Posts Tagged ‘bad moments’

What do do about very bad moments.

May 25, 2015

A note for those who’d be wise

If it comes as a surprise

It’s most likely bad.

The good times you’ve had

You could probably already surmise.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record System (EMR) I can get along with. I spent the winter in Nome, Alaska, and finished a couple of assignments in rural Iowa.

Time comes to us, not as a series of days or years, but as an unbroken chain of moments.  Each moment lasts a second or three.  As human beings, when we awaken in the morning we all know we’ll have good moments and bad moments.  Most moments come and go as neutral.

I enjoy saying that if we let the bad moments contaminate the neutral moments we’re giving them too much power, and if we let them sully the good moments we’re missing the point.

Time spent thinking of bad moments that haven’t happened constitutes a misuse of imagination.  The psychiatric community calls it catastrophizing, thinking of sequences that follow from a bad “what if.”

Most of our good moments come to us announced.  Yes, once I really did find a diamond in a stairwell, and the gift of a soprano saxophone in fact rendered me literally speechless.  But my marriage, my children, my graduations, all arrived more or less on time after much anticipation.

In contrast, with few exceptions, the really bad moments come to us as complete surprises, unannounced and unexpected.   Bad medical news, such as my diagnosis of appendiceal carcinoid, and news of our daughter’s climbing accident, for example, came with no warning.   When I think of my lifetime’s 10 worst moments, I have to admit that they ambushed me, every time.

Both Bethany and I had very bad moments yesterday, the kind of moments that, despite all efforts to the contrary, ruin the rest of the day.  We commiserated, we supported each other, and we hugged.  And later, taking my own advice, I put a rubber band on my wrist for self-administered aversion therapy.  When a negative, useless thought intrudes, I pull the rubber band back about 9 inches and let it go; bad thoughts creep in with less frequency as long as I keep the rubber band on my wrist.

In the late part of the day we attended a social gathering, which celebrated Bethany’s last day on her job.  She has done a lot of good work for the last couple of years, and we’re looking forward to spending more time together.

At that gathering, a former patient I hadn’t seen for years, talked to me about a very bad diagnosis.  I listened, sympathized, and told her about my personal experience with carcinoid of the appendix.  But we also discussed our music community, and the person congratulated me on taking saxophone lessons.


A rubber band on the wrist to help you forget: self-administered aversion therapy

May 26, 2011

If toxic thoughts you want canned
What you need is a plain rubber band
It never has missed
When placed on the wrist
Of a person’s non-dominant hand.

Synopsis: I’m a family practitioner from Sioux City, Iowa.  On sabbatical to dance back from the brink of burnout, while my one-year non-compete clause ticked off I’m having adventures and working in out-of-the-way places.   Currently in New Zealand’s South Island, I’m living in Amberley and working in Waikari, less than an hour from quake-devastated Christchurch.

I live my life according to principles and usually I don’t have to prioritize them. Yesterday I did.

“Do what’s right for the patient” governs my professional life. “You can either be happy or you can be right” generally leads me to choose being happy in my personal life.

I had to choose doing the right thing for the patient, and, in the process choosing to be right.

I made the right clinical decision, the patient disagreed, and a confrontation followed.

I probably puzzled the next patient by being so happy to see him, but contrast remains the essence of meaning.

Though I enjoyed every patient after the first one, the gnawing, intrusive thoughts from negative interaction haunted me the rest of the day. I didn’t take my own advice.

We get time in a series of moments. When you get out of bed in the morning you can be certain that you’ll face good moments and bad moments, and most moments will be neutral. If you let the bad moments contaminate the neutral moments, you give them too much power. If you let the bad moments into the good moments, you’re giving up joy. And if you let hypothetical bad moments in at all, you’re missing the point.

I had some bad moments towards the beginning of the day. It had been so long since I let negative thoughts resonate I’d forgotten the rubber band trick.

Put a rubber band on your non-dominant wrist.  When you experience a thought that brings useless worry, pull the rubber band back twelve inches and let it go.

The psychiatric profession calls this technique “self-administered aversion”.  It works for any intrusive mind activity, including a name, phrase, or song that annoyingly gets stuck in your head.  It can do away with any habit if the patient is motivated enough to do it.

It doesn’t work if a person doesn’t want to change, and it will not modify a person’s basic personality characteristics. 

It serves as an aid to not remembering.

I slipped a rubber band on my wrist this morning when I left for work.  By now, I forgot why.