in a daze, dancing,
to the twin silver trumpets of praise.

~Annie Dillard Pilgrim at Tinker Creek

 

Every day should be a day of dancing,
of celebrating the fact we woke afresh,
a new start.

If I’m honest, not much feels new.

As I stumble about in my morning daze,
readying myself for the onslaught to come,
I step out and mumble “Glory”
and then “Amen”
until I really feel it
and believe it
and live it out.
Amen and Amen again.

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Shoulder the Sky

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The chestnut casts his flambeaux, and the flowers
Stream from the hawthorn on the wind away,
The doors clap to, the pane is blind with showers.
Pass me the can, lad; there’s an end of May..

…The troubles of our proud and angry dust
Are from eternity, and shall not fail.
Bear them we can, and if we can we must.
Shoulder the sky, my lad, and drink your ale.
A. E. Houseman

 

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Shade of His Hand

photo by Josh Scholten
photo by Josh Scholten

Is my gloom, after all,
Shade of His hand,
outstretched caressingly?

~Francis Thompson from “The Hound of Heaven”

When I’m down, discouraged, overwhelmed,
I focus inward,not out and beyond my own troubles.

If I were to look outside myself
I would see there is a reasoning
for my darkness.

His hand hovers over ready
to hold me when I fail and fall
so I’m unable to see past
to the broad expense of light
that is the rest of His glory,
not hidden, just invisible to me

at this moment.

Send Rain

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See, banks and brakes
Now, leavèd how thick! lacèd they are again
With fretty chervil, look, and fresh wind shakes
Them; birds build — but not I build; no, but strain,
Time’s eunuch, and not breed one work that wakes.

Mine, O thou Lord of life, send my roots rain
~Gerard Manley Hopkins from “Thou art indeed just, Lord”

As I look out through a tear-streaked window at the beginning of this dark day,
I fear I’m inadequate to the task before me.
Parched and struggling patients line my schedule;
they are anxious and already weary and barren, seeking something, anything
to ease their distress in a hostile world,
preferably an easy pill to swallow.
Nothing that hurts going down.

While others are thriving around them, they wilt and wither, wishing to die.

Lord of Life, equip me to find the words to say that might help.
May it be about more than genetics, neurotransmitters and physiology.

In this dry season for young lives, send your penetrating rain.
Reach down and shake our roots
fiercely
and slake our thirst.

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Welcoming Heart

Keep a green tree in your heart and perhaps a singing bird will come–
Chinese Proverb

I need reminding that what I offer from my heart reflects what I will receive there.  If I’m grumbling and breaking like a dying vine instead of a green tree, my discouragement entangled by the cobwebs and mildew of worry, then no singing bird will come.

So much better to nurture the singers of joy and gladness with a heart budding green with gratitude, anticipating and expectant.

The welcome mat is out and waiting.

Any time now…

To Whatever End

photo by Josh Scholten

To whatever end. Where is the horse and the rider? Where is the horn that was blowing? They have passed like rain on the mountains. Like wind in the meadow. The days have gone down in the west. Behind the hills, into shadow. How did it come to this?
~J.R.R Tolkien

Some days start dark, stay dark, end dark.  There is no reprieve, just impending loss.   There are so many who live out their days in the shadows, unable and unwilling to do what it takes to find the light again.

How did it come to this?  How far back was the turn that led to being lost?  How did we abandon a clear sense of direction, struggle to find purpose for getting up each day, forget to feel gratitude for the tiny things?

If we are to follow the path out, it must be with a sense of utter need and conviction.
We must give ourselves up to the rescue.
To not give up the fight.
To climb out of the shadows high enough to see the light again.
To be touched by light again.

To whatever end awaits us on the other side.