Smiling Again

This Monday morning, a wonderful thing greeted me as I opened the door to see my first patient of the day.

A smile! Bright and beautiful, and…with no mask to cover it up.

On my end, I was able to give a smile that had not been seen in my clinical work since March of 2020.

Over three years. 1,133 calendar days ago to be exact. Over a thousand times that the sun had risen and then set.

On April 17^th, UNM took off the requirement that masks must be worn in our clinical settings.

“My face feels naked,” I kept saying throughout the day. It was surreal to see patients faces again. And to be able to share mine.

About a year ago, as the pandemic dragged on like a movie with an inadequate budget for editing (“Where is this thing going? The exciting stuff already happened in the first 30 minutes.”), I made a conscious decision to stop waiting for masks to go away. 

I resigned myself to doing masked medicine for a while longer. I tried to forget how much I enjoyed seeing people’s smiles and expressions. I even stopped wondering or worrying about what stories and connections were missing beneath our face coverings. 

I got used to trying to comfort people who were crying or expressing deep emotion – the eyes becoming the one part of the face left with which I could read and respond.

There was an article pre-pandemic that reported "Science has shown that the mere act of smiling can lift your mood, lower stress, boost your immune system and possibly even prolong your life."

But what if you know others can't see the smile you are trying to express. And what happened to the similar benefits of seeing others smile during these COVID years?

Now, I am able to see those beautiful smiles again. Equally excited to share my smiles with the folks who call me their doctor.

It brings me back to my first time seeing patients via virtual visits five months into the pandemic, having done exclusively phone visits until that point.

Don’t get me wrong – I am thankful for what masked life represents. Doing the best we can to protect each other, adjusting to a new normal.

But man, is it great to see people – all of them – again.

Enjoy smiling today. My wife always reminds that it is simplest way to give to others.

And enjoy receiving smiles in return. Each time, you are receiving a wonderful, unmasked gift.

Directions

As an expert in the art of daddying, I decided it was time to teach my 5 year-old Sihasin about the cardinal directions. We were on our sweet spray-painted daddy-daughter bike and it went something like this:

Dad: Let’s talk about opposites. What’s the opposite of down?

Sihasin: Up

Dad: And what’s the opposite of cold?

Sihasin: Hot

Dad: Okay, well when we face toward the mountains, we are going east. And when we face away from the mountains, we are going west. East and west are opposites. Got it.

Sihasin: Got it, dad.

Dad: So, when we bike this way, toward the mountains, which way are we going?

Sihasin: Straight.

Mic drop. (Or bike drop? Dad joke!)

 

As you can see, being a daddying “expert” does not mean my children will give me the answer I am looking for. Rather, an expert simply becomes less surprised when answers like “straight” are given.

Daddy knew to smile and resist the urge to correct. Instead, I spent a few moments quieting my inner voice that was saying “wrong answer” before it could rise to an audible response.

 ~~~~~~~~~~~~~~~~~~~~~~~~~

Today, life may give you a similarly surprising answer. An answer that at first seems completely wrong.

But maybe it is completely right.

Maybe it is a moment to find space and place to listen…

And then listen deeper to what the answer and the person giving the answer may be saying.

It may be life sharing a gem that you need.

And when you walk/run/bike/dance toward the beautiful Sandia mountains today, remember Sihasin’s teaching: You are heading straight.

Heart Medicine

 

Shijei (my heart)

I hear you beating life’s drum

Can you see and feel me?

 

100,000 times today, you will       beat

                                                     beautyway

                                                     synchrony

                                                     symphony

100,000 times today, I will be reminded how fragile life is.

Will I slow enough

                                                2

                                                                listen?

100,000 times today, a double beat representing    4 valves

                4 chambers

                             (timing their efforts perfectly in the)           4 Directions

                                                                                                        pumping life my way

Shijei,

I bow in gratitude and reverence.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The Colors that Speak Words is a collaboration that explores how visual and poetry art translate and transform one another. 

Mallery Quetawki (visual artist) and Anthony (poet) take pieces that each other has done and respond with art/poetry. 

In the piece above, Mallery is responding to Anthony’s poem. 

A larger exhibition of The Colors That Speak Words will be coming to the Indian Pueblo Cultural Center, with opening reception Friday, June 9^th. This show will include another poet Chilan Mustain and a calligrapher Blythe Mariano.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Today, find a piece of art or a place in nature that speaks to you. Get out a writing utensil and begin to translate and transform that scene into words. Or vice versa - make art to a piece of writing that inspires you.

Calf Injury

It felt like someone had shot something into my calf.

I looked around and yelped a “What?”

The others on the basketball court looked at me confused. There was no one there, and nothing had hit me.

The pain was so intense that I was close to passing out a few minutes later, sweating to take small and painfully slow steps.

Turns out that I tore my calf muscle. First time on crutches in my life.

My good friend and sports medicine guru Dr. Chris McGrew, given that I was not jumping or moving when it happened, diagnosed it as “spontaneous combustion.”

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

But this piece is not about the injury.

No, that kind of piece belongs in a medical school lecture but not here.

What I have felt most intensely over the last hours since the “spontaneous combustion” is the overwhelming support.

Starting with the guys on the court who went out of their way to take care of me. Thanks to the “Noontime Legends” as we call our group.

As I limped badly to the exit of the gym, a wonderful UNMer went to look for crutches. (I made sure to promote our upcoming Running Medicine season in return. Hey, he was wearing a track and field jacket.)

Within minutes of the injury, Dr. McGrew was on the phone with me, thinking through the next steps.

My family dropped everything and made their way to campus.

And as I limped to across campus Tracy and Tim, two of our long-time members of the Running Medicine community, offered to give me a ride. (I think the exact quote was “I saw you 20 minutes ago and you were about 15 feet from where you are now. Not your normal speed, Anthony.”)

My own clinic, the 1209 Clinic at UNM went out of their way to make room for me to be seen. One of my former students now serving as my provider.

I even noticed the way that passer-bys on UNM’s campus looked on with concern and empathy. They didn’t know what to say or do, but expressed their concern.

~~~~~~~~~~~~~~~~~~~~~~

I invest in my life in others.

I feel good about this investment. (A piece on that subject from January)

Today, the investment “matured” and showered me with amazing returns.

I also noticed today that it is hard for me to accept the role of “receiver” and “patient”. I need to work on this. 

So, as I limp to bed, here is an update:

My calf hurts.

My heart is filled.

I am grateful.

I wish each of you an amazing Thursday.

Act Accordingly

Act accordingly.

In the last week, I have been chased and haunted by these words.

In my last piece, the last line – “act accordingly” did not sit well with me.

Addressing and naming privilege is the easy part. But how do we “act accordingly”?

So, here I will tackle that two-word imperative. I am grateful for the people who have shared their thoughts. I am grateful for a few conversations this has created amongst myself and other overly privileged folks on the subject.

Thoughts for those of us who carry excessive un-earned privilege on how we can begin to “act accordingly”:

Internal work

* Humility has to replace guilt; humility will move us to action/healing whereas guilt usually makes us feel bad without prompting action/healing.

* Naming privilege and developing an awareness of such privilege as you walk through each day. (A piece from early on in the blogwhere I used the wind as a metaphor for privilege)

* Thinking back to your first experiences when you were taught that race matters, to the first time you were exposed to anti-LGBTQ or anti-immigrant rhetoric. How were you taught to “other” people that didn’t look and sound like you? And how do you “other” people in your current existence. What would it look like to see those “othered” people as your brothers and sisters, aunties and uncles, sons and daughters?

* Then a deeper question rises within our internal work – do these set of biases fit with who we feel we are at our core being? Do these biases fit with what we believe about the worthiness of those around us. How do these biases affect how we see and treat others? If we believe that all human beings are equal, how do we deal with a set of biases that divide humans up on a privilege hierarchy?

 

Interpersonal work

* Once we have begun to do internal work, we are ready to find ways to be courageous in how we relate to others.

* We can try being more intentional in speaking about privilege, for example. In a doctor-patient conversation where I am worried that my un-earned privilege is inhibiting my patient from sharing, I can be courageous. “I recognize that right now you may not feel safe in sharing, and I wonder how my un-earned privilege is contributing to that.” In such a statement, the room is transformed. The 800-pound gorilla has been named. And, most important for this person’s care, they may feel comfortable sharing.

* We can find ways to open the door to the room for those not invited. We can find ways to amplify others’ voices in the room while we silence our own.

 

System-level work for equity

* In your workplace, in your sphere, what are systems-level policies and structures that allow un-earned privilege to determine who gets hired, who is promoted, and who is served by your organization? How have these systems benefited you directly? What changes would it take to make them equitable? Find your voice to change them.

* Speak up for equity. This will often mean speaking out against current policies and ways of doing business. This will mean speaking out against systems that have led to inequities. In this work, ask those lacking un-earned privilege for their input and talk openly about whether or not it is safe for them to be a part of the action/activism. (The old model put all of this on people of color and other marginalized groups, often under the guise of a “diversity committee”, asking them to suggest needed changes. This old model ignores the reality that this group that lacks un-earned privilege may not feel comfortable saying what needs to be said, while also allowing those with un-earned privilege to stay silent/safe/comfortable.)

 

Now, I can say the two words that have chased me.

Act accordingly.

It is going to be hard, and there won’t always be a clear best/right answer.

Act accordingly.

It will make you uncomfortable and put you in situations where you don’t feel safe or supported.

Act accordingly.

Feel the pain of brothers and sisters not given opportunities that you are afforded, simply because they don’t carry un-earned privilege.

Act accordingly.

Privilege

My privilege often opens the door to allow me into the room.

My privilege allows me to dress funny, casual, or the way I want – I don’t have to worry about impressing anyone or about stereotypes placed upon me.

 

Once in the room,

My privilege allows me to speak

My privilege stifles others’ voices

 

White privilege

Male privilege

Doctor privilege

Faculty privilege

Economic/wealth privilege

English-language privilege

High quality education privilege

Parents paying for that education privilege

Heterosexual privilege

Married privilege

Husband privilege

Assumed to be Christian privilege (see White Privilege above)

U.S. Citizen privilege

Living in the U.S. privilege

Able-bodied privilege

Being able to hear and see well privilege

Not having mental illness privilege

BMI < 30 privilege

Height privilege (taller folks are affored power/authority)

Middle-age privilege (not too old or too young to be discounted)

 

And those are only the ones that I can name. Surely, there are others.

 

How do I name and claim this privilege in the room?

How can I better amplify, not silence, others’ voices?

Should I even be in the room at all?

Maybe my best contribution would be to hold the door open, including for people who might not have been on the “invite list”.

I give thanks to the community that continues to teach me how I can be a better custodian of privilege. A group of people who guides me as to whether I should be in the room or not, a group that gives me “privilege pointers” about how to be once in the room.

I give thanks for you – Shannon, Tonya, Anita, Freeman, Val, JP, Karen, Enrique, Jennifer, Danielle, Loni, Marlene, Kee, Christy, Doreen, Moneka, Tanya, Lawrence, Mallery, Angel, Miriam, Sanda, Surya, Vivette, Miriam, Nadia, Hakim, Michael, Chilan, Dustin, Kara, the NHI community and so many more – for the ways that you guide me in this realm with patience and love.

 

Take a few moments today to name your privilege.

Sit with that privilege.

What questions naturally arise for you?

Sit with those questions.

Repeat daily.

Act accordingly.

 

 

Time on Feet

Mission: Connect an obscure distance running concept to our wellness journey

Tighten your seatbelts, ladies and gentleman.

The term is one I learned as I started to get into ultra-running, which is running distances longer than a marathon.

Time on feet.

“Say what?” I asked when first introduced to the concept.

Time on feet is a divergence from the way running performance is usually measured, where the time on the clock and the distance covered are the two things that matter.

You might run mountain run where you only cover ½ of the expected distance over a 4-hour run. Maybe the terrain is so tough and the run is so long that you spend most of the time walking. (Runners hate to admit when this happens.) The run simply gets logged as “Beautiful terrain. Time on Feet = 4 hours”.

Time on feet is a reminder for the ultra athlete that simply persevering, simply pushing on, simply not giving up has replaced the things your smartwatch tracks and the numbers usually uploaded to Strava.

Time on feet is an exercise in letting go of the idea that “how far” and “how fast” define success.

Time on feet recognizes one’s effort as a new measure of success.

 ~~~~~~~~

Time on feet applied to your wellness:

Today, try practicing a simple re-focusing of what you feel is needed for success.

Work/school: Give yourself grace as you consider time on feet translated to your “to-do” list.

“Accomplish X, Y, and Z” becomes “Give my all toward X, Y and Z getting done.”

Wellness: Apply the time on feet principle to your wellness goals for today and this week.

“Eat X number of calories, walk for Y minutes, and get Z amount of sleep” becomes “Eat, walk and sleep for health today”.

Play with this today.

            Play today.

                        Play.

Time on feet allows us to relax a bit, smile, and become a child again. Things that were chores, tasks, “to-do’s” now become play. A sacred dance where gentleness and forgiveness toward self are two of the primary goals.

May time on feet enhance your efforts and self-care today.

You don't even need to spend hours out on the trails.

~~~~~~~

Epilogue

Why do ultra-runners use time on feet in the first place? They do so because it is actually more consistent with success than relying on traditional parameters such as distance traveled and minute/mile pace. A workout defined by “Time on feet = 4 hours” in preparation for a race that is expected to be 8-hours in duration is more important than exact mileage. It is a measure of mental and physical aspects that being on one’s feet for 4 hours does to strengthen. Time on feet is not done in defeat, but rather as a way to ensure victory where the new set of rules are about enduring and not giving up as opposed to being about speed.

So, as you apply time on feet to your day, you are honoring this same aspect of your journey. Taking the arbitrary parameters our jobs and neighbors (and even our doctors) give for success, remixing them to be more consistent with your values and the things that ultimately matter. That, my friends, is the real path to success.