This is an audio recording of my pastor of seven years. He is gone now and I miss him.
Tonight, please enjoy one of his sermons and let me know what you think.
All my best to you.
This is an audio recording of my pastor of seven years. He is gone now and I miss him.
Tonight, please enjoy one of his sermons and let me know what you think.
All my best to you.
I’ve been hoping, asking, looking, waving awkwardly in the hospital hallways, trying to find someone who would join me in this great blogging experience with you on self-care. And, finally.
Please join me in welcoming Dr. Helme Silvet! You will love getting to know her, and she will love, as I do, sharing space with you. Keep on.
Helme Silvet, MD, MPH, FACC
Loma Linda University School of Medicine
Chief of Cardiology, Jerry L. Pettis VA Loma Linda Healthcare System
My Blog Journey
Sana (or Dr Q) and I have known each other for two decades or so (and yes, we have lived that long). We have spent hours talking about what makes us excited to be physicians, what gets us up in the morning, and what makes us upset. Finally, we decided that it was time to share some of these thoughts together. Taking care of self is a principle that we both try to teach our patients, but also practice ourselves in order to be effective parts of our families, communities, and humanity. The goal of this blog is to attempt both from the, perhaps, somewhat unique perspective of biology, and medicine as the starting point to self-care.
My Professional Journey
My medical experience started in the “old country” behind the Iron Wall – I grew up in Estonia and graduated from medical school there. After the Soviet Union opened its borders, I made my way to the U.S. and finished an internal medicine residency at Loma Linda University and cardiology fellowship at Brigham and Women’s Hospital/Lown Cardiovascular Center. Starting in 2003, I have worked at the VA system as a cardiologist. Along the way, I also graduated with an MPH degree from Harvard School of Public Health. I am passionate about making people get better – this includes preventing, treating and managing heart disease as a cardiologist – but also helping my patients make sense of their life journey. One cannot treat and prevent disease without caring for the whole person.
My Life Journey
Between my two sisters and myself, we have lived in 5 different countries – this has made for interesting holidays! Seeing different parts of the world up close has given me plenty of experience, but has also come with a certain sense of displacement. It has been a continuous struggle in my life to figure out where I fit in the wide world in general, and in my little microcosm of a world in particular. In this context, it has been fascinating to learn different things from different cultures, and observe how people with different life experiences can effectively communicate with each other. And I noticed that somewhere along the way, my quest for truth and knowledge is giving way to a quest of understanding and compassion.
The thoughts on this blog are my own and do not represent entities I belong to in a professional capacity. The stories that I tell are true in principle but the details may have been changed to protect people’s privacy. The blog is not meant to offer professional advice or treatment advice for specific medical conditions; the goal is to share ideas, general principles and stories of a personal journey.
Had a great time at, “Seams of Gold.” Great example of how community is friendly to “Me.” Met a wonderful man.
Me: Hi! I’m Dr. Quijada! I’m a psychiatrist.
Him: I’m Frank. I’m a recovering Alcoholic.
Got to love love that kind of company. Thank you to all who participated and volunteered.
Found after our evening, was thinking about that darn “justice” ever skirting so much of Me. The way becoming the victim to abusive treatment drives “Me” into helplessness all around us. Things like money turn us to blame and ugliness. In the end, telling our story, we hear from our own selves more about the behavior of the curmudgeon than would ever leave cause/change/control space for an innocent like “Me.” Yep. It’s them.
Using the behaviors and emotions of others is never useful to explain/justify the emotions or behaviors of “Me.” We are as free to choose to be a victim as we are to not.
Programs like, Seams of God, and people like Frank, remind us that turning toward something better is, Way! It is way, like opening a window to a hot room, like turning the lights on, like biting into a ripe home-grown cherimoya. Turning toward something good rather than away from “bad” is choosing to be free.
Be free. Everything starts and ends with Me.
Keep on, dandies.
“Taylor Swift is a rock star!”
The girl was in awe. She had written versions of this all over her paper in various star-quality designs. Everything was about Taylor Swift. I was watching her at the park and drifting among my own thoughts, when her father leaned over and said, “Now write, Susan is a rock star.” Young TS-Fan, alias Susan, looked up with an expression capturing a combo of wisdom with a big flip-off. My thoughts were not adrift. She was my interest. She was a star.
And so was her dad! What a guy!
Think about what your temperament gave you. Think about what you like most to do, what your thoughts noodle when you aren’t “thinking.” Is there someone who emulates the “star?” Write that person’s name down in a bumper sticker statement. Now write your own name in another. You are peers. Meet your cohort.
Susan’s dad had it going. Be productive at any age. Know that you have something to offer. You have valuable stock. Put you name out there, where ever that is.
Christian is a brilliant gardener. Mindy is being her real self all the time. Craig works words in classic timeless style. You are a star.
“I like the way he sees me. I have a lot of trouble seeing myself.”
Madge really had it going, as far as I was concerned. In this one statement, she is insightful.
Juxtaposing being able to see into oneself with the self-declaration of not being able to see, is ironic. It is lovely, like going toward anxiety to diminish its power over us. It is complex, as are the many hues of gray. A beautiful weed. Great weakness. Useful trash. It is a pretty great irony to come to that place of wisely recognizing how little wisdom we have.
We have trouble seeing ourselves. Part of what makes it so hard to be friends is that doing that is like shaking our own hand. When we try, we are a purse flipped inside out. The crude insult, “Her head is stuck up her own a–!” comes to mind.
Many like bullet points to give a, “How to.” For example, look at Yahoo!
Cook watermelon. I know someone is saying, “Made you look.” And maybe when I say, “How to see yourself in these moves,” someone else is swirling their eyes. But, as I am not about to say that I know better than Yahoo!, here’s my try:
1. Origins, (God)
2. Brain health
5. And a big magic mirror
Mirror, mirror, on the wall, how do I see Me?
Maybe my list is out of order and maybe it is not a perfect step approach into the soul. So be it. Editors of Yahoo! feel free to instruct.
Madge, in one statement, covered community and limitations. It was nice to be in her space.
Self-Care Tip: How do I become a friend to Me? Start with seeing.
We have a tenuous relationship with ourselves. Very conditional, as if we were in a constant state of probation. Have you noticed? Conditional love: part of the human condition.
I was reading the The Golem and the Jinni: A Novel, by Helene Wecker, and found myself getting into her golem-philosophy, that went something like this,
Since so many of us have it, can’t you just say it is the way things are, and not about freedom or fairness?
Wecker in such eloquence ironically describes the human condition from the story of two inhuman beings.
The New York Times, PATRICIA COHEN, describes it as,
When they are later confronted by the evil power who controls their fates, they discover that the ultimate expression of free will may lie in the embrace of limitations.
In considering our limitations in loving our own self, this idea can be useful to come to terms with the day in and out internal conflict of loving what is imperfect and distasteful, with what we would otherwise rather not identify with, and with the acts of friendship toward this seemingly inhuman part of our selves. In embracing our limitations, we may find less conflict in loving Me, less conditioning, or perhaps a shorter probation each day. We may experience the probation differently, Chava, The Golem, when we say, “It just is this way with all of us. I have the community of humanity.”
Getting into the space of where our “tenuous bond” between what we love and would otherwise not love about ME, in fact diminishes the frailty and increases the strength in our personal journey. Rather than putting us into further danger of internal conflict and self-loathing, it allows us to experience what will happen from and in the company of the tension.
More specifically, in brain health, getting into the space of our conditional love for our self, allows us to do things like seek medical treatment when needed, ally with help, with medical treatments that once repulsed us, with something as formulated as putting a pill in our mouth seven days a week indefinitely. Or another treatment, such as ECT.
We are conditional with ourselves. It is part of our human condition. That is pretty close to, “Normal.”
Question: How often are you aware of your own difficulty loving yourself, your Me? What improves this? Why does difficulty with loving Me recur and recur without end? Please tell us your story.
Self-Care Tip: Get into the tenuous space between the “good and bad” of Me where you are normal.
sharing some of what she has done in friendship.
“Celebrating being a friend to myself by becoming the ACTIVE artist that I have always wanted to be. Actually have an image that has been juried into a calendar which is being sold National Colored Pencil Society of America convention at the in Brea this summer…and I will be attending the convention, thanks to my husband’s generosity. So excited!! Never thought, when I was in my darkest of places twenty years ago, that I’d be willing to attend a convention alone!! Learning to be a friend to myself has given me this gift and I couldn’t be celebrating more or be more grateful to you and my friendtoyourself friends!!! Bless you all!!
This is the picture I did in colored pencil – the one going into a calendar to be sold at the CPSA Convention in LA this summer.”
Nicely done Nancy. We celebrate you.
The blue dragon lifted her head from near-sleep. She knew. Pouncing onto the rocky ledge gave her the advantage. No one would challenge her. The fresh corpse was for her alone. As she ate the remains of Dionna, the red dragon who had never flown, the memories of Dionna infused her. The blue dragon in this had saved those memories and would live them into the forwardness of time.
Why is it that we repeat the mistakes of our forefathers? It would be nice if we could somehow be able to capture their hard-earned life experiences. If dragon lore were true, perhaps.
In Papua New Guinea, Congo, cannibals on the Disneyland Jungle Cruise and who knows where else, eating brain to preserve the life force, save your daughters or avoid the mistakes Dad made gets you a bad and yucky disease called, kuru. Nothing good comes from eating brain.
And so the blue dragon, whose scales shone in the morning sun, began to tremble and seemed confused over the years. Her brain got holes like a sponge and she laughed at inappropriate times.
We just cannot get a leg up on wisdom and experience. We are not made for it. Each of make our own mistakes, have to work our own fingers to the bone, and other knowing clichés that in this case just are the darn truth.
What blue dragon and kuru are trying to tell us are that the agenda Love has for us is not to build up experiences like some sort of mental tower of babel. It is not about the mistakes. It is about our life experience.
We cannot help but wonder, though. After working in psychiatry for these many years, I wonder what a joy it would be to give that experience, knowledge, skill of practice and such to my daughter some day. Ah. As if it had its own life force, passing it on to my daughter feels like a bit of immortality.
When I die, just eat my frontal lobe, darling. Not the limbic system.
We are meant to live. In that living, we inevitably repeat foibles and build up muscles and manage to survive all kinds of suffering. In that living, we are beat up and rejected. We are perfect. We are flawed. We are marvelous.
Maybe the agenda is not to get it better with each generation or to get it right. Maybe the agenda is to live.
Question: Have you ever been frustrated at how quickly your gains in life will be/are lost? What is the agenda of your life? Please tell us your story.
Self-Care Tip: Live life with a quality-experience agenda.
I want to meet you on a narrow path. A trail that only we can fit so we bump into each other often. We apologize in turns until finally the collisions become familiar to us both and we accept that you and I are not alone. Less space so we bang along, is just what I am and was hoping for.
Happy Thanks-Giving my friend. I am thankful for you.
Self-care tip – allow the space to bring you into company and connection. You are not alone.
Much of what we do in medicine is elementary. I wouldn’t know how to quantify the amount of plainness involved with our goings-on. Behind the writing of controlled substances on pricey government controlled paper, behind our, “Hmm’s”, our flow of learning and teaching, and more (or less) than the laying on of professional hands, we are… we are common.
To say it simply, physicians are dealing with themselves. In medical practice, separating the self out, effectively breaking the emulsion of the physician from their personal journey leaves many of us suspiciously grouped into the numbers of old and lonely but practically excellent. Some medical specialties are infrequently bested by anything other than 80+ hour work-weeks, knowledge retention and steady hands. The imminent peril and the literal moment by moment of life-saving interventions helps the rest of us understand.
Even so, I’ve known some who have been “the best” and still managed to be connected to their personal. I imagine some other dimension is forced open by all the space that that kind of nearly fictional human occupies: Cardiothoracic surgeon, Anees J Razzouk, M.D., at Loma Linda University, for one; Gisella Sandy, M.D., critical care specialist, general surgeon and medical missionary in Peru, for another. We are all happy to say that the list is long here. We think of the ordinary physicians planted around our planet who are heroic enough to do the simple. After all, how much can a physician offer to her patient if she hasn’t taken care of herself first?
Those of us who seek medical care from a physician will be interested to know that the physician as well as the patient can only carry so much before things start to fall out of their arms. Before a sack tears on our way from the car to the kitchen, before there is spillage and things go unnoticed, we want to know that they thought about it. We want for them what they want for their patients in other words. Accountability to Me.
Wanting this for others, because we are afraid, is understandable. But it’s not at the aorta where life pumps and freedom flows. Each of us, regardless of fancy prescription pad or paper gown, to trust the other, we must have their own wanting. Wanting this for themselves. For Me. That is the pulse on trusting each other.
Questions: How has being a better friend to yourself improved your trust in those who are serving you? How has being a better friend to yourself improved your ability to trust those you hope to serve? Please tell us your story.
I remembered my grandma’s hair today. She had this little vanity. Used to roll it up at night and put her net over. In the morning she was careful about it.
She had good hair. In her 80’s it was still pretty full and it was white. Really white like forgiveness. Something about it carried a message. “Here is a woman who has beauty.”
When my grandfather died, I am told that there were men who wanted to marry her. Men with farms, a business or something to offer. Grandma, when she thought the time was right, would introduce them to her four sons. Big sons, with big bones and the quietness from working in the inconsiderate conditions of nature and element. Sons who had a father once but lost him, like a ring that slips off your finger in the water without you knowing it was gone. Worse than that.
It’s important to have a message when you live under working conditions, where horrors happen. A little sister burns to death in front of you. Your finger gets twisted off in a washing machine like a bottle cap. You canned. Canning was never a hobby for Grandma but I never had the sense that she disliked it.
What made Grandma’s hair stand out so for me and my brothers was that it was her indulgence. Why an old woman with no teeth, in a wooden farm-house sleeping next to a man she didn’t marry for love, (although she loved him), would roll her hair every night as if she was going to have family pictures in the morning – just has to make you smile.
She used to leave her dentures in a cup of water by her bed and her mouth would leak a little when they weren’t in. How good her kisses were. I’m glad I didn’t know to think they were gross. Even when Grandma got really old, smelled like medicine and her rotting insides, I didn’t think so.
Mom would go in and roll Grandma’s hair for her because her fingers turned at odd angles. She couldn’t do her hair and she couldn’t play piano. Later, when moved into a nursing facility, there was a beauty contest. My mom found out about it and enrolled my grandma without her knowing. She told Mom afterward that she won because of her hair. I had never heard Grandma talk about her hair like that, even though the rest of us had, and my brother’s and I laughed until we cried. And then we cried some more.
Question: What is your indulgence? What is the message in it from your secret self out to the world? What does it bring to your ability to be your own friend. Please tell me your story.
Self-Care Tip – Celebrate your indulgence, acknowledge its message about you and see what it brings to your ability to be your own friend.
Even car accidents happen for “good reasons!”
Wanda didn’t want to hear the reasons.
Anything could sound like a good reason for bad performance. It is what it is. Just own it!
And Wanda was out. And just as quickly as she concluded, I flashed back to the quivering resident who messed up on internal medicine rounds. I stood there with my spine like a steel rod. My white coat felt heavier with my fair-weather reference books bulging in my pockets.
Keep your chin up and look at her! I told myself.
This wasn’t the first time for me, so I had the “luxury” of practicing a previous well-described lesson from my attending on how to respond to feedback. Those days seemed like a series of stings, burns and frost-bite, but I am grateful for that at least – the knowledge of how I’m supposed to “take it.”
Wanda came back into my mind’s focus as memories of internship faded. Wanda wasn’t even mad at me. She was telling me this story as an example of her difficulty coping with anger. Here she was asking for help while justifying her position. Don’t we all, though?
I saw the irony in her criticism of those who gave reasons for their foibles as compared to her own explanation for anger and medical care. Yet again, aren’t we all inconsistent like this? Wanda is not alone. She even had good insight too. Explaining away our mistakes is shabby, lacks class and is insincere.
Some time ago in a post, Please Don’t Say “But”, we talked about this, which later we termed “presence.” But why see a psychiatrist about these things? Because insight is only worth so much. If the mechanics to respond to the insight aren’t well, then you’ll be able to withdraw from your self just that. In Wanda’s case, it was spitting anger, hot to the touch and not much safe. It had quite an effect on her interpersonal relationships and quality of life.
When we find that we can’t do what we want, don’t respond the way we intend, have negative emotions and behaviors we didn’t invite, see the associated deterioration in our connections and quality of life – when we are suffering, we need to look for help. It’s hard to be productive and survive without support. Any bit of nature will tell you that. Ask a peach tree if you don’t believe me.
Question: Does it make sense to you that emotions and behaviors might be all we have to show us that we are medically ill? If not, please tell us why.
Self-Care Tip: When insight isn’t enough, consider a medical consult. Be a friend to yourself.
In gratitude I move between these letters. My step is often clomping and loud, but is that what we would name a “sure-step?” Not always. Even tripping and clipping corners bruising my legs, with my mistakes returning echoes to remind anyone who wants to know what my shifting sounds like. Even when, I move gratefully. And it is for you and Me and God. We have decided confidently once at least. At least once we have in like-minded strength chosen to dedicate our force to move us to the purpose of becoming a friend to yourself. Many, more often than once. Many have decided as often as they deliberately step, like a recovering spinal cord injury remembers just how to lift the leg, tilt the foot and ease it down. Many find this purpose we have chosen at least as difficult as that.
How bout you? More? Less? Gratitude is an assist for Me, as are the woven combinations of all that make up my process, my presence or we could say personal journey. Within that weave, there is this thing that runs on the fuel that only kind feed-back can generate. You people. In truth, I can not move very far with out you.
I have two specific thank-you’s of this kind.
Some time ago, Beth Parker, gifted the Liebster Award and more recently, Cathy gave the Versatile blogger Award. These girls are kind. They are friendly and they are funny. They give and some of what they give, specifically incredible generous feedback like this, is essential to Me. I’m pretty sure it’s on the periodic table of elements. Without it, I’d poop out, like an old jalopy in the desert. I am grateful.
There’s a bit of an overlap in some spaces of these awards and I’m going to snip it back a little since the day is spent. The good stuff really is naming off you wonders out there who have voices that must be heard. I’m going to remake the to-do’s of these awards, because I can and that’s the kind of girl I am ;).
My deep gratitude compels me to name off the folks who comment. They talk. They speak and connect and let themselves know and be known. What an honor. You, and to all have had the courage to write your vulnerable self into words and engage – Thank you.
This commenting-thing is more than pom-pom action. When we speak out loud, we open closet doors, shame is aired, fears are invited for tea and then ushered out more easily. We hook into the self-care tips and make them our own when we breathe out audibly. We may not know it but we claim them and the people in this community of “Friend to Yourself-ers” or FTY’s. (How do you like that? FTY?) This is awesome and powerful and free. As we say here, “speak.”
You may or may not be on this “WordPress” generated statistic of commenters, but either way, you are here with us. You fuel us in our life journey uniquely and importantly. For those who read but don’t comment, thank you as well for letting us share ourselves with you. Comment if you will, but keep coming either way.
Water, is taught by thirst. Land -- by the Oceans passed. Transport -- by throe -- Peace -- by its battles told -- Love, by Memorial Mold -- Birds, by the Snow.
I have been quiet here for what seems like a long time and I am happy to be talking out “loud” again. Thank you for being, friends.
Over the past year-and-a-half of writing and reading with you, of speaking and hearing, teaching and learning – instead of diminishing my interest, exhausting my energies and instead of completing this “task,” I am rather in process of crescendo. This thing called, being a “friend to yourself,” apparently must continue. It must because otherwise we would not.
Emily Dickinson knew the value of what was missing; but more so, she knew the value in the wanting of it.
Water, is taught by thirst.
I am ever aware that you and I do too. It is this wanting that spurs in us our creative genius in this effort. In any area of interest, in fact, whether it is this, to cultivate the caring of our own person, or to improve our eye of canvas, to swing our sword or to put pen to paper – if we do not sense potential, pleasure still to come, if we do not see beyond where we are to what might be and if we don’t want it, we will miss our selves. We will lose our pearl to the muck that hides us.
Counter to intuition, presence is in fact enhanced by our wanting. We clarify our point of reference to each other and to Love when we realize that we are toward something greater than ourselves. Having that point of reference is nourishing. It is active and it is connected. The understanding of what we want still, have yet to obtain, rather than destabilizing or isolating us, it improves our footing and our community. And like Emily, we give up much just to experience the exquisite process of joining our own journey.
This is what thirst has taught me. What about you? Please tell me your story.
Self-Care Tip – Before the gift of your thirst, pursue it knowing you are blessed. Be a friend to yourself.
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He still has some lingering vestigial baby-smell that sets the pheromones into motion. I turn soft and doughy sniffing his hairline and would claw out any threat; as if there would be one within our stuccoed walls in jungled suburbia. But just in case, I am primed. Grrrr.
This moment that comes in one lungful of air sets off the sixth sense, like chimes in the wind, into a little pretty song of contrasting emotions – something warm and nice against fear and aggression. Lovely. Complex and simple. I breath in and taste what is in the air again more slowly. I let it come together so I can pull it apart. I am in awe.
What creatures we are.
Big breath everyone. What contrasts come together for you? Is the experience of letting yourself watch them coalesce and then dehis add any sense of presence to your moment?
Self-Care Tip – Let things come together and fall apart to experience them more fully – presence.
What do you want?
It is one of my challenges as a physician when someone comes to see me for reasons I’m not able to accommodate. I can’t validate them. I can’t tell them what they want to hear.
What can I do? Help them “realize” that they came to see me for another reason. Another way to say it is to help them “choose” another agenda. A part of them realizes their need for help; they came. A part of them believes I am a person that can help; they came. A part of them. A part that I and the patient are responsible to find and shift agendas deliberately or by any wiles possible.
We are an unusual team in this. How often do you find another so awkwardly paired? Yet these are some of my best patient-doctor relationships.
What do you want?
When there is a meeting up, a connection and everyone is working for the same “want,” both presence and movement are natural responses. It’s like we’re standing still in the moment, senses taking it in, and moving all the while. The process of moving itself brings pleasure and healing. It is not always about arriving. It is not always what we think we want.
Self-Care Tip – Enjoy your re-choices and what you will get from them.
Questions: Have you every found yourself being “helped” to have a different agenda that improved your presence and movement in your personal journey? Please tell us your story.
It’s summer break already and that means more Mom-time for the kids,… and a few other things. But if there’s more Mom-time for the kids, we all know what there is more of for Mom. These things come together and equal more spending-money-time combined with less work-time. This can’t be without consequence.
I’m thinking stress, memory-makers, lots of kissing marshmellow-cheeks and tears to show. Always tears. The kids cry of course but if I do, its all,
Mom! Oh NO! Mom! Stop crying! Agh. I can’t stand it when you do that!
Lots of exclamation points are involved. I’m thinking this summer will have some of that because some days are stressful and painful. Others are just too beautiful to leave unstained with tears to sign my name by. Get ready kids!
Tonight, this is what I have.
I am licking my finger and turning a page. I feel the book as the page slowly fights the air to pass over. I haven’t seen the other side yet but the way the page lifts up and toward me, I know that this part is significant in itself. Lick my finger, press it down and sweep up. Up and passing over, just. The page is turning and so are we.
Question: What is turning in your life?
Self-Care Tip #280 – Pay attention to what is turning in you.
It’s 9:23 PM and our little kids are still awake! They’ve cried. They’ve laughed. We’ve cuddled. We’ve spanked. They’ve taken two showers and brushed their teeth twice. We ate several times.
I was riding my bike, watching a movie, (I love that!), and my daughters were taking turns coming in to complain, wet me with their tears, snuggle, hold me; you get it. My exercise and my movie were peppered with refreshing breaks. Sitting on the couch chair nearby with my five-year old during one of these intermissions, holding her, I was able to say,
I was able to do this because I was the one in the casita getting pumped up and my husband was the one in the house herding children to bed. He had the tough job that turns me into a turnip and I had this.
You can do it. You can try again. You can try again, even if you are trying for the one-hundredth time. You try and you try and you try again because that’s what makes our lives beautiful. The trying part mostly. Not the arrival.
And that’s when I grabbed her and held on. I suddenly felt so blessed. From this off-night, I was given the reminder that the trying part of life is where it is at.
It’s 9:33 PM and I think they’re asleep. Sigh. Tonight was awesome.
Questions: How is your journey? Have you been enjoying your failures lately? Please tell me your story.
Self-Care Tip #273 – Enjoy your failures.
PattyAnne came in knowing what she wanted. She was sure she was struggling with ADHD. She could not focus, she had difficulty connecting with others, and she was impulsive. This was limiting her intimacy with the people she wanted in her life. PattyAnne had read about ADHD and was relieved thinking that taking a stimulant would improve her that much.
PattyAnne is rich inside, dark chocolate, not white, aromatic and effectively affecting. Being with her means being touched. When PattyAnne is good, her fresh aura in our shared space is healing. Many baffled by this wonder why, when she passes through, they feel so much better.
Consistent with this intensity, when PattyAnne is not good, whatever comes from her is chemical warfare, and we are not safe. You can leave, but you will always leave touched. Any time with PattyAnne feels like either too much time or too little. We are wanting: wanting more or wanting less, somehow with PattyAnne, we will never feel satisfied.
This is part of why PattyAnne projected confidence while self-diagnosing. Her temperament and coping skills predisposed her to do it. Self-diagnosis in her and others also happen because of fear, lack of trust in their medical provider or defensiveness per their feelings of inequality.
There are good things that come with self-diagnosis to consider.
The self-knowledge each of us has on either side of the patient-doctor relationship is not inherently dangerous, and consider the inverse. Clinicians come to the room with their own self-diagnoses as designed by biases and countertransference. And which clinician is not also a patient? There is good with bad and we have a choice, as always, within stories within stories….
Patients and clinicians perceive self-knowledge, at least in part, as self-care, and we are right. Like Dad says, “Knowledge is never wasted.” How many times have clinicians asked why patients do not try to educate themselves about their disease? To begrudge them for it is to deny the value of that process and what clinicians also do under the guise of a license to practice.
Any of us can imagine that for both parties, these types of encounters cost emotional and physical energy. For PattyAnne, we have mentioned already that she came defensive.
For me, I regret the times when I did not own responsibility for my feelings. When a patient self-diagnosed, I too quickly assumed mal-intent, personalized behaviors and missed my opportunity to benefit from the connection inherent in the patient-doctor relationship. This is what I wanted to avoid with PattyAnne.
I celebrate, however, these past many months our work on FriendtoYourself.com. I experience much more pleasure in my profession. I am even more clinically effective by taking care of myself first; by being present with myself. My self-care professionally mirrors my personal self-care in that when I am first able to be present with my own self, such as through writing and interacting with you, my online community, I can then be present with my patients.
…I thank you for teaching me and hope we share this exchange for a long time.
When I can be present, I do not have to moralize my perceptions of patients’ behaviors and feelings. Self-care is not a moral issue.
In the following posts we will discuss more about these terms: presence, moralizing self-care, trust, and the patient-doctor relationship.
Self-Care Tip – Grow your self-knowledge and find what it offers you, in turn, when observing it in others.
Questions: What has your experience been when you have gone to your clinician with self-knowledge? How has gaining self-knowledge been a friendly thing to yourself? Please tell me your story.
Self-Care Tip #256 – Think about the good and the not so good on scheduled memory-maker days like today.
Questions: What do you think scheduled intimacy has to offer you? How do you manage to allow the not so good to come together with the good in your life? Please tell me your story.
Just like any scheduled memory-maker, Mother’s Day brings the good and not so good. And for most of us, we have some of both, even if just a little.
Yesterday, in the company of my three healthy children, I couldn’t help but notice the lady I sat beside was sniffling. “Should I say something? Should I not say something?”
…Almost six years ago, my nine year-old niece suddenly died. One week later I delivered my second child.
I don’t remember most of my daughter’s first year of life except a couple random things. My sister-in-law, sitting alone on a rock just staring. I remember her clothes, the weather during that moment, the texture of the rock, but I don’t remember nursing my baby. I think this was still in the first month when I saw my sister-in-law on the rock.
We buried my niece’s ashes under a Jacaranda tree and it took forever for that tree to bloom. I watched its skeleton month after month thinking, “This is terrible! It needs to bloom!” Isn’t that ridiculous? And I remember my brother, red-eyed. The lines on his face cut in deep. He said,
I’m so glad you’re having this baby Sana. It’s just what we need. You remind us, this baby is reminding us that we are still alive.
The good and the not so good.
Of course I sensed what my brother was saying, but I still had a moment of hypervigilance when my body seemed to say, “What?!”
There was a lot of insecurity and emotional confusion that year but I don’t remember much more. I believe my daughter breast-fed, learned to sleep through the night, transitioned to solid foods and took her first steps. But I don’t remember.
Yesterday, I turned to the lady and asked,
Are you sad? Is there something you are sad about?
I used to have a son. I had a son. He died.
The good and the not so good.
Right on schedule. Mother’s Day came. We knew it was going to happen. And yet our bodies crack open, poorly defended. Little our calendars did for our emotional preparation.
The lady grabbed my hands in further intimacy than I anticipated. She told me her name but I wasn’t listening. I was thinking about my niece, her sometimes blooming tree, my children around me; so much. I was thinking about the good and the not so good on scheduled memory-maker days like today.
There is a coming together of our parceled selves that have been scattered to the east and to the west by the winds. There is a coming together that this Mothers-Day, Christmas, Valentine’s or my nieces birthday, have on us and the process itself is bruising. It is an opportunity to gather what we will or won’t. It is an opportunity to be present with our changing selves. In the tears, in my daughter’s crooked rainbow pictures and backwards letters,
bear mommy, i love yu….
In the grip of a stranger’s hands, in the company of our own Mom’s, wherever we find ourselves on these blue-lettered calendar days is where we have this
opportunity to do some of the sometimes hard work to grow presence. Without it, we will continue to change. That can’t be stopped. But with it, with our choice-making, with accepting the gift of our folding up of the space between our past and our present, if we hadn’t cried again for our loss, if we hadn’t we might not have remembered what has made us and who we are. Changed. Covered by Love. Connected. Doing what a friend would do for Me.
Tonight my daughter sits on my lap. We are watching a blue-ray recording of Les Miserables (musical) Twenty-Fifth Anniversary touring production at the London’s Barbican Centre. I am listening to an excellent tale of the good and the not so good in life.
To God, our Mother, today was scheduled and I thank you.