I am an all-or-nothing kind of person. A lot of us are. It has its pluses and minuses. I can be very driven about the things I want to achieve. That’s good. But for the things I know are necessary but not what I want to do, I fall into Newton’s first law of motion – I am an object at rest that isn’t going to be anything but at rest. That’s not good.

The reality is that there is very little black and white in the world. Most of it is shades of gray, but I just don’t think like that. Add my tendency to have my feet on the figurative gas pedal and the brake at the same time, and you have the ideal setup for failure.

Of course, this hits the hardest for me with exercise. Because it’s me. I hate it, especially cardio, which works like magic on blood sugars. And maybe food logging, which (to paraphrase 10 Things I Hate About You) I hate with the power of a thousand suns.

This week, I spoke with a patient with a condition that is difficult in a way mine aren’t, and they made me think. They were always active, but as their condition progressed, they had to ease off some of their favorite sports because the symptoms of their condition physically shut them down. They are particularly competitive, and stepping back upset them, but they had certain things they love they just weren’t willing to give up for the condition. That was their red line.

It’s weird to write a whole post about a car, isn’t it? Although I have alluded to this before. But this car has been with me for almost my entire adult life. Maybe my entire adult life, considering I always felt I was behind my peers by a few years or ten.

In another lifetime, I worked for Honda North America. I wasn’t at a dealership. I was at their legislative affairs (lobbying) office in downtown Washington, DC. When I started, I was driving an Oldsmobile Delta 88, a real boat of a car I had “acquired” from my parents after my mom died — primarily because I had been doing all the driving while she was dying — and just sort of kept.

It used to be that every October, I would get a cold. It was like clockwork. Sometimes it was the only time I got sick. Sometimes, the littles in my family gave me a few more over the year. (I actively decided a long time ago that spending time with my littles was worth a cold now and then.)

Then COVID happened, and I didn’t get anything because I wasn’t around anyone. Or anywhere, for that matter. It was nice.

This year, it feels like my clockwork clock is missing a few gears.

Election Day

I was hiding in my shower earlier today. Before I voted. (I wait until Election Day because my polling place is in my building, and it tickles my funny bone to go in my pajamas.)

I’m happy I voted in this historic election, and I will make sure I write 2024 on my sticker before I put it away with other mementos.

I try not to pay attention to the news at all. I know nothing will be worth knowing until results start pouring in. Fielding calls from half a dozen friends and relatives all day helps.

A few hours in, I have a pit in my stomach.

In the last week or so, some of my work projects are picking up, and it’s making me think (beyond the project. Of course, I am thinking about the project.). A major part of one of them is the idea of “treatment success”. I have not heard it often, but I get the feeling that this phrase is commonly used by non-patient stakeholders to help them determine what specific approaches are working and which aren’t.

Now, I am a big proponent of patients developing their own goals and making sure their care team is aware of them, especially when those goals differ from the clinicians’. But oddly, I never really thought about what success would look like as it pertained to those goals.

Pretty sure most patients don’t think about success the same way other stakeholders do.

I’ve often thought feeling isolated is one of the biggest threats to the patient community. When you are struggling to manage the demands of a medical conditions on top of the rest of your life, it is not uncommon to feel like you are the only person dealing with your particular set of circumstances, that no one else could possibly understand what it’s like to be you.

It’s lonely.

Don’t you just love it when physical trauma results in psychological trauma?

I spent over a decade working as a contractor for the Department of Defense. Whether you are working in a healthcare setting or not, it is hard to spend time around soldiers and not learn a fair share about post-traumatic stress disorder, a mental health condition that affects those who have experienced or even witnessed an extremely stressful or scary event.

Symptoms fall into four categories:

We all have them – those healthcare stories which invariably result in the silent question, “Did you really just say that to me?”

The one that stands out most in my patient life was when a Fellow who had never met me before spent time arguing with me over my labs, then dismissed three months of hard work as the margin of error. I still want to slap that chick when I think about it.

In the interest of the absurdist nature patient life often assumes, here’s another one.

It’s coming up on my 10th patient interview at Georgetown. I always enjoy it. I get to connect with an endocrinologist I’m still close to, even though it’s been about 15 years since he actively treated me. The students also seem to get a lot out of it. Every class is different, and the interview goes where they want it to, so I never know what I am going to talk about. Oh, and it is surprisingly cathartic for me to talk about my experiences in long form (usually between 60 and 90 minutes). An odd development for someone who previously never talked about my patient experience unless specifically asked.

I was talking to my endo about how we should change it up a bit this year, and he mentioned that a student had commented once that the interview had been depressing. I don’t usually have access to the feedback they collect on the class other than that the students get a lot out of it, so I had never really given much thought to the dark nature of my stories before.