Posted by: First Mate | April 12, 2014

Why We Need an Internal Editor and How to Find Yours

I write grants, proposals, abstracts, curricula and manage projects for a living.  I have the editing down to a science and when I am off my game there is always a colleague, reviewer or the Captain to help me. When I write for myself, I am a disaster, especially if I write daily, which all writers need to do.  I misuse there and their, effect and affect, here and hear and loads of other things you can spot daily on this blog.  These errors are not because I don’t know the difference, rather, I am writing to get the thoughts that crowd my mind out.  It’s a purge. When I have had a chance to go back and review the piece of myself I have just provided the world, I realize…. I look like an idiot.  Which I assure you, I am not.

I have been living my life without an internal editor for several years.  To clarify, I have not been following my gut instinct or inner wisdom.  I took on projects even though my inner voice said “you will be miserable.”  I spent time with people despite the fact I always felt awful afterwords. I continued with work I loathed in the grand quest for money I wanted but didn’t need. I spent money, procrastinated, read, cooked, ate, drank coffee and wine and did many other things to avoid listening to my inner voice. Sound familiar?

One day, not so long ago, I had an awakening.  I’m no yogi or visionary but I knew in my heart that my lifestyle was not/is not sustainable.  I have this cool clock on my dashboard that tells me how much I drive in a day. Driving four hours a day five days a week isn’t a bad thing if you’re a trucker or even if you live on a majestic island in the middle of the Pacific.  It’s not sustainable for me. I love  that we listen to books on tape on the way to school and while we live in an amazing location, we don’t live where my daughter can walk outside and find a neighborhood friend to explore with.

Cool car clock

Cool car clock

I have had my own business for almost 12 years.  It is both wonderful and awful, feast and famine.  It has given me the freedom to live in Hawaii. Many days I dream about having a simple office job with specified tasks, a regular paycheck and 9-5 hours, do those jobs even exist any more? Either way it wouldn’t work for me.  Medical education and the business of medicine have changed so much in the last few years and my perspective has changed with it.  I and much of my industry have provided education and research while missing the importance and necessity of providing tools for behavioral and systemic change.  If a process, whether a lab procedure, clinical decision tree, or a group of medications provides a better outcome, why are awareness and satisfaction targets vs. behavioral or systemic change? And the science behind so much of the ‘proof’ is skewed also – just ask Ben Goldacre. Ok, this is getting boring and many are working toward change, it is just slooooow. My point is, I wasn’t practicing in my own life what I was proposing and preaching, unintentionally, in a sense I had become Sisyphus. I was plagued to do the same job over and over with the same results or what Einstein called insanity: doing the same thing over and over again expecting different results. Then I read a book by a tiny 5’2″ firecracker from Phoenix, Az called Alison Levine. The book On The Edge: The Art of High Impact Leadership is wonderful.

I’m from Phoenix, and somehow her anecdotes on life and leadership struck a chord with me: namely that getting up the mountain is only half the battle, getting down safely with your team is what is important.  My epiphany was like waking up and looking at your partner and realizing “I don’t love you anymore and I am profoundly unhappy.” What now? Note: I still love and admire the Captain, but I didn’t have a lot respect for myself after what felt like several years of pimping myself out (figuratively speaking-my 10 year old reads this blog) for tedious tasks with what I determined had no impact on public health, physician and health system outcomes. I know I am not the only one banging my head against a wall about healthcare. But I was making this a pattern throughout my life.  I was lifting everyone else up, solving problems, being the superhero mom, while I had lost my own direction and was spinning out of control.  I lost my internal compass.

It took me several months and a lot of reading including The Inside Out Revolution by Michael Neill to start moving and making changes.  I fired my biggest client and am terrified but happy. I started exercising every day – and when I am sore or too tired I forgive myself. I made sleep a priority. And I slowed my life down and spent real time with my family.  Not what I call “Facebook” time where something fabulous and photographic is scheduled and everything appears perfect from the outside. Rather I attempted to spend time listening, dreaming, talking and thinking.  Funny thing: they were at the same place I was/am. My daughter doesn’t like all the activities: she doesn’t want to swim on a team right now, or sail – ok, great.  As a family, we are going to downsize, our great retirement plan started owning us. We faced the myth of ownership, when what we really want is time and adventure together.

The awakening or key to behavioral change won’t be the same for everyone but one thing is consistent: YOU MUST LET GO, slow down, let your mind wander (and not about deadlines, laundry, or whatever eats at you.) Get off the treadmill, stop spending so much time with other people and be thankful/grateful for what you have and who you are for 5 seconds a day.  Write down one thing you want – whether happiness, health, a car, a job, a trip to Hawaii :), a better doctor, you get the drill.  And MOST IMPORTANTLY – stop blaming other people: it is not your boss, your husband or your child’s teacher – it’s you.  Don’t take things personally.  I say this because I learned it was always me – be responsible for your own unhappiness and change it. Admit it is you over and over and discover what you want. Be HONEST, I don’t care if you are a professional poker player – you have to be honest with yourself.

This applies to organizational change as well.  A very wise Kapuna, or Hawaiian elder once told me never look at an organization and think “I’m going to fix these problems.” Rather understand  the organization and it’s Ohana (family and community) and kuliana (responsibility) FIRST.  Then work with the members to establish tools – identify assets without always focussing on problems.  There is a sign at Queens Medical Center that says “No coolers (or cooking equipment) allowed in hospital waiting rooms.”  Okay, I may have added cooking equipment  for humor. The hospital is attempting to keep the waiting rooms clear of the many large families or Ohana that come with those hospitalized patients.  Under the Compact of Free Association (COFA), Hawaii is obligated to provide medical care to Pacific Islanders, so large extended families fly from outer islands and literally move into hospital waiting rooms.  For the hospital and staff this can create problems, but can this be beneficial to the patient and their family?  If the organization looked at the cultural implications of these actions, can a public health intervention be provided to the extended family early?  By slowing down and looking at all sides, creativity blossoms. But first we must let go.





  1. Anne, first of all, great Blog! I love the line “The myth of ownership”. And all it’s implications. Also that prat about where you are is where you put yourself and not making it others fault is so true. The Native American Peoples practice and compete in a sport of hoop dancing. The hoop represents so many things in their culture including a circle of life which has no beginning and no end but is continuous. It is used for healing ceremonies to restore balance and harmony in the world. The dancer becomes a counselor and the hoops representative of a circle that returns the responsibility for a problem to its creator. What a concept!
    Thanks for getting back to Blogging!

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