I’m looking forward to presenting at the Minnesota Sheriffs’ Association’s Correctional Health Division Conference on October 13th. I’ll be discussing the use of clinical decision rules in assessing inmates for chest pain, head injuries and other high-risk presentations. You can find my PowerPoint here.
I recently contributed a “lunch and learn” to PreferredOne’s annual health fair. We talked about some key topics related to behavioral change, including process thinking, end-gaining, means-whereby and indirect methods. Please see my PowerPoint for more.
The health dimension is a 30-day challenge based on Tom Rath’sEat Move Sleep(book) and companion website. I encouraged the audience to make some small choices that could lead to big changes in both their quality and quantity of life.
Many thanks to Donna Larson, Shelley Markve, Susan Bernstein and PreferredOne’s Wellbeing Committee for pulling together the event and making the book available to employees. ✸
_ Postscript [10/07/2021]. Nell Hurley brought my attention to James Clear’sAtomic Habits (book). Looks like fantastic read that syncs of up with Rath’s work. BTW, Nell was recently featured in a Star Tribune article on the contemporary sober movement.
_ Postscript [10/10/2021]. For those intrigued by the Alexander Technique, I suggest booking a few lessons with Brian McCullough or another qualified teacher in your area.
I was surprised and delighted to run into Father Steve LaCanne at a celebration of life over the weekend (he officiated). Those with a HealthEast connection may recall that he was the longtime Director of Spiritual Care at St. Joseph’s Hospital, in downtown St. Paul, Minn.
And direct our spirits he did! Father Steve shared the following passage from Thomas Wolfe, which is a great meditation for the week:
To lose the earth you know, for greater knowing; to lose the life you have, for greater life; to leave the friends you loved, for greater loving; to find a land more kind than home, more large than earth—
—Whereon the pillars of this earth are founded, toward which the conscience of the world is tending—a wind is rising, and the rivers flow.
Father Steve is now semi-retired and splits his time between Minnesota and Florida. ✸
And “less” often meant counseling sometimes desperate patients that they were unlikely to benefit from surgery.
Chuck, more than any other physician who I’ve met, practicedprimum non nocere (first, do no harm). This began early in his career and intensified over time as he saw the actual harms of surgery in all of the second opinions that he rendered.
Gabel’s Rule: Don’t just do something; stand there
Holmes’ Rule: Surgery is guilty until proven innocent
where the latter means that the clinical trials need to be compelling and patient selection must be meticulous.
Chuck has left a void in my life—but that void means that I had the opportunity* to be mentored by a great physician and remarkable human being. He’ll live on in the care that I deliver and the students and residents who I mentor. ✸
— * I owe that opportunity to Bob Moravec, M.D., former medical director at St. Joseph’s Hospital in St. Paul Minn. It’s a great story and post for another day.
The Shot: The green has a wicked slope from right to left with a bunker to the right. An elderly golfer behind us noted that she always plays to the right, which seemed like solid advice. My ball landed on the right edge of the green and rolled downhill into the cup. I was stunned, Ayden was elated and the elderly golfer was absolutely tickled ✸
_ * For whom I hope to caddie in college—he’s nearly a scratch golfer on youth courses
Life has ways of surprising you when you least expect it. One of those moments occurred for me in a Fairfield Inn in Naperville, Illinois. We were visiting Joan’s relatives in Chicago and I hung back at the hotel while our kids napped.
In order to arrive at what you do not know You must go by a way which is the way of ignorance. In order to possess what you do not possess You must go by the way of dispossession. _
This was both startling and counterintuitive. Up until that point, life seemed additive—knowledge and experiences building on a foundation of prior knowledge and experiences, stretching back years into childhood. Eliot was suggesting otherwise and I knew in that instant it was true. ✸
— Postscript [08/09/2021]. Here’s a related passage from Anthony de Mello: “They didn’t teach me how to live at school. They taught me everything else. As one man said, ‘I got a pretty good education. It took me years to get over it.’ That’s what spirituality is all about, you know: unlearning. Unlearning all the rubbish they taught you.”
I just completed a year of mindfulness* meditation with Muse, the brain-sensing headband. And what an amazing, consciousness expanding year it was! Many thanks to InteraXon for developing and bringing Muse to market. Also much appreciation for Stephan Bodian and Sister Mary White, my meditation teachers. ✸
— * Sort of. My practice has evolved from mindfulness to awakened awareness. (Please see Stephan Bodian’s masterfulBeyond Mindfulness for an exploration of both.) Accordingly, I’ve adapted the way that I use Muse: I’ve turned off Feedback, Birds and Background (Session Volume Settings), which reduces the temptation to manipulate attention. Muse mainly serves as a meditation timer when configured in this way, although, as a doctor, I love to review the resulting EEGs.
— Postscript [07/30/2021]. I’ve long advised medical students and residents to acquire some psychotherapy skills, regardless of their eventual specialty. Motivational interviewing (MI) and cognitive behavioral therapy (CBT) are relatively easy to learn and have broad clinical utility.
Some MI resources include:
Miller WR, Rollnick S. Motivational Interviewing, 3d ed. New York: Guilford Press, 2013 [classic textbook]
Sim MG, Wain T, Khong E. Influencing behaviour change in general practice. Part 1—brief intervention and motivational interviewing. Aust Fam Physician 2009;38(11):885-888 (PMID: 19893835; and here)
Sim MG, Wain T, Khong E. Influencing behaviour change in general practice. Part 2—motivational interviewing approaches. Aust Fam Physician 2009;38(12):986-989 (PMID: 20369152; and here)
Hall K, Gibbie T, Lubman DI. Motivational interviewing techniques—facilitating behaviour change in the general practice setting. Aust Fam Physician 2012;41(9):660-667 (PMID: 22962639; and here)
Searight HR. Counseling patients in primary care: evidence-based strategies. Am Fam Physician 2018;98(12):719-728 (PMID: 30525356)