Yesterday could have gone better. I was a little stressed because my residency list was due, I was a little miffed because Iím a social misfit in my class and wasnít picked for the dodgeball team (OK, it was the student-nominated honor society, but whatever. Same difference.), and all this culminated in me rushing to answer the doorbell and succumbing to gravity significantly sooner than expected, leading to a couple of stair-sized bruises on my back that look suspiciously like reddish-purple bacon strips (Primal side effect that anything dark and squiggly automatically resembles bacon??). At least I made it to the door before the mailman ran off with my package. Wonder what he made of the preceding thud-thud-thud-thud that was me ever-so-gracefully banana-peeling down my stairs? So, I had a square of 72% Ghiradelli and took a nap before Pilates instead of getting there early to do some slow movement prior. Well, at least I walked to school yesterday and got some sunshine earlier. (NB: even writing about yesterday is cursed: MDA erased my whole post instead of submitting it. Awesome. Re-writing from memory. If you donít like the post, imagine the erased one was better. ☺).
Back to bigger picture issues, I thought maybe I should talk a little about the title of this journal. ďSee one, do one, teach oneĒ is a time-honored concept in medical education that highlights the role of independence, OJT, and learning by doing. Perhaps itís self-explanatory, but the idea is that you watch someone do Procedure X, which then qualifies you to perform Procedure X, which in turn qualifies you to teach a junior colleague how to do Procedure X. This idea is not officially endorsed anymore since it obviously leaves a lot to be desired with respect to patient safety and pedagogy, but you still hear the phrase a lot in medical education settings. My purpose in using it for a title is that I think it's a great model for my PB plan: Iíve seen some incredible examples of success on the blog and the forums using PB (see one), I now plan to BECOME one such success story (do one), and then hope to join the countless other members here who provide guidance to help others achieve success, as well as help my colleagues and patients get healthier and happier if they so choose (teach one).
Iím a private and performance-driven person, so it pains me to air what I perceive as personal failings, but I think itís important to acknowledge ALL of the reasons Iím here, and what issues I bring to the table. You may not need to know them, but I need to say them in the interest of transparency, catharsis, and measuring progress. Without further ado:
#1: Weight. Iím between 5í7-5í8, and currently weigh ~162 lbs. I wear a US size 8, sometimes 10. At my biggest, I graduated high school at a size 14. When I graduated college, I was about a size 10-12. Despite having made some very modest progress over the years and not having as great a challenge in front of me as others here might, being an overweight teen made an indelible impression. Iíve always had body-image issues. I canít remember the last time I was happy with the way I looked, and I rarely feel comfortable in my own skin from an appearance perspective (though do my damnedest to hide this fact). It has never helped that my mother, also my best friend and usual shopping companion, has always been a petite, cougarific 5í4/115# who always looks amazing. Sheís also very devoted to health/fitness and works damn hard for her figure, but itís a blow to the ego that she has ALWAYS looked better in cute jeans than I have. And she doesnít look old enough to be my mother, either. At least I have good genes. ☺ Since my parents have always been into fitness, you might imagine that this was a heavy influence on me growing up. True story, but it sort of back-fired.
On to issue #2: Exercise/Fitness. Until I was in my early 20s, I had a physical condition that made it feel like I was suffocating every time I got my heart rate above ~150. As a kid, this meant that any endurance activities, especially running, were really miserable. I was misdiagnosed for over a decade, mostly with asthma or just being ďout of shapeĒ, and so nothing ever helped and I was just always down on myself for not getting into good enough shape. I lived with it and did what I could, which was quite a bit so long as I could titrate my heart rate carefully; spinning and the elliptical were fine (though my stridor was a little loud in spinning class), but running was categorically out. I think my favorite anecdote is the time when my *opponentís* coach stopped a Tae Kwon Do sparring match because he thought I was going to keel over (like I said, my breathing difficulty was loud, fast, and really obvious). I eventually self-diagnosed the issue and sought out a specialist for definitive surgical treatment (which helped a LOT), and have subsequently gotten over most of my conditioned aversion to cardio (though I still canít run anything other than sprints; jacks my heart rate up to 190+ for reasons that I think must be psychological rather than physiological). All of the above notwithstanding, Iím just not a person who LOVES to work out. I recognize the importance, and do it on a fairly regular basis, but not with much enthusiasm. I like lifting more than cardio (which happily works quite well with PB), but am easily intimidated by the meatheads and figure competitors in my gym (SoCal, how I loathe thee. Let me count the waysÖ), so tend to avoid lifting at the gym. I have some fairly light (10, 15#) dumbbells at home and can certainly do bodyweight work, but itís not really the ďheavy liftingĒ Iíd like. Iím very tempted to try crossfit since I think it might be a good fit, but am intimidated by the hard-core-ness of all who seem to practice (hey, Iím becoming a surgeon, itís not like I donít have hard core in meÖitís just been misplaced with respect to fitness). Clearly a work in progressÖ
Finally, #3: Mood. This is the most personal issue, and one I really donít want to discuss, but here goes. Iíve had mood issues for most of my life. Probably best categorized as dysthymic disorder. Being happy is the exception rather than the rule in my life, and I hate that. Now Iím still a very productive member of society, and I think my colleagues would probably be surprised to learn this fact about me. Nevertheless, Iíve been on low-dose meds for some time to keep things under control and *stay* a productive member of society. Even with that, I can easily (and do) spend an entire weekend laying around my house because I donít feel particularly motivated to get out of bed or off the couch if I donít have work to do, and even if I can think of something fun to go do, it usually just seems like too much work (too much work to go play? Yes indeed.). And anyone want to guess what my favorite comfort vice is? Food. Of course. How did you guess? Now, I think that a lot of my mood issues are context driven. For example, my move to SoCal a few years ago was a turning point for the worse. For whatever reason, I donít have close friends here that I want to hang out with outside of school/work, whereas I did where I lived before. So, some of these things are in my control and I just choose to ride them out rather than change them immediately. I acknowledge a certain amount of responsibility for all this (yes, if I gave up my medical career Iíd sleep more, get outside more, and worry less), but I also believe that sticking to PB may improve some mood issues if I give it some time. I also have reason to believe that my life context will change in a few months, so thatís probably good news too. Stay tunedÖ
B: 3 organic scrambled eggs. 4 pieces uncured bacon. Mmm. Said ďno thank youĒ to free cupcake with sprinkle frosting made by classmate. WIN.
S: 2 oz nuts and dried fruit.
L: Passed on free anti-PB catered lunch. WIN. Instead waited for green salad with 4-ish oz salmon filet and a sprinkle of goat cheese with EVOO/balsamic vinegar.
Post-stairs fail: 1 square 72% Ghiradelli
D: Sort of lost it with dinner. Way to much of a heap of good things. Small piece of roast beast while waiting for leftover mini-meatloaf to heat up (lamb/buffalo base w/ veggies, coconut flour, eggs and topped with, what else, bacon!), then meatloaf with sugar-free ketchup. Whole avocado. Then frozen blueberries with whipped coconut cream AND a paleotreat macaroon. Then an Athletic Greens smoothie with a splash of almond milk, coconut milk, heavy cream, cinnamon, and a handful of frozen blueberries (no idea what I was thinking). Oiy. Getting full just re-reading this. Oh yeah, and topped it off with most of a square of 86% dark chocolate.
Walk to/from school (~25 min total), Pilates (50 min), losing fight with gravity & stairs (2 sec)