If patients are the enemy, call in sick today.
Set to work on your spiritual condition.*
Keep calling in every day until you’ve set it right.
*I use this term a lot and people don’t know what I am talking about.

Spiritual Condition manifests as compassion, forgiveness, empathy, gratitude, generosity. It’s not those things though. It the feeling of wholeness, safety, strength, connectedness, appreciation.
For many humans, spiritual condition is something that happens to them. An accident. “I’m having a good day today!”

Same with bad days. “Everyone is a jerk!” “I’m so unlucky!”

This serves many purposes, mainly that your spiritual condition becomes someone else’s fault.
If you can’t call in spiritually sick today because you have to pay bills, etc., do what I staterted doing about 15 years ago.

Study and learn from your patients.

Some have illness and pain that should crush their spirit yet there they are, asking how your day is going.
Facing the end of life, they say, “Thank you so much for all your kindness and help.”

Notice the patient who apologizes for pooping in the bed as they are dying. Learn from this person. They might be dying in the physical, but their spiritual condition may be 1000x yours.
This is where I began 15 years ago. Ona day feeling angry, resentful and tired. Unappreciated and exhausted. I saw this old woman who was headed toward death. The worst kind of “case.” Decubitus ulcers, alone and impoverished, chronic diseases with acute frosting on top...
She said, “You look down today, doctor. What’s wrong?”

Without thinking, I started to tell her “what was wrong.” After a minute, I looked over and she had her eyes closed, nodding. A very powerful feeling come over me. Shame and ingratitude. Utter embarrassment. I stopped.
“What’s your secret?” I asked. I felt like a little kid sitting down at his desk on the first day of kindergarten.

She went on to list a few basic concepts. (Things, BTW, that I repeat over and over right here like a carpenter driving a nail):
Basic Foundation of a Healthy Spiritual Condition
- notice your good fortune
- turn your attention toward the suffering of others
- look for places to help
- loneliness magnifies pain
- if you feel bad, stop doing the things you think make you feel better and try something new
- don’t hand the reins of you happiness to other people and expect them to ride you to peace & contentment
- ignore the “rightness” of your own labels. “Friend” and “enemy” are characteristics of your mind, not of other people
Unlike millionaire self-help gurus and other thieves, I’m not here to tell you the solution. I have nothing to sell on this topic.

If patients are your enemy, it is a symptom.
Your spiritual condition is unhealthy.
There are many cures. Some work.
Seek and suffer less.

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More from @medicalaxioms

Sep 18, 2018
Let’s see if we can come to some consensus about what a doctor looks and acts like. I’m going to share my experience which may be very limited and provincial. Feel free to share your opinions as we go along to help us flesh out this definition.

Gender: any
Skin tone: limited to the available hues available to humans on earth. (Note: tattoos are okay, so we’ll add the visible spectrum)

Country of origin: limited to the countries on earth

Religion: any. (Note: my nurse friend practices Satanism. He’s very nice)
Hair: I’m going to be conservative about this one. Bald to real long. And everywhere in between. But I think a doctor’s hair should be kinda tidy not full on caveman/woman. Need comments here. I’d like to be more specific. I’m not sure if I know what hair doesn’t look doctory.
Read 12 tweets
Sep 4, 2018
I know I shouldn’t do it and it’s unkind to take advantage of another person’s weakness but when I come across a short-tempered person who is quick to anger I sometimes make them angry on purpose. Then I make them come, sit, lie down, and roll over. It’s just so easy.
When I was younger and (more of a) hothead people did this to me. I never understood the irony that my anger I used to gain power and control actually made me very easy to manipulate.

The light went on when I realized my anger was a response to being hurt.
One of my shrinks suggested I “stop at hurt.” Just pause right there without releasing the adrenaline and preparing to hurt back. It’s not easy. Takes practice.

Now I see the initial hurt is always less then the self destructive rush of anger.
Read 11 tweets
Sep 3, 2018
Attaching emotion to physical objects that are inherently temporary leads to inevitable sadness. #MuseoNacionalDeBrasil
You have two superior options:
1. Celebrate each day a temporary physical item is not destroyed. “Good morning, coffee cup! It is so great to see you not broken again today!!”
2. Put your effort and emotion into unbreakable eternal projects. Beads on the string of causation.
Here’s a short list of things that won’t be eventually ruined predictably in a fire, flood, or disaster:
- teaching someone
- forgiveness
- love
- helping someone through a hard time

These project lead to other effects and so on. Eternally. Each is indestructible. Causation.
Read 12 tweets
Sep 2, 2018
There is a line between sickness and health where we stop treating the person like a person, “hi it’s Dr. Reid here, nice to meet you,” and start treating them like a situation or a procedure “hand me that suction, this is a tough one.”
When I was a rookie, this line was way out here towards health. To the the point where the patient might say, “I can hear you. I’m right here.”
With time, I’ve moved the line out to death. Then I heard a bunch of pathologist on #medtwitter talk about how using good manners around the dead is necessary to maintain their humanity. So I’m trying to get rid of the line altogether.
Read 4 tweets
Aug 8, 2018
Even more powerful:

- walk up to a colleague you don’t always agree with or who seems not to respect your opinion
- out of the blue, thank them for being a dependable & helpful colleague and all their good work
- walk away leaving them shocked or baffled
- do it again
I enjoy this kind of thing. It is subversive. The Evil Demons who would like to keep shirts playing skins and X fighting O despise this kind of disturbance.

Vanishing grudges and dropped resentments infuriate the Evil Demons who thrive on conflict and hatred.
They want everyone to play their part. Hatfield and McCoy. Mongoose and snake.

It’s jolly fun to ruin the predictable pattern. Wipe the slate clean. Join the world as it is instead of as it used to be.

Let bygones be bygones.
Read 5 tweets
Aug 8, 2018
Try this today: Compliment your colleagues
- Notice what they do well
- Let patients know how lucky they are to see them
- Mention a time when they inspired you
- Appreciate their skill
- Celebrate their wonderfulness

@choo_ek @screamingmd @MDaware @HeartOTXHeartMD @laxswamy
After so much training and work, and daily labor to heal the sick, we tend to take each other for granted—nit pick and critique when we should be grateful for their remarkable talents and boundless efforts.

@DrJenGunter @DGlaucomflecken @emily_fri @adamcifu @drjenniferbest
Our patients often don’t know how hard we work, together, trying to solve their problems and make them feel better. Probably because we don’t mention it. It’s okay to notice and appreciate the lovely people we work with every day.

@cedrekmd @DavidJuurlink @DrEricLevi
Read 9 tweets

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