Friday, September 23, 2011

How to (really) deal with stress.

Stress. We all suffer from stress at one time or another. There are books and medications and web-sites and even Dr. Phil on tv and all of this is meant to help us cope better with the stress of our lives. And how has it really helped us?  Well, we are more stressed than ever before.

We are stressed by just about every turn in life. Our jobs. Our kid's performance in school.  Our financial portfolio. The mess in our house. The endless to do list.

We don't have enough money. We aren't thin enough. We feel bad about our co-workers or boss. A loved one is sick. We have been diagnosed with something awful. We lost our job. Our dog died.  We cannot pay our bills.

The list goes on and on. And you cannot really rate stress. You cannot say that one stress is worse than another. It is all in the eyes of the beholder. And it all feels the same. Stress is, well, stress.

And we all feel it. No one is immune. Sometimes it is like a low electrical current that is just something we live with day to day.  Or maybe we have calm days and then explosive days.  Or sometimes we are under a cloud so thick we feel like we cannot breath. And we shut down. We wear our responsibilities like a noose around our necks. And it is hard to breath.

Stress is universal. I am not sure we could be living human beings without it. And many have pounced on this fact and there are books and CDs and professional counselors and gym memberships and massage therapy and anti-stress creams and what not all designed to eliminate the stress of our lives. Somewhere, someone is making a fortune from our stress. Mainly the pharmaceutical giants.

But we stay stressed anyway.

So, what is the answer? I wish I knew. I feel stressed at times as well. And I have tried all the things they say to do; walking, deep breathing, writing things down, yoga, putting things into perspective.  I have really done it all. And you know what works best?


But in the morning, there it is. Stress. Rearing it's ugly head once again.

To be honest, I have learned a lot about coping with stress from the people I work with who have a lot of it. My patients. They make most of my stress go away. Many times my stress just disappears because I am  just happy I am not them. I am happy that I have a healthy child. That I am still healthy. That my husband is still healthy. That I can still go and do ordinary things.

And therein lies the answer to stress.

Embracing the ordinary. Embracing yourself.

All these books and such that say to do this or that to control the stress of your lives is just, well, bullshit. You have to go into survival mode. You have to embrace what is truly important to you, what is your true essence. Then you have to build a wall to protect it, because everywhere you turn someone is trying to rip it away.

Becoming real is the best protection.  Facades in your life that you are trying to hold up becomes exhausting.  Why can't we be just who we are?

I think that is why people who are really sick and dying have little stress.  They have fear, but not stress. Why? All that has been stripped away from them.  They have discovered what was  important all along. And some people, if they get better, live by this new rule. But others don't and they return to their regular lives and everyday stress.

I think it is because most people are afraid of change.  They would rather live their stressed out lives than to face the fear of changing it. I understand that. But it is a shame. Because stress makes your life shorter.  It makes you sick, literally. It makes those around you want to run. So there you are, stressed, sick and alone.  Not a pretty picture at all.

So, what to do? Well, you could do like most people, just simply live with it.  Muster on. Perhaps take a slew of drugs to control your high blood pressure, your depression, your anxiety, your stomach ailments and your headaches. You can lose yourself each night to crappy TV. You can sleep a lot. You can drink. Or you can be one of those crazed people who never sit still because sitting still makes you think and thinking makes you even more stressed.

Or you can do this; make a list of the things that describe the true essence of who you are.  Not your family or your kids, just you. Who are you?  What makes you tick?  What makes your heart sing?  Figure that out and write it down. Now write down your real life on a list next to it.  All the external things that keep you apart from your true essence. Then make a choice. Decide how you can return to the real you. Or at least part of the real you. Even a little you is better than none.

And that is it. Start living for yourself. Stop trying to impress others.  No one is really keeping score, and if they are, so what. Start being real and tell others what you really think.  (Well, in a nice way.)  Start by saying no to the things you don't want to do and occasionally say yes to the things you need to do.

Fix yourself up. Feel good about how you look on the outside. Self image is really important. It arms you. It protects you a bit.

And protect your body, the inside, while you are dealing with all the turmoil in your life.  Take a vitamin pill daily.  Drink water. Get some sleep. Stretch. Walk. Take deep breaths.  I call them stress breaks.  They don't eliminate stress, but they help you cope. And they are good for your heart. And if you mess up your heart you are in big trouble.

And go out into nature. Most people do not do this. Not really. Remember when you were a kid and you delighted in playing outside?  Do you really think because we are adults we don't need that anymore?

So start liking yourself again. You are all you have. Take care of that and everything else may become a bit easier. And a bit easier really does make you smile. And smiling makes your heart sing. And isn't that the essence of life anyway?

To be nobody but yourself in a world which is doing its best, night and day, to make you everybody else means to fight the hardest battle which any human being can fight; and never stop fighting.
 ~e.e. cummings, 1955

Before you put on a frown, make absolutely sure there are no smiles available.
~Jim Beggs

Everything great in the world is done by neurotics; they alone founded our religions and created our masterpieces.
~Marcel Proust

When we remember we are all mad, the mysteries disappear and life stands explained.
~Mark Twain

Saturday, September 10, 2011

A nurse's nightmare.


You see us at MD offices, on hospital floors, in your home. We can be chatty and kind, intense and focused, sometimes chided for being abrupt like a nurse Ratched. We are moms and sisters and aunts and grandmothers. We seem like nice people. Many are amazed that we can do what we do every day.  And we always seem nonplussed by it all. Like we are going off for just another day of work and coming home and getting on with our daily chores and lives.

It looks that way, it does.

But you cannot always tell a book by its cover.

We don't talk much about our days, especially those of us who work with the critically ill and dying.  And why would we?  Who wants to hear about that?  We don't even like to hear about that.

We bury it way down, or at least try to. But occasionally, it comes back up. We feel stressed and sad. Sometimes despair creeps in.  Life seems unfair and we are powerless to help. It can all become too much to bear.

A nine year old that dies. A mother with two kids, 44 years old, sent home on hospice to die. A woman who needed emergency heart surgery dead of a simple complication. A man who was cut off on the highway while riding his motorcycle (with a helmet) dead of a head injury, extubated with his 15 year old son standing next to his bed.  An ALS patient who cannot breath at 3pm on a beautiful Monday afternoon.  A man who came in with a cough, leaving with a death sentence of small cell lung cancer after a routine CAT scan.

I could fill pages with the patients I have seen.  And this abbreviated list was compiled in just my prior working week. 

I am not complaining or looking for any sympathy.  I don't need or deserve it. My patients and their families do however. 

I am not an angel, special or a saint. I have been called all, as so many others in the medical field have been called. But we don't see it that way. We try to be helpful, compassionate and competent. We try to make people healthy and well; and when that fails we try to make them comfortable. It is all we can do. Many times, it falls short of the mark.  Feels like it is never enough. And many times it isn't.

It would seem as though this is the stuff of nightmares; of what could keep me up at night fretting about the tragedy of life and our own unknown futures. But it isn't. This is not what my nightmares are made of.

So what is it? I will tell you. It is seeing healthy people blindly leading their lives who just don't get it. It is watching people continue to smoke knowing that it will shorten their lives eventually and reduce the quality of it dramatically. It is watching someone not paying enough attention to their kids or being cruel to them under the umbrella of  "discipline."  It is hearing people talk about the petty nonsense of their lives looking for sympathy and being angry when it doesn't come their way, lamenting that "no one understands me." It is dealing with people who have never seen tragedy in their lives and who are selfish and never lend a hand to anyone else.

I know that sounds a bit angry, and perhaps it is.  And perhaps I have been guilty of some of it myself.  But the truth is, most of us don't really want to get it. We like protecting ourselves with our day to day lives and our trivial complaints, it is safe there. We hope we never have to deal with tragedy. We hope to be blessed with the mundane.

And that is why we nurses and doctors don't talk about our days. No one wants to hear about the bad we see. If they don't hear it, they don't have to acknowledge that it exists. They don't have to learn from it.  They don't have to feel it.

I can certainly understand that. But it is a shame because death has so much to teach us about life.

We don't have to think about death or disease to know about life. We can go through each and every day without giving it a thought until it is presented to us. But what we miss by thinking that way and shielding ourselves is huge.

Honestly, the happiest people I know are those who stop trying to harden themselves to the truths of life.  The happiest people I know are those who have softened themselves and let life and love in, with all of it's scary, messy feelings.

Being strong enough to let down your guard and actually love someone without abandon, that is true freedom.  And freedom is happiness.  But most people don't do this until they face a sure end, when they finally feel they have nothing left to lose. But what they failed to realize, as most of us do, is that they never had anything to lose to begin with. Not really. And by the time most come to this conclusion, it is too late. And they die with much regret, leaving regret in their wake for future generations, the ones they had sought to protect. 

Not living life fully, that is my nightmare. It is not the patients I have seen and tried to help. They were my teachers. I am forever in their debt.  I don't want their lessons to go unheard. That would be the true tragedy. The scariest nightmare of all.

Do not fear death so much, but rather the inadequate life.
~~~Bertolt Brecht

Until you divest yourself of the notion that you are a collection of needs, an empty vessel that someone else must fill up, there will be no safe place to harbor yourself, no safe shore to reach. As long as you think mostly of getting, you will have nothing real to give.
~~~Merle Shain

Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.
~~~Steve Jobs

Saturday, September 3, 2011

Our Push Button Society.

The other day an interesting thing happened. We had a storm pass through from Hurricane Irene and the power went out.  This is a common occurrence in our town when a storm passes through and we are usually inconvenienced by darkness for perhaps an hour or more.

But not this time. This was a major storm and we, like so many others, lost power for several days.

Nothing that we use on a day to day basis worked anymore. I could not simply push a button and use my lights, my microwave, my stove, my air conditioner, my ipod or my computer. I couldn't use my blow dryer.  I didn't have hot water.  I could not open the garage door by pushing the little bar on the remote in my car. Woe is me, right?

Well, as I was begrudgingly lifting the garage door manually to take my daughter to school, it suddenly felt  familiar.  We never had a garage door opener growing up, we always had to get out of the car to open it. And I never felt it was a big deal. It was just part of our lives then. But now it seemed like an inconvenience for me to have to do it because I had to actually get out of the car and walk over and manually perform a function I normally could just push a button to achieve.

And that is just it. We have become a push button society. We like to push a button and make things work. We don't ever want to have to get up to change a channel, open a garage door, go to the library and thumb through books to do any research or write things by hand. We never want to actually wash dishes or take a towel to dry them. We have drive through's and computers and instant heat. In the summer we have cool air blowing through our homes automatically. Our clothes get dried easily. We can heat up a meal in minutes. Why, we even have robotic vacuum cleaners.

We may think that all these conveniences are just dandy and make our life so much easier than our ancestors who had to cut wood or shovel coal for heat, who hung laundry out to dry, sometimes after washing it by hand; who washed and dried dishes after each meal and who cooked things slowly, sometimes all day long for just one glorious meal.

We may laugh at the way they hand shoveled snow all day, or raked a lawn or swept debris with a broom. We snicker at the thought of how they chopped wood or canned foods, made homemade bread or wrote long letters to loved ones.  We don't have to do any of those things anymore. We don't even have to read a book made out of paper. We can download it instantly and read it on a screen. We can send email or text. We are a technologically advanced society.

But we are bored while we sit on the couch scrolling through the 200 channels we get on our large screen TV's all the while complaining that there is nothing to watch. If we want information, we google it instantly while sitting at our computers or smartphones no matter where we are and we complain that the information is taking too long to download..  If we want music, we put ear buds into our ears, push a button and settle in. No more manually placing records on a turnstile and having the sweet melody fill up a room.

And are we really happier for it? Does it really make our lives so much easier, so much better? Do we really have so much more time now?

I don't think so. And we certainly are not healthier for it. We are fatter and sicker than ever before.

We never used to have an obesity problem in the United States.  We moved more. We walked. We rode bikes.  TV was less of a distraction because we had fewer choices.

Now we sit more.  We drive everywhere. We join gyms to exercise all the while having someone else clean our homes and do our yard work.   

And don't even get me started on how isolated we have become looking at our little screens all day long.

So, while it really was an inconvenience to not have power for 4 days and a reminder to be thankful for all the things we do take for granted, like hot showers and lights, it also reminded me that all the conveniences we have come to rely upon are really not that essential to our well being.  Perhaps just the opposite. And that doing things ourselves, by using our own brawn and our own effort, is a very healthy, satisfying experience that we need to think about returning to.