Wellness Ideas:

Hard work of being lazy:

• Post on Book of Life on the importance, and seriousness of being lazy.
“By contrast, the easy bit can be the running around, the never pausing to ask why, the repeatedly ensuring that there isn’t a moment to have doubts or feel sad or searching. Business can mask a vicious form of laziness.The point of ‘doing nothing’ is to clean up our inner lives. The heroically hard worker isn’t necessarily the one in the business lounge of the international airport, it might be the person gazing without expression out of the window, and occasionally writing down one or two ideas on a pad of paper. They go to every conference, but don’t get around to thinking what their work means to them; they catch up regularly with colleagues but don’t consider what the point of money might be. Their busy-ness is in fact a subtle but powerful form of distraction.”
• Can’t speak for everyone, but this sounds like me on many days. Give yourself some quiet time in a room alone to digest life. 

Bird By Bird:

• When going through books and deciding what is worth keeping, you come across some books that just have too many profound passages. Instead of jotting some notes down, you just buy a few more copies of the book and start passing them out to friends. One such book is Bird by Bird, by Anne Lamott. Tim Ferriss recommended it, and I spent a few weeks savoring the first 1/4, then devoured the last 3/4 in a day. 
• It is a book about writing, but also about making sense of life’s narrative. Lamott is funny but subtly taps into life’s transcendent moments. Check out this story of giving, credited in Bird by Bird to Jack Kornfield. 

Compassion Cultivation:

• Congrats to UL School of Medicine folks on this article in BMC Medical Education: Compassion cultivation training promotes medical student wellness and enhanced clinical care, by Laura A. Weingartner Susan Sawning M. Ann Shaw and Jon B. Klein. 
• They describe lessons learned in three years (45 students) of the Compassion Cultivation Training course at UofL. The course targeted behaviors to be used clinically, but benefits extended beyond this goal. Many students appreciated the tools for dealing with stress and personal relationships. 

Exploitation:

• You probably didn’t miss this article in the NY times by Danielle Ofri, a physician with writing focus on the medical humanities. She argues that the healthcare industry depends on exploitation of doctors and nurses. 
• Here is the Happy MD’s take on the topic. No surprise, he agrees. The purpose of any business is to “wring every last drop out of your limited resources to maximize the ROI.” He lists reasons this occurs, and Ofri and he blame our acquiescence on out send of responsibility. 
• Drummond gives a couple anecdotes on exploitation, links to his awesome post on how the EMR was meant to be a simple staffing issue, and gives some guidance on how to overcome this “phase” in healthcare. 

Beast: 

• You can have the impressively long cold or hot time of a Yeti mug for half the cost. Many cheaper versions are out there, but The Beast is the best one I have used. The lid is actually leak proof, and the whole thing is dishwasher safe and easy to clean. 

Coffee Hack:

• Ok we have had no shortage of coffee posts on PofW, but any way to consume more coffee safely should prolong our lives. New thing we are doing at the Huecker house is mixing caffeinated beans with decaf ones 50:50. Drink twice as much life-giving coffee, and no palpitations. Highly recommend. But you have to buy quality decaf beans, which is difficult. The Amazon brand is good, and locally Quills and Sunergos have good decaf beans. 

Student Grades:

• Whether you are a medical student or someone who might be curious as to how medical students are graded, this new article in Academic Medicine is enlightening. They surveyed 319 faculty at 5 academic medical schools. The top five characteristics for a student to get the highest grade (Honors) were taking ownership, clinical reasoning, curiosity, dependability, and high ethical standards(in descending order). Onedeals with smarts.
“Twenty-one characteristics fit into three factors Clinical reasoning did not fit into a factor. Factor 1 was the most important (mean rating 8.7/10 [95% CI, 8.6–8.8]). It included professionalism components (ownership, curiosity, dependability, high ethical standards), presentation and interviewing skills, seeking feedback, and documentation. Factor 2 (mean 7.9 [95% CI, 7.7– 8.0]) included aspects of teamwork and communication, such as positive attitude and comments from others. Factor 3 (mean 7.6 [95% CI, 7.4 to 7.7]) addressed systems-based thinking, including patient safety and care transitions.”
• I believe these characteristics apply to residency and non-healthcare settings. We do admire competence in coworkers, but at the elite level most people are competent. You  want someone who is a team player. Check out the article for a deeper dive. 

Stuffy:

• Washington Post article on the science behind that sluggish feeling you get at the end of a long meeting or class. An astronomer measured carbon dioxide levels in a meeting room with 100 people for a few hours. The CO2 level in the room exceeds the ASHRAE recommended indoor limit after 30 minutes. The article cites studies showing worsened cognition / decision making with these high levels.
• So open some windows or the door today, or stop outside every 30 minutes. 

Exercise:

• The old post Crossfit in 100 words might be the most concise nutrition/exercise recommendation in the past 100 years. The last sentence is: Regularly learn and play new sports. This is not terribly easy for busy professionals, but it can be done.
• We recently made it into Climb Nulu to see how this bouldering thing works. The monthly family membership is about 2x the cost of an individual, which is hard to pass up when you roll with several kids. 
• Bouldering does not use ropes, and become pretty intense when you reach the top of the wall and have trouble finding a path back down. It is a full body workout in addition to the mental sharpening effect. You will develop grip strength (which is associated with longevity), arm and leg strength, and like any bodyweight exercise, you send a signal to your body to get lean. Give it a shot Withington.
• Just try not to fall the wrong way, or you may break an ankle or wrist. Respect the wall and take it slowly. 
• Thanks Mateo Bernal for persistence to get us into the climbing gym. 

Saints and Sages:

• Another deep passage by the great Jonathan Sacks. He pulls from Maimonedes on the idea that one can be noble or holy in different ways. 
• The Saint is the hermit who leaves the world for an ascetic life of prayer – noble, difficult, and extreme. But the Sage is a person of moderation, who observes the golden mean/middle way of balance. The Sage does not go to extremes, “knowing the twin dangers of too much and too little.” 
• Sacks says these are “not two types of person, but two ways of understanding the moral life itself.” Does being moral mean personal perfection, or creating gracious relationships and a decent, just, compassionate society? Sacks says one person cannot have both, at least with the same behavior. Eventually he admits Maimonedes really did practice both behaviors, acknowledging the contradiction. Paradox anyone? 

Thanks
BY W. S. MERWIN

with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
standing by the windows looking out
in our directions

back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you

over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you

with the animals dying around us
taking our feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
thank you we are saying and waving
dark though it is


 W.S. Merwin, “Thanks” from Migration: New and Selected Poems. Copyright © 2005 by W.S. Merwin.  Reprinted by permission of The Wylie Agency, Inc..