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Thoughts from the COVE 

Dr. Jeffrey Chipman provides observations on disruptions during the COVID-19 pandemic.

 

The When Then Phenomenon

At times it is easy to think that by simply reaching some future date or milestone, everything will magically be better. I call it the “when then phenomenon,” and some of us are very good at using it.  The surgeons may have developed this maladaptive skill as a coping tool to justify the sacrifices required to join our professional ranks.  Have you ever talked to yourself this way?  When I finish this exam, then I will stay caught up on the reading.  When this semester ends, then I’m going to stay organized with my studies.  When this school year ends, then I’m going to start exercising regularly.  When I get into the hospital and clinics, then I will shine in med school.  When I start my residency, then I’m on the homeward stretch.  When I finish residency, then… When this paper is submitted, then… When this grant is written, then….
 
If you haven’t figured it out yet, the elusive “then” never happens.  It is always in the future, around the next corner, with the next rotation, hospital, or job. The grass will always seem greener on the other side.
 
I’ve found myself feeling this way about COVID-19.  When case numbers drop, the stress level will diminish.  When we don’t have to wear masks, then society will get back to normal and not ready to explode. When I can travel again, then I’m actually going to take that trip I’ve planned in my head.  If only this were true.
 
To avoid when then-ing your life away, it helps to consider the foundation of our happiness, our being, our joy, our purpose. Perhaps this is why exercise, mindfulness, meditation, or prayer, however brief, can be so effective.  Also effective is developing interests and hobbies outside of medicine as long as they don’t cause us to lose a digit (you know who you are). I’ve already mentioned in this blog the equation for how many bicycles (Rob Madoff, Todd Tuttle, Rafael Andrade), triathlons (Rob Bulander), guitars (Wolfgang Gaertner, Masato Yamamoto), baking pans (Sherri Novitsky), cameras (Subree Subramanian), backyard chickens (Megan Hadley), sewing machines (Lisa Rogers), hats (Orit Ackerman), or horses (Rose Kelly) are needed to have. (As a reminder, # needed to have = N + 1, where N = number currently owned). It’s one thing to have the gear, but we also need to make time to use it.  Running (Chesney Siems, Steve Huddleston, Julie Ottosen, Jenn Rickard), baking (Matt Bobel), acrylic painting (Harika Nalluri), sketching (Christine Vincent), yoga (Amanda Brower), Indian classical dance (Maddie Rao), and email (Sayeed Ikramuddin) all require time. These are just a few extracurriculars that I’ve discovered from among the members of the department staff, residents, and faculty our department. I’d love to know what other hobbies are held.  We shouldn’t be those who, when retired, don’t know what to do because we have never done anything else. 
 
Self-care is important, but equally important is how serving others can help us forget our own problems.  This is part and parcel to what we do as doctors, but I’m not talking about that. I’m talking about something different, outside of our daily grind.  Perhaps it is coaching bunch ball (6-year-old soccer), teaching someone to fish, volunteering with a community project, making a phone call, or taking dinner to someone.  All help us to see beyond ourselves and recognize that many others struggle more or in ways that we don’t.
 
I can sum up all of this in the words of one of my mentors, Dr. Hugo Villar; “Jeff, at least it’s not pancreatic cancer.” Perhaps I could add, “at least it’s not ARDS from COVID-19.”
 
Jeffrey G. Chipman, MD, FACS
Frank B. Cerra Professor of Critical Care Surgery
Division Head, Critical Care and Acute Care Surgery, 
University of Minnesota
Executive Medical Director, Critical Care Domain, M Health Fairview
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