Superpower: Opening our hearts

I’m scared but not shocked. The level of disappointment so many people feel about their lives profoundly saddens me. I should have more. I would have more if it weren’t for others – all sorts of others. Feelings of injustice can power so much. I don’t pretend to understand all the righteousness, anger, and meanness that erupt when disappointment builds. But it feels as familiar as the human condition throughout the planet and over the ages. It’s like earthquakes from fracking.  I’m thankful that my mother, a Holocaust survivor, is no longer alive. She would be apoplectic and inconsolable.  What’s going to happen now? How should I act? As when grieving, I will mindfully minimize controllable stress – exercise, rest, listen to and play more music, spend more time with friends and family. I will continue to give thanks for all I have in my first world life. I will continue to pursue my passion for maximizing the experience of people at the center of care. I pray for the physical and spiritual strength to speak up, stand up, and act when the moments seems right. I’ll need strength to take the high road in this low road time. More than anything I’ll pray for unexpected open hearts. The community needs it. Our grandchildren need it.  The unborn need it. Onward.

The Minute Before and the Minute After

 

calla-brandonI officiated at my 26th wedding yesterday – a young lady I’ve known since she was born. So honored to be asked. Now I’m in DC to meet the few week-old son of a couple who’s wedding I performed  several years ago.  After the 10th marriage I’ve done, I say to every couple, there’s a minute before which you aren’t married and the next minute you are.  What’s the difference? Five of the first ten are still married. All of the rest are still married.  Correlation? Who knows?

Life is a series of thresholds. The minute before and the minute after. We transform during thresholds. I relish participating as a minister, a nurse, or as a human in transforming thresholds. Thresholds are intimate and beautiful. It’s love.  So whether it’s a wedding, at the clinic’s registration desk, hearing good or bad news, or simply witnessing a life moment, how we engage people over thresholds profoundly affects the experience for us and for them. Be present, appreciate, wonder, make a difference. Thanks.

I’m So Discouraged

Several times this week I heard a variation on: I’m so discouraged, I thought I was doing better. I just keep sliding back. I really suck at this. The topics: meditating every day, losing weight, managing anxiety, soloing, recovering from surgery. I heard each from more than one person. Several people said it about multiple things. One person, me, said it about losing weight and soloing. Two things strike me here. First, sucking and second sliding back. Can’t we give ourselves a break and celebrate that we’re trying? I’m trying to meditate every day, lose weight, improve my mental health, solo on my sax!!!! Yippee for me. Yippee for us!!! Recovering, healing, learning, changing habits doesn’t happen in a straight upward line, steadily better. It’s two steps forward, one step back. It’s up and down, first wildly so, then smaller cycles of up and down, over time with forward progress. Looking at just 2 data points only frustrates us, since we tend to recognize the down after the up, rather than the up after the down. In each of the scenarios someone heard the other and provided a good job, way to go, keep it up, keep me posted, call me anytime

I honor you’re work of healing, learning, recovering. Good job, way to go, keep me posted, call me anytime.

Learning from What Doesn’t Work

Notice how young kids learn to walk. Try, fail, try again, over and over until they get it right. On the other end of the continuum are politicians accusing each other of changing their minds. Dragging up statements from years ago to slap each other with a change in direction. When did they lose their ability to be proud of learning? When did voters start expecting politicians not to learn, recognize failure, and try something else? I don’t understand this. I once said I would never get married, I would never have kids. Now I’ve been married for 40 years and have a fabulous family. I learned much since my ignorant adolescent days. Living successfully with chronic illness requires trying, failing, getting up again and trying something else. Diagnosis depends on testing, trying a treatment, measuring its success or failure, and repeating the cycle until something works to decrease suffering. The tragedies are when trying never leads to a better life, or the team stops trying. Research faces a similar dilemma. Supposedly research tests hypotheses. One treatment or approach works better than another. Yet peer-reviewed journals publish articles that prove the hypothesis and doesn’t publish articles that disproves the hypothesis. What is this bias? I know that I have learned more from my mistakes than my successes. What if I couldn’t recognize a mistake or a failure and kept sticking with it? Thank God I can shift and try something else. I’m more skeptical when th change is degeneration of values. Less empathy, more fear, less generosity, more cruelty. I could appreciate more empathy, less fear, more generosity, less cruelty. Let’s honor rapid discovery of and learning from mistakes and courage to try something else. Let’s learn from those kids.

Presidential Candidates on #Healthcare?

How do I research presidential candidate views on healthcare? What if I google each candidate’s web site?

Donald Trump has a Positions page on reforming the VA Medical System. Much hyperbole, but he does say: Under a Trump Administration, all veterans eligible for VA health care can bring their veteran’s ID card to any doctor or care facility that accepts Medicare to get the care they need immediately.

Bernie Sanders has an issue pages for Fighting to Lower Prescription Drug Prices (allow Medicare to negotiate with drug companies, allow Americans to buy from Canada, require price and cost transparency, prohibit deals that keep generic drugs off the market, plus more). Elsewhere he has advocated for universal national health insurance. Bernie has the most substance. Continue reading “Presidential Candidates on #Healthcare?”

Limits

Limits. Spending time this weekend with friends of 30-40-50 years – lots of young kids my grandsons’ ages in the mix. Watching the constant shifting dance of setting limits, testing limits. Children cutting their teeth on their parents and grandparents. Also observing us 60 something oldsters bumping up against our physical capabilities – joint disease, surgery, acute and chronic illness. How long can we keep up the pace we’re accustomed to, how long do we want to? How do we maintain or extend our capabilities? I watch my 87-year-old mother, in pretty good health, slowly winding down, withdrawing from some social and physical activities. Limits – acculturation, recalibration, will. Limits impact community engagement, social connectedness – Physical access, relationships, conduct, opportunity. We respond so differently to limits – tantrums, frustration, anxiety, negotiation, determination, resignation, relief. A magic lever of best health: our response to limits.

Oatmeal for Break

Today, I’m a bit overwhelmed with my self-committed obligations: write a blog, finish the family birthday calendar, print the Xmas cards, be a good member of my in-person and virtual teams (professional, community, family), take my medicine, play music, exercise, eat well, rest enough… OMG. Why do I do this? Am I nuts? What would I do instead?  It’s all so fun, except when it isn’t. What would I be if I didn’t do all this stuff? A shell, a zombie, a wraith? The zen of balance. Mostly I feel balanced. My barometer at work is: feel like I can manage 3 days a week and wonder if I can manage 2 days a week.  If it’s the other way around it’s too crazy. If I can handle it more than 3 days a week I’m not pushing the envelope enough.  So, it’s oatmeal for breakfast.  Thank God I love oatmeal. Have a good week!

Health-Hats: It’s Been a Year

I started this blog a year ago, more than 70 posts – now settling into one a week. Thanks especially to Jane Saransohn-Kahn who set me on this journey, Eric Pinaud and Jodi Buckingham who provide technical support, and Kathy Pooler, who inspires me and encourages me to write regularly. My almost 100 readers provide me with feedback and encouragement. They range from caregivers, ePatients, and advocates to administrators, policy wonks, and techies. All wear more than one hat. Don’t we all? I’ve been a student of personal, team, and organizational health for more than 40 years. It’s a gas to reflect and comment on best health for the past year. I love to write. It’s only sometimes a challenge to find something to say. It’s often a challenge to keep it in the 250-450 words range and its always a challenge to remember the varied community I live in and write for. I thank you all for being with me for this study of magic levers of best health – so simple, yet so hard. On top of mind for the next year – caregivers, self-determination, data exchange, measuring success, life balance, and appreciating what I have. Wheeeee. Off we go. See you next week!

PCORI- Patient Centered Outcomes Research – and us

You may remember that I’m a Patient Reviewer for PCORI (Patient Centered Outcomes Research). PCORI, a federal initiative, helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers and the broader health care community. It’s vision is that patients and the public have the information they need to make decisions that reflect their desired health outcomes.  So far PCORI approved 51 awards, totaling $88.6 million over three years, to fund patient-centered comparative clinical effectiveness research projects. I’ve spent the last month reviewing applications for grants.  I can’t tell you about the grant applications that I reviewed but I can remind you why this important for us and give some observations about the process. Continue reading “PCORI- Patient Centered Outcomes Research – and us”

Work-Life Balance

Once again, I’m self-focused as I transition from sabbatical to full employment.  This too will pass:) After 2 weeks I’m acutely aware of my struggle to keep up my exercise, diet, family time, and music, not to mention all the non-work professional activities that accrued during my sabbatical. Fortunately, my new work environment is both intensely busy, focused, rewarding and actively supportive of work-life balance. My strategy so far is to book family time first, only a little scaled back. Then I’ve cut my music time easily in half, but I haven’t yet figured that out – not cutting any group playing – the combo and big band. Two gigs coming up. The job has a jam once a month. Longer between lessons? Oh, lord. Exercise is harder. Maybe ride the trike every third day and not every other day. Strangely, diet is easier. I’m so much more deliberate about my meals – packing a lunch. I think my diet is better and I’m losing the few pounds I’ve gained during the sabbatical. Longer between massages? I hate to. Makes so much difference in my overall well-being. I will maintain this weekly blog. You all are a gas and a half. Much less TV. What’s suffering most is time with my wife. I definitely need to schedule some date time!! Work-life balance: a magic lever of best health.