MANAGING EXPECTATIONS — A Guide to Serenity

We all seek more serenity in our lives. Whether we refer to this as “peace of mind”, “contentment” or “happiness” or any of a dozen other similar terms.  As The Buddha noted centuries ago, life is about suffering and the end to suffering.  Of course there are many reasons why we suffer but I will address one in particular here– unrealized expectations.

We live in a time and place where we are exposed to the desires and lives of others. We constantly meet people who seem to be happy with their life circumstances.  We continuously compare our own lives with theirs. Difficulties arise. Who ever coined the term “compare and despair” was not far off the mark.  

We have developed expectations of what our lives should be like from our personal connections and the media which surrounds us 24/7.  This may explain why we secretly relish the suffering of celebrities, billionaires, the rich and famous who we previously envied. Unfortunately we may even do the same for those friends and family who we otherwise love and appreciate.

 The “why me” response seems primal and reflexive.  “Why not me” is its corollary.  Expectations are particularly problematic for us because they involve circumstances beyond our individual control.  Why doesn’t my boss appreciate  me?  Why doesn’t my brother step up to the plate and assume responsibility? Why don’t my friends value my opinion? Why does my spouse seem disinterested? Why do I struggle with less money, less fame, a weaker marriage, a child who isn’t living up their own potential? Etc. ad infinitum.

And what about our expectations for our own lives, even those to which we have influence.  We may take note of what we are grateful for but fixate on past dreams which crashed and burned or remain unrealized.  Why am I not in a committed relationship? Why isn’t my health as good as my neighbors?  Why do I covet my friend’s spouse? Why didn’t my career progress as far it should have?

 Letting go of expecations is extremely difficult.  That doesn’t mean we shouldn’t have them.  It doesn’t mean we need to doubt our own feelings.  It has to do with releasing our attachment to our expectations.  We need to stop ruminating on them, revisiting them over and over.

We need to seek a larger perspective on our individual lives.   We need to recognize that to pick and choose what we envy from the lives of others is not reality. We must realize that life, every life is a totality. Be careful what we wish for.  The unknown aspects of the life of others might be quite different from what we fantasizse.

We must recognize that we are both totally insignificant in the span of eternity while paradoxically undeniably important.  Our smallest gestures of kindness and compassion move the cosmos as much as any president’s directive. The value of each individual life remains undeniable and unexpected. And there may be unrecognized karmic factors which make each individual life unique.  Despite our best efforts to control the chaos around us, to micromanage our own lives and the lives of others, this is not only impossible but a further blow to our expectations.

 Perhaps catch and release is an apt metaphor. Feel free to examine your expectations of yourself and others, then let them go.  They are only your perception of your life which can change in a heartbeat. To paraphrase the Serenity Prayer—accept what you can’t change, change what you can and let go of any burdens that remain.

Release your attachment to your expectations  and be grateful for the opportunity to live this life.  There will be other lives to live.  Stay tuned. 

PATIENT PORTALS — Unintended Consequences

Everything new brings with its introduction unintended consequences.

Patient advocacy, access to our own medical records, the concept that we need to take ownership of our health care–all resonates as true and laudable.  What happens in the real world, however, is often chaos and unnecessary suffering.

Please allow me to offter real world examples of this notion.  Patients are able to access their radiology reports, blood work, endoscopy and surgical reports with their associated pathology reports even before their attending physicians.  Sounds great?  Not really. What immediately occurs is a frantic Google search for any medical terms which are unfamilar to the patient.  What often follows is sheer panic and misery when uncertainty and confusion ensue.  This is understandable.  Even the most intellectually gifted layman (my patients, of course) do not understand the  clinical significance or relevance of what occurs on a lab, XRay or pathology report.  

Traditionally (in past days) the patient would receive the initial information while in the presence of their doctors.  Immediate discussions would occur. Analysis of the real consequences of a radiology report which might recommend a follow-up procedure based upon some vague and usually benign finding could be quickly and easily placed in perspective. ” Yes, let’s order another study just to confirm that these findings are probably nothing.”  That would often assuage the patient’s fears and avoid unnecessary panic.

The situations is quite different now.  I find myself dealing with borderline hysterical (or nearly) patients who have convinced themselves via the internet that they are absolutely dying from what may be a totally innocuous condition.  

My plea to my patients and to the patients of other physicians is to bring your reports to your doctors and, in persons, review every line of the report itself.  Frankly, most of this interaction cannot adequately be performed over the telephone (sorry about that).  Often the emotional content of the discussion can only be dealt with on a person to person basis.  Often I rely on diagrams to elucidate the results.  That is the way to promote the best in doctor/patient connections and to alleviate unnecessary chaos and distress.

The system is assuredly changing. Let’s all take a deep breath and try to make it work to everyone’s benefit.