Sunday, August 24, 2014

Help Shape the Mental Health Conversation at Medicine X

Mental health too seldom is discussed. There remains a stigma associated with with conditions that impact the brain. Why? The brain has no better protection from illness than the heart or the lungs or the skin, yet we hold it to an entirely different standard. This antiquated philosophy must change—and only will change when we bring conversations about mental health to the forefront.

I am an advisor to Medicine X, a healthcare and emerging technology conference held at Stanford University each September. During and after Medicine X 2013, attendees and those engaging in the conference via the livestream and Twitter feed called for greater inclusion of mental health issues—and we listened. At Medicine X 2014, mental health and psychology weave their way in and out of various presentations. Daniel Siegel, MD will give a keynote speech and lead a 90-minute Master Class on "Compassion, Connection and Engagement: How Health Arises from our Mind, Body, and Relationships." Dustin DiTommaso of MadPow will take a look at the psychology of motivation and how to close the gap between people's intentions and their actions. Allison Darcy presents her work to develop and pilot a smartphone app for patients with eating disorders. Four CEO's will talk about building companies to bring emerging technology to mental health; and psychologist Dr. Ann Becker-Schutte leads a panel discussion about mental health as a turning point for whole person health.

It would be remiss of me to talk about bringing mental health into the light without being open about my own. As a freshman in college, I was diagnosed with depression and anxiety. Changes in environment and my support network brought the diagnosis about—I am an only child, and frankly, I always got along better with adults than I did my peers. I went to a relatively large university where 200 to 300 students filled giant lecture halls for introductory classes. My professors didn't know I existed. I became withdrawn and my grades suffered (taking 17 hours of classes didn't help). I did best in the two classes I had registered for without my advisor's approval—junior/senior level classics and political science courses in which I was one of 20 students. I made it through the school year, went home for the summer, and took stock of my situation. I made changes, and I made it out of there three years later. 

My depression and anxiety didn't resolve with graduation. My first job as a reporter meant always being on call, covering murders and deadly accidents, never knowing a holiday, and hardly seeing my parents. Perhaps I should have taken it as a sign that the newspaper had a group discount rate with a local counselor. At my first appointment, I spent the full hour talking to her but looking at her two dogs whose soft, soothing ears and warm brown eyes invited me to be honest with myself. 

My second counselor came into my life after I had triple bypass surgery that resolved a host of problems but created a new relationship with my body that I did not know how to negotiate. My third counselor and I stuck together for years, and he created an environment in which I was safe enough to explore my teenage traumas and tackle issues that prevented me from being as emotionally present as I wanted to be for my husband. 

I could not and would not have successfully navigated the past 15 years to get where I am now without help from mental health professionals. Their training in turn trained me how to help myself. Like any expert, they had knowledge that I did not. If I had wanted to rebuild an engine, I would have gone to learn from a mechanic. If I had wanted to learn how to fly, I would have gone to learn from a pilot. If I had wanted to learn how to paint, I would have gone to learn from an art instructor. I wanted to learn how to best care for my mental, emotional, and physical self, so I went to learn from a counselor. 

And there's not a single day that I regret doing so. 

Does my diagnosis mean that there's a mark in my medical file? Yes. Does that mean that I'll never be hired to become part of the CIA's spy network? Yes. Are those things more important than the fact that I am happier and healthier than I ever would have been without addressing my mental health needs? No. Is it fair that some people will and do judge me for taking this action to advocate for myself? No. Do I particularly care that they do? No because it is clear that they missed the anatomy lesson explaining that the brain is an organ—an extremely complex organ, the mysteries of which we are so very far from understanding. 

At Medicine X, I will be moderating a panel: "Depression in Chronic Illness and Coping Through Online Communities." In order to open the conversation to as many who wish to participate and address questions may not find answers elsewhere, I am asking you—yes YOU—to pose your questions to the panel. 

All questions submitted as a comment to this post between Sunday, Aug. 24 and Wednesday, Sept. 3 will be considered. Panelists will choose one question from those submitted to answer from the Medicine X main stage. Anyone interested in the conversation may tune in to Medicine X's through the Global Access Program, which will feature this main stage panel discussion from 5:25 to 6:10 p.m. Pacific Time on Saturday, Sept. 6. Real time commentary will be happening on Twitter via #MedX

After the conference, panelists will have the option to respond to additional questions in writing through a series of blog posts. 

Help us shape this important discussion about depression, chronic illness, and online resources. What do you want to know? Leave a comment to submit your question, and if you're on Twitter, connect with panelists at: @AfternoonNapper, @bacigalupe, @DrBeckerShutte, @ekeeleymoore, @Hugo_OC, @Strangely_TI

Tuesday, August 12, 2014

Written Upon The Passing of Peter Pan

Those who give us so much sometimes give up too much of themselves. Hearts must receive to survive or they simply bleed out.

Find what fills your heart, what sustains you. Return to it again & again. Turn away from what drains you. You deserve a whole heart.

If you carry a whole heart, seek out those who do not in order to help them. Have the patience to hold another's heart — mindfully.

So much of depression is not sadness. It is emptiness. It is numbness. And self-destruction so often is an attempt to feel anything at all.

Do not think that depression must present itself through tears. It is a chameleon-like beast, hiding in plain sight.

To "struggle" with chronic depression is real as it never ever leaves. It lives with us — sometimes in a cage & sometimes in our chest.

The beast can be tamed. It is DAMNED HARD WORK to do & no one can do it for you. It will be terrifying. It will be worth it.

Once you have the tools to tame depression, you can develop the skills. These skills never will leave you; you can rely on them to save you.

Depression is cunning, almost comfortable for its familiarity. Change — even good change — is threatening because it is new.

If we open ourselves to the possibility of happiness, we run the risk of falling into the pit of despair, so we avoid feeling at all.

But joy — JOY! — is so luscious, so warm it is worth the risk. FEEL ALL THE FEELINGS! You are capable. You can control the beast.

Ask for help when you need it & if you are not heard ask again. Ask a stranger if you must.

If you need help, just want help, think that maybe help could perhaps be worth investigating — get you some. It's good stuff.

No part of depression equals being lame or being a failure or being weak or being dumb. It's just called being human.

And never ever feel that you are alone. You are not. You may not have found your people just yet. But you're not alone.



Captain James Hook: Prepare to die, Peter Pan!
Peter Banning: To die would be a grand adventure!
Captain James Hook: Death is the only adventure you have left!
"Hook" (1991)
Robin Williams (1951-2014)

Monday, August 4, 2014

Access Medicine X: Live Stream Brings Silicon Valley Direct To You

Stanford Medicine X is a catalyst for new ideas, designed to explore social media and information
technology’s power to advance medical practices, improve health, and empower patients to participate in their own care. But Medicine X also seeks to engage and empower those unable to attend in person to still get involved in the discussion.

Through Medicine X’s Global Access program, main stage content from the three-day conference will be made available through a high-quality live stream. Anyone with an Internet connection around the world will be able to view keynote speakers such as Daniel Siegel, MD, clinical professor of psychiatry at University of California-Los Angeles and author of The New York Times bestseller Brainstorm: The Power and Purpose of the Teenage Brain, and panel discussions such as Gonzalo Bacigalupe's focusing on the e-health movement and inequality among marginalized populations.

“Medicine X has distinguished itself through a singular commitment to inclusivity and by finding new ways to bring every voice and perspective into important conversations about health care,” said Lawrence Chu, MD, associate professor of anesthesia at the School of Medicine and the conference’s executive director, according to Stanford's press release.

The Global Access program encourages ePatients, academic scholars and students to participate in the conference virtually. In addition to watching main stage presentations, virtual attendees may engage in real-time discussions with those in attendance at Stanford via Twitter.

In 2013, Medicine X broke all records for the most tweets per day from a health care conference, besting even TEDMED and HIMSS, according to analytics data firm Symplur. More than 3,500 participants engaged with Medicine X via Twitter, making it the most talked about conference of the year with nearly 27,000 tweets in three days.

MedX's reach: Symplur's choropleth map shows
from where tweeters engaged with the conference.

Medicine X also had the highest engagement of U.S.-verified physicians among the four top healthcare conferences and the largest and most diverse program for patient engagement of any leading healthcare conference.

“Medicine X is all about people working together toward changing health care for the better, and everyone is welcome,” said e-patient Hugo Campos, according to Stanford's press release. “Patients are on an equal footing with all other participants, and that’s fundamental for fostering true partnership toward change."

The “X” in Medicine X is meant to evoke a move beyond numbers and trends—it represents the infinite possibilities for current and future information technologies to improve health. For the Global Access program, X also represents what it costs to tune in to the live stream. X is the value virtual attendees get from the experience. X is what it’s worth to be included. X is up to you.

Virtual attendees must register to access the free live stream. At any point during the three-day conference, live stream viewers may choose to contribute in recognition of the content provided. All funds raised support Medicine X’s effort to provide access to the community at large. To view the full schedule and register for the Global Access program, visit medicinex.stanford.edu.

However, the only way to access the expansive content not shared on the Medicine X main stage is to attend in person. The Medicine X Master Class program, a series of small-venue seminars taught by experts in specific disciplines, will feature Lloyd Minor, MD, dean of the School of Medicine; Charles Ornstein, Pulitzer Prize-winning journalist and senior reporter at ProPublica; Wendy Sue Swanson, MD, pediatrician and author of the Seattle Mama Doc blog; Bryan Vartabedian, MD, assistant professor of pediatrics and director of digital literacy at the Baylor College of Medicine; and Roni Zeiger, MD, CEO of Smart Patients.

“As a pediatrician trying to change how we deliver health care, Medicine X is a lens to the future for me,” Swanson said, according to Stanford's press release. “Innovators, developers, nurses, patients and staff come together to improve the architecture of seeking and delivering health care.” It’s a place where the hallway is as exciting as the stage — the networking, the stories and the solutions and partnerships that come out of Medicine X have been transformational for me.”

Medicine X is a project of the Stanford University School of Medicine Anesthesia Informatics and Media Lab, and is sponsored in part by the school’s Department of Anesthesiology, Perioperative and Pain Medicine. Other sponsors are Stanford Hospital & Clinics, the Agency for Healthcare Research Quality, Stanford Hospital Corporate Partners Program, Eli Lilly COI and Boehringer Ingelheim.

Connect with Medicine X on Twitter @StanfordMedX and follow #MedX. Find Medicine X on Facebook at facebook.com/stanfordmedx.


ePatients, learn more about Medicine X's ePatient Scholars Program!
The 2015 application cycle will be announced before year's end. 

Monday, July 14, 2014

Design for Your Future, Design for Yourself

Recently faced with making a series of major life changes, a friend of mind decided to apply design thinking principles to his personal situation. He had accepted a fabulous new job that would require leaving the town he loved and long called home for our nation's capitol and doing so in a relatively short timeframe. Familiar enough with D.C., he started his relocation process with the information closest at hand — the dog and the cat were coming with him. And then he interviewed himself.

"I asked myself questions like: self, what kind of place do you want? What should it be near? What do you dislike about your current place? I made Post-Its with my must haves, wants and dislikes," he wrote.

Post-Its are a key component to the process at IDEO—the Silicon Valley design firm where my friend and I have been lucky enough to explore questions that begin "How might we..." and focus on patient-centered solutions within health care. Post-Its allow one to jot down an idea or make a meaningful doodle that is then both tactile and disposable, preserved but not permanent. From the multicolored confetti came a series of hotel stays in various D.C. neighborhoods to practice the commute to work and sample local restaurants. "In other words, prototypes," he wrote. 

I'd like to say that when I decided to approach my problem of achieving better work-life balance concerning my job as a magazine editor, my consulting and advocacy and my relationships with my family, friends and self that I too reached for my Post-Its and Sharpie. Rather I took a very literal approach to form following function. I made a flow chart, or perhaps more accurately, a decision tree

The goal was to determine what personal parameters I would apply in deciding whether or not to accept an opportunity. Some opportunities offer an abstract pay off while others come with cold, hard cash. Some clearly are worthwhile while others offer nothing by way of joy or enlightenment. For all there is a price to be paid, as saying yes to one thing limits one's ability to say yes to another—doing two things half-heartedly is no greater accomplishment than doing one thing well.

I spent a week on my own posing questions, redirecting arrows and contemplating additional possibilities before I sent my draft decision tree out to a group of personal advisors for review. Advocates praised it. Company managers played devil's advocates. And my friend who was designing his new life first suggested, "Seems like you are really wrestling with getting paid for doing the work you want to do," and then asserted, "Follow your damn dreams."

Following dreams inherently is easier when others believe one's dreams are worth following and thus will help make those dreams come true. I am fortunate in that this is the case for me and my dreams. It is enormously satisfying to know that those in the industry I have come to respect and admire seem to feel the same way about me. Their encouragement, partnered with my own stubbornness, has kept me moving along this path. 

Shortly after completing my decision tree, I had cause to implement its process, and accept a year-long contract to serve as administrator of an ePatient scholarship program that enables advocates to attend one of the foremost health care conferences. I also will be leading a workshop on making clinical trials more patient-focused and speaking at this conference as well as speaking at the world's premier nephrology conference. I have applied for a two-week design thinking internship with the intent of researching generosity in relation to financial giving so as to further develop strategic plans for my nonprofit and to a mindfulness in health care symposium focused on patients and caregivers within palliative medicine. If I am selected, I will consult my decision tree to determine these opportunities' return on investment. If I am lucky, this fall will be busy, financially feasible and personally and professionally rewarding. 

Too often I hear complaints from people who are so overwhelmed by what they have to do that they have no time for what they want to do. I say—put in the time and effort to determine one's priorities, to establish standards such that saying no allows one to say yes to something better. Design not for your current self but the self you want to be. 

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