Fact is, we’re always practicing something… we might as well be intentional about it.

“What nine months of attention does for an embryo, forty early mornings will do for your gradually growing wholeness.”                                                                                                                                                                                             –Rumi, The Illuminated Rumi

My Story of Practice: How the Physician Was Born

I practice medicine. I’ve practiced medicine from the very first inkling in my mind, thirty-five years ago, that I would one day become a physician. When my professor said, in my first class in nursing school, “nursing is not medicine,” I was already beginning to practice medicine. Her comment was meant to mean something positive about nursing, that it was unique and distinct as a profession (which it certainly is). What her statement meant to me, to my great discomfort and disappointment in that moment of hearing it, was that I was in the wrong place. The two years of prerequisite course work, the expectations, the fixed idea of being on the right track, all evaporated in that single moment… and thus my new direction was born.

My practice of medicine began with that very first understanding of what medicine wasn’t, with the collapse of my ideas about nursing, that expanded into new possibilities, at the base of my new mountain to climb, the mountain that I could not see clearly yet, the mountain that continues to challenge and delight me, the mountain of my journey as a physician.

I had to wrestle with the idea of me going into medicine. What audacity it took to imagine myself on this new path, not quite mine in the beginning. There were to be the years added onto my college preparation and the huge monetary investment required (I had no money). So many considerations and complications to contend with.

That wrestling and audacity–my practice–paved the way to my future.

Over the months, after hearing my professor’s words, I struggled, dared to imagine, questioned, attempted to stay satisfied with nursing, researched the path into medicine, cried, and, with encouragement from friends and family, I finally arrived at acceptance of my new, undeniable direction. I arrived at a decision about my true calling, though it was still vastly beyond my perceived reach, I had chosen to believe, however blindly and naively, that I could do it. It was just an idea. But it grew into a powerful idea. I couldn’t let it go. It had me.

My practice of medicine began with the idea, grew into a vision, expanded into the decision, became a commitment, and exploded with the work I undertook in pursuit of my dream, each and every day. I didn’t know what the hell I was doing, but I was all in. The physician was born. Her practice well underway.

Then there was chemistry and physics, calculus and biology. Anatomy and physiology and biochemistry. Each class, itself, a mountain to climb. My mountains. One at a time. Expanding my knowledge, growing my awareness of myself as a learner, laying the foundation for what was to come.

Then medical school and again, one class, one clinical rotation, and one experience at a time. Histology, cell biology, pathology, pharmacology, internal medicine, ICU, obstetrics and gynecology. Growing my doctor brain. Expanding my neural networks of the doctor mind.

Fast forward to residency, post-residency, seeing patients in my own practice. Discovering how the conventional medicine paradigm that shaped me so profoundly had disappointed me. Once again facing a new direction, a fundamental shift, a minefield of uncertainty about my direction. My training got a lot right, but an awful lot wrong. It was not the holy grail of healing that I had hoped it would be. I learned the politics, history and shenanigans that made our healthcare system what it is: human, fallible, ripe for change.

With so much more to learn from Life School, my brain stretched and morphed to take in these changes: to learn Functional Medicine, to affirm the mind-body-spirit reality of my patients and of myself, and the bearing of this holistic picture of humanity on illness and healing.

Practice is Showing Up

Every experience of my life–every patient, every training, book, idea and new horizon, every success, failure and disappointment–has shaped me, made me who I am. Together they have become the essential threads of my growth and evolution. One experience at a time, folded and shaped into my brain, my synapses, my neurochemistry, my mind, my entire being: my practice of medicine.

Every moment of my personal evolution as a physician and as a person has been a practice, amplified by fierce passion and perseverance. Every accomplishment and improvement in my thinking and abilities has been the result of showing up and doing the work–all shifting and shaping me–bit by bit, day by day, week by week, year by year.

My success—indeed all of our successes—arise out of the very first decision that we make, that first inkling of a direction. The brain grabs hold of the idea and it unfolds, evolves, explodes, and gives birth to something unimaginable, miraculous, even holy.

Our minds with their vast potential, the manifestation of ourselves through belief and a multitude of decisions, commitments and hard work—through practice—all of these things are holy.

We’re Always Practicing Something

We’re always practicing something. Always.

When we think we’re just living our lives, thinking our thoughts, minding our business, we are practicing. All of our dreams, aspirations, thoughts, imaginings, ruminations, efforts, skills, habits, and quirks come about as a result of practice.

We’re creatures of learning. Repetitive thought and behavior lead to the development and expansion of our neural networks—the mind pathways of our learning and achievement. What we do or think or don’t do strengthens our neural networks to support (or undermine) our future proficiency at everything.

And practice makes progress, deepening and strengthening all of our ways, regardless of how they serve us on our paths–nourishing and ennobling us or damaging and sabotaging. So we may as well be intentional about it.

Practice is the Secret to Our Success—at Everything

We are born to learn and wired to succeed through practice.

Not natural talent, not giftedness, not exceptional resources, not luck. It’s more the actions we take–choosing, planning, imagining, showing up, and implementing. Not magic or stunning genius. Add a sprinkling of tenacity, grit, and perhaps audacity, and virtually anything is possible for all of us.

Practice leads to progress. The longer we practice and the more we bring to it—commitment, time, structure, improvisation, and determination—the more competent and proficient we become.

It has been suggested that ten thousand hours of practice can take us to the expert level of whatever we do. Practice something for long enough eventually leads us to a deep maturity and mastery that allows us to flow, to become so skilled and competent in our chosen work that we “lose” ourselves in our endeavor. The yogi masters called this “bliss.” The late psychologist, Abraham Maslow, called this “peak experience.” Elite athletes call these “flow states.” This is our potential and what can happen if we practice long enough and well enough. We can succeed. We can heal.

Practice Powers Healing

Sustainable healing requires practice.

The well-worn, long-established habits, thoughts, emotions, and patterns of behavior that have become so comfortable may no longer serve us or support our health and wellbeing.

We may need to revamp how we eat, sort through our pantry and kitchen, learn new recipes. We may need to work on becoming more conscious about ourselves, about how we think and behave. We may need to get quiet, breathe deeply and take time out of our busy days to reflect. We may need to work on sleep, reduce stress or start exercising.

All of these endeavors involve change, learning new information, and acquiring new skills–all needing to be practiced.

I’ve needed to learn all of these things, one at a time… always starting with a decision, then a plan, and daily practice.

Practice: Claim Your Superpower

It all starts with an intention: make a decision.

Practice.

Repeat.

Show up daily.

If it’s important, work hard.

Choose faith and determination.

Allow for mistakes.

Fall down.

Fail.

Ask for help.

Get up and get back to work.

Set a new intention and perhaps tweak it.

Practice.

Focus on just one thing–and embrace the sacrifice (we can’t do it ALL, at least not well).

Repeat.

With time and practice the miracle of transformation will be felt and realized.

Today’s Practice

You may not know yet what you want to begin working on to improve your life, but you do know yourself, and my guess is you know what you’d like to change.

Reply to this post and tell us the thing about your life (your health, your energy, your joy, whatever!) you’d most like to change. Then, write out your intention—your decision—to make the change happen (even if you have no idea how you’re going to do it).

Make your intention “sticky” by keeping it positive and present tense. This harnesses the deep resources of your inner wisdom and brain power. It invites us to support you and cheer you on.

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Resources

Malcom Gladwell. Outliers: the story of success. 2011.

Angela Duckworth. Grit: the power of passion and perseverance. 2016.

KARYN SHANKS MD

Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-five-year career. She believes that the bones of healing are in what we do for ourselves.

 

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