Health : Taking Care in 2017

Malealea, Lesotho. January 2017.

Like with most transitions, the new started before I really began processing the old. I tend to have some anxiety around New Year's Eve.  I rarely make plans to celebrate it, and then regret spending it at home.  The past few years, the event has been marked by various opposite-of-fun experiences: sleeping through midnight because I had to get up early for a 14 hour shift the next day, wallowing alone in personal woes, and the worst virus of my life (grown-ups, you too can get hand-foot-mouth disease and you will feel like you're dying).

This year, I spent New Year's Eve flying halfway across the world to South Africa, to visit our friend L who is working there in a rural hospital.  After everything that has happened in the world and in my life this past year, it felt fitting to transition while in transit and start the new year in a different place.

It was a little surreal, in that Cape Town really is as much like San Francisco as people say, so it was like being at home very far away.  Then, we traveled to the middle of nowhere, which was far away in space and feeling. And as always, I'm grateful for this spectrum of experience.

Like everyone else at this time of year, I'm in the mindset of considering my approach to 2017. Traveling to South Africa in January texturized a lot of otherwise hazy, mixed-up feelings I had in December.  In reflecting on the themes I've used to focus my life, this trip helped define some of my goals moving forward.

Health:
To get to my friend L's house, we drive a windy, bumpy, unpaved road up a mountain called Ghost Mountain.  Once we arrive, L's dog, a three-month-old Ridgeback named Juba (Zulu for "pigeon"), pummels us with paws, licks and teething bites.  "She's antsy," L explains.  L just broke her right fourth toe and hasn't been able to take her puppy out for exercise.  Once we're able to help her expunge energy on long walks, Juba comes home calm and soothed and instead of pummeling, she snuggles.

I've come to realize that I'm not much different than puppies, and regular exercise is really important to keeping me sane (and snuggly rather than pummelly).  With that in mind, these are my health and fitness goals for 2017.

Daily morning exercise: With the jet lag of traveling twelve hours ahead in time, the disorientation of traveling for 48 hours, losing a day and gaining it back two weeks later, we were often awake much earlier in the morning than I usually am.  I found that I liked it, and that being active early irons out the rest of the day.  So, I will try to:

• Sleep by 10 PM and wake up at 6 AM to exercise for half an hour most weekdays. This also gives me time to actually eat breakfast before work, instead of assuming I'll eat at work which often doesn't happen.

Running: I'd like to incorporate running back into my life in a natural, laid-back way that allows me to experience nature, without becoming a chore or overtaking other things I want to do (which means, no more marathons for awhile).  So, I will try to:

• Run three half marathons. I love connecting to places through running, which is why all my races have taken place in San Francisco, giving me a deeper, different love for my home. This year I'd like to connect to other places in my life. Tentatively this is planned for Fremont (my hometown) in April, Chicago in September (to run with a friend), and Berkeley (where I work) in November.  To get back into it all and to experience another view of my city, I'm starting with the Angel Island 10K in March.

New things: I think we all struggle with finding the balance between trying new things and getting better at the things we already do.  The answer is different among people and changes for the same person at different stages of life, but I think posing the question is similarly beneficial and important to ask.  For me, at a period of transition in my personal life and considering how to re-shape my work (about this below), it's important for me to keep this part of my life steady.  I want to focus on things I already do, but to sustain a forward sense, I want to venture into new parts of them.  So, I will try to:

• In climbing, learn to trad climb.
• In yoga, work on inversions.

Travel:
While travel is unlike exercise in that its clarity often comes from its rarity and infrequent glimpses into different life, I want to sustain it as a regularly irregular presence in my life.  So I will try to: 

• Take shorter trips.  Tentative plans include Denver, Pittsburgh, Chicago, and Olympic National Park.
• Take one more trip abroad.

People: 
When I asked L what she would miss when she comes back to the U.S. after spending so long working in South Africa, she mentioned her sense of purpose.  In light of the current threats to our healthcare system, I'm re-evaluating how best to use my training to advocate for our most vulnerable patients.  So in my work I will try to:

• Advocate. I've seen firsthand the opportunities the ACA has paved for patients, and it's devastating to see these destroyed.  I want to work both within and outside of our clinic to fill these extreme gaps in care, as well as to address the increasingly awful threats to our community's rights and diversity.
• Stay patient.  Despite loving work as much as I did when I started over a year ago, I know I've become more quickly irritable as the workload has increased.  As frustrating as work can sometimes be, the crises facing healthcare now remind me how much more instability our patients face and we need to provide them with as much stability as possible.
• Deepen skills in mental health. I've been lucky to attain additional training this year in providing psychiatric care in the primary care setting, and would like to make this more common across health systems.  Especially as the scarcity of mental health resources is only going to get worse.

Reading:
As an English major in college I averaged reading a novel a week.  Then residency happened and I can probably count on two hands the number of books I read during those three years. In 2016, I read 51 books, and though these books mostly completely unrelated to medicine, I've learned so much about patient care and caring for myself.  So this year I will try to:

• Read 75 books.  This means listening to audiobooks on my commute instead of radio talk shows, and reading at night instead of watching bad TV.  I'm committing to putting my computer and phone in a separate room from 9-10 PM so that I can do this.

Now a month into 2017 and seeing the depth of the challenges we all face personally and as a community, I feel strongly the need to continually return to this concrete structure.  I hope that everyone is taking care of themselves in these hard times, and finding the balance between seeing the world beyond our daily lives and living our daily lives in a healthy, sustainable way.