Loosening My GRIP on Control

Sheltered at home for several months in 2020, I spent much of my day integrating a tele-health practice, exploring evolving research with peers nationwide and searching through the daily barrage of information to find answers - how does this virus work, how do we mitigate the impact on the lungs, how do we keep our community safe as we identify treatments?

Even once I returned to my office, masked and socially distanced from my patients, clear answers were not available.  We were still learning, and while we had gained valuable insights, we did not have enough understanding to prevent the devastating consequences of this disease. 

My uncle was awake and talking upon arrival to the ER.  Yet, within 24 hours, his ability to oxygenate plummeted and he was transferred to the COVID ICU and connected to a ventilator.  Motionless except for the artificial inhalation and exhalation mediated by a machine, pressor medications were prescribed to help him circulate blood to his vital organs. 

Physicians and nurses did all they could to keep his body functioning while searching for effective ways to treat this novel infection. Without a clear understanding of the pathophysiology of the virus or proven treatments, the virus was free to attack his body unimpeded.

Lack of control is sobering - compelling me to sit with feelings of uncertainty and helplessness and respect their power.

The patients I have been privileged to work with over the years have often provided me with insights.  People who awoke one day to a new reality, a life threatening illnesses that challenged everything they held dear.  

I recall the day Yvonne came in to the office. Convinced that her headaches were due to chronic sinus infections or stress, she looked at me incredulously when as gently as possible, I informed her that her brain scan was abnormal, likely identifying a tumor. 

Twenty years later, I still remember the feelings of that day.  As we talked, the air in the room felt heavy and the lights seemed to darken.  This patient who I had known for many years, who had sent me gifts when my children were born and remembered their birthdays, seemed to pull away, occasionally glancing up at me as if to say:  “do something … make this different… say something else.” 

But I couldn’t make it different - and in that moment, my body ached, my breathing quickened and I experienced a profound feeling of helplessness.

Yet, in the days that followed, in small ways, we learned together how to navigate this new normal - a world inclusive of a brain tumor - a world filled with unknowns, immense challenges and pain, and paradoxically, opportunities and blessings.

We became familiar with the unexpected and unwelcome.  We confronted our perceptions of helplessness by strengthening our connections with each other. 

The medical professionals caring for my uncle similarly endeavored to develop meaningful connections with him and with our family. They joined us as we navigated our unprecedented new normal. 

My uncle lived for 28 days on a ventilator, enduring severe secondary infections, two gastrointestinal bleeds, kidney and liver dysfunction and a myriad of other serious complications.  The physicians and nurses compassionately shared what they knew -  and acknowledged what was still unclear.  We walked together into the unknown.

In an unexpected turn of events, my uncle recovered.  The day that the endotracheal tube was removed, the healthcare team that had worked so hard to provide him with the best available care despite limited scientific data, cheered him on, cried with us and expressed gratitude for this unlikely outcome.

At times in our lives when we do not have answers, our relationships provide us with the strength to weather inconceivable storms.   They help us make room for both the tragedies and the gifts, and recognize the ever-present opportunities for compassion and connection.

My Uncle Harold - 6 weeks after discharge from the hospital.

He celebrated his 88th birthday with his family.

Authentic But Not Seamless

In 2018, with the help of wonderful friends, family members and colleagues, I organized a 2 day medical conference. Our hope was to address the suffering of physicians who due to the many changes in the healthcare system, are often unable to provide the quality of care that they feel patients deserve.  Physician suicides had escalated to more than one physician per day in the U.S., and many of us in healthcare felt that it was imperative to actively respond.

Developing this initiative was a full time job with a steep learning curve. As an introvert by nature, I found myself far from my comfort zone. Yet, at the same time, I was inspired by the opportunity for creativity and the possibility of bringing people together to explore ways to address this public health crisis.

On the morning of the first day, I arrived at the conference center at 6am with boxes in hand.  As I looked around the room, an overwhelming feeling of fear arose:

What was I thinking?  

Why did I think that organizing and facilitating a medical conference

to address a major public health crisis was a good idea? 

For 3-4 minutes, anxiety washed over me, imploring me to focus on all of the ways that this could go very wrong. I sat down near a window as the sun started to rise.  I took a few breaths to quiet my body, hoping that my meditation practice would enable me to find my ground and expand my perspective.

I looked around at the beautiful conference room, appreciating the funky blue sofas with colorful pillows, dramatic artsy structures and bright sun streaming in through the abundant windows.  The aroma from the organic coffee and the freshly cut flowers was nourishing.

Grace, an ambitious and talented pre-med student was scurrying around the room, setting up tables and anticipating our needs.  Joe, a gifted flutist was arranging his beautiful wooden Native American flutes so he could share his music with us during the conference. 

After driving all night from Montana to support me, my two sons were nursing large cups of strong coffee and grateful for comfortable couches at a professional conference.  My daughter and husband who had survived two years of evening discussions about the details involved in organizing a 2 day medical conference, woke up extra early to bring me food and encourage me to eat.

Painfully aware of my increased heart rate and rapid breathing, I thought about the advice my youngest son Nick had offered to me a few days earlier. Moose (that is my nickname and another story!), just remember:

It is more important to be authentic than seamless.

Before I could give my feelings more consideration, attendees starting filing in - friends and colleagues who had worked with me to identify ways to create an experience that would facilitate connection and productive collaboration, peers who had changed their schedules and awakened early to provide support for me, their colleagues and this initiative. 

I felt comfort in the recognition that I was not doing this alone - but more importantly, I remembered why we had organized this event. We believed that if only one doc felt heard and understood, more connected to his or her community, more hopeful or inspired, our vision was realized.

The days were definitely not seamless:

On the first day, a beautiful sunny day with out a cloud in the sky, while I was in the middle of my presentation, an entire city block (including our conference center) lost power.   It took me a few moments to absorb what had happened and realize that our finely tuned schedule had just evaporated.

But the memory of that moment that stays with me was captured in a picture taken by my oldest son Angelo.  My husband, daughter and son Nick, who know that I get nervous when presenting in front of large groups, were sitting on a couch nearby. When the lights went out and the screen went blank, their mouths dropped open and eyes widened as they looked on with disbelief.  I still laugh when I see this photo.

My fear and doubt did not simply disappear that day, but upon reflection, I have come to believe that rather than trying to suppress or eliminate uncomfortable emotions, it is valuable cultivate my capacity to accept and explore these feelings. Doing so provides me with the opportunity to learn more about myself and choose my responses with enhanced awareness and compassion for myself and others. When I lean into the discomfort, I find it easier to show up unedited, and hopefully, make it easier for others to do the same.

Authentic but not seamless

These words carried me through the conference and convinced me that when I align with a commitment to stay fully present, prioritize relationships and embrace the unexpected with curiosity and kindness, details and expectations loosen their hold on me and I can more easily embrace and appreciate the experience.

Superheros

A few years ago, two young patients came to visit me for osteopathic medical care.  These two children, ages 7 and 10 at the time, spent 15 minutes describing to me in intricate detail the “superhero abilities” that they would like to acquire. It was an amazing conversation.  I was so impressed with the level of detail - the physics behind their supersonic suits, the array of colors on their garments, the composition and purpose of their accessories, the ways they both felt they could save the world.

A true hero isn’t measured by the size of his strength, 

but by the size of his heart.

– Zeus

I so enjoyed listening, but eventually, they asked the dreaded question:  “Dr. Deb, what superhero ability do you want to have?” 

I say dreaded because when you are 7 and 10, these answers are clear and uncomplicated.  If someone asks you “What is your favorite color?” - without hesitation, you answer blue!  But as we get older and tend to evaluate our answers through a filter of emotions, expectations and judgments, it becomes more complicated.  Well, I like blue, but purple is also nice - and sometimes, I really like green.

I thought for a few moments, and tried to allow myself the freedom to imagine as I did when I was a young child.  After a minute or two, I somewhat hesitantly shared my answer with them.  

“If I could be a superhero and have a special ability,” I told them, “I would like to reflect to everyone I meet their inherent value and beauty.”  

Surprisingly, they shook their heads as if to let me know that this was an acceptable answer - but before I could relax for too long, they quickly shifted gears and asked  “So what will you wear?”

I didn’t have an answer at the time, so they gave me several creative suggestions, and I told them that I would have to get back to them on the costume.  

A few years later, when I was visiting the Ann Frank memorial in Boise with my friend Amy and sharing this story, she provided the answer:    “You would wear a mirror.”

This story is dedicated to Spirit “Superdog” Roman.  I am so grateful his beautiful heart and always unconditional love.  (2003-2020)

A true Superhero - Spirit flew through the foothills without wings - simply pure joy.

Physician and Patient: Together We Heal

In space between us

Transformation reflected

Together, we heal

Navigating the Currents

When I am moving through days or weeks with a very demanding schedule - a myriad of tasks to accomplish- frenetic energy often carries me from place to place - usually ineffectively - as I trip over my shoes on the floor or wash a full load of clothes on a small setting.

My body clearly reflects the continual forward momentum as I lean into the day, rarely allowing my shoulders to meet the back of a chair or even rest upright above my hips.

My thoughts consume most of my attention, as I negotiate ways to manage the expectations of a culture focused on achievement and image.

I embrace the illusion that I am navigating the currents without injury.

But as I ask myself to step back for a wider view, I more deeply experience the agitation that consumes the lion share of my energy. I notice the discomfort in my neck and the shallowness of my breath and become acutely aware of the depth of my fatigue.

My sterile checklist boasts a multitude of completed tasks, but lacks the messiness and unexpected that bring substance to my life. Even the unwelcome surprises, a lost suitcase, a struggling child, a serious illness - all vastly beyond my control, awaken me to the generosity of connection and engagement. 

I step back even further and allow myself to feel the loneliness of my rapid pace and telescopic focus. 

I gently bring my shoulders upright, welcome the support of the ground under my feet and quietly scan my inner and outer world.  My awareness of community - the relationships that connect and sustain us - expands. I untether myself from the expectations that pushed me into high gear.

My next steps are slower, more flexible, less urgent - with my shoulders upright, I can now lift my head and be with the world.