The Healing Power of Farmers Markets

Posted on May 6, 2023 by marylbrandt

Rituals have great power, but some more than others. For me, going to the Farmers Market has become a ritual that is almost as important as the food I buy there. So I spent some time this morning pondering why…

It’s outside. Sun, clouds, breeze. Sometimes a little cool, sometimes too hot… but always the season that matches the fruits and vegetables being sold that day.

There is music. And dancing… people dancing with children, children dancing alone, folks dancing in their wheelchairs.

Everyone is happy. Seriously. Not a dour face anywhere!

There is delight in the colors, odors, and tastes.. It’s beautiful… and that sensual beauty evokes all kinds of good emotions – delight, joy, and even awe.

It anchors you to the season. We don’t have peaches in January at the farmer’s market. So when they show up in May it’s a day of celebration! Eating what is being grown in the season keeps you somehow anchored to life around you and, according to some traditions, is better for your body. It’s certainly better for the planet, since this is food grown within miles of where it’s sold… not half way across the world.

You develop relationships with the people that grow your food. Lisa’s new tortoise gets a spectacular salad every day, so we chat about his salads and her goats. I get to practice my French with the Congolese farmers who grow their produce on an inner city farm developed to provide new refugees a place to farm. Some of the vendors know my name, most of them know and recognize me with a smile (even if they don’t know my name), and all of them are happy to share how to prepare their food and what’s happening on the farm.

And then there is the food. There is no question it’s often (but not universally!) more expensive to buy your food at the farmer’s market, but for the reasons above it’s worth it. But there is one other reason … which is probably the most important reason of all.

How to Harvest and Store Potatoes -- Harvest to Table

Photo credit

One of the very first times I went to a farmer’s market, I bought potatoes. I remember distinctly thinking that it would not be worth the extra money because “it’s just a potato”… but I did it anyway. Every potato I had ever bought in a store tasted the same as every other potato … so I didn’t expect these to be any different. Wow… I was SO wrong. A potato that has been pulled out of the ground the day before you cook it is absolutely amazing. A light went on. Fresh food raised in smaller quantities by people who are devoted to doing it tastes better. It just does.

Plant It Forward CSA shares ready to be picked up

There is most likely a farmer’s market near you if you live in a city, but if there isn’t you have a other options (The USDA Local Foods Directory is a wonderful way to find farmers markets, gardens, and local farms near you if you need help. )

CSAs (Community Supported Agriculture). Google “CSA’s near me” to find farms that make up boxes with small portions of anything they are harvesting that week to distribute to people who have signed up with them.

Community Gardens. If you love to garden (and you can spare a few hours every once in a while) you might want to actively participate – it’s also pretty soul soothing to dig in the dirt and grow your own tomatoes. But it’s also worth asking if you can buy any produce that isn’t otherwise promised.

A local farmer or neighbor who has a big garden. You don’t know unless you ask. Offering to buy some of their produce might end up being a win-win. They may have too much produce, need a little extra income, or both. And you end up with fresh produce and a relationship with the person who grows it!

A Hundred Words for “Tired”

Posted on March 1, 2023 by marylbrandt

It has been said that the Inuit people have a hundred words for snow. When you live in a dangerous environment, it’s important to learn the variations of snow to survive. But, when you look into the origin of the “hundred words for snow”, it turns out it’s not exactly true – Inuits don’t have more words for snow than other languages…Their detailed understanding of snow is a lived, not spoken vocabulary.

The same is true for those who spend nights awake working in a hospital. We, too, have a lived vocabulary that includes hundreds of subtle variations of fatigue, even though we don’t have words to describe them. (The closest I’ve come to being able to describe this fatigue is in “sleep equivalents”, specific events or things that makes you feel like you have had more sleep than you actually did. For example, a shower after being up all night can give you the equivalent of anywhere from 20 to 60 minutes of sleep depending on how tired you are. Brushing your teeth after a hard night of call is usually 5-10 minute sleep equivalent. A good strong cup of coffee can be as much as 45 minutes of sleep equivalent – although it’s important to titrate it so you don’t end up with anxious jitters instead of just being awake.)

Knowing how to manage this level of fatigue it is part of medical training. (Don’t get me wrong… I’m not advocating that trainees must get tired on a regular basis to “learn how to manage it”) Learning to successfully manage the fatigue of long days and nights on call hinges on two things and both have to do with deliberate choices.

Learning not to trust your first instinct if you are sleep deprived is the first important lesson. Even if it’s a drug you know well, or the chest x-ray looks ok, stop and be deliberate. Consciously review the data, look at the options and, for really important decisions, ask someone to look at the situation with you.

The second lesson in managing fatigue is maybe even more important. The bone deep fatigue of medical training is not solely the result of sleep deprivation. When you stay up all night you also lose the liminal spaces of waking and falling asleep, the threshold between night and day. In scientific terms, this means there is a major disruption of your circadian rhythms. But it’s more than just physiology. The drowsy moments between sleep and being awake take place in the liminal spaces of dawn and dusk. We lose more than orientation to daylight when we lose this liminal space. The Irish poet and priest John O’Donoghue, teaches that liminal spaces are moments and places where the spiritual touches the finite. By losing the profoundly important rhythm of rest – including these liminal spaces – we end up physiologically, psychologically, and spiritually unmoored.

You have to be deliberate here, too. By trial-and-error work to find the things that ground you, the things that help you recover in a deeper way than just catching up on the sleep. Make lists of anything and everything that helps you recover from call for the times you are too tired to remember or choose. Look at those lists before you leave for your call day and choose something to do for yourself when you leave the hospital the next day. It might be going to the gym for a light workout, having a great cup of coffee in a cafe, a slow, grateful walk outside, playing with a pet, a hug from a loved one…or finding a way to “play” outside.

May the sacrifice of time and sleep you make for others come back to you as joy … and may you find deep rest in knowing you make a difference in so many lives.

Why don’t we do the things that bring us joy?

Posted on November 16, 2022 by marylbrandt

All of us have a list of things we know we should do every day… and usually don’t. They shouldn’t be that difficult to fit into our day, but we somehow end the day holding our intentions and the struggle rather than the completed task. I’m not talking about the things other people need from you, or the requirements of jobs or school. I’m talking about the things that bring you joy (whether immediate or delayed), things that are really important to you.

Why don’t we do the things that bring us joy? The first step to conquer this paradox is to make a master list of the things that bring you immediate joy (e.g.prayer/meditation, reading, journaling, playing music, calling or writing to a friend you haven’t seen in a while, walking in nature, checking in with older relatives if it’s been more than a couple of days, learning something new, cooking for your family and/or friends) …and things that might be hard at the moment but will bring you joy in the long run (e.g. working out, organizing and cleaning your living spaces, working on a big writing project)

Once you’ve made this master list, acknowledge there is no way you are going to be able to do all these things in a day. It’s important to name these things, to make this list and revise it as new things are recognized… but it’s equally important to acknowledge that you are going to have to make some choices. Pick what you currently think are the two or three most important things on this list and make a covenant with yourself that you will do them “every” day. The “every” is in quotes because let’s be real… life happens. Promise yourself that you will do these things every day, but give yourself grace for the occasional day when it’s just not possible.

Photo credit

Next, pick a way to remind yourself and keep track of your progress:

Schedule them on your calendar. This is probably the best way to do this for most people, but you have to build in a “what if” plan. If for some reason you don’t accomplish it at the time you scheduled it, it doesn’t break the promise you made to yourself. Move it on the calendar, commit to doing it later, but don’t blow it off.

Keep a “routine checklist”. This is separate from any other to-do list you create. This is for you. Not the things you have to do for other people, but the things you are doing for yourself, the things that add goodness to your days.

Morning is best (if you can). There is an adage in finance that you should pay yourself first. In other words, the first thing you do with your paycheck is to put money aside for investment in your future. Time is no different. Doing the important things first, the things that are just for you, is an investment in the day and your future.

The power of streaks. Put an X on a calendar every day, like Jerry Seinfeld or get the app that lets you put the Xs on a digital calendar. (There are other streak tracking apps, too.) Alternatively, create your own visual record of a streak with Excel or a Word document. The power of a streak is that you become more and more invested in not breaking the streak as time goes on.

Final thought. We are all busy, and we are all tired. This era, more than most, is one of being pushed and pulled in so many directions and in so many ways. Take the time to identify the things that bring you joy. If that’s all you do, it will be a good start, because just making that list will make it more likely you will add joy to your days. When you are ready, make a real covenant with yourself, a promise that you will do the one, two or maybe three (no more that three!) things at the top of that list every day. And then, do your best. Give yourself grace when you stumble… and start over.

When a Thought Won’t Let You Go

Posted on February 15, 2022 by marylbrandt

We’ve all been there (yes, all of us). Something happens and we can’t stop thinking about it. It can be a complication, a misdiagnosis, something that happened in a toxic work environment, a failed exam, a harsh word. Not being able to let go of these thoughts means you are a normal person who cares… but it is not comfortable.

It will stop. At the time you are caught in the spiral of rumination, it seems unending. But it can’t and won’t last forever.

You are not your thoughts. There are your thoughts (and this annoying thought in particular) and then there is “you”. Hold that thought (then see below).

Don’t make it worse by yelling. It’s human nature to try to push an uncomfortable thought or image out of your mind. But it doesn’t work. Yelling at yourself (in your mind) because you are not able to move past the thought/event makes it even worse.

Get curious. Berating yourself makes it worse, but there is a way to disarm the thought and even make it go away:

When the thought arises, just notice it.

Wait….if “you” are noticing it, then the thought isn’t “you”.

Exactly.

Every single time the thought arises, say to yourself “I’m thinking about it again.” But – and this is the most important thing – when you notice that the painful thought is back, you have to notice it without judgment. Not… “I can’t believe I can’t let go of this thought.”…or “Something must be wrong with me.”… Just “There it is again.”

Mindfulness. The practice of noticing without judgment is called mindfulness. There are good data that an informal practice of mindfulness helps when we find ourselves with a thought that won’t let go. A daily practice helps even more. Set aside just 10 minutes and sit still. Just notice everything that comes up, acknowledge it, and don’t judge. Ditto for the next thought, and the next, and the next…

Here are some links if you’d like to learn more about mindfulness:

If you only read one thing about mindfulness, make it this book: The Miracle of Mindfulness: An Introduction to the Practice of Meditation by Thich Nhat Hanh

Headspace is a fantastic app to help you learn mindfulness

Mindfulness for Beginners from Psychology Today

National Suicide Prevention Lifeline 800-273-8255. You are precious. You matter. Call if you need someone to talk to.

Shoes to Wear in the Hospital (And Other Tips for Your Feet)

Posted on June 25, 2021 by marylbrandt

Working as a surgeon for as long as I have, trust me, I have learned the agony and ecstasy of foot care. After a long case or after 24 hours on my feet it’s the agony. But I’ve learned how to make my feet happy… and I’ve learned that it’s not that hard.

Shoes

The ideal hospital shoe has a wide toe box, is flat, laced (I’ll get to clogs in a minute), lightweight, slip-resistant, fluid resistant, and can be thrown into the washing machine. You can expect to spend around $100 for these shoes. Don’t get cheap shoes – spend the money!

Although many running shoes meet these criteria, my current favorite shoe is from Merrell, which has been a go to company for me for years. The other major contender right now for favorite hospital shoe among medical students and residents is All-Birds.

Even though I wear lace up Merrells most days at work, I love clogs when I operate. They let me back my feet out of them and lower my heels to stretch my calves. I can kick them off and stand barefoot for a while if I need to change the pressure points on my feet. I had Dansko clogs for years, which are almost a tradition for surgeons, and then changed to Merrell clogs (which are pictured above) Although they are great for standing, the problem with clogs is that your toes have to grip the shoe when you walk (or run to a code), which means they aren’t the best shoes for the rest of your day.

Here are some other options beside running shoes, Merrells, and All-Birds to consider. If you have tried these or have other shoes I should add to the list, please let me know!

Atoms – Great reviews and an amazing story about the owner of the company

Bala Shoes – designed by nurses with consideration for structural differences in women’s feet

Birkenstock shoes

Brooks Addiction Walker

Casca Shoes – This is an interesting company that offers custom fit and a variety of options

Clarks

Columbia Tamiami

New Balance Slip Resistant 626v2 work shoes

Timberland TrueCloud

TropicFeel

A note about high heels…

There is practically nothing worse for your feet than wearing high heels. (Sorry if you love them). If you wear them, please wear them only for special occasions and keep the heels as low as you can. If you are wearing heels in the hospital because it hurts to not wear heels, that’s a huge red flag and you need to really work on it.

Socks

When John Wooden, arguably the most famous coach in the NBA, starts the season by teaching his players how to put their socks on correctly, you can bet it’s important. Don’t skimp on socks. Buy good socks that fit well and take time to put them on correctly.

Compression socks have the potential to change your life. Ok, maybe that’s an exaggeration, but this is one thing I wish I had started earlier in my career. It’s not clear that they do anything to prevent the occupational hazard of varicose veins, but boy do they make your legs feel better at the end of a long day.

Make sure you throw an extra pair of socks in your call bag. There is nothing that feels better than taking your shoes and socks off after 10-12 hours, massaging and stretching your feet (if you have time) and putting on new socks before the second half of a 24 hour call. BTW, the same is true for shoes. Swapping out shoes (if you have two good pairs) is also really nice for your feet during a 24-hour call.

Foot stretching and massage – every day

A friend recently lent me this book which is written by Katy Bowman, with the help of 4 “goldeners” (all older than 70) about what they wish they’d known about caring for their physical wellbeing. Feet are literally the foundation of our musculoskeletal “chain” and unhealthy feet not only hurt, they can affect the function of your kness, hips, and back. Here is the routine recommended in the book to care for your feet. It only takes about 10 minutes and is something you will look forward to doing at the end of the day since it feels so good.

Dorsal foot stretch. Put the top of your foot on the floor and stretch your toes and ankle. Hold it at least 30 seconds and repeat it at least three times. If you get bad cramps (which is normal if it’s tight) it just means you need to keep doing it. Let the cramp subside and start again.
Sole of the foot stretch. Buy this foot massager (or one like it) right now! Stand on it to to stretch and massage every single square centimeter of the sole of your foot. You’re welcome.
Toe circles. Grab each toe separately, pull on it a little and then move it in a circle (both ways) for several rotations.
Toe stretches. Pull each toe away from each other (medial to lateral) then put your fingers between the toes and leave them there to continue the stretch
Toe lifts. Lift your big toe first and work your way up to lifting the other toes as individually and as high as they let you.

As an alternative, if you want a guided yoga practice for your feet, check out this video from the amazing Adrienne Mishler.

Pedicures and Ingrown Toenails

Every time you take a shower, look at your feet with intention. If you have calluses use a pumice stone to take off the layers of dead skin. Don’t let your toenails get out past the end of your toes and never cut them in a curve like you do your fingernails. If you start to get an ingrown toenail, soak your feet twice a day, dry them well, and then wiggle dental floss under the corners of the nail. Leave the dental floss in place until the next time you soak and then put another piece under the corner of the nail. Continue doing this until the nail grows out enough to be cut straight across. Since toenails grow about one millimeter a month, plan on it taking at least a month.

By the way, if you’ve never had a professional pedicure, ask around to find a good place and try it. It’s not just for women, so if you are a man who has never tried this, step out of your comfort zone (no pun intended) and try it at least once!