Late Start

Once each week, my day starts later than the usual 7 or 8am call to duty, shifting clinic into the evening hours to improve access for patients. I have used these precious moments in a variety of ways, some more productive than others. There have been magical mornings filled with extra snuggles, elaborate breakfasts and bonus workouts, sending me to clinic relaxed and fulfilled. There are occasions, however, where I have felt unsettled, anxious and even guilty in this free space. This often escalates into aggravation as I drive to the office, lamenting a wasted opportunity and wishing I had just started the workday at its usual time. Through all of this, I am acutely aware that many are not granted the opportunity for gratuitous hours to start the day and recognize that what I should most feel for the time is appreciation.

Rather treating the symptoms by masking the emotion, however, I seek the root cause of these adverse reactions to what should be a positive situation. Why the struggle with free time? Drawing on my medical training, seems appropriate to develop a differential diagnosis:

Busy has long been my tempo. Moving from one activity to the next, checking items off of a to-do list, looking for the next-thing – I am used to go-go-go so when I don’t find the same rhythm in the early hours, I simply feel “off.”

I allow my own perception of how others view time to influence my feelings of deservedness, rendering myself subsequently unable to enjoy the morning.

The paralyzing overwhelm of countless tasks awaiting completion makes “something” seem inadequate but in an ironic turn leaves the even more disappointing “nothing” in its place.

Having identified potential sources, which all seem at least partially relevant, and wishing to dwell in solutions rather than problems, development of a treatment plan seems the best next step.

“Busy” has been highlighted in the media in recent months as a disease of modern culture. I have struggled with this because I truly feel that through much of my life I thrived in the setting of consistent activity. I have not felt burdened by juggling multiple tasks or keeping the calendar full. In context of the difficult unfilled hours I have experienced with my late starts, however, I have seen that busy, though often full and productive, can unsuspectingly become pathologic. From this, I will view the unsettled feeling as the canary in the cave – a warning sign that busy has overstepped its bounds, that the productive has pushed out the pleasure and it is time to take a deep breath and replace the commotion with calm.   While active will most likely characterize my days, it must also encompass the ability to feel ease in life’s moments of dynamic stillness.

Having long been sensitive to the thoughts and “judgment” of others, learning how not to have this negatively impact my experience has been a life-long struggle. Countless times my dad would quote Eleanor Roosevelt and remind me that “No one can make you feel inferior without your consent” but it seemed I had signed a global release early-on in life. I have been encouraged as I make my way through the works of Brene Brown in recent months and am finding myself making the shift from managing perception to practicing shame resilience through courage and compassion. From this, I am learning that the best I can do is encourage others in their opportunities and begin to better own mine.

One of the most powerful lessons of residency training was time and task management. We simply could not do everything for every patient in a single visit. Prioritizing, sequencing, making notes for their follow up were all methods used to acknowledge and address concerns within the realistic time frame available. I have used on more than one occasion a quote from Edward E. Hale in my lectures when speaking to the incorporation of OMM into routine care of patients for its context and convenient ending with DO:

I am only one, but still I am one

I cannot do everything, but I can do something

And because I cannot do everything

I will not refuse to do the something I can DO

Similarly, CrossFit Endurance programming has reframed my approach to the time/value equation in the gym, enabling me to make greater gains with less time and converting previously useless minutes into meaningful training opportunities.  From this, I am encouraged to conquer the overwhelm and recognize that something (even that something is doing nothing!) can be more than everything.

And so, just as my patients leave the office with tasks intended to maintain improvements from treatment, I will look to these tools if the triad of unsettled, anxious and guilty creep their way back into my late starts.  Today, I am simply grateful to have had the time to complete this entry.

May we preserve the best of busy, break free of the limitations of perception and see through the overwhelm to opportunity, finding ease in the dynamic stillness of life’s extra moments.



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