Remember how we were always taught that Sunday is a day of rest? You were supposed to rest and gather your mojo to prepare you for the rest of the week with no hard labor or rushing around. You were supposed to slow down, make time for reflection or worship and just…be. I have to confess, that concept has completely gone to the wayside for me for many years now. Sunday has become the catch all day for everything that I didn’t get to throughout the rest of the week: grocery shopping, running errands, cleaning, going through the email back log, etc. I treat it as if Sunday somehow contains more hours than the rest of the week, at least in relation to the unrealistic expectations I have of what I can accomplish. That way I am sure to be disappointed no matter what happens. I am not sure how it happened exactly. I think it crept up on me slowly through the years. There is no rest to be had on Sunday. It has just become impossible. But, is that really healthy? Don’t we all need some down time? Isn’t that an essential part of self-care, the biblical recommendations not withstanding?
In fact, down time IS an essential part of self care. We need a day to reflect, regather our thoughts, and actually rest. A day of rest is important physiologically to help your body replace the energy stores in your muscle cells so that your battery can be fully recharged for your next workout. A day of rest allows for some mechanical repair from your previous exercise. A day of rest is important psychologically because it allows us to slow our minds down from the daily, emotionally exhausting grind. When we unplug from our relentless, preplanned day to day activities, we can actually stop to enjoy our surroundings, take a momentary deep breath and do something just for ourselves for no reason and mentally prepare for the rest of the week. I am reminded of the words of Matthew Kelly, author of Resisting Happiness: “Don’t waste a single Sunday. If you don’t waste Sundays, you will be less likely to waste Mondays, Tuesdays, and Wednesdays.” The bottom line is, sometimes you gotta brake now, so you don’t break later when you don’t mean to. Happy Sunday everybody!
You’re gonna find your way to heaven is a rough and rocky road
If you don’t stop and smell the roses along the way.–Mac Davis
Stop and smell the roses. It’s a powerful statement that really has nothing to do with flowers. It means take a minute and pause to recognize the beauty of the world around you. How many of us actually take the time to do just that? How many of us consciously stop ourselves in the middle of rushing about our daily lives to just take note of our surroundings and appreciate them? Not too many I bet. I know that I don’t do it often enough. I think most of us spend the majority of our time running in multiple directions at once, marveling at our multitasking skills, and then find ourselves wondering hours or days later where our time actually went and have trouble actually remembering what we really accomplished. Time flies past us without a glance and we have nothing to show for it. The truth worth of an experience is measured in it’s memories. If we are moving too fast, we won’t have any. It’s time to slow down a little.
What am I talking about? I am talking about gynecological care guidelines. Most recent guidelines from the USPSTF recommend pap smears every three years from ages 21 to 65 if using just the pap smear or every 5 years between 30 and 65 if using the pap smear and HPV testing. These recommendations are based on epidemiological data and costs. The few issues that may be caught before the age of 21 and after the age of 65 are too few and far between to be considered economical to screen for.
I have a problem with this in both the translational sense and the practical sense. With regard to the translational sense, these recommendations have the tendency to confuse adult women based upon terminology. Most women equate getting their pap and their annual check up as one and the same. They are not! In my office, the pap smear is about a 10 second clip of what I do. It is just one small piece of the puzzle. The real meat and bones is in the head to toe exam that I offer which allows me to check for anything that could be wrong in all body parts. You see when you tell most women they don’t need a pap but every three years, if at all, they think sweet! I am off the hook for any gynecologic exams for three years at a time and they don’t come in at all. In the practical sense, this lack of clarification is both irresponsible and potentially deadly. Obgyn is blessed to have some of the best preventative tools in the business but we become crippled by these recommendations because the patients don’t show up. Add to that the fact that insurance companies jump on the bandwagon and start trying to refuse to cover paps/annuals and these women are potentially really screwed. In the practical sense,, the thing is that most gyn conditions do not present with symptoms until the condition is pretty advanced. A little itch on the vulva could actually be a vulvar cancer. A little feeling of fullness in the abdomen could actually be an ovarian tumor. But, unless someone is looking(i.e me), the patient doesn’t know, the condition goes unrecognized and the situation goes from simple and treatable to serious and deadly. In addition, I would challenge the academicians that sit behind the desks and formulate these recommendations to sit down with the patients whose diagnosis you missed and explain to them how it’s ok because the cost/returns ratio was just not in their favor to justify screening. I am not sure that quoting guidelines will help the patient or the family feel any better either.
The bottom line is that I am a fan of the annual exam, whether or not the pap is performed. It is definitely the most bang for your buck way to be watchful for your patients. It really goes back to the OPPOSITE of the old adage: what you don’t know or can’t see CAN hurt you! Have a great day everybody!
Shakespeare had the right idea a long time ago. I think that we have just forgotten it lately. There have been songs and poems written by many about the utter preciousness of life, and yet we still complain bitterly, we forget to notice what we do have, and we have forgotten how to recognize the good.
This also begs the question: Is it really a matter of life being too short, or is it a matter of wasting the time that we have? Seneca once wrote that “it is not that we have a short time to live, but that we waste a lot of it. Life is long enough and a sufficiently generous amount has been given to us for the highest achievement if it were all well invested.” He also goes on to say that most of us don’t even realize that life is passing us by as we are distracted by greed, poor living, etc and that it is only when death is knocking at our door that we finally “get it,” but then it is too late.
The bottom line is that it is up to us to savor live