THE PRESSURE OF MEETING THE DEADLINE

All of us might have experienced deadlines in some way or the other. The deadline can be sometimes quite short but no matter whether the deadline is short or not, it always gives us pressure. And this pressure keeps us stretched and straight towards meeting the deadline. So, today I am going to tell you about the pressure we face when we have a deadline. As we know, Pressure is a situation wherein we feel the urgency to complete a task in a very little time and maybe, with a very little resource. It compels us to complete the work on time and also, in a way that is effective and fruitful. The pressure always monitors our mind, so that we can give our best in a very limited time period. Sometimes it may result adversely. As all of us know working in a peaceful and relaxed environment is better.

I have experienced the pressure of finishing the work in a given deadline. And whenever I had this, I was completely into the work. Whenever I got a deadline, it seemed very important to complete the work as soon as possible. And for this, I would do whatever felt necessary and time-saving. Yes, you got it right. Whenever there is pressure, we want the work to be completed as soon as possible. Also, we take care of the effectiveness of the work. Maybe we succeed at it but somewhere something gets wrong. Do you know what is it? It is mental peace. Whenever we are under the pressure of completing any work on time or managing more than one thing at a time, we become a bit anxious. Whenever I am in such situations, I become restless. This restlessness, however, results in completing tasks on time but for this, I tend to skip my meals and would stay awake. Unless until I finish the work, it stays on my mind and even if I sleep, I am unable to have a sound sleep. Further, it results in my frustrated and furious behaviour. Sometimes it affects my health but one thing is sure that whenever I am in such a situation, I get annoyed easily on small things.

It was the year 2017 when I had to manage a function as a part of my academics. So many responsibilities were on my shoulders and so were the expectations. Undoubtedly, these two things came with working pressure. At first, I was calm. Maybe because I decided to carry things in a relaxed way or perhaps I thought it will be very easy, but eventually my calmness turned out to be stormy. I was experiencing pressure because the time was very limited and we had so much to do. I was handling several responsibilities. All of them were of equal importance. Those, whom I was supervising, didn’t get the scolding because it was me, who was assigned the work.

At that time I had an insight – pressure arises when the time is limited and we are in a very relaxed state. Gradually the deadline seems to be near and the work seems to be never-ending. Maybe at the beginning, we think, I’ll complete the work before the deadline and we get involved in other things or we might become lazy. And hence the pending work scares us. We become agitated. We get furious over little things, everything and everyone seems disorganized. Though we end up getting praises for being on time and carrying out things in a good way but our mental state seems to be in turbulence.

COME WALK IN MY SHOES FOR ONCE!

Waiter: How would you like your coffee, Ma’am?

Me: With kids tucked in their beds.

And the next scene, waiter scratching his head, “What does that mean?” 🤔.

Ok, that was just an exaggeration, nothing of that sort has happened so far.  But trust me parenting is never an easy job. And unlike any other job it doesn’t come with a manual.  So the foot is always on the pressure pedal.  From healthy eating habits to good etiquette; from studies to extracurricular activities; from explaining them about their bodies to respecting their privacies  – we have much more to look after and we can’t  take up fancied portfolios as per our ease.  I repeat parenting isn’t easy!

And the pressure of parenting a child with special needs is altogether a different ball game. Ask me!

In the year 2014 when it was finally established that my son is Autistic, I went blank.  I sensed it, yet wished it not to be.  Since then to this day it’s always been a run – from pole to post.  With such a diagnosis tag, an entire army of questions spurt up in front you. Though I don’t belong to that school of parents who decide a career for their offspring even before naming them but I must confess that at this point of time I worry about his future. ” What would happen to him after us?”, “Who would take care of him?”, “What would be his future like?”, ” Will he ever be able to take up some formal education?” And the questions  continue to infinity.  The fear and pressure, looking at the world around is immense.

Soon after, the school was informed about the diagnosis and they took no time to ask us to take him out of the school as they were not equipped with the expertise to work with an Autistic child. I don’t blame them for that, trust me.  It was the first jolt as he had no place to go by then and was still on the waiting list of the day care section of the hospital. But my prayers were soon answered and things kept rolling since then as far as his schooling was concerned as he later got a place in special school and he is continuing.

So where’s the pressure?  Pressure churns when he is unable to express himself about the intangible things like pain for example,  for he is still non-verbal (though now he has started uttering single words about the things he likes, for example: pasta, park, school bus 😁 etc.).  And it’s equally difficult for him to comprehend “NO“.  If he wants something badly he just wants it and won’t take a ‘No’ for an answer.  I can’t explain the consequences to him as I could do to my daughter.   He simply shuts himself down, though unintentionally.  And that causes major meltdowns – could be a result of many factors, sometimes without any apparent reason. And when meltdowns strike, he goes all violent, shouts, cries, taps hands and legs on the floor vehemently, simply lies down on ground and that ground can be of a bus stop, pavement, supermarket, literally anywhere.  And with people oblivious to your situation watching you with a judgmental overview, shivers are sent down the spine and the voice chokes while hands go numb and cold.  While handling and calming him (which sometimes take really long and sometimes I am clueless about what to do) along with keeping an eye on the second child is enough pressure to take, explaining the onlookers “Why and What” is equally painful.  I simply hate telling people about the issue, about why he is behaving absurdly.  Few People tend to understand, few come forward to lend a helping hand but few make faces (really few so far, shall I care about them🤔?). Whatsoever maybe the reaction I always have a bated breath and watch of an eagle when out with him. Going to stay this way, at least for a while😟.

Also searching and booking a place for him in the activities during long vacations (Belgian calendar has too many for kids 😁) is nothing less than pressure cooker situation for me.  With really limited number of places available, his constant need for individual attention makes it real tough for me to have one place ready for him.  I usually start working three to four months in advance for he enjoys his activities, he enjoys discovering and I want him to.  There are instances when I was rejected straightaway.  Bearing it all and to be on a look out constantly is my job now. By the way, his autumn break is busy!😁

Who helps me out? Family and friends – too obvious, isn’t it?  But I have an elongated list here:

  • Surprised you will be to learn that I owe Facebook too a thanks.  When you read a lot of stories from all around the world from people sailing in the same boat on one page it definitely refills the depleting levels of confidence.  It reminds me, “You are not alone and we are together, let’s make it a better place“. So many motivational and inspiring stories kicks in the positivism I need.
  • Organisations working for and with my son including his school.  Their innovative ideas, patience and moral support have gone a long way in making things a bit better and every bit matters. They told me that “You Are Strong” and that helps, period!
  • A lady, my friend whom I am unable to meet often but we do have long conversations often (that’s technology for you 😁) and she is full of wisdom. Always gives a positive perspective of looking at things and instills courage in me. I can’t name her here since no permission taken but I would drop a hint to her – an experienced trainer of English language/ business communications. Thank you dear.
  • And last but not the least – my kids themselves.  My daughter – just three of age but acts like my shadow to her brother, gives me a ray of hope.  And when my son laughs with me, plays with me, embraces me, it seems he is giving me a message “mamma, you, me and God will set things straight“. By the way I forgot to tell you that he seems to be more inclined towards the supreme power as at home he spends a great amount of time singing devotional songs 😁😁.

 

Did I tell you that sometimes my son gets up at 3 or 4AM in the morning and demands a breakfast – that’s also a pressure – 😂😂😂.

And for all those who have free advise on what shall I do to raise my kids prim and proper I request, “Come walk in my shoes for once”.

 

 

 

AVOID DEPENDENCY TO HANDLE PRESSURE WELL

I am worst at handling pressures. Yeah, you might think how I can say that being a leader. But it is a truth about me that I shout a lot, get bogged down a lot and get stressed out easily when I am under a pressure situation.

Yet, in certain occasions I am very strong and handle the pressures much better than how other can handle in the same situation. So my behaviours vary from different pressure situations. In some cases I struggle and in some other I show the real character.

Negative life situations always have negative or positive effects on a person. It will either make you or break you. And it is different than daily pressures of life. I am good at handling long term pressure situation but not well at managing a daily one. The reason could be that I am accustomed to doing things slowly and when a pressure situation demands to do things or accomplish something quickly I tend to get worried or stressed out. When I am asked to do things or decide things right away or quickly it’s very difficult for me to come to a conclusion or manage it. And it is more pathetic when your decision is dependent on people. I love to do things at my own pace and deciding on my own. I hate pressure cooker situations. So I take precautions. Let me give an example…

It was last Sunday in the afternoon when I received the news of my granny’s death. And there are very few tickets available next morning on Monday and if we had to travel in the same night we had to catch a bus as there were no train tickets available. Now I was depending on three persons around me to take a decision.

First one was my wife who was confused whether to go with me or not.

Second one was my brother who was confused when to go considering his hospital duties.

Third one was my uncle who actually was ready to help me out but wants to go according to his schedules.

My wife knows how irritated I was that evening. I was scolding and was frustrated and the whole evening I kept discussing and struggling to take a decision till I decided I will go on my own and bought the ticket by-passing everyone else. I travelled to Cuttack comfortably and alone at the end.

I learnt one lesson from the whole pressure situation – “Never to be dependent on others when I can accomplish something very important on my own.”

THE SURGICAL CONUNDRUM

Chatting with some med students, a good question was raised: how do we, as doctors, deal with the emotional baggage we encounter in our profession? It’s high stress, we see disturbing things, and sometimes we make mistakes that can result in harm to patients. The pressure and responsibility can be very hard to handle.

These stresses, if unmanaged or poorly managed, can carry severe consequences for physicians. Burnout is rampant among docs (and trainees, too). Doctors have high rates of divorce, substance abuse and have the highest suicide rate of any profession.

A normal day at my job is hard: I’m running nonstop for 8 to 12 hours, I’m constantly interrupted, I have patients making demands of my attention and empathy, I’m saturated with information and need to make rapid decision without adequate information, and I know that if I make an error or miss some important piece of information, the human, professional and financial consequences can be disastrous. It’s a pressure cooker.

And that’s a day where things go well. A bad day can be very bad indeed. Sometimes it’s just the emotional strain of dealing with particularly difficult patients. Maybe you go through a run of giving out terrible diagnoses. Maybe you deal with the death of a child. Or a patient who pulls at your heartstrings in some unique and personal way. Maybe someone dies on you unexpectedly. Worse, maybe someone dies on you and you’re not sure if it was your fault or not. Perhaps you know you made an error, and that you’re going to have to face accountability for it.

These are the days that drive physicians over the edge. I’ve had them, and I remember them so vividly even years later. There was the one lady with a gallbladder attack on Thanksgiving, many years ago. She had classic signs and I saw gallstones on my bedside ultrasound. She crashed and died right in front of me from a ruptured thoraco-abdominal aortic aneurysm. Her abdominal aorta had looked normal on my scan; the aneurysm was in the chest and ruptured into the thorax, which is very unusual. That didn’t make it any easier to go home and sleep that night.

So I guess my take on the question is not how do we deal with the psychological stress but how should we? I am not an expert, but here are my thoughts.

The first step, which most practicing professionals have already accomplished, is to learn what is called “professional detachment.” This is an unnatural skill in which you must suppress your innate sympathy for the suffering experienced by a fellow human being, pain which you may be personally inflicting. The first time you stick someone with a needle, it’s probably as traumatic for you as for the patient. More advanced applications involve you ignoring someone’s pain or personal tragedy while trying to figure out the hidden life threat. This is a necessary skill if you are to function in the medical environment.

Another way to think of the same skill is to maintain a sense of distance. Remember, an older teaching physician once told me, the patient is the one with the disease. This helps you remember that the patient’s condition is not your doing (usually) and their outcome, if negative, is the result of their disease and not necessarily a reflection on your care.

While this detachment is useful and necessary, it can be maladaptive if taken to extremes. First of all, as a physician you do need to express empathy and compassion. It’s part of the job. But the emotional demands will be overwhelming if not governed in some fashion; we have limited capacity for caring. My solution is to dole out my compassion and empathy in measured doses, as appropriate to the case and my own mental state. This is not a license to be callous and uncaring in other cases, but rather to be polite, professional and reserved, emotionally.

Furthermore, you need to understand that the professional reserve does not equate to repression of emotion. You suppress it, in the moment, set it aside to get the job done, but that doesn’t mean it never happened. For minor stuff it probably is okay to suppress it & forget it. But the bad things — they won’t go away on their own, but will fester and bubble up at the most inopportune moments. You need to take some time, when appropriate, to unpack the experience and re-live the emotions to deal with them. Maybe it will be just turning the case over in your head the next day. Maybe it needs to be more immediate. We’ve sent docs home after bad pediatric arrests when it was clear they were so upset they needed some time. It’s essential, in any case, to explore the disturbing feelings so you can come to a resolution and move on.

Many institutions will have formal critical incident debriefings for the entire team, for particularly awful events. While this doesn’t need to be performed formally for routine events, it’s a good idea to informally debrief with a trusted partner, superior or mentor. Talk through the case, review the medicine and the science, review your actions and outcomes, and your emotional response to the situation. It is helpful to do this with someone you respect, so he or she can give you valuable feedback. This can be over coffee or a beer or three; possibly better that way.

There can be a lot of shame involved when there was a bad case, even when well-handled, but especially so when you know that you made an error or may have. A lot of docs like to bury these as deep as possible. But these in particular are helpful to talk about, and the more publicly the better. This is not easy, but can be invaluable. We instinctively shy away from openly talking about our mistakes, but when you do you will probably receive a lot of support from your colleagues, many of whom have done the same or understand that “there but for the grace of god go I.” An additional benefit is that your mistakes may have been due to a system error or a cognitive bias and by reframing the discussion in an educational light, by seeking out the root causes, you can improve the quality of your own care and that of your partners.

Keep a sense of perspective, and try to stay positive. When the job is really getting you down, take a break, go out to the ambulance bay, take a few deep breaths and try to remember the big picture. We have a great job. It’s a privilege and an honor to be allowed to care for patients. We can sometimes make a huge difference in people’s lives. We have respect and status in society, and are quite well paid for it. Many people would give their right arm to be where you are. Yes, seeing the 10th drug seeker of your shift is a drag, but damn, it’s still better than sitting at a desk and moving numbers from column A to column B.

Sublimation is a defense technique that is particularly valuable in the ER. It is a form of displacement where the negative feelings are transformed into something positive, or at least more-or-less acceptable. The most common form it takes is “gallows humor.” Tragedy and comedy are deeply linked, and a morbid witticism can provide a lot of relief of the emotional tension that builds up in a clinical setting. Others may channel these feelings into art or literature. To each their own. If this is not your thing, find an outlet. I practice karate, and there’s nothing like pounding the hell out of the heavy bag — or a white belt —after a bad day.

Finally, and possibly most importantly, when you know you screwed up, when you know there was an error that harmed or may have harmed a patient: forgive yourself. You are human, as are we all, and we make mistakes. Take the time to understand it, do your best to learn from it, and forgive yourself. Let go of it, file it away, and move on. If you don’t or can’t, self-doubt and self-hate will paralyze you and in the end it will sink you.

One last thing: if you are really having trouble, get professional help. If you’re self-medicating, or if you are bringing work home to the point it’s affecting your family, be humble and realize that doctors can benefit as much as (or more than) any other patient from psychological counseling and support. Many hospitals have a confidential Physician Assistance Program, staffed by professional counselors trained to deal with the issues doctors struggle with. I’ve seen doctors torpedo their careers with behavior and substance issues, and I’ve seen programs like these successfully rehabilitate physicians who were in a downward spiral. Check with your medical staff office and use the resources that they offer.

THE PRESSURE OF BEING NICE

 

So, this used to be my problem some time back. I was (hopefully) a people pleaser kind of a person who would go to any level of discomfort to make people happy. Who were these people? Family, friends, acquaintances and sometimes even strangers. Why did I do that? Was I seeking some sort of validation about me from these people? Or did doing so make me happy? Not really. I am not sure why this was the case – but the situation turned around for me a few months back. I hit the rock bottom at that time feeling worthless with complete lack of self-respect.

I cried, I threw things in anger, I kicked myself and I did a lot more for being such a jerk. I hated myself for not standing up for my own feelings. And then something happened. Something changed in me. I did something that I never did earlier – I replied back assertively (to my Mother in law). Then came a long period of a cold war which was torturous but I stood my ground. I decided that I will not go back to being who I was – if this relationship is important to her as well, she will have to initiate the talk this time. To my surprise, she did. She did that after a few weeks and things came back to normal. This made me realize that I just had to go through that period without giving in. Sometimes it is important to give an opportunity to others to be nice to you. This has always been difficult for me.

Something similar happened at work. In a meeting I was expected to say a “Yes” like I always do, but I stood my ground and said “No, I do not agree. With all my authority I will stay with my decision.” There was silence in the room for a few minutes and then people just looked at me and said ‘Ok’. And sky did not collapse that day. Work was as usual and this time thankfully nobody had to take a brunt of my decision.

Both these incidents were highly liberating for me. It was like the cap of the pressure cooker was released and my head became lighter and lighter with all steam rushing out of it. I realized that I just had so much time to be creative and think about myself when I do not have the pressure of being nice to all.

Another pressure that disturbs me a lot is the one of looking good. So, you see it is not just important for me to be good to others but also look good to others. Every time somebody would come and tell me that he/she lost a few kgs – the pressure would just double. It would triple itself when FB shows “see your memories” and I get to see the pics of myself from years ago. “Why the hell is it so difficult for me?” After climbing on that weighing machine for almost 5-6 times in a day – I would wonder what I am really doing wrong. And there was no answer ever. After trying out all known diets, workouts, supplements, homeopathy, Ayurveda meds – I was dejected.

Then one day I woke up and asked myself – what would change in my life if I would suddenly weigh about 15 kgs lesser than what I am now? I would be able to wear those jeans and skirts that are hiding inside the bed box. What else? People would come and compliment me. What else? That’s it. Really? That’s it. Just for these minute things I am taking so much pressure.

I am my own enemy when it comes to building pressure. I have done that since my school days. I always took hell lot of pressure of my studies when I could have just taken a chill pill – the world wouldn’t have fallen if I scored a few marks lesser.

Deadlines at work don’t make me feel pressurized. In fact it really excites me. Working without deadlines is rather boring. It is like swimming in an endless ocean of work. I like to swim and swim really fast when that finish line comes closer and closer. Working becomes really exciting when that release is on the horizon. And then the sense of achievement that follows the success. Nothing makes me more motivated at work.

I am learning to be nice to myself and not to take pressure of something that is unnecessary. I am trying not to take pressure and to speak my mind. I have learnt to respect myself before others. It is difficult, really difficult and many times I fall back to my old self.

 

 

 

 

 

 

LET THE LID OFF

 

Long back the Welsh post W.H. Davies opened his famous poem ‘Leisure’ with the lines –

What is this life if, full of care,

We have no time to stand and stare.

These lines stand true even today, in fact, in a more profound way. Technological advancements, considered to be a mark of development were meant to make life easier, simpler and less hectic. But, a peek into our own lives and into the lives of those around us would surely give us a different picture.

Before workplaces were digitized, manual paperwork mounted pressure on both employees and employers, and of course resulted in systemic delays. Today with digitization, we still have overworked employees with employers desperate to continue their visibility in a market of steep competition.

Without home appliances, household work seemed so cumbersome. Now with tools and appliances of all possible types, the pressure still remains.

Pressure is not merely the presence or absence of certain elements (people, situations, conditions) in our lives, but also the perception of it all. Take a school/college examination for example. One student feels pressurized to perform well, whereas another is too cool about it (keeping all other conditions constant). Both write the exam and score approximately the same. What’s the difference? One was too anxious. The other was not.

While many of us are made to feel the pressure and acknowledge the same, some are more prone to picking up the stress from the air just by the sniff of some probable occurrence. While there are no cut-out solutions for all types of pressures, some coping mechanisms that work well in most pressurized circumstances are worth enumerating.

  1. Avoid gossip, suspicion, scandals and rumours of all types in all circumstances. Of the major sources of unwanted tension/ stress/ pressure are these listed above. Do not let these dwell in your heart and mind. Somebody has written the following lines very aptly –

If some bit of gossip come,

File the thing away;

If a scandalous, spicy crumb,

File the thing away;

If suspicion comes to you

That your neighbour is not true,

Let me tell you what to do –

File the thing away.

 

Do this for a little while,

Then go out and burn the file.

                                                                                         – Anonymous

  1. Delegate responsibilities and tasks. You may be the best planner in your house or the most meticulous performer in your team. Still, do not shoulder the tasks of everyone upon yourself. One clever way of people shifting their share of responsibilities on to you is by a word of appreciation. Don’t be deceived. Stick to your work. Of course, you can lend a helping hand to others. But, do not be too naive to fall prey into such tactics.
  2. Do not procrastinate your to-do tasks. Prioritize instead. When there are too many assignments for a given day, we tend to put off certain tasks for another more convenient day. At times when the time constraint is real, such a step is needed. But frequent procrastination when chores can be well done the same day, leads to piling up of tasks and hence, an increase in situation.
  3. Open the lid when required. Imagine a pressure cooker that doesn’t let out the accumulated steam. Such a pressure cooker is a faulty appliance and is a potential threat to one’s safety. In the very same way if you allow too much pressure to pile up within you, you put yourself at risk. So, let the steam out.
  4. Take time off. Take time off from work to be with family. Take time off from family responsibilities once in a while to rejuvenate yourself. Work these out and you’ll be amazed as to how your productivity and efficiency be it at home or work, improves.
  5. Do not keep abuse to yourself. If you are a victim of any form of abuse be at home or work, do not keep the saga to yourself. Don’t endure the pressure by building tall walls around yourself. Share with trusted people and seek help.
  6. Alternate caregiving. If you are taking care of an ailing family member, keep alternate caregivers handy. They may be relatives or friends or hired helps. You need to avoid the burn-out so that you are available during the most crucial times.
  7. Seek suggestions. When in dilemma, especially during phases of decision-making, seek suggestions from experienced people. Don’t lead yourself to splitting headaches thinking about the pros and cons of things you don’t know much about.
  8. Find ways to give vent. Hit the gym. Cry. Sing. Spend time in the lap of nature. Talk with friends. Eat your favourite delicacy. Visit the shopping mall of your choice. 
  9. Share it with God. No matter what be the pressure situation in your life, you can share it with God. Pour out your heart before Him. He may seem to be a silent listener. But, He is a compassionate worker behind the scenes as well.

Apart from these general tips of handling various pressures, situation-specific ways of coping with pressure will be discussed in different articles this week.

Remain stress-free and release the pressure.