Fear of Failure

I did not take the most recent belt test at our dojhan, but the essay question inspired me.

How can we overcome our fear of failure?

Do you know, sometimes it is hard to come here and work out with these young bucks?  (that’s what I call them in my head: “young bucks”).  I have good flexibility but my stamina wanes faster than theirs and builds more slowly than theirs and sometimes I am just so distracted.  But on the other hand, working out with athletic artistic people is a great way to be an athletic artist, don’t you think?

The weeks that I am on call for hospital patients, I often forget all kinds of things in martial arts that were perfect the week before.  I am preoccupied and middle-of-the-night phone calls wear down my body and mind.  Sometimes, I am disheartened in class or after class.  But instead of identifying this as failure, I am telling myself that even a disappointing hour at the dojhan is still better for my mind and body than an hour at home fretting or slouching around.

We can overcome our fear of failure by realizing that failing is awesome!  What I mean is, when I fail, I am trying to do something at which there is a possibility that I will fail.  I am creating an ambitious goal.  Creating a goal is a fabulous first step in ultimately reaching that goal and a certain way to learn SOMETHING.  And learning something always counts as a success.  It IS possible to never fail, but that would mean that I was never trying anything new or hard.  Where is the excitement, the growth, the opportunity, the FUN in that?

Life imitates Martial Arts

Essay question for belt testing December 2014:  Why must we, as martial artists, maintain our, martial arts spirit both inside and out of the dojhan?

This question made me think of the philosophy that Life imitates Art.  Making a quick Google search on the subject, I was educated on the fact that this is in fact a topic of theses from such revered Western philosophers as Aristotle, Plato and Aristophanes.  The following is an excerpt from Wikipedia

 Oscar Wilde,… opined in his 1889 essay The Decay of Lying that, “Life imitates Art far more than Art imitates Life”…Wilde holds that anti-mimesis “results not merely from Life’s imitative instinct, but from the fact that the self-conscious aim of Life is to find expression, and that Art offers it certain beautiful forms through which it may realise that energy.”.[1][2]

What is found in life and nature is not what is really there, but is that which artists have taught people to find there, through art. As in an example posited by Wilde, although there has been fog in London for centuries, one notices the beauty and wonder of the fog because “poets and painters have taught the loveliness of such effects…They did not exist till Art had invented them.”.

In the case of our Martial Arts, the “martial arts spirit” can be identified as our Creed, which we recite and attempt to follow when in the dojhan.  What happens outside the dojhan?  To follow Wilde’s example of Life imitating Art, although there is excellence in the world and in our individual selves, we notice the existence and wonder of that excellence because martial arts has taught us to appreciate them… They did not exist until Martial Arts revealed them to us.  Then we should maintain our martial arts spirit outside of the dojhan to help us to access the possibility of excellence in all areas of our lives.


My friend ran the Chicago Marathon.  What a woman!  Then she hosted her son’s 10th birthday party the next day at School of Rock.  Upright.  With a smile.  As always.   Unbelievable.  A few days later, we were chatting and she mentioned she’d improved her time by 4 minutes.  She ran it in 3:24:20.  I’m not the bestest mathematician (or grammaratician!) but my calculations show that’s less than 8 minutes per mile for more than 26 miles.  Wow.  If I run one mile in less than 8 minutes, that’s good for me.  Two years ago she ran a half-marathon and said in surprise afterward, “I won first place in my age group actually!”

But this gal is also a doctor.  Well, she was one in Britain before she found her man and got married and he left professional music to return to corporate life so that they could raise a family that way.  Essentially a Family Medicine doc since that’s what docs do there, not just one age group or just one body part so much.  They once went camping and her husband dislocated his shoulder and she had to reduce it for him in the wild.  She kind of giggles and shrugs when she tells the story, “Well, it needed to be reduced, and there wasn’t anyone else there who was going to do it!” An American would have added, “And he wasn’t going to sue his own wife if it worked out poorly, anyway.”

She has been able to train for marathons running only 3 days a week, which has been very compatible with her family schedule.  She still gets the kids to soccer and baseball, feeds the clan, organizes PTO events, and walks the kids to and from school every day, plans and runs the birthday parties.  When she talks about training, she explains that she runs mostly with men, then again shrugs and says, “I like to run faster than most of the girls, you know.”

I love it.  She’s an Animal. Inconceivable! (Hello, Princess Bride fans)  And when I look at her and think of her running, I think, man, she’s a kick-ass Primary Care doctor too!

Because it takes a lot of guts and determination and discipline to train in medicine.  Gray’s Anatomy was based on one of the hospitals that I trained in, but those residents had it WAY easier than any resident I knew there, especially the Surgery residents.  But that’s another story.

I had to build capacity for factual learning. I had to learn to prioritize learning to get the most bang for the buck in terms of passing classes.  I had to develop reading, learning, listening stamina to tolerate the long hours of studying.  I had to learn to ask the right questions and find the right answers quickly and accurately.  But I tell you that when I read for work now, I know how to identify what question I need to answer and how to find the information that I need quickly.  I can read for facts now, and fast.  Which is interesting because reading was a totally different experience for me for most of my life. I read voraciously growing up, for fun, all fiction, lots of fantasy with a sprinkle of mystery.  But I enjoyed classics and poetry as well.  I’ve read quite a bit of Shakespeare as well.  I was an English major, after all.  So I had a hard time initially in school because I didn’t know how to read fast for information, without nuance or metaphor.  But eventually, I learned it.  Practice, practice, practice.  It really was like training for a race, building stamina but also specific skills like speed and how to pace yourself and what to eat and drink and when, and how to run up or down hills effectively.

As a learner, I had to learn to wade through personalities and learning opportunities to focus on the opportunities with the most bang for the buck.  Sleep was at a great premium during training.  I had a one year old when I started internship and was pregnant with my second during my third year of residency.  I attended lectures, but if it was a topic I knew well or seemed low-yield, I would close my eyes in my seat and nap.   One of my friends would wake me up to tell me I was missing the lecture and I would have to keep telling her not to wake me, that I was napping on purpose.

In terms of personalities, we had the opportunity to work with so many seniors and attendings in training.  The students and residents of different levels and the attendings were always on a different rotations, so we’d usually get two different senior students, interns, senior resident and attendings.  Each had different strengths and weaknesses as did we/I.  Sometimes it was useful to ask questions or ask for clarifications, other times it was better to just say, “ Yes, Sir” or No, Sir,” whether you agreed or not in order to move the day forward.

The Grandmaster that I study martial arts with now once said to me, “If I had you 10 years ago, I could have made you the best in the world!”  which is flattering.  But my only response was that I couldn’t have done it 10 years before. Because I didn’t know how to shut up until I went through those years of medical training.  And I wasn’t as efficient at being taught something and then almost unconsciously creating a learning plan to solidify my knowledge and yet be flexible as new information/corrections were added.  And I didn’t have the experience to accept loss of skills and knowledge as part of the learning process and the experience and patience to repeatedly teach myself again.  It was because of those days, weeks, months, years of pushing myself to learn more, do more, sleep less, think harder, learn again, communicate, organize, forgive, keep learning and reinventing that I can be the martial artist that I am now.

Sometimes the training is hard, overwhelming, strenuous.  But in the end, you gain strength, stamina, speed , and confidence and knowledge about yourself.  These last two are perhaps the most important, because you need these for whatever you do next.

Jake Shimabukuro

Dear Jake,

I know we’ve never met but I feel like I know you.  When I saw  you play live on stage, I feel like I knew you.

When you play Blue Roses Falling, I feel like I know why a boy from Hawaii would visit his friend’s grandmother in the hospital.  Do people in other parts of the US do that?  I think so, but not necessarily where I live now.  Not even his own grandmother…  I feel like I know what it is like to chat with an elder in Hawaii, to listen to them, with respect and compassion.  To listen to them, to talk story.  To hold a soft, dry hand.  Or perhaps just sit.

When you push the speed of your flying fingers, I feel like I know how you sat for hours upon hours, days upon days, building focus with and without monotony until your mind and your fingers could perform both precision and emotion faster, ever faster.  Was I there on the days when your fingers would not do it, would not do it, would not do it, until you had to venture out to clear your mind?  Did you return day after day of fruitlessness to try again?  Or were you patient, taking it at the speed you could every day, just a little, push a little here, draw back there, push a little again until one day 6 months later you were just a little bit faster than you had been?

Did you get chocolate milk and syrup on your ukulele from the kitchen counter?  For heaven’s sake, did you take a break when you were on the toilet or did you play, to your mother’s dismay, even in that little room?

Do you play in your back yard in the shade lying on a mat under a tree, gazing up at that tropical Hawaiian sky that smells like … mangoes and music?  In the background are Matt’s lawnmower down the street and Hoku’s children splashing and screeching while Joshua yells at his dog to “GET over here!”

Do you sometimes hear music in your mind as you drive past Walls then wander up and sit looking out from Diamond Head just to hear the rest of the tune?  Is your skin sun-warm as the breeze presses your shirt to your chest and you watch the breaks?

I took my kids to see you this time, so they could see what discipline and courage and love can birth.  I’m so glad I did.

I know I don’t really know you.  But that is the beauty of art, isn’t it?

Aloha and Mahalo,


Checklist for the winter in Chicago

Make sure I have these and they fit and work.  Some need to be checked that they are not too ratty looking:

  • Kettle for hot water
  • Hot chocolate mix
  • Tea
  • Gloves – light pairs and snow building pairs
  • Scarves
  • Snow bibs
  • Winter coats
  • Hats -wool preferable
  • Winter shoes/boots
  • Wool socks
  • Wool pants
  • Wool sweaters
  • Rotate clothes
  • Weather app
  • Indoor shoes to leave in school locker or at work
  • Urban clamp-ons (new this year, I’m gonna try them – found them at Costco!)
  • House slippers

What have I forgotten?

It is too cold here!

My feet have been cold ALL DAY! And all day yesterday too. Despite wearing wool socks and wool house slippers all day. And a cashmere sweater. And drinking hot water all day. It is November 17 and it was 14 degrees when we left to walk to school today. But then, it snowed on Halloween this year. I am beginning to believe that this winter is gonna be a rough one. For this Hula Girl.

Last Thursday, I went to Costco to get a few things and came home with 5 pairs of gloves and a scarf. BTW, there’s only 4 people in the house. But I was so cold I just kept throwing things into the cart that I thought would help keep me/us warm.

And the truth is, it isn’t even winter yet. It will get at least 20 degrees colder this winter. Too cold. For this Hula Girl.

“Heart Murmurs” has been Published

Dear Sharon (Dobie, MD),

I received my copy of Heart Murmurs and have been reading an entry here and there.  Thank you so much.  It is heartening to read, actually.  I often (really, every week) wonder what the heck I am doing still slogging away at Primary Care.  I know it is my gift but it often seems useless.  It is difficult for me here in Chicago-land where I feel Primary Care is poorly understood, respected and appreciated.  It is ridiculous the amount of hooplah I must perform that does not impact my patients in the least (ordering labs this way for this insurance and that way for that insurance, clicking buttons on my computer to prove I have addressed the flu vaccine then documenting in another area so the nursing staff can find it when they have to chart reviews for the ACO we participate in) and the amount of docs who do not bother with the things that I feels can provide benefit to patients (sending notes of their consults, forwarding requested records, following evidence based screening recommendations, performing physical exams and documenting them, maintaining up-to-date medication or problem lists).

On the other hand, I realize that when I wasn’t working for the first year or so that we moved to Chicago, I really didn’t get any more done around the house, just spent more time doing it.  I wasn’t any less stressed, I just stressed about different things.  At least when I work, I concern myself with some things that actually have a chance of improving someone’s life.

But reading Heart Murmurs reminded me that perhaps it is important for me to practice for me, so that I will grow.  I am always so conscious of how activities that my children do and how they do them or patterns/habits that we as parents require of them are helping them to grow and develop.  Heart Murmurs is reminding me that I should be a doctor also because it helps me to continue to grow and develop.



Do your doctors share what they have learned from you? Likely not! With little precedent for physicians to open up about the impact their patients have on their personal development, Heart Murmurs: What Patients Teach Their Doctors breaks tradition with a collection of stories by author and editor Sharon Dobie M.D. and 35 other physicians. Aware for years that her patients taught her at least as much as she gave them, Dr. Dobie’s acknowledgement of this reciprocity led to this project. Grouped thematically, the stories encourage health care providers to think about their relationships with patients and through that reflection, to know themselves more deeply. They also take all readers from the specific to universal messages, asking all of us to see how we are changed within all relationships, doctor-patient or otherwise. These humanizing tales draw us back to basics: relationships matter for us all.

Learn one thing

Sometimes medical school, martial arts, life is overwhelming.

When I have time to review one-on-one with my students, I ask them to name one thing, two things, three things they learned from each patient we saw together.  It can be something about how to introduce yourself, clean your hands before your touch the patient, ask a question, redirect a wandering conversation, or the core medical information such as key history for a sore throat, first line antibiotics for sinusitis, how to do a pap, anything.  In the sea of all the things we strive to know, sometimes the place to start is where you are.  If you can name one thing (or two or three) for each patient, even though you still feel overwhelmed and insufficient and far from where you want to be, you’ll know you are smarter, better by the end of the day.

Grandmaster Yu reminds us to be better today than yesterday. And when we want to get stronger, he tells us to start with 10 pushups and add one each day.  If I could do 12 yesterday, surely I can do 13 today!  By the end of 2 months, I’ll be doing 70.

Learn one thing.  Do one thing more or better than last time.  Today.

Body math

It’s math.

Energy in, energy out.

In = food, fluids, sleep
Out = urine, poop, exercise, thinking

Your body and mind are living, dynamic things, so providing quality fuel and maintaining its flexibility and agility with exercise is essential to maximizing its potential for faculty and longevity.

Slip on shoes and half buttoned pajamas

I think about our medical students all the time. It is quite a leap from great undergraduate or graduate student and employee to medical student.  Even if you’ve been in the top 1% of all your classes before, now you are surrounded by the top 1% percent.  The pressure is intense.

Where I went to medical school (I love my medical school), we were “graded on a curve” (do schools still do that?) or so we believed. This means that grades were all competitive, compared and there was a bell-shaped curve with outliers at the top and at the bottom with the bulk in the middle.  So, basically, there were folks at the bottom who were failing.  And we might be competing with kids who had already published their undergraduate work in major scientific publications, like Nature.

For my science requirement at Princeton, I took a summer Botany course at the University of Washington. My father had an annoying habit of teaching us and quizzing us on plants while we were growing up.  This annoying habit meant that I knew half the plants we had to “key” in lab and could often leave within the first half hour without having to go through the painstaking labor of differentiating leaf, stem, petal, ovary characteristics until the flower was identified.  I thought it was quite a coup.

Did I mention that I was an English major at Princeton? My track in English was the rarely opted Literature and Theater track.  For the theater part of my major, I took Dance.  Did I mention that Dance at that time at Princeton, was Pass/Fail only?  Really, if you show up to class three times a week and move around, how can you fail?  I shouldn’t belittle it too much.  I created a dance show for my Senior Thesis and was the first dance student to ever win the Louis A. Sudler Award in the Arts, for artistic contribution to the campus, for our senior class.

However, these achievements prepared me poorly for the intensive and competitive scientific milieu of Medical School. I had to learn to read for facts, not story or philosophy.  I had to memorize voraciously.  I had to learn chemical and physical pathways and anatomy and energy cycles and pharmaceutical methods.  Woe is me, we all had to and have to.

I accessed the schools tutors, formed study groups, created flash cards, experimented with different types of note taking, recorded lectures to repeat in the car while commuting.

But as challenging as that was, and I even managed to fail one core clerkship (a story for another time), residency was even harder. The time pressure was immense as well as the need for high efficiency and productivity.  I had already had my first baby, who was 17 months old when I started internship.

There were no mandated work-hour restrictions yet when I was an intern. We had call no more than every 3 night, usually every 4.  (My father reminds me they were on call every 2!)  I’m pretty slim to begin with and I lost 9 pounds in the first 4 months of internship and bought cases of Ensure supplements for over a year to maintain weight.  When I was on my surgery rotation as an intern (which was, by the way, the easiest location for the Surgery residents and considered their “cush” month) I was on the road at 4:30 AM with a burrito-rolled wrap in hand to eat as breakfast on the way.  We rounded at 5:30.  When I was on call, I gave myself 15 minutes for breakfast and lunch and 30 minutes for dinner.  Other than that, I ran all day and all night.  I visited all my patients once more before I went to bed and there were many nights when I didn’t sleep at all.  I recall once going to bed at 2:00 and thinking “Oh, that’s not too bad” until I realized that I needed to get up at 4:00 and that to think that 2 hours of sleep was “not too bad” was/is ridiculous.


Time was so short that I found ways to cut around wherever I could. Skipping showers was not always an option.  But fresh socks and tooth brushing was always a must before starting pre-rounding in the morning.  And even when I was at home, I only buttoned half the buttons of my PJs.  And I never bought shoes that couldn’t be slipped on.  Some of my cohorts slept with their shoes on but I just couldn’t.  So I needed shoes I could jump out of bed and be in quickly without fumbling.  And they had to be supportive shoes since I was on my feet for so many hours.  Merrill slip-on sneakers were my trusted companions.  The vast majority of my tops were on-sale Banana Republic long-sleeve and short-sleeve nice tees that could be paired with decent pants (or scrubs) to look professional enough but not be mourned if ruined with someone else’s body fluids.


That’s how much I needed to prioritize and squeeze the potential out of every moment. Slip on shoes, on-sale tees and half buttoned pajamas.


Hang on, my students, build your flexibility, access your creativity, maintain your passion and know I believe in you. All these skills will come in handy as you face the challenge of prioritizing what needs to happen first for your patient, fashioning a way to communicate with someone to get that test or evaluation done,  identifying where your limits are, and empathizing with a patient or family under stress.