Putting Myself First


I started this post in January. I swear. Like Stuart Smalley in “I’m Good Enough, I’m Smart Enough, and Doggonit, People Like Me” (Al Franken), I vowed not to let my perfectionism be the enemy of progress. Stuart wrote an entry for January 1st five times. I finished my New Year post the last day in February… first second third week in March.

Happy New Year.

The consummate individual, whether a well-raised child, an individual in recovery, or an evolving leader, must put self-management first. Self- awareness, self- care, self examination. Only when one is sovereign over herself can she be supremely effective in her dealings with others. I did not learn this as a child. I did learn this in the numerous leadership activities I attended. I learned it, I could teach it, but I did not own it, and I did not practice it very well.

I have seen small children who are sovereign over themselves. They position themselves perfectly in space. They are aware, without ever speaking, of their place on the planet, their own worthiness. I’m not sure if this is a product of genetics or parenting, but it is an amazing thing to witness. These children are not afraid of others, and they do not bully. They have clear boundaries when it comes to themselves and others. They know when to say yes, and they know how to say no. They are sensitive to the needs of others.

Leaders must engage first in self-management. Self care of the physical body. Awareness of one’s own emotions and empathy toward others. Control of behaviors. The ability to build relationships. Given today’s current events, I would also add a moral compass that supports a healthy society.

Those who are undergoing recovery from personal illness, relationship loss, job loss, or other major crises, must also prioritize self care on the road to the new normal. Think of a crisis, even a crisis of faith, as a Stop sign in life. Maybe it’s a gentle pause, or maybe you were careening madly out of control before this sign hit you in the head.

In my own recovery (ies…), I was struck by how the things I was learning were the same things I learned in my leadership courses, the same things my parenting friends were confronting with their children. It comes to reason that we are all trying to master the human condition.

Many years ago, I wrote a piece for young plastic surgeons, entitled “Balance is the Root of Happiness”. I talked about the body, the mind, the emotions, and the spirit. These columns still hold true.

Self care of the body

I wish that I could be one of those people who could write papers until midnight, waken fresh at 4 am, and hit the gym before my 7 am surgery. I also wish I was the Queen. Like most humans studied, I must have eight hours of solid z’s in order to function. I determined that sleep was the one thing in my life that had the most significant effect on every other thing in my life. It has also been a major challenge. Wouldn’t it be cool if there was a silver bullet for sleep? No such luck. I have to try to have regular hours for downtime and wake time. Stop work at 7 pm. No food or electronics in bed. (Ok, no TV in bed- Phone and IPad get a pass). Set the nighttime thermostat at 65 degrees. Clean white sheets and lightweight down comforter. The body pillow that I bought before my back surgery feels like I am floating on feathers. Rudy, my pup, sleeps by my side. Soft spa music. Eight hours of sleep, waking at 7 am. CPAP and I are still on the skids.

In my time off, I have been binge watching Top Chef. Season after season, clean, beautiful, healthy, delicious food goes to the win. I love this kind of food. I do I make it a regular part of my day? Sometimes yes, sometimes no. Fresh, colorful salads? Check. Nicely cooked proteins. Check. Bread? Um, …heck. Well, there goes the butter. Olive oil, avocado, Yes! Soups made with tomatoes, onions, garlic, celery, carrots, kale? Check. Ice cream sandwich cake (Layered Coolwhip, ice cream sandwiches, hot fudge sauce, caramel sauce, Heath bar and Butterfinger bits, and maraschino cherries in a loaf pan) devoured while watching said Top Chefs cook healthy food? Oops. Thank God for the InstantPot. For while ice cream sandwich cake cannot be formed in one, many a steamed and sautéed Brussel sprout came to glory in its depths. As a Type II diabetic, I know the life-giving quality of low glycemic index greens. As an adult child, I want candy. It’s all about the balance.

We have had a very dry winter this year. Dry scalp, eyes, lips, and skin. It’s really hard to stay hydrated when I am not at work with my ubiquitous water bottle. All the homemade soup I make every day isn’t quite enough. So, I got all the different flavors of LaCroix water, and now I repurpose the cans for art supplies. I got a winery labelled Hydroflask, which makes it feel sneaky (and fun) to drink. My scalp, hair, and skin respond well to liberally applied coconut oil, which is also a terrific facial cleanser. Yes, I am a plastic surgeon, and I do have bins of expensive lotions and potions that work well. Not everyone wants to feel like a slippery pina colada.

Movement gets us from one place to another, requires and develops strength and conditioning, defines physical boundaries, allows for intimacy, and is a profound source of personal expression. A healthy body that moves well is a gift. Weight control reduces stress on joints and improves mobility. Sleep and appropriate Vitamin D levels affect bone health. Stretches, yoga, walking, cardio, and weight circuits improve bone density and metabolism. Playful exercise provides a sense of connectedness and well-being. For me, Pilates and other core-building exercises have been key. This wonderful vessel must be protected. This means routine doctors visits and screenings, sensible protection from physical violation and diseases, and personal safety practices. I carry a full calendar of doctor appointments, but have an aversion to exercise that I don’t understand. It feels so good to finish and to be strong.

I have a terrible habit of wanting to coccoon myself in a blanket, isolating when times get tough. Stiffness leads to more stiffness, isolation to anxiety, and both lead to pain. Something to work on.

Care of the Mind

To me, this is the simplest. So many of us live in our minds. Here are some thoughts for the right brain. Curiosity, learning, compassion. Observe, read, learn, think. Walk slowly and pay attention. Learn something new. Learn a new way to do something old. Listen deeply. Read books on paper. Smell the ink. Lick your finger. Doodle. Write letters.

Emotional and Self-care

When I think of someone who is emotionally healthy, I think of someone who has an accurate and compassionate sense of self. They have clear boundaries, and understand where they end and the world begins. They practice frequent self- reflection, adjusting their coping behaviors as the situation requires.

Mindful self-compassion is well described in the work of authors Tara Brach and Kristen Neff. Mindfulness incorporates the practice of being awake, of centering and sitting in awareness. Self-compassion takes that awareness one step further, into a place of acceptance and love, rather than criticism and self-loathing. This should not be confused with self-indulgence, which makes no distinction between positive and negative, and centers in narcissism and craving. Self-acceptance includes a path towards becoming one’s best self without negating the self in progress. We come to understand our suffering, fear, and sadness as part of the human condition. This is the core to empathy and resilience. When we understand someone else’s experience, we have a better ability to connect. This hold true in intimate relationships, the doctor-patient relationship, and stewardship or leadership.

Self-compassion has been a lifelong struggle for me. It has always been easier to doubt or criticize myself that to love myself. This has resulted in personal crisis. My work in progress is to meditate once or twice a day, journal, ask myself “What is going on?”, ground myself (“It’s ok”….), connect with the people who love me, and commit to positive action. I have to practice everyday, because it is that hard and that important.

Spiritual care

For many, the core of spiritual care is a relationship to a higher power, something bigger than oneself. The higher power is innately good. It may be God, it may be my inner voice, or it may be the doorknob. We are creatures that do not do well in isolation. My higher power is an amalgam of God, Buddha, Mother nature, Mother Mary the healer, and love. In my imagination, it looks like a shimmering ball of light. When I connect, I know that it protects me, not from the events of life, but from the pain of being alone. Creativity is the energy that flows from me when I am connected. This can be the inspiration for my art, the magic that lets me see a problem from the inside out, or the warm light that delivers me from pain.

Unfettered play is something that most children get intuitively. The sheer doing of something for happy pleasure. Climb a tree. Twirl in the sunshine. Run downhill. Laugh. Be unconcerned. Tap into your own silliness. It is in this space of pure delight and self-acceptance that we are living with open hearts.

As Brene Brown writes, we are wired for human connection. This is the land of empathy. This is a touchstone for living. The success of 12 step programs has been largely linked to the impact of fellowship. Empathy requires an appreciation of common humanity. How can we understand others if we don’t sit with them, physically or spiritually? Buddhist teachings revolve around the idea that all sentient beings wish to be free of suffering. In lovingkindness meditation, we begin with compassion for ourselves, then spread it to our loved ones, those who bring us trouble, and finally, to the universe. Doctors who touch their patients may confer added wellness. Effective leaders must understand their constituents. Reach out. Touch someone. Sit with them. Be.

Even as children, we have a sense of right and wrong. Philosophers know this as moral imperative, the inherent good or evil in our actions. We have values, which is our personal sense of what is important amd what is not. We contain purpose, the reason for our existence. When we align our morals, values, and purpose, we are on a direction for a good life.

Recovery circles have a well oiled phrase- “You have to put your recovery in front of everything else”. We have to begin in the center, as if our life depends upon it. Because it does.

Imagine if we actually lived a life that started with rich self care. Imagine if we all did this, and then sent that glorious energy into the universe. Imagine what could happen.


Compassion Diaries

By their mid fifties, most people believe they will settle into a certain position. If not of comfort, a place of contentment. Some dreams achieved, some relinquished. Some plans still laid ahead.

I’ve been through a lot in my life. A stressful childhood, an anxiety disorder, breast cancer, financial challenges, job changes, loss of a parent, loss of a home. Nothing has affected me as harshly as being blindsided.

I left a successful day in surgery. Two months later, I returned home from a treatment center. For one month, I felt my heart beating out of my chest in panic. Once this feeling subsided, it was replaced with intense grief. There is nothing worse than having your entire identity ripped away in one moment. It is harsh. It is cruel. It is a form of death.

I thought I would never make it back to life. I came home frightened and confused. I found myself subject to regulations and monitoring that screamed to me that I was defective and untrustworthy; a child without self-will. New treatments dealt with the anxiety that was filling the space in my chest. Medications requiring approval. Meetings in places I was afraid to go. Finding support in unexpected places. Being let down by some whom I thought would hold me up. This felt like drowning.

Anxiety is a bird let loose in my chest while my hair is on fire. The moment metal hits metal. The gun in the dark. Depression is a vat of sulfurous, boiling oil. Rotting from the insides out.

How do I, who has died, return to life? I do not believe in the resurrection. As a Jewish Buddhist, reincarnation is more my style. I had to find a path. I tried study, contemplation, discussion, meditation, 12 steps, and begging. So far, this is what I have come to understand.

1. I have to place self-care before everything else. This includes care for my physical being, mental state, emotions, and spirit. Sleep, stress reduction, healthy eating, exercise, grooming, and medication management. I underwent the back surgery for the herniated disc and spinal stenosis that were causing so much pain. I have been compliant with my post-op care, which is new for me.

2. I have to accept myself. Part of this is to surrender- surrender to what happened, to my death, to my anxiety and the limitations it imposes on me, to the fact that I have to accept help, and to the fact that I will never be the same. I must be brutal and kind in my self-awareness. The second part is to have love and compassion for myself in my entirety. When I am afraid, I must sit and meditate on the fear.

3. I have to connect with my higher power. I’ve long had a deep sense of my higher power. It’s been a big ball composed of God, Buddha and the dharma, the universe, nature, and love. I cannot connect to this right now. I can only show up everyday with an open heart. I am honest, open, and willing. I will listen and have faith.

4. I must practice gratitude on a daily basis. It’s true, that no matter how bad things are, no matter how full I am with fear and dread, there are gifts in the world. As a Buddhist, I know that the greatest gift is to be born a human. There is a list in my journal. It helps me feel safe.

5. I must return to a life of service. Right now, it is very small- putting a chair away, making some gifts of my art, baking someone a loaf of bread. I hope that it will grow as I heal.

Everyday, I come a little closer to feeling human. When it is hard, I must act as if I am human. The friends who have supported me are the lights in my life. The ones who let me down are my teachers. I learn and I press on. Then I rest.