Taking One for the Team

Simone Biles knew that something was wrong. She had pulled herself out of the team gymnastics competition at the Tokyo 2020 Olympic Games after she developed a case of the twisties. This condition severely impairs a gymnast’s ability to know their position in the air and relative to the ground, something that could lead to serious injury if not addressed. She also decided not to compete in some of the individual events in the days afterward, citing mental health issues. Rather that find herself lost in the air, unable to add to her team’s scoring and possibly injuring herself, she decided to withdraw. “I knew they could do the job.” She wanted her teammates to medal, and she saw herself as a stumbling block. In an interview, she said, “We aren’t just athletes or entertainment. We are humans too. We have emotions that we don’t tell you about. I felt embarrassed at first. You have to put your mental health first. It doesn’t matter if you are on the biggest stage.”

There was mixed response to this turn of events from around the world. Some mental health advocates were very supportive of Ms. Biles. Some of her peers, such as Michael Phelps and Naomi Osaka, called her to offer their support, in that they had also struggled with mental health issues that affected their performance at times. They applauded her decision to put self care first and to keep herself safe. Others, not very sympathetic to her struggles at all, said that she should have “taken one for the team” and pushed on to compete in all the Olympic gymnastic events.

“Taking one for the team” means willingly undertaking an unpleasant task or making a personal sacrifice for the collective benefit of one’s friends or colleagues. It derives from baseball in the 1970s, when a player was asked to take a pitch on the body to get to first base for the benefit of the team.

The path that Simone Biles chose was self care.

In an October 22, 2020 Harvard Business Review article titled “Serious Leaders Need Self Care Too”, Palena Neale PhD addressed this very issue. She asked questions such as “Why are so many leaders so resistant to taking a bit of time for themselves?” She found that “it usually boils down to misperception around what good leadership is, what self care is, and how self care actually works.” One thing that is often lost is that “self care is an investment that can increase overall productivity and effectiveness as a leader.” Ms. Biles had faced similar circumstances before in her career, and I am quite sure that she expected her competitive days to go forward as well, so getting past a temporary block in her overall journey just made sense for her at that time.

Diet, exercise and sleep are three components of a healthy life that we already know about. Then why is it so hard for most of us to eat right, exercise daily and sleep enough hours? One of the answers that Dr. Neale found was “I don’t have time for that!” The feeling of constant stress to manage a busy life, perform, always be on, and to juggle too many tasks is “sadly all too common.” “Taking breaks can prevent decision fatigue, renew motivation, increase creativity and improve learning.” Could Simone Biles have accomplished all of her key priorities, including tying Shannon Miller with seven Olympic medals after coming back to win bronze on the balance beam this year, without paying attention to her health and sense of wellbeing?

Another response found by Dr. Neale was that “leaders need to be strong. If I’m a good leader, I shouldn’t need self care.” This is simply incorrect. Leaders are often taught to not show any vulnerability. They feel that they should have all the answers. I think that many medical students and newly minted doctors feel that they know everything that is to be known when they finish their training. It is only later, when one has practiced in the real world for a time, that one realizes that learning never ends, and that the correct answers are constantly changing. Leaders sometimes feel that if they do not meet these criteria that no one will follow them at all.

How do we follow the example of Simone Biles and make self care a priority in our lives? According to Dr. Neale, we should integrate self care into our daily routine. Make it your own. Make time in your agenda for self care. Experiment with different things to keep it fresh. Share with others when you have found something that works for you that you think might benefit others. After all, Simone talked with Michael, Naomi and even Oprah! Your team will see these activities and actions and resolve and will follow you. Everyone wins.

What lessons can we take from the experience of Simone Biles in the 2020 Tokyo Olympics?

First, if you see that taking one for the team will lead to injury to you or disaster for the team, then stop and reevaluate. Biles stated in an interview that “it didn’t go like I wanted it to go, but it will open doors for bigger connections”. Pause for self care when you need it. Almost everything can wait. Model your decision making and share with others what worked for you. Encourage others to follow your lead.

Come back stronger and achieve even more because instead of taking one for the team, you decided to take some much needed time for yourself.

A Milieu of Unfriendliness?

As we had our all agency meeting at work the other day, involving mental health employees from all three of our sites and from all types of job descriptions, I was struck by something that come up as we discussed issues of cultural diversity. We had had a good presentation on diversity and how it was germane to the people that we serve everyday. Then, a few folks made observations that made me understand immediately that they felt misunderstood, unappreciated, and unacknowledged in the positive ways that they obviously felt were important.

How could that be, I thought? I started working for the local mental health center in Aiken part time in 1991 and came on full time in 1993 for the specific reasons that I loved the patients, the clinical environment, and most of all the people that I worked with. I have stayed at the center for almost twenty nine years for those same reasons. Now, I know that we are not perfect, but I do get the sense that the folks I see and work with every day are basically good people, caring people and people who care about my wellbeing as well as their own. For the most part, we cooperate, we commiserate, we collaborate and we celebrate, all important parts of being on a team that pulls in the same direction for positive changes and outcomes. I was a bit saddened to hear that some of my coworkers do not seem to feel respected, genuinely valued or appropriately acknowledged.

How did we get from 1991 to 2020 and this angst? I have a few ideas about what might have changed.

We work in a culture of fear-driven productivity at the expense of much else. Being a part of the management team as medical director, I understand this from a purely operational viewpoint, in that we must do a certain amount of business, bill a certain amount, collect a certain amount of money and constantly push for provision of appropriate services to keep our doors open. Otherwise, we would not be much good or be able to provide services to anyone at all. I get that. But it does seem to me that a lot of our staff feel pressured by the numbers, the spreadsheets and the bottom line, regardless of the emotional toll that this pressure takes on them daily. In this twenty first century world, we have perfected the art of cranking out widgets, but we have sometimes lost our drive to connect in meaningful ways with each other in the bargain.

As a corollary to that, the time that we spend with each other, WITH each other, is minimal.  I have noted, as have others, that sometimes we can pass each other in the hallways and not even acknowledge the other with a smile or a kind word of greeting. Now, there are some of us who are excellent at that kind of connection, bright rays of sunshine in an otherwise clinical gray haze, but I’m afraid many of  us, myself included, can easily fall short at times. We need to connect emotionally and model that behavior that we often try to teach our patients about.

I began to think, we have lots of folks working here, lots of people like me and not like me, with different values and priorities and hopes and dreams and ways to act and dress and walk and talk and interact with others. We preach acknowledging these differences, even elevating and celebrating them in our patients, but are we failing to do the same with those who work in the offices next to us? Based on what I heard at our meeting, I’m afraid that might be the case.

Are we fostering a workplace culture of exclusion? A milieu of unfriendliness?

There is enough stress in the world right now to go around, and then some. There are social, cultural, political and class stresses that make us wonder how we will ever get through some days. In spite of those stresses, we do get through each day.

We need to be consciously  aware at home, at work, at play, wherever we are, that there are those who feel marginalized, unappreciated, unloved, unseen and disconnected.

We must start somewhere.

Smile. Acknowledge. Say hello. Check in. Look up. Make eye contact. Tear down the wall that surrounds the milieu of unfriendliness and build your own bridge to a culture of appreciation and hope.

It starts with me, and with you.


Time Out

We are all caught on a treadmill of expectations. 

We have obligations to work, spouse, kids, church, friends. 

We love to watch TV, listen to music, read books and magazines, surf the Internet, email, text, talk, write, paint, remodel, clean, shop, eat, and socialize.

We sometimes even need to sleep. 

Add it all up. Numbers don’t lie, do they?

Most of our waking and sleeping hours are spoken for. We make some of these choices about how those hours are spent. Others are made for us, usually with our tacit approval. 

I would submit to you that we also need time to learn, think, train, assimilate, absorb, plan, assess, dream, commit, network and care. 

The main problem is, if we don’t schedule the time for this, and I mean hard schedule it, on your calendar, taking up a block of time, it will never happen. 

You must put yourself in time out. 

I mean it. 

Go into the corner (whatever that space is for you) and put your nose to the wall and block everything else out. Give yourself time for yourself. 

Think. Dream. Plan. Scheme. 

Because if you don’t take the time to do this, and you’re never sure where you’re headed, any old road will take you there. 

Don’t let the treadmill win. 

Get off. 


The Importance of Being Earnest

The Importance of Being Earnest, ATrivial Comedy for Serious People is a play by Oscar Wilde. First performed on 14 February 1895 at the St James’s Theatre in London, it is a farcical comedy in which the protagonists maintain fictitious personæ in order to escape burdensome social obligations. (Wikipedia)


I have a hard time relaxing.

(Okay, I’ll wait a sec while you all get back up off the floor, close your mouths and gather your wits about you again.)

Yes, it’s true. I love to work. I love my work persona.

He’s a cross between an intelligent eccentric, a person who needs people, an introverted recluse, an arrogant sonofabitch, a great clinician, a mediocre boss (my minions might not even give me that much credit!), an insatiable learner, an organizer, a compassionate man who sometimes tears up at sappy songs and commercials and a sometimes accidental creative. He’s basically a nice guy, I think. He will never, ever retire. He will more than likely die at his desk. If not that, then at his laptop, or while using his Dick Tracy smart watch. Or maybe he will be so busy taking pictures with the Google Glass attached to his own spectacles that he will run headlong into a telephone pole and have a massive subdural. Hey, we all gotta go sometime.

Anyway, I have a hard time relaxing.

So, this weekend, I decided that I would force myself to get away. To practice what I’m always preaching to my dear patients (who I do like, sincerely, just don’t tell them that because it would counterbalance the arrogant sonofabitch part of me referenced above). I decided that to escape the burdensome aspects of my beloved work life, I would get myself the hell out of Dodge (read Aiken) and go south to another beloved place. I would take on another mantle, as it were. I would relax. I would have some fun.

(Don’t look at me that way. Writing blog posts is fun for me. You know that. I’m listening to soothing solo piano music while I write. Does that count for anything? Don’t make me come over there…)

So, tonight after a leisurely ride out of town and down to the Lowcountry, I checked into a very nice hotel downtown.  I went to dinner. A very nice dinner in a very nice place with a very solicitous and nice server named Lisa who did her best to make me happy. I had some good whiskey. I ate some scrumptious seafood. I had creme brûlée for dessert. I drank good, strong, dark coffee. I read some of The Accidental Creative by Todd Henry. (You thought I just made that part up, didn’t you?)

Tomorrow, I will go to the gym for a few hours. I’ll drink more coffee and read the New York Times. I’ll ride out to the Atlantic to Hunting Island, walk the five mile beach, take pictures and climb the lighthouse there for the umpteenth time (I love that lighthouse and the view that you’re always rewarded with when you get to the top). I’ll come back to town and have a late lunch/early dinner at one of my family’s favorite places. I’ll shop for some gifts for a few of the special people in my life. 

I might even take a nap.

May I be serious for a few minutes?

I have had a lot of losses this year. Some of you, dear readers, have too. We all deal, right? We deal. The best way we know how.

I’ve learned some things. May I share them with you, if you have just a few more moments to spare?

Loss, even if it results from your own conscious decision to let something or someone go, is very, very real. It’s not a game. It’s not a dream. You’re not going to wake up and find it gone. You cannot wish it away. You cannot pretend that it doesn’t exist. You cannot sweep it under the rug and hope it goes away on its own.

It will never go away. 

The sooner you recognize it for the ugly, hurtful, spiteful, angry, killing thing that it is, the sooner you can deal with it directly and move on. Because you know, we all must move on. What choice do we have. Hell, I’m not done yet. I’m gonna die at my desk. According to a very close friend of mine, that’s going to be when I’m ninety-six years old. I hope she’s right. 

No matter how many times you return to that place, that state of mind, that trigger, it will never, ever be the same for you again. This is another one of those hard lessons that I’m still trying to learn myself, and maybe you are too. I can drive back there, I can go there in my mind, I can try to recapture the magic, but it’s gone. GONE. It is never coming back in exactly the way I had it before. If I insist on getting it back exactly the way it used to be, I’m always going to be disappointed. It breaks my heart, but I must go forward and find some other way to get a similar feeling, to be in a similar place, to do a similar thing. And that’s okay. I must grieve. You must grieve. I tell my patents all the time how normal that is. I need to listen to my own interpretations. 

Finally, dear readers, I have learned one more thing.

There is joy in the world, and there is enough of it to go around. I can have my share. It’s okay. I deserve it. I need it. I want it. I crave it. 

I have felt small slivers of it in the last few months. Perhaps you have too. I have felt the pure exhilaration of holding my granddaughter, hours old and sleeping in my arms without a care in the world. I have seen the wondrous order and fascinating patterns of snowflakes and early morning frost on windows. I have pushed myself physically and felt the adrenaline flowing when I thought I couldn’t do any more, and did. I have felt love, coming at me from out of the blue and leaving me speechless and in awe. 

I have learned these things, or better to say that I am trying to better learn and understand them. 

There is a great importance in being earnest with the world around you, with those you care about and who care about you.

There is an even greater importance in being earnest with yourself. 

I’m going to climb a lighthouse tomorrow, look out at the Atlantic Ocean, and feel joy.

What are you going to do?


Time to Recharge!



Dear readers,

Why have I asked you to take a look at a new blog? Don’t I post enough stuff on the old one  to keep you busy, seeing that you read about eighteen gazillion other blogs already? That may very well be the case, but…

This is the blog that is going to let me be me. I’m going to be a little freer here than at gregsmithmd.com, which is my prerogative, yes?

Do you wonder what I do when I’m not working? 

Do you wonder if I’m ever NOT working?

Well, here’s part of your answer.

I’ll post about trips I’ve recently taken or am looking to take, books I’m reading or have read, movies, music, sports, you name it.

I may post personal musings, thoughts about things in general or things in specific. I may wax eloquent about news of the day, or I may just be silly sometimes. (Feel free to skip those posts if you are not the silly type. Your loss.)

If it has nothing (or very little) to do with medicine, psychiatry, mental  health, or working, then I’ll post it here. Yes, my friends, I do have a life outside mental health. Shocking, I know, but true nonetheless. 

Your reading is welcomed,  your comments are shamelessly solicited, and I hope you enjoy this little diversion from the serious. 

I know I intend to.