New Home Forums Monthly Challenges November 2017 I've Got This! Operation Healthcaring 750Words

74 replies, 10 voices Last updated by  Laura Koller 5 years, 12 months ago
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    Hey @laurakoller Wow but you are doing some heavy duty writing. Well done woman. I can’t wait to see your blog. I’m hoping that this challenge builds a nice bank of blog posts that I can share and get back to writing a blog post at least once a week. My hope is that I continue with even after the challenge is finished.



    @laurakoller I LOVE this! This is gonna be my new best friend for awhile. Thank you for that!

    And I LOVE the experiential quality of The Pill story…so good. So easy to identify with…thank you!


    Sara McCann

    Laura, I’m so excited about the ground you’re covering, the thoughts you’re having, the breakthroughs you’re creating and the words you’re typing. You move so fast I find it hard to keep up with you sometimes. I swear you must run on Duracell! Anyway, whatever you’re running on – it’s working – so keep going amazing lady!

    Oooh, and also…had parents evening tonight for my middlest…saw this and thought of you! ūüėČ

    Harry nearly died with embarrassment when I took my phone out to take a picture of it. “Like Mam, what are you ACTUALLY doing!? Stop taking photos in my school….oh god!” LOL!


    Laura Koller

    @mars – There’s a lot of¬†content for me¬†to navigate in the past two weeks of writing.¬† I love that you have already used material for your blog posts.¬† That inspires me to put my words out into the world, too.¬† My next step is to figure out how to structure my website to get the blog on there and functioning and working together with everything else.¬† That technical stuff is not my top interest, but it’s necessary and I’m learning.¬† Once that’s up, it will be so much easier to convert my writing from in process to published.¬† Removing barriers, one wall at a time!

    @saramccann – LOVE THE QUOTE!¬† I love that you’re noticing these things as you walk around, and especially that you took a pic even though it turned your son’s face bright red.¬† Isn’t it so fun to make our kids uncomfortable?


    Laura Koller

    Today’s stats – 1673 words


    This morning I received a message through my LinkedIn profile asking if I would be interested in¬†BLOGGING for¬†a website that’s dedicated to promoting a long-term healthful and flavorful diet for kidney patients.¬† I had two immediate reactions – the first one is I want to do this, and the second one is I don’t have time to do this.¬† It could be an opportunity to share my message with more patients, expand my professional network, and enable me to connect with more like-minded individuals.¬† The top priorities for me would be that I could link readers back to my website and also repurpose the content for other uses.¬† I replied by asking if we can talk in early January, after I’ve fulfilled some extra work commitments and family obligations, and after I’ve had more time to invest in my own website.

    That gives me some fuel to actually invest some more time in MY OWN WEBSITE.¬† The top priorities for that are 1) LEAD MAGNET- this is going to be a 4week/4email course called “Four Wins in Four Weeks” that outlines four strategies I’ve used in my Creative Ways to Teach Patients presentation.¬†¬†Each week will focus on a different strategy.¬† I have a framework in mind that includes question/reflection, content/lesson, homework/practice, and sharing.¬† I need to script out the content/lessons and then figure out how I’m going to ask people to share.¬† Other priorities include 2) WEBSITE FORMATTING – I want to take advantage of the theme and add a blog to the site.¬† 3)¬†BLOGGING – It’s time to take some of this writing material and publish actual content on the site.¬† I need to stop thinking about finishing and instead work on getting this stuff out there.¬† It¬†needs to hit people’s eyes and ears, it needs to start conversations.¬† When people start talking about these different approaches and there’s a buzz about different ways to educate patients and engage patients in healthcare, then I’ll know that my work is being done.¬† It’s not about getting it right.¬† It’s about starting the conversation.

    Last, I talked about how I want to start using SCENARIOS as part of my course and blogging content.¬† The idea is to share a situation – something concrete and tactile, a story¬†that people may have experienced or can¬†imagine experiencing¬†– and use that as a way to pull people into the lesson or conversation.¬† It gets people’s minds engaged in solving a problem, and it enables people to think about how they typically respond in that scenario, it encourages people to consider other viewpoints and think creatively, and it invites sharing and community.¬† It’s one of those ideas that hit me sometime in the middle of the night, an AHA moment.

    So that’s what I’ve got for today.

    Oh, one other thing – I now have 3 PEOPLE SIGNED UP FOR MY EMAIL LIST!¬† 1 last week and 2 of them yesterday.¬† I’m not sure where they came from and I’m not even sure if my MailChimp Welcome responder is working the way it’s supposed to (that’s another task to check out this week) but I have an email list and I’m making progress.¬† Crazy, right?


    Laura Koller

    So this is crazy.  Today I accepted a writing gig with a website called

    I was really clear with the chef/founder about the type of writing that I want to do, and it sounds like he and I are on the same page about what we want for kidney patients.¬† He has some grand ambitions for growing the site this next year which is really inspiring.¬† I agreed to contribute one article a month starting in mid-January.¬† I’m actually REALLY PSYCHED about the opportunity and hope it ends up being a good match for both of us.

    Thinking about¬†the writing process I want to use, I’m thinking I will choose “themes” for my writing (i.e. Mindset or Shrink the Change or maybe even something specific like Implementation Intentions) and free write on the theme, I can¬†write about¬†personal experiences and¬†patient stories related to the theme,¬†and then I can take that writing and use it for various purposes.¬† So perhaps for the rest of November I can write about Mindset and then I can use that information for the email course on Mindset, for a kidneychef article, for a blog post (text/audio) on my site, for a mini-webinar (audio/video) like the one I presented to a group of dietitians this past week, and who knows what else.¬† It’s kind of like doing a brain dump on a topic and then picking out the pieces and putting them together as various mosaics.

    And then the next month I can start again with the same process.

    That’s an idea!



    That is FANTASTIC @laurakoller Wow but this challenge came at the right time. Well done and congratulations.


    Bradley Morris
    Mountain Guide

    Look at you MISS LAURA WRITER!! I love that youa re now writing for someone else. That is so exciting. YOu are on fire!!


    DavidJ Jurasek

    Hey @laurakoller

    I was thinking of you yesterday and the vital work you do and felt like writing this as my 1000 words today.


    This is to Laura and all the healthcare practitioners out there.

    Yesterday, I went to see an eye specialist. I’ve never needed glasses – or so I thought — but after learning I have that service covered by my insurance and going with my wife to get my eyes checked I discovered they could be useful. I also was told by the Walmart optometrist that there was an irregularity in my left iris. Something that could be nothing or something serious. Since then, I waited 3 months to see this expert.
    Yesterday, I arrived in his office.

    First, the standard fill out these forms and write down all the stuff we should already have in our database but we are too lazy to check so here’s a clipboard.

    Then, a nice lady calls me in and has me visit a room. Silence. I sit there. She comes back. Asks me stick my head into a weird metal machine. It shoots images that go blurry and clear. Blurry and clear. Beeps and whirs. She’s gone again.

    Then, “Come here please.” I am escourted to a dark room. A man, friendly at first, explains another test. It’s harmless. Just stare into white space and when I see a light – no matter how faint — click on a button. It measures my peripheral vision. It starts. I click. And click some more. Ten minutes of clicking. Must of been hundreds of times. My eye gets tired and blurry. I wonder if I am screwing up the test. And if this is a concentration task which I am failing. The man has disappeared. Alone with the void and endless task. But, he returns just in time to have me switch to my left eye.
    The procedure is repeated.

    When the first lady, unnamed, returns I am led to a third room and another battery of tests. After which, she approaches me with some pointed tool which she pokes towards my right iris. “Please hold still and do NOT blink.” She says. My eye lids flutter She repeatedly tries to poke my eye and my lids refuse to open. She seems frustrated. I am such a jerk. “Please relax. It’s just a drop and to measure your… ” I don’t remember. I felt self-conscious. I am TRYING! Then, it hit me. My eye lid is acting involuntarily but also doing the right thing. It was designed to keep stuff out, especially sharp things. She sighs sharply. Then tricks me to look sideways and sneaks in a drop. It stings. No big deal. But I exclaim, “Ah. It stings!” surprised. She ignores my comments. Then she is gone again.

    45 minutes in, I am led to a fourth room. Waiting. I text my wife, “At eye doc’s. Kafka-esque experience. Will explain later.” She replies quickly. A worrier. “Any news.” I am more an ostrich with dealing with scary medical stuff, but it hits me also. What are they finding?

    The doctor comes in. Well groomed, smiling and young. He makes small talk. When I answer. He doesn’t seem to care. He’s just trying to distract me as he sits me into another apparatus to shine extremely bright light into my iris. Again, my silly iris is not cooperating. More intense drops are applied. These make it impossible to read or drive, forcing my pupils to dialate.

    Halfway through, he turns his back and scrolls on his screen. Ten minutes of looking at his back. Sitting there in silence. Not able to veg on phone as it hurts to look at anything close. I decide to talk to him like a human being. He suddenly becomes warm. We chat and laugh. He was checking his emails cause it takes time for the drops to create maximum affect.

    Finally, he checks my eyes again. Nodding and mumbling to himself and… “We’re done.” I get up and shake my head. “So, everything’s ok?”

    “Oh yeah yeah.” He speaks while staring at his screen. “Just an abnormality.”

    Having cancer and other abnormalities in my family, I’m not reassured.

    He pops his head up and we make eye contact. He is human again. Sits me down and gives me medical details, which I (knowing about the nervous system from my pre-med years) translate for myself and for him out loud into jargon real people can understand.

    In the end, I have a weird eye, but it is not weird enough to cause blindness, which it does in others.


    Here’s the point of my detail accounting of this benign yet odd experience.

    I am 41 years old. Happy, healthy and very easy going. This experience was without a long wait time and in offices that were stark yet uncrowded and quiet.

    And yet, I was left thinking about the millions of people who have serious conditions and how they are treated in rushed hospital hallways and packed clinics, by stressed and overworked medical staff. How, even in this private clinic where they close shop at 5pm and provide plush seats, there is something inhuman and surreal going on.

    Even me, with my high tolerance for pain and super relaxed nature, somehow my body and it’s healthy instincts were a source of annoyance and frustration to otherwise warm and nice people.

    How did we get to a place where medicine is about herding and prodding cattle? Why we even do that to cows is beyond me but for another reflection.

    How did we forget as clinicians that people have names and to introduce ourselves as having them also? To give basic courtesy like looking at someone when speaking to them. Actually asking how they might be doing. Realizing the most obvious elephant in the room which is that when a patient is told that something terrible might be happening, they might be nervous and needing some human contact to help them understand what is happening next.

    I feel so privileged and this incident was so mild. And maybe that is why I feel the need to highlight it. Because even under the best conditions, with the happiest, healthiest patients, something is not right with how medicine has moved away from healing human beings and instead it has become a heartless and mechanical intervention.

    Lasting thoughts…¬† how do doctors feel when they go in for these tests and play the patient?

    I am so glad I wanted away from becoming a doctor 21 years ago and instead choose to become a mental health therapist where I get to talk to people and listen to them and help them to make changes, as their guide, ally and partner in growth.


    Laura Koller

    WOW @davidj Рthat’s a really powerful Рand saddening Рaccount of your experience. How stark and emotionless. *sigh* More ammo for the cause.

    Thank you for sharing. Maybe I’ll ask you if I can share your writing on my website one day soon. You know, after I figure out those hard and technical aspects of getting the website to do what I want it to.

    By the way, I’m glad your eye is okay. And I love the Kafka reference. So true!


    Laura Koller

    Today’s writing stats – 1928 words rambling about priorities and the need for uninterrupted time – here for anyone who wants to read.


    This morning @tripphanson said that some days it’s really hard to write. He’s right, of course. It is hard to write some days. The hardest thing for me has been to carve out the time to do it, to figure out the reason that would enable me to make it a priority in my life. The daily writing habit is something I’ve thought about since I was a college student, more than 20 years ago. Maybe even earlier, when I had an inconsistent journaling habit in high school. As long as I was able to produce assignments, though, and earn good grades, I felt it was unnecessary. I could create what I needed to create when I needed to create it. I could write when I wanted to write. I’ve always dreamed of being a professional writer, writing articles in many of the popular magazines I enjoyed as a teenager and young adult, or maybe even writing a book of my very own (I always envisioned writing fiction though I always struggled with that and I’ve now realized that nonfiction is much more my speed, at least at the moment). And yet I never set time aside to realize that dream. I never made my writing a priority. I never really thought about what I wanted my priorities to be, what I really wanted to do when i grew up. So I’ve made the choices that I’ve made and I’ve arrived here, now, and this is the person that I’ve become. I envision all these parallel universes – the ones that exist had I put more effort into completing homework assignments, had I chosen a different college major the first time around, had I selected Medical School instead of dietitian school, had I ended the relationship with my husband before we ever even considered getting married, had my twin pregnancy been a singleton, had I agreed to look at the house for sale down the street instead of staying put. I can’t say that I regret any of the decisions that I’ve made. Each of them has helped to craft the person that I’ve become, the life that I’m leading, the people with whom I’ve connected, and I now feel a great sense of purpose and direction and vision for where I’m going from here and I’m in this unique position that any of those other parallel selves would not be in at this moment in time. I see the great promise that I have to offer to the world with my message.

    The challenge for me is carving out the writing time and keeping my focus and tuning out the interruptions. Like my children who are right now playing hide-and-seek and now fighting and the constant interruptions are pulling me away from this world in my head where I have this vision and I’m struggling to put it into words on the screen so I can formulate the ideas and somehow figure out how to bring them to life. I think that if I had one day I could sit down and type without stopping for hours, as long as there were none of the interruptions – the cries from children, the need to put dinner on the table, the need to enforce consequences for my son who earned an F in Spanish class not because he couldn’t learn the material but because he couldn’t remember the homework assignments and turn them in. I’m riding this fence between the two worlds – the good Laura mom and worker who does all the things she’s supposed to be doing to fulfill the obligations she’s committed to others, and the visionary Laura writer and course creator who wants to bring her thoughts to life and make a difference in the world for many. Oh, it’s so frustrating. I’ve read the research on focus. It takes 15 minutes to find your flow, and even a moment of distraction can pull you away and require another 15 minutes to find that flow again. That’s why parenthood makes it so hard to get anything done – because children are constantly interrupting the flow from the moment they enter the world and need to be fed and read to and instructed on all the routines that are so essential to me not having to exert the same energy every morning and every night to get the same simple and concrete actions done, from waking up to getting dressed to eating breakfast to turning off the screens and going upstairs at the right time. So those are the parameters for home, and then at work I have more control over the minutes and the hours (lucky me I have a flexible position) and even then I have obligations that are required in order to keep my job and fulfill the needs of my patients to a level that satisfies me. So my problem is not what to write. It’s carving out the time to make it happen, and of course the time that I actually make that a priority is the time when so many other things are also priorities and it makes it so difficult. Oh, if I could only tell my 20-something counterpart what a luxury all those uninterrupted hours truly are! Then again, my 20-something counterpart hadn’t lived the experiences and stories that my 45-something self has gone through to arrive at this place. And my 45-something self is so short for time that, if I want to make progress to the vision, then I must set aside time whenever I can make it happen and not just when it appears on the schedule. Ha!

    Which leads me to this – I think that given the opportunity I could sit down and write a whole NaNoWriMo in one day flat. I figure that conservatively, without interruption, I can write 500 words in 10 minutes. So in 60 minutes I can write 3000 words. In 10 hours I can write 30,000 words. in 16 hours I can write somewhere close to the 50,000 words of NaNoWriMo. “Oh, Laura, you couldn’t write straight for all that time. What would you have to say after the first 3 hours?” Me? I have plenty to say. It floats around in my head sometimes for days and weeks and even months and it’s waiting for a capsule or a spot to land, to settle, to be expressed. I can make the rule that my fingers keep moving for 55 minutes out of every hour, and if I stumble on a word or a phrase then I can just keep typing and write my way around it – much like when I talk to my Spanish-speaking patients and I don’t know how to say I’m concerned or that’s so awful so I say “mi corazon tiene dolor” which means my heart has pain – and in some ways that’s far more beautiful than the thing I’m thinking in regular English. Just like many things can be said far better in free-form thought than by struggling to find the exact right word. Finding words is not for free writing. That’s the editing process, and people enter into that far too soon. The free writing is the time to spill out all of the contents of your brain on to a piece of paper and not even think about how all the pieces fit together or the fact that it’s going to take you many more hours to organize those multiple thoughts into some kind of framework or even decide what’s worth keeping and what’s not worth keeping and what needs to be the priority first. It’s one big brain dump, perhaps even a lobotomy on the screen, and that doesn’t take much thought. It just takes a keyboard and a screen and as big a chunk of uninterrupted time as possible.

    Which lands me to the last thought I’m going to be able to express today, since I’ve already promised my kids time to work on a baking project they’ve been talking about for two weeks and our lives are so full and mentally draining that I haven’t been able to make that a priority so for their sake I must follow through – I have people ask me how I have the time. How can you manage to work having kids? (That one’s simple – there are many days working at my job is like a spa day, or at least a day to pick up the pieces in the rest of my life. Choose the right job and it’s okay. Those people with super demanding jobs and schedules with little time for free thought and expression, I don’t know how they manage). How do you find so much time to read? (I enjoy it and a couple of years ago I heard myself say that I didn’t have free time for anything other than caring for my kids and it sounded so empty and pitiful and I knew I needed to carve some time out for myself to do something, so I checked out an audiobook for the library and I started listening to books in the car and that gave me a piece of my life back, and then when I discovered titles I wanted to read that weren’t on audiobook then I checked those out and carved out 15 minutes before bedtime to read those). How did you get volunteered for this task/presentation/speaking opportunity? (I actually volunteered for it because it’s something I care about and it’s something that’s improtant to me and if I don’t volunteer or make a deadline for it then – I know myself well enough – it’s not going to happen.) And instead of deciding that I’ll work on my priorities when I have free time (ha!), instead I’ve decided my priorities and I intentionally make time for those. Interestingly enough, most of the other urgent and important thigns still get done – it’s the nonessentials that go by the wayside or the tasks that my kids need to learn how to do anyway. If they matter more to someone else or if someone else is capable of performing them, then they can take care of them because I do enough for others and I deserve this time for my priorities. I’m learning to say NO.¬† Mostly because my priorities are going to be helping a whole lot more people, and they’re going to set the example that I hope I can inspire other people to follow.

    I have so much more to say about my message, my experiences, patient stories, aspirations, things I’ve learned from others, books I’ve read, observations that I’ve made, items that others have shared that have made such an influence on me. I wish I had time to delve into those today, but I don’t. But I did have time to tell you that this is my priority, that I’m making time for this, that I’m frustrated because I can’t make it my only prioirty, and that finding uninterrupted time is my biggest challenge. I coul write and write and write and then my biggest challenge would be finding the time and energy to wade thorugh all of that muck to find the core message and outline – something super valuable – but until I have all the ideas on the paper it really doesn’t make much sense to outline it all. My first step is to let it all drip, drain, and dump from my brain – without judgement, without apology, and without interruption.


    Judy Brenneman

    @laurakoller Laura – We must have been sisters in a previous life…

    Yes, re: nano in 16 hours, except you need to add maybe another 45 minutes to the total, because you’ll need potty breaks (trust me on this). And snack breaks (trail mix works pretty well).

    I *love* your closing sentiment in this post: without judgement, without apology, and without interruption.

    I’ve found (most days) that remembering “without judgement” and “without apology” results in much fewer interruptions. It’s all about boundary setting, even more than prioritizing. I have an ADD brain, which doesn’t really understand priorities (everything is equally important), and I have an upbringing that denied personal boundaries in significant ways. When I began framing “I need time for writing” as “I will establish, maintain, and defend boundaries,” things got easier, especially when I realized that I didn’t have to apologize for wanting boundaries (which Other People get to have; it’s just ourselves that we think can’t have them). And then I realized that the only reason I felt I needed to apologize was because I was judging myself harshly for having this “need” — time/space for writing — for something that was absolutely appropriate. Those three things–judgement, apology, and disrupted time–are closely linked. And they can be unlinked. (And yes, there will be times when you get interrupted; life happens. But next time, you’ll be aware of the who/why/how, and you’ll find the boundary again, and you will keep writing.)



    Laura Koller

    Today’s stats – 3380 words!!! ¬†More than an hour dedicated to my writing.

    Summary of realizations:

    First, I started writing for all of you, as though I was going to share with you. ¬†And then I realized I was holding back, that I was trying to write something finished, and so I decided that my intent was to spill my brains on the screen without consideration for what comes next. ¬†That’s what I’ve learned about my writing process – the first writing needs to be uncensored and without expectation. ¬†Later on I can decide what’s worth sharing. ¬†This realization will shape my writing process for the kidney chef gig – rather than trying to produce a finished piece of writing that speaks to an audience (focus on outcome) I need to spill out the contents of my brain (focus on process). ¬†This speaks to every bit of motivation science that I’ve read – that focusing on results is actually the least effective way to generate results. ¬†That’s why I’m telling my hockey-playing sons to focus not on scoring goals, but rather on taking shots on the goal. ¬†Rather than waiting for the perfect invitation, they will improve their practice – and you never can tell which shots will go in!

    And then I wrote at least a couple thousand words about bitterness and resentment. ¬†I’m not sure if that came through my writing yesterday, but I’ve been feeling those emotions a lot lately and they can disrupt and drag down my day. ¬†It especially grates on me when I feel those emotions in relationship to my kids and my family. ¬†Essentially, my conclusion was that bitterness and resentment are not products of the things that happen to you, they are based on your RESPONSE to what happens to you. ¬†Specifically, the bitterness often comes from the gap between our reality and our expectations and how we handle that. ¬†I’m learning that curiosity and asking questions are a great way to deal with this emotion and figure out how to cope and move forward.

    Here’s the last segment of my writing on the topic:

    So what does all of this have to do with Operation Healthcaring and caring for patients? I think it has everything in the world to do with it. How many times do we work with the same patient and still not make progress? How many times do we deal with the same situation and stew over it and become bitter becasuse it doesn’t change? I have several quotes taped to my computer screen at work on the topic of criticism and complaining. “Complaining is just a bad way of making a request.” and “We criticize others for not giving us what we are afraid to ask for” In essence, complaining and criticizing and blaming and venting and feeling bitter and resentful – these are all things that we do in order to let off steam (that’s what we think) but they don’t actually get us anywhere.

    I’m not saying those emotions are not allowed. I’m not saying that we shouldn’t create a space for sharing those feelings – although I do encourage a spirit of curiosity and not a feeling of entitlement. In fact, it can be really importannt to carve out those spaces with our patients. “I’m feeling really frustrated right now because we’ve been talking about this issue for a long time and I don’t feel as though we’re making any progress. Are you feeling that too? Does this bother you at all? What is going on here?”

    Neuroscience makes a case for working through our emotions first, that in order to open the door between our amygdala (the home of emotions, defenses, and automatic reactions) to our prefrontal cortex (the home of intellectual thought and creativity) then we need to pacify and calm the amygdala first by discussing the emtoins, the things that are getting in the way, so we can open that door and talk about the best ways to cope with those feelings and work on making progress toward desired goals.

    We need to be conscious of our expectations for patients and how those differ from reality We need to think about whether our expectations are eevn realistic, or whether we can adjust them somehow so they become more achiebalbe and maybe the gap isnt so large. Shrink the cahnge, shrink the gap, shrink the goal – somehow we need to make that leap as much of a hop as possible so it’s easy to bridge the gap and then use that momentum to propel us forward.

    The other way bitterness and resentment applies to this is that sometimesour patients arrive to us with those very same emotions. They feel bitter and resentful about a diagnosis. They feel it’s not fair, that others have done worse things and they’re still okay, that they didn’t desrve this outcome. I’ve spoken with patients who have seen this coming, and with patients who were blindsided. It’s possible to see bitterness and resentment from both of these peopulations.

    I’ve had two patients start dialysis at the same time, and one of them took it in stride and the other one never really adjusted to it at all. It’s not because it was fair for one and not for the other. It’s not because one was more prepared than the other. I think it really does come down to this gap between expectations and reality. The one recognized that the reality of his health had changed and therefore he adjusted his expectations. He didn’t fight the idea of dialysis 3 times a week, of adjusting his diet. Did he have better social support than the other one? Maybe.

    But the other one continue to question this whole bit about dialysis, continued to think that it wasn’t fair. He never adjusted his expectations to fit his reality, that although it wasn’t fair it’s what happened and what he chose to do with his life would be related to his reponse to this change of circumstances. No matter what he did at this point, he would never be able to change the health of his kidneys, he would never be able to get off of dialysis witout a transplant (And I don’t even think he was a candidate, which meant that dialysis was a lifetime sentence for him). And yet he continued to fight this reality.

    The other one accepted his reality and chose to see the benefit of this therapy that could prolong his life and enable him to do the things he loved to do and be with the people he loved. Expecting that things could be different doesn’t alter the reality. But it takes time to get there, more time for some than others.

    So this is where I’m going to go with this one – that our first and primary job as heathcare professionals is to evaluate the reality of our patients and find ways to help them cope with it. We can do this ourselves by listening to patients and inviting them to share their reactions and responses to whatever the diagnosis or treatment might be, and doing so without judgement or expectation. If this is too deep or overwhelming or time-demanding than we can provide, then we need to know who we can refer this patient to, someone who can provide support and space to process this information and cope with it and move beyond it. When people are caught up in their emotions and reactions, it’s often a lot harder to get them to consistenty follow treatment recommendations. And we have to be mindful of the gap between our own realities an expectations, and curious about what our emotions are telling us about that gap.

    Bitterness and resentment are not handed to us by others, but rather they are our own responses to our own realities. Ulitamtely, bitterness and resentment are opportunites to ask our selves questions about what we are expecting and how wel that fits with our reality.

    As Maya Angelou once said “If you don’t like something, change it. If you can’t change it, change your attitude about it. Don’t complain.” But sometimes to access the solution – you do need to complain first and work through your current attitude, in order to realize another response leads to a better outcome. ¬†But yes – if you can’t change your reality, then change your expectations. ¬†Don’t wallow and gloat and get stuck in the mud. ¬†View the pieces clearly, decide what to do next, and then take the next step forward.


    Laura Koller

    @judyb – So you’ve done NaNoWriMo in a day? ¬†I think you’ve alluded to that long sprint in the end. ¬†You must be someone who responds best to deadlines – much like me. ¬†Have you read or heard about The Four Tendencies by Gretchen Rubin? ¬†You can read the first chapter of her previous book Better than Before on Amazon, and that chapter captures the essentials of the book. ¬†I’m an obliger through and through, and obligers are the ones who benefit the most from knowing their tendency, because it enables them to set things up in a way that empowers them to meet outer expectations because so often we obligers manage to put our own needs and desires dead last.

    I’ve now realized – even moreso through this challenge and the accountability it’s created for my writing – that writing enables me to clear my head, free myself from emotional clutter, and create a space for the ideas that need expressing. ¬†I’m a better person when I have that time, either because I’m getting the ideas out or because I’m reflecting on experiences and therefore I’m able to learn from them. ¬†John Dewey once said, “People don’t learn from experience. ¬†People learn from reflecting on experience.” ¬†(I didn’t check the exact quote but that’s the idea.) ¬†Anyway, this daily writing practice enables me to learn and grow and be a better person, and by doing that I’m better able to serve others – which is a huge motivator for me. ¬†To write for the sake of writing, without those other reasons – not so much. ¬†It is also becoming a much stronger habit now, and that can be another reason to get to the keyboard – because it feels like something is missing when I don’t make it. ¬†You know, like when you go to bed without brushing your teeth.

    Writing is that opportunity to stand outside of myself and observe things from a different perspective. ¬†It’s like stepping outside of myself to be the coach and counselor while I’m talking through all the ideas out loud. ¬†That must be why it feels so therapeutic. ¬†Therapy is exactly what it is – Laura as the client and Laura as the therapist. ¬†That’s when the “without judgement, without apology, without interruptions” part comes into play, too. ¬†Aren’t those significant elements of a good session?

    After writing so much this month I feel like I’m living in an alternate existential universe. ¬†Anyone else?


    Laura Koller

    Today’s writing stats – 2371 words in two separate writing bursts. ¬†I’ve now written more than 30,000 words this month including the week of daily pages I wrote prior to the start of this challenge. ¬†That’s an average of 1500 words a day. ¬†Pretty impressive!

    The theme – reflection on the new writing gig, business planning strategy for my site.

    I just told the twins they could play the Wii for 10 minutes before we leave to pick up their older brothers from a friend’s house. One of my next thoughts – 10 minutes? That’s enough time to get my writing in for the day! (No longer morning pages, but day pages nonetheless. The sun is still up outside, at least for the moment.)

    I do have material to write about, because I jotted all my ideas down on a piece of paper while I was sitting at the park with the twins. I felt a little like @judyb who writes out all her morning pages (God bless you! I write longhand SO MUCH slower than I can type, and the thought of having to come back and type it all out again just saps my mental energy. I’m glad it works for you, though, and I can see the advantages of that approach – so I’m not knocking you or your approach!) except that my writing out was more like random notes scribbled on various parts of the paper, more like a mental map or mental scraps. Something like that. So here are so many of the things that have been coasting through my mind:

    First of all, I was thinking about how much extra money each month it would take before I could cut back my job by another 8 hours a pay period. That would mean I’d be working 4 days a week. Actually, it would be more like 9 days every pay period, with a few days held in reserve for the next batch of school holidays that I need to reserve my time to cover. I figure if I can figure out how to make an income of $500-1000 a month, then I could justify cutting back my schedule. The only stipulation for me would be that extra day each month would need to be reserved for WRITING and WORK and not for chores around the house (which I could really use some extra time for, but I’m not going to give up my paid time off to cover that. As far as I’m concerned, the house can stay extra cluttered and blurred around the edges. When I make enough to pay for a maid service, we’ll talk about that one then!)

    I decided that I’d like for morning pages to be a daily ritual and priority. They may be work related, they may not be work related. The overwhelming purpose for morning pages is to write “What needs to get out and/or what’s getting in the way of expressing it?” That means I’ll need space of more writing each day – a period of time for writing purpose-related content, reviewing what I’ve written, and crafting it into some type of finished content. Perhaps I can think about dedicating 3 chunks of time to that each week (scheduled at the beginning of each week depending on my schedule) and perhaps I can think about a month-long cycle – such as a writing period, a reviewing period, a finishing period, and a publishing period. Something like that. It makes sense, but of course it remains to be seen what will actually work until after I’ve tried it and put it into practice.

    Next, I’ve been thinking about this new writing gig. I’m feeling some barriers and walls. I haven’t sent back the contract I received late Friday, although I did reply and tell him I would review it and return it to him later this week. He also sent writing guidelines. I was thinking some kind of framework or structure, but the only writing guidelines were in relation to citing 5 to 12 sources per article with a heavy preference for peer-reviewed articles blah blah blah. I don’t have a problem with that. I think the issue is that if that’s the guidelines that are set out, I’m going to have problems with my writing process if I’m writing to prove something. I need to stay authentic to my process and then, after I’ve written content worth sharing, then I can bring in the evidence. It seems like an extra step because I’m going to have to go back through many of the resources that I’ve essentially incorporated as part of my practice without specifically citing anywhere. It can be done, it’s just an extra step. And I have to decide if I can get over that barrier – which I think I can, and I think it will make my writing stronger for the time when eventually I consider writing my own book and certainly it will help add evidence to my blog as well. Anyway, I have to think about the process and not make it about citing sources, but stay true to telling stories and sharing experiences.

    So that led me to think about the WHAT IFs that could make that possible. What if I could free write about a theme and create 2-3 articles from it? What if I could keep my eyes and ears open for specific patient examples? And what if I could stop for 10 minutes after I notice those examples and free write about my observations?

    I think I’ll start with Mindset, the ideas of Not Yet, What If, Reality versus Expectation, Things are hard before they’re easy, It takes practice, Be patient. I can also refer to some other articles I’ve written for a renal newsletter and another renal-related purpose. I’d love to have an article or two in reserve so if I hit roadblocks in my writing process (namely lack of time, my very biggest worry of all) that I can have something to fall back on. Giving myself a cushion, even if I never use that cushion, will help me to breathe easier.

    More to write, but out of time to write it. I’m about 1000 words in and I’ve got to go pick up the older boys. More later!!!

    Back again! It’s now 9:10pm. Back to the references bit. I’m going to write for the sake of writing and then come back to cite actual sources and/or add material as needed so that I can cite necessary (and relevant) sources. Once again, I don’t want to write with the intent of proving my point or sharing information. The most important priority is to change behaviors and the best way to do that is with stories, examples, and opportunities for practice – you know, homework or experience assignments. Whatever you want to call it.

    So I’m imagining that maybe I start by free writing about 3000 words on Mindset, or maybe a week of free writing on mindset, and then I use that material to write my articles/blog posts/podcasts/etc. I can think about using a patient question, a patient example, a patient concern as the starting point for my writing, since I always seem to be so helpful when it comes to providing help for someone else. That would be a great prompt for my writing, whether it stays the same each day or changes each day. I can even scour my listserv for questions, but I don’t want the scouring for questions to become a job in itself. I want the focus to be on the writing and helping.

    The framework I see for the article is to a) present a problem, b) share evidence and research, c) share a strategy, d) resolve the problem using that strategy, and e) give practice homework to the reader and maybe an invitation to share somewhere. Not sure that will exist at the kidney chef website, but certainly I can make that happen at my own – sometime, someday – right?

    This was a similar framework to what I was using for Motivation Superhero. It worked well. My biggest concern using this to move forward, though, is that I don’t want the skeleton or framework to feel limiting or constraining. Those articles were kick-butt, very thorough, I was really proud of how they turned out. That being said, they were also very time intensive. I’m wondering whether it’s possible to accomplish something similar only without so much time invested. Am I asking if there’s a shortcut? Perhaps. The truth is that I shouldn’t be looking for shortcuts. I should be willing to invest what’s needed in order to get the job done, especially in the beginning when I’m trying to set an example and establish a vibe and expectation and reputation for my work.

    I do worry that writing for Kidneychef may take me off my focus. Maybe this is something else that I’m signing up to do and it’s going to be more work for me when I should be focusing on my website and my material. maybe. That being said, I think I can repurpose some of the content for my own website and my own articles. The biggest challenge is going to be switching between audiences. For the Kidneychef website I’m going to be writing for patients, and for my own website I’ll be talking to providers. I can likely use the same story for both purposes, with some slight revisions to make them fit each one. And I do think that the exercise of finding supporting evidence, specifically peer-reviewed articles and government sources, will be helpful for me in the long run. It’s just that it’s lots of steps and I’m agreeing to do it not for myself but rather for someone else. I’m agreeing to follow through on someone else’s deadline and that’s more pressure. If I fail for myself, that’s one thing. If I fail for someone else, though, disappointing them is much harder to face. Maybe it will be different when I have an audience following me. Maybe. But at least to my audience I’ll feel like I can come back and be honest and authentic and they’ll get me. That’s the kind of vibe I’m trying to convey with my writing, my stories, my work. For someone else, I’m thinking that’s not going to fly. This other person may not be interested in personal stories as much as cold, hard evidence. Maybe. I’m still not exactly sure.

    So the last thing that I wanted to review is the priority for my writing. First I want to create that email course, because that will be the lead magnet that may attract people to sign up for my site and build my audience – and an audience is what I’m going to want when I start to offer courses and other cool things. The lead magnet can increase my subscriptions, and with the community/sharing component I’m planning that can increase engagement and participation – especially if I can figure out how to create some kind of community forum. I want people to feel hooked and share it with their friends. The email course I have planned is a four email series called “Four Wins in Four Weeks” that will have four creative ways to approach patients and teach them information in a way that engages them and better prepares them to succeed. I’ve got the framework. I just need to sit down and jot the whole thing out. I don’t think it will take a lot of time. I just have to see what content I’ve created, what questions I want to ask, and what needs to be added to make it complete. Not perfect, but good enough.

    The next priority will be to script and possibly re-record some or all of the podcast episodes. Ultimately, I want to put these episodes on my actual website with audio and scripts. These can be assignments included with the email course I’ve described above. I need to look into this SoundCloud bit, too. So I need to look at the scripts I have, listen to the recorded episodes without scripts and create them, and then post these to my website and possibly re-record and reorganize the order of the podcasts on my Podcast. If there’s a series from a presentation, then I need to post the ending episode first and the first episode last so that the series runs from most recent (first part of presentation) to more distant (ending part of presentation). I’m not sure if I described that well here, but I know what I’m thinking in my head.

    And then I want to start thinking about the course. I’m thinking about it as a video course, but perhaps it won’t start with video – that’s going to be the most challenging part. I can include all the other parts and maybe basic video, and then add to it as I’m able to find the “human body” footage and record with a green screen. I’ll start with one body part at a time and create a course around that, then go on to the next one. The goal will be a whole bunch of body parts with badges that can add up to a complete Healthcaring approach. Not sure how I’ll structure membership – per course? for the whole thing? monthly cost with additional fee for continuing education credits? Not sure right now and I’ll have to look at some other sites to see what other pricing schemes are out there and how sensible those seem to me.

    Lastly, I’ve got to look into mail chimp and see if my welcome letter is working, see if the switch to single opt-in is going okay, and then think about sending an update and/or newsletter to my existing subscribers (there were 3 the last time I checked) to keep them posted on the status of things at the site, things they can share with others, and what’s coming down the pipeline.

    So that’s the mental map and mental scraps from my sitting session at the park today. A course for action, an idea about where to start. I need to figure out a schedule, if I think a schedule will work at all, and figure out where I’m going to start generating income so I can cut back my work schedule and actually make more time for realizing my vision for this project.

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