Coming Up for Air

I’ve “had my snorkel up” the last couple of months. My senior partner introduced me to the phrase after I started practice in Rooks County, so perhaps it is unique to our group. If you take a minute to reflect on the words, you’ll know what they mean: I was underwater and one big wave away from losing my lifeline to the surface. Although critical functions were accomplished (patients cared for, charting done, work deadlines met, family events attended), many items of personal importance went by the roadside. I worked out only four times in January, my Christmas letter is still unwritten and this blog has lay fallow since Thanksgiving. Some people use January 1 as a new start on the year; I suppose February 1 will be my date in 2020.

The good news for me is this: “snorkel up” is a safe set of key words to use in my circle. It means: lend a hand if you can, forgive any grouchiness, and help me find the light to swim toward the surface. In the short term, my family is tolerant of long days at work and my team and partners jump in to lighten the load where possible. In the long term, change is necessary to successfully come up for air and stay above water. And I love change, so change I did.

The slide underwater starts so innocently. Certainly, not all bumps in the road lead to being overwhelmed, and the state of being “snorkel up” isn’t always precipitated by a negative event. The nidus can be something as simple as a crazy day in clinic during flu season and a bunch of notes that don’t get wrapped up right before leaving for vacation. The death of my father in 2018 created an unexpected instability that affected my rhythm for months. This fall, I was offered the opportunity to take on an exciting new scope of work and underestimated the time needed to get it up and running smoothly.

I’ve finally made it back to the surface, and, having come up for air, I want to grow as a result of the whole experience. So what are my lessons from this winter?

1. Time is finite, and taking on something new means giving up something in place. While that would optimally be other work obligations, for me it is often the “soft” commitments I have made to myself: sleep, exercise, eating well. For a very short time, that’s ok. When a day or two turns into a month or two, I sink deeper than my snorkel has reach.
   Lesson Learned: Take time at the outset of a new project to explore the time commitment required, both externally and internally. Budget that time in my life and ensure other projects can be deferred or given away to accommodate the budget and keep promises to myself.

2. New work is fun and exciting, often more so than the day-to-day work already on my plate. I am attracted to the sparkle of something new and tempted to back burner those things less entertaining. This quickly leads to operating in a “just-in-time” delivery mode more often than is comfortable.
   Lesson Learned: Stay in the groove and hold fast to good habits, layering in the new work as it fits with existing patterns. When each day starts with exercise, coffee, and the EHR at inbox-zero, my sense of accomplishment for the day is high and my stress levels much lower.

Next time around, I’ll be wiser and more experienced in my approach to adding a major commitment. Today I will celebrate my new year; I exercised this morning, my EHR inbox is zen at zero, and I have a rhythm established for the new work.

Maggie does a better job of being underwater than I do.