from 8.29.08

The alarm on my $10 powder blue digital wristwatch wakes me up, without fail, each morning at 5:30 am. 

"Get up, you've got 15 minutes to get ready," I pledge to myself, lying there not moving. It is more like 30 minutes before I actually get out the door. If I'm lucky, I will be on a rotation that doesn't require my presence until 8 am so that I can go for my morning swim and get that good start for the rest of my day. I have a long commute to work where I can either quietly collect my thoughts, listen to medical Spanish or thumb through various radio stations. Today, I decided to collect my thoughts.

I spent my entire morning commute thinking about how I could take this energy bubbling inside of me to some good use. I'm in search mode, looking around for direction and purpose outside of my known roles professionally and personally. I've been here before, this search mode. It feels familiar and therefore I know it is a good feeling to have. Last night was the 45th anniversary of Martin Luther King Jr.'s "I Have a Dream" speech as well as the finale of the Democratic National Convention. Each year, I listen to Dr. King's speech and it stirs my spirit. What, I asked myself, can I do to engage myself and others in community advocacy? What are the issues that matter to me and my community the most? Where do I start? How can I help organize the framework for social change? What would the projects look like? And lastly, what would be the endpoint?

I've decided that residency is a good time to revisit these questions. Daily lecture begins at 8 am. We talk medicine. I love juxtaposing the reality of my interactions with patients to the evidence-based recommendations we discuss, getting my noggin to think hard so early in the morning. Every topic hits a cord more so now than ever before because as family physicians, we see peds, we see adults, sports med, ob-gyn, surgery, emergencies - we are involved in the entire life cycle of the human experience. My learning curve has exponentially steepened because of built-in academic didactics - and I love it! The sole agenda of a residency is to produce good doctors so, and in turn, help people live healthier lives. I like that agenda. Even more so, I like the agenda of building healthier communities, not just improving physical health, but mind and spirit as well for total well-being. That, to me, is what separates a great residency from good residencies.

Now, to push the envelope further, what if residencies not only created leaders to build healthier communities, but facilitated the development of civic responsibility and engagement of the patients as well as the residents? What if these developments crossed and integrated other disciplines, producing advocators of advocates, empowering citizens with the leadership skills as the common thread that ties so many social issues? Wouldn't this improve the critical thinking education of our minds, bodies and spirits? Wouldn't these skills tackle fundamental issues and chronic barriers? WHOA there, you may say. This is WAY out of the scope of practice and way out of the scope of medicine at large. This may even be out of the scope of the most idealistic of family physicians.

If you look at your daily life and the breakdown of your day spent toward work, family, entertainment and personal organization, the skills and efforts of each of these aspects are often segregated. However, in reality, we negotiate between these efforts all the time, trying to balance each within the time constraints of a day. This is what makes balance so difficult. Instead of wearing so many hats, I challenge each of us and every organization to recognize people as wearers of one hat that encompasses them all: Citizens. Our personal lives are tied to one another. Our well-being is often defined by the sensation of perfecting a balancing act. How we develop and utilize our skills as employees, students, partners, sons and daughters, parent, consumers of media and citizens of our communities are affected by the affairs of our institutions, the actions of our leaders, the politics of history. They are affected by our daily interactions at work, at home, at school, on the web and in public. How can we better engage the lock, turn the key, and open the door?

I have a dream, too. I have a dream that individuals, institutions and all the layers of organization that govern our daily lives acknowledge the interconnected responsibility we aim to balance by creating long-term bridges for living healthier lives in healthier communities.            

I want to live my best life and I want to make it easier for everyone to live their best life too.