What an incredible photograph of this nascent star and it’s protoplanet WISPIT2b, 437 light years from earth. It’s worth sitting with this image for a minute to “right-size” what it means to be one of 8,283,368,818 people on our planet (as of the time I am writing this).
“Often there is a lot of self-doubt for people at my career stage,” she says. “I hope this discovery helps others to realize that while they might not know it all yet, they still know enough to do big things.”
Chloe Lawlor
Better than counting sheep
If you find yourself tossing and turning as “to dos” flash through your brain at night, you might want add a “worry window” to your schedule. The technique, as described here, is based on stimulus control training.
There are three simple steps:
Schedule a deliberate, but short (10-15 minute) time to “worry” in the late afternoon or evening. Set a timer.
Make a list of what is occupying your attention (i.e. causing you to worry)
For each thing on the list, decide on a small action you will take the next day.
According to the authors, this technique may not work at first, but stick with it – after 2 weeks you should see a difference. If worries pop up as you start to doze off, they suggest using the same response every time – “I have a plan. It’s in the notebook. I’ll deal with it tomorrow.”
How to be a Dinner Fairy
Something I do when I’m making plans with friends who have little kids… I pre-order Door Dash to their place for it to arrive after bath- and bed- time. This way, my friends don’t have to deal with the hassle, expense, and chaos that comes with hiring a sitter, plus free dinner! I get to see their kids for a bit, and we can all have adult-time. Yes, it’s very empty-nester-fairy of me, and I love doing it.
There are surprisingly a lot of interesting items here – particularly for travelers.
How to fall asleep
My go-to when I am having trouble falling asleep is Nothing Much Happens, a podcast which you can find on all the platforms. . There’s a reason that parents all over the world read to their kids to help them fall asleep…it allows your brain to detach from thinking just enough to quiet down.
If that doesn’t work for you, this recent article in the NYTimes makes a good case for using a Kindle (instead of your phone) to read before bedtime.
I came across this story in Annabel Abbs-Streets’ book about walking and I was intrigued. I suspect there is more to the story about how EMDR (which is an effective treatment for PTSD) was developed, but isn’t this wonderful?
“In 1987, Dr. Francine Shapiro was walking in her local park when she noticed that the simple process of scanning the landscape made her feel calmer and less anxious. After years of research, she developed a therapy that mimicked this process but could be used indoors by therapists making a series of hand movements. The therapy—known as EMDR, eye movement desensitization and reprocessing—has been successfully used on thousands of people with PTSD and validated in over fifty studies. But its success is rooted in eye movement, something that happens involuntarily as we stroll.”
I recently was invited to a meeting where a group of residents and educators were tackling the topic (and reality) of resident fatigue. We started by reviewing the ACGME Program Requirements. When it comes to mitigating fatigue, the ACGME requirements are (in my words):
Teach residents and faculty how to recognize fatigue, why it’s dangerous, and how to mitigate it.
Make sure there are adequate places in the hospital to sleep when residents are on call.
Arrange for alternative transportation for residents who are too tired to drive home.
They also list some strategies for mitigating fatigue; “…strategic napping; the judicious use of caffeine; availability of other caregivers; time management to maximize sleep off-duty; learning to recognize the signs of fatigue, and self-monitoring performance and/or asking others to monitor performance; remaining active to promote alertness; maintaining a healthy diet; using relaxation techniques to fall asleep; maintaining a consistent sleep routine; exercising regularly; increasing sleep time before and after call; and ensuring sufficient sleep recovery periods.”
All of these are great ideas, but it’s important to realize that there is an assumption behind them which is that fatigue is physical, and mostly the result of sleep deprivation.
As someone who survived surgical training prior to the 80 hour duty hour regulations and who practiced for a long time, I know from personal experience that although sleep is foundational, there are a lot of different ways to be tired. It is true that physical fatigue, particularly sleep deprivation, is the primary reason residents, practicing physicians, and other healers are tired. But it’s not the only reason. Saundra Dalton-Smith, MD has thought deeply about this, and thinks there are seven different kinds of tired.
It should be obvious, but it’s worth stating – to get to the top level (where you can achieve your full potential) you have to start at the bottom. If you are hungry, thirsty, or scared you aren’t ever going to be able to give or receive respect and appreciation. And without meeting the four levels of need below the top level you won’t be able to fully show up to heal patients and contribute.
I think most of us would agree that the soul crushing fatigue that comes with recurring moral distress is worse than the fatigue of a non-stop beeper when you are on call, which is worse than the fatigue you feel after an hour charting in the medical record.
So I took Shapiro’s model and asked this – What if fatigue can be thought of as a hierarchy? If the model makes sense, like Shapiro’s work, it should be able to guide us as we work to mitigate fatigue for our trainees.
It’s a draft, but a new idea I think is worth exploring. Let me know what you think.
I read a fascinating study1 this morning (thank you to @docmom61.bsky.social for the link!) For those in medicine, you know why this paper on call schedules and sleep deprivation is important … because you’ve lived it.
This study prospectively compared two groups of residents working in pediatric ICUs who were assigned to two different call schedules. The cool science here is that they modeled different schedules to choose which one to test against “the way we’ve always done it”.
The first group (EDWR) was, in effect, the control group, since they were put into a traditional Extended Duration Work Roster (24-28 hrs of continuous call with up to 88 hours/wk of total call). The other group (RCWR) was assigned to a Rapidly Changing Work Roster with variable lengths of call designed to limit extended call hours . (“…scheduled continuous duty hours limited to 16 hours (RCR-16) consisting of a short day shift (7:00-15:00), a long day shift (7:00-22:00), and a long night shift (21:00-13:00).”)
The RCWR is not a schedule I’ve seen before, but it does make sense. More importantly, it’s based on mathematical models, not fingers on our hands or days in a week!* For anyone who has seen the unintended consequences (emotional as well as physical) of the isolating night float system, anything new to consider is a welcomed alternative.
Here are my takeaways…
Total amount of sleep in the week (regardless of the schedule) was associated with less impairment. Focusing on more sleep is always the right answer if you are a physician, physician-in-training, or other healer.
It was a little easier to get more sleep on the RCWR schedule. The big picture here is that we need to be able to think out of the box when it comes to call schedules. Just because it has “always been this way” doesn’t mean it’s the right thing to do.
There was a lot of variability (for many reasons, all discussed in the paper) This is hard science to do, but important.
*Lest we think we choose numbers in medicine scientifically… have you ever noticed that we usually prescribe antibiotics based on American football scores? (Think about it… just where did our standard 7, 10, 14, or 21 days come from?)
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.
Every year about this time I put out a list of the best presents for folks about to start medical school, nursing school, physician assistant school or any medically related school … as well anyone “leveling up” to the next level of training in their field (i.e. internship, residency, fellowship, etc). This is my edited post for 2023. I hope it gives families and friends ideas on how to support the people they love who are learning how to heal.
The Gift of More Free Time
The everyday needs of a household can become oppressive if you are working 80 hours a week. And, because bathrooms need to be cleaned, and floors need to be vacuumed, this is time that takes away from downtime needed to recover from hard work.
Here’s a list of things that just about every healer or healer in training would appreciate to help free up time:
A cleaning service. Hire someone to do a “deep clean” of their home once a month. Look on the internet for bonded cleaning services or call people who might know the best companies.
Car washes. Who doesn’t love a clean car…. and who has the time to wash and vacuum their car?
Instant Pot. The number one time saving kitchen appliance for busy people is the Instant Pot. My Instant Pot has fundamentally changed the way I cook – and has made it easier to eat well.
Air Fryer. I’m a new convert to air fryers. 15 minutes to get wonderful roasted or air fried veggies is amazing! Hard to choose between this and the instant pot. There is an instant pot with both, but I’m not sure it does quite as good a job as an air fryer.
Gift certificates for food. Do a little sleuthing and find a healthy grocery store near where they live. Other ideas might be a smoothie or juice shop, their favorite restaurant(s), or coffee shops
Prepared meals. Most cities have small, local companies that deliver prepared meals to your door. That would be my first choice (support local!) but there are also national companies and do this, too. Most companies offer gift certificates which is probably the best plan to give flexibility between a subscription or a la carte ordering.
Home cooked meals. If you live near, think about cooking a batch of favorite food(s) and putting them in single serving containers to freeze. You might also want to create a certificate for your personal “cookie/meal/soup of the month club” with a promise to deliver food once a month.
A Good Cookbook. Mark Bittman’s cookbooks are all wonderful, but How to Cook Everything Fast is a particularly good choice for busy people.
Vitamix. It may seem expensive for a “blender”… but this is much more than a blender. These are the blenders you see in professional smoothie stores. Smoothies become a lifesaver for busy healers. (The Vitamix also makes great soups, sauces, etc…..)
The Gift of Good Beverages
Insulated Coffee Mug. Rounds in the morning often starts with “running the list” around a computer, often at “dark thirty” when the rest of the world is just thinking about getting up. Having good coffee or tea from home or a local shop that stays warm for several hours is such a pleasure. The mug of choice for just about everyone I know is a 10 or 16 oz Yeti tumbler.
Water Bottle. No one drinks enough water at work in the hospital (and we all agree on this). Again, having a great water bottle that you can fill in the morning with ice water (and a slice of lemon if you like) makes the day better.
Nespresso (or other) coffee maker. If they are a coffee drinker, a good coffee maker is key. Nespresso is my personal favorite, but be creative and look at all the options!
Good coffee (or tea). There are local roasters in most cities, so rather than support the big chains, look for them and consider a gift of coffee.
The Gift of Music
For those who find solace and joy in good music (and isn’t that just about all of us?):
A good Bluetooth speaker for their home or study space. I love the Klipsch The One II speaker I have at home, but I’m sure there are other equivalent speakers, including some that aren’t as expensive.
Air pods or noise cancelling headphones
A subscription to one of the many streaming music services like Spotify or Apple Music.
Tickets to the symphony, ballet, jazz performances, or opera in the city where they live.
The Gift of Good Sleep
Good mattress, pillows, sheets. How we sleep determines how well we function the next day, particularly in high stress jobs. Is it time for a new mattress? Is there a better mattress that might help? High quality sheets are usually a welcome gift, too.
Light blocking curtains or shades. Post-call sleep is during the day and sunlight can interfere with sleep. Special curtains or shades to block the sun really help.
Nothing Much Happens. This is a free podcast with the subtitle of “Bedtime stories for adults”. Since it’s a present, think about supporting this wonderful series with the very cheap subscription (which means you get the stories without ads.)
The Gift of Healthy (and not aching) Feet
Working in the hospital means a lot of time on your feet. John Wooden, probably the most famous basketball coach of all time, spent the first week of training every year teaching his players how to put on their socks…. because he recognized that if you didn’t pay attention to your feet, it would affect your game. The same is true in medicine.
Good socks. Don’t go for cute, go for high quality, well padded, and functional.
Compression socks. There is some debate about whether compression socks can really prevent varicose veins, but there is no debate that your feet feel better at the end of a long day when you wear them!
Pedicures. Lots of women (and some men!) have learned the joy of a professional pedicure for tired feet. Don’t underestimate the power of a gift certificate for pedicures. But, as an alternative, put together a kit for home pedicures.
The Gift of Fitness
This might not apply to everyone, but most people who work hard know that they feel better if they exercise a little every day. But – a word of caution – tread lightly with fitness gifts since they can be misinterpreted as conveying a “need” to exercise.
A bicycle. For many people a good bicycle can make it easy to add some exercise by commuting to work by biking instead of driving. Regardless, it’s a great way to get some exercise outside. If they have a bike they use to commute, you might think of some ways to make it easier such as
A gym membership. You may have to do a little detective work to find the right gym that is close to where they live, but it’s worth it.
New shoes. Runners are supposed to get new shoes every year or so. Give them a gift certificate from a running store near them, if there is one. Or, be creative and put cash in a tiny toy shoes and wrap them in a shoe box.
Fitness equipment for home. Resistance training is important for all of us, regardless of gender or age. Although a bench and weights are part of the classic home gym, they take up a lot of room (and weigh a lot!). I’m a big fan of the TRX system, which makes a great present. Since it has become almost a cult among physicians during the pandemic, I have to at least mention Peleton as another potential fitness gift for healers and healers in training.
The Gift of Calm
Massage and/or Spa Services. This, too, may take a little effort to find the right place, but this is a wonderful gift for stressed people.
Headspace. This might seem a little unusual as a gift idea, but I can’t recommend it enough. Meditation is discussed in most medical schools and hospitals as a tool to gain insight and recover from the depletion that is part of the work we do. The best way I’ve found to learn this practice, and then stick with it is Headspace, which is a great app. The first 10 lessons are free, but for a gift, go ahead and get the annual subscription.
The Gift of Time and Stories
Human beings heal their hearts and souls by telling stories. Although there are many stories your loved one can’t tell you (at least not the specifics) you can totally ask how what they are seeing and doing is making them feel. Set aside some time for a coffee or another beverage and ask – with intention – “How are you doing?” And then just listen. Don’t try to “fix” anything … just listen.
Along the same lines, think about a letter… yes, a handwritten letter or note. Maybe a long one for a specific holiday or birthday, maybe a series of shorter ones through the year. Imagine how you would feel after a particularly hard week if you had a letter to reread that talked about how proud someone was of you, filled with funny stories and words of support.
Every year about this time, I try to put together a list for people trying to find the right gift for someone they know who is graduating from medical school.
If you haven’t heard of @medgradwishlist on Twitter, it’s an amazing grassroots effort to create Amazon wish lists for URM medical students with financial needs to help them get ready for their internship. This is a brilliant “pay it forward” initiative. I’ve been a Program Director and a Dean of Student Affairs and I know how many new grads finish medical school with enormous debt and empty bank accounts. The ~17,000 students graduating from medical school this year are about to start on the exciting – but stressful – path of becoming a physician. Not being able to afford the things that make that journey possible just isn’t acceptable. You can buy things on their list anonymously (or not). When you find the right thing for the right person, don’t forget to include some memories of your internship, advice, and words of encouragement!
If you are a student (or even a struggling resident) in need, please join this effort to get what you need. We are sure you will pay it forward to extend this support future classes! If you are a student who can afford to support others, please do. And regardless of whether you participate in #medgradwishlist or not, the following ideas will help with graduation presents.
I spent quite a bit of time looking at all the #medgradwishlists on Amazon, and I’m happy to share what I learned. In addition to their great ideas, I have some suggestions to add…
Instant Pot. This was on a lot of the Amazon lists, and I agree!!! II had to suggest one item to make life as a resident easier, it would be this. Several people asked for air fryers on their Amazon lists. I love my air fryer and use it all the time so please put it on your list if you think it will help. Just as an FYI, you already (sort of) own an air fryer since your oven set on convection does close to the same thing!
Someone to help clean and do laundry. I know you can’t put this on an Amazon wish list, but if you have a family member who either can do this for you, or pay someone to do this for you, it’s one of the best gifts you will ever receive.
Digital gifts to make communicating and studying easier. The single most important tool for an intern is their phone. If they don’t have a new phone that can reliably work with WIFi and cellular, this should be at the top of the list. A computer that works, has the ability to do streaming well, and is reliable is also key since it’s how they will study, write, and watch educational videos. They’ll want the flexibility of studying in a coffee shop (once we get COVID19 under control) or on their couch so make sure it’s a laptop and not a desktop computer.
There were some great ideas on the Amazon lists for items that aren’t quite as expensive as computers that you might consider as well: ring light for Zoom meetings, LED study light, lap top desk for your lap, iPad Pro, Apple pencil.I should add that buying a large quantity of pens to be “borrowed” by attendings would be a big win, too.
The kitchen (other than the Instant Pot). It’s so important to eat well when you work as hard as interns work (and to stay well caffeinated). There were some great ideas from my new colleagues on their Amazon lists including single serve coffee makers, pot and pan sets, nonstick bakeware set (if they are a baker!), wine opener :-), food storage bags and containers. A box or two of Kind Bars (my favorite) or other meal replacement bars is a great gift, too. And for the times cooking is just one task too many – Door Dash, Uber Eats, and/or Grub Hub gift cards are a great gift. One other must have… a Yeti mug to keep coffee hot during rounds!
Clocks and watches. We all have phones that can serve as alarm clocks, but an alarm clock that gently lights up the room is a much better way to wake up than sudden noise. I wouldn’t say an Apple watch is essential (and if you do a lot of procedures it might be easy to lose) but it is worn by a good percentage of docs.
USMLE3 study book. If you are a family member who is thinking about getting this as a present, you might also want to include a check for $895 as a “bookmark” to cover the cost of registering for this exam.
Make your home a stress-free zone. If you are setting up a new home, this list can be really extensive. You’ll need to go home to a clean, happy space, so whatever you can do to make that happen is important. There were a lot of good ideas in the Amazon wish lists including self-cleaning cat boxes, pet hair removal brushes, furniture, shower curtains, towels, and a video doorbell. I’d add a Roomba vacuum cleaner to this list, too! BTW, a good TV is important, too. We all need to binge watch the Great British Baking Show as therapy sometimes.
Sleep. In this category I would include good quality pillows, a new mattress, light blocking curtains, white noise machines, and electric or weighted blankets.
Music. Most people fill their space at home with sound as well as light, so think about good WiFi speakers like Sonos and/or gift certificates for ad-free music services like Apple Music, Spotify, Pandora.
Health. Last but not least! The most important thing on this list in my opinion is a great water bottle since, particularly with masks on all day, none of us drink enough water. A new Sonicare toothbrush or WaterPik for dental health will be appreciated. Foot care is another important part of being a healthy resident, so consider gifting compression socks, new shoes for the hospital, work insoles and/or a foot massager. Anything that promotes or makes fitness easier is also a good gift – a new bicycle for commuting, workout gloves, free weights, resistance bands. You might also consider a meditation app like Headspace, or subscription to yoga classes on line.
Scrubs. I noticed a lot of folx asking for scrubs. Nope – don’t do it! You will be required to wear the scrubs from the hospital since there are rules about them being washed in the hospital laundry. Ditto for things to wear under scrubs. You’ll get too hot, they get dirty, and they are against the rules in all operating rooms (and many hospitals)
Textbooks. You are pretty much guaranteed to have access to a library where these books will be in digital format and free. These books are heavy! You aren’t going to take them to work and when you get home, you may have other things to read that take priority.
Printers. Printers (and printer ink) are expensive and you just won’t use them. You are going to have to stay digital to really learn what you need to learn as a resident. Besides, if you do need to print out the return slip for Amazon, there will always be a printer at the hospital you can use!
Black bag. If you are a family member thinking of getting one of these… don’t.
May your journey through this liminal time be as stress free and as joyful as possible. May every day as an intern bring you hearts to heal and hands to hold, new learning, and a sense of wonder and awe.
We are so happy you are joining us in this noble and sacred work!
Every year about this time, I create a list of presents I think busy healers (and healers in training) would appreciate. I don’t have to tell you that this has been a year that for all of us, but especially for everyone in medicine, has brought a new level of stress and sadness. The healers need healing… and in that spirit, here are some ideas of what you can send your friends in medicine for Hanukkah, Kwanza, Christmas, the Winter Solstice… or to celebrate the end of 2020 and beginning of a new year of hope.
#10.White coat, jacket and/or scrub “bling”. Everyone who works in a hospital has a badge that must be worn all the time. And we all need pens (except for the attendings… we just “borrow” pens that students and residents keep in their pockets for us … just kidding … mostly). Here are some suggestions: Find a lanyard or badge holder from their favorite sports team or that will otherwise have meaning for them. Buy a box of cheap pens (that can be given away to needy attendings) + a great pen that will remind them of you every time they write with it. For white coats, find a meaningful or humorous pin that could be worn on other clothes as well.
#9 Happy Feet. Think about putting together a “happy feet” box – include things like warm slippers, good socks, a certificate for a pair of shoes to wear in the hospital, compression socks, toenail clippers, and any other foot care products that sounds right.
#8 Better sleep. Sleep can be hard if you have had a really hard stretch at work. It’s especially hard if you’ve worked all night and have to sleep during the day. You can put together a combination of gifts like new high-count sheets, eye covers and ear plugs for sleeping after a night shift, a certificate for a new mattress, a white noise machine or a weighted blanket.
#7 Work food. Busy students and residents frequently miss meals. Think about creating home made “snack packs” for the hospital by combining options like nuts, dried fruits, and high quality candy into small zip lock bags. Or buy healthy meal replacement bars in bulk. Make sure they are high quality, real food bars. My favorites are Kind bars but there are many other bars that are healthy and delicious.
#6 Gift cards. When you ask students and residents which gift cards would be most appreciated it’s pretty consistently these three: Amazon, Trader’s Joes, Whole Foods or other grocery stores, and Starbucks.
#5 Digital upgrades. A high-quality phone is a critically important tool in the hospital. Everyone in medicine spends a good part of the day texting each other, looking up patients on Haiku (the Epic phone app), checking UpToDate for the latest treatments, finding other medical information in many other places and – of course – staying in touch with our teams, friends and families. Up to date computers, iPads, and AirPods (or equivalent) are also great gift options for any student or resident.
#4 A cleaner house. Pre pandemic, I recommended someone to help clean as the number one gift for medical folks. But, even with the limitations imposed by COVID, there are still gifts that can help! Number one on this list would be a Roomba so they don’t have to vacuum.
#3 Healthy meals at home that don’t take time. The Instant Pot has been my top recommendation as a gift for students, residents and busy healers for several years. Another wonderful gift I’ve recommended before is How to Cook Everything Fast: A Better Way to Cook Great Food by Mark Bittman. This year, I would add a certificate to meal delivery plans. The one I use is Clean Creations (because I like to have vegetarian options), but many of my friends swear by Freshly. Every city has companies that are similar, so do some homework and you’ll find several to compare. If you are a good cook, you might consider creating your own “meal deliveryservice” for your loved one, especially if you live in the same city.
#2 Caffeine. This comes in different forms for different people, but unless they avoid caffeine for religious reasons, almost every healer and healer in training I know has a go to form of caffeine they love. For most people, it’s coffee. The number one gift on the list (my opinion) for coffee lovers is a Nespresso machine (and some pods to go with it). You can also get them a metal “pod” for their own coffee rather than the Nespresso pods which will save some money. There are other options for pod coffee machines, so you might want to read about them all before deciding. Having tried coffee from a variety of machines, I personal think Nespresso makes the best cup of coffee, but I am partial to espresso. Another great gift option for serious coffee drinkers is programmable coffeemaker so their coffee is ready when they get up at “dark thirty” to get to work. For tea drinkers, there are many options for teas, brewing systems, and pots. For all healers, regardless whether they are coffee or tea drinkers, a gift at the top of the list would have to be a Yeti or Contigo tumbler. These tumblers keep coffee or tea hot for hours… so your drink is still there and still hot when you get pulled away from that first sip.
#1 Money. Students and residents, with rare exceptions, don’t have money for special things. Some don’t have enough money after rent and loans for things most of us would consider essentials. Giving money may seem a bit impersonal, but you can make it personal with a letter, a card, or creative packaging.
Like most of
you, my New Years resolutions in past years have been something like “Exercise
every day” or “Eat fruits and vegetables with every meal.” And, I bet that you
had the same experience I did… a few weeks of “success” and then they seemed to
fade away. The problem with these kinds of goals are how they are structured.
They end up being “either-or” goals … you are either able to do them or, more
often, you miss a day (or two… or three) and feel like a failure.
It’s a simple, but very powerful concept. Set your goal as a destination… as a “lighthouse” in the distance, and then head in that direction every day. As Ryder Carroll explains, “When goals are lighthouses, success is defined by simply showing up, by daily progress no matter how big or small…”
So instead of the usual New Year’s Resolutions, pick a few “lighthouse goals”. Write them down and keep track of how you are doing (every journey needs a map). This can be as simple as one piece of paper for each goal, but I am such a fan of the Bullet Journal, I hope you consider using it.
When you get up every morning think about how to move towards your goal(s). If you veer off course, that’s part of the journey…. look up, find your lighthouse, and correct your course. Every once in a while (maybe monthly?), look at the progress you’ve made and celebrate it! If, on the other hand, the goals you originally chose don’t make sense for you any more, pick some new goals, draw a new map and start over.
Potential New Year “Lighthouse” goals
Learn
more about compassion and practice it
Be
a better friend
Write
genuine thank you notes to people who have helped me
Become
more fit
Eat
real food for as many meals a week as I can
Find
out more about who I really am through meditation
Keep
a “stop doing” list
Be
better at my work through deliberate practice (practicing and learning the
things I don’t like and aren’t good at until I’m better)
Stay
organized so I don’t waste time (and end up focusing on trivial things instead
of what’s really important)
Read
things that bring me joy
Learn
about and use a Bullet Journal
Find
a community to support me
Learn
the names of as many people at work as I can
Take
the stairs as often as I can
Make
my living spaces enjoyable spaces
Keep
a journal to remember milestones and work out struggles
