Friday, November 21, 2014

How Ballroom Dance Makes Me a Better Doctor

Amy Rothenberg, ND 11/06/14 10:28 PM ET
I was at the Barcelona airport with my husband listening to "Red & White & Blue & Gold" by Aoife Donavan. It's the perfect rhythm and feeling to inspire a nightclub two-step. I grabbed my surprised husband and there on the mezzanine, my iPod in his shirt's breast pocket, he gave me a beautiful dance with all the swaying and turning and dips that can be tucked into that style of dance. Ballroom dance has gotten under my skin and I cannot get enough of it. As a naturopathic doctor, approaching 30 years in the field, I think about how social ballroom dance makes me a better doctor.

First there are all the things consistent exercise, which involves body and brain offer: more energy, a clear mind, excellent sleep. I have a lower resting heart rate, better endurance and more flexibility. My balance is improved as has my overall feeling of wellbeing. There is a way that learning something entirely new spills over and has me energized and excited about other parts of my life.

Between a newly empty nest, a cooperative work schedule and a willing partner, the past two-year's immersion in social ballroom dance has been complete. Like the truly faithful, we have gone four to five nights a week to learn and once or twice a week to a social dance to practice and enjoy. We have danced in cities across American and in Europe as our teaching schedule allows. The social, musical, sensual, cognitive and physical elements, the demands and rewards, suited both my husband and I and added dimensions to our lovely long marriage while also bringing new and wonderful people into our lives.

But there are some things unique to ballroom dance that I relate to being a doctor and some ways in which immersing in this world helps me in the clinic. The ones I'd like to focus on are: 1. Frame 2. Finding, strengthening and keeping access to one's center 3. Timing and rhythm 4. Connection/the dynamic of lead and follow 5. Broadening confidence 6. Mindfulness/mindlessness 7. The idea of a complete experience

1. Frame: While attending a recent medical conference, several long-time colleagues asked if I had grown taller. At 54, I seriously doubt any climb up the height chart, but good frame, standing tall and broad, with shoulders back and head straight forward gives that appearance. I have always had good posture and know the power of walking tall into a room, which of course has less to do with actual height and more to do with how you carry yourself. When you have good frame as a follower on the dance floor, you can follow most any capable leader. And when you have good frame as a leader, you can lead most any follower. It's a mutually encouraging part of dance, where you help your partner immeasurably by constantly working on your own frame. When I am following in the confident arms of a well-framed leader, I know I can relax a bit, it's the near contradiction of ballroom dance: the better and more secure your frame, the more relaxed the dance.

How does this help in the clinic? The concept of frame and posture, so central to ballroom dance is relevant in the office, literally & figuratively. I focus on frame and structure, on having office routines that work, having patterns with patients that streamline my efforts. My posture toward my patient: open, compassionate, dispassionate and non-judgmental, are other essential pieces to my practice of naturopathic medicine and I would think any kind of medicine at all. Ballroom reminds me to periodically assess the framework in the office and recommit to it; I reinforce the good habits and free myself to do the work at hand.

2. Finding, Strengthening and Keeping Access to One's Center: This is the secret to every beautiful dancer and is at once the simplest thing while also intermittently elusive. Once you find that centered place, which starts in your core but permeates your whole system, strengthening it and keeping clear access to it is so essential in ballroom dance, even when not always articulated. Like a lot of things in life, you have to take care of yourself first. As that skill is developed the next step is sensing it in your dance partner, which is when the ability to dance together lifts right off. If you can find that and stay true to it in dance, it improves every style of dance you might choose to learn and each dance you might take with a partner on a given evening. When I practice from this place as a doctor with my confident, calm, centered self leading the way, patients benefit. Further, I would add, my learning and further articulating this piece for myself has me looking for it in my patients, encouraging them to look for it in their lives as one route to more complete healing. When I look for those things that give my patient's life meaning, if I are able to understand their pathology in context of the rest of their life, and see how the ailments impact their ability to find and keep access to a balanced and centered place, and then help them to get better, I am aiming my medical approaches in exactly the right direction.

3. Timing and Rhythm: It's obvious that in dance, timing and rhythm, pacing and a sense of the music helps a whole lot. A fun part of social ballroom dance gathering is to hear a few bars of a song and know implicitly by the rhythm and the tempo if it's a Foxtrot or a Waltz or maybe a dance you could do either Cha Cha or West Coast Swing to. The music gets in your bones and the desire to move is nearly irrepressible. My husband and I have been known to stop the car when a really good song comes on, like Smooth by Santana, and do a little Cha Cha on the side of the road. Or grab a bit of West Coast Swing to Back it Up by Caro Emerald in the middle of dinner! Being exposed to all kinds of music from different eras and vastly varying styles has been its own education and I appreciate how essential it is to inform and inspire many forms of dance. How does this relate to patient care? It has underscored a sense of many things for me related to pacing, including how long a patient visit is and how to keep on schedule. There is a rhythm to case-taking and timing related to performing a physical exam. And like in dance where I might periodically lose the rhythm or lose the count, I can self correct. With a patient I am more keyed into when we have gone off topic, or when I have not used my time well: I constantly work to improve my skill set here.

3. Connection/The Dynamic of Lead and Follow: In terms of connection, in the world of social ballroom dance, there is an understood premise that with each person you dance with, you try to give that person the very best dance of the evening, whether you are leading or following. This requires being open enough to connect with your partner, focusing only on them for the duration of that song. With so many distractions in our lives, what a gift it is to focus on one person only. This has reminded me to be this way in the clinic too, where I train myself to shut out everything else and make it my singular job to connect with my patient, regardless of what else might be going on around me, in the office, in my life.

The need to connect with your dance partner is a given. The particular dynamic of lead and follow is also central. As a long time feminist, I rather balked at the whole concept of men leading and women following as typical roles. I had to let go of trying to control anything at all when learning to dance. My only job was to follow my leader's lead. In time, I found that kind of surrender rather appealing. If I took care of my frame, focused on my own center and understood the basic count of the dance and let the rhythm of the music surround me, that's all I had to do. About a year in to learning ballroom, I decided to also learn how to lead. I am enjoying the challenge of learning the other side, the different part of the brain it engages and how it has impacted my following. It widens my overall understanding of each dance style and perhaps most importantly, allows me to better understand (and appreciate!) what my leaders go through each time they take me in their arms. In a medical setting the idea of lead and follow shows up all the time. As I doctor I am leading my patients in some ways but I also rely on my patients to lead me, especially to guide me to understand what is bothering them. This year as I have undergone treatment for breast and ovarian cancer, I have seen first hand the lead and follow from the patient side, too. An engaged patient who brings their perceptions, thoughts, feelings, and understanding to bear, is at least for me, the very best kind of patient and allows the lead and follow to unfold. The give and take of information, knowledge and resources are prime examples of lead and follow in the naturopathic medical practice.

6. Broadening Confidence: Any time we can do things that bolster confidence it crosses over into other parts of our lives. I have seen this time and again with patients, family members, friends, and myself, when efforts and energy has been spent on developing a skill or competency, especially when it takes time & dedication, other areas perk right up. For me, I feel that influence between ballroom dance and my medical practice and know this is a positive kind of cycle to be in.

7. Mindfulness/Mindlessness: Like any new skill, at first we must be extremely conscious of everything we are doing. With ballroom dance, here are typical things that might go through your mind: Where are my feet? How do I hold my arms? Where should I look? Should I be moving my hips? Oh my God, I must look like an idiot! How does the teacher get his head to move like that? Oh dear, I'm off rhythm. The list goes on. Similarly, I remember first learning how to do a physical exam. It took so long, each little part of it, leaning in to look into a patient's eye, or trying to hear the different sounds of a beating heart. I thought, oh my God, what patient will want me to take an hour doing a screening physical? I was so conscious of each of my movements, trying not to be too clunky, trying to remember how to turn on my otoscope, let alone use it. I so much wanted competence! But the more I practiced, the more I did feel capable. Just like dance, the more you do it, the better you get. And then one day, someone asks you for a waltz and before you realize it, you're swirling around the room, not a care in the world, not thinking, not trying, not focusing on anything in particular, flying really, and you're dancing! Like in anything, getting to that point is worth every minute of study, frustration and practice. Now when I am with a patient and in my unconscious yet quite focused state, it's the same thing. I do not think too much when I am doing a physical or taking a patient history. I am present, I am focused but I have also relegated much of my skills to the unconscious mind. By spending years and hours and lots of dedication I went from being incredibly mindful and focused, to a more mindless time, where I steeped in the art of medicine.

8. A Complete Experience: Many pursuits we have in life have a very long arc to the reward. Many activities are partial or you can only get through some of the project at a time. Some of the most important things like parenting or creating a career or nurturing love take place over decades and longer. There is a way that dancing to one song, from beginning to end and doing a good enough job, is simply put, a pleasantly whole and complete experience. If I have kept frame, been in touch with my own center, connected with my leader or follower and paid attention to the music, I have probably had a lovely dance.

In my practice it is immensely satisfying when working with a patient to feel like we have been thorough, taken into account the whole person and created a plan that raises the person's overall level of health while also addressing their chief complaint. I do not always hit these markers either on the dance floor or at the office, but I like to think of this as a possibility and aim for it every day.

Finally, my own immersion in something new and something fun has me encouraging others, both in my practice and in my life, to do the same. Of course, it does not have to be ballroom, but anything really, that catches your fancy, captures your attention and demands your dedication. Enjoy!

No comments: