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Welcome to the Mind Wise Video podcast, which presents holistic mental health, healthcare, and wellness perspectives and information. I am your host, Ron Parks, MD writer, teacher, and consultant.

RP: Today’s video podcast is about:

Collaboration: friend or foe in making critical choices?

What is the cure for indecisiveness in personal, business, or political matters?

There is, I believe, an art to being more decisive. It requires developing your innate inner resources and collaboration with trusted others. What follows are several personal vignettes and discussions to highlight what to consider and do to be better guided when making important choices.

Mentoring or biased advice?

Recently, in a conversation with my adult son, I wanted to better understand the benefits versus the risks of collaboration with others during times of challenge and indecision. My son was in throngs of indecision about whether to return to graduate school. As a parent, one often finds oneself in the problematic place of wanting to give advice but knowing that if taken by your child, you might get blamed if things go awry and may not have supported their growth of self-confidence and independence. Our conversation concerned the value of my son calling and collaborating with his graduate school educators about what they were offering regarding courses and support. Doing so would help him better assess if returning would be in his best interest. But is seeking help or collaboration from others always the best consideration?

Making a discerning choice between two or more options is sometimes fraught with the potential of being misguided. Psychologists have called it a double bind when one gets stuck in not knowing which way to go, creating fear of the consequence of a possible poor choice. We all face these dilemmas and indecisive movements that may become protracted with undo worry and evolve into despair and health breakdown—physical, mental, and spiritual—with the loss of zest for living, ability for adaptive change, or thriving. Also, during times of challenge, our awareness of our human limitations and vulnerability comes to the forefront, and we can only know what we have learned with an occasional intuitive glimpse at future possibilities. With age and wisdom, at least to me, it has become apparent that help is often available by reaching out to others.

Collaboration with others may be easier for some than others. Ease with social communication can vary widely from person to person. Someone who has experienced significant trauma from others might be more reluctant to be trustful. Some may uniquely function best and express their talents by working alone, without pressure or distractions. An example would be those with a talented genetic predisposition to work and perform better when they can maximize their concentration without distraction from their environment or social interaction. People with such neurodiversity can be the best researchers, analysts, tech specialists, physicians, mechanics, artists, and other fields requiring exceptional intellectual ability to combine diverse data and elements for unique solutions for complex problems.

"Going from the frying pan into the fire when adversity prompted flight—perhaps the best I could do, considering the circumstances."

When I was young, in the earlier phases of my medical specialty training, I started in a residency graduate program at one of the prestigious institutions in the Midwest. I felt fortunate and privileged to get into what I thought was such an outstanding program. A relative of my wife was a leading neurosurgeon in our city and spoke highly of the program and how it got his career off to a successful start. Coming from a modest, industrious family with few members who had gotten medical, graduate, or college degrees, it was a big jump for me. I had trepidation about getting accepted into such a well-known residency training that was quite rigorous and demanding.

The day before I left with my wife for our new destination in a midwestern city, I met an older physician who had been in the same program that I was to begin. When I brought up proudly that I was going to start there also, he became upset, with a lot of expressed anger toward his former training program. He said the pressure there was immense, triggering intense anxiety and difficulty sleeping and focusing, to the point where he went to the psychiatry department there for some help. According to him, he was immediately dismissed when the residency program discovered it. He had to return home and restart his career and training at a local institution.

So, whatever my trepidation or fear, they increased maybe 1000% before I left for my new training opportunity. Earlier in my career, I had some difficulty with anxiety and occasional panic attacks, which I thought I had learned to manage.

When my wife and I arrived in the quiet, conservative, midwestern town home to my new internal medicine residency, we were well received and befriended by another physician on the faculty there and his family from our hometown area. I admired him and his work in preventive medicine and research and thought this might be an area for me to pursue. A rigorous schedule began for me, including night calls, and I felt the stress with mounting anxiety and increasing irritable bowel symptoms, especially as I was on the run all the time and grabbing snacks. I did not realize then how gluten-sensitive I was.

It was a time when I could have received some wise counseling or guidance beyond the small circle of friends that my wife and I had. Of course, I was terrified of what the older former trainee, previously at the same institution, had told me about being dismissed from the program when he reached out for help. Also, several of my fellow physicians were up in arms about the weaknesses and abuse they felt from the program. The faculty physician I knew there was a way on a sabbatical. So, as I thought I had to be resourceful, I needed to seek a better situation on my own.

With my wife's support, I got on the phone. I called some of the top Master of Public Health and Preventive Medicine programs on the East and West Coast. I thought I would pursue an academic career as the physician I befriended on the current program faculty. One physician I reached was the head of the Preventive Medicine Program at UCLA in Los Angeles. He was amazed that I called at that moment, and when he heard of my plight, he said that he had just gotten a grant for a new training position and asked how soon I could transition out there.

My wife and I pulled together in the fantastic collaboration we have had in a short amount of time. I resigned from the residency program. I told them about my acceptance into the new program and my desire to attend. The residency program director said they had 200 other resident trainees and could accommodate me for the new position. We got a rental truck, packed all our belongings, and got to Los Angeles in two weeks.

When we arrived, I was warmly greeted by my new boss and head of department at UCLA. As he could not get me a paycheck immediately, he reached into his pocket and gave us cash to tide us over for a few days. I felt immediately at home and well-supported. But the quick transition would take a toll on my psyche that I could not have expected.

From the beginning, I found things disappointing in the new program, such as lacking the content, structure, and training I had expected. I fretted I had not given enough consideration to my choice by not doing enough investigation or consulting others. I felt increasingly anxious, with my thoughts racing to find some helpful solutions, and I had difficulty relaxing or sleeping. Venting with the calming influence of my wife or talking with close friends in the area did not help. I felt terrified and insecure that maybe I had ruined my career with an impulsive decision.

I knew I had to seek help, so I took a deep breath and made an appointment with a psychiatrist in the student health program.

Once I had reached out for help, I felt some relief. It was my great fortune that the person assigned to me was very understanding, humanistic, and listened with compassion. She astutely observed that I was more angry than anxious, probably with myself, but mainly with the program for not meeting my expectations, especially with my prior training and academic background. The psychiatrist was not arrogant, didn't label me or pigeonhole me into some diagnosis to medicate me, but was there to allow me some space and time for insight with her collaboration and support. I felt understood and validated. I almost immediately felt clarification of my dilemma and the direction to take. Most importantly, I felt relief from my worry and anxiety.

It was a one-session wonder, as I felt quickly back to normal. The door remained open if I needed to talk more in the future. The psychiatrist was a role model for me when I went into psychiatry later in my career. Also, my long-time friend, Jay, suggested a part-time clinical job at the LA County Hospital emergency room where he was training, the busiest hospital emergency room in the country. Re-engaging in some clinical work was very helpful and grounding.

Getting in touch with my feelings, especially anger, helped me get unstuck and act. Almost directly, I went to my new program's faculty and the head of the department, where I vehemently expressed my concern and disappointment. With my assertiveness, additions, and modifications occurred, making the program more workable and valuable to my needs. It became an excellent ...

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