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!
My super power is accepting what is. Doesn’t mean I settle for what is. After all I’m a catalyst for change. Accepting and appreciating what is makes for a solid foundation and a realistic start. I can’t get from here to there if I don’t know – and value – where here is. I give thanks for my super power. I didn’t do anything to get this super power. No degree for it, no lightening strike – I was born with it – lucky genes and family history, felt safe growing up. I give thanks for (value) clean drinkable tap water, regular garbage pick-up, laden grocery shelves, the sun shining as often as it does. I give thanks for my sons, their wives, my grandkids, my extended family, my home life, my inspiring co-workers, my health and especially, my honey. I give thanks for the health problems our system has – I don’t live in a refugee camp outside Syria.
I give thanks, for you, my loyal readers. I look forward to this virtual community every week that welcomes my musing on the magic levers of best health. Happy Thanksgiving!
Working in Quality Management in health care, I’m driven by 3 things: 1) that we do no harm, 2) that we meet our standards and commitments, and 3) that we continually improve the care we give the people we serve. Health care is risky business. People are in need, their defenses are down. Providers of health care use to tools of medicine, surgery, and life style change to try to affect health. Nothing always just does as hoped. There are side effects to everything, even life style changes – For example, increased activity can lead to injuries. Anyway, this month I’ve focused on Monitoring and Alert systems at work. We serve people with complex challenges in programs funded and regulated by many state agencies, insurance companies, and contracts. Families, neighbors care about and are affected by the people we serve. How can we monitor everything to make sure we meet our commitments and do no harm? How do we alert the people who run the programs and are served by the programs when we find something that can be improved? A challenge is monitoring effectively and efficiently. We could spend a fortune monitoring thoroughly, but then we’d have no money left to give the services. It’s a balance of science and art.
Monitoring and alerting for personal health is similar. We don’t want harm to come to ourselves or our loved ones. We want to keep our fingers on the pulse of our heart, our activity, our mood, our discomfort, etc. We’d like to know if we are approaching danger before it hits us. We could get tested for everything on the chance something gets uncovered-think full body scans, genome analysis. We could stay indoors to avoid an accident outside-boring. For monitoring I keep a spreadsheet of my weight, miles walked, miles on the stationary bike, hours playing saxophone, hours of sleep. When any of them (except weight) go down that’s an alert. When my wife tells me to go sit down because I’m exhausted and unstable on my feet, that’s an alert. Monitor and alert – a magic lever of best health.
Drop a pebble in and watch the ripple. Mesmerizing. Several ripple experiences this week on health journeys. A colleague caring for parents as they slip toward dementia. Challenges for the parents, challenges for their children. A friend whose parent had a stroke canceled a scheduled meeting. Children sick – parents can’t make it to work. Health is not just about me or the person identified as sick or disabled. Ill health affects my family and my community as much as me. Ripples upon ripples.
World-wide: person, family, community all affected by immobility. My wife and I attended a benefit for the Free Wheelchair Mission, a program we have supported for several years. Approximately 100 million people in the world can’t walk and need wheelchairs. Many conditions can result in the inability to walk such as cerebral palsy, muscular dystrophy, polio, diabetes, amputations from war, violence, and disease. Most of the people needing wheelchairs can’t afford them and live in locations without paved roads. Don Schoendorfer, an MIT trained mechanical engineer designed a wheelchair using easily found, easily maintained, and easily shipped materials. The wheelchairs cost $72. The Free Wheelchair Mission has shipped over 750,000 wheelchairs to 90+ countries. Getting a wheelchair changes the receiving person’s life dramatically as well as their family’s life, and their community. Again, an astonishing ripple.
Honor the caregivers, help the helpers.
Health team relationships challenge me as much as any relationship. Especially the advice part. Some people are very free giving advice, some are comfortable getting advice. I’m free with giving advice and very mixed at receiving it. The worse I feel, the harder it is to listen for the germ of truth in the advice given, solicited or unsolicited. Unfortunately, the worse I feel – thinking less clearly, tired, worried – the more I need good advice. My first reaction is to usually to resist advice. Who do they think they are? Yes, but…. Yet, they’re on my health team. I chose them.
My uncle used to host dream groups – sharing and interpreting dreams. Someone would tell their dream and then the others would say, If that was my dream, it would mean…. an easier way to hear people talk about my dream. Seemed like a more equal power dynamic or something. My wife and I have had some of our worse times together driving. We are both serious back seat drivers. I wish I could learn to say, if I was driving, I would… Same with my health team: If it were my life, I would …. Think I’ll try that.
As LBJ said about Gerald Ford, I can’t walk and chew gum at the same time. Yesterday, while rehearsing and improvising on the baritone saxophone, I reflected on my continued difficulty keeping my place in the tune while improvising. Either I listen and keep my place or I improvise, get lost, and lose my place – so frustrating. It feels like multitasking and I’m notoriously bad at multitasking. I notice that some others in the combo, don’t lose their place, but they lose the groove. I seldom lose the groove – it’s in my bones – I lose my place. H’m, feeling the groove doesn’t feel like multitasking to me, but does to someone else. Maybe if I play much less while improvising and focus on the chord changes and the structure of the tune I would be less likely to lose my place.
As a catalyst for change at work, my challenge is to listen, feel the rhythm of the work flow and be a catalyst. The more active and frenetic I become as a catalyst, the less I listen. Not so different from improvising. Listen more, feel the groove, do less.
How about as a patient? Listening to my body, understanding the machinations of the world around me, and picking one or two routines or habits at a time to work on. Listen more, feel the groove, do less. Might work.
Many years ago my wife and I got a letter from Zimbabwe: Dear Mr. and Mrs., I’m your son’s health partner. He’s fine now, but he had malaria, was in the hospital for several weeks, and almost died. Our son had gone to Zimbabwe as a development aide worker. During his team’s training, my son asked me to teach a health unit for them. I was a nurse and had been a paramedic. I essentially suggested they keep it zipped, know where their food and water came from and had them select a health partner in the team. The idea was that if anything should happen, health-wise, they would have someone who would stick with them as they got the treatment and recovery they needed in this unfamiliar place. I’m so glad I did. I’m reminded as many of have children leaving home now for college, do they have a health partner? Who will stick with them if they get sick? Navigating health care when you feel like crap is tough at best. Identifying a health partner before it’s really needed is the key. I don’t think of it much myself. My wife is my health partner. My sister and my kids will step in if need be. I’m blessed. Who is your health partner? Who are your children’s health partners?
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!
We had a family birthday party this morning. I’m reflecting on the tragedies we’ve weathered, the illnesses we’ve endured, the fun we’ve had as our kids grew up. Now our kids are parents with grandsons learning to value and trust family while testing boundaries and making decisions about their environment and relationships. Talking now with my wife, highlighted that all our kids knew was trust and that we took action in the face of tragedy or setback. Our kids parents didn’t die young, no one was assaulted or abused, they didn’t go hungry. We rallied in the face of challenges – death of loved ones, losing a job, no money. When our son, Mike, received a terminal diagnosis, we took action, consciously putting one foot in front of the other and finding things for others who cared to do. It helps to be busy. After Mike died we tried to adopt a teenager. It never worked out, but these young people clearly didn’t trust, didn’t have solid boundaries, and weren’t able to make choices in their lives. A feature of the adoption program we used was that the teens would be making their own decisions about adoption. The one young lady we would have adopted decided not to be adopted by us. Big step for her. Sad for us. Trust and self-determination: magic levers of best health.
My aunt got married to her longtime partner last week. Mazel Tov! My wife and I just celebrated our 38th wedding anniversary – we’re in love. My parents were in love, yet my dad was gay. Love is complicated. Especially when you add other people – society. I hail the recent Supreme Court decision to strike down the Defense of Marriage Act. Loving relationships can be a magic lever to best health, but it’s no guarantee.