This is my very first blog.  I have been writing in a journal since I was a child.  At one point I burned all of my journals from college in a bonfire at Burning Man.  I don’t think it will be possible to do that to this form of self expression.  In fact, I can’t even seem to find the delete button yet so here it goes.  I have always been verbose, I am not going to apologize for that any more, enjoy.

Some times in life, transition is all around us.  Its within and without.  People are moving, changing jobs, having babies, getting married, moving on, passing away.  If I knew anything about astrology perhaps I could put this into context more in a universal solar system type of way.  The most I do is what my mom taught me, that when things are crazy you can always blame the full moon.

This year my transition feels very much like the life cycle of a butterfly.  It is easy to think of that as point A-catepillar and point B-butterfly.  What a beautiful transformation!  But alas, there are many steps in between.  The egg, catepillar, chrysalis, emerging adult and butterfly.  I certainly feel like I am in the non glamorous stages of the emerging adult.  My wings are wet and floppy, beautiful and full of potential but not quite ready to fly.  I’ll get there.  I can’t go back into the cocoon now, certainly there is no turning back.  I am vulnerable, sensitive and authentically a new form of me emerging.  It is about time, really.

How do you transition?  How do you deal with change?  I like to shop it around-talk to everyone, get a lot of opinions.  I prefer to make changes on consensus, when possible.   There is a moment though, in the process of reflecting my ideas off of other opinions that I become very clear in what I think and believe.  It is the same as flipping heads and tails.  You know what you are going for when you flip for what you don’t want and say, “Ok, best two out of three”.  The power of those reflective choices, I have always trusted that to show me my own truth.  But sometimes you have to go into the chrysalis and turn the light inward to see what is there, and what emerges may be profoundly different than anything I could have expected.

I was told in residency that making decisions by consensus wasn’t right.  I have now seen both sides of this criticism.  On the one hand, patients want me to be definitive, dogmatic, this is what I believe and I am right and this is best.  This conveys trust, confidence.  To others, it turns them away because arrogance and ego can not be easily disentangled from confidence.  I have always preferred collective reasoning, talking it through, building on everyone in the team’s opinions.  I love the new medical rhetoric to make “shared decision making” with patients.  Good bye paternalism, hello empowerment and collaboration.  Its a good thing I am a doctoring in this new generation where my approach isn’t wrong any more.  I am a symbol of the young, feminine generation of physicians that provide information and say-here is the evidence, take or leave what you feel applies to you.  I will tell you my opinion if you want to know how I think the evidence applies to your particular case.  You tell me, where are you coming from?

And thus, we all change and transform together.

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