5 Things I’m Grateful for this Holiday Season

This was a big year for me. I finished my pre-medical classes, took the MCAT, applied to medical school, and then I got into medical school. My youngest brother graduated college. My grandfather was buried in Arlington National Cemetery. I got a new job in the emergency department where I get to spend most of my day caring for patients. One of my dear friends had her first baby, and I’ll get to meet him this December (because I’m visiting my beloved Paraguay!!).

The laundry list above is just a sampling of the year. I’ve also made some great new friends, met some amazing people, done a tiny bit of national travel, and spent good hours learning new things. I could fill pages about the year, but I won’t just now. Instead, as the holidays approach, here are 5 things for which I am grateful:

1) My family who made it possible for me to get into medical school. They’ve listen to me gripe. Told me to stop whining and act. Shared my excitement for small victories. They’ve cooked, visited, hosted, taken me out to dinner, pitched in when I was in a pinch, made me laugh, talked me off the edge of tears, and helped me keep going when I wasn’t sure if going was an option.

2) The friends who stay in touch even though we live lightyears apart in separate, though equally chaotic, universes. The new friends who have joined me in sweating over biochemistry, hiking through Vermont’s woods, undertaking food adventures, and soaking in the quiet moments of life. The hardest part about moving as much as I have is that many of my favorite humans live far away. It’s a testament to their greatness that despite our distance they remain a positive force in my life.

3) The folks at my new job who reminded me what being part of a good team feels like. Who taught me the tricks of a new trade. Who show up every shift ready to do what needs to be done and between saving lives have energy for a smile or laugh.

4) The mentors and teachers who taught me all I know about medicine and science. But, also, my life mentors—the ones who have been there since undergrad (or before), the ones who’ve shown me the ropes of being an EMT, and the ones who set an example of what kind of old person I aspire to be.

5) Vermont. Sometimes my little home state is cold (actually, it’s usually cold). Sometimes Vermont is too homogenous and too isolated to quench my love of the new. But, this year, I’ve basked in perfect summer days where the sun is just right. I’ve soaked in the smells and silence of the forest and absorbed the wind that makes waves on Lake Champlain. I’ve reflected on the mountains that guard the horizon. I’ve enjoyed creemees, apple orchards, and maple syrup. I’ve watched the rain fall with mate in hand. I’m from Vermont. And while I don’t often call Vermont my home, it is the place where my roots have always been and always will be.

I’m grateful for the moments I’ve had to enjoy all the people and places that make life worth the sweat. I’m thinking about those moments as the holidays approach.

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Marathon Goals

I remember the conversation I had with my best friend that sealed my desire to become a doctor. We were in our relatively new apartment, in the living room that was an extension of the kitchen. The city sun of Washington, DC filtered in the large windows and onto the bedraggled plants we had lined along the window sills. I’d been contemplating the idea of entering medicine for months. The thought came to me shortly after I started working in health communications. What I liked most about health communications was the medical research, knowledge of life, and opportunities to interact with people. I wanted to find a way to fill my days with those things rather than dabble in them. My friend worked in a primary care office, on the administrative side. She encouraged me as I talked about possibly switching careers. “You’d be a good doctor,” she said. Thus, began my marathon goal to become a doctor, a process I call “the doctorhood quest.”

That conversation was 5 years ago. Recently, what started as a thought became a real possibility. I’ve been accepted to medical school. There’s still the question of financing and survival, but with an acceptance to school, there is hope that the rest of the journey will fall into place. I will be a doctor.

Marathon goals. I’ve always been a planner and as a runner I prefer long distance. But, there is something uniquely challenging about making goals that will take over a decade to accomplish. There is no way to know the future, and absolutely no way to predict a future as distant as 10 years from now. But, somehow, the uncertainty and hidden challenges that the doctorhood quest presents have not deterred me. I reflected on the prospect of doctorhood during my years of Peace Corps service and, once back in the States, I started jumping through the hoops of medical school applications (I had no science background when I began). The long wait to medical school acceptance has only made me more excited to start my studies. The doctorhood quest isn’t even half over—medical school, residency, and board exams will be the longer leg of the journey. Yet, as I sit on an acceptance letter and wait to hear back from more schools, it’s thrilling that I’ve come this far.

People around me, to me or to others, often comment on how intelligent one must be to get into medical school. I usually remain silent, but smirk inwardly. I believe “smart” comes in many forms and not all are suited to medicine. I’m disinclined to suggest one person is smarter than another because life has shown me that humans have different gifts and society needs all of them to function. But, more specifically, my journey has shown me that medical school admittance has less to do with how smart someone is and more to do with how resilient they are. The doctorhood quest requires you to be gritty and determined. It demands that you jump up and try again each time you fall while tackling the perils of the road.

If resiliency and grit is the secret to pursuing marathon goals without losing hope, how does one get those? Experience and inward reflection are my guesses. We learn by doing and we expand our scope of understanding the more different experiences we have. Nothing proved this more to me than my years in Paraguay. I am not the same person I was when I first stepped off the plane in that hot, humid country. The people there showed me how they found happiness; they defined respect and God and love in ways completely different from any definition I’d ever encountered for those things; and, above all, they exposed me to foods, ways of life, and shared moments I could never have imagined.

Experience is the foundation for growth, but to truly grow one must reflect on those experiences. Paraguay, once again, taught me reflection. It is impossible to describe just how lonely and hard it can be to be the only one from your culture in a foreign place unless you’ve experienced it. Your world is turned upside-down and every definition and rule you ever thought was a given is no longer in play. Your default becomes mild confusion and curiosity about the new culture in which you have fallen. Most importantly, you are forced to examine how your culture does things and why. Once you start picking apart your host and native cultures, it’s an easy, logical jump to start evaluating and thinking about different aspects of your personal life—like your interactions, feelings, and activity choices. Once you build in time to reflect on experience you can start to shape your path more purposefully.

The secret to marathon goals is accepting you can’t know the future, but you can influence the present. The secret is celebrating small victories, making educated guesses about the best course of action today, and seeking out the people, places, and experiences that rejuvenate you when your hope falters. We do not achieve marathon goals alone (it takes many helpers) but it is only from within ourselves that we find the strength to withstand what’s hidden behind each bend in the road.

Go Vote on November 6

Elections are November 6. That’s a few days from now. If you haven’t registered, there’s still time. There’s also time to figure out where to go to vote. There’s time to review the candidates and pick which ones you want to lead us. Now’s the time.

Recently, a friend shrugged when I encouraged her to register to vote and fit a trip to the polls into her busy Tuesday. Elections are this Tuesday, November 6, 2018. “I haven’t been affected by the current president,” she said.

“Are you sure?” I asked. I wondered how she hadn’t noticed the ways in which our leaders’ decisions were posed to shape American lives for generations. I wondered when we thought the only person we voted for was the president. I wondered about the apathy of the masses. I wondered when we had forgotten how much politics matter.

We don’t only vote for the president. We vote for the school budget and those who decide how our towns and cities and states should be run. We vote for congress men and women every 2 years and we vote for senators every 6 years…and those two groups make up the Legislative Branch. The Legislative Branch is important because it’s a counterweight, a check and a balance, to the Executive Branch (the president) and the Judicial Branch (the judges, picked by the president on the national level).

US democracy only works if you care about all 3 governmental branches because the 3 keep each other in check. US democracy only works if you care about federal, state, and local politics because they work with and against each other in a constant tug-of-war between different beliefs. When one fraction of the government is ignored by most voters, the voices of a few predominate, and those vocal individuals then make decisions for other people whose lives they don’t understand.

But, let me stop ranting. I have a few points that are more concise. A few issues to keep in mind. A few things I remember when elections come.

  • What’s the price of gas these days? Did you know tariffs and trade agreements made by our politicians can lower the price of gas for the period leading up to elections?
  • What is your voting district? Did you know district borders are drawn by politicians? The lines are often drawn to ensure the current party always wins.
  • How do you feel about access to health care? For the elderly? For the poor? For those who have pre-existing conditions (those who are already sick)? Access to and education about birth control? Your politicians decide how hard it is to see a doctor and get the medications you need to feel well.
  • What is love? Who are you allowed to marry? Who gets legal rights to visit a loved one as they lie dying in a hospital? Who can adopt children? Your politicians decide.
  • Who’s protected by civil rights laws? Your politicians get to set legal definitions of things like gender, sex, and race. Did you know children used to not have protection under the law? They had fewer rights than animals. Politicians changed that—with pressure from lobbyists and people who thought it was wrong to beat children or make children work.
  • Where and when do we go to war? How to we care for veterans? Who do we allow to join the armed forces? Your politicians set those guidelines. What are we doing in Iraq and Afghanistan now? What are American soldiers doing in Syria? Are we going to attack Russia or China? It’s your government that makes those decisions.
  • Are billboards allowed? Billboards are illegal in Vermont, thanks to local politics. Vermont depends on tourism…so were billboards banned for economic reasons or was it because some politicians thought billboards were ugly?

The above are just the beginning. There are so many other things that depend on politics. The price of food, for example. The minimum wage. Life is a complex web. Claim: our immigration policies influence the price of oranges…can you puzzle out why?

The thing about politics is that it permeates life in subtle ways. In the US, we are lucky because political decisions don’t often lead to obvious shortages of essentials or the disappearance of dissenters (we don’t have camps where we hold people prisoner, or do we?). It’s naïve to believe that everything from our wallets to privacy or marriage to jail terms are not shaped by the decisions our legislators, judges, and political leaders make.

My point is simply that your opinion matters. Make yourself heard and go vote. Take part in democracy. Be a citizen of the US and go vote. Go vote because it’s what you should do. Go vote because it’s what others are doing. Go vote because you can. Go vote because your country needs you to vote. Go vote.

Golden Leaves and Golden Sun

Autumn in Vermont is like a pendulum; it swings between cold rainy days and bright sun that reflects off the yellow, orange, red, and brown leaves soon to fall off the trees. The damp days and frost-laced evenings are a prelude to the winter soon to come. The strong sun on the loveliest days of October is not only a reflection of the summer just past, but also particularly appealing because it contrasts with the brisk wind and cool damp air inherit of autumn.

Earlier this October when the sun looked like a flood of gold as it reflected off the hills, I set out with a friend on an easy, wandering hike through the woods, past beaver dams, and up the tame slopes of a hill with an outstanding view. The shade and wind carried the hint of frost, but the sunlight danced so joyfully through the birch, beech, and maple leaves that I didn’t feel cold while wearing only a light jacket. The pleasantness of the day penetrated through my slight haze. The previous weeks had been a whirlwind of adventure, topped off by working the night shift the night before our hike and running a half marathon with my sister two days earlier. But, as we parked the car and started walking I didn’t feel tired. My mate had kicked in and the day was too charming to pass inside. There’s something about the woods in Vermont…they recharge me more than anywhere else. [Text continues after image.]

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I grew up in Vermont, but moved to the city for college and work and then moved abroad. I’ve been back a few years, enjoying the time until more schooling picks my next home. I imagine, just as I did as a new adult, I have more city turns and many places to live before I sleep for good. I imagine many of those places will be about as different and as far from Vermont as possible on our small planet. While I never really miss the Green Mountain State in its entirety, when I live elsewhere I periodically find myself aching for the quiet woods that always awaits me here.

The woods in the fall are my favorite. Fall is my favorite season in Vermont for its smells—piles of leaves, apple cider, wood smoke, and pumpkin baked goods—and perfect temperatures. The leaves already fallen rustle underfoot and the tangy, earthy smell of the soil and crisp foliage tingles your nose in an only pleasant way. The natural world is getting ready for sleep and a long stretch of harsh weather. The chipmunks and squirrels are in overdrive, jumping about like bunnies with cheeks full of nuts. Wild apples, acorns, cherries, and berries adorn the trees, weighing the branches down and feeding the deer and other woods dwellers. There’s an influx of geese and other migrating birds—their flocks fill the ponds and trees and raise a chorus of excited chatter about their long journey south.

The forests of Vermont aren’t epic like those of California and Washington state. They aren’t misty, exotic, and lavish like the Amazon or the jungles of Central America and Africa. Nor are they tangled and concealing large snakes, jaguars, and anteaters like the forests in Paraguay. In contrast, it’s their humble scale and unassuming beauty that brings thoughts of the Vermont woods, my childhood haunts, to me when I’ve spent too long away. I always know when those thoughts percolate it’s time to visit.

My friend and I paused on the hilltop to enjoy the view and take in a few golden rays before our descent back into the forest. I sat, knees pulled up against my chest, and gazed out over the rolling patchwork of gold, green, and bronze. The stone face on which I sat was slightly warm thanks to the sun. We were shielded from the breeze. No one else was around. There was a quiet that’s forgotten even in the smallest of towns. The calm was a relief after the rush of work in a hospital and traveling for medical school interviews—places full of complicated thoughts and human interaction. In those moments on the hill, I was thankful for the forest. I also felt a pang of bitterness about the cold winter soon to come, but I know (as I’ve said before) that the cold is one thing that keeps people from flooding Vermont. And, anything that keeps the autumn woods here quiet so I can sneak away and meditate on life’s challenges is welcome.

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Name the Fear

My stepmother’s friend used to play a game called “Name the Fear and Conquer It” where she identified things that scared her—like bungee jumping— and then did them. My sister has a philosophy about hesitation: If you hesitate because you don’t like something then it’s okay to abort, but if you hesitate because you’re scared you ought to dig for courage and forge onward.

The above thoughts are good summaries of how I, too, approach undertakings that make me nervous. The difference is that I don’t necessarily seek out thrillers like sky diving. I prefer to look around me so I can maximize normal life, avoid falling into mindless routines (I like to break them when they form), and daydream about the next challenge I’m going to tackle. Here’s an example.

Wrestling uncertainty was something I did when I became an EMT. I distinctly remember my tumultuous beginning. I threw myself into a condensed EMT course, having no clinical background, that moved so fast it didn’t even have lectures. It’s one of the only classes, and the only one since sophomore year of undergrad, that made me cry. I didn’t know if I’d survive the class. I didn’t know if I’d pass the licensing exams. I didn’t know if I’d like running on an ambulance. But, I made an educated guess and decided it was worth the gamble.

At first, I felt uncomfortable touching strangers—a necessity when you’re taking a pulse and blood pressure or doing a physical exam. I had to coach myself to be still and not run away when my classmates practiced taking a pulse on me. Understanding how the lungs and heart worked wasn’t intuitive. And, for my mind, memorizing isn’t enough. I must understand. I spent many hours reading and rewriting notes.

I lived through the class. Some tears, but I mostly just buried my nose in my textbook and practiced as much as I could during our practical classes. Despite my efforts, I failed a few stations of the psychomotor exam (physical skills) the first time I took it. I couldn’t concentrate and I messed up things I knew on several stations. (The traditional student in me came through though, and I passed the computer portion of the exam in one shot). I almost quit after failing the psychomotor exam. But, I asked myself, “If you can’t be an EMT how on earth are you ever going to be a doctor?” I practiced more. I gave myself many pep-talks. I passed everything on my second try because I focus on how much I wanted to start working with patients and how certain I was that I was pushing myself in the right direction.

I was so nervous thinking about starting as an EMT that I can’t recall my voyage to my first EMT shift. Despite my panic, though, running on an ambulance started way better than my EMT class had. My crew captain assured me he wouldn’t let me kill anyone. Further, he and the rest of the crew went above and beyond to show me the ropes (well, actually, they showed me the tubes, the gadgets, the bandages, and all the other gear that fills the numerous nooks of an ambulance). Time would show that I enjoyed being on an ambulance. I loved the puzzle of figuring out what was wrong with patients and how to treat their condition. I loved chatting with patients when there was nothing to be done but ride to the hospital. Patients almost always have amazing life stories to tell.

About a year after becoming an EMT, I took another leap. I left my communications job—my undergrad degree was in communications—and dove professionally into health care. I began working as an EMT in the emergency department. Yet, despite the major change, this professional jump wasn’t scary like my EMT class had been. During my first couple of months on the job, I learned a ton of new skills like how to place IVs. While I wasn’t an expert at anything new right away, I knew I’d get there if I focused and practiced. My EMT course proved that.

EMTing pushed the boundaries of my comfort zone. This surprised me because I have a wide comfort zone. After all, I’ve moved and built a life in two completely new countries (once as a student and once as a Peace Corps volunteer) and I’ve moved from the country to the city and the city to the country–which is to say I’m comfortable with change. I think the hands-on work and using assessment to inform treatment of living beings challenged me most when I started learning clinical skills. However, I’m so glad I pushed through the bumpy beginning of my career in health care delivery because medicine is the most fulfilling professional pursuit I’ve undertaken to date.

It’s easy to avoid things we’re bad at because they make us uncomfortable. But, as I told myself many times leading up to round two of the EMT exam, if everything was easy then life would be boring. With that, I leave you with a quote from Amelia Earhart:

“The most difficult thing is the decision to act, the rest is merely tenacity. The fears are paper tigers. You can do anything you decide to do. You can act to change and control your life; and the procedure, the process is its own reward.”

English Social Vocabulary Cramps My Style

While I can bore you with a VERY long laundry list of why I love speaking Spanish more than English—especially the Guaraní-Spanish mix (called “jopara”) spoken in Paraguay—I won’t. There’s one term, however, above all the other turns of phrase that I still (years after returning to the US) struggle without. The term is “guapa” (“guapo” for males).

In the Paraguayan context, “guapa” means hardworking. It’s a compliment that’s dished out like gravy at Thanksgiving—in copious amounts and without restraint. If you show up at a friend’s house, you’re “guapa.” If you do the dishes, clear the dishes, or help in any minor way, you’re guapa. If you study like crazy, you’re guapa. If you work long hours, you’re guapa. If you remember someone’s birthday, you’re guapa. If you take two seconds do to anything for anyone else, you’re guapa.

Despite its prevalence and low-barrier for use, I think “guapa” is the most wonderful term. Why? Because it promotes a spirit of teamwork. The word builds into social culture an easy way to constantly appreciate others for their contributions to the wellbeing of the whole. Anyone can be guapa and multiple people can be guapa at once because the more guapa-ness there is the better off everyone ends up.

In my workplace and social spaces, I’ve tried to substitute in English words for “guapa.” “Rocks star,” “champion,” and “genius” are among my favorites, but none of these words hold the shared meaning that “guapa” does in Paraguay. In Paraguay, when you call someone “guapa” it as if you’re saying, “Not only do I notice that thing you’re doing, but also I appreciate both the outcome of your action and you for making it happen.”

In the US, we are busy. In the US, we have high standards. Why the heck don’t we have a word whose sole purpose is to cheer on our colleagues, friends, and family as they undertake their daily adventures? Sometimes I wonder if it comes down to our emphasis on individualism. But, in my mind, even the strongest individual required a village to reach their full potential. I believe we (American English speakers) do more harm than good not having a term to thank folks for all their small acts that make our lives a tad bit brighter each day. “Guapa” makes appreciation a natural part of interaction, not something done out of obligation or because it improves outcomes. I miss being able to use “guapa.” I miss the community feeling words like “guapa” create.

What Is a Hero?

Quandary and Claim

Recently, the discussion as to whether the football players who took a knee during the national anthem were heroes has been zooming across my social media feeds. Often those who do not believe they were heroes show a side-by-side of a sportsman next to a soldier and proclaim that the soldier is the real hero. The first time I saw the comparison it irked me because it is an-apples-to-oranges argument. Further, I think the logic is founded on false pretenses because it says that what title you have determines your hero status. History has shown us many times that title and profession have little to do with heroism. Think of any recent disaster you’d like, you’ll find a story of some common human stepping up to be a hero. Further, being a hero is not exclusive, which is to say that just because one human is a hero does not mean another cannot also be a hero.

Being anything, even a soldier, does not automatically make you a hero. Many soldiers grow to become heroes, their line of work can be a selfless one, but not all. It is unwise to overlook the crimes specific, individual soldiers have committed—the pain they caused soundly rules them out as hero candidates. It would also be foolish to say that any highly-paid athlete is a hero—providing entertainment and winning games does not a hero make.

Some Incomplete Definitions

Google defines hero as, “a person who is admired or idealized for courage, outstanding achievements, or noble qualities.”

My Merriam-Webster dictionary ap defines hero as, “a person who is admired for great or brave acts or fine qualities.”

These definitions leave a bit to be desired because they do not define what exactly an “outstanding achievement” or “brave act” is nor do they define what “noble” or “fine” qualities are. So, let’s explore those concepts.

Outstanding Achievements and Brave Acts

I do not believe that just any outstanding achievement or brave act makes you a hero.

For example…

Getting into medical school is an outstanding achievement, but all medical students are not heroes. It is brave to ride a motorcycle down a curvy, highly-trafficked highway (if you worked in the emergency room you’d think that too), but not all folks who ride motorcycles in dangerous places are heroes.

Selfless acts make heroes.

The acts and achievements that bring “hero” into the dialogue are those where an individual does something that will help another person or group (family, peers, race, gender, nationality…etc.) even though the cost of that act for the individual outweighs any potential personal gain.

For example…

The firefighter who rescues a kid from a burning building. A bystander who helps an old lady cross the street even though he is then late for work. MLK who scarified his freedom and life to fight for equality. The soldier who threw himself on a grenade to protect his comrades. The teacher who stayed after school every day to help a struggling student grasp the material. Malala Yousafzai who spoke up for women’s rights even though it put her in harm’s way. The list goes on…and on…

Noble and Fine Qualities

Similarly, not all qualities that are noble and fine are heroic qualities. Being kind is a noble quality. But kindness alone doesn’t make you a hero, it just makes you a decent human.

Qualities that heroes often embody are selflessness and a fierce definition of right and wrong. I would argue, however, that a hero need not exhibit these qualities every moment of their life.

So, what is a hero?

A hero is someone who changed the course of another’s life (or many others) in such a way as to reduce their suffering, increase their happiness, or protect their individual freedom to reach their full potential (I’ll leave you to define “full potential”) without directly benefiting themselves. Heroes can be local, national, or global. The scale does not detract from the heroism, it simply describes how widely known the hero’s story is. I believe a child who stands up and stops other students from bullying a classmate on her playground is as much a hero as Nelson Mandela, even if the impact is smaller. It is not easy to act selflessly. It is true, however, that some professions and circumstances provide more opportunities to be a hero. I would also argue that “hero” is not inherently a permanent title. It is fleeting and describes a specific act during a specific time. However, some people are so often heroic that they earn the description again and again.

Conclusion

It is not productive to nitpick whether Colin Kaepernick is more of a hero than a soldier. It is worth acknowledging that Kaepernick did something that many football players have not. He brought race discussions to the forefront of entertainment. He forced us to examine if our country is living up to what we claim our guiding principles are in a time when public figures have attacked just about every minority and women. In making us question if our country is truly fighting to give ALL its citizens the right to life, liberty, and the pursuit of happiness Kaepernick made me wonder if we are giving our soldiers the chance to be national heroes or if we are putting them in impossible situations where they can only be heroes within their unit because their country is sending them into battles that cause more harm than good. I think it is important to remember that even if not every soldier is a hero their profession is asking them to put country before their own life. That is a big request; it would be worth reminding our leaders that such a request should weigh heavily on every decision they make.

Leader vs Boss

The many teams I work on (of varying sizes) throughout my shift in the emergency department have provided ample opportunity to experience different team leads. And, in recent weeks, I’ve been reminded of a lesson I once taught my Paraguayan students (I taught life skills classes to grades 7-12 as a Peace Corps volunteer in Paraguay for 2 years). The lesson was during our leadership unit and it was on the difference between a leader and a boss.

Lesson

I started my class with the following image:

I defined the differing titles as follows:

Leader

A leader is someone who leads by example. They are skilled, trustworthy, and levelheaded. A leader is confidant with their abilities, but they are willing to change their tactic if any team member has a better idea. A leader gets their hands dirty. A leader reminds you of your strengths and approaches weaknesses as learning opportunities not permanent shortcomings. A leader is willing to have that hard conversation or make the decision no one else wants to make. A leader makes every team member feel like the project belongs to them, not just the leader.

Boss

A boss is someone who leads by giving orders. They think their way is the only way and expect others to follow them. A boss is an expert, but they are not someone you go to when you’re having a problem. A boss is the first to address a shortcoming or mistake and says little when a job is well done. A boss stands above the work, but tells you how you should complete each task. A boss makes all the decisions, but when something goes wrong blames it on the team. A boss expects you to pledge allegiance to their project.

Reflection

It’s not the breadth of knowledge or the level of skill that distinguishes a leader from a boss. They are differentiated by how they approach their colleagues. When I was a teacher, I asked my students to reflect on which type of team lead they’d rather follow and they always picked the leader. I asked them, then, how they were going to be leaders rather than bosses.

“Listen and be kind,” they said.

We could all remember my students’ advice. For some it comes easily while others have to remind themselves to listen and be kind. However, as long as the end is reached, it’s okay if being a leader doesn’t come naturally at first.

When work is slow, the opportunities to dish out compliments are obvious and abundant. Amid the chaos of a high census (lots of tasks all at once) or when faced with a critical patient, it can be harder. Leaders always find a way to lift us. That’s why we follow them. When the going gets tough, leaders bring us together while bosses push us apart.

Choose to be a leader. Your team needs you.

Work-Life Balance

Why do some people always seem to have time for vacation, camping trips, and concerts while others always seem to be working? How do some people function on what seems to be no sleep? What exactly is work-life balance? Is being a workaholic a problem or just one way of giving life meaning?

Some Case Studies

Hospitals

Health care is full of people who work almost around the clock—nights, weekends, and holidays are fair game. But, for example, the shift work of nursing can allow for many days off every 2 weeks. Plenty of nurses I know take advantage of 36-hour, full-time work weeks (broken into 3, 12-hour shifts). A sample biweekly work week is 3 days working, 1 day sleeping, 3 days working and 7 days off. Despite the exhaustingly long shifts, these nurses enjoy 4 more days off every 2 weeks than a person who works a job Monday through Friday.

My American Family

In my immediate family, there are many models of work. Several of my family members are self-employed. They may work every day but they might also take long stretches off. Some days are long; some days are short. My sister is a trainer and fitness queen. While she often works fewer than 40 hours per week, her hours are spread out across every day of the week and at different times of day such that taking even one day off requires scheduling magic. There’s my step-mom who has the stereotypical workaholic, business schedule which is based on an 8-hour slot Monday through Friday. Of course, a few hours are tacked onto each day and she works additional hours over the weekend. In the end, she works something like 80 hours a week even though she’s on paper for 40—and, stepping away for any stretch of time seems impossible.

Paraguay

In Paraguay, holidays are sacred, summers are lazy, and commutes are so long they seem unreal. Except for the man I knew in the Navy and some small business owners, no Paraguayan I met while living there worked during a national holiday. Perhaps that’s different in Asunción (the capital) and in major hospitals (of which there are few) but generally Paraguayans don’t work holidays. Additionally, few people work on Sundays. Almost nobody works past midnight. While many Paraguayans have long commutes to work and work long hours, the number of days off they have in a year dwarfs the number of days off many Americans choose to take.

Paraguay vs US

In Paraguay, family comes first for most people. Most people work to support their family and buy nice things. Most Paraguayans prioritize time off visiting, eating, celebrating, and watching soccer over working endless hours. Most Americans prioritize working. Many Americans bank hundreds of vacation hours that they cash out or lose entirely. Of course, these are stereotypes…but, during my experience living in both countries, the stereotypes of family-first for Paraguay and work-first for the US seemed justified. I’ve often asked myself, “Who has it right?”

The Perfect Balance

The balance between work and other activities isn’t static. The perfect balance, the one that yields the greatest happiness, is unique for each human. Neither the Paraguayan approach nor the American life approach is better, they are just different. Paraguay taught me the importance of downtime while the US emphasizes overtime and constant production. Regardless of who you are, there are times when work should come first and times when family, vacation, rest, or anything else must come first.

Winning the balance comes down to being willing to reflect on your life and to make changes. For example, when one of my friends frequently complains about working too much or is always exhausted, I often ask if it’s time to scale-back or change their work schedule, job, or approach to working. When another friend often talks about being bored at work or not making enough money, my thought is that it’s time for them to invest more effort in professional growth. Is it easy to change things up and move toward something different? No.

It’s hard to reflect on your life and make meaningful changes. What I do to face the challenge is break my life into chapters and then identify what made me happiest and saddest during each chapter. I use what I identified to inform my guesses about what I need to do today to tip the scale more towards happy going forward. I tend to be work-centered (mostly because I love learning and feeling productive). As a result, the life side of my balance always requires more attention and energy than the work side. Knowing this, I put extra effort into “life” to keep my scale level. My scale often dips one way or the other, but I try not to let the off-kilter stretches jar me. Rather, I make small adjustments until I waver around a mix of experience that feels right for the time.

Sirens

Life boils down to tidbits like sounds. These days as I walk the sidewalk—scuttling, rambling, or strutting from one place to another—I listen to the sirens. Since running (EMT talk for “working”) on an ambulance, I accidentally developed the ability to distinguish fire truck, police car, and ambulance sirens. Since studying the Doppler effect, I can tell if the sirens are approaching or withdrawing. And since learning to drive an ambulance, I know that a change in siren tune or the blast of an air-horn indicate that the vehicle is at an intersection.

I never cared much for automobiles. I still don’t. I’m not particularly proud or impressed by my siren radar. Nor am I gleeful about that fact that I always notice ambulances, no matter where I am. Before joining a rescue squad, I hardly ever processed sirens or saw ambulances because I lived in a city where there are so many of both they become part of the background. But, since moving to the countryside again and joining the world of emergency medicine, my consciousness has changed. I find myself almost subconsciously tracking the progression of sirens around my large Vermont town. A cop car went first—drugs or a car accident maybe? Just an ambulance—maybe the firetruck is out already and it’s just a medical call? Firetruck and ambulance—maybe cardiac arrest?

I started noticing that I listen to sirens because I was thrown into a different world of sounds: the soundtrack of the emergency department. The emergency department is noisy. There are the heart monitors that beep along with patients’ heart rates and alarm whenever the heart rate or oxygen levels deviate from a norm. There’s the clicking of blood pressure cuffs inflating. There’s the sound of wheels scraping as wheelchairs and beds and carts with supplies skid across the linoleum floor. There’s the clacking of those typing about what medications they gave and assessments they did. There is the thud of quick footsteps and the shuffle of walkers. Patients groan and puke and roll in their beds. And that is only the beginning.

I think all the noise is why, after a long week of work, I seek a few hours where people are scarce. It’s hard to think when there is so much to grab your attention. In the bustle of life, we can forget what the wind and the waves and the trees and the birds sound like. But more than anything else, we forget the sound of silence. I’m not talking about the strained, artificial silence of a library during finals week. When I say “silence,” I mean those moments when no one else is there to drop a pin. I’m talking about the silence that can’t be found in a city and is endangered by our social lives. If nothing else, I think true silence helps us ground ourselves and gauge when life’s racket is distracting us.

When I stroll about my town, I always hear the sirens. When I visit the woods where I grew up, I erase the ringing of so many sounds and soak in the quiet of the trees. I’m grateful that I can experience both.