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Dr. Nally’s Twenty Two Tough Truth’s

Sunday’s are my day of rest, . .  . if a physician ever really rests? I’m sitting out under the stars very late on this Sunday evening, into the wee hours of Monday morning.  (It’s our turn for flood irrigation at 2 o’clock in the morning).  But, I appreciate these times of solitude.  It is on Sunday’s that I’ve been able to work on twenty two life lessons (tough truths) that make life better. I do my best to treat Sundays as a “sacred” or “holy day,” a day of rest from my temporal labor, to contemplate the word of God, to pray & meditate, to participate in public worship and focus on where I am at in my personal spiritual development.

Yes, I know.  I’m a physician; and yet, I believe in God.

No, it is not a contradiction.  (I can already see my in-box filling up with agnostic castigation.)  Friends of mine claim atheism or agnosticism.  Yet in the day to day trenches of life, I find there is no real atheism. There is no such thing as not worshiping.  When it comes down to it, we all worship something.  We each have the choice of what we worship.  Worship being defined as giving adoration, reverence or homage to someone or something.

We have the choice of worshiping the God, a god (however you may define god), spiritualism, truth, ethical principles, nature, football, money, your body, someone else’s body, power, fame, etc.  You and I know this on a basic level, we just have to come to grips with what it is we hold on a pedestal, and to which we “pay homage.”

There comes a point, when one deals with life and death on a daily basis, that a person must question the very existence of God, and come to terms with who or what we actually pay homage.  I’ve sincerely asked that question . . . I’ll leave that story for another time.

It’s during my Sunday afternoons, that I’ve been able to contemplate and attempt to re-apply the “tough truths” of life that seem to challenge me.  So, instead of sharing some bacon with you this evening, I thought I’d share twenty two of the truths that I am working on improving in my life. (Though . . . they’re almost as good as bacon!)

Twenty Two Tough Truth’s that I’ve Learned & Had to Re-Learn in Life:

  1. There is much about life over which we have absolutely no control. You cannot control everything that happens in life, but you can control how you respond.  Your response is your greatest power.  “The joy we feel has little to do with the circumstances of our lives, and everything to do with the focus of our lives.” (Russel Nelson)
  2. It’s not about the cards you’ve been dealt, it’s about how you play the hand. (Randy Pausch)
  3. W. C. Fields said, “Smile first thing in the morning and get it over with.”  My expectations often make me utterly unhappy.  Happiness is letting go of what you assume your life is supposed to be like right now, and sincerely appreciating it for everything that it actually is. 
  4. In mortality, we will always be incredibly imperfect.  If you wait until you’re perfect before you share your stories, ideas, talents and gifts with the world, no one will ever hear from you.
  5. A moment spent worrying is a moment wasted. Worrying will NEVER change the outcome.  Do more, worry less. Train your mind to see the lesson in EVERY situation, and then make the very best of it.  Liberating ourselves from our fears, automatically gives people the ability to do the same around you.  
  6. The best lessons often come from the very hardest days.  If you are having a hard day, stand strong, there is a lesson here.  Sometimes you have to experience a low point in life to learn a good lesson you couldn’t have learned any other way. 
  7. Success easily gets to our heads, and failure easily gets to our hearts.  Our true character is usually revealed at our highs and lows.  Be humble at the mountain top, steadfast in the valley’s and faithful in between. 
  8. We often confuse being busy with being productive.  What you pay attention to grows.  So, focus on what truly matters and let go of what does not. “You are the average of the five people you spend the most time with.” (Jim Rohn)
  9. More money left un-managed just creates more problem.  Yes, we need money to live.  Earn it. Save it. Invest it. But, avoid spending money you haven’t earned, to buy things you don’t need, to impress folks you don’t even know. Manage your money so it doesn’t end up managing you. 
  10. Most of us don’t need more to be happy – we need less.  When things aren’t adding up in life, begin subtracting.  Life gets much simpler when you clear away the physical and mental clutter that makes it complicated. 
  11. Our fancy gadgets (phones, computers, tablets, radios, etc.) often get in our way and dehumanize us.  We all need to learn to be more human again.  Don’t avoid eye contact.  Don’t hide behind the gadgets.  Smile often.  Ask about people’s stories . . . And, then, listen.
  12. We don’t always get what we give.  You will end up sadly disappointed if you expect people will always do for you as you do for them.  Not everyone has the same heart you do. 
  13. Most arguments we have with one another are pointless.  Be selective in your battles. Peace in this moment may be better than being right. You actually don’t need to attend every argument into which you’ve been invited. “You will never reach your destination if you stop and throw stones at every barking dog.” (Winston Churchill)
  14. I’ve never met a strong and confident person with an easy past. Be grateful for your scars.  Be thankful for the emotional muscle and physical strength you gain from standing against the winds of life.
  15. The only way to completely avoid pissing people off is to do nothing of importance. 
  16. The true definition of “Hell” is to meet the person you could have become on your last day on earth. 
  17. Just because you fell off the ketogenic wagon today, doesn’t give you license to drag it into the woods, set it on fire and use the insurance money to buy Twinkies
  18. “You only live once, but if you do it right, once is enough.” (Mae West)
  19. Ignoring your passion in life creates anxiety.  Ignoring the anxiety, creates panic and hopelessness. Never ignore what moves you. Mold your work around the lifestyle that brings you passion, don’t mold your passion around your career. 
  20. The human body tends to move more or less in the direction of your expectations.  This is why it is so important to know that the attitudes of confidence and determination you feel and hold are just as much a part of your treatment program as medical science and technology.
  21. The hottest places in Hell are reserved for those, who in times of great moral crises, maintained their neutrality. (paraphrased from Dante Alighieri)
  22. A man would do well to carry a pencil in his pocket, and write down the thoughts of the moment.  Those thoughts that come unsought after in the moment are commonly the most valuable, and should be secured by recording them, . . . because they seldom return.  (Brigham Young)

Over the years, I’ve carried a leatherbound little notebook with me and I write down thoughts or quotes I hear into that little note book.  Among these thoughts and quotes I’ve collected, I’ve found that on Sundays, I can let my mind chew on them.

One of the things that I’ve learned over the years is that observing a weekly “day of rest,” or “holy day,” is that this behavior is one of the most important safeguards to health and wellness.  I’ve learned this from my personal experiences during periods when I didn’t observe the “day of rest” and periods where I have closely guarded that “day of rest.”  I’ve found that observing the Sabbath has truly become a “delight” as spoken of by the Old Testament prophet, Isaiah.

Science Demonstrates Importance of Day of Rest

What is fascinating, is that science has recently demonstrated how this works.  In early 2000, Marcus Raichle from Washington University demonstrated that the human brain demands 20 percent of the body’s energy and uses only 5-10 percent more when solving calculus problems, reading a book (or this blog post, for that matter) or writing a letter.  However, they noticed that some areas of the brain became notably less active when concentrating on a mental challenge, but fired synchronously when laying flat in an MRI scanner, allowing their thoughts to wander (1).

This was confirmed by a number of other researchers who noted that there was a coordinated communication between diverse areas of the brain when people were “resting.” This mysterious coordination between different parts of the brain during “daydreaming” has become known as the default mode network (DMN).  In the last few years, we’ve learned there are actually five different “resting state networks” that coordinate vision, hearing, movement, attention & memory. However, the DMN is the most researched and appears to be the most important.

Dr. Immordino-Yang reviewed the research on the DMN and found that downtime is an opportunity for the brain to make sense of what it has recently learned. It is during this “day of rest” that the mind coordinates unresolved tensions, conversations we had earlier in the week, re-writing verbal blunders, and practicing standing up to those that intimidate us.  Our minds shuffle through the neglected to-do lists and post-it notes on the mental refrigerator of our brain, searching for solutions and answers.  It moves back and forth through childhood scenes and futuristic adult hopes and dreams. It is during this time that our brain looks at the moral connotations of our performance with others (3).

Other research demonstrates that the mind solves very tough problems during this period of rest and day-dreaming.  You may have experienced something like this when you solve a problem while in the shower.  (I hate to admit it, but many of my problems get solved in the shower.)  When the mind isn’t actively working or learning something new, it can accumulate, memorize and rehearse recently learned skills, actually transcribing them onto new brain matter (4).  Recent research demonstrates that this recording of new memory and skill, called “sharp-wave ripples” actually occurs more often during “rest periods” than during sleep (5).

Meditation and the Day of Rest

Meditation and/or prayer have been shown to strengthen connections between regions of the DMN.  Those that observe a day of rest with meditation develop a more intricate wrinkled cortex, the outer layer of the brain that gives us the ability to perform abstract thought and introspection.  Meditation appears to increased both the volume and density of the hippocampus, the area of the brain essential for memory storage and the frontal cortex that allows us to control or rein in emotions.  Fascinatingly, meditation and observance of a “day of rest” slows the natural “wilting” of the brain regions required for sustained attention that normally withers as we age (6, 7, 8, 9).

How soon does observing a rest day or “keeping the Sabbath” become effective?  A number of studies show that noticeable changes occur within a couple of weeks.  More importantly, daily meditation has been show to be more effective in the long run than the total hours of meditation over one’s lifetime (10,11).

As a physician and a clinical hypnotherapist, I personally use and recommend daily meditation.  If you want a free copy of my self-guided meditation program for relaxation and weight loss, CLICK HERE.

Now, what I want to know, is does bacon intake during the rest day have any effect on the hippocampus, frontal cortex or wrinkle cortex?  I guess we’ll have to wait for that research to be completed.  In the mean time, check out my membership page to see what we do know about the use of fat and cholesterol does to help attention and energy.

References:

1. Raichle ME, MacLeod AM, Snyder AZ, Powers WJ, Gusnard DA, Shulman GL. “The maturing architecture of the brains default network.”  Proc Natl Acad Sci U S A. 2001 Jan 16; 98(2):676-82.
2. Moussa MN, Steen MR, Laurienti PJ, Hayasaka S.  “Consistency of Network Modules in Resting-State fMRI Connectome Data” PLOSone. 31 Aug, 2012. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0044428.
3. Immordino-Yang MH, Christodoulou JA, Singh V. “Implications of the Brain’s Default Mode for Human Development and Education.” Perspectives on Psychological Science. 29 Jun, 2012. 7(4): 352-364.
4. Payne, JD. “Learning, Memory, and Sleep in Humans.” Sleep Medicine Clinics. Mar 2011. 6(1):15-30.  https://www.sciencedirect.com/science/article/pii/S1556407X10001220.
5. Perlow LA, Porter JL. “Making Time Off Predictable – and Required.” Harvard Business Review. Oct 2009. https://hbr.org/2009/10/making-time-off-predictable-and-required.
6. Zeidan F, Johnson SK, Diamond BJ, David Z, Goolkasian P. Mindfulness meditation improves cognition: Evidence of brief mental training.” Consciousness and Cognition. Jun 2010. 19(2): 597-605. https://www.sciencedirect.com/science/article/pii/S1053810010000681#]
7. Luders E, Kurth R, Mayer EA, Toga AW, Narr KL, Gaser C. “The unique brain anatomy of medication practitioners: alterations in cortical gyrification.” Front Hum Neurosci. 29 Feb, 2012. online. https://www.frontiersin.org/articles/10.3389/fnhum.2012.00034/full
8. Pagnoni G, Cekic M. “Age effects on gray matter volume and attentional performance in Zen meditation.” Neurobiology of Aging. 28(10): 1623-1627. https://www.sciencedirect.com/science/article/pii/S0197458007002436
9. Luders E, Toga AW, Lepore N, Gaser C. “The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter.” Neuroimage. 15 Apr 2009. 45(3) 672-678. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184843/
10. Chiesa A, Clati R, Serretti A. “Does mindfulness training improve cognitive abilities? A systematic review of neurpsychological findings.” Clinical Psychology Review. 1 Dec 2010. 31: 449-464.  http://psy.fgu.edu.tw/web/wlchou/perceptual_psychology/class_pdf/Advanced%20Perceptual/2011/2011week15_HaoChen_paper.pdf
11. Chan D, Woollacott M. “Effects of level of meditation on experience on attentional focus: is the efficiency of executive or orientation networks improved?” J Altern Complement Med. 2007. Jul-Aug. 13(6): 651-657. https://www.ncbi.nlm.nih.gov/pubmed/17718648.

Burnout

Ask yourself the following questions:

  • Does your job limit interaction with people and/or do you spend most of your time with a computer screen?
  • Have you become cynical or critical at work?
  • Do you drag yourself to work and have trouble getting started once you arrive?
  • Have you become irritable or impatient with co-workers, customers or clients?
  • Do you lack the energy to be consistently productive?
  • Do you lack satisfaction from your achievements?
  • Do you feel disillusioned about your job?
  • Are you using food, drugs or alcohol to feel better or to simply not feel?
  • Have your sleep habits or appetite changed?
  • Are you troubled by unexplained headaches, backaches or other physical complaints?

burn outThese are the ten most common signs of “burnout.”  46% of respondents in surveys indicate at least one of the above symptoms of burnout. Two or more of these imply that you are suffering from some degree of “burnout.” The classic triad of burnout is:

  1. Exhaustion
  2. Cynicism
  3. Questioning the quality of your work, or questioning whether you are making a difference in the world any longer

What is burnout? It is defined by “Mr. Webster” as “physical or mental collapse caused by overwork or stress.” But, that definition doesn’t seem to do it justice, and many people experiencing burnout don’t actually “collapse.”  They do, however, become significantly less productive, depressed, and loose the enjoyment of life.  Work begins to feel like slavery, exercise becomes a chore, food begins to have associations with guilt, friendships are seen as obligations and love looses its luster and looks more like a social construct.

Burnout is often likened to discontent, however, these are two very different emotional feelings.  Discontent can be defined as dissatisfaction with ones circumstances. There are two kinds of discontent in this world: the discontent that works and the discontent that wrings its hands.  The first kind often gets what it wants and the second looses what it has.

Burnout differs from discontent, in that continued work toward a goal brings on the triad of emotional exhaustion, depersonalization and the feeling of reduced personal accomplishment. Burnout is, in reality, the sum total of hundreds of thousands of tiny betrayals of purpose.

Burnout can occur in any field of work, however, a study published in the 2012 issue of JAMA reveals that over 40% of the ~800,000 U.S. physicians are experiencing burnout and are more prone to burnout than any other worker in the United States.  The journal Academic Medicine recently reported that medical students, when compared to age-matched fellow college graduates, reported significantly higher rates of burnout.

So, how do you overcome burnout?

I’m an Osteopath.  I see disease in the context and inter-relationship of the mind, body & spirit.  Overcoming burnout requires one to restore balance in these three areas.  I am impressed by the work of Charlie Hoehn in his book, Play it away: A workaholic’s cure for anxiety.  Charlie does a wonderful job of describing the broken inter-relationship of the mind, body and spirit in a person experiencing burnout.

The first step to repairing the broken inter-relationship is to recognize and remove those anchors keeping you tethered to the feelings of burnout.  The anchors are the stressors that cause you to worry on a daily and weekly basis.  Journaling these stressors, writing them down in 3-5 word sentences is the start.  Identify which of these stressors is the biggest or causes the most angst, then write out the following question.  “How can I eliminate [stressor] from my life?  Do this with the largest two or three stressors. Then write out a solution that is small and uncomplicated to each stressor.  Put the solution to work immediately. If your solution has not improved your feelings of stress and anxiety within a week, then drop the first and try to find a second stressor, or otherwise switch to a second solution. Journaling these thoughts, questions, feelings and answers allows your mind to change from a self-centered focus to an action based focus.  It clears the mind to move into action. Nothing is more important in reducing burnout, than nourishing the imagination. Using a journal helps stimulate thought and the imagination.

The second technique is scheduling some real play. Write down the five most fun activity involved with play that you did as a child. Then, set aside dedicated time for your favorite activity of play.  It is essential that you actually schedule this play time into your daily activities.  There are a couple of rules associated with play time.

  1. Disconnect from all social media
  2. Harmony of the playtime is more important than winning
  3. Have some serious fun
  4. Shoot for 30 minutes of play time per day
  5. This should ideally be done outside in the fresh air and sunlight

“A lack of play should be treated like malnutrition: it’s a health risk to your body and your mind.”  (Stuart Brown)

“Play is the highest form of research.” (Albert Einstein)

Technique number three is related to sleep.  It is essential that you have a consistent bedtime and give yourself the opportunity to take an afternoon nap.  You can optimize your sleep by turning off electronics before getting into bed, going to bed at the same time each night, decreasing the room temperature to 68-70 degrees Fahrenheit, draw the curtains to make the room dark, and use a relaxing loop of quite background sound like ocean waves, or the sound of a trickling stream to ease your mind (can be found on a number of apps).

It may take up to a week for your body to unwind and get used to this schedule.  Also, schedule a 20 minute afternoon nap.

Meditation and/or prayer is the fourth technique.  Sit or kneel, close your eyes and observe the thoughts that enter your mind for 10-15 minutes. Listen to and keep your breathing calm and deep. Pay attention to the rhythm of your breathing.  Reading can also be a form of meditation and has become an important refreshing part of alleviating burnout.  We can only be as good as the books that we read.  Read, ponder over and talk about good books.

Fifth, eat healthy meals with healthy friends.  Decrease the carbohydrates and increase the good omega 3 fats in your diet.  The insulin response to carbohydrates stimulates the inflammatory and parasympathetic nervous system making you more fatigued and tired. Reduce the bread, rice, pasta, potatoes, carrots and corn intake in your diet.

Increasing the good fat in your diet (like Kerrygold Irish Butter, Coconut Oil, Olive Oil, and real animal fats) actually increases your bodies access to essential B vitamins and improves the use of Vitamin D.  Making dietary changes become a habit is often easier when it is done with a friend.  Schedule opportunities to eat healthy meals with family or friends attempting to do the same thing.  You will help support each other and be more likely to succeed.

The last recommendation is spend time in nature.  One weekend a month spend at least two hours out in nature. Take a hike, go on a nature walk, go camping, swim in the river, etc. Give yourself permission to unplug during these times.  Then, pay close attention to how you feel when your in different environments.

In the words of Shakespeare, “Self-love, my liege, is not so vile a sin/As self-neglecting” (King Henry V, Act 2, scene 4).

I conclude with the rhetorical question, “If you work for a living, why do you kill yourself working?” (The Good, The Bad, and the Ugly)