It is easy for me to nurture others, something that I find natural and comforting. I recently got a cat for this reason. It adds to the collective at home of fish, dog, kids, turtle. There is something settling in me when I care for others, which is why being a physician was a natural calling.
The cat has brought welcome slow down, a moment to pause in the mindfulness of purring and rest. To marvel at another creature’s ability to sleep all day, and watch the shadows playfully at night. It reminds me of the speed I have been going to get where I am.
I remember in college at UC Berkeley walking around the beautiful northern California campus so lost in thought about where I was going next or what I needed to study that I would be unconsciously walking faster and faster. Suddenly, I would realize my center of gravity was far out in front of my feet. My backpack was so heavy that it hurt my low back to walk this way. As always, with pain, I paid attention.
As a small moment of mindfulness, I would practice “walking over my feet”. I would catch myself busily rushing forward and consciously bring my center of gravity back over my hips. Head suspended, chin slightly tucked, shoulders back, core present over the pelvis, feet moving ahead but always, settling, under. Moving together, as a unit. It is funny how much this small physical attention would change my mind and my space.
Life has moved a lot faster since that time. Berkeley was busy but medical school was like trying to take a small sip out of a fire hydrant of information. Residency was doing and practicing, gaining clinical sea legs but moving so quickly through the fatigue that working became a rote muscle memory. Walking over my feet at 3 AM sometimes meant running to labor and delivery to catch a baby.
In surgery, as a resident, I learned my job was to anticipate the surgeon’s next move at all times. That is the best way to get involved and gain experience and confidence. It trains your brain always to think steps ahead, as a physician must. You must sit back from the playing field and understand all of the possible paths from this point so you can anticipate and outsmart fate when it is possible.
I remember the nights in the hospital when I had a patient that was already a head of me. The process of dying had set in, and very much like the process of labor, when it was gaining momentum there was nothing you could do to stop it. You would try ordering tests or antibiotics or fluids and medications but sometimes there was nothing you could do but at one point realize, I am walking ahead of my feet. If I sit back and see what is happening here, I know it’s time to tell the family what we are facing. Rooted in the realization I would tell the family the cross roads at which we had arrived.
Moments of mindfulness like walking over your feet do not require a week long meditation retreat or even in depth study. The simple act of paying attention changes everything. Getting out of our heads and into our bodies can teach us profoundly, where to soften, where to strengthen. I want to share my journey of how I moved toward direct primary care and opening my own clinic. Here is where it starts. Right here, walking presently and mindfully, over my own two feet.