At My Best

I have felt a little ill at ease lately.


A tiny bit anxious.

Have you?


My country, my immediate world and indeed the larger world, are in flux. Change is afoot, change that in many regards I have no direct control over. Change that I am forced to watch and to endure the best way I can.

Personally, I am the happiest I have been in some time. Years, truth be told.

The world, though, seems  a little irritable.

What are we to do?

Well, I can only speak for myself, but when I get these unsettled feelings, for any reason at all, the best thing for me to do is to fall back on my tried and true methods for centering myself. I need to pay attention to what I am doing, what I am feeling, how it affects me and how it affects those around me-spouse, family, friends, patients, and coworkers.

I am at my best when I take good care of myself.

I am at my best when:

  • I am well rested. My propensity is to stay up late and get up early, which I have been able to do for many decades. It started in college in earnest, and medical school and residency only cemented those not- so-good habits. I still like to get up at five, because my quiet morning time gives me space to read, listen to news, have that first cup of coffee, or plan my day. However, in order to get up that early, I now understand that my body expects me to go to bed earlier, like ten PM, eleven at the latest. Just ask my wife (who has my number in more ways than one) how difficult that has been for me to incorporate into my regular daily schedule. She will most likely add five years to my life expectancy because of the way she helps me live healthier. (Thank you, my love.)
  • I exercise regularly. Today was a federal holiday of course. After sleeping until 9:30 AM (hey, my wife is in Amsterdam and I didn’t have to work today! See how that works?) I got up and had a leisurely morning. Then, at about 1:30, I struck out on a wonderful, three and a half hour, eight mile exploration of the beauty of spring in my neighborhood. That plus cold brewed coffee as a mid-walk break. I know that I feel better when I walk, lift weight a couple of times per week, ride a bike, hike a mountain, or otherwise push myself. I even got a standing desk setup this week so that those long telepsych shifts will not entail sitting for hours at a time.
  • I am learning something new or stimulating. Trina and I went to a neighborhood concert of Irish music in a local home this weekend. We heard three wonderful Irish musicians play and sing music that is not what I normally listen to. I sat next to a man from Ireland who had married a Georgia girl and works here now. It’s a very small world, and there are things to be experienced and learned!
  • I am “in the zone”. Whether working or writing or exercising, it is better for my general health and wellbeing if I give my entire attention to the task at hand and “get in the zone”. You’ve felt that way I’m sure. That time when things flow, when  you have to expend very little effort to get stellar results and when you seem to be moving effortlessly through your day.
  • I reveal just a little bit of myself to those around me. As I have been reading in multiple articles this week, physicians and especially psychiatrists are often trained to be stoic, resilient, and in our case, “blank screens” that divulge little of what they feel and less of what stresses them out. I have found over my career that this does not work well any more, especially when I am working with those with major psychotic mental illnesses. They often need to know that I am “real”, that I have a team I pull for in the Super Bowl, that I do have grandchildren, and that I like to hike to relieve my own stress. I was very well-trained in my youth, but the older me now knows that there is something to be said for judiciously and professionally sharing some of oneself with others when it is indicated. and that both parties will leave the relationship or encounter the richer for it. Do I also need to mention that this works well for friends and family and spouses? I am (still) learning that as well.
  • I enjoy the stories that I hear every day. I have already written a recent post about this, but I need to say again that if I do not regard work as a stressful chore, but look at it as a way to learn about others and hear fantastic stories that they trust me to hear, that I can have fun and help others at the same time. We cannot change the way that life throws stress at us sometimes, but we can certainly decide how we are going to respond to it.
  • I let myself be human. Your struggles are my struggles. Mine are yours. I know some things and have some specific expertise. So do you. Contrary to what some have espoused, we cannot do this alone. Life is a team sport, a contact sport. If we let someone have our back and we have theirs, whatever comes can come.
  • I give time  to my family, friends and my spouse. Let’s face it. We are all busy. I work two jobs. My wife travels internationally. My children live in three states and my four grandchildren are an eight-hour round trip from my home. If I want to see people, I sometimes have to make time to travel and see them! My new bride and I love our time together because we already know how precious it really is. Our parents are aging and need our phone calls (Yes, I called my mother this morning to catch up) and our personal visits. We are at our best when we give of ourselves, our time and our attention to those we love and who really love us. That time is never wasted. Never.

So, if you feel a little anxious, a little stressed, a little out of focus in the weeks or months to come, figure out what grounds you, replenishes you, recharges you and feeds you, body and soul.

Make time for those things. Take care of yourself, because you know as well as I do that others are not going to do it for you. It ain’t happening, so get over that right now.

Figure out what makes you the best you can be, and do it.

Have a great week!



Rosie and Me: Eight Days and a Wake Up, or The Hitchhiker’s Guide to the Lower Forty Eight

My father was, to my knowledge, the first person in his family to go to college. He and my mother grew up in rural Georgia, a place where men were farmers, women could cook fried peach pies that would melt in your mouth, children played in the rushing waters of swollen ditches after a rainstorm and great-grandmothers could send a stream of brown tobacco juice fifteen feet into a Prince Albert can on the floor by the pot bellied stove.

My dad co-oped, that is, worked and went to school in order to be able to earn his degree from the Georgia Institute of Technology, a school he loved with a football team he loved more. (Dad was at Tech from 1950 to 1953, in the Bobby Dodd era, when Tech was a powerhouse and lots of games were won at Grant Field,many attended by a much younger yours truly in the sixties. The 1953 team went 9-2, was ranked 8th in the land in the final AP poll and beat West Virginia 42-19 in the Sugar Bowl)

In order to get back and forth to school in Atlanta from middle Georgia (which might as well have been Saudi Arabia at that point), Dad hitchhiked. Imagine that. Putting your thumb up in the air, waiting for a complete stranger to have pity on you, pull their 1946 Ford over and offer to take you as far as Macon. It was pretty commonplace for students to hitch or thumb rides back then, and no one thought much of it. I’m sure there were the mothers and fathers who worried obsessively about their progeny on the roads, but from what I hear it was a pretty safe practice back then. It was the accepted way to get from point A to point B if you were not affluent enough to own a car. I’m sure many a tall tale was told in those cars during those rides, friendships may have started up, or at least amiable conversations were enjoyed along the highways and byways of an America that was fresh off a victory in a world war and didn’t have much to fear.

Today, we travel a different way. We hop onto the internet, thumbing and hitching and tagging along with chats, boards, list serves, podcasts, E-magazines and E-books, text messages and Skype. We meet new people at every turn, most of them good folks who like peach pies just as much as we do, some bad apples that hang out in the dusty corners of the world wide web, but mostly, good folks just like us. We might leave a comment here, a line or two there, we might chat a few minutes or even over a few days. We might never connect again. Sometimes, some sweet times, words are exchanged, a joke is told, a turn of phrase catches our ear, a gentle reminder to be safe or watch out or tweak this or change that font hits us just right, and we know that the person on the other end of the clothesline, the person with their ear on the tin can opposite our own, is somehow the kind of person we want to know more about.

It’s hard to describe, this cyber-connection that happens between people who have never met. It’s hard to help a regular person, much less the occasional Luddite, understand that close personal connections, meaningful relationships, caring partnerships can be forged not only IRL (in real life, for the uninitiated) but on line. It happens. It is real. It is strong. It is lasting. As real and strong and lasting as any friendship or connection even made on sold ground and sealed with eye contact and a firm handshake.

As I head out next Friday, I anticipate seeing at least two dozen friends across the country, people I know from almost four decades ago when we were small children right up to people I’ve talked to on line but have never even spoken with on the phone. Of the two dozen, at least six I have never met in person. A couple I have talked to on the phone once, twice, maybe three or four times.

Funny thing, these half dozen and their counterparts already know as much about me as any friend I’ve ever had, some probably more. They’ve told me their stories and they’ve heard some of mine. They’ve told me what they get angry about and I’ve told them what I’m afraid of. We’ve shared recipes and we’ve talked about how broken the health care system is. We’ve rejoiced, virtually, over the wonderful successes of our children, and we’ve comforted each other when losses of physical health, marriages, and jobs have set us back. We have shared parts of our lives that are very real. All while thumbing and hitching that wilderness that is (still) the internet.

I will enjoy sharing a meal and a glass or two of wine in Chicago, IL, with my friend Jordan Grumet (@jordangrumet on the Twitter for those of you so inclined), physician, art guy, thinker, writer, and all around compassionate man. I have heard him speak, read many of his blog posts, talked with him on the phone, sought his advice, and have never met him face to face. We will fix that soon.

I will have lunch in Fargo, ND, with Julie Kuehl (@JulieKuehl), a lady I first heard of while listening to the International Mac Podcast (it disbanded on June 29, 2013). She has a presence elsewhere in the podcasting world, and most intriguing, she rides a motorcycle. She knows IT and is a smart lady. I very much look forward to picking her brain about what it’s like to live in the northernmost part of our nation.

My hostess with the mostest in Seattle will be none other than the brilliant and fascinating Dr. Elizabeth MacKenzie. We have become friends over the past year or more, swapping tales of mental health treatment dilemmas, sharing recipes, sending each other birthday gifts, and having a chat or three on the phone. Elizabeth has very graciously offered to host a Seafood Extravaganza at her home for me and several of my high school friends who live in the Seattle area. What fun that will be! We are also going to explore as many coffee shops as we can (my request) until I get caffeine toxic and have to stop. Other shenanigans will follow.

I will catch up over breakfast with Diane Misch MD, a friend who worked for me at the mental health center in Aiken way back in the day when she was pretty fresh out of training. Now, she is quadruple boarded (I think, at last count) and can run circles around me.

I will see my daughter and her new husband in Denver for the second time (my first visit was over the Fourth of July weekend and was fabulous), one of my oldest high school friends who is now a professor at Tulane, Mark Vanlandingham, and will have dinner with Dr. Ramona Bates (@rlbates) and her husband, who even offered to get tickets to see the DAWGS play the Razorbacks in Little Rock if I wanted to go. (Alas, the tight itinerary won’t allow it this time) She is knitting me a beautiful black Möbius scarf, which I may need to wear if fall keeps coming on as cool as it has the last couple of days.

Do you see, my friends, the richness of this landscape? Do you see the possibilities for friendships to blossom and grow, for stories to be shared and places visited and enjoyed together? We have never, in any other time, been able to connect to so many people in so many ways as we can now. The thumb in the air has given way to the DM, the hashtag and the follow.

I feel so very blessed to be able to meet up with all of these folks and more, to share a moment or a meal or a day or two days with them. I feel honored that they would trust me enough to invite me to enter their worlds, and that they want to be a part of mine.

We live in rapidly changing times, but some things never change. The need to connect, to belong, to share, to love and to be loved will always be the same, as long as man lives.

I am going to reach out, as best one man can, and make those connections that will lead to a richer, more productive, more satisfying life.

I look forward to sharing more with you here over the next month.