October 2022 President’s Message

October 2022 President’s Message

The donut philosophy: Don’t focus on the hole

by E. Jeanne Kroeker, MD

Our family has a shared family-owned cabin at Kanopolis Lake. The foresight and daring of my husband’s parents and grandparents led to the purchase of property on the lake shortly after the reservoir was created in the late 1940s. The lake home gradually transformed from a tent on the lot to a simple, family-built cabin with a couple bedrooms, one main room with a rudimentary kitchen, and a tiny bathroom. I hear stories about the early years in the cabin, with its original dirt floor and outhouse, and am rather glad I missed those phases.

In the last 30 years, I have been part of so many projects at this 70-year-old cabin. We struggled with repeatedly plugged well pumps and then celebrated when the rural water system ran plumbing to our cabin area and we hooked in. We celebrated even more when our decrepit septic system was rebuilt two years ago, allowing us to use all the plumbing without fear. We have repainted both the exterior and the interior twice. After an unfortunate mold and mildew crisis caused by abnormally high rainfall and leaky walls in 2019, we rebuilt and re-floored the bedrooms. Twenty-five years ago, we reroofed the cabin ourselves, and we just paid to have a new metal roof put on this summer.

Because there is always work that needs to be done, I admit that I sometimes see the cabin as a time-sink and money pit. I can get overwhelmed by the to-do list and only see all the things that need updating or repair. It can be hard for me to truly relax at the cabin, but when I do, it is delightful. The quiet of the rural setting, the ever-changing mood of the lake water, the deer and wild turkeys that meander through the yard, and the curving path down the hill from our cabin to the lakeshore are all delights for the senses.

The cabin cupboards and rooms are filled with leftover or cast-off furniture and items from multiple households. Every visit, I drink my morning coffee from one of a set of 1960s mugs that are called the “Official Dunker’s Cup.” These oversized coffee mugs brag that they are big enough to float a whole doughnut and have four silly rules for dunking on the face of the mug.

On the back of the mug is “The Optimist’s Creed.” The creed is simple and I have reread it a hundred mornings at the cabin: ìAs you ramble on through life, brother,/ Whatever be your goal, /Keep your eye upon the donut, /And not upon the hole.”

Research shows that this quote has been used and adapted by many people, but it was originally publicized in 1931 by Adolph Levitt, a Russian immigrant who invented the first automatic doughnut-making machine in his Mayflower Donut chain of shops. He plastered this creed all over his shops and on every box of doughnuts they sold.

It is ironic that this mug tries to remind me of the Optimist’s Creed as I look all around the cabin seeing the work yet to be done and overlook the benefits of this rural refuge. When I interact with patients, it is really easy to think about and remember all the times I missed a symptom or misunderstood a history, and I forget the times that I truly helped someone or educated someone.

As we physicians are all subjected to Google, Yelp and Press Ganey reviews, it can be too easy to focus on the less favorable reviews and overlook the positive words and evaluations. When we have a challenging patient encounter, it can bring the day down more than a good encounter might brighten the rest of the day. Sometimes, my brain focuses too much on the things that have not improved for my patients and not enough on the diagnoses or diseases that have resolved or remitted and the subsequent positive changes in their lives.

Endless struggles with EMRs, administrative and non-clinical responsibilities, MIPS and unfunded mandates, overbooked schedules, and challenging patient interactions can weigh on my mind well into the evening, making it hard for me to relax and enjoy my non-working hours. I think about the charting I need to do, the CME I need to complete, the upcoming Board recertification study I need to start. But these are just part of the “hole,” and they should not be my focus. I need to spend more time remembering the challenging sleuthing and problem solving that medicine requires, the incredibly intimate and trusting interpersonal interaction that medicine allows, and the reward of lives made better that medicine enables.

As my family winterizes and closes the old cabin later this month, I may need to swipe one of the doughnut dunker mugs to use at home each morning. Or maybe I can just incorporate the Optimist’s Creed in my daily life without the mug as a reminder. Focus on the donut; focus on what matters. Stop focusing on the hole and certainly don’t fall into it, because it is a hard climb out.