Unplugged

Trust me, I realize the irony of writing about digital overload in an online forum. But seeing as how I have no print media willing to publish my rants, this is what we're stuck with. The latest "Outside" magazine featured an article by a (supposedly) well-known tweeter and blogger who unplugged for a year (he could do Google maps and online searches, but no "daily news cycles or social media...I would not blog, tweet, share, pin, like, star, favorite, or forward anything.") Holy buckets, I can barely go without checking facebook at a red light.

But I can put at least some of the blame for my digital addiction on the neurobiology of something called variable intermittent reinforcement. Compulsive behavior is built by varying the timing and size of rewards, leading to increased dopamine release in the brain. It's why slot machines are so successful. "One time you check your inbox and there's a single new message, from LinkedIn, which reminds you that you can't figure out how to delete your LinkedIn account. Sad face. The next time you check, you have five new messages, including one from an old friend and another from a potential employer. Happy face! So you check, check, check."

There's also a deeply ingrained response from childhood where we are rewarded when "a signal sent gets a signal back." At 2 months of age, a baby learns that when they smile, they are rewarded with loads of positive attention. Toddlers will repeat a behavior (good or bad) over and over if it continues to get a response. And we carefully word our facebook posts to garner the most likes--signal sent, signal back.

A 2012 study by two Boston University psychologists found that Facebook use is driven by two "primary needs"--the "need for self-presentation" and the "need to belong." Broadcast and be acknowledged: that's a ping. Each one affirms our existence as efficacious agents in the world and prompts a squirt of reinforcing hormones from the brain's reward center. "That is why people will respond to a text while driving a two-ton vehicle." (sound familiar?)

That constant leak of dopamine in our brains is why we sit around a table all staring at our smartphones. Why I constantly check my phone to see if anyone loves me. Yes, that's the way my reward-addicted mind phrases it. As if a lack of text messages during a shift at work or a paucity of likes on a status update somehow diminishes the reality of my relationships.

So, what's an addict to do? Bottom line: improve mindfulness. Recognize those impulses as a legitimate chemical reaction in your brain and make a conscious effort to replace the impulse with something else. Engage in what you are actually doing. Recognize the beauty around you. Connect with a friend, listen to a song, exercise, smile. Meditation is one of the most well-established ways to improve mindfulness. Conscious presence actually does cause changes in brain chemistry and activity. Bottom line? We have to find other ways of activating those same reward pathways. Otherwise we end up like the rats in early experiments that die because they push the "reward" button in their cage to the exclusion of everything else, including eating.

If you've never been exposed to mindfulness training or are unsure where to start, I recommend a short little book by mindfulness guru Jon Kabat-Zinn called "Wherever You Go, There You Are." It introduced me to meditation in a whole new way, helping me to recognize my thought patterns and be present more fully.

Now here's hoping that I can practice what I preach and stop reaching for my phone every time there's a lull in the constant stimulation of my day-to-day.

Gifted

"Since we have gifts that differ according to the grace given to us, let us exercise them: if prophecy, in proportion to the faith; if ministry, in ministering; if one is a teacher, in teaching; if one exhorts, in exhortation; if one contributes, in generosity; if one is over others, with diligence; if one does acts of mercy, with cheerfulness." -Romans 12:6-8

In the Christian faith, we know, at least on an intellectual level, that we each have unique gifts given to us by God to further His kingdom. On an emotional level, we often feel quite lacking when confronted with the likes of Blessed Teresa of Calcutta or Saint John Paul the Great, who many of us have had the chance to see and study within our lifetimes. Even more personally, there are people in all of our lives who radiate various charisms, the name given to the spiritual gifts each of us are given. Those people seem to have been especially blessed, filled with the Spirit, and on a higher plane; we attribute it to some sort of spiritual favoritism.

In reality, each of us have been given charisms (I'm convincing myself of this truth in my life as I write, don't worry), but many, I dare say most, of us have not spent the time discerning and developing these gifts. Just like someone given incredible athletic talent spends untold hours refining their skills, so, too, we must put the same effort into our charisms. We spend so many hours and days (at least I do) begging God to show us His plan for our lives, to tell us what to do, and yet we don't recognize the tools He has placed in our bag as a clue.

At the St. Mary's Young Adult Group last night, Scott discussed that in baptism, we share in the mission of Christ. His mission--namely, to bring about the Kingdom of God on earth--is our mission. Determining and strengthening our charisms is the best way to engage in our mission. Many people have written about the charisms. Sherry Weddell's "The Catholic Spiritual Gifts Inventory" is perhaps the most well-known and widespread for Catholics, certainly the one I've heard the most about. Thanks to my compulsive-online-shopping sister, we now have a copy of the Inventory, Workbook, and Workshop DVD in our (her) possession.

Administration, celibacy, craftsmanship, discernment of spirits, encouragement, evangelism, faith, giving, healing, helps, hospitality, intercessory prayer, knowledge, leadership, mercy, missionary, music, pastoring, prophecy, service, teaching, voluntary poverty, wisdom, writing.

I admit I was surprised by my results, both to realize that certain things I've taken for granted in my life (powerful experiences of intercessory prayer, for example) are actually gifts to help further the kingdom, and to see that many of the things I regret not being better at (hospitality, music) aren't really the things that God is calling me to do anyways. The book explains that "charisms shouldn't be a penance", that we should enjoy using our gifts for His glory. Not only that, but your gifts should be effective, that is, bear fruit; and should be affirmed by others.

There are full-length parish workshops devoted to identifying and developing your charisms, but I think the first step is to know they exist, to pray about them, and to look for confirmation in your own life of how God already uses you. And if anyone wants to complete the Inventory, come on over.

Nashville music and other musings

Broadway was out of a movie--fiddles and bass lines spilling out into the street every time the doors swung open. Blissfully, the bars were non-smoking, and without a cover you could wander in and out on a whim. Miller Lites and Michelob Ultras abounded, much to the chagrin of my craft beer palate. But it wasn't about the drinks; more than a few were left unfinished on the table if the band wasn't up to snuff. It's all about the music. The pop-country-by-demand of Tootsies ($20 will buy whatever song your heart desires, even if they have to look it up--thank goodness for smart phones) seemed to be the most popular (and lucrative) of styles. But there was old-time honky-tonk, bluegrass, and plenty of electric riffs as well. The talent was incredible. Even when they were reading lyrics and chords from said smart phones, there was no mistaking that these were professionals.

Even more so at the famed Bluebird Cafe, where we were fortunate enough to see a "Songwriters in the Round" concert. These guys were in. cred. i. ble. They took turns playing their own songs, which the others had never heard before; but just by knowing the key and watching the leader play, the others were able to join in, playing harmonies and solos and even backing up the vocals. I wish I could explain it better. It was a treat to watch. I think a smile was plastered on my face the entire time, just watching their faces and fingers as they, too, just enjoyed good music.

As I write this, I'm listening to Michelle's second guitar lesson unfold in the family room. And it all resonates so well with the book I'm reading by acclaimed neurologist Oliver Sacks. "Musicophilia" explores the science and medicine behind our experience of music. From the preface--"What an odd thing it is to see an entire species playing with, listening to, meaningless tonal patterns, occupied and preoccupied for much of their time by what they call 'music.'" Music is a part of us from infancy, for nearly every culture and era in our history, and yet, as I mentioned in the last post, it serves absolutely no evolutionary purpose, has no immediately recognizable benefits for humanity.

I still don't have answers. What is it about music that moves us, challenges us, excites us, touches us? What is it that makes singing praying twice? (or once if you're JPII or me) That makes even atheist Nietzsche say "Without music, life would be a mistake"? To me, it's poignant evidence of a God who wants to speak to our hearts, who delights in our creative exploits, who created us to live life to the fullest. Not merely to our evolutionary potential, but to the FULL.

Cause it's a musical

My latest literary endeavor details the science of music--how our brains react to it, why some people have perfect pitch, etc. The prologue explores the curiosity of music, the fact that it has no easily discernible evolutionary value, yet is so ubiquitous and even necessary for humanity. Why do we love music? Why does it move us so profoundly? Don't expect me to have the answers; I just think it's interesting to ponder.

I'm grateful for music. As much as anyone, it has shaped my life. Many of my most vivid memories are centered around songs. Waking up to Dolly Parton and running downstairs to dance in our pajamas before school. Learning Bible stories while Mom sang the verses of "God Loves a Cheerful Giver". Screaming "na na na na" at the top of my lungs with Tom Duckett at Servant Leadership Weekend. Skillet's "Comatose" album blasting in the car while I drove with tears streaming down my face (on multiple occasions...it's my go-to emotional release). There are songs that will always be associated with specific events in my life, that can make me smile or bring tears to my eyes with just a few notes. Those are some powerful neural connections in the brain that can do that.

When we were introducing ourselves at the beginning of my Wilderness First Responder course, in addition to name, credentials, and why we were there, we had to share our guilty pleasure song--the one we sing at the top of our lungs when no one else is around to laugh at us. Seeing all these hulking EMTs proudly claim Disney songs, Taylor Swift, and One Direction proved that music speaks to us in a way that words alone do not. I can't explain it, but I love it.

Woofer

This last week, I suffered a rib fracture with a pneumothorax, lumbar spinal cord injury with paralysis, dislocated shoulder, hyponatremia and heat exhaustion, an intracranial bleed, and an ectopic pregnancy. Sorry, I mean I simulated suffering from those things. They were fake (phew about the pregnancy, right?). Makeup bruises, imagined pain, lots of drama, but I did manage some real tears for the paralysis scenario. Although when you're lying on your back on a rock in the rain, not allowed to move your legs, the tears aren't that hard.

I spent the last five days in a special wilderness first responder (WFR) course for medical professionals, during which we all got to play rescuers and patients to the point that I was dreaming about it by the last night. My last CME course definitely did not find me building traction splints from hiking poles. Or traipsing through waist-high grass in White Ranch Park looking for "victims" of a lightning strike, and then waiting in the dark for a litter team to arrive so we could evacuate her safely. Or experiencing first-hand the ear-popping pressure change inside a Gamow bag, which can treat high-altitude pulmonary edema. (My last CME course did get me to pass boards, so there's that...)

We were 29 plus our fabulous instructors (oh, one of them is the NOLS director of education, you say? he wrote the textbook, you say? and we get access to his brain all week? yes, please). EMTs, paramedics, RNs, and MDs from all walks of life, from psychiatry to FBI (yup, FBI!). And most of these people practice pre-hospital medicine every day. You know, the stuff before they come to the ER all pre-packaged and stable? The part without the lab and the radiology suite and the pharmacist? The hard part? Yeah, they do that. I felt super under-qualified.

But that's why we learn. And boy howdy, did I learn. Practical hands-on things like knot-tying and ankle-taping and one-person log rolls, as well as teamwork skills, planning skills, ideas for a first-aid and survival kit, and plenty of wilderness medicine (did you know you don't do CPR in severe hypothermia because of the risk of V-fib? me neither. Now I do). So now maybe I don't have to feel quite so worthless without all my technology and fancy hospital things when something happens in the wilderness, and people are like "Oh, you're a doctor? Great!" Cause, yeah, my MD means nothing out there. But now I got some extra letters and stuff, so I guess I'll be okay.

Checkin' the mail

Michelle teases me that I am so diligent about checking the mailbox every day. She laments that fact that all she sees are ads and bills. For the most part, that's all I get too. (Although I have subscriptions to a few magazines that occasionally make it worth the trip down the driveway.) But once a week or so, I can count on a hand-written letter from Omaha, and that is the primary reason for my checking.

The letters come from my friend John, a retired banker and alum who is a faithful member of the Creighton 5 pm daily Mass community. As a regular attendee myself, especially during my last two years, I would often see him there, and we progressed from the casual nod hello to friendship. John enjoys getting to know the students and keeping up on Creighton sports, and we often enjoyed chatting about the latest campus news, pop culture happenings, or vacations. Once I moved off campus, he would offer me or the roomies rides back to the House after Mass, especially if the weather was bad. And when I graduated, he asked if I would keep in touch every now and then during medical school, "even if you just write a quick 'hi' on the Church bulletin and throw it in the mail so I know you're surviving."

The thing about medical school (and residency, and perhaps life in general) is that it's busy, but also isolating. People marveled that I found time to write to John a couple times a month, but the truth was I looked forward to it. It was a chance to decompress, to process everything that was going on. I stored up stories to tell, about anatomy lab or powderpuff football or my crazy patients, waiting to put them in the next letter. I wrote in anticipation of the next day off, or my next trip, or the next family birthday, and that helped me to keep things in perspective as well. Knowing that I had someone to share my experiences with (a real someone, not the ubiquitous facebook post) somehow made them more vivid. I would be in the midst of something and think, "I'll have to share that with John later." Sometimes I even made lists so I wouldn't forget to include anything.

In residency too, the letters were a lifeline to someone outside the medical field. I could describe the horrors of an 80-hour call and know that he would be appropriately astonished at the schedule we kept. Or I could brag about our notorious post-Owl Team breakfasts and know that he would marvel at our camaraderie and delicious food choices. In return I am kept abreast of Creighton basketball, changes on campus, news items I missed, interesting stories from students, and his or his brother's trips to Okoboji, Guadalupe, and everywhere in between. We exchange thoughts on book and movie reviews, culinary delights, and of course the weather.

Now eight years later, I still save up stories for John, giving him a little window into the life of a young pediatrician and outdoor enthusiast. I of course select the things that will make my life seem thrilling and worthy of documentation and leave out the boring routine, which is most of life. But it reminds me of a simpler time. A time when everyone had to wait two days or more to hear from their loved ones, and letters lagged behind the present just a bit, as conversations were carried on over weeks instead of minutes. It makes you think about what is really important enough to share, and how much should be shared. It requires intentionality, and I think that's what I love about the trip down to the mailbox. It's the opposite of the false transparency of social media and online friendships. It's tangible and personal, sometimes whimsical but sometimes weighty. It makes me live a life examined, because I know someone is waiting on my report (not that he necessarily watches for the mailman like I do, but I know he enjoys the updates).

Because I know my own joy at the handwritten word, I try to be more conscious of sending along cards and notes to the rest of my friends as well, something that might brighten their day (I encourage you to try it as well). And if anyone ever wants a pen pal, I've got some pretty good practice, and a nice supply of stamps.

The Way of the Cross

Saturday I ran the Rugged Maniac, one of the endless "adventure races" cropping up around the country where participants pay a premium to crawl through mud for "free" beer. Or at least that's kind of how it seemed on race day. Having never done an adventure race, and wanting a trial run under my belt before the Warrior Dash next month, I was pretty much ready for whatever. Oh, except a broken toe. Coming down from rock climbing with the boys last week at Camp W left me with bruising and buddy tape and a little bit of apprehension, but I was going to go for it anyways. Don't worry, on the second of 25 obstacles, I kicked a rock and went down, mimicking the original injury and sending shooting pains down my foot. But maniacs press on.

Muddy water can't stop me. Broken toe can't stop me.

The group that I was supposed to be running with, a motley crew of South Campus nurses and SO's, was, let's just say a lot less into physical activity than I was. I pretty quickly left them in the mud by that second disastrous obstacle and found myself running alone. Throughout the race, I lamented that I had no cheering section, no partner in misery/triumph, no one to balance me as I nearly ate it on those narrow beams (but I did have a guy high-five me at the end for my last-minute save). I thought how much better the Warrior Dash with the wombmate would be, and how I even wanted to encourage random strangers as they walked hunched-over, knowing how important it is to feel that support.

Blame it on spending two weeks this month at Camp W, where everything is a metaphor for the Christian Life, but as I was praying the Stations yesterday in the dry, clean comfort of my living room, I thought back to the course as I pictured Jesus walking Calvary on His own. Yes, he met the women of Jerusalem, and His Mother, and reluctant Simon, much as I occasionally struck up conversation while in line for obstacles, but the walk, the burden, the suffering, was borne alone. How much would He have given for a companion to whisper encouraging words, or just to share the journey! Fr. Gaitley, based on the revelations to St. Faustina, talks about offering to Jesus our presence at the cross, loving Him and being with Him in His suffering. And now I have a concrete experience of the value of this. Our God who transcends time was also fully human, and ached for a friend for the journey just as much as we do.

I don't really have a metaphor for the muddy water, or the fire pits, or the free beer. Sorry.

Fire pit--check!