Not so graceful, but giving myself grace

It’s a week for self-disclosure, mostly to let you know why my recent posting has been so irregular.  Don’t brace yourself for something really exciting or you’ll be terribly disappointed.

A week ago I was meeting with one of my colleagues in my office, who commented on my Personal Kanban board in my office, which is covered with bright Post-Its (surprise!).  I told him it’s really the only way I feel like I can begin to keep all of the plates in the air.

Until I can’t keep them in the air, that is.  This week has definitely required lots of latitude from others, and has made me grateful that apparently none of the plates I was juggling were particularly fragile.

Here’s the truth: While the amount of time we all have in a given day or week is fixed, our energy is variable from one of us to another, and even for each of us as individuals at different times. I am generally a high-energy person, though I am also well aware of the things that are more likely to drain my energy. A series of days with early meetings drains me, and that’s been the case for my schedule this week. Not getting my workouts in or getting to yoga = draining (as counterintuitive as that may seem). Falling behind on my email = tiring. Not writing or creating = complete energy paralysis.  You get the idea.

And, as luck had it this week, I did manage to run on Wednesday and Thursday and I am mostly caught up on responding to email (though not meeting all of the scheduling requests/ demands contained therein).  It was a week when I had little control over most of my schedule because, as I often say, “We just take care of the people.” Blissfully, I did have little night call with our crazy days, which made the clinical demands generally achieveable.  However…I was late to a session with the students on Tuesday, I missed a Tuesday night conference call, and I didn’t make it to conference on Wednesday morning.  By Wednesday afternoon I had it all down to a dull roar and was able to not feel like I wasn’t struggling at every turn.

Why am I rambling about this?

Mostly to help people understand that sometimes even those of us who you often think do it all “effortlessly” aren’t effortless at all.  We mess it up.  We miss obligations. We get tired. We are human.  I don’t try to be anything but that, and on Tuesday afternoon I apologized profusely and made sure that I was 100% present once I made it to class.  Tuesday night I apologized via email for the whims of my schedule and was given a gracious, “It’s okay. We understand and we love it when you can be here.”

The best part of that response? It reminded me that I’m not failing dismally, and that I’m not even failing. I’m just managing more-than-a-few-things right now.

And that maybe, just maybe, I need to give myself a little grace when it’s like this.


April reading round-up

What’s caught my eye in the literature lately?  A few things.

  • The POISE-2 trial’s aspirin data, showing that perioperative aspirin in non-cardiac surgery patients increases the risk of perioperative bleeding but doesn’t impact the risk of MI or cardiac death in that same time period.
  • A decrease in complications in Florida that is driven by a NSQIP-based quality improvement process.
  • The evidence-based modern management of diverticular disease.  As someone without a general surgery practice, this review provided a nice way to keep me current on an important disease in general surgical practice.
  • PPIs may not be the Holy Grail of GI prophylaxis in the ICU.  Provocative data, to be sure, and the authors’ call for a prospective multicenter trial is appropriate.
  • Does Gabapentin help with the management of post burn pain?  Apparently not, at least for non-neuropathic pain.  To be answered:  The role of Gabapentin in burn itch.
  • Sarah Smailes’ group in the UK continues to generate terrific work on the role of tracheostomy in burn patients, this time comparing perch trach and surgical trach complications and dysphagia.
  • And, last but not least, my work with a wonderful group of surgeons on the use of Twitter at academic surgical meetings.  Our publication stands in interesting contradistinction to the conversation I had with 20 4th year medical students on Friday in which I discovered that zero of them are on Twitter.  Many of them said, “We don’t understand the point of Twitter.” Here’s hoping that giving them some professional justification can change their hearts and minds.