Category: Being human

Reflections that focus on life in general and more specifically on what it means to be a human being!

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Being human Medicine Reflections on Life, Being Human, and Medicine Reflections on the Christian Life

The Hype Video: Purpose and Meaning that Drives What You Do

The big screens lit up and the speakers boomed. The crowd cheered as the video played. By the end we were all excited. The freshmen were lined up with some upperclassmen holding them back. Then the upperclassmen released the freshmen and they stormed across the football field as they ran the “Baylor line.” 

It was a five years ago and I was in McLane Stadium at Baylor University. I had flown down to visit my daughter JJ. We had walked around the tailgating areas and had bought green (it was a green day) Baylor logo hats and shirts to wear. We were in the huge stadium and the “hype video” was a key part of the experience. We spent the rest of the day with our arms in the air doing the Baylor Sic ‘em. The weather wasn’t the greatest. It rained. Baylor didn’t win. But it didn’t seem to matter all that much. It was fun to be there and experience it and especially to do it with JJ.

So much fun watching the freshman class run the Baylor line!

The hype video was well done. It really got me excited about the game. I felt happy to be in the stadium and be a part of all of it.

It reminded me of a story that I had been told many years before. 

One of my teachers had worked for a large appliance store before he became a teacher. He told how each morning before the store opened they would get all the salespeople together. They would go through a “pep” talk – sort of the equivalent of a hype video. They would tell them how it was their duty to (a) sell, (b) sell and (c) sell some more. The more they sold the stronger the economy. That would then mean jobs and prosperity for our community and our country. He told me they would get them so hyped up that by the time of the doors would be opened he said he was ready to go. Every day he would be enthused and ready to convince anyone who came in to buy the latest and greatest electronics equipment. It was his noble and patriotic duty to do so.

When he told me the story, it made me understand that store better. Every time I had been to that store the salespersons had always been very eager to sell. I bought a big powerful stereo from that store. I loved it. It was strong enough that you could feel it as well as hear it.

It does, however, raise the question that confronts a lot of us: Do we have purpose in our lives?

A part of being human is a need to have a sense of purpose. We need to believe that what we are doing has meaning and value. To do less than that can lead to drudgery and eventually to burn out. “It’s time to make the donuts…” was the old commercial[1]. At times any job can seem like that: a never-ending cycle of delivering a product or service. But we all want to go beyond that. We all have a need to find purpose and meaning in what we do. 

You can argue for or against the hype that the electronics store used. Honestly, it sounds ridiculous to me. But if that is your business, you likely will need to work through what you are doing. If it is just about doing something over and over again for no reason, you will not last. You will not be effective. If it is just about making money you may find a deepening hole in your soul that will eat at you. To last and be happy you will need to think through it to find a purpose or meaning.

I was unsettled. It is a long story but ultimately I had decided to leave my primary care internal medicine practice and go back to training and into a cardiology fellowship. My purpose had shifted. I couldn’t stay. In spite of the risk and loss of income I had to make a change. It was the right move for me.

In the time of that transition, I was at a dinner meeting and I ran into Mark. He was another internist that I had known for several years. “I thought about doing what you are doing,” he said to me as we put our coats on and walked toward our cars. “I admire you for it. I was really close to going back to fellowship myself at one point.” 

“Why didn’t you?” I asked him. 

“Growing up when I thought about wanting to be a doctor it was because I had a vision – a desire – to be “someone’s” doctor. In my mind it was the long standing and lifelong relationship that defined what it meant to me to be a doctor. I thought about specializing but realized that to do so would betray what my purpose in being a doctor was about.” 

It made sense to me. I was happy that he had figured it out. He was in primary care because that was where he found purpose and meaning. The reason he didn’t do a fellowship wasn’t because of a lack of ability or courage or drive. It was because it would have been wrong for him to betray his purpose. I was happy he saw his purpose.

It challenged me to think about my purpose. It was clear to me that there was something – or some things – that were driving me to do the fellowship and pushing me forward. The unsettled feeling was all about purpose. For me it may have gone further to even be a calling or a vocation.

How do we each find purpose and meaning in our lives? I have learned that it is a very individual thing. It also can shift and change throughout your life. 

It might not be at work. Some never find their purpose or meaning in their jobs. That is okay. Obviously throughout human existence there are times when just surviving is enough. Trying to find some deeper purpose or meaning in your work can often be a luxury. There are millions of people in the world who work to just survive. They still have purpose in their lives, but the content of their work may not be where it is. 

We all know people who do work to have the resources and time to find their purpose elsewhere.  For them their purpose is found in many different places. Family is a common driving purpose. Sometimes it is friends and the time invested in them as they pursue their favorite hobbies. Clearly faith and serving God is a big and driving purpose for many. Some do amazing things in their churches or other areas.  To them a demanding job might just distract or pull them away from their purpose. 

Some find meaning in the how rather than the what of what they do. For them their drive comes from doing whatever they do with quality and excellence. This is a common source of purpose early in a career. There is a real challenge and satisfaction in mastering an art, skill or field of specialty. In that phase of life, purpose and meaning is found in the effort of acquiring competence and eventually expertise.

There is something admirable about being an expert – or a craftsman – in whatever you do. I am convinced that a clerk at the gas station can have true purpose and meaning in their work if they are determined to do it well. The book, “The Fred Factor”[2] is an excellent discussion about this type of thinking.  The subtitle explains the concept, “How passion in your work and life can turn the ordinary into the extraordinary.”

The point is I am convinced that the secret to sustainability in whatever you are doing is to find your purpose and drive in your life.

And now I pause.

Because it sometimes is easier said than done. Sometimes your purpose is crystal clear. Other times it shifts and changes. 

Sometimes you get cancer and it stops you in your tracks and confuses everything. Sometimes even though you recover from cancer surgery and treatment, you are left easily tired and not the same person as you were before. Sometimes you can no longer drive hard anymore. You find that you can no longer stay up late, working into the night, and then pop up in the early morning to continue to work for an hour or two before the clinical day starts. Sometimes you have a gym membership that you used to go to at 5:30 each morning that you still pay for but leave unused for months on end. Sometimes you get home at night and do not have the energy or desire or drive to answer the emails that accumulated during the day. Sometimes you have to figure out again what drives you – or what motivates you – or what is worthy of the energy that you do have.

I am not complaining. As I went through the cancer diagnosis and treatment, it occurred to me that I had no desire to continue with business as usual. I was eager to rethink what was important. It meant digging down into my person and my soul and my world to see what I wanted – or what I needed – to do. And even now, I continue to dig down and evaluate where I am and what I am doing. I would be disappointed if nothing changed. I would feel like I had wasted the trauma of having cancer (can’t I get something good out of this?)

What drives my hype video now?

Over these past three years since my diagnosis, I have been slowly figuring out some things. 

It is not about selling stereos. I don’t care about selling a product or making anyone profitable.

Some of it may have elements of what my friend Mark said. It has been a real honor to play the role as a heart failure cardiologist for the good of my patients and their families. In the past I would think in broad sweeps about systems of practice. Looking back now I realize that systems rise and fall and come and go. It is the patients, families, friends – the people – who have been helped that makes me really happy and satisfied. 

It doesn’t mean that improving systems and pushing to improve things doesn’t matter. I can remember the many times when I had a vision of ways that things could be so much better. In those settings, I was driven not to just endure the status quo but to work to make substantive changes. There is real value and honor in improving the systems. You can make things better not just for yourself but for everyone else as well. But the purpose is not just to have a shiny system to show off. No matter how wonderful and shiny the system is, it always tends to get rusty. The purpose is to have systems that work so that people get taken care of.  It still comes back to the people.

And so, the focus begins to return for me. I want to do whatever is necessary so that people are helped. Sometimes the best way for me to do that is to be a worker in the process. Maybe it is a time in life for me when the best thing for me to do is to “make the donuts.” But is there more?

I have found a desire to expand the reach of our specialty of advanced heart failure. It is for this reason that I have been pushing to have an increased role in developing outreach clinics. I want to see and help the patients that might not have been referred to us or might not have been willing to drive to Grand Rapids to see us.

What about beyond medicine?

It is odd to me the passion I have found for writing. I was never the student that was drawn to writing in college. I gravitated toward math and the sciences. But now it is a joy for me to pour out myself into these blogs. I hope that somehow maybe this writing could influence people in positive ways. 

I don’t know that I have it all figured out. I do know that there are things that I want to do. If one of them is to in some way help you – or push you – in a positive way then I am sincerely and deeply happy.

Please do not just exist. 

Don’t settle for just “making the donuts” for the sake of making donuts.

What motivates you? What is important to you? What do you care about? What do you wish you could change? Is there something that gets you excited or that can drive you? Even within what you currently do, is there purpose or meaning that you can find?

I can hear the hype video starting. The screen is large as the images start to appear. The speakers are powerful with deep base tones. The booming music is starting up. What is it saying for you?

For me it is:

  • There are patients who need help and hope in the midst of their advanced heart disease.
  • There are people who are suffering who need a kind and understanding physician to maybe make it just a little bit easier.
  • There is a large community of healthcare workers who are getting lost and forgetting their purpose. They are burning out not because they can’t do the work. They are burning out because they are losing their purpose and meaning in the midst of the pressure of their work. They need to resist the forces and the stresses that threaten to make them just workers selling or delivering a product. They need to find again their purpose and meaning in what they do. There is so much good that the do. Can they see it or hear it again?

Can you hear the hype video now? It is playing loudly. I can – I will – get up in the morning and ignore how tired I feel and how my achy muscles are – and go to work. I can do it. I want to do it. It is worth it.

[1] A reference to a classic Dunkin Donuts commercial that depicts the owner getting up early every day to make the donuts fresh. https://www.youtube.com/watch?v=1AA1XDqK8tY

[2] The Fred Factor, by Mark Sanborn, Penguin Random House LLC, 2004

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Being human Medicine Reflections on Life, Being Human, and Medicine

Sometimes I Pretend They Are My Father

My patient was a reconsult in the ICU. This was a patient my colleagues had seen the prior week. They had provided input and then signed off (left his care to the Intensivist). He had a complex combination of health problems including heart failure. The ICU team called us to come back and provide further input. 

There was not a lot for me to add. I dutifully reviewed his chart and his imaging studies in depth. I then went in to talk with and examine him. He was in his 80s. He had recently suffered a stroke. His speech was slow. He was not completely oriented, but he still tried to maintain his dignity and his identity. His wife and daughter were there and were almost too attentive. They anxiously participated in my history and exam of the patient. They seemed to hang on my every word. I didn’t have a lot to add to his care. I thought of making a quick exit from the room and moving on with my day.

And then I didn’t. 

Something happened that changed the whole scene and honestly changed my whole day.  

I looked again at my patient, and then at his wife and daughter, and the whole scene in the room. It made me think of my Dad. In that instant, I thought about my father, his times of illness and his times in the hospital. How would it change how I viewed things if the man in the bed were my father? In order to understand I decided to (in a sense) pretend he was my father.  Not fully pretend – but just enough to look at him and try to picture my patient like I would have looked if it were my Dad in the hospital bed. 

This changed things A LOT.  Suddenly there was more to the man who was in front of me in the hospital bed. I could see beyond. I could imagine what he was like before age and illness had changed him. I looked into his eyes and then turned to look at how his wife and daughter looked at him. It was then that I truly could understand. They didn’t see an elderly frail, weak man with so many medical problems. In their eyes I saw reflected a younger, stronger man. I saw someone who worked hard. I saw a solid secure person who was the one that they leaned and relied on.

As a child, I remember being amazed at my Dad. He could do or handle anything. I would struggle to lift the bushel crates of apples (about 50 pounds).  My Dad could stack two bushel crates together and then lift both of them over his head. He would do this so that he could stack them in the cold storage higher than any of the rest of us.

My mind drifted to more memories of my Dad. I thought of him navigating the small little forklift around moving boxes of apples in tight areas. He had to wrap a pull rope on the engine to get it started. If it wouldn’t start, he could fix it. He was confident. He could fix anything or do anything that he needed to do. If it needed to be done, he would just do it. I remembered listening to him talk with my grandfather. Together they would work through complex decisions about running the farm. 

I thought of him as a high school teacher. He was always calm and always in control. He never seemed to get flustered. He loved to laugh and would get a twinkle in his eye at times. He was a solid reliable figure in the school. Everyone loved and respected him.

My Dad passed away last November. His cancer had aged and weakened him before he died. But when I think of him, I don’t remember that stuff. Instead, I remember him as the strong and robust man who could do anything. 

I looked once again into the eyes of my patient’s wife and daughter. The scene was so different than what I initially saw when I first walked into the room. Their facial expressions, their attentiveness, and their questions now all made sense. They could see so much more than what was obvious. I looked back at my patient, and I slowed down. There was indeed so much more there. I suddenly didn’t want to leave the room. My long list of patients and work yet to do didn’t matter as much. We talked more. As we did, I learned more about him. He was truly frail and not able to tell me much, but he didn’t need to. The four of us could now somehow together see a much more full and complex understanding of who he was. 

When I left his room, I was honored that I was allowed to be a part of his medical care. I felt better. I’m not exactly sure why. I think part of it was a feeling that what I was doing was important. I had purpose. The person I was taking care of was important. 

I decided that it was good what I did in my mind that day. I resolved that I should do it more. Who is the person beyond the hospital and before the illness? What is their world like? What was their world before?  

Since that day I have continued my game. I refuse to just see who they are in the hospital bed. Instead, I pretend they are people who have been important to me. Let me be clear. I don’t assume that they are the same as my family or friend that I remember. But if they were, how would I want a doctor to see them, to talk to them, and to care for them? In this thinking of the depth and complexity of my family or friend, I am able to push myself to see more.  

Today I was consulted on an 89-year-old with heart failure. She was hunched over and asleep when I went into the room. I woke her to talk with her and examine her. She was small and frail. She had a prominent kyphotic (bent over) deformity of her spine. She was confused. She didn’t provide a lot of information to me. 

I paused a minute. I imagined my grandmother. My grandmother was a strong farm woman in her day. I thought of all that she was and meant to me and my family. I stopped. I pretended that this patient was my grandmother. This changed the entire scene for me. Suddenly there was a lot more going on. My patient was complex with a long life and lots of details to her past. It would be amazing if I could somehow learn more of who she was. I was determined to do the best that I could to help her just like I would have wanted others to do for my grandmother.

And so, sometimes I pretend they are my father.