December 2017 – Page 2 – watercress words by Dr Aletha

Most viewed post #4 -5 steps to manage stress and strain

Read the 4th most viewed post on my blog this year about managing stress #stressmanagement

In the 4th most viewed post I offered some personal reflections.

I developed the post idea after reading a medical journal article about ways to help patients dealing with depression with or without medication. The article offered advice helpful to anyone dealing with a crisis, or even the ordinary stress of life.

When I wrote the post, I was dealing with a personal health crisis, so I had the chance to take my own advice. (We physicians tend not to do so.) Now, the crisis is resolving, but I intend to continue to practice the

5 steps to manage the stress and strain of life

As a college graduation gift, I gave a friend’s son a gift certificate to Barnes and Noble Bookseller. He earned a mechanical engineering degree and will work as a rocket structural engineer.

He sent me a nice handwritten thank you note (which few people do these days) and said he plans to use it to buy a book that other structural engineers recommend. The book is Roark’s Formulas for Stress and Strain.

Wouldn’t it be nice if there were a formula for handling the stress and strain of life?

Many health issues would resolve or be easier to manage if life stressors would just go away. Three fourths of the patients treated by primary care physicians have problems aggravated by emotional, social, or behavioral issues.

Life’s interruptions and disruptions won’t disappear, but you can make them less of a strain on your time, energy, and resources. There’s usually no quick fix but 5 steps can lessen their impact.

I’m learning the value of these steps now as I deal with the stress of a foot fracture that is not healing as expected. I’m now facing surgery to correct it, and a longer convalescence than I expected. For someone who is used to being active, this prolonged inactivity stresses me both physically and emotionally. These 5 steps were already a part of my life, but consciously choosing them now helps me cope with what would otherwise cause frustration and sadness.

5 steps to manage life’s stress and strain

1. Create and maintain a routine and schedule.

Having a plan for your time helps you feel more in control of your life. Resist the tendency to become socially isolated or avoid activities you usually enjoy.

a smartphone lying on a calendar page with a planner and cup of coffee — from Lightstock.com (affiliate) stock photo site

Times of crisis, loss, or illness may leave you feeling disconnected and adrift, but having a schedule provides structure and connection. When you are busy, you are less likely to feel overwhelmed and hopeless.

2. Recognizing and reaching out to social supports

Your family and friends are your first line of support during times of stress and duress. It’s nice if we don’t have to ask for their support, but their lives are busy too, so don’t be hesitant to ask for help if you need it. If they don’t call you, call them.

2 women talking over coffee with open bibles — Conversation over coffee can be therapeutic. graphic from the Lightstock collection( affiliate link)

Other sources for help include your healthcare professionals; don’t be embarrassed to share that you need social and emotional support. Your doctor can help you identify and get connected with community resources.

Look for help from your or your spouse’s job, your religious community, organizations you belong to, your school, and online resources for support- educational sites, forums, support groups. Although not as personal as face to face support, these are helpful if you are geographically isolated or mobility is difficult.

3. Reframe by refocusing on the positive rather than the negative.

Recognizing and emphasizing the positive in life makes the problems less overwhelming and distressing. Look for something to be grateful for, or that brings a little joy into your day. It may be as simple as flowers blooming in your yard, your favorite tea and sweet, a funny story in a magazine.

balloons-get well IMG_2269.jpg — Balloons are nice, too.

Remembering and observing happy events, occasions, and celebrations can also be sources of renewed joy.

Norma, a woman facing terminal illness, reframed her crisis by finding joy in small things, like jigsaw puzzles, new foods, and a “good perm”. Read more about her at

Driving Miss Norma- a book review

4. Stay active mentally and physically

Physical activity doesn’t have to be a chore, boring, or expensive. Many things can be done at home or in your neighborhood-walking, bicycling, cardio, yoga. If exercise isn’t your thing, try dancing, gardening, swimming.

If your physical mobility is limited, try something stimulating mentally-sewing, crafts, games, puzzles, writing, cooking are just a few possibilities.

5. Nurture your inner self

Sometimes we need to withdraw from outward activities and stimulation for times of quiet rest and reflection.

You may find help from mindfulness, meditation, prayer, devotional reading, music, journaling, or a combination of these approaches.

Breathing exercises can lessen anxiousness and tension.

Free Loose Leaf Tea Filter and Free Shipping with any Mighty Leaf Wellness purchase. (affiliate link)

In this post, a retired nurse blogger uses gardening for both exercise and mindfulness.

The Zen of Gardening

“But what I like most about gardening is how I can get lost in the moment of whatever I’m doing; whether it’s planting, weeding or pruning. It truly is a togetherness of body and mind.”

Tyndale House Publishers offers spiritual and devotional books.

Try their free Reader Rewards Club at this link.

Affiliate disclosure; some of the photos in this post are from Lightstock, a source for photos, videos, and graphics. With a free account, you can get a weekly free photo.

Learn more at this link.

cheesy-free faith-focused stock photos — Please visit Lightstock.com for quality photos, graphics, and videos (an affiliate link)

RoboForm Password Manager. (this is an affiliate link)

You’re likely reading this post on a computer, tablet, or mobile phone, so you visit sites that require a password. How do you remember them all? You don’t have to if you use RoboForm Password Manager.

a sketch of various electronic devices — RoboForm Everywhere to manage your passwords

My husband introduced me to RoboForm years ago and I am glad he did. I have used it continually to remember my passwords so I don’t have to. It syncs to both my computer and my phone so my passwords are always available. It will even generate passwords for me.

Go to this link to try RoboForm Free; if you like it you can upgrade to RoboForm Everywhere version with all the features I mentioned above. With Roboform, you will have one less thing to feel stressed about.

Please share with your friends and

follow Watercress Words as we explore the HEART of HEALTH.

Thank you. Dr. Aletha

Most viewed post #5 -Driving Miss Norma- a book review

She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness

The 5th most viewed post of 2017 was a book review. I think I was first attracted to this book by the title; it reminded me of one of my favorite movies, Driving Miss Daisy starring the late Jessica Tandy, Morgan Freeman, and Dan Aykroyd.

The plots are quite different but both stories are about an older woman and illustrated many of the same themes-family, friends, relationships, aging, illness, disability, and death. They both show how people do or don’t live life to the fullest.

Driving Miss Daisy was fiction but Driving Miss Norma is true, and her family keeps her story alive in this book and on social media. I’m glad so many of you read this post, and are reading it now, and I hope you will read the book.

Driving Miss Norma

One Family’s Journey Saying “Yes” to Living- a memoir

By Tim Bauerschmidt and Ramie Liddle

Harper Collins, 2017

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book. I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel trailer they parked in campgrounds and Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

Atul Gawande- Being Mortal-book cover — This book caused Norma’s daughter-in-law Ramie to being thinking about end of life issues in a new way

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon — Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States — Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

You can continue to follow Tim and Ramie on Facebook where they are still

Driving Miss Norma

2 DOCS TALK reflected on Norma’s decision to forgo cancer treatment in this podcast

Do You Want a Long Lifespan? Or a Long Healthspan?

Driving Miss Daisy was a Pulitzer Prize-winning play brought to television starring

Angela Lansbury and

James Earl Jones .

Now available as a DVD or

watch online.

The Power of Meaning: Crafting a Life That Matters

by Emily Esfahani Smith

“In a culture obsessed with happiness, this wise, stirring book points the way toward a richer, more satisfying life.”

To explore how we can craft lives of meaning, Emily Esfahani Smith considers an array of sources–from psychologists, sociologists, philosophers, and neuroscientists to figures in literature and history.

Drawing on this research, Smith shows us how cultivating connections to others, identifying and working toward a purpose, telling stories about our place in the world, and seeking out mystery can immeasurably deepen our lives.

She explores how we might begin to build a culture that leaves space for introspection and awe, cultivates a sense of community, and imbues our lives with meaning.Inspiring and story-driven, The Power of Meaning will strike a profound chord in anyone seeking a life that matters.

Support Independent Bookstores - Visit IndieBound.org

About the Author

Emily Esfahani Smith’s writing has appeared in the Wall Street Journal, New York Times, The Atlantic, TIME, and other publications. She is also an instructor in positive psychology at the University of Pennsylvania, as well as an editor at the Stanford University Hoover Institution, where she manages the Ben Franklin Circles project.

Drs. Paul and Lucy Kalanithi reflected on their experience facing terminal illness in this review-