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Restoring a Sense of Buoyancy

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Fisch_explaining.jpgThe patient had been perfectly healthy and now he had this new diagnosis of cancer. Now he is just miserable. And I reflect not only on the details about the disease and treatment, and the facts about treatment goals and prognosis, but I wonder how he can restore a sense of "buoyancy" (that force that keeps one afloat as opposed to sinking)?

I'm a cancer physician, not a pop-psychologist, but nevertheless I find it useful to get my own clear sense of buoyancy -- to understand my patients and to understand myself, too. I've decided that these 10 parameters (specific "floaties") are most important. They're in no particular order, they don't have equal importance, and their contributions to my overall buoyancy vary over time.

  1. Autonomy (freedom to choose). It's good not to be told how to act, dress or do every little thing at work.
  2. Exercise my skill (do my thing). I love being a cancer physician.
  3. Establish and maintain meaningful relationships. This applies for all aspects of my life (work, family, other activities).
  4. Being awake to my present reality. That means knowing that I'm not an astronaut, but also being able to tell when I'm tired or hungry or angry.
  5. Gratitude. The glass must be half full, at some level.  
  6. Courage (managing fear). There's no avoiding fear and doubt.
  7. Appreciation of impermanence. This just means that I "get it," that all things change. I may not relish change in all instances (like my aging body or my changing bank account in this economy), but I can see this truth.
  8. Compassionate mind frame. Empathy with benevolent intent.
  9. Finding and keeping my safety and security. This varies for each person. It might be a religious thing for some, or it could be related to having enough money or living close to family. It's that grab bag of individual stuff.
  10. Answering the question "do I matter?" This could be the ultimate existential question at some level, or it may apply in smaller situations (like "do I matter" on this project, or coaching this kids' soccer team, etc.).

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