I coached a 1 hour, 45 minute Spinning ride last night, about which I was uber-petrified. I struggle to hold my own attention that long, let alone a room full of 25 people who don't have nearly the amount of intrinsic buy-in to the physical and mental benefits of that type of endurance training.
An under-appreciated point about coaching a Spinning class is that anyone who's worth their weight in your mineral of choice expends an extraordinary, even CRAZY, amount of time preparing: theme, heart rate training parameters, music, and... cues. That is, the stuff you say. It's huge. When I was a full-time Spinning instructor, I spent hooooooooooours and hours every day just reading and taking notes. Books (sports psychology, technical cycling, interpersonal communication, business management, self-help and spirituality -- a host of other genres), blogs, e-zines, quote websites -- you name it. It was a full-time job in and of itself. A full-time job with killer benefits, as it were: namely, an appreciation that I was contributing to people's lives as a function of the time and creativity I invested; and, in so doing, contributing to my own spiritual, cognitive and emotional growth. Truth be told, the richness of the subtleties that shape the way I see the world and my role in it were borne and crafted directly out of my preparation to guide other people.
And so, this week, in anticipation of my daunting undertaking, I planned to read a book I'd had on my shelf for a while: Stephen Covey's "7 Habits of Highly Effective People." Except life got in the way -- working at the clinic, making cameos at school, that whole sleeping thing. But yesterday I took off from school entirely to "cram" for my ride. Once I started reading, I couldn't put it down. There is something so psychologically gratifying about reading a text of a reputable writer describing, with exquisite detail, your specific concept of self-concept, self-advancement, and self-efficacy. Something so gratifying that I canned the theme of my ride, for which I'd been preparing for a weeks, and began anew with an hour til showtime.
I called my ride "The Promise." The idea of making a commitment to yourself and honoring it as a reflection of the very fiber of your integrity -- the idea that just framing it that way makes ALL the difference. I structured the ride in five blocks, each with a different sub-concept: 1) awareness (of thought patterns, synchronyzed breathing and movement, subtle influences on mood and concentration, of the deep-rooted principles and values that guide all of the above); 2) proactive choices (reflective of responsibility to further that which one has set out to do); 3) self-discipline (remembering what one wants, and why -- and tapping into the empowered strength that guides choices to hold fast to those things); 4) being responsive vs. reactive (giving one's self permission to be influenced by the things around him or her -- but within the framework of the principles and values at one's core); and 5) synergy (putting everything together, embracing the joy of control and achievement and the advancement of self-understanding). Yeah, not going to lie -- it was the best ride ever. It was that good.
And now I'm distracted. I had all of these ideas just reading the first 50 pages of this book. I want to keep learning and discovering and thinking and talking and writing... but, as it turns out, I'm a medical student. I have to do that "studying" thing, given that I've read self-help books all week and have a GREAT sense of how life should work and how happy and inspired and empowered I am, and blah blah blah. Hello. You're a MEDICAL STUDENT. GO LEARN MEDICINE.
Where's the disconnect? There shouldn't be one. So now I'm taking the time to synchronize the things that are making me happy yet distracting me from the realities of my life -- the realities that, in theory AND in practice, I actually like.
I think that perhaps I find that "life as a whole" is more masterable than, say, the liver. On its face, that sounds absurd. It actually is absurd. But that may be at the root of my procrastination: that is, my self-handicapping. If I can't know everything, why bother knowing anything? If that's what it is, this is a safe place to be. I can work with that.
One of the things that blooooooooooooooooooooows me away about my preceptor at the clinic is that he has just the most extraordinary memory. Random crazy insanely "trivial" details about obscure associations between x and y and z; he knows them all. He just spouts them out. He's brilliant. I know that my brain can work like that, and works like that all the time. I just don't deeply encode enough new material anymore. It's almost like physical overtraining, a concept I coach and write about ad nauseum: your muscles, your heart, just get tired. You can't reap the benefits and pleasures of movement under those conditions. Is that what is happening to my brain? Or has it just forgotten to look for those details, forgotten to organize them meaningfully? Copping out before it has a chance to succeed?
At the clinic on Wednesday, we saw a patient who had burning in the entirety of both her legs. She described the burning as a numbness, tingling, and "cold fire." I thought of my nerve adhesions in the aftermath of my iliopsoas tear and bulging vertebral disk, especially as the patient described the onset as following a deep tissue massage. My preceptor agreed with my thought that it was worth asking a physical therapist about. But then the next day, in a small group session on cholesterol and cholesterol-lowering drugs, we learned about muscle toxicity in use of statins. Cue the light bulb.
One thing about medical school is that there are so many damned drugs with so many different mechanisms and side effects and niche pharmacokinetic properties and dose-limiting factors that they're all the friggin' same in the end. You see a symptom -- is it related to a drug? Sure, why not? Every drug causes everything, when it's all mixed up in your brain. The key is just having the awareness to look up a symptom and check on its possible relation to a given drug. What distinguishes my preceptor is that he knows a SHITLOAD of things and recalls them on the drop of a dime, even before he looks it up (he looks up a lot, all day long -- he's inspiring that way, too -- I'm just talking about the insane amount of info he has in RAM at his disposal).
I've spent so much damned time actively training my brain to get things OUT of RAM -- to free it up to be thoughtful and creative. The lists, the structure, the notepads. It has taken three years (inspired by my first read of Edward Hallowell's "CrazyBusy" when I left The Forensic Panel) but I can honestly say that I have gotten SO good at keeping my RAM free. I naturally select the specific environmental stimuli to which I attend. I don't read billboards. I don't hear car horns. I don't see dangerous cracks in my glass plates before I eat off of them. But you know what? I also don't hear ceftriaxone and think gallstones. And I need to.
Yesterday I emailed my preceptor about this muscle tox and statins question -- that I thought I remembered taking a mental photograph of her meds list and thought I'd seen a statin, was that true? And if it was, does muscle toxicity actually present like this kind of burning?
He just wrote back. Turns out, he'd thought of that, too. He's going to stop the meds for a while and see what happens. If the burning subsides, he will reintroduce the drug to see if it returns.
On the drop of a dime, I thought: Coates' Postulate. A random detail that I'd heard someone mention in passing this week, that describes this common medical approach to identifying the cause of a side effect. Maybe my brain can do this, after all.
It thrilled me that I had a useful medical thought, supported by someone I already really respect. I literally glowed, starting bouncing around the room. I can glow all the time if I just stop reading and thinking and "being aware" -- and start DOING. If I honor my promise and commitment to myself, that reflection of the very fibers of my integrity. If I make choices that are consistent with my principles and values in the pursuit of feeling this way all the time. If I discipline myself to remember that I want to feel this way all the time, want to feel things that are more empowering and intense than even this.
Sure. I can do that.