Clarity in solitude

It's been a busy few months and I have had so much I wanted to share on this page. From 

educational outreach on LGBTQ+ health to 

insights from developing our compassion curriculum to 

inspiration from training in open dialogue to

excitement from a multidisciplinary collaboration on a new manuscript to

strengthening connections and brainstorming in my new role as GME wellness director to  

training up a wonderful cadre of resident/fellow peer supporters to 

collaborating with colleagues to fortify and safeguard FM education in the new med school curriculum to 

co-facilitating professional development in wellness-centered leadership with wellness colleagues to

heartfelt moments with learners and patients to 

precious moments with my children as they wrapped up the school year and extracurriculars and launched into the beautiful chaos of summer camp...

Well-- I'm tired, but the good kind.  I just know I need to do some stretching and cool down to integrate things after an intense period of growth and learning.

My heart and mind are full, and desperate to do some processing.

And the universe has granted me just that, as this week I have the home completely to myself as my two children have gone off to sleepaway camp and my partner tends to family matters out of state. 

I'm trying not to get an A in relaxing this week, nor am I gunning to catch up on all the things on my to-do list. I'm definitely looking forward to some restorative time and connecting with some parts of myself that tend to collect dust in the caregiving journey. More than anything, I know that a lot has happened, and sometimes it might seem easier to just keep on trucking when the pedal has been slammed to the floor. But everything has been pointing me towards the need to slow down and enjoy this ride more, so I'm putting on cruise control and giving myself some space to look back a little. And in that way, I know I can earn even more clarity about where I'm going. 

You can't be all things

On the surface, it can sound pretty exciting to be a full-spectrum family medicine physician and Associate Clinical Professor, Wellness Director for the Department of Family Medicine, Wellness Director for Graduate Medical Education, and Co-Director for the School of Medicine's new Compassionate Action and Real Engagement in the Community course. The reality:

~30 residents with varying needs and feedback on my teaching style and engagement

~75 faculty colleagues with a myriad of needs with respect to their wellness 

~150 medical students with varying opinions of our compassion course

~700 patients on my panel with a number of perspectives on the care I provide

~1000 residents and fellows with a myriad of needs with respect to their wellness

Every time I have to read through feedback, be it from colleagues or learners or patients, I can be so filled with dread. The fact of the matter is that I really want everyone to be happy and it kills me when people feel that their needs aren't being met. Whether I'm caring for patients or teaching and mentoring, I want people to feel supported, listened to, cared for. 

When you get feedback that you are too close for comfort, and try to back off, then you are at risk of being called disengaged. When you offer openness to feedback and co-creation, if you don't incorporate all the ideas, you can be seen as dismissive. It's a dizzying pendulum swing. 

In our efforts to try to be all things to be all people, our identity and values can easily become compromised. I am trying to keep that in mind as I forge a path forward with so many factors weighing on my conscience.

I know that I cannot be perfect, and given the privilege I have to be involved in the lives of so many people, there are going to be some unhappy people. And I have to be okay with that. It's just really uncomfortable. And I have to make up for it with more self-care and therapy and self-assurance that if I stay true to myself, I can lean on the inner compass to guide me forward as a leader, educator, and healer. 

I'm going to challenge myself with a little reframe - I'm so grateful that I am in a position to fuss over these "first world problems" and that I have the agency to have a seat at the table to use my voice and enact change. I just need to lean into personal resiliency a bit more so I'm prepared for the inevitable challenges along the way.

I appreciate those of you who made it through this vulnerability post which offered me a little catharsis at a tough time. If this struggle speaks to any of you out there in mentoring or leadership roles, know that you are not alone. And I'm happy to grab coffee or Zoom and decompress and strategize as we work through how we can show up as our best selves in our work. 

And just remember:

Maybe it all works out

I told my 9-year-old daughter that I was giving a talk tomorrow and was feeling a little nervous, and she said, “Oh, Mama. You say this every time you give a talk, and it always turns out fine.”

Holy smokes, y’all.. my tween dropped some solid wisdom helping me identify my cognitive distortion- 

The thought: You worry something won’t work out well
The reality: You’re always prepared and it always goes fine 

While planning for the worst has historically been a solid strategy for me that I’ve used to my advantage to try to stay at the top of my game, the mental load is heavy and it is so unnecessary.  What if, just maybe, it all works out?

Trusting my inner wisdom and experience is so much more freeing than anticipating the worst. And sometimes you have to hear the facts from someone outside of yourself to knock you back into reality. Yet another reason why I am such a fan of talk therapy and embracing some vulnerability with friends and loved ones to externalize the unhelpful thought streams that can take you on a wild ride.

Our thoughts can be our best friend, or our worst enemy. We can choose to embrace a self-compassionate voice of reason but often find ourselves enmeshed in the rants of a self-critical catastrophizer. It seems obvious what the default should be, but our negative bias can lead us down some scary paths.

So when I see myself starting to spiral, I try to ask myself, “Is this thought helpful? Is it true? What are the facts here?” And while that’s all fine and good if we are in the headspace to do this thought work, it’s also perfectly acceptable to just try to focus on releasing the unhelpful thoughts and just breathing and grounding yourself until you are a little more regulated. I find that I use these strategies with patients not infrequently, but only recently have I started taking the time to do it for myself.

Can you imagine the healing we could bring ourselves, if we gave more freely to ourselves all the goodness we pour out in others?

I've been crafting a session on self-compassion for our medical students, and it's been, well, damn hard - because I feel like I'm kinda bad at the whole self-compassion thing. But, as a thought experiment, the self-compassionate part of me wants to say...

Maybe you don't have to be an expert at this. Maybe you can just share your truth about the struggles of self-compassion. There is powerful learning in that, too. And maybe you can own some of the small wins that you've experienced in the beauty of self-compassion, because that can be accessible and inspiring to others. And maybe you can fall back on collective wisdom and encourage others to share their stories, because that is a strength you have, to build safe spaces for authentic presence.

Ack, even saying that last part, telling myself I'm good at something, feels weird. But a wise person once told me, keep doing the good self-care and self-talk - eventually it will feel natural and normal. It's only weird because it's not happening enough. 

May we all fill ourselves back up, trust our voice, and get grounded in our strengths to buoy us even in the hard times.