drinking from the firehose

dog-firehoseI had the best intentions at the beginning of the year.  I scheduled half days in my calendar to write. I went for 20 minute walks every day.  I downloaded the Headspace app and dedicated ten minutes each morning to meditate.  I was calm.  I could think.  And then real life interfered.

My husband received a call early one morning that his dad had unexpectedly died.  I flew to Vancouver for a job interview.  We took our family dog Sam into the vet to get him euthanized.  My husband was named executor in his dad’s will.  I got the job in Vancouver.  Aaron was booked for surgery. We are caught up in a strange tornado of grief and excitement and terror and anticipation.

Fast forward:  we got our house ready to list.  It is listed.  I keep it in show home condition and we vacate the house for showings every evening.  We started saying good-bye.  I am wrapping up work projects and scheduling overdue dentist appointments.  We are researching schools in Vancouver.  We are praying that the rental gods shine down on us and we can find somewhere to live.

My leisurely world had suddenly turned upside down.  I started lurching from one activity to another.  I lost my ability to think.  I had no time to reflect.  Any ideas I had for writing evaporated.  There are way too many tasks to tick off.  I don’t like it one bit. My focus has shifted to doing, not being.

I hate the busy thing.  It is a trap, but now I recognize that situationally, life can suck you into the busy vortex.  (Of note: some of this busy I brought on myself.  And some of it is good busy too).  I often talk about reflective practice in my presentations to health professionals.  The only thing I’ve learned over these past three weeks is that you absolutely can’t be creative, reflect, or relax when you are over-scheduled.  There is nothing you can do but swim like mad, and then fall into bed every night and start a new day afresh.  My epiphany is that’s the reality for many professionals that work with our kids.

This morning I had a speaking engagement at the university.  I left a bit early and parked far away so I could hike across the campus and get an a little walk in before my talk.  This afternoon I had 15 minutes to myself.  I turned on my little mediation app and listened to a ten minute session.  I was distracted and fidgety. But at least I did it.

I’ll be back.  I now feel more empathy for those stuck in the busy life, and I’m going to do my best to claw my way back out.   Andy, my mediation guy, has informed me that there is always blue sky beyond the storm clouds.  I’ll find my slow life again, but the next time I’ll see it, it will be many weeks from now, in Vancouver, the land of mountains, ocean and infinite beauty.

 

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slow medicine

turtleMeghan O’Rourke wrote a brilliant article for The Atlantic (is there any other kind in that magazine?) called Doctors Tell All – and It’s Bad.

You know when you read something and you think: gosh, I wish I was talented enough to write that?  This is a manifesto for a return to compassion in the health system.

Meghan recounts her own experiences, ill and undiagnosed for ten years, and shares her perspective in her journey with her mom, who had metastatic cancer.

{And YES, the n=1 (or 2, in this case) counts. Stories matter. One person’s story matters}.

She describes the hospital experience as including physicians who were brusque and hostile, harsh lighting, noisy rooms and terrible food. Two years ago, when I was hospitalized overnight after complications from day surgery, all I wanted to do was to go home. The night-time was the worst. The woman beside me was moaning in pain, and the nurse who worked nights didn’t seem to believe that I needed pain medication. Call bells went unanswered, and I literally dragged myself along the floor in order to go to the bathroom. It was really bleak.  I begged to be discharged the next morning – I figured that the misery was the system’s way to keep the length of stay down.  The hospital (despite being shiny and brand new) was hardly a healing place.

Canadians can stop being all smug about our health care system. Yes, our inpatient costs are covered by our public system, but we spent a lot of money without a lot of return. We pay out of pocket for dental, optometry, pharmacy and rehab medicine services. Pile on top of that stories of long wait times, nightmares navigating the system (nightmares even finding our clinic room in vast hospital settings with no wayfinding), long waits for pathology (the 12 days I spent thinking I might have ovarian cancer were the longest in my life) PLUS crappy tales about health professionals who treat us with distain…well, my goodness, things are a bit of a mess, aren’t they?

O’Rourke’s piece confirms that physicians think so too. And while we might not have the managed care or HMOs like the US, there are many similarities. Appointments, particularly with specialists, are rushed. High powered, well-dressed efficiency consultants have marched in to pressure health professionals to shave seconds off of patient interactions to save time (and money).  Where’s the reward for kindness? There isn’t any.

Patients don’t have time and aren’t taught the advocacy skills to make sure all our questions are answered properly.  (Morgan Gleason, age 15, profoundly said:  “doctors go to medical school, but patients don’t go to patient school” – this is brilliant).  I feel for the overworked physicians, who are mostly on a fee-for-service structure for added pressure – for the more patients they see, especially the complex ones, the more they get paid.

And I’ve watched the friendly conversation between health professionals and patients fall by the wayside. That’s the first thing to go in the chase for more volume. I mean, how happy can physicians be in these situations? Surely this stress has to be transferred onto their patients (and the physicians’ own mental health, if you look at the suicide rates for doctors).  You can say the same for all health providers, not just physicians.

I preach that in the pursuit of efficiencies and time saving measures, we have cut out the compassion. Nobody gets paid to sit and hold that elderly lady’s hand in the ED until her family comes.

The solution?

Danielle Ofri quotes Frances Peabody, who tells the graduating medical class of 1925:

 “The secret of the care of the patient is in caring for the patient”

But why are the simple things so hard?

O’Rourke pines for a doctor who understands that conversation is as important as a prescription, a doctor who knows that healing is as important as the surgery.   Me too.

That brings us to Slow Medicine. I love the slow stuff. I saw Carl Honore last January speak at an autism conference, and that was the most important presentation I’ve been to in years. I write about slow here, here and here.

But Slow Medicine! O’Rourke introduces me to that term. I love it. Guess what that brings us: happier doctors and happier patients. Slow Medicine reminds physicians that it is a privilege to serve patients. As I like to say, health care is a noble profession. That needs to start being honoured and recognized by administrators and executives. Patients are not cars in a car factory.  Stop treating them like such.

My biggest take away in my presentations is also the simplest. It is a little acronym, KIDS, borrowed from Children’s Hospital of Philadelphia, that says:

Knock
Introduce yourself
Describe your role and what you are there to do
(And for goodness sakes, please, please, please…) Slow down

Slow medicine.  Slow health care. YES!  An idea whose time has come.

 

 

 

 

tightly wound since 1993

IMG_4817I know where I belong, and it is 11 hours and 25 minutes from where I reside.

I live in Edmonton, a dusty, but frantic, prairie city in the middle of Oil Country, Canada’s Texas.  We holiday in Naramata, a hippy village perched on the east bank of Okanagan Lake in beautiful British Columbia.  Naramata sparkles with a patchwork of vineyards, fruit orchards, and the clear water below.  My youngest son, age 11, announces:  “this place has a nice view, Mom!”  And so it does.

Naramata has been proclaimed a slow city, including all 2,000 inhabitants who are a motley mixture of peacocks, dudes in pickup trucks with big dogs, young French Canadians with dreadlocks, old left-leaning types (aka the locals), and the tony folks who own the million plus dollar houses on the Bench that nest over the tiny village.  All these diverse citizens do the same thing:  meander down the middle of main street, sleepily wave hello to each other, and playfully jostle for position in line for ice cream at the town’s only store.

We spend a chunk of each summer here.  We rent a friend’s mom’s place.  We housesit for my old boss.  We stay with my father-in-law across the lake in Summerland.   We will do anything to spend time in Naramata.  This year, we have rented a perfect little cottage in the flats, a two minute walk to the weekly farmers’ market and the pier, where Aaron climbs to the top railing and cannonballs into the smooth, clear water.

The cottage is obviously a grandma’s old house.  I wonder when she passed away.  The new owner has put in new lino and laminate.  The walls are painted a beachy light blue and yellow.  When we drive up, we shout with glee at the unexpected hot tub and fire pit.  I’m enamoured with the clothesline in the back, which isn’t allowed back in my Edmonton suburb.

There is an elderly lady living next door.  Rae is originally from New Zealand, and spends her days puttering in her garden.  She leaves baskets of warm freshly picked cherries on our back table.  One day she knocks on the door with two handfuls of raspberries in her garden-dirty hands.  These are only for you, she whispers.  I know how much work it is to be a mom.  My eyes tear up in gratitude.

Aaron laps up being unscheduled.  He gets up and watched Rio 2 on his iPad.  He sets up his ziplock bag of Batman and Shrek figurines and coordinates a dance party to Pitbull music.  He sits in his bedroom and reads anatomy books.  He wears his goggles in the hot tub and snorkels for invisible fish.  He gets dressed on his own, with no nagging from me at all.  He’s proudly figured out how to open a Fanta pop all by himself. He has me post pictures on his Facebook, all with a similar caption:  “I am the most awesome dude in the house.”  And that he is.

My newly-graduated daughter and her boyfriend arrive for a week.  We go floating on inner tubes in the river canal and shriek when we get seaweed stuck in our feet.   We take them to Salty’s in town for fish tacos.  We watch the salmon jump off the dam.  They go go-carting and spray each other on the bumper boats.  Ella and I go to the spa for leisurely massages.  Mike and I escape for twinkly-light and wine-filled evening with Joy Road Catering at the aptly-named God’s Mountain.  When the older teenagers leave for their own camping adventures, I feel the pang of missing them.  Ella has written, “Yay!  Holiday! Bye family!  Love you!  Have fun!” on the chalkboard in the kitchen.

We even have friends here.  We consume a goat-cheese and basil trout, charred vegetables and strawberry and rhubarb crumble feast with a food writer friend, her husband and their lively house guests up the hill.  My husband goes mountain biking with a work colleague, and he and his partner come over for a vegan spread of carefully chopped medley of watermelon, raw corn & mango and potato salads.  Our Edmonton pals have a boat and we zoom around a southern lake with them in the hot sun, while the kids jump off the boat and the moms supplement their coolers with extra vodka.

Here, the furrows leave my forehead.  My shoulder migrate from under my ears and settle back in their natural place.  I stop fretting about the next meal, or the cleanliness of Aaron’s face, or the sticky floors in the cottage.  My biggest concern becomes what should we pack for a day at the beach.  I’m only right here, in the moment, because that’s all I have, in this limited, precious time.

I’ve been tightly wound since 1993.  In Naramata, I finally, finally relax.  My only question now is this:  how do I bottle this Naramata nirvana and transport it back home?