Portable Devotion, “Socialization”, and How to Eat Well On Call.

Posted on December 3, 2025 by marylbrandt

Portable devotion

What a fascinating journey this morning as I travelled 1500 years back in time (via the internet) to this medieval portable altar.

On my first roll of the digital dice on this website that randomly links to other websites, I arrived at a database of portable medieval altars, created by a historian whose research interest is “portable devotion”. Lots to think about here…

“Socializing” an idea

I suspect the word has been around for a while, but I learned that “socializing” has become part of “business speak” in medical centers and hospitals, as in… “Go socialize that idea with them first.”

It turns out this new vocabulary is just a new way of describing what great leaders have known all along…you don’t know what you don’t know.

“Socializing” a new idea starts with determining who might want to “veto” your new idea and then meeting with them, not to persuade them, but to learn from them. With each meeting you learn more which lets you refine the project and, at the same time, allows your organization to evolve with you.

The best thing I learned is that the concept now referred to as “socializing” came from the Japanese concept of Nemawashi (根回し)… “Nemawashi literally translates as “turning the roots”, from ne (根, “root”) and mawasu (回す, “to turn something, to put something around something else”). Its original meaning was literal: in preparation for transplanting a tree, one would carefully dig around a tree some time before transplanting, and trim the roots to encourage the growth of smaller roots that will help the tree become established in its new location.” (Wikipedia)

#CallFood

There are lots of people who spend nights in the hospital to care for others… physicians, nurses, techs, and many others.

Especially for trainees who work long hours, eating well when you are on call is not easy. There are usually few (if any) options available in the hospital, and when you are exhausted it’s hard to prepare and bring your own food.

But eating well is really important …. not just nutritionally, but emotionally as well. Here’s a link to the system I’ve found works the best, but deciding that Diet Coke, graham crackers, and cereal are not major food groups is the critical first step.

Link to “Things I Wish I’d Known From the Beginning: How to Hack Eating Well”

p.s. I post recipes that meet the “pizza rule” (less time to cook than it takes to order a pizza) on Bluesky, Facebook, and Instagram with the hashtag #CallFood.

p.p.s Here’s the recipe for my breakfast tacos (which are also the best 2am #CallFood you will ever have).

Do What’s Right

Posted on December 8, 2023 by marylbrandt

I have the extraordinary of gift of sitting with my father, Floyd Brandt, in hospice this week. His (beautiful) heart is failing, but his mind is still sharp, and his spirit is completely at peace. The following is his last lecture as a professor (to his graduate seminar in Business Ethics)

It gives me great joy to share it with you.

Retiring is a little like having your first child. There is nothing particularly unique about the exercise except it is a first time experience that requires no specific skills or expertise and arrives with an unknown outcome .

The initial inclination while preparing comments for a last class is to draw from all the literature and all of one’s experiences to craft some statement filled with lasting words capable of shaping the hearts and minds of students for their remaining years.

Shortly after entertaining such a prospect, it became immediately apparent that teaching has taught me that that while the words may be forthcoming, the impact is not likely to be so resounding. Given that reality, the best course of action is to make a few short comments and say good-bye.

The closing line from Stephen Sondheim’s song “Send in the Clowns” came to mind. “Isn’t it rich, isn’t it queer, losing my timing so late in my career.”

In these last few minutes of the last organized university class that I will teach, I would like to suggest to each of you:

Define what is important to you. Attempt to determine what you are worshiping, because without that understanding, you are adrift and likely to be pushed ever-which-way.

Come to terms with the finite and the infinite dimensions of your being. Until you come to terms with the end of your existence, you will find living in the present to be difficult.

Cultivate the disciplines necessary to contend with the vagaries of the world around you. Perhaps the most important are the disciplines of the mind and of the spirit. The first step is often that of finding a quiet place to meditate and contemplate.

Learn the significance of uncertainty, choosing, and evaluating and then celebrate them. The definition of who you are is largely a product of the questions you ask and the choices you make. It is difficult to learn that the choices made today are the offspring of choices made yesterday.

Experience the joy of thanksgiving. Recognize that joy and hope are rooted in faith in the belief that what you have and what you are is a gift. As much as possible expunge the demons of comparison and competition and accept that sweeping out the harpies circling round the “enthroned self” never ends.

But then how does one end a last class in ethics except to recall that ethics is obedience to the unenforceable; a product of what you ask of yourself and not what others ask of you.

And finally, do whatever is right.

How to Succeed in Clinical Rotations (and residency, too)

Posted on January 9, 2018 by marylbrandt

Today I have the incredible joy of talking to the medical students on our rotation. No agenda, just a conversation that they requested for some “advice”. They just started their surgery rotation last week and it’s their first rotation. First rotation, beginner’s mind, unbridled enthusiasm… it is so wonderful!. I decided I would come up with what I wish someone had told me at the beginning of my rotations…

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Be mindful, deliberate and excited about learning.

This is probably the most important piece of advice I can give. Clinical rotations are often a whirlwind of work and you can be swept away without realizing it. Residents can ignore you, people can be cranky, patients can be difficult… and in the midst of all this, you are expected to learn to be a doctor. You have to stay in charge of that mission, no matter what is happening around you.

Take a little time to reflect on why you are doing this and what kind of person/doctor you want to become. When times get tough (and they will) hold on to it. If it helps you, come up with a slogan to repeat, keep on a piece of paper in your wallet or on your wrist

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Learn about the practice of mindfulness. Mindfulness has been shown to be effective in decreasing stress and may help to prevent burnout. It’s not hard to learn, but it’s hard to master … which is the point of a “practice”. (e.g. the practice of medicine)

Learn to keep a “beginner’s mind”. When I was a student on core medicine I had a senior resident that showed me what beginner’s mind looks like. It was 2am and I was tired. We were seeing a gentleman at the VA hospital for his diabetes, hypertension and some electrolyte abnormalities. I presented the patient to the resident and then we went to see him together. He had a rash, which I thought was so insignificant that I didn’t even include it in my presentation. But, instead of scolding me, this resident got excited. Yes, you read that correctly, 2am and excited about a rash – because he didn’t know what it was. (This next part will date me, but it’s a great example to make us grateful for the access we have to information now). He called security and had them open the library. We spent a wonderful hour looking through books – like a treasure hunt when we were little kids – until we found the rash in one of the books. We were laughing, excited and couldn’t wait to get back to start the appropriate therapy.

Understand what you are going to learn (the big picture)

On every rotation, you will be given a list of learning objectives. By all means, know them, study the things listed and make sure you know them (they will be on the test). BUT… please realize that diseases don’t stay conveniently siloed in a single specialty so this is not learning “surgery”, it’s learning about how surgeons approach a specific disease you will see elsewhere, too. You also need to know that what is listed as learning objectives today may well be obsolete tomorrow (if they aren’t already).

You have chosen a career that ethically demands life-long learning. That means that one of the most important skills to learn is how to develop a system of learning that you can use in medical school, residency and later in practice.

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Develop a system for lifelong learning now

Learning is iterative. You will learn broad concepts on each rotation along with a “fly over” of the entire terrain of the specialty You will need the information you learn on your surgery rotation on your medicine rotation when you are consulted on a patient with an ischemic leg who needs surgical treatment, or on your pediatrics rotation when your patient with a pneumonia develops an empyema. If you choose surgery at your career, you will read and learn the same topics throughout your residency (and after) but with increasing depth.

The practical points on how to develop a system to learn during your rotation are here: How to Ace the NBME Shelf Exams: How to Ace the NBME Shelf Exams, In-Training Exams and Your Boards, but the key points are summarized below:

Remember it’s school.
Make a list of all the topics in the textbook.
Breathe deeply. You are not going to read every page in the textbook in addition to your assigned reading.
Create a schedule to SKIM every chapter
TAKE NOTES. All the time.
Figure out how to store your notes so you can find them in the future
Go through your daily notes in the evening and then store them in your system
Review, review, review

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Take care of yourself.

Pay attention to ergonomics, diet, exercise and sleep. Most importantly, take care of yourself emotionally and spiritually. You can’t learn or serve others if your tank is empty. Come up with what is important for you and make a list. Seriously. Make a list of what you find helps you stay on track and then check it off every day. Look at it before you go to bed. Celebrate the things you did and don’t be hard on yourself for the ones you didn’t get to.

Don’t forget to take a “Sabbath” every week. True time off is critical for recovery from this stressful work.

If it gets too hard, seek help. It’s a sign of strength, not weakness, and most (if not all) of the people around you have been there.

We have the most amazing job on earth. When the administrative issues or political conflicts get to you (and they will), just remember – you get to take care of another human life with the goal of relieving their suffering. What could be more important than that?

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Elements of a Self-Care Protocol – from The Resilient Clinician by Robert J. Wicks

Posted on June 27, 2010 by marylbrandt

The following is taken from The Resilient Clinician by Robert J. Wicks. Dr. Wicks writes primarily for psychiatrists and other mental health workers, but his advice is applicable to anyone who works with patients.

There are basic elements of a self-care protocol that most everyone needs to renew themselves on an ongoing basis. It really doesn’t require too much to take a step back from our work routine to become refreshed and regain perspective. Some of the basic elements might include:

• Quiet walks by yourself

• Time and space for meditation

• Spiritual and recreational reading-including the diaries and biographies of others whom you admire

• Some light exercise

• Opportunities to laugh offered by movies, cheerful friends, etc.

• A hobby such as gardening

• Phone calls to family and friends who inspire and tease you

• Involvement in projects that renew

• Listening to music you enjoy (Wicks, 2003, p. 50)

Other simple steps at self-care and renewal might be:

• Visiting a park or hiking

• Having family or friends over for dinner or evening coffee

• Going to the library or a mega-bookstore to have coffee, a scone, and to peruse the magazines

• Shopping for little things that would be fun to have but not cost a lot

• Taking a bath rather than a quick shower

• Daydreaming

• Forming a “dining club” in which you go out once a month for lunch with a friend or sibling

• E-mailing friends

• Listening to a mystery book on tape

• Reading poetry out loud

• Staying in bed later than usual on a day off

• Having a leisurely discussion with your spouse over morning coffee in bed

• Watching an old movie

• Making love with your spouse

• Buying and reading a magazine you have never read before

• Fixing a small garden with bright, cheery flowers

• Telephoning someone you haven’t spoken to in ages

• Buying and playing a new CD by a singer or musician you love

• Taking a short walk (without listening to music) before and after work and/or during lunchtime

• Going to a diner and having a cup of tea and a piece of pie

• Going on a weekend retreat at a local spirituality center or a hotel on large grounds so you can take out time to walk, reflect, eat when you want, read as long as you’d like, or just renew yourself

• Arranging to spend a couple of days by yourself in your own home without family or friends present just to lounge around and be alone without a schedule or the needs or agendas of others

• Getting a cheap copybook and journaling each day as a way of unwinding

Religion and Spirituality

Posted on April 4, 2010 by marylbrandt

People who are ill or hurting often turn to their religious roots for solace. The mind and body connection is a powerful one, and one that can contribute to good patient care. Spirituality in medicine can take an overtly religious tone, but only if both the physician and patient are completely comfortable. No matter what your religious background, you will care for patients whose belief system is different from your own. The true root of spirituality in medicine is compassion. Regardless of your religious background and your personal beliefs you can cultivate a philosophy of compassion. Both you and the patients you care for will do better because of it.

The workday can be onerous and fatigue can make you lose perspective. It is important to find something greater than you and spend some time there everyday. The most efficient method is to look inside of yourself by just sitting. Learn to just sit. It is harder than it sounds, but very powerful when achieved. Slow your breathing, close your eyes and let the thoughts go. Concentrate on your breathing and relax all your muscles. Don’t fidget, don’t move. When the thoughts start running (and they will), just acknowledge them and let them go. Try to get to a moment (and that it all it will usually be) when your mind is silent and your body relaxed. This is the moment to listen. Being able to quiet yourself this way is very conducive to allowing your mind to work on the “big picture”. If you spend even 10 minutes everyday in this kind of meditation, you will be surprised at how some of the things that are worrying you become “solved”.

Work at finding beautiful places where you can sit for a minute or walk. Nature is one of the most powerful spiritual experiences. If you have a favorite place to hike or be outside, take some pictures and blow them up for your house or call room. Put beautiful plants in your house and then take care of them. (Dead plants are a bad way to cultivate spirtituality…) Watch for the surprising moments of beauty in a day and notice them. Look for the flower blooming outside a patient’s room, the proud look of a father watching his two-year-old totter into the hospital, a new painting on the wall.

Cultivate a sense of wonder. Have you ever seen anything more incredible than a beating heart in a surgeon’s hand? Allow yourself a moment to be amazed in the middle of the day. People have incredible resilience at times – notice it and appreciate it.