What a Non-Catholic Can Learn from Observing Lent

A week ago was Ash Wednesday. I saw many people at work going about with a black ash cross on their forehead. Although I am not a Catholic by any stretch of the imagination, I have always respected Lent. I think it has a beautiful symbolism, in so far as my understanding goes. If you want to learn more generally about Lent, here's a good overview. The forty days of Lent (Sundays do not 'count' because Sundays are a celebration of salvation) mark a time of prayer, penance, and fasting (meaning a different diet, not total starvation) in preparation for the resurrection of Christ at Easter. Many people see the temporary sacrifices of Lent (chocolate, TV, internet) as another way to do penance, develop self-discipline, and remember the sacrifice of Christ -- for instance, this 25-item list put together by and for teenagers. Pretty impressive for high school students, right? One could argue it is artificial hardship, but I was thinking how valuable it could be for anyone, not just the Lent-observing Christian, to 'do without' for 44 days.

It seems this practice would bring us closer to those people who have less than we do, while reminding us that we have much more than we think. Especially during this Great Recession, I've been remembering the old saying, "Use it up, wear it out, make it do, or do without." Not that I live a deprived life -- we live in comparative luxury on our modest income (ie my research stipend and his intern stipend). But of course it's good to be careful and frugal with money, and to be thankful for what you have -- no matter how much it is.

The 44 days of Lent are also valuable to the non-Catholic as a dedicated time to learn a new habit. It takes people anywhere from 18 to 91 days (depending on the individual, the behavior being learned, and which study you read) to really establish a habit, but 44 days is a pretty solid amount of time to devote to a new practice. Check out this Slate article on one (Indian-American) woman's experiment with becoming a morning person. You could apply this to anything, from nagging your children/spouse/employees all the way to kicking a dependence on caffeine, alcohol, or cigarettes. Speaking of which, isn't it neat that our medical school's first-year syllabus requires that we attend an AA meeting if we've never been to one, so that we understand what it is we are recommending to patients?

So my Catholic neighbors and colleagues have inspired me to re-examine my own life. What do I indulge in? What could I do without? What would make me a better person?  I think as I get older (I'm now 27 years and 4 months old), I need to decide what my priorities are going to be. As a high school student, especially, I had this strange idea that I could do everything. I could act in plays, sing in a choir, choreograph dances, ride horses competitively, study hard, do research, volunteer, etc etc. And I could do it all, but I was perpetually exhausted, never saw my family or friends, and I think I averaged about 4-5 hours of sleep a night my junior and senior years. Obviously (in hindsight), that was not sustainable. However, we'll see if I've still got it (residency is coming)!

Our little older Siamese (she's 13) had a health scare this weekend: she chewed a bump off her shoulder which turned out to be benign (a self-operating cat! Dr. Cat, M.D!). But the reminder that she, like all of us, is mortal made me want more focus in my life. I am currently deciding on a specialty (almost there; really close to deciding), starting a marriage, and trying to find enough time for family and close friends. Given that I am in the medical field, I don't know how much room there will be for anything else. Maybe kids, someday? Running? Riding? Pets? I don't think I'll be choreographing another can-can anytime soon.

At this point, I want to devote more time to my career and calling -- to becoming a really good doctor. It takes way more time than I had anticipated. But not more time than it deserves. Because it's worse to be a lousy doctor than to not be one at all. I'm in a research lab at the moment, but the MD is the goal. I need to start thinking about my future patients: which skills do I need to acquire in order to be the doctor they would want? So until Easter, I am going to read one article or chapter every day that will make my sub-internships easier during fourth year and beyond. I am also going to spend ten minutes each morning in a lovely meditation taught to me by a friend who was also a minister a few years ago. It went something like this:

The Friend Map:
Picture a map of the United States or the globe in your mind. Picture everyone whom you carry in your heart -- friends, loved ones, colleagues, frienemies, or any other group -- as pinpoints on that map. Now scroll across the continent, sending a prayer/good wish for each person. This cultivates gratitude for their presence and a loving demeanor, both of which will strengthen your ability to weather storms. And who knows? They may sense that someone is thinking of them/praying for them.

Why This Blog Is Only Nominally Anonymous

I bumped into a couple of dear friends yesterday and had a surprise Valentine's Day 'date' with them. I was walking near their place, so I should have somewhat expected it, but it was still a wonderfully unexpected meeting. Over Thai iced tea (yum), I found out that one of them knew about this blog! I was so pleased (hello K if you read this)! It feels safe and warm to know that friends occasionally pop in.

As someone who keeps a blog for the primary purpose of keeping in touch with family and friends and reflecting on my personal life, it is important to specify what this blog is and what it isn't. Although I do not post my name, address, medical school, or other identifying information for the world to see (and Google), I am fully aware that someone who really wanted to know who I was could find out based on clues and the sieve-like nature of "secure" information online. The Dr. Lindeman case (read his interview about it on ScienceRoll) illustrated perfectly why blogging, especially blogging anonymously about controversial topics, can lead to trouble.

Essentially, he is a Yale-and-Columbia-trained pediatrician who blogged as "Dr. Flea" for a few years. He had a straight-talking approach to the medical world and his commentary was often somewhat controversial. A lawsuit was brought against him by the parents of a 12-year-old boy who died of diabetic ketoacidosis six weeks after an office visit where his diabetes went undiagnosed. Because his team did not think it was true malpractice, it went to trial. During the trial, Dr. Flea blogged about the case, the jury, the attorneys, and the defense strategy. The prosecuting attorney then found a comment that linked Dr. Flea to the person on trial! I wonder if the person who posted that comment had any idea how much trouble it would cause. Basically, the attorney unveiled Flea's real identity in court, and he settled the suit. This whole saga made the Boston Globe. I have no more knowledge of or connection to this case, as far as I know, than the information available online. I feel bad for everyone involved.

That said, I do believe that medical students, residents, and doctors have a unique view of society and should try to participate in conversations about topics important to them. It's just that in a shrinking world of increasing internet fluency, it's utterly naive to think that you can post opinions that will never be identified with you. This is why I rarely blog about patients, I don't publish scathing critical reviews of anything, and I assume that my boss's kids will one day print this out and hand it to her! This blog is not a forum for me to rant about medical school or to air personal vendettas against specific people (which I don't really have, anyhow). I write to create a place online where people can check in and perhaps find something to think or at least smile about. But I have no desire to be an infamously controversial blogger; blogging, like so many things in the context of medicine, may be best done in moderation.

With all this in mind, I have drafted the following pledge:

The Sane Blogger's Pledge

1) I will not write anything 'anonymously' that I would be ashamed to have attached to my name.
2) I will not disclose secrets that do not belong to me.
3) I will remember who I am in real life and not let my blog identity overwhelm it.
4) I will blog about my past and present while remembering that what I write may affect my future.
5) Uncharitable thoughts are no less uncharitable in written form.

Does this mean no hot-button issues? No, it just means that when I take a stand, I do so knowing that to most of the people who read this blog, to our circle of friends/family/colleagues, and to anyone who does enough hunting, I am not anonymous.

Which brings up another issue: should I just post my name as the author? Would you consider blogging under your real name? What do you guys think?

Yours online,
Nia