The Practice of Wellness

Move. Rest. Nutrition. Wisdom. Community.
Build resilience.
Be present.

Martin Huecker, MD
Chair, Wellness Committee

Hey everyone! Hope you had a fulfilling month. Here are some ideas for wellness practice.

Big Concerts at a Tiny Desk

Here is a music recommendation you cannot pass up. If, like us, you have been out of the loop since 2012 on NPR’s Tiny Desk Concerts, immediately check them out on the NPR website, YouTube, or in iTunes podcasts.

These are 3-5 song concerts performed in the NPR office at a ‘tiny desk.’ Quite a few big name artists, but many independent ones and even some who were discovered in a contest for the show. Some of our favorites are Leon Bridges, Macklemore, Coldplay, Lumineers, and if you are feeling adventurous, Moon Hooch. Thanks, Trent for the recommendation!

When to exercise

I always say that what you eat is less important than when you eat. A healthy circadian rhythm matters for exercise as well. This article covers the impact of exercise on circadian rhythm, with specific attention to subject chronotype (early bird vs night owl). Exercise is a reliable zeitgeber (“time-giver”) (like eating, caffeine, bright light): if you work out early enough in the day, it wakes you up right then and facilitates better sleep that night.

Results of the study showed that early chronotypes should exercise in the morning: when they exercised late in the day, they delayed their circadian rhythm and had trouble sleeping. (Thus, if you are an early bird entering a night shift, you might want to exercise in the evening).

Good news for us late chronotypes, we can work out anytime. Morning workouts can “phase advance” us, helping us fall asleep that night. But an evening workout does not phase delay us (make us fall asleep any later than we already do).

Call nights

Speaking of exercise and sleep, what can you do about sleep inertia, the feeling of walking through molasses when you wake up in the middle of the night. You can shine bright light in your eyes (painful), you can smack yourself in the face (also painful), splash water on your face (effective). Some choose to chug coffee, but the onset is 45-60 minutes and it stays in your system for 6+ hours, causing difficulty falling back asleep if you are lucky enough to have the time to do so.

This study looked at a short interval of exercise just after waking at 2am, and its effect on sleep from 4am-7am. Comparing sedentary to light exercise to intense exercise, the light exercise group had the best results, with better sleep from 4am-7am.

So if you have to go check on a patient, or a sick child, at 2am, a brisk walk or other light exercise (in this study they used a stationary bike) can help you wake up for a couple hours, but more easily fall back asleep if you get a chance.

Taking Care of Residents

Check out this article on leadership behaviors in residency programs across Mayo Clinic. The level of perceived support provided by faculty members correlated with lower burnout scores in all domains. Think about the following questions in how you approach educating residents (and medical students):

My residency program leadership team…
Holds career development conversations with me.
Empowers me to do my job.
Encourages me to suggest ideas for improvement.
Treats me with respect and dignity.
Provides helpful feedback and coaching on my performance.
Recognizes me for a job well done.
Keeps me informed about changes taking place at Mayo Clinic.
Encourages me to develop my talents and skills.
Responds appropriately to issues or concerns that are raised.

How to STOP being happy,
from Farnam Street Podcast with Derek Sivers:

“Number one, prioritize lifestyle design. You’ve made it, so it’s all about you now. Make your dreams come true. Shape your surroundings to please your every desire. Make your immediate gratification the most important thing. How to stop being rich and happy, number two, chase that comparison moment. This is from the book Stumbling on Happiness. You have the old thing, you want the new thing. Yes, do it. Be happy for a week. Ignore the fact that the happiness only comes from the moment of comparison between the old and new. Once you’ve had your new thing for a week and it becomes the new norm, just go seek happiness from another new thing. Number three, buy, not rent. Why rent a house, a castle, a boat, or a car when you can buy? It’s not about the thing, it’s about identity. This shows who you are now. Number four, internalize your new status. You worked hard to get here. Celebrate, relax, admit that you’re in a different class of people now with different needs. Understand there is no going back. Number five, how to stop being rich and happy, be a connoisseur. Learn what others say is the finest. Insist on only the finest. You will now be unhappy with anything but the finest …”

How to START being happy

Churro pork rinds

Who does the healing?

The Latin phrase Vis medicatrix naturae translates as the “healing power of nature.” Or in Greek, Νόσων φύσεις ἰητροί (“Nature is the physician(s) of diseases”), a phrase attributed to Hippocrates.

What is that life force that actually heals a patient once we remove the barriers (bacteria, cancer cells, toxins, etc)? It is hard to not think in supernatural terms when you see how organisms repair themselves.

Miraculously, our bodies want to come back stronger after a challenge, we are Antifragile. Nicholas Nassim Taleb wrote that when we inappropriately use antibiotics, we pass/give the beneficial antifragility to the bacteria. They get challenges, and potentially become stronger. I thought of some other examples related to Katy Bowman’s idea of outsourcing movement. When we use automatic kitchen devices instead of our hands, when we drive to the coffee shop that is within walking distance, elevators instead of stairs, taking the dog to the dog park instead of running with him. Usually, doing the harder thing, embracing voluntary discomfort, will make you live longer. Use it or lose it.

Quotes

One of the first duties of the physician is to educate the masses not to take medicine.
– Osler

“The art of medicine consists of amusing the patient while nature cures the disease.”
|
“Doctors put drugs of which they know little into bodies of which they know less for diseases of which they know nothing at all
– Voltaire


Follow on:

Check out the Journal of Wellness
www.journalofwellness.com
Submission Page

WEBSITE: www.practiceofwellness.com

Twitter (@First_Wellness)
Instagram (Practice_of_Wellness)

If you know anyone who might benefit from the newsletter, just forward it along. They can SUBSCRIBE HERE