October 2024

In the mid-seventies, when learning to be a labor and delivery nurse, one of the first people I met at my new job was Nurse A, a wizened veteran of the department. She stood four feet, eleven inches tall, weighed ninety pounds, had short dyed brown hair and was ten years past retirement age. She sprinted up and down the halls, rushed in and out of rooms, talked nonstop and ordered everyone around like a drill sergeant. Her trademark was the “3 H” enema – high, hot, and hell of a lot – to stimulate contractions.

It seems as if I’m always asking my patients what they’d like to work on. And whether it’s their sleep patterns, their career goals, their symptoms of anxiety or depression, or something else, my role as a behavioral health clinician is to help motivate them and create behavioral activation.

Having had breast cancer and vitreous macular traction myself for the past few years, I am also keenly aware of my own goals for health and mind-body wellness. This fall, I want to encourage others to focus on cancer prevention (mammogram screenings and early detection save lives!), as well as on self-care strategies: health-care providers need to continue to nurture themselves so they can continue saving others.

The older I get, the less motivated I become. I imagine the dust gathering on my carpet, and I see it covering my walnut-colored end tables with a light gray film. Yet, I cannot push myself to vacuum or clean. The laundry gets done, but not as often as it did when I was younger than springtime. My listless days consist of reading, watching dismal news on CNN, and taking adult education classes via zoom—while often still dressed in my pajamas.

Dear readers,

A good part of my career as a doctor was spent trying to motivate patients to do what was good for them, like eating more fruits and vegetables, getting exercise or remembering to take their pills.

Most patients wanted to do the right thing–go to the gym, stop smoking and get their diabetes under control. They felt bad about themselves for not doing better.

With that in mind, I didn’t think it was productive to lecture them and make them feel even worse. I thought they’d be more likely to get motivated if they felt hopeful and positive–so I did my best to offer some understanding and encouragement rather than criticism.