Breaking the Silence

What a week we’ve had.

Last weekend, one of the most dear and most cherished people in my life threatened suicide.  This beautiful person had a date, a plan, and a rationalization…everyone’s lives would be better without them (I realize not grammatically correct, but I will respect their privacy).  This gorgeous, successful, loving person has it all, or so it seems: a successful and busy career as a great physician, a truly happy marriage with a loving spouse, wonderful children, a beautiful home, a flossy car, fancy vacations…the list goes on.  On the surface, this person has the absolute definition of a perfect life.  On the outside looking in, there could be nothing in the world wrong for this person.

Yet, beneath the veneer of those Insta-worthy pictures, a storm rages.  Self-doubt, insecurity, Imposter Syndrome, Depression, and loneliness are a few of the invisible demons.  We spoke for a very long time, and we managed to talk through the storm, to see the rainbow on the other side.  This beautiful human still lives.

In the handful of days since those heavy and heart-wrenching conversations, I have now lost a mentor (also a physician, writer, and artist), a style maven (her style strikingly similar to my own), and a foodie/wine icon (who inspired me think of new food as an opportunity, he was cantankerous but fabulous)- all purportedly due to suicide.  Each one had been an inspiration to me, and they are gone.

My heart breaks.

What can be done?  As I think of these four people, they are have something in common: by all appearances, they seem successful, are/were wealthy, well-established, had families; the world has been shocked by these suicides.  We do believe these “things” are enough to make us happy.  We assume that successful people are happy, but this is not always true.  They were likely depressed (but maybe still high functioning) before they were successful- and unless it is addressed, they are likely to remain or return to depression after the sheen of the successful life wears off.  The old internal monologues resurface.

If we are waging a war against suicide- we are losing it, in my opinion, because we aren’t fully acknowledging the problem.  We aren’t acknowledging the depression- we hide it.  We aren’t reaching out to hold these people as a community.  We shun those with mental illness.  But, if we’re being honest, we all are or could be in their shoes.

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True Friends

On Sunday afternoon while my kids nap, I take a few moments to look at my week ahead.  I already know I’m going to be grateful to get to Friday- and it’s still Sunday afternoon.  In fact, I can get so wrapped up in the upcoming week, that I forget to enjoy the here and now.  I still have several more hours of weekend time, but my mind is already jumping ahead to Monday.

Friday is a big day; hubby and I are supposed to hear some rather large news on Friday (could be good or bad).  If you pray, please pray for this news on Friday (or rather, our acceptance of whatever the news is).  I’m shaking in my boots, and I don’t consider myself generally easily ruffled (unless it’s a scary movie).

I am thankful to have friends and family, and I try to distract myself by thinking of a recent (fabulous) trip to Texas to see my BFF.  I hadn’t been back to Texas in years, and it was wonderful and therapeutic to see her.  We enjoyed shopping, eating, drinking, and all kinds of girly fun- which I don’t usually get with my house full of boys.  I didn’t realize how much I’d missed her- and also that side of myself.  I need to find more of myself in my day to day.

Thinking about my days, though- I realize that very little of my day is actually mine.  From the moment I wake up, to getting to work, to getting home and doing the dinner/bath/bedtime routine, and working in exercise and hubby time…there is nothing left over for me.  Not only that- but there is the paradox of the working parent: viewed as lazy at work (usually because of having to leave at a certain time to pick up kids/family duties), and viewed as a sub-par parent (the guilt of being away from your kids all day).  The working parent can not win this paradox- and I’ve seen and felt both sides.  My hubby feels this paradox, too- it is not even reserved just for women.  All of this can leave someone feeling very…lost.

I guarantee it is happening to a working parent you know, if you aren’t already that working parent.  This is where our friends come in- our tribe- to put a stop to the madness.  They are little mini-vacations in every text, call, or hug.  A reminder that we are loved, noticed, cherished.

To all of my true friends- thank you.  From the bottom of my heart. My next goal is to make myself my own true friend, too.

Some people make   Your laugh a little louder   Your smile a little brighter   And your life a little better

 

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The Storm

Every Monday morning, I find myself in a countdown to the weekend- the Monday through Friday rat race that we find ourselves locked into.  No matter how many obstacles the week may hold, we tell ourselves to “Push through” to the end.

We create a plan for success.  We set our alarms the night before, so that we wake up in plenty of time to get out of the door.  We might have already laid our clothes out, meal-prepped for the week ahead, or rehearsed that presentation for the 4th time.  We prep ourselves in any conceivable way, to ensure our success.

Then, the unexpected happens- and you know what it is.  Like a big hairy green monster, something unexpected uproots our carefully laid plans, tears it into a thousand pieces, and blows them away like dandelion fluff.  Some days, this unexpected thing almost seems like it was purposefully planted there, just to make our day more difficult.  Sometimes, it’s a string of unexpected things; other times, it’s just one very big unexpected thing.

Does anyone else feel it?  Something big and unexpected is coming.  The air feels different, like when you can smell the rain before a spring storm, taste the dust before a dust storm, or see the sky turn that sickly shade of bluish-green before a hail storm.

Our next move is the most important.  Do we:

a) Batten down the hatches- hide in a protected spot out of the storm’s path?

b) Run- try to outrun or avoid the storm altogether?

c)  Stand still- observe the storm: feel the raw energy of the rain drops as they pelt your skin and soak your clothes, allow your coiffed hair to become unpinned, and watch the powerful beauty of the storm?  Do you simply observe or do you become the storm?

d) Get so caught up in the rat race that you have unknowingly ignored all the signs of the storm, and now are caught off guard, unprepared, in the middle of a flooding highway?

At different points in our lives, we have been in every single circumstance.  In fact, we are sometimes in every circumstance within the same week.  There are many times in our lives when the storm can be completely overwhelming, times when we unknowingly outrun or avoid a storm, and times when the “storm” turned out to be just a sprinkle or two.

If every week feels like a new storm, you’re burning out- if you’re not already burned out.  We weren’t meant to live in a constant state of panic, to constantly feel as though we need to run/prepare/hide/avoid.  It may be time to re-evaluate your week.  If every week is a push to the weekend, with very little sparkle during the week, it’s time to re-evaluate.

What is “the end” we are trying to reach?  In this case, “the end” is the weekend- a time to relax, let our hair down, be ourselves without rushing here and there and everywhere.  Anyone ever notice that when a storm comes up on a weekend, it’s not such a big deal?  We have the bandwidth to handle the unexpected on the weekend- the flexibility.  It’s glorious.  A mini vacation, of sorts (except with laundry, dishes, and cooking)- a time for our minds to readjust.

Finding ways to inject more flexibility during the week- whether it’s committing to fewer school/work/extracurricular activities to allow flexible timing, or perhaps adding yoga/meditation to increase our mental flexibility- makes the week easier to get through.

Though my career choice is all about delayed gratification- 12+ years of delayed gratification- I am not alone in realizing that it’s healthy to have a little bit of gratification (or sparkle) to each day, so that we are flexible enough to handle the “storms” when they come our way.

Inspirational quotes and sayings about summer: “Rise above the storm and you will find the sunshine.” -Mario Fernández

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The Business of Medicine

I believe moderation is the key to a healthy, well-balanced life.  Though medicine is a field that touts moderation for our patients, it paradoxically demands excessivity from our physicians- leading to depression, poor work-life balance, frustration, suicide, and burnout.

The relatively more recent increase in employed practices (i.e., owned by a corporation or hospital) means a loss of autonomy for physicians, complete with the “pressure to increase production.”  Protests made by physicians stating that patients cannot be distilled into “production units” are met with consistent pressures to see more patients in less time, double book, and increase the work day.

Many physicians are fed up.  Our work is undervalued, our time becomes less precious, our patients are given less time.  The tides are starting to change; physicians are beginning to speak up in larger numbers (which makes us harder to ignore), but it will take a movement before they listen.  Patient care quality is always more important than quantity.

I have met many physicians who are burned out, spoken with many young people disinterested in medicine, and see the longevity of my field shrinking.  We have got to continue to demand work-life balance, more time with our patients, and improve the quality of life for our colleagues.  The fact that we face a dire physician shortage upcoming dictates that we must start to improve the field now, so that we can attract and retain future physicians to the field.

I strongly believe that this includes improving maternity leave policies, pumping locations and availability, childcare coordination, and acceptance of females in the workplace.  It has been a “boy’s club” of sorts since the institution of the field, yet 2017 was the first year female students outnumbered male students matriculating into medical school.  As a field, we need to start listening to our female colleagues now, to understand what challenges must be overcome in the future for these upcoming female medical students.

We need to unionize; I am under the impression that physicians are not able to unionize in the political sense, but in the sense of coming together to improve quality of life for all physicians.

After all, for many fields, “It’s not personal; it’s business.”  Medicine, however, is inherently personal; we need to change the culture.  We need to advocate for ourselves, which is something not all physicians do well (very much including myself).  There are many CME offerings regarding the business of medicine; I believe this should be taught in medical school and all the way through residency.  If we are to win this game, we first need to learn the rules.

Next, we need to treat each other respectfully, from medical students to attendings, and everything in between.  This is a huge cultural change, but necessary if we expect to retain people in this field.  From my own experience, I can say that a young, blonde female physician never stops fighting for respect- true also for minority physicians (regardless of gender).  If we don’t treat each other with respect, how do we expect our patients and administration to respect us?

Finally (but not lastly), we need to demand quality patient care be rewarded.  I’m not talking about Press-Ganey scores (or other customer-satisfaction surveys), which are easily invalidated.  What I mean is specifically good patient care- which should be determined by us, the physicians.  We need to set the standards for measurement of quality in our field, rather than allowing non-clinical administrators to determine how to define what we do.

Let’s take medicine back.

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Through the Eyes of a Child

As a child, I frequently thought that I was an absolutely unremarkable person.  I am a middle child in my original family, which means that I was not necessarily remarkable in my birth order or in my point of view of life.  I was naive and idealistic; I was introverted in social situations but outspoken in small group settings.  I was shy but had courage in my convictions, even at an early age (probably to the dismay of my siblings, lol).

Now having my own children, I can see the reckless abandon with which they live their lives.  They are each incredibly remarkable in and of themselves; they truly are individuals.  They surprise me with their innocent and beautiful views of the world, and they remind me of the things that were important to me as a child.

Some of those things I still do, but many I’ve let go (mostly due to lack of time and effort):

1. I loved wearing pink.  It is, in my eyes, the most cheerful color in the world.  Then, I loved all forms of pink.  Now, I really love a blush pink; not too “bubble gum,” which conjures almost a cloyingly sweet reaction from some.  Rather, the blush is more subtle.  I would love to paint a room in my house Magnolia Rose.  Unfortunately, in a house full of boys, I haven’t carved out a space that is just mine.

2. I had large swaths of time to read- for pleasure, not limited to studying only.  I have read mountains of texts, literature, and articles in recent years, but reading for pleasure is a rare occurrence.  Yet, it was such a beautiful way to escape from reality, even for just a small while.

3. Prayer/meditation- I used to watch the sunset in the painted desert sky, or watch the stars twinkle over the lake.  There was something very grounding about this, something that brought peace and order to my days.  The sunset had always brought a sense of peace to my days, until I suffered from Post Partum Depression.  Suddenly, this symbol of the end of yet another day felt like I had not accomplished enough, that the day had slipped quite through my fingers.

4.  I allowed myself creative and athletic time.  In school, we had “Art class,” which was always one of my favorite times of day- I could forget everything but the canvas.  “Gym class” was a little harder, since I was very self-conscious, was always picked last for any team sport, and frankly, I looked a little different, being taller than my other classmates (so awkward).  In college, I finished almost all of my required courses in the first semester of my senior year.  The second semester I filled with classes and I wanted to take, but felt there wasn’t time: pottery, particularly, but also racquetball and athletics. I had a blast, even in the athletics class- and began walking regularly with my roommates.  In med school/residency, there were not classes for these things; so I did various things over that timeframe: I played volleyball for a short stint (I was again, one of the worst on the team), I ran a half marathon, I painted at a wine/painting studio.

Here is my theory: when we are children, we are the purest form of self.  I believe that those years are useful to help teach us about ourselves, about our core beliefs and values.  Thus, for those of us who are burning out and exhausted, perhaps it is time to rediscover our truest sense of self, and rediscover our inner child.  Look for those clues, those things that still call to us, even after all this time.

In the spirit of this theory, I sat with my older child yesterday and watched the sunset over the mountains.  It was gorgeous, as if the skyline was on fire.  There was a sense of beautiful poetry with my son watching the sunset, just as I had many years ago.  We both sat in awe of the beauty before us, not speaking (much) but absorbing.

The world demands every minute of our time, but we need to take back the control of how we choose to spend that time.  Look for the clues from your childhood, take your younger self by the hand, and follow your heart.

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Authenticity

Somewhere along the way, I lost myself.  I felt that I needed to change so that I could “fit in” with the culture of medicine.  On my first day of residency, I showed up in pink heels, a skirt, and a pink blouse.  My hair was curled, my make-up was done.  I felt excitement and nervousness, and wanted to appear both feminine and professional.  I resolutely refused to change my appearance to one of the more “acceptable” uniforms: boxy scrubs or black pants and a button down shirt.  I had always believed that dressing for success was real, and that even if I was nervous about my first day- my professional appearance might help to bolster my nerves.

Rather than being seen as a prepared professional, though, my appearance garnered the wrong kind of attention.   Some of my male colleagues stared at me, and some even commented on my “nice legs.” Hospital staff whispered behind my back, and bolder nurses told me where I could find scrubs.  Patient after patient told me that I didn’t “look like a doctor.”  The attending asked me to bring coffee, while the rest of the residents went to table rounds to discuss patients.  At then end of my day, my attending told me I had not picked the right career, that I was not cut out for neurology.

Defeated, I went home.  I knew what I needed to do: I replaced my pink blouses with scrubs, I stopped highlighting and curling my hair, and I traded my high heels for (gulp) crocs.

Looking back, I can see that the prejudice didn’t stop, despite my wardrobe change.  A surgeon told me that not only was I not cut out to be a physician, but women in general shouldn’t be in medicine- or drive.  He told me that women were a waste of medical school seats- that we couldn’t compare to our male colleagues, since most of us took maternity leave and then exited the workforce or only returned part-time. A different male attending told me to “stop reading about lipgloss,” while my male co-residents played x-box in the physician’s lounge.

I had caught the eye of a few males, and had been outrageously hit on at work; there were unprofessional texts about watching or touching me, “accidental” bumping into my boobs or butt, and unwanted prying into my personal life, like “Do you have a boyfriend?” type questions.  It was obvious sexual harrassment,  but I was at a distinct disadvantage- I was just a resident.  These men were my superiors- my career was at stake.  I had proof of my would-be allegations, but I knew I would face retribution if I brought it forward.  I was furious and appalled, seeing that there was very little protection in place for this kind of harassment in medicine.  Already being told by a few attendings that I was not cut out for medicine, I was afraid to bring forward these men, knowing that they had power to end my career.

My husband and I had our first baby in residency, and when I was pregnant, a lot of the harassment stopped- for a while.  When I returned, it had changed flavors somewhat: I was not given time to pump for my newborn and comments were made about how inconvenient my leave had been for my male colleagues (one even jokingly declared that no one else was allowed to take maternity leave).

As a female physician in training, I realized that if I wasn’t being unfairly sexualized for my appearance, I was seen as an occupational hazard for reproducing (a very distinctly female rite of passage).

When I graduated, I ruminated on the fact that I had shown all of them wrong- I had made it.  And for a while, that was enough.  For a while, I luxuriated in the fact that I was no longer a resident- I was an attending; I was the boss.  It’s been some years since that graduation, but it is no longer enough to simply have graduated, knowing that there are women in medicine still suffering like I did.

However, even as an attending, even as the boss- I still am told that I don’t “look like a doctor.”  Patients ask when the doctor is going to come in, even after introducing myself.  Staff still asked when my attending was going to round, or ask which doctor I am working with- and refused to look at, or maybe ignore, the fact that my badge and coat both state my name and credentials.  I have been bullied by a male surgeon who inappropriately cancelled a stroke alert: “Young lady, I have been in this field for over twenty years.  I trained at Johns Hopkins.  I will decide when the stroke alert is called on my patients,” and my CMO (at the time) did nothing to correct him or support appropriate stroke alerts.

I gave up- I burned out.  I became jaded and sad.

But after thinking about the difficulties and iniquities of my path, I realize this: if we are doing nothing to teach our female students and residents how to present and protect themselves, we are doing them- our future- a disservice.  I will not change who I am or what I look like for this job; it’s not worth that self-sacrifice.  If I am not actively doing what I can to change the toxic and sexist culture of medicine, it was all for nothing.

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Blackwell Beauty

I love the spa.  I really, really love the spa.

There is something magical about the relaxing music, hot tea, snacks, magazines, and (of course) the Piece de Resistance: mani/pedi, massage, scrub!

When I was pregnant, I looked for creams and lotions with as few added ingredients as possible, knowing that it was best to limit certain chemical exposures during pregnancy.  I fell in love with Lush, but my favorite face scrub, Let The Good Times Roll, was about $32 for just over 8 ounces.  I knew I could do better than that at home, and I could control the quality of the ingredients.  But who has the time to create a line of beauty products??

Well, I decided to make the time, and I haven’t looked back.  I realized there may be other women who are looking for the exact same thing, and I hope this can be helpful!

Blackwell Beauty Butter Bars:

 

Blackwell Beauty Body Scrubs:

 

Remember to take some time to love your body this week.  After all, it is a temple.

 

1 Corinthians 6:19 - Verse of the Day 6/26/14 - Whats in the Bible "Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own."

With the turning back into rags after midnight....

In the near future, I hope to create a video tutorial to make your own scrub at home, for any who may be interested!

 

xoxo

Lauren

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The Sounds of Silence

After the tragedy in Florida, I see + hear a lot of other words: soapboxes, dialogue, love, hate, anger, bullying, acceptance, and rejection.  I see people not necessarily speaking to each other, so much as writing strongly worded diatribe on social media, hiding behind their screens, not actually hearing each other- just wanting to make their point.  As Simon & Garfunkel said, “People talking without speaking, people hearing without listening.”

What I also see is that my voice is not the one that needs to be heard right now- though there are many voices that do need to be heard.

So I listen, I ponder, I consider…before I decide how to speak.  For now, a moment of silence from me means that I could use this platform to lift up another voice, someone I believe needs to be heard.

This incredible young woman, Emma Gonzalez, represents a new generation- who is fed up with the shootings. You may not agree with her, but her voice deserves to be heard, by virtue of what she has survived.  After all, she is from a generation different from many of us: she grew up practicing “active shooter” drills at school, wondered if her classmates might someday cause harm, and now grappling with the reality that her classmate did kill.  Her reality is different from many of ours, her voice (and the voices of her classmates) should be louder than any others.  And we, as the responsible adults (theoretically) in this situation, should be listening- really listening, displaying maturity and kindness, realizing that these young adults have already withstood more carnage than many of us may in a lifetime.  Though they are young, this kind of experience changes people; ask anyone of our Veterans, ask physicians, ask those in war-torn parts of the world, those who have lost a son or daughter (and many others).  Senseless death and destruction (and witnessing such) will change someone for the rest of their lives.

So, let’s take a breath.  I think we all agree that there should be no more school shootings.  We don’t reach solutions by screaming at each other and tearing each others’ eyes out. But something must change. We cannot expect different results if we change nothing, after all: nothing in life works this way.

Here is Emma’s speech.  She is passionate (of course), and I believe she deserves to be heard (whether you agree or not), because she stands where many of us have not: she is a survivor.

The other words I find particularly poignant at this time are the lyrics from Simon & Garfunkel’s prophetic song, The Sounds of Silence, the relevancy of which cannot be denied:

[Verse 1]
Hello darkness, my old friend
I’ve come to talk with you again

Because a vision softly creeping
Left its seeds while I was sleeping
And the vision that was planted in my brain
Still remains
Within the sound of silence

[Verse 2]
In restless dreams I walked alone
Narrow streets of cobblestone
‘Neath the halo of a street lamp
I turned my collar to the cold and damp
When my eyes were stabbed by
The flash of a neon light
That split the night
And touched the sound of silence

[Verse 3]
And in the naked light I saw
Ten thousand people, maybe more
People talking without speaking
People hearing without listening

People writing songs that voices never share
And no one dared
Disturb the sound of silence

[Verse 4]
“Fools”, said I, “You do not know
Silence like a cancer grows
Hear my words that I might teach you
Take my arms that I might reach you”
But my words, like silent raindrops fell
And echoed in the wells of silence

[Verse 5]
And the people bowed and prayed
To the neon god they made

And the sign flashed out its warning
In the words that it was forming

And the sign said:
“The words of the prophets are
Written on the subway walls
And tenement halls
And whispered in the sound of silence.”

Listen more, talk less. When you listen, you learn. When you talk you're repeating what you already know.
For a laugh:
Grumpy Cat | I WISH MORE PEOPLE WERE FLUENT IN SILENCE | image tagged in memes,grumpy cat,silence | made w/ Imgflip meme maker
pinterest//mylittlejourney ☼ ☾♡
 

Let’s listen, hear each other, and find the ways we can make change together.

xoxo

Lauren

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Whiskey-Mint Cough Syrup

This cold/flu season is rough, for sure.

We all have colds at my house right now, but back at Christmastime, my mom made some DIY cough syrup that not only tastes good, but it also uses up all those leftover candy canes from the holidays.

Whiskey-Mint Cough Syrup

Yield: 20+

Ingredients

  • 1/2 c. water
  • 1 c. candy canes
  • 1 c. whiskey
  • 2 c. honey
  • optional: 1/4- 1/2 c. lemon juice (to taste)

Instructions

  1. Boil water in saucepan; turn heat to low-medium and add candy canes.
  2. Stir frequently, until candy canes are melted.
  3. Take off the heat and add whiskey, honey, and lemon (if desired).
  4. Simmer on low heat 3 minutes, and remove from heat.
  5. Allow to cool to room temp and pour into bottles; store in cool, dry place.
  6. *If honey begins to sugar, can reheat.
http://www.theblackwelllegacy.com/2018/02/13/whiskey-mint-cough-syrup/

Obligatory disclaimer:

 

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Seeds and Weeds

When my grandma passed away, I created seed packets with Forget-Me-Not seeds inside, for anyone and everyone to plant in her honor.  She loved flowers, and I believe she would have loved the physical and metaphorical overlays between planting new seeds at the time of her passing. Here’s a pic:

 

Now, I love flowers, but I have no patience.  I plant seeds, but I immediately want to see growth.  When a week passes, and I still see no results, I become impatient.  I would be the worst farmer- and indeed, I have no (living) plants in my house.  I am the palliative care of gardeners- I gently escort them out of this life.  I joke about having a “Gray Thumb.”  I fully intend to plant these seeds, but it’s anyone’s guess if they’ll live.

My mother is the opposite- patient, steady, consistent.  She has lots of beautiful plants in her house.  They flourish in her presence- no matter where on earth we’ve lived.  I think it’s a little disgusting that they just continue to look fabulous amazing that she is able to nurture, so effortlessly.  She will have fields of Forget-Me-Nots.

I pondered this.  Part of being a good gardener is balance.   It is, in part, letting nature take its course, without interfering too much (again, very hard for me to do): don’t unearth the seeds to see if they’re sprouting, don’t overwater, etc.  Another part (equally important) is not neglecting- don’t forget to water and fertilize, don’t forget to weed the garden, etc.  The last part is to enjoy the harvest- enjoy with family and friends, share the seeds with other gardeners, perhaps store away for the winter.

Obviously, I’m not talking about gardening.  When thinking about the garden of my life, I oftentimes get sidetracked by a variety of different “seeds” and “weeds.”  By focusing on which things I would like to see reach full bloom, I can better decide which seeds to plant (or not), and which things are plants vs. weeds.  By thinking about my end goals and purposes, it becomes much more clear which of the “weeds” that come with everyday life require weeding out, which plants may need more attention/water/fertilizing, and which plants needs a little more or less sunshine.

This week, I need to answer a few questions about my garden of life:

  1. Which plants do I want to see in full bloom in 10, 20, 30 years?  What are things that I want to be able to say I have done by the end of my life?
  2. What are the “Weeds” in my life?  How can I get rid of them?
  3. Am I overnurturing or undernurturing any seeds I have already planted?  Can I restore balance?
  4. Are there new seeds in my life I need to plant, but haven’t realized yet?
  5. How will I pass these seeds on to future generations?
  6. How can I enjoy the harvest, and with whom will I enjoy it?

 

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They tried to bury us, they didn't know we were seeds #quotes #motivation…

xoxo

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