The Mindful M.D.

when I am stuck

I am paralyzed by choice. 

Thinking about the best ways to contribute, to live and to love. 

When I think about how to be fulfilled, what are the questions I should ask myself?

My mental model is often of scarcity, of comparison and of fear. This is the way that I tend to approach a decisions and projects. If I take on the writing assignment, or if I take on these new clinical duties, I might fail, I might look stupid and need help. When I am thinking about potentially taking academic jobs, this is the script that I play: Will I be exposed to shame? Do I have the ability to do this and not look stupid and what will everyone think? 

This. Is. Scarcity. Operating from fear. 

Instead of scarcity, I will pivot to sufficiency. 

My new model is of sufficiency, 

-- operating from appreciation/gratitude

-- operating from a desire to contribute

I will recognize shame, but if the new project or opportunity is consistent with my values and my ability to contribute, and it is a hell yes. I will show up, learn and be compassionate. These will help me measure success. 

 

Any thoughts on fulfillment?

Dont ask Dont Tell

Failure in medicine is a major taboo. It is the Don't Ask, Don't Tell of the medical field.

We are cultured, from day one in medical school to not speak up unless we are right. This continues into residency where most residents stake their well being on being right.

I had to divorce my sense of success from my knowledge base. Use the uncertainty and fear of not knowing the right answer as an opportunity for growth.

I have to reconnect with my curiosity and think about the unknown as fun again. It used to be.

Resistance and Growth

I have real resistance to moonlighting. It seems that this is extra, unnecessary and currently it's not a HELL yes.

There is this great quote from Derek Sivers about how to choose projects. He says that your should ask yourself, "is the a Hell YES? if no then the answer is NO." 

The problem is defining the criteria for a HELL yes.

For the next few things that come my way I will experiment with this system to decide:

1. What does my gut tell me?
2. If yes, what are the long term goals this project will help me attain?
3. If yes, what are the values that this project is consistent with?
   1.    Creativity?
   2.    Contribution?
   3.    Compassion?
   4.    Community?
   5.    Growth? 
   6.    Health?

 

1. If I hesitate, NO. 

Any other thoughts of taking on projects?

 

 

Because sometimes it is worth it!

Occasionally, you get a sign that what you are doing is adding value. 

Alyssa is an intern. Due to a schedule quirk, she was on my team for two months. 

 

Occasionally, you need a sign to keep going and today I got it. 

About one month after our rotation ended, I get this text:

"I wanted to remind you that you're a great attending and physician! Youve impacted me as a physician for the better. You helped me think critically and question everything. I appreciate everything I learned from you."

It is okay, even for doctors, to celebrate the victories. 

Happy memorial Day. 

 

 

Struggles and Systems

I want to live a good life, an examined life, a healthy life.

Hence, I read a lot about self actualization and do an inane amount of self experimentation. I think it is part of my DNA or the culture of medicine. Probably both.

Scott Adams said "Losers have goals and winners have systems."

So, what is a system?

• it is a series of of interlocking processes that work together to efficiently and effectively have you make the right decision, every time. 

So, can you set up a system without having a goal?

- This is unlikely given the system should be measured against some outcome. ACTUALLY MEASURED. 

My health span system is below, GOAL included (to be measurable.)

Goal: less than 205 lbs 

System:

• Intermittent Fasting: my current obsession, 5:2 with no breakfast on other days
• Mediterranean diet on the 5 off days. 
• HIIT, Cardio, yoga alternating for 5/7 days. 

This is the health span system. easy. no drama. scientific. 

Do you have any systems that work?

 

Purpose and Principle #1

How do we learn to be fulfilled in clinical medicine?

This idea about slowing down into presence at work came from a deep desire to find a way to love my job again. Many physicians and residents in internal medicine are heating up and burning out. I struggle with resistance to my work on a daily basis and want to change my questions and hence change my life. 

The idea for this blog is to document that journey, interview mentors, process errors, grow into the clinician I want to be and learn about a recipe for happiness in clinical medicine. 

You are going to here principles, results of personal experiments, ideas about happiness, poems, rants and quotes. I hope these can add value to your life! That is the ultimate goal, adding value. 

#1: Your definition of success determines your level of fulfillment at work. 

People in medicine have existed on a steady diet of external measures of success and people pleasing probably since grade school. Get good grades in school, do well on the SAT, thrive in college, get into a good medical school and get into the top residency programs. However, if we take a breath (slow down), we soon recognize that there is always another level, another goal or another publication.

If you always let the next achievement determine your success and fulfillment, one day you will realize, too late, that the next publication or project success is not going to make you happy. We all too often seek achievement instead of fulfillment. 

 

Writing Exercise: 

How do you define success?

 

My definition? 

If I can show up,  learn one new thing, and be compassionate to my patients, then I call it a success.