This has nothing to do with my ADDled brain … but it’s still important

“The people are the only censors of their governors: and even their errors will tend to keep these to the true principles of their institution. To punish these errors too severely would be to suppress the only safeguard of the public liberty. The way to prevent these irregular interpositions of the people is to give them full information of their affairs thro’ the channel of the public papers, & to contrive that those papers should penetrate the whole mass of the people. The basis of our governments being the opinion of the people, the very first object should be to keep that right; and were it left to me to decide whether we should have a government without newspapers or newspapers without a government, I should not hesitate a moment to prefer the latter. But I should mean that every man should receive those papers & be capable of reading them.”

— Thomas Jefferson in a letter to Continental Congress Delegate Edward Carrington

That famous bolded section of the quote above was repeated recently by the host of a local radio show I recently had the pleasure (and terror) of being interviewed on about the importance of local media. Thankfully, it was not live!

On a chilly gray Saturday, Jeff Milchen and Steve Kirchoff, hosts of “The View From Here” on KGVM brought me and Bob Wall, Operations Manager for the community radio station, into the studio for a lively discussion.

If I sound like I know what I’m talking about, I guess, I do. As a former reporter with the Bozeman Daily Chronicle (among other daily newspapers), a current freelance journalist and a radio DJ on KGLT — a primarily music-oriented local station that intentionally avoids the news — I felt I had a good handle on the subject matter. It helped that I came prepared with quotes and stories from other sources to support the assertions I made.

Here’s a link to the recording.

I’m curious. What are your thoughts about the media and its role in preserving democracy?

Feel free to post your comments. I’d love to know what you think.

What does it mean?

So I’m kind of flummoxed here. Is it weird that I dreamt last night that I had a surplus of cauliflower in my refrigerator that was about to go bad (which, by the way, isn’t the case) and then this comes in my New York Times daily briefing?

 

Why my challenges are also a blessing

A few months ago, I challenged myself to do something scary. Really scary. I spoke about having ADHD and dyslexia in front of hundreds of people over two nights here in Bozeman.

It was a PechaKucha talk meaning I had six minutes and 20 seconds to tell my story. I created a Powerpoint of 20 slides that played 6 seconds each behind me on stage at The Ellen Theatre. It was a powerful experience hearing people react to my words as I spoke.

It was also affirming having folks — even people I didn’t know — praise the presentation. More importantly, I was surprised and pleased to have several people thank me, themselves having been recently diagnosed or having struggled with these issues for years. Some even sought me out for advice.

Whoa!

If I think back on the days when I first started keeping this blog, I realize how far I’ve come from that anxiety-ridden, depressed woman. Now, I feel strong, confident and capable. And I’m getting things done … not despite, but BECAUSE I have ADHD.

Don’t get that? Watch the video.

The Mighty Doctor: Considering the Power Dynamic Between Patient and Doctor

“I always made a point of telling the doctors I was sane, and asking to be released. But the more I endeavored to assure them of my sanity, the more they doubted it.”

— Nellie Bly

I often ponder the power dynamic between patients and their health care providers. Clearly, doctors spend years gaining medical knowledge that people without this training do not possess. It is exactly this level of education that gives doctors the upper hand.

I have a neighbor, a retired nurse, who refuses to put on a gown or change out of her clothes in any way before she speaks with her doctor. She has a point. Who doesn’t feel vulnerable in those awful gowns? It automatically puts the doctor on higher ground – she’s fully dressed, you’re not.

A 2016 study* found that although current trends in health care seek to minimize this power dynamic through shared decision making, many doctors do not fully perceive, appropriately use or aim to curtail their authority when interacting with patients.

Historically doctors did have knowledge their patients did not. But now, well, now we have the internet, yes? (However, I do caution people to use well-respected sources and check more than one site when looking for answers).

Innately curious (yay, ADD) (and, yes, curiosity may kill the cat, but obviously knowledge is power), when I have a medical issue, I typically research my symptoms and discuss possible causes with my doctor. She listens. She has compassion. She answers my questions. She feels more like a partner than someone with superior knowledge. She respects my intelligence and my preferences.

Many years ago, I had an infection that needed medical attention. I had just moved to Portland, Maine, and hadn’t yet sought a regular doctor. The doctor I wanted to see upon recommendation from a friend was not taking new patients, but there was a new doctor in her practice who had an appointment available.

Dr. Peter Gordon became my primary care physician for nearly two decades. When I moved to northern Maine, I even traveled more than three hours to see him.

The reason?

That infection I had is usually treated with antibiotics. But I was adverse to taking them and told Dr. Gordon so. He wrote a prescription for the drug saying I didn’t have to fill it if I took other less-invasive measures and was able to rid myself of the infection within a day or two. If not, he encouraged me to take the antibiotic. He HEARD and RESPECTED me. In the end, I was able to avoid the drugs and I recovered. And that’s how it went with him and I’m sure still does for his current patients.

If your doctor isn’t treating you this way, you might want to consider finding a different health care provider.

Laura Nimmon and Terese Stenfors-Hayes, the authors of the aforementioned study wrote that although a caring, respectful, and empowering communicative physician-patient relationship is proven to improve patient outcomes, there are barriers to employing this level of care due to the inherent power imbalance by virtue of doctors’ qualifications and training. The authors recommended doctors are educated early on and have opportunities for ongoing professional development to raise awareness of their inherent power and teach them to exercise patient-centered communication “through reflective, effective and professional use of power…”

The following statements were taken from the study, during which doctors were interviewed about their perceptions of the doctor-patient relationship. Which of these practitioners would you be most likely to go to and why? Please leave your answer in the comments section.

A) “There is always a power relationship … Patients, they have to put their trust in you because you’re talking about and doing things that really they don’t understand or don’t have a background in. So they have to have a faith that you’re doing what’s best for them, and so you have to be cognizant of that to make sure that you never ever take advantage of that role.”

B) “There is a power imbalance … I mean, you are empowered by the knowledge that you have and the ability to treat patients. So there is an inherent power imbalance … that power imbalance is in knowledge.”

C) “I think you’re seeing that patients probably think they have more power. I think because there’s more consumerism within medicine, people have a U.S.-style consumerist way/approach where ‘I have all the information, you should do this treatment because I think this is what I need.’”

D) “A lot of patients really want to be an equal partner in the learning. And some of them are very intelligent and they will ask you difficult questions. And that’s fine, I kind of like that.”

 

* Laura Nimmon and Terese Stenfors-Hayes, The “Handling” of power in the physician-patient encounter: perceptions from experienced physicians (BMC Medical Education: 2016) [also posted on the National Institutes of Health’s PubMed Central

A silver bullet? How a notebook changed my life

If like me, you’d never heard of Ryder Carroll, you’re not alone. It’s not like the Brooklyn-dwelling digital product designer is a household name. Until yesterday, I’d never heard of the guy either. But he changed my life and so many others when he invented a system of task organizing he dubbed bullet journaling.

I first learned about keeping a bullet journal during a Society of Children’s Book Writers and Illustrators meeting when author Janet Fox spoke about it. I was intrigued but felt like it was too complicated and free-form for me. How could I possibly keep my ADDled brain organized with something so seemingly random?

But a bullet journal can be complex or it can be fairly simple. The idea is basically to keep all your thoughts, ideas, to-do lists and calendars in one place – a notebook. Any notebook. That you WRITE in.

It starts with a few pages in the front of the book that will serve as your index or table of contents – this is key. Then numbering pages as you go along, for each topic you write about in your journal, you enter it the index so you can find it again later.

from The Lazy Genius Collective

So, for example, you know all those scraps of paper you’ve collected over the years with suggestions for books to read – you can put all of those on one page in the journal with the heading “Books to Read.” Then when you are heading to the library or bookstore, you can scan the list (finding the page via your index) and pick which book to seek out.

from The Art of Simple

OK, so maybe this seems counterintuitive with all our phone apps meant to keep us dialed in to our lives. But here’s the thing. How often do you actually go to your Goodreads list? Where do you keep your ideas for your next project or notes for that project? Have you lost them? Do you use multiple apps to keep track of all the things that pop into your head daily?

I used to do everything on my phone and kept a random notebook with thoughts. But I found all those apps overwhelming and the ideas would get lost in the ever-present notebook. Maybe that’s just me. I do still use Google Calendar for my appointments and the mundane tasks of life, but all my lists and ideas – they go in the bullet journal. The reason this works, at least for me, is because it keeps all my goals and lists organized and in one place so I CAN FIND THEM AGAIN.

Bonus: I’m not using digital media, so I don’t get distracted by something I see on the web or an email that’s popped into my inbox. In other words, I’m not tempted to “multitask.”

Yes, I put that in quotes.

McGill University neuroscientist Daniel Levitin wrote about the phenomenon of multitasking for The Guardian. Quoting Massachusetts Institute of Technology neuroscientist Earl Miller, he wrote, “‘When people think they are multitasking, they’re actually just switching from one task to another very rapidly. And every time they do, there’s a cognitive cost in doing so.’ So, we’re not actually keeping a lot of balls in the air like an expert juggler; we’re more like a bad amateur plate spinner, frantically switching from one task to another, ignoring the one that is not right in front of us but worried it will come crashing down any minute. Even though we think we’re getting a lot done, ironically, multitasking makes us demonstrably less efficient.”

I love that. It sounds a lot like ADD and not exactly productive, right?

E.J. Masicampo, a psychology professor at Wake Forest University, studied something called the Zeigarnik effect whereby unfulfilled goals can linger in the mind … even hound us. Ever wake up in the middle of the night in a cold sweat realizing you’ve got a project due in a day that you haven’t even started? It’s like that.

Essentially, his team found that participants who planned out a goal were less likely to get distracted by another (easier?) task than those who had not thought about a plan.

“If you just take a moment to make a specific plan for a goal that was previously unresolved and worry-inducing, then it gets rid of that stickiness,” Masicampo told Nicola Davis of the Guardian.

Levitin noted using a blank notebook might also have a positive impact on productivity. Some people spend time creating gorgeous layouts in their journals – some may be daunting to see. On face value this may seem a waste of time, but Levitin thinks otherwise. “Research tells us that if you can take time off from your workflow and let your mind wander – maybe doodle, listen to music, draw pictures or even just stare out the window – those periods of inactivity are actually essential to having productive periods of activity,” he says. “When you’ve got a piece of paper in front of you, it sort of encourages you to expand your visual field and expand your imagination.”

A plethora of research has also shown how expressing one’s thoughts in writing can improve mental and physical health. By jotting down a thought as it pops into your brain, you can temporarily put it aside and stay focused on the task at hand. Can you say productivity?

So, there is science that illustrates why bullet journaling works for so many people. In fact, Carroll, the bullet journal’s creator has ADHD, but relishes the break from screen time (which has its own negative effects on the brain).

Writing on nice paper is soothing to me and there’s a certain gratification I get from checking off a finished task (which I will do as soon as I post this). My bullet journal keeps me accountable and organized – like any trusty sidekick should.