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Engaging with Sax – Good as I Am – Merry Holidays

By ePatient, Family man, Musician, Podcasts

Sometimes I wish I had fallen in love with the flute. It would be easier than carrying the 40-pound sax up and downstairs. But it motivates me to keep doing my squats and increasing upper body strength as my lower body function diminishes. So, engaging with sax is perfect for me. Using different parts of my brain, learning every day, keeping me humble, and spiritually strong. Are you still playing the baritone sax? is a spot-on personal health outcome for me. So merry holidays everyone. I hope you have a musical season

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Pausing – A Magic Lever of Best Health

By Advocate, Caregiver, Clinician, Consumer, ePatient, Family man, Leader, Musician
Yesterday, my wife took me to Boston Improv for my birthday. My daughter-in-law took me out for lunch. This week I found myself spacing out several times at my desk.  I listened to the rhythms of conversation in meetings at work.  Today, I played some blues on my bari sax. What do these scenarios have in common? The pause: A moment’s break to listen, to reflect, to balance.
During improvisation, comedy or music, players need a second or two to listen and feel the groove while contributing. Otherwise it’s cacophony. The pause, not blowing the horn, not talking, is integral to the rhythm. You could say that the rhythm is the space between the sounds. When work piles up with e-mails, reports, and to-dos, we need desk time with a few minutes to reflect on the purpose and quality of our work. Otherwise it’s disconnected and exhausting. The pause, however brief, settles the mind, allowing it to breathe. During conversation we need a few seconds to digest the message we hear before jumping back in. Active listening requires time for the person to complete their thought.  Often I jump right in, rushing to contribute as soon as the sound from the speaker’s lips stops. Getting my sound in before someone else jumps in. Lord, that’s a tough one. During the chat with my daughter-in-law, we spoke about a different kind of pause: pace of life and balance – allowing the space for music, exercise, family, health appointments.  It’s a challenge for working parents and someone with a chronic illness, or both, or neither for that matter.
Honor the pause. It’s integral to best health.

Walking and Chewing Gum at the Same Time

By Consumer, ePatient, Family man, Leader, Musician
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.


By ePatient
Started a new job – first day – a form asked if I was disabled – along with race. Hmmmm. I checked yes. Last week, went to a church function with my mom. Several people with canes and walkers, including me. Buffet style meal. Disabled first in line with gentle insistent assistance. I was guided to that pre-served group. I can manage my own plate with my cane hooked on my arm, but what the heck, they were nice.

According to the World Health Organization: Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
I have Multiple Sclerosis. I drive to my full-time job, I play my saxophone 4-6 hours a week.  I can ride my recumbent trike 10-15 miles at a time. I can walk about a mile, then my left foot drags. I play with my grandkids. Takes me a while to get up from the floor. I can’t run. I can’t dance. I can’t stand in place too long. If I spin around I go kaboom (as my 2-year-old grandson says). I need a cane about half the time, I just don’t know which half. When asked what jungle animal I should be, my four-year old grandson says, one with balance. I have double vision some of the time. Can be annoying when I’m reading music. I have trouble reading white on pastel. I often don’t know where my body is. I will run into the door jamb if I’m not careful. I have to hold on going up and down stairs. So I guess I’m a person with disabilities. It’s a health hat.

Improvisation, rhythm, repetition, and caregiving

By Caregiver, ePatient
I’m learning more about improvisation in my musical life – jazz improvisation. In my early days I had thought that the improviser just let loose playing whatever came through his fingers with the rhythm section in the background. Creating music on the fly. I’m learning – not so much. The structure of the tune – melody, chords, rhythm – provide the framework. Then the improviser draws on a library of note patterns aligned with the chord structure that she has repeatedly played into muscle memory. This library provides the material of improvisation. Much structure, much practice leading to better improvisation. Some minutes I think I’m a better improviser, most hours I think not.

In my health journey improvisation helps me understand the importance of melody, rhythm and repetition – structure, muscle memory, habits in care. The melody is the state of the person receiving care, with the rhythm being the daily pattern of care (activities of daily living). The more challenging the care, the more severe the disability, the more importance the melody, rhythm, and repetition. It seems that even with the most severe disability, caregivers can more easily manage and improvise if the pattern, repetition, and muscle memory is there. It’s when the melody and the rhythm frequently change, when the unexpected constantly occurs, that playing and improvisation becomes too draining and almost impossible in the best of circumstances.
Can we help the helpers better cope and improvise if we explicitly clarify and simulate the underlying melody and rhythm?


By Musician
As an amateur jazz musician I spend 3-6 hours per week working on improvisation.  In NY I studied with Al Golladoro, a virtuoso extraordinaire. Now in MA I learn from Jeff Harrington, a saxophone professor from Berklee College of Music, and for the past year I’ve played weekly in a student combo practicing improv under the direction of Dan Fox.  I’m blessed with the chutzpah to venture outside my comfort zone. I’ve landed on several fundamental principles while studying improv:

  1. Listen first, play next
  2. Know the underlying tune
  3. Keep my place
  4. If nothing else, feel the rhythm
  5. Less is more
  6. A good sound beats dexterity
  7. Forget it all and have fun
The lessons of improv serve me well as patient, caregiver, nurse, and leader. Subsequent blogs will dive into improv and the other hats, but I can distill it down as follows:
  1. Listen first, act next 
  2. Excel as a team member on a good team
  3. Know the goal and the related systems
  4. Keep it simple
  5. Enjoy life
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