Healing perfectionism by crying in words; a case study.

We all have things we do that speed up the the break down of our body and bring about the inevitable freedom of our soul from the confines of the meat-monkey-suit.  I always thought it would be my sweet tooth that has enslaved so many in my family and race(es) to the slow decline of diabetes and then heart disease.  Alas, as of this year I have finally sprouted a small gut who in its growth threatens to speed up the tendency in my DNA to insulin resistance and then diabetes.  I am wrong, that may be a mere footnote in my medical history.  The real cause as always lies much deeper.

I was innocently reading one of the extremely heavy novels I am apt to read (When I am stressed I like reading about situtations worse than my own and then I don't feel so bad) when I hit page 115, the final words of the chapter jumping off the page, slapping me across the face, bloodying my nose and echoing into my psyche... "You can't ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving."  Shit that is me.  "When Breath Becomes Air" is a stellar memoir that will leave you reevaluating your life, its meaning, and what to do with the time we have on the planet.  The author Paul Kalithi is a Stanford Trained neurosurgeon who gets lung cancer during his residency and speaks to his epiphanies about life, death, and medicine as he alternates between being patient and doctor. 

Here is the sentence in context:

"Our patients' lives and identities may be in our hands, yet death always wins.  Even if you are perfect, the world isn't.  The secret is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win for your patients.  You can't ever reach perfection, but you can believe in an asymtote toward which you are ceaselessly striving."

His comment about perfection was profound to me because I think he was indirectly telling me that that was the ultimate cause of his death, yet he never comes out and says that.  In his book he never talks about the etiology of his lung cancer, however, I did find an article where his wife Lucy states that he was not a smoker and they worked with the Chris Draft Family Foundation to raise money for lung cancer research and to dispel the myth that lung cancer is merely a smoker's disease.  I wonder how much his having to constantly strive for perfection as a neurosurgeon ultimately lead to his early demise at age 37.

His line about perfection strikes me because it is the un-healed wound in my journey.  When I look deeply about my behaviors for coping one would see succumbing to sugar cravings, sex, exercise, and scouring the internet for the latest cancer theories and treatments.  The latter is largely responsible for some of my success as a doctor, I am a master of finding information and wading through data.  All of the above are attempts to jack up dopamine in my disappointed brain.   However, a deeper look and I see that my coping mechanisms in life come from a root in perfectionism.  When I fall short (or mis-percieve myself as falling short) I turn to cookies, which ruins my perfect physique, leading to obsessive exercise out of the fear that if my body isn't perfect i won't get to have sex and thus I should just be a perfect doctor to get love and justify my time and space on the planet.

There it is, that damn "I am not lovable thing" that has haunted me since childhood.  Rationally, I can see that this is all a crock of shit, but it is still in my tissue, aching my bones, tightening my muscles, draining my energy, weakening my immunity.   I can see it in the mirror in my greying hair, sagging eyes and growing belly; the physical embodiment of the stress of a wedding, of the potential loss of my daughter to a move out of state by her mother, totaling my car in the recent floods, and working with cancer patients.   Yes, things are far from perfect in my world.  Icarus falls from the sky.  I am human.

And Trump is not helping with is war on immigration, the planet, and everything else dear to me...  But maybe he is.  Maybe it is healing to know that I have never stopped watching my back despite moving to the one of the most liberal places in the US.  I am always aware of how much I stick out.  The Black Sheep.  Maybe this is all catalyzing a big healing crisis for me and for the planet.  Thanks Trump, you really have been good for business. At the next deeper level, I have never relaxed, never been at home anywhere, never fully exhaled and I fear it will prematurely take me off the planet should I not figure out how to heal that hole in the soul.  I have never fully belonged.

It really irritates others when I speak of my death, as if talking of it is enough to will it into existence.  How much more powerful is writing about it?  I don't really subscribe to that belief, working with cancer patients has taught me that death comes for us all despite my perfectly imperfect attempts at a perfect treatment plan, that power is not in my hands.  My body will die whether I speak of this, write of it, ect.  I do think that HOW one does it can set things in motion faster or slower.  So no I am not suicidal, morbid, depressed or dying.  I am merely aware of my death and that is truly the gift of working with cancer.   The awareness that time is precious and life is an amazing journey.   It makes all the long hours, all the hard decisions, all the tears shed in my office worth it.  I am aware of the strangle hold this perfectionism has on my life and health and will strive to heal it in a slow and imperfect manner becoming a patient.  I have made an appointment with my doctor to begin this journey.

So thank you for listening, for I cry in words and in doing so release the emotions and tension from my body from a hard year.   Bear with me as I learn to accept the imperfection, root out the disease of perfectionism,  and embrace the humanness it brings me.

Unpacking my baggage

I just finished listening to Macklemore's new song "White Privilege II" after a week of raw processing about race with multiple people.   I about died, cried with a cacophony of emotions with the line "white supremacy isn't just a white dude in Idaho" for I grew up in Idaho around many white supremacists.   Growing up there I learned subtle and not so subtle messages that were not true about myself.  In the end, it would take me half my life to begin healing those early childhood wounds, wounds that have quietly continued to haunt me as I became a young adult, a father, and soon to be a husband. 

When I turned 18, I could not wait to get out of Idaho and left for the grey skies and liberal views of Seattle.  However, even in liberal Seattle I learned to still be vigilant, the world does not see me as my friends see me.  Seattle has been good to me.  I never had a problem with the police there, a welcome relief from the time in Idaho when I had been pulled over five times in one month and never ticketed.  That does not mean that there were no problems with Seattle PD, but from 18 to 33 I had zero altercations with officers.  Moving to California was a return to reality and a return to vigilance.

I landed in Seattle in 1998 where that November Proposition 200 passed in Washington. This proposition remove any preferences on the basis of race, sex, national origin, color or ethnicity for the goal of creating a diverse student body among other things.  As debates about it ensued over the next few years, I felt all eyes on me.  At the time Seattle University was not a diverse student body.  I became the poster boy for diversity.  I had to answer for the minority view in every class in a private school with a predominantly wealthy white student body.   People wondered if I got in on the quota.  I wondered if I got in on the quota... I had to prove that I belonged there academically, a stress I would never wish on anyone, but in a weird way it worked out for me, I am now a doctor.

I am vigilant about how I am SEEN.  I spend an inordinate amount of time and energy worrying about: being pulled over, about getting shot while I am on my run, being perceived as a sex object, being perceived as a sexual predator, being seen as unintelligent, being seen as a thief, being snubbed in the surf lineup, being a perfect father so I don't loose my daughter, being seen as an Uncle Tom, being seen as militant, what people think about my hair, my daughter getting in trouble in school, explaining my races, getting searched at airports and boarders, being seen as cheap, being an oreo, being a coconut, being seen as abusive to partners, and never ever show ANGER.  Angry men of color are scary.  I wish I could express it the way he did, but will not.  Be cool and unemotional.  I am Spock. I have not gotten to BE.  Hold your tongue, cope with the ache in your jaw from not saying what needs to be said in the moment.  Take a white pill for my growing hypertension, not for me, I am treating it's cause...

This my friends is White Privilege.  If you don't have to worry about the things in the above paragraph, then you have White Privilege.  For those who are still in denial of this concept please watch this scene from "The Color of Fear".  If you still don't get it, you never will.  For those that want to go a little deeper watch the film "Traces of the Trade". 

I am tired of being a second class citizen.  I am unpacking my baggage, someone else will have to carry that shit now.