Monday, November 2, 2009

Taking a moment.

It was right out of a movie. I met someone. And I fell in love. *BAM* And just like that, I have a whole new life. I've had this epic, cheesy, ridiculous over-the-top grin on my face for three straight weeks --glowin' on right through depressing renal pathology, indistinguishable hematologic cancers, and even a personal adventure with likely H1N1. (When I stopped hacking up my lungs long enough to have a conversation, a friend of mine accused me of glowing so much that I was emitting vitamin D). I'm just so utterly, ridiculously friggin happy.

Is my attention suffering? Maybe. Is my schoolwork suffering? Nah. Are my priorities skewed? I don't think so, either. Am I still making time for the things and the people I hold important? By and large, yes.

But there's one change that I don't think I'm okay with. I've not been writing.

In my last entry (a month ago!), I reflected on a concept in Jeremy Spiegel's book, Mindfulness for Medical Students, about how to own one's changes -- reflecting on them in real time, incorporating them into a larger context of "self" without being derailed towards another version of self that is inconsistent with one's original goals and values (as sometimes happens to doctors in training). Most of what Spiegel advocates, I've been doing for a while. But after internalizing his perspectives, I developed a framework that I decided would work for me:
1) "What's new?"
2) "Where did it come from?"
3) "Do I like it?"
4) "Is it consistent with my goals and values?"

In my last entry, I took the concept of "riding Centuries" -- this thing I apparently now "do." I identified these dramatic undertakings as a direct consequence of my perceived inadequacy as a future doctor -- and my strategy of deciding that if I could dedicate myself towards continuous improvement of a concrete, measurable task of riding a bike for 100 miles, that I could build the confidence I need to dedicate myself to the less concrete, more unnerving, ridiculously high stakes goal of learning enough to be responsible for a human being's life. Does riding three 100-mile rides in an 8-week period mean that I'm going to be a better doctor? Of course not. But do I think about it under conditions of extreme self-doubt and awkwardness? You'd better believe it. So this change -- do I like it? Damned straight. And is it consistent with my goals and values? It's, in fact, the most precise embodiment of my goals and values that I've ever practiced.

So, now "what's new?" Me, the writer with a huge chunk of her self-concept staked within the domain of self-reflection, self-awareness, written expression, and the active "remodeling" of life experiences, stopped writing.

"Where did it come from?" There's only x amount of time in the day. There's only x amount of energy. I've made an active choice to redirect that time and energy. I've never been happier with the results of my choices. But my happiness has come at the expense of choosing not to write.

"Do I like it?" I don't think so.

"Is it consistent with my goals and values?" One of the reasons I'm so happy in my new relationship is that I've been accomplishing almost ALL of what I accomplish by writing, just differently. But there's something very specific about reflecting in written form, creating a record of my life experiences (that I really do go back and re-read within a new context, afforded by another week or month or six months' perspective) that I really cannot, and will not, do without.
I think.

Over the weekend, I had an experience that I knew that I would never forgive myself for not making time to capture the way I've captured so many moments that have led up to it.

I attended a family medicine conference in New York. I shouldn't have been there. My fever had resurfaced and I felt terrible. Just as I was prepared to retire at 7PM for the night (lame...), I decided to take another lap at the residency fair. I'm not applying to family medicine residencies for another several years. There was no need to. But I was curious. I was curious about a program somewhere near my new boyfriend's hometown in rural North Carolina. So I strolled over, and started chatting with a third-year resident about her experiences. I was quite impressed.

And just as I started to walk away, a gentleman who -- no joke -- looked exactly like my preceptor at the clinic where I train (Irony: my preceptor trained in North Carolina) started talking with me. I told him I was from NYC, and shocked at how much I love Vermont, and how this has taught me to be open-minded about the experiences that will bring me a sense of rewardedness. He began to speak of what makes him feel rewarded as a family doctor...

"I'd been taking care of a woman for 35 years. One day, she came to me and said that her husband wasn't doing well. I went over to their home to see him. I said I'd be back in 3 hours -- but by the time I arrived, he had completely decompensated.

I told her that her husband wasn't going to make it through the night.

She was frantic. She started talking about needing to call this daughter, and that daughter, and this daughter and rushing him to the hospital.

'No,' I told her. 'There's no time for that. Here's what we're going to do. Call one daughter... and then ask yourself: What would your husband want right now? How would he want to spend this time?'

'He'd want me to hold him,' she said.
'Then go do that. Go into your bedroom. Close the door. And just hold him.'

And that's how he died.

Moments like that.... that's why I'm a family doctor. Life is a collection of these moments, these lessons you'll never forget, where people allow you into their spheres of values -- and it's your job to help them make choices that reflect those values."

My eyes brimmed with tears. I told him that, for what it's worth, that this moment was going to be one of those lessons that I'll never forget for the rest of my life.

After we parted, my immediate response was to go find somewhere to write. I didn't. I had H1N1. I went to sleep. But not before sending a text message to my new Alternate Reflection Mechanism. I felt at peace.

When I returned to Vermont and shared this story in person, my reflection had a special quality to it that was a "moment" in and of itself. A moment I didn't need to document on a blog (but apparently am, anyway). A moment that stood on its own as the version I'd remember, that I'd call up when I needed it. A moment that would last forever.

"I'm going to be here to share in these life-altering moments with you. And I'm going to make even more of them."

I may be okay with not writing so much, after all...

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