Just One Step

Attempting a new endeavor sometimes leaves me feeling like I’m standing in my hiking boots at the base of a slope, debating whether there are enough handholds to scramble up without falling and breaking my leg.  Or my neck.  Whether it’s writing papers, doing research, or starting a new phase of medical school, it’s often daunting to summon the internal energy needed to begin.

I’m beginning to realize, however, that my ability to gauge the energy required to take a particular action is not always so accurate.  I enjoy meeting goals, and I have some long-term ones in place as guiding stars for my life journey.  It’s like picking a distant mountain peak and saying, I am going to trek from here to there.  Doing so may keep me from getting completely off-course, but if I think that I need to have enough energy to make the 100-mile hike in a single shot, I’m not likely to ever get out the door.

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In reality, I would only need to have enough energy to make it to my first campsite.  I wouldn’t presume to have enough stamina to make it to the end without pausing, and if I felt beaten at the thought of doing so I wouldn’t blame myself.  But I certainly do that with less tangible journeys.  If need to start something and feel overwhelmed at the thought of carrying it to completion, I can respond to myself in any number of ways and they usually aren’t positive.  It’s something I’m trying to become more aware of, and perhaps this post is, in its own way, a part of sorting this out.

Being more realistic certainly would help.  If I realize that I only need enough internal power to get started–to create the ignition spark–it will help keep me keep the big picture in mind without feeling daunted by its implications.  One strategy I’ve used is committing to a first step that is so small, it would be ridiculous not to do it.  Need to write an email I’ve been putting off because it feels like too much to do?  Just log into my computer and open my inbox, and that is all.  No expectations beyond than that–if I get into my inbox, I’ve accomplished my goal.

By beginning with something small like that, I’m able to overcome the inertia of starting because I narrow my focus to what I need for the step right in front of me.  I’m no longer trying to bully myself into walking for miles; I’m just lifting one foot off the ground. I’m surprised each time I do this by how well it works–usually I end up getting far more accomplished than I had planned.

So far, I’ve applied this strategy mostly for writing-related things like papers or emails.  We all face more in life than emails, however.  I have a few landmark peaks in the distance, and the highest one would be realizing my dream to become a physician-writer.  That’s what I’m aiming for: to be someone who cares for the body without forgetting that it contains the human spirit.  It will be a lifelong journey, one that will hopefully include matching into residency, graduating from medical school, finishing my post-graduate training and finding my place in the world as an attending physician.  Right now, I’m just trying to figure out how I’m going to make it through clinics.  It feels overwhelming to think about right now, but I’m going to try taking the one–step approach to starting my rotations this April.

Review how to take a medical history.  One step.

Find one video to practice the eye movements in the neurological exam.  One step.

Watch the video.  One step.

Sign up to volunteer again at one of Stanford’s free clinics.  One step.

They’re little steps, and they don’t seem like much, but they’ll keep me from postponing everything until I feel ready.  Because, honestly, I’ll never feel completely ready.

And one day near the end of April, I’ll take a deep breath and remember to keep my head up.  And I’ll take one step that will carry my over the threshold into my clinical years.

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