Sunday, December 27, 2015

The F Word



There is a woman from New York in my head.

Well that’s not very interesting,” she kvetches every time I try to write something.

I hold down the delete key.

Better starting writing, or we’ll be here all day,” she chides and stamps her imaginary foot in time with the blinking cursor.

GET OUT OF MY HEAD,” I yell to no one.

Even the most accomplished authors, E.B.White- who wrote Charlotte’s Web, Steven King-- the notable horror story writer and inspiration for the movie Carrie, have written extensively about the voice of their inner critic and how they deal with those pesky and rather annoying voices. My favorite method for banishing one’s inner critic comes from Bay Area author Anne Lamott who recommends shrinking down your critic until they are small enough to fit in a mason jar. Then put them in the jar and close the lid tight so you can’t hear what they are saying. Then throw the jar off the roof.

Okay, okay—maybe I added that last part. Not that you would ever think of something like that.

As we head into a New Year with all of the promise of fresh starts, second chances and a clean slate, we are encouraged to leave our failures behind us. Throw everything that hasn’t gone your way out with the Christmas trash, leave it curbside for someone else. 2016 is nothing but blue skies and clear sailing. Believe me I want that. I really do. But my nasal East Coast inner critic reminds me how important it is to bring the struggles and failures you have had with you.  

I have had lots of failures—most the commonest of shortcomings and some fairly spectacular ones too. I failed O-Chem during my sophomore year of college. And I’m not talking D here people, nope, the big F stamped right there on my transcript for the rest of my life. Ironically the same grade a drunk frat guy unaware that he was even enrolled in the class would get. I did everything I could not to fail. I went to every lecture, met with tutors and the unsympathetic and wholly unhelpful professor. I took the final, knowing I would fail the class.

In retrospect, I learned way more from failing than I would have from squeaking through with a C-. Did you know that its possible to get a 14/100 on a final? Yup, It is. I learned that. I also discovered that even though I got an F in a class, I still had a nice warm dorm room to come home to. I still had food to eat and a loving family. My other classes had gone well, so that my overall GPA that quarter wasn’t actually all that terrible. The world kept turning, the sun came up, I was still a student (albeit not one that passed O-Chem, but nevermind). And that was it. My first real meeting with failure as a newly minted 19 year old. Now I’m told anyone over 18 is technically an adult—although being 29 I have to say I’m still waiting to become one.

I have had other failures since O-chem. Failed relationships—some I caused the end, others I chose to. I quit a summer job my senior year of college as a lifeguard—in a spectacular blow out one only dreams of doing. I let my boss have it real good. I knew I was burning a bridge—or rather soaking it in lighter fluid and throwing the match behind me. It felt good at the time, but ultimately the shortcomings in that position were partially mine.

The first time I applied to med school I sent applications to 28 schools. I got no interviews and received rejection letters from every single one. Apart from being an expensive adventure- it was an exercise in emotional stamina. One can really only read so many rejection letters before it starts to get to you. At least send my $70 back to cushion the blow.

During medical school there have been more times than I care to recount that I have walked home from school convinced I failed something, bombed a quiz or totally blew it by giving a wrong answer or having an awkward interaction. Maybe you’ve walked there too? While most of the time my worries are completely made up in my head as opposed to real problems, I greet failure each time. I know its presence and as much as it sucks, I welcome it, for it has been the failures in my life that have fueled my grit, my success and my ability to function with every test, every situation where failure might be possible.

As we hurtle towards 2016, I know the desire to have the fresh, clean sheets of the New Year. A clean slate. We’ll do things right this time. No more waking up with a bottle of red and a half eaten chocolate cake on your night stand…repeat after me…celery, lots of celery.

Let’s remember how important it is to take your failures and your inner critic with you into the New Year and all of the years to come. May they inform your life and help you deal with unforeseen circumstances.

I wish you nothing but success in 2016, but when you feel failure looming over your shoulder or become deafened by your inner critics, don't run from them or put them in a jar-- rather turn towards them and say, “hello old friend, its good to see you.”

Thursday, December 17, 2015

Jew Me


This year Cards Against Humanity sent those who were dumb enough to give them $16 (aka me) Eight Sensible Gifts for Hanukkah. Basically this December, 8 envelopes full of fun/stupid/awesome things have been showing up in my mailbox. My most favorite yet (mail is slow so we are still on day 6) has been vacation photos from the people who work in the factory in China where Cards Against Humanity is made. Part of the $16 went towards giving everyone who works there a week's paid vacation. 

I am also now the proud owner of the Jewish expansion pack to CAH (if you want to play with me, meet me at the Boathouse with wine and you're on). In addition to little presents, a letter of parental advice (because Jews duh), from a different dad of the Cards Against Humanity creators (all 22 of them are Jews you know) is included. Today's by Josh's Dad was just too good not to share. I love when you're just going along in life and all of a sudden you read something, or see something or someone does or says something that really hits you right in the feels and knocks you out of being your tired, overly self-involved, under caffeinated, miserly self. 

l'hadlik ner shel hanukkah

On Gratitude
By Josh's Dad

What's your superpower? Can you run faster than a speeding bullet? Can you leap over tall buildings or fly through the air like a plane? Probably not. But everyone of us does have a superpower that we carry with us at all times. It's not vulnerable to kryptonite or any comic book villain. It's the superpower of gratitude and it can empower its source as well as its recipient.

We have the ability to demonstrate our appreciation for what other persons do to make the world or our lives a better or nicer place. These things don't need to be profound events. Everyday people are interacting with you. It does not matter if you interact with them in person, over the phone or online. A "thank you" or an acknowledgment of their effort can mean the world to them. Think of the person in a tollbooth. They are confined to a five foot square box all day inhaling exhaust fumes, likely too hot or too cold. You may not be able to help them get a better job but you can make their job better. A smile and a hearty "thank you" for being here for me can make their day just a bit more tolerable. If enough folks did the same then maybe that box doesn't seem so small.

I own a small business and I try everyday to express kindness, empathy and yes gratitude towards those who work for me. It's harder to be grateful for, or even aware of, the hard work a stranger does for you on the other side of the ocean. I'm proud of the Cards guys for helping us show our gratitude to them too this year.

Just as Superman performs his feats with ease so can we. The opportunity to express your gratitude to you siblings, parents, coworkers, and strangers is available almost continuously. When you express any kind of gratitude there is almost always a reward. You often get a thank you but a smile or just a nod feels as good. We all have that power, the superpower of gratitude.
Don't let it go to waste.

---Josh's Dad


Wednesday, December 9, 2015

The Monster Inside Us

I am a monster.

I fear I have relegated myself to the darkest, most dank place on the internet.

The comments section.

Here in the semi-anonymous maze of haters, trolls, religious zealots and the self righteous, I find myself, fingers hovering over the keyboard. 

You see, this morning NPR posted a most interesting article about how medical students depict their attendings and other supervisors in a 'Comics in Medicine' class taught at Penn State College of Medicine. The comics and artistic renderings of the med students are hilariously funny but the point of the article is that the majority of students drew their attendings as monsters.

Its not hard to understand why. Med students often feel bad, stressed, worried, tired and berated by the doctors training them. The comic class offers an outlet for students and insight into how doctors are trained. Many physicians remember feeling horrible during their training and perpetuate the cycle of abuse. There is work to be done in medical education. And its ironic that medicine—a profession which extols health and wellness, should inflict such misery on those within it.

A physician from Pennsylvania commented on the article that, “maybe they are taking the wrong medical students.” And that those in training just need to suck it up. I bet no medical student has ever drawn that guy as a monster ;).  I looked him up. I was possessed by rage. Turns out he has multiple actions taken against his medical license and was fined for lying about the completion of his CME credits. Geez, maybe the “wrong medical students” they take turn into doctors who lie to the medical board. 

I want to call him out. I type a scathing comment. Impressed by my razor sharp wit and vicious rhetoric I re-read it over and over. Then delete it, and go downstairs to make coffee.

It scared me what a rush I got at the notion of belittling someone on the internet. I can see the thrill. And its powerful.

I suppose I am especially aware of the impact of internet comments at the moment, because last week my post on KevinMD got a nasty comment from a doctor in Utah. The discussion was on Doximitry—a kind of doctor’s only LinkedIn. As I am not a doctor, I wasn’t allowed to see the comments section. Rather, I found out about his comment, which criticized my work ethic (I have 3 master’s degrees, screw you) by an overwhelming flood of supportive, loving emails from doctors all over the country.

Don’t worry about that doctor from Utah,” one reply read, “We’re handling him.”

Another from an endocrinologist in New York read, “Your insights are superb, and I'll be forwarding your url to my current (and future) students.” And then he invited me to lunch the next time I’m on the east coast.

Some doctors sent me helpful links and access codes to e-books they had written. Most offered loving words of support, food, encouragement and coffee- should I ever be in their neck of the woods.

I have seen the best of the best during my medical training…and some monsters too. I don’t want to be one. If it means forgoing feeling powerful and smart all of the time, then I’ll take it--its better to actually be smart and influential as opposed to just feeling that way. It's hard to show love and patience, especially to people that probably really deserve getting called out. But I'll try to make a different choice and try to find other, more positives ways of discussion. We all have a little monster inside us. It speaks by interrupting, by tearing other people down and through self-righteous quips that feel good for a second, and turn to ash in your mouth. 

Let's be doctors who are kind and loving even when it is difficult to do so.  Let's be the way forward. Let's stand up for a better way to train doctors. To the good ones who we have the privilege of learning from-- you inspire us to show empathy and understanding and love. You give us the strength to ignore those who are not as courageous—those monsters who would rather belittle than help.

May they be relegated to the comments section.