Olympic Inspiration in the Clinic

Like any athlete, I put effort into getting into the zone with patients and creating easy access to that place. For me, it stems from being able to quiet my mind, especially in the exam room setting, regardless of the history that is unfolding.
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As we head into this summer 2012, I have the Olympics on my mind. I think back to a sultry day in 1972, sitting spellbound in front of a Magnavox TV. Wide-eyed on the cool linoleum floor, I am riveted to the screen where Olga Korbut, the spritely Belarusian gymnast, strikes a pose. With her twinkling eyes and pixie grin, she zips along her floor exercise routine, performing her heart out, ending, her jaw jutted out in triumph. I have a distinct thought: I want to be in the Olympics.

Instead, I become a naturopathic doctor.

Not exactly the same thing, but I think for health care providers, there are parallels with many aspects of both athletics and gaining expertise.

Although a far cry from a floor exercise mat or baseball diamond, when I am in the clinic, work takes on the feeling of an athletic pursuit. Listening all day to patients' stories requires a kind of endurance. Like any athlete, I need to be comfortable in my body, undistracted by surroundings; I need to be in the zone. For a naturopathic doctor, this means knowing the routine of taking a patient history and performing a physical exam. It means understanding the patient's lifestyle and stressors in their life. I need natural medicine strategies for all manner of diagnoses, or need to know how to access such information. And I need to be able to do all that in a timely fashion and with confidence.

I need to know my teammates -- who is the best referral for this patient for further diagnostic workup, or for natural medicine or allopathic treatment modalities I do not offer. Like a teammate, I need to remember I have colleagues I can call upon. I need to be able to keep in the game even in the face of setbacks, whether it's a non-compliant patient or someone for whom my approaches fall short. I need to be resilient when a patient passes away. When things are going well, I need to focus on what's working and try to do more of it. If I am not doing well with a patient, I need to work harder and smarter, both in my own analysis of the patient and in my use of available resources.

Like any athlete who develops field awareness, I need all my senses to observe my patient and to react with both subtle and larger adjustments to things I perceive. Most pitchers have all kinds of pitches they throw, and have to select the right one to a particular batter. I have to come up with the right plan, tailored to the right patient; I have to be flexible taking abilities I possess and using them appropriately to the patient before me.

As athletes do, from high school to the pros, I need to periodically review my game, be self-reflective, ask for feedback -- how am I doing, is this approach working? How are my patients doing? Am I enjoying this? What can I do to keep my career -- this game -- interesting?

When I am in the zone at the clinic, hours spin off the clock. Asking good questions allows a patient's medical history and personal story to unfold. Understanding the stressors in the patient's life and their symptoms in context of that life, help me create the most effective individualized health plan. Without understanding the patient, it's so much harder to help.

When I create a plan for a patient -- in particular those with chronic ailments -- from suggesting an appropriate diet to a constitutional homeopathic remedy, from an exercise plan to a supplement recommendation, from a suggestion about mindfulness or taking up a hobby, I need to apply the skills I have gained through education, training and practice. At various moments with my patients, I may feel like a manager, a teammate, a coach or a cheerleader!

Like any athlete, I put effort into getting into the zone with patients and creating easy access to that place. For me, it stems from being able to quiet my mind, especially in the exam room setting, regardless of the history that is unfolding. Increasingly, patients present with complicated stories, overlapping diagnoses, multiple pharmaceuticals on board and a boatload of supplements they are wondering about. It could be easily overwhelming! I look to strike a balance of confidence and humility. I work to stay in the moment, using information and understanding gleaned from many past moments, but not worrying about the past or the future.

And burnout that athletes experience is certainly a familiar thing to many health care providers, naturopathic doctors included. To avoid that personally, I see patients on a schedule that works for me, I make sure to show up well-rested, well-exercised and well-fed. I make to-do lists. I take time off. I make time away from the clinic to pursue other interests. I take continuing education classes. I keep close to the surface of my mind that a patient before me needs my help; it is my only job at that moment. In ways, this realization is liberating as it's my only job right then, and though I may be "multi-tasking" in the history-taking itself, by being observant, by letting my observations inform my questions or while performing a relevant physical exam, etc., it is still much easier than, say, running a household with three teenagers!

So, as I cheer on participants in the upcoming Olympics, I will take encouragement from the dedication and focus of these elite athletes and draw inspiration from the way such competitors can get and stay in the zone, and how they put to use the skills -- physical, mental and emotional --they have worked so hard to develop.

For more by Amy Rothenberg, ND, click here.

For more on mindfulness, click here.

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