Releasing Resistance, Flowing With

Riding my thoroughbred mare in a neck ring without her bridle is alternately frustrating, enlightening, and thrilling.  I love the feeling of using my body and energy to communicate with her rather than micromanaging with my hands.  It is exhilarating to let go of control (at least some of it!) and lean into this new experience.  Sometimes, with my eyes closed at the walk, I can feel where the edge of the arena is, where we need to turn.  Other moments, steering becomes more of a negotiation.  Make a suggestion, take a suggestion.

Often, it is in the canter that I feel most in sync, most connected.  One day, during the canter, I could feel Monarch’s energy rising, and suddenly we felt rushed and out of control, like a semi-truck careening down the highway.  I braced initially, holding my breath, and pulling back on the neck ring, but my ex-racehorse only barreled faster forward.  The words “relax and go with” floated up, something I had heard before in a moment of stillness.  I grabbed some mane and breathed and allowed my body to flow with hers. We were going fast, but it didn’t feel so scary anymore.  After a few seconds I imagined slowing my energy just a little, exhaling long.  Her energy came right down with me into a lovely rocking horse canter, and then down to the trot.

All this got me thinking about how maybe sometimes it’s necessary to find a way to “sync up” with people first as well before trying to change the energy in a room or the direction of a conversation.  “Syncing up” could look like listening first with an open mind, really trying to appreciate something from another perspective before perhaps offering a slightly different point of view.  In his book “The Five Invitations” Frank Ostaseski implores us to “push away nothing.”  He suggests that even experiences we don’t want have important lessons for us if we can choose to lean in and get curious, rather than immediately resisting, pushing, or heck, shoving them away.

I spend a lot of my days meeting with patients and families dealing with serious or chronic illness that no one wanted.  There is often a bracing against the illness, a sense that it is something to resist, fight, push away. The suffering that comes along with serious illness is staggering- physical, emotional, spiritual, and financial.  It’s natural to resist.  Leaning in takes a special kind of heroism.

At times, I feel the same resistance happening in me when we share different points of view on how to move forward.  But, when I can “relax and go with”, really listening to appreciate my patient’s point of view rather than bracing against and trying to shift it, I feel the most connected and the most fulfilled in my work.  Perhaps I need to offer another possibility gently, an invitation to slow the semitruck down, to pause and reflect on where we’re at, what is most important to them, and where they want to go from here.  Perhaps it’s my point of view that needs to shift.  Make a suggestion, take a suggestion.  It feels more like a conversation when it goes that way, and ultimately more of a shared decision about how to proceed.

Both my patients and my horses are teaching me that bracing, immediately resisting, or trying to convince another only creates more tension, dissolving the possibility of real connection.  By “syncing up” in a genuine way, through intentional listening and appreciation, relaxing and breathing through the brace, we can work together to find a stride and a pace that feels just right to both of us.

Finding the Meaning in Medicine

As healthcare providers what do you find meaningful about your work?

I remember the face of an elderly African American woman who was dying of pancreatic cancer.  Although she was loved by the family whose children she had raised, she was often alone in her hospital room during the busy work week.  Her cancer was advanced.  Her frail, emaciated frame looked tiny in the huge hospital bed. She did not have the energy to get out of bed or the appetite to eat.  It was clear to all of us caring for her that any attempt at aggressive treatments were more likely to cause harm than benefit.

I remember the moment I kneeled down next to her bed to talk with her about how we could best care for her during the time that was left.  Her eyes were luminous, beautiful, her gaze resting softly on mine with a gentle smile on her face.  She was gracious in her response to the news I had to share, appreciative of all the care she had received and would continue to receive with hospice support.  She was radiant.  I was not her primary care physician.  Although I had only known her a few days, the sense of connection in that moment was profound.

I may not always remember the names of patients like her, but I remember their faces, their stories, and the moments of connection that fill my soul and remind me why I want to continue to practice medicine.

In this Annals article the authors asked internists to write a brief account of a work-related experience that they found meaningful. They studied the 83 stories by means of narrative analysis and identified 3 major themes: a fundamental change in the doctor’s perspective, sense of connection with patients, and a difference made in someone’s life. They note that nearly all the doctors described nontechnical, humanistic interactions with patients as experiences that fulfilled them and reaffirmed their commitment to medicine.

Paying attention to these moments, reflecting on them with gratitude whether through journaling or discussing them with colleagues, is one important way to stay connected to the meaning in our work.