One of my projects over vacation was to do a 3-day juice cleanse. It’s always something I’ve been interested in, it’s something I’ve attempted a few times but never fully completed, and something I’ve found impossible to do while working a job fueled by coffee and calories.

Why a juice cleanse? For me, I wanted to get unstuck from my coffee addiction, practice discipline, feel healthy, and get a physical and mental flossing. I also saw it as a symbolic cleansing of the end of this year of residency, and a rebooting for the beginning of my final year.

I knew I wanted to pay for a program so it would all be prepped and as easy as possible. I found this article on different options in the Bay Area, ended up choosing between Thrive and CAN CAN Cleanse. I decided on CAN CAN in the end because they had good yelp reviews, I liked that they provided 8 drinks a day, I liked Teresa when we spoke on the phone, and the pick up was easy and in my neighborhood. It was pricey, but they all are. In some ways I think paying that much made me even more committed and motivated to actually follow through on it.

Overall, it was easier than I thought it would be. The caffeine withdrawal headache was worst on day 1 and gone by day 2. I never felt ravenous and didn’t even finish all of the drinks each day. I was pleasantly surprised by how much I liked some of them (Spring Root Soup, Grapefruit Mint Juice, and Almond Milk were favorites). I felt alert and energetic (except on day 1 when I felt the opposite). I slept deeply. I felt light and agile and could twist like never before in yoga (no intestinal contents opens up a lot of potential space). Finally, I felt a sense of accomplishment at actually doing it, and finished the three days feeling healthy and happy.

I’m on vacation and starting to feel alive again! So far my big project has been getting back into a daily mysore practice. What is it about the soreness of a deep yoga practice that feels so good? I love being barely able to move when I wake up. Love it!

I hope this 22 minute trailer on Iyengar inspires you as it much as it did me yesterday. The filmmakers are seeking the final funds to finish the film and I hope they reach their goal cause now I want to see the whole film. 

“As long as you are maintaining that stable mind in all the upheavals of your emotional life, for me, that is Samadhi (union with God).” ~Iyengar

“The body is the most powerful means to transform a human being.” ~Iyengar teacher in film

Need more? Here’s an old Iyengar post for additional inspiration. And here are some Iyengar oldies but goodies:

“Freedom. From each and every part of our body. Until freedom is gained in the body, freedom of the mind is a farfetched idea.” 

“Make the mind feel the stretch. Awaken the mind of the little toe.” 

“If you keep your armpits open, you won’t get depressed.” 

“When confronted with difficulty, take an action, no matter how small.”  

“Residency got you,” a friend wrote to me over email, reflecting on the recent silence on my blog.

Ahh, it’s true! Residency has got me.

I’m feeling hopeful though: 1) I just got my schedule for the coming year and it’s looking pretty great compared to the past two years, and 2) I have vacation coming up and am heading back to Costa Rica for friend-family-rest-reading-beach-yoga-surf time… Costa Rica has a way of restoring me and I am way overdue for a visit.

I’ve been working a lot of night shifts lately, but they’re getting easier. Maybe part of it is that I feel slightly more competent — making it all much more fun and rewarding, even if I am bleary eyed in the middle of the night.

It’s really hard not to lose oneself in residency, but here a few things making me feel maybe like it hasn’t completely got me yet:

• Midnight yoga in the call room. Our call rooms are pretty sparse but work surprisingly well for a makeshift yoga space.

adjustable thermostat! yoga mat?

 

• Things I’m reading when not at work:

• My herbs. They’re still alive!

• Running. Waking up from my post-night slumber and running in the warm afternoon sun, starting to build up to the SF half marathon which I’m thinking of actually running this year.
• Pulling out my massive whiteboard to brainstorm what the future might hold.
• Post-call dreamy days watching Downton Abbey.
• Bonfire on the beach. Something I’ve wanted to do ever since moving here and it finally happened (windy and cold but so fun).

I’ve been working on eating more greens. As we all know, it’s super hard when there’s little time to cook, free enticing hospital food, and rushed unpredictable meal-times.

One solution I’ve been working on is getting into the habit of making a morning green smoothie.

I keep my kitchen stocked with:

• Huge bin of washed organic spinach
• Chia seeds
• Flax seeds
• Frozen organic fruit: berries, mangoes, peaches
• Bananas
• Hemp milk (vanilla unsweetened)
• Plain full-fat greek yogurt
• Raw oatmeal

The key has been having a quick and easy to use blender. I love my blender because the cup IS the blender — you attach a special lid with a blade and simply turn it upside down to blend.

I generally put 2 tbs chia seeds, 1 tbs flax seeds, ½ cup of fruit, ½ a banana, 1 cup of hemp milk, a dollop of yogurt, and 1-2 tbs of raw oatmeal depending on how thick I want it.

Most importantly, I stuff in as much spinach as possible. Sometimes I’ll blend first, and then add in more spinach, and reblend.

It takes me about 3 minutes to make these and I carry it in my bag until I get hungry for breakfast.

They might look gross but they’re actually pretty good (and more importantly, they FEEL so healthy)!

I’m open to suggestions on what else to put in them — I think it’s time for some more variety!

It’s no surprise that physicians aren’t great leaders — we spend our twenties in medical school studying, and resurface years later expected to be great communicators, decision-makers, and change-makers. 

Our residency program recently funded a session on leadership and the Myers Briggs analysis to help us be better.

Prior to our session we were sent a link with the Myers Briggs analysis and asked to take it. It took under 15 minutes, and if you haven’t taken it before you can easily google and take it online.

The Myers Briggs is based on Carl Jung’s theory that we are born with innate preferences in the following areas (oversimplified explanations below):

• Extroversion/Introversion (E vs I): Do you tend to gain energy by being around other people, or by being alone?
• Sensing/Intuition (S vs N): Do you tend to gather information from data and facts, or from relationships and associations?  
• Thinking/Feeling (T vs N): Do you tend to make decisions based on logic and reason, or based on people’s needs and harmony?
• Judging vs Perceiving (J vs P): Is your external world very orderly and planned, or do you tend to be more spontaneous and flexible? 

Similar to how we have one dominant hand, we also have natural preferences for one end of the spectrum over the other.

When we arrived at our session we were handed a lengthy document explaining our “type” and what it means specifically with regard to leadership. I found this fascinating!

The point of all of this was to study and understand our own personalities and our decision-making processes. If we know our own natural strengths and weaknesses, we can build on our strengths, and strengthen our weaknesses. And we need to be extremely comfortable with who we are in order to better understand others and effectively lead a diverse team.

What do you think? Have you ever taken the Myers Briggs and found it at all useful?

I finally made myself a doctor’s appointment and before my appointment I had to fill out a questionnaire.

Well! What a great idea Put the patient to work. Have them do some pre-contemplation and goal setting before the visit. Help them feel invested in your time together.

The questions I had to answer included the following:

• How would you rate your current physical health? List specific health problems you are currently experiencing.
• How would you rate your current sleeping habits? List any specific sleep problems you are currently experiencing.
• How many times were week do you exercise? What types of exercise do you participate in?
• Please list any difficulties you experience with your appetite or eating patterns?
• Are you currently experiencing overwhelming sadness or grief?
• Are you currently experiencing anxiety?
• Are you currently experiencing any chronic pain?
• Do you drink alcohol? Drug use? Tobacco?
• Are you currently in a romantic relationship? On a scale of 1-10, how would you rate your relationship?
• What significant life changes or stressful events have you experienced recently?
• List health problems in your family.
• What is your current employment situation?
• Do you enjoy your work? Is there anything stressful about your current work?
• Do you consider yourself spiritual or religious? Describe your faith or belief.
• What do you consider to be some of your strengths?
• What do you consider to be some of your weaknesses?
• What would you like to accomplish out of your time with your physician?

I’m now on a 3-month stretch of outpatient block with more manageable hours and fewer night shifts. After sleep and exercise I now feel my curiosity coming back, something that can quickly evaporate when my most basic needs are not tended to.

One of my co-residents inspired my rediscovery of Evernote as a note-taking tool.  

Ok first! Why didn’t I use this in medical school?! What a lost opportunity! I could have had have all those notes and lectures accessible for the rest of my career. Now they are lost to me.  Any med students out there please think about this!

At least I have it now. It has revolutionized my learning and organization system. Some of the benefits:

• All my notes in ONE consolidated place. I cannot emphasize the value of this enough.
• My notes can be accessed, edited, and referenced from my laptop, ipad, AND iphone. They all sync with each other immediately and automatically — a note on my computer automatically syncs to make a note on my iphone.
• I can pull up my notes at any time (including in the middle of a patient visit) and access my library of information.
• I can insert pdf’s, powerpoints, word documents, or pictures into the notes. Any time I read an article or come across a treatment algorithm I want to quickly have access to, I immediately put it into a note.
• It’s free. You can pay more for more space and offline access which I will likely do one day.
• It can be used for ANYTHING. Medical notes are the obvious one for me, but I can also use it for recipes, lists of books to read, movies to watch, trips to go on, quotes, yoga notes, etc. 

I started bringing this portable keyboard with me to lectures and it has turned my ipad into a functional note-taking machine. 

How do you keep your constant deluge of information organized and accessible? 

We recently had a seminar on “life after residency.” We were asked what we ultimately want in our job and career.

In the midst of residency demands, what I crave most right now is freedom and autonomy — to make my own schedule, to have a routine, to sleep each night in my bed, to have time for a yoga practice and involvement in a yoga community.

One of our exercises was to write down the 10 things we would want in our “Dream Job” if we could design it ourselves.

Here was my five-minute stream of consciousness list:

1. Clinic time: ~2 days per week working with underserved population
2. Research time: researching and writing on obesity, nutrition, community interventions
3. Academic environment where people are learning, writing, reading, and questioning our current practices
4. Inspirational and motivational colleagues
5. Travel: both domestic and international conferences/projects/research
6. Routine and (relatively) predictable schedule
7. Income, loan pay-off, and retirement savings
8. Piloting of new technology
9. Office that is my own: uncluttered, big desk, bookshelf with important books, plant, window
10.  Office environment that encourages creative and innovative projects

What’s on your list? 

Love it. (Thank you, Mariam)

I thought I needed a vacation to the beach. I wanted to escape, replete my Vitamin D, and go surfing.

While the beach sounded idyllic, instead I decided what I really needed was time at home with my parents. I am so glad I did – I cannot imagine a more restorative way to have spent the past 10 days.

I arrived home in one of my lowest states. Working in the ICU and then a long string of night shifts left me depressed, exhausted, and fragile. The first few days at home all I could do was sleep and lie by the fireplace covered in blankets.

I think my parents were seriously worried about me! My dad bought me lots of fresh fruits and vegetables but I didn’t have an appetite at first. My mom made me tea, lit a candle, and found me some special soap for a bath.

After a couple days I began to get my energy back. I started practicing yoga and slowly eating green smoothies and soups.

It took me another few days until I was able to move up the Maslow hierarchy of needs and start thinking clearly and creatively.

My main goal of my vacation was to reconnect with my passion and purpose. I met with close friends from high school to remember who I was and what things excited me ten years ago. I brainstormed and wrote down ideas of possible paths I could take after residency. I called up a mentor to talk through different possibilities. I worked on my personal mission statement, writing up my roles (physician, daughter, sister, partner, friend, etc) and goals under each role. I also started working on my New Year’s Resolutions for 2013, which include the following:

• Find more mentors both inside and outside of residency
• Look into fellowships related to obesity and nutrition research
• Work on taking better care of my own physical and emotional health
• Start a handwritten journal and write a little every day
• Reconnect with my yoga practice and get to know the Bay Area yoga community better
• Learn more about the growing field of mobile health

I’m still working on the rest and would love hear what New Year’s Resolutions you plan to make…