Let It Be Simple

If you missed last week’s email, the TL;DR is that I’ve been sad lately.  Specifically, I’ve been sad, terrified, ashamed, and embarrassed.  If you’re curious about all the gory details, you can find them here: Anger.  Fury.  Rage. Once I figured out that the anger I’d been stuck in for weeks was sadness, I was able to process it and not get over it, exactly, but at least it stopped looping in my brain and taking up all of my time and energy.  I looked at all the things leading to my sadness and could figure out what, if anything, I wanted to do about them.  While I was marinating, a piece of advice I’ve heard from master meditation teachers came to mind: let it be simple.  Life coaches have turned this advice into a thought exercise: how can I make this simple?

Last week, I slowed down to figure out why I felt so badly, which was pretty clarifying. Instead of everything being wrong everywhere, I saw only four things driving me crazy.  Well, figuring out four things is undoubtedly much more straightforward than sorting out everything everywhere.  I was able to get focused.  I could shift my energy to those four things and let myself be “good enough” everywhere else.  One of the work-related things I was feeling poorly about was not being able to make critically ill children healthy quickly.   I was on service last week, so writing notes would need time and energy.  Writing notes wasn’t one of the work things I was feeling bad about, though, so I let them be good enough.  I didn’t re-type everything to make sure the grammar was correct.  I didn’t spend time making sure my punctuation matched.  For those who use Epic, you’ll know what I mean when I say that I used dot phrases liberally (and created more when I noticed I was typing the same sentences repeatedly despite my already long list of dot phrases).  My notes were good enough.  I had fantastic learners with me on rounds, but teaching wasn’t something I was feeling bad about.  So, I let my teaching be good enough.  Then came time to tackle what I felt terrible about: my shame that some of my patients were not getting better, no matter how many things I tried.  How could I make that simple?  Here’s the tricky part: just because something is simple does not mean it’s easy.  By letting everything else be “good enough,” I was able to have more space in my brain (and honestly, my emotions) to do the simple hard thing: I told parents how sorry I was that their children were just not getting better in the way we had all hoped.  I was honest about what we would try next, but equally honest that those things might not work and we may have to start planning for the worst.  And what happened?  None of the lovely parents of my critically ill patients blamed me.  They didn’t blame anybody.  They let me into what they’ve been going through as a family while waiting, hoping, and praying for their child to get better.  Some families showed me their resilience.  Some families showed me their pain.  I was open to the entire human experience, including my own.  It was hard.  But it was also really simple.

Another of the four things I had to figure out was caring for my grandma from afar.  She still lives independently despite some family objections.  Her deep stubbornness is part of what’s helped her live independently this long.  It’s tough to help stubborn people.  How did I make helping my grandma simple?  I let go of the shared decision-making my ethicist self had been trying to use and started notifying her of what we’d be doing to help her stay safe in her home.  When she protested, I’d remind her of the data we’d gathered that safeguards were necessary: forgotten medicines, the dust that covered every surface and could make her asthma flare up.  When she’d get frustrated and accuse me of things she knew to be untrue, I refused to let her bait me into a fight.  Talk about the simple action not being an easy one.  We hired a home health aide and housekeeper and notified her that we would try them out for two or three months, and if she had problems with them after that, we’d figure something else out.  The other way I made this situation simple is by building the time trial into it: stakes feel high if I’m making decisions that will last forever, but decisions don’t feel so serious when I realize that I can always figure something else out if what I’ve decided isn’t working.  I’m anticipating that my grandma will love having these people around, keeping her company, helping her go shopping, and keeping her house clean, so much so that I won’t even need to remind her when the two-to-three-month reassessment mark comes up.  It’ll be her new routine; she’ll love it, and we’ll question why we didn’t hire help sooner. 

What are the three or four things that are bothering you right now?  Maybe when you drill down, it’s not even three or four things: it’s just one or two.  Take each of those things and ask, “How can I make this simple?”  You may be surprised by all the possibilities you come up with.  But our brains also love routine and want to hang onto the status quo (even when it’s painful), so your brain might answer, “I don’t know.”  Sometimes, our brains would rather keep us in a painful status quo than risk novelty.  So if you ask, “How can I make this simple?” and your brain answers, “I don’t know,” ask it, “Well, if you did know, what would the answer be?”  It’ll start coming up with suggestions you can begin to try out.  Let your notes be “good enough” while you commit to coaching up the residents you’re rounding with.  Nobody will notice that your notes aren’t up to your standard.  Have a hard, honest conversation with a loved one after you’ve spent months being polite but have gotten nowhere.  You might be surprised to learn that your loved one has become exhausted from being polite, too.  You don’t have to solve every problem everywhere.  The reality is that you can’t, no matter how efficient, how intelligent, how big-hearted you are.  So, narrow it down.  And then make it simple.