Meaningful Engagement - At & With - Work

     "For many years, it has been recognized that work fulfills a variety of individual needs other than financial. More recent studies have consistently demonstrated that people rate purpose, fulfillment, autonomy, satisfaction, close working relationships and learning as more important than money. With the decline of neighborhoods, churches, civic groups and extended families in developed societies, the workplace is now being seen as a primary source of community and a place to feel connected. As the last twenty years have increasingly demanded that employees adapt to the changing needs of organizations, it is now perhaps appropriate to recognize and consider how organizations should respond to the changing needs of their employees."

        Cartwright S, Holmes N. The meaning of work: The challenge of regaining employee engagement and reducing cynicism. Human Resource Management Review 2006; 16(2): 199-208.

Photo: Ekaterina Negoda   www.dpreview.com

Perception Requires ALL the Sense Doors

Bird

It was passed from one bird to another,
the whole gift of the day.
The day went from flute to flute,
went dressed in vegetation,
in flights which opened a tunnel
through the wind would pass
to where birds were breaking open
the dense blue air -
and there, night came in.

When I returned from so many journeys,
I stayed suspended and green
between sun and geography -
I saw how wings worked,
how perfumes are transmitted
by feathery telegraph,
and from above I saw the path,
the springs and the roof tiles,
the fishermen at their trades,
the trousers of the foam;
I saw it all from my green sky.
I had no more alphabet
than the swallows in their courses,
the tiny, shining water
of the small bird on fire
which dances out of the pollen.                         Pablo Neruda

Paul Hannon   http://paulhannon.com/

Smart People Can Do Dumb Things

     "The 'win-at-all-costs' attitude of self-serving leaders may result in great harm to others and even to themselves. In their book Why Smart People Do Dumb Things, Feinberg and Tarrant cite several reasons for incredibly talented people acting in what turn out to be incredibly destructive ways. These reasons are arrogance, hubris, narcissism, and an unconscious need to fail. Arrogance is an exaggerated sense of pride and self-importance. Aristotle referred to hubris as 'hamartia,' a tragic (fatal) character flaw that distorts the inner moral compass of even the smartest among us. Sanders has said that 'the single biggest threat to an organization’s success is pride.' Narcissists typically lack connectivity to the world in which they live. Many exhibit such a lack of connection that they speak of themselves in the third person. Narcissists often believe that they are better than others and therefore not subject to the same basic rules and social norms. They develop a sense of entitlement, which may eventually lead to their unraveling. The harmful effects of such narcissists may extend beyond their immediate circle and the organizations of which they are a part if they achieve a high profile in the public eye. Pinsky and Young in their book The Mirror Effect explain how narcissistic entertainers have negatively altered what are considered 'normal' behavior patterns of young people." 

       Certosimo F. The servant leader: a higher calling for dental professionals. J Dent Educ 2009; 73(9): 1065-8.

     A recent study of teenagers showed that most of them would rather be the assistant to a celeb than themselves having significant positions such as CEO of a Fortune 500 company, or president of Harvard.

     Can we health-care professionals rediscover the meaning in our calling, when so many of us barely survive on junk food? Can we heal society to thrive on meaningful engagement with each other and life itself?

Andre Gallant   http://www.andregallant.com/

"I don't mean to be the devil's advocate, but ..."

     Avoidance of dealing with the discomfort of change is a chronic constipator to progress. But change is constant, unavoidable and rapidly accelerating! We either learn to flow with it creatively or are swept aside by it. We need to nourish fresh, creative ideas, lively positive conversations, and do away with grumbling, passive-aggressive friction.

     "We have a rule about a creative insight: if somebody offers a novel idea, instead of the next person who speaks shooting it down - which happens all too often in organizational life - the next person who speaks must be an ‘angel's advocate,' someone who says, ‘that's a good idea and here's why’".   Dan Goleman, Psychology Today
 

Photo: zambie   www.dpreview.com

From Idealism - to - Disruptive Behavior - AND BACK !!

     Most health-care professionals start out being idealistic, wanting to make a real difference - reducing mankind's suffering and increasing joy in the world, one patient at a time. This is the timeless calling of all healers.
     A proportion of health-care workers maintain a positive, energized attitude throughout their careers (with short-term fluctuations). A proportion burn out & leave. However, far too many exhibit "disruptive behavior" ie one that "interferes with delivery of quality care."
     Why far too many? Because you don't have to be throwing instruments and yelling at co-workers to disrupt quality care. If you're cynical, would rather be doing something else, and simply don't have your mind-heart in healing, you're probably causing more harm than good. Stats show roughly 50% of physicians regret having chosen medicine as a career but feel stuck, and the same proportion advise their kids not to choose medicine as a career.
     Sadly, cynicism and other forms of cognitive armoring are epidemic among today's educated, especially those of us with little or no training (or interest) in the humanities, fine arts, etc. This group simply lacks the skills to find deep meaning and joy in their work-life or even life in general.  Meaning and joy ARE here, but the tools to uncover them were never developed.

     See also: http://mindfulnessforeveryone.blogspot.ca/2013/11/432-i-try-and-i-try-but-i-cant-get-no.html

Photo: Kivi   www.dpreview.com

Healing - Transcending Suffering - Mindfulness

     "Healing may be operationally defined as the personal experience of the transcendence of suffering. Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering."

       Egnew TR. The Meaning Of Healing: Transcending Suffering. Ann Fam Med 2OO5; 3: 255-262.
 

     "To practice medicine in this way — that is, to cure when possible and to foster healing even in the absence of cure — the physician needs to add the form of consciousness called mindfulness to the traditional “black bag.” This state of consciousness can be taught and learned through practice. Numerous medical schools around the world have recognized the need to broaden training such that curing and caring are equally valued and simultaneously provided in the best interest of the patient. Outcomes may depend upon it."

       Dobkin PL. Fostering healing through mindfulness in the context of medical practice. Curr Oncol 2009; 16(2): 4-6.

See also: http://mindfulnessforeveryone.blogspot.ca/2012/11/232-cultivating-wisdom-to-know.html

Andre Gallant   http://www.andregallant.com/

Mindfulness & Hypnosis / Western Psychology

     "Is there really a distinct difference - an almost impermeable membrane of some sort - between the psychological search for personal fulfillment, mental health, and well-being, on the one hand, and the striving for transformative spiritual self-realization and sublime enlightenment through contemplation and meditation on the other? Are not both paths to free our mind of limitations and open our hearts, becoming more self-aware and relationally mindful and attuned in the process, for the betterment of one and all?"             Lama Surya Das

       Yapko MD. Mindfulness and hypnosis. The power of suggestion to transform experience. WW Norton & Co, NY, 2011.

Andre Gallant   http://www.andregallant.com/

Authenticity, Empathy, Engagement

     “I find each encounter with a patient shapes not just the patient’s reality but also mine. To provide a therapeutic presence, I need to give not just a technical opinion but also give of myself. I shape and am shaped by events, and this constant molding defines me not just as a doctor but also as a person. The self is constantly in dissolution and creation; my identity is defined by my actions and choices. I find this model authentic in capturing the reality of the doctor–patient relationship because it views the doctor as an active participant. It acknowledges the vitality of each relationship and with it the power of human connection. Almost two decades in the ‘trenches’ has taught me that beyond empathy lies engagement, that the road to self-awareness is bumpy and admits no return traffic, and that our patients are our best teachers.”

       Schapira L. An existential oncologist. J Clin Oncol 2003; 21(9 Suppl): 77s-78s.

Vincent Van Gogh The Church at Auvers

 

Cracks in the Armour - a Great Gift!

     “I just went through a series of heart attacks, and the greatest gift that’s come out of that for me is a deeper appreciation of vulnerability, which is usually seen as weakness. But I’m experiencing it as a kind of porousness, of feeling less defended, less armored. If we can impart to younger people the gift of that vulnerability, it may help them to embrace aging.”           Frank Ostaseski

      To successfully negotiate transitions requires full open-hearted conscious engagement – mind, heart and body – so that all aspects of the learner can be transformed. According to models of normal human development, the learner becomes one step more mature, which results in a greater ability to comprehend and deal with complexity. One’s “self-concept” is a fluid, evolving process. One first develops an ego, then slowly we let go of egocentricity, gradually becoming hypoegoic, allocentric and ecocentric. Mystics and saints in various traditions strive to shed their ego altogether.

      “We all operate in two contrasting modes, which might be called open and closed. The open mode is more relaxed, more receptive, more exploratory, more democratic, more playful and more humorous. The closed mode is the tighter, more rigid, more hierarchical, more tunnel-visioned. Most people, unfortunately spend most of their time in the closed mode.”           John Cleese

JMW Turner (1775–1851)   The Burning of the Houses of Parliament

PREVENT impairment among health professionals

     "two common misconceptions need to be dispelled. First, impaired health professionals who seek treatment are most often referred by their therapist rather than disciplinary or regulatory agencies. Second, despite the frequent assumption that 'impaired professional' is a phrase referring to substance abuse problems, those professionals who seek treatment are more likely to have difficulties centered on interpersonal, relational, & emotional concerns than around substance abuse. This finding has important implications inasmuch as physician or other professional health programs, licensing boards, and hospital risk management programs should be geared to address a wide array of interpersonal and psychological problems rather than limiting themselves to a focus on chemical dependency. Moreover, by waiting until overt actions or external behaviors occur, these agencies may miss the opportunity to intervene earlier and more effectively on less 'noisy' problems that may create a good deal of personal and professional distress. 

     We hope that regulatory agencies take proactive steps to identify professionals with social and emotional vulnerabilities who may be at greater risk for unethical and negligent behavior, rather than intervening after ethical violations. Moreover, the surprisingly low rate of employer-risk management referrals is of particular concern because these groups are in a position to observe the professional on a daily basis. Employers and risk management groups can implement psychoeducational programs for health professionals, teaching them how to identify early signs of distress and impairment, as well as how to put into place referral systems for confidential treatment before the emergence of disruptive behavior. Finally, it is important to dispel the myth that 'impaired health professional' simply implies an individual who violates a boundary, suffers from substance abuse problems, or has problems with anger management. This myth encourages health professionals to believe that they are not in distress or impaired until they have acted in an inappropriate manner, rather than helping them identify early warning signs, the predisposing and precipitating factors that contribute to disruptive behavior." 

     Psychologists undergoing psychotherapy "most often cited benefits of therapy were increased self-awareness, self-understanding, self-esteem, and improved skill as a therapist." 

       Katsavdakis KA, Gabbard GO, Athey GI Jr. Profiles of impaired health professionals. Bull Menninger Clin 2004; 68(1): 60-72.

Henri Rousseau   The Sleeping Gypsy

Emotional Intimacy - "too busy"?

     Gabbard & Menninger (below) examine the impact of physicians' busyness, compulsiveness and postponing gratification on their marriages.
     "The frequent tendency to use the demands of medical training or practice to justify one's absence or unavailability is a reflection of a significant emotional issue for many physicians, especially men - marked discomfort with closeness and even more marked reluctance to acknowledge this discomfort or deal openly with it. Such tendencies are particularly prominent among those who have compulsive personalities, in which difficulty with the management of strong feelings, both positive and negative, is a central feature."
     Many physicians become incapable of expressing love and nurturance - "the legacy of life-long constriction so characteristic of compulsive personalities.
     ... perfectionism, a susceptibility to self-doubt and guilt feelings, a chronic sense of emotional impoverishment, difficulties managing dependency and aggression, and a limited capacity for emotional expressiveness. ... lead to rigid, emotionally flat, automatonlike styles of relating that are adaptive in medicine but maladaptive in one's personal relationships. The language of feelings may be entirely alien, especially for the male physician.
     ... physicians actually prefer work to family life ... postponement is not so much delay as avoidance - avoidance of intimacy and marital involvement. Work becomes an effective defense against intimacy."
        Gabbard GO, Menninger RW. The psychology of postponement in the medical marriage. JAMA 1989; 261(16): 2378-81.

     See also: http://healthyhealers.blogspot.ca/2012/06/substitute-gratifications.html 
     and: http://www.johnlovas.com/2013/01/shine-light-of-awareness-embrace-process.html

Photo: Tran Cao Bao Long   www.dpreview.com

Wisdom & Well-being Can Increase into Old Age

     "Psychologists have long sought to identify strategies that are reliably associated with greater well-being. The observation that wise reasoning improves into old age in conjunction with experimental work on the malleability of wise reasoning suggests that it may be possible to train people to reason wisely. Our findings further suggest that wise reasoning is a potential psychological mechanism that may explain age-related differences in well-being. This finding dovetails with work ... demonstrating that as people age, they shift their priorities toward interpersonal issues and develop greater emotional competence. Extending this work, the present research demonstrated that older adults show greater ability to reason wisely about social conflicts than younger adults and that among middle-aged and older adults, such reasoning is positively linked to socioemotional benefits."

         Grossmann I, Na J, Varnum MEW, Kitayama S, Nisbett RE. A Route to Well-Being: Intelligence Versus Wise Reasoning. Journal of Experimental Psychology: General. Advance 2012 online publication. doi: 10.1037/a0029560

Fall in Nova Scotia

Compulsiveness of Physicians, Dentists, other health-care professionals

     "Doubt, guilt feelings, and an exaggerated sense of responsibility form a compulsive triad in the personality of the (typical) physician. This triad manifests itself in both adaptive and maladaptive ways.

     Maladaptive (ways):
• difficulty in relaxing, 
• reluctance to take vacations from work, 
• problems in allocating time to family, 
• an inappropriate and excessive sense of responsibility for things beyond one's control, 
• chronic feelings of 'not doing enough,' 
• difficulty setting limits, 
• hypertrophied guilt feelings that interfere with the healthy pursuit of pleasure, and 
• the confusion of selfishness with healthy self-interest.

     ... paradox: compulsiveness and excessive conscientiousness are character traits that are socially valuable, but personally expensive. Society's meat is the physician's poison.

     One of the determinants of the choice of the medical profession may be to defend against the horrible existential dread associated with feelings of impotence in the face of one's own ultimate death. ... there is often a secret omnipotence in the form of overdeveloped expectation of one's self ... unconscious or conscious fantasies that he can outwrestle the Angel of Death. ... (yet) The practice of medicine is, for the most part, only palliative; another grand paradox on which to reflect is that those individuals who are so vulnerable to feelings of helplessness choose a profession where they are repeatedly reminded of their inherent impotence in the face of disease and death."
       Gabbard GO. The role of compulsiveness in the normal physician. JAMA 1985; 254(20): 2926-9.

     See also: http://healthyhealers.blogspot.ca/2012/10/calling-all-risk-averse-avoidants.html

     “Wisdom is deep understanding and practical skill in the central issues of life, especially existential and spiritual issues.”

        Walsh R. Essential spirituality. The 7 central practices to awaken heart and mind. John Wiley & Sons Inc, NY, 1999.

Fall in Nova Scotia

Our Intelligences - Balanced & Symbiotic?

     "What is intelligence? Some theorists have divided intelligence into two types: crystallized and fluid. Crystallized intelligence refers to what a person knows. In the case of radiologists, this might be a list of differential diagnoses for a particular imaging finding, or key points to cover when obtaining informed consent for a procedure from a patient.
     Fluid intelligence refers to what a person can do, including the ability to reason about abstract relationships, as in solving a problem. For example, a good radiologist does not merely recite long lists of differential diagnoses but develops a targeted approach on the basis of the particular circumstances of each case.
     Emotional intelligence refers to the ability to understand and respond to emotions in daily life. It involves identifying emotions in facial expressions, vocal intonations, and posture, as well as the ability to appraise the emotional nature of situations. Some people are simply more attuned to and better able to perceive others’ emotional states. In addition, emotional intelligence involves recognizing and understanding emotional meanings, as well as the ability to use emotion in reasoning. For example, curiosity enhances the ability to learn. Finally, emotionally intelligent people are adept at managing emotional responses, muting some and amplifying others. They are less likely than others to “fly off the handle” when things are not going well.
     If we are to thrive, emotional intelligence and what we usually call reason need to be in a symbiotic relationship. We need to be able to reason about our emotions and to use our emotions to assist in reasoning. Emotional responses may be more or less appropriate, and sometimes we need to talk ourselves out of overreacting or remind ourselves how much we really care about someone or something. Conversely, our emotional responses to important issues can enable us to focus more intensely on the more crucial aspects of work and life." 
        Gunderman RB, Brown T. Emotional intelligence. J Am Coll Radiol 2011; 8(5): 298-9.

     Mindfulness practice has a uniquely effective way of managing difficult emotions: http://mindfulnessforeveryone.blogspot.ca/2012/11/physically-processing-emotions.html

Fall in Nova Scotia

Solutions to Postmaterialist values in Healthcare

     Younger generations are undergoing a deep change in values “shifting from an overwhelming emphasis on material well-being and physical security towards greater emphasis on the quality of life.” Having grown up in relative economic security, they take survival for granted and prioritize “other needs, such as autonomy, self-expression, and quality of life; thus, the rise of post-materialist values.”

     “the shift towards post-materialist values is only one aspect of a broader cultural change. First, the polarisation between traditional values, which emphasize religion, respect of authority or national pride, and secular-rational values, which have the opposite characteristics. Second, the polarisation between survival values, which include, for instance, materialist values, homophobia, sexism or distrusting people, and self-expression values which involve post-materialist values, supporting women and gay rights, or environmentalism.”

     The very definition of “a good life” is shifting.

     The "expression of postmaterialist values cannot be achieved through... issue-orientated organizations; predictably, post-materialism becomes a contributor to extra-institutional activism."
        George Diakoumakos: “Post-materialist values and crisis.
 Explaining the Greek political crisis according to Inglehart's theoretical framework.” Paper presented at the European Sociological Association Social Theory Conference "Crisis and Critique", 6-8 September 2012, Athens.

     This suggests that young people feel disconnected and disengaged from the mission(s) of the organizations in which they work, and in order for them to be authentic, they must engage in activism outside (or against) their organizations.

     BUT there are proven ways to mine the values, interests and talents of individuals as well as members of organizations in order to generate energized harmony instead of conflict. At the one-on-one individual level, Solution-Focused Therapy; and for organizations, Appreciative Inquiry.

        Cockell J, McArthur-Blair J. Appreciative Inquiry in Higher Education: A Transformative Force. Jossey-Bass, 2012.

        Greenberg G et al. Solution-focused therapy. Counseling model for busy family physicians. Can Fam Physician 2001; 47: 2289-95.

Rural Nova Scotia

 

Physicians - Healers, Teachers & Wise Elders

     "This book is for physicians who have good days and bad — and whose bad days bring the suffering that comes only from something one loves. It is for physicians who refuse to harden their hearts, because they love patients, healing, and the healing life." — Parker J. Palmer
     For many years, Parker Palmer has worked on behalf of physicians and others who choose their vocations for reasons of the heart but may lose heart because of the troubled, sometimes toxic systems in which they work. Hundreds of thousands of readers have benefited from his approach in The Courage to Heal, which takes physicians on an inner journey toward reconnecting with themselves, their patients, their colleagues, and their vocations, and reclaiming their passion for one of the most challenging and important of human endeavors.
     This book builds on a simple premise: good healing cannot be reduced to technique but is rooted in the identity and integrity of the physician. Good healing takes myriad forms but good healers share one trait: they are authentically present in the clinic, in community with their patients and their calling. They possess "a capacity for connectedness" and are able to weave a complex web of connections between themselves, their calling, and their patients, helping their patients weave a world for themselves. The connections made by good physicians are held not in their methods but in their hearts — the place where intellect, emotion, spirit, and will converge in the human self — supported by the community that emerges among us when we choose to live authentic lives."

     Doesn't everything above ring true? Yet in the original quote, all the words in blue referred to teachers and teaching, for Palmer's inspiring books are written for teachers, not (specifically) for physicians. Of course physicians are also teachers: to patients, health-care policy-makers & administrators, and healers-in-training. And most importantly, the finest physicians teach everyone, by the example of their own life well lived - a life of wisdom.

        Palmer PJ. The Courage to Teach: Exploring the Inner Landscape of a Teacher's Life. Jossey-Bass, 2007.

     Inspired by Palmer's writings, on April 24-27, 2013, the 2nd annual gathering: 

Integrity in Healthcare: The Courage to Lead in a Changing Landscape

http://www.couragerenewal.org/institute

 

Fall in Nova Scotia

Fresh opportunities blossom each moment - Carpe diem

     “Each day the first day: each day a life. Each morning we just hold out the chalice of our being to receive, to carry, and give back. It must be held out empty – for the past must only be reflected in its polish, its shape, its capacity.” 

Dag Hammarskjöld, second Secretary-General of the United Nations

http://www.daghammarskjold.se/photos/

Great Novels, Ideas, Conversations, & Life

     “To gain access to the life-enriching power (of great novels) requires a great investment in time and attention. Such works cannot be perused lightly, just as we cannot enjoy the benefits of great conversation if we attend to others only superficially and intermittently. To gain the full benefit, we must bring our best powers of perception, feeling, and thought to the text.

     Just as judicious reading can fuel the moral imagination, so great writing has an equally important role to play. For true wisdom lies not in memorizing what others have to say but in learning to express great ideas in our own words and in the living of our own lives. We do not grasp them fully until we have made them our own. Writing, whether in the form of journals, letters, or even manuscripts for publication, can be a worthwhile means of doing so. The discipline required to do so is analogous to the investment required to attain a high level of physical fitness and vitality. There are no shortcuts, but those who make the effort are often richly rewarded.”

Gunderman RB. Writing and being. J Am Coll Radiol 2012; 9(3): 162-3.

Artist: Joanne Hunt CSPWC, SCA    http://www.gallery78.com/

Self-reflection & Life-long Learning - beyond CME

     "when it comes to the highest and most important levels of understanding, the good educator is primarily a poser of questions. And the truly great educator is not merely a poser of questions but one who develops and inspires in learners an appetite for posing questions on their own."

        Gunderman, R. Deep questioning and deep learning. Acad Radiol 2012; 19(4): 489-90.

     How many of us sympathize with the following statement: "I know myself as a husband, as a father, as a physician, but who am I? And what do I really want? I have absolutely no clue."

     'Self-reflection' in the medical literature is about double-checking if we ordered the right tests for Mrs. X yesterday. This level of questioning is important and leads to upgrading our professional knowledge and improving patient care.
     A much deeper form of self-reflection is asking open questions like 'What is this?' and 'Who am I?' Open questions cannot be answered quickly or definitively. They guide us to intentionally face greater depths of our being, with curiosity and a sense of wonder at our complexity.
     A surprising proportion of us, for various reasons, are averse to introspection. This is unfortunate, because avoiding a deep, meaningful relationship with ourselves inevitably leads to "a life suffused with world weariness, a weariness that leads eventually to despair."

        Gunderman RB. Life's stages. J Am Coll Radiol 2007; 4(9): 640-2.

     As one learns to relate maturely with one's depths, "one can act and live in the world in accordance with one’s values and preferences, finding a way to care about oneself, others and the world. It is only by knowing oneself that it then becomes possible to act in the world; knowing what to do and what not to do."
        Odde D. Motivation and existence: Motivation in Kierkegaard and Heidegger. Existential Analysis 2011; 22(1): 56-69. 

See also the most popular post on this site: http://healthyhealers.blogspot.ca/2012/02/maturation.html

Artist: Joanne Hunt CSPWC, SCA    http://www.gallery78.com/

Communication - starts from our own Depth

     “If we’re not at home with the depth of our feelings, we’re likely to skirt the deep feelings of others. Do we love ourselves / others only when we / they are feeling fine?”
     “Don’t we often try to secure happiness by fortifying ourselves against imperfection?”
        Barasch MI. “The Compassionate Life: Walking the Path of Kindness.” Berrett-Koehler, 2009.

     “If caring for patients and families starts to feel like hard labor rather than a labor of love, clinicians need and must begin to take steps and talk to others and discover ways to begin the work involved healing the healer from within.”
         Showalter SE. Compassion fatigue: what is it? Why does it matter? Recognizing the symptoms, acknowledging the impact, developing the tools to prevent compassion fatigue, and strengthen the professional already suffering from the effects. Am J Hosp Palliat Care 2010; 27(4): 239-42.

     There is “… a longing for ways of speaking of the human experience of depth, meaning, mystery, moral purpose, transcendence, wholeness, intuition, vulnerability, tenderness, courage, the capacity to love … it arises from the hunger for authenticity, for correspondence between one’s inner and outer lives. … there is a desire to break through into a more spacious and nourishing conception of the common life we all share. … trust, loyalty, and connection, find place and resonance.”
          Parks SD. Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith. John Wiley & Sons, San Francisco, 2000.

Fall in Nova Scotia

Blindspots, Ethics & Evolution of consciousness

     A very self-assured young student had a conflict with an instructor. They were both convinced that the other was unprofessional. The student came to see me shortly after the incident, and was incensed at the instructor. I tried to soften his attitude, to help him behave more professionally at the time as well as in the future. This was part of my follow-up email to him:
     "I was suggesting you consider a softer approach in the future. The direct impact we can have on others' behavior is pretty minimal, while our own attitude sets the tone of our own (and others') lives. The question, 'would you rather be right or happy?' contains a lot. 
     Here's an old story of possible interest:        'A big burly samurai comes to the wise man and says, ‘Tell me the nature of heaven and hell.’ And the roshi looks him in the face and says; ‘Why should I tell a scruffy, disgusting, miserable slob like you?’ The samurai starts to get purple in the face, his hair starts to stand up, but the roshi won't stop, he keeps saying, ‘A miserable worm like you, do you think I should tell you anything?’ Consumed by rage, the samurai draws his sword, and he's just about to cut off the head of the roshi. Then the roshi says, ‘That's hell.’ The samurai, who is in fact a sensitive person, instantly gets it, that he just created his own hell; he was deep in hell. It was black and hot, filled with hatred, self-protection, anger, and resentment, so much so that he was going to kill this man. Tears fill his eyes and he starts to cry and he puts his palms together and the roshi says, ‘That's heaven’."

     And the young man's response? He emailed back that he preferred the following:
     "When somebody hits you, hit'em back harder" - Donald Trump

     Most students studying to become health-care professionals are not adults, but at best "emerging adults". They agree to professional codes of conduct, yet are, for the most part, simply not capable of relating to themselves, others, or ethical codes of conduct the way more mature people can. This is not immorality or amorality, simply an immature set of priorities / capacities, consistent with their immature stage of psychological / consciousness / moral / character development. AND, both dental and medical training have repeatedly been shown to NEGATIVELY impact normal maturation. Don't we need to improve on this?

Garden of Dreams, Kathmandu by Raewyn Bassett PhD   www.raewynbassett.com

The Quality of our Conversations & the Quality of our Lives

     “To Socrates, we are defined above all by what we know, which is reflected in our goodness. No amount of wealth or power can ever make a person wise or good. The truly good life is one of conversation around the pursuit of understanding, as represented in the text of Plato’s Socratic dialogues. ...
     In a sense, we can only be as good as the words that make up our lives. What sorts of things do we read, and to what degree do they open up possibilities for the full realization of our capacity to live and enrich the lives of others? We become what we habitually attend to, and our reading habits reflect our choice of destiny. If all we read are box scores or stock market quotations, this capacity is likely to lie dormant and unfulfilled. To a lesser degree, the same might be said for medical textbooks and journals, which provide an important kind of practical know-how but typically provide little insight into life’s more elevated possibilities.
     I am not suggesting that we stop reading newspapers and the medical literature; far from it. To be our best, we must understand the age in which we are living, as both citizens and professionals. Nevertheless, many of us would benefit from reading some better material. Moreover, many of us would do well to shift some of the time we devote to watching television or surfing the Internet to real reading. To repeat, our lives are to a great extent the product of the ideas with which we live, and by improving the quality of our ideas, we can enhance our own lives and the lives of those we live with and serve.”

       Gunderman RB. Writing and being. J Am Coll Radiol 2012; 9(3): 162-3.

Artist: Joanne Hunt CSPWC, SCA    http://www.gallery78.com/