Sagarmatha Beckons

At the beginning of last year, I was reading a travel magazine and came across an article for a trek to Everest Base Camp. The pictures of the world’s highest peak and its surrounding landscape were breathtaking and I immediately wanted to experience the trek to the third pole. However, the article also mentioned that although the trek did not require mountaineering experience, “trekking in Nepal is for active people in good health who enjoy vigorous hiking…. We expect participants to be strong, experienced hikers in good physical condition…and a good physical conditioning program must be undertaken several months in advance to get into shape.” Therefore, I set out to create a plan of action to optimize my chances of completing the trek. While, the details of the plan of action are irrelevant, however, the framework of a plan of action is what I would like to discuss.

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As health care delivery is being transformed, there is much speculation regarding the effects of ‘Obamacare’ on health care outcomes. I, as a frontline provider am of the belief, that although ‘Obamacare’ will improve access to healthcare and probably even decrease healthcare costs, the immediate effects on outcome will be minimal. I am of this belief primarily because the conventional model of health care delivery assumes a one-way transaction in which practitioners provide care and patients consume it, with “health” as the primary outcome. However, health is not something that can be handed to people; it is a state that patients must produce themselves by interacting with the health care system. Providers and patients should co-create health.

I recently read a book titled Flow by Mihaly Csikszentmihalyi. The author writes about the process involved in achieving inner harmony and attaining optimal experiences (flow). Csikszentmihalyi writes, “optimal experience is not the result of a hedonistic, lotus-eating approach to life…[it] requires determination and discipline.” It requires a process of goal-directed actions that “provide shape and meaning to an individual’s life.” This type of well planned, clear, and disciplined goal setting is what individuals need to achieve optimal health.

The necessary steps to establish such a framework for goal setting (modified from Csikszentmihalyi’s book) are outline below:

  1. Setting clear, well-defined goals that are sufficiently challenging but also realistic and attainable
  2. Developing a plan to achieve the goal and become immersed in the activity to achieve the goal.
  3. Constantly measuring progress with appropriate metrics and readjusting the goal when milestones are met.
  4. Sustaining involvement by wholeheartedly committing to the goal and concentrating on the task. It is the depth of involvement in the activity that will remove distractions and keep the involvement sustainable.Image

Achieving optimal health cannot be a unilateral transaction directed by the physician and passively consumed by the patient. At best, this approach will slow the progression of chronic disease but mostly it will just curtail the symptoms of such diseases. However, in order to reverse or prevent the onset of these diseases it requires a dramatically higher level of participation by the patient. It will require the type of disciplined goal directed actions outlined above.

Last month, I embarked on my trip to Everest Base Camp. It was a demanding two-week trek that included -20 Celsius nights, austere living conditions, and an oxygen deprived environment. However, the Khumbu region is a magical place full of spectacular mountain peaks, an otherworldly terrain, and a hearty people (Sherpas) that are renowned for their friendliness. This spirit sustained me to achieve my goal of completing the trek. The views from Kala Pathar and Everest Base Camp were breathtaking and my enjoyment was only compounded by the sense of accomplishment that I felt. “There is a mutual relationship between goals and the effort they require. Goals justify the effort they demand at the outset, but later it is the effort that justifies the goal.” (Flow)

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