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Us, Interrupted: How Television Host Tommy DiDario Is Adapting His Regimen To COVID-19

Us, Interrupted: How Television Host Tommy DiDario Is Adapting His Regimen To COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Tommy Didario is a television host and on-air lifestyle expert who has appeared on The Rachael Ray Show, The Today Show, and Entertainment Tonight. He covers everything from celebrity interviews to human interest stories to lifestyle topics in the fashion, trends, grooming, travel, health, fitness, and wellness worlds.

We spoke to Didario about how his formerly regimented lifestyle has been changed by the COVID-19 outbreak and how he’s doing his part to slow its spread.

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?

I was very regimented. I get up at 5:30 a.m. every day, and I do a 20-minute yoga session. Then I’d head to the gym for a workout and come back to have breakfast before getting to work. With my work, which is in the entertainment/lifestyle business, I never know what the day is going to look like, so getting my core “me” time in early on is key. And living in New York City, I crave my outdoor time, so I’d make a point to walk to any meetings that might be a 20-minute or less walk. I also enjoyed writing for fun or work—it was a creative outlet for me—and reading. Eating healthfully with a balanced diet was also important.

Read more in MindBodyGreen.

Us, Interrupted: How This Internist Is Responding To The Impact Of COVID-19

Us, Interrupted: How This Internist Is Responding To The Impact Of COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Mark Shapiro, M.D., is an internist and the associate medical director for hospital services with St. Joseph Health Medical Group in Sonoma County, California. He is also the creator and host of the Explore the Space podcast, which considers the relationship between health care and society.

We spoke with Shapiro about working in the medical field during the COVID-19 outbreak and how it’s affected his work and personal life.

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being in and out of the hospital?

I was in a pretty good place balancing family life, my clinical and leadership work, Explore the Space podcast, and my own self-care. Keeping an exercise routine, good nutrition, reasonable sleep, and having fun were things I was feeling more and more comfortable with.

Read more in MindBodyGreen.

Us, Interrupted: How Uché Blackstock, MD, Is Taking Care Of Herself While Caring For Others

Us, Interrupted: How Uché Blackstock, MD, Is Taking Care Of Herself While Caring For Others

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Uché Blackstock, M.D., is busy. She is the mother of two small children, the founder and CEO of Advancing Health Equity, and an emergency medicine physician working on the front lines of the COVID-19 pandemic in New York City.

We spoke to Blackstock about a life working in medicine during the pandemic, and how she’s balancing caring for herself, her children, and her patients during these unprecedented times.

What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being in and out of the hospital?

To be honest, it’s hard to remember what life was like before the COVID-19 pandemic hit NYC. I’ve been immersed in the crisis for the last two weeks caring for patients in urgent care clinics in central Brooklyn. As a parent, practicing physician, and the CEO of my own consulting firm, I’ll admit that finding the time for self-care has been quite challenging for me. I try to eat healthy and to maintain a healthy exercise schedule. Before COVID19, I took up journaling, especially in the evenings to decompress before I fell asleep. I also consider self-care to be maintaining my connections with my loved ones and friends, so I try to be intentional about finding meaningful time to spend with them.

Read more in MindBodyGreen.

Us, Interrupted: How Writer Charles Yu Is Adapting To COVID-19 With His Family

Us, Interrupted: How Writer Charles Yu Is Adapting To COVID-19 With His Family

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Charles Yu is a writer of fiction and nonfiction whose writing has appeared in numerous magazines and literary journals, including Slate, Esquire, Wired, and New York Times Style Magazine. He has also written for television, including HBO’s Westworld. Yu’s newest book, Interior Chinatown, was released in February 2020. His first book, How To Live Safely in a Science Fictional Universe, was named a New York Times Notable Book and listed as one of the best books of 2010 by Time magazine.

Here, Yu shares with us how he and his family are adapting to life during COVID-19: with exercise, getting outside, and maintaining connection with loved ones online, as well as the challenges of self-care during this difficult time:

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?
It actually wasn’t that different from my life now. Since 2014, I’ve been writing full-time (after having been a lawyer for many years), and although I have worked in a number of TV writers’ rooms (for the past couple of years, I have been lucky enough to be writing scripts in development), I have been working from home.

My day-to-day routine is get up, walk my dog, pour coffee, and write. I tried to exercise at least three times a week, either a class or a 3- to 4-mile walk. My wife ordered some home exercise stuff (resistance bands and floor sliders), so we can try to get workouts in while isolated at home.

Read more in MindBodyGreen.

Us, Interrupted: How Soledad O’Brien Prioritizes Well-Being Amid COVID-19

Us, Interrupted: How Soledad O’Brien Prioritizes Well-Being Amid COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Soledad O’Brien is a powerhouse. As the CEO of Starfish Media Group, host of the show Matter of Fact, and an award-winning broadcast journalist, she is used to busy days. She also started the PowHERful Foundation with her husband, supporting women in their journey to higher education.

Here, she shares with us how she and her family are adapting to life during COVID-19: with schedules, long walks, and how it has affected her physical and emotional well-being.

What was your life like before we learned about COVID-19, in terms of your self-care & maintaining a sense of well-being?
I don’t think I was very good at self-care. I travel a lot for work, and it’s easy to get exhausted. I tried my best to get six to eight hours of sleep and avoid red-eye flights as much as possible. The main thing was eating well and trying to get enough sleep.

In terms of other aspects of my well-being, a big part of it for me was needing to feel “useful,” as in getting stuff done. I’m a box checker, and I’d feel good knowing if I got everything on my list done. I never found much relaxation in cooking, but I’d volunteer to clean up, for instance; that would help me feel like I was being useful.

Read more in MindBodyGreen.

My plea to corporate America to help us stop the spread of COVID-19

My plea to corporate America to help us stop the spread of COVID-19

Some of America’s biggest companies should consider leveraging their logistical capabilities—from using drive-thru windows for screening to turning megastores into diagnostic and treatment centers—as part of their corporate social responsibility, during these dire times.

Dear CEOs of McDonalds, Apple, Nike, and Marriott:

As you probably know, the success of both China and South Korea in decreasing the number of new cases of COVID-19 required both social distancing but also widespread testing and isolation of confirmed cases away from their homes. In other instances, testing even more aggressively made a big difference, and the World Health Organization now strongly recommends expanding COVID19 screening as well as isolation. Italy may have waited too long to implement crucial measures and North America has lagged behind for some time: estimates show that the US is now less than two weeks behind Italy and extremely behind in COVID-19 testing.

Testing is not widely available in the US and Canada, with the spread of misinformation leading symptomatic people to head to their local hospital or family doctor to try to get tested (with limited success while overburdening the system). It’s even more dire knowing that, in New York City for instance, an estimated 80% of ICU beds may already be occupied.

As powerful corporations, I hope you consider leveraging your own logistical capabilities, as part of your corporate social responsibility, during these very dire times—particularly in hotspots like Seattle, San Francisco, Toronto, Vancouver, and New York City. Here are some suggestions for what you can do during these perilous times.

Over the past week, McDonald’s announced they are closing seating. There are over 14,000 McDonald’s in the US alone, most of which have drive-thru windows.

So, my first idea involves pausing fast-food manufacturing for a few weeks in some of these outlets and using the existing drive-thru infrastructure for in-person fever screening (window 1) and COVID-9 throat swabs (window 2, if fever is present). These could be staffed with local nurses (wearing personal protective equipment, or PPE) who might typically work in community clinics that are currently closed. The brand recognition of McDonald’s means that most North Americans would easily be able to locate their nearest franchise. These would effectively serve as “Level 1” screening and diagnostic facilities for the next several weeks, with repeat testing weeks later to assess when an infection has cleared.

Second, over the past week, Apple (which has 272 stores in the US) and Nike (which has 350 stores) have closed their stores. Both of these stores, which maximize negative space and average several thousand square feet (so up to 4.5 million square feet of unused space), have design elements that may help reduce transmission during a pandemic. Some of these stores could be refashioned to serve as “Level 2” diagnostic and treatment centers, for more in-depth diagnoses and assessment of confirmed COVID-19–effectively “cohorting” positive cases together. Also, since both Nike and Apple have longstanding manufacturing relationships with China, with independent shipping and warehouse capabilities, they could help store any donated medical supplies from China and the country’s business leaders. Doctors who are not currently skilled to work in an emergency department or intensive care unit (for instance, most general practitioners) could administer the tests and basic treatment at these sites while wearing appropriate PPE, which offloads the burden on hospitals (which in turn serve as “Level 3” treatment sites for more advanced care). This could work better than military tents.

Third, China’s success in reducing transmission was in large part due to effectively quarantining cases away from their family (so as not to infect other family members). Yet building large quarantine centers, as China did, is not logistically feasible in North America. As such, now that there are fewer travelers, Marriott, which has wide reach across North America, could offer designated hotels in which to isolate the confirmed positives for 14 days to help induce “suppression.”

To be sure, North America should still follow the lead of both Britain and France by harnessing local manufacturing capabilities (which requires a Defense Protection Act), specifically for personal protective equipment like N95 masks, gloves, and gowns for first responders–this is even more crucial given the shortage. However, the bigger challenge will remain logistical. We may even end up having enough expensive equipment like ventilators (which may be used to serve multiple patients) if the milder cases are effectively identified and treated early.

I agree that “brands can’t save us” — but companies can leverage their strengths in collaboration with government. In fact, there have been countless examples from history of corporations pivoting to assist in public health challenges. The most prominent one that comes to mind is Coca-Cola. For decades, Coca-Cola offered its cold chain and other logistical capabilities to assist public health programs to deliver vaccines and antiretroviral medications, because donating money, simply put, just isn’t enough.

Through innovation, you’ve been able to place a thousand songs in our pockets, boast the largest market share of footwear, become the biggest hotel chain in the world, and serve as the most popular fast food company. Facilitating widespread screening, diagnostic testing, and facilitating the safe isolation and treatment of mild-moderate cases is not an impossible feat, especially if you work together with the healthcare system. Instead of allowing your brick-and-mortar businesses to sit idle please consider pivoting towards a solution in collaboration with government, as part of a coordinated and effective pandemic response.

Time is running out.

**Originally published in Fast Company on March 19 2020**

Interview Series: Bryant Terry

Interview Series: Bryant Terry

Bryant Terry is a James Beard Award-Winning chef, educator, and author renowned for his activism to create a healthy, just, and sustainable food system. Since 2015 he has been the Chef-in-Residence at the Museum of the African Diaspora (MoAD) in San Francisco where he creates public programming. Alice Waters has remarked, “Bryant Terry knows that good food should be an everyday right and not a privilege.” San Francisco Magazine included Bryant among 11 Smartest People in the Bay Area Food Scene, and Fast Company named him as one of 9 People Who Are Changing the Future of Food. Bryant’s fifth book, Vegetable Kingdom, will be published on February 2020. His last book, Afro-Vegan, was published in 2014 and was named one of the best cookbooks of 2014 by and was nominated for an NAACP Award in the Outstanding Literary Work category. Bryant is also the author of the critically acclaimed Vegan Soul Kitchen: Fresh, Healthy, and Creative African-American Cuisine, which was named one of the best vegetarian/vegan cookbooks of the last 25 years by Cooking Light Magazine.

1. You had an interesting journey before being a food activist What prompted you to begin your work as a food activist?

Years ago, in high school, I first heard the rap song “Beef” by the hip hop group Boogie Down Productions. The lyrics discussed the impact of eating meat on human health, the environment, and animals. That was the first time I realized that I held all of these assumptions about how animals are treated in our food system, and I began eating less meat. I learned a lot about the many reasons to maintain a plant-based diet from lots of older Black vegetarians and vegans. While I was doing doctoral work at NYU in American history I learned about the “Survival Programs” created by the Black Panther Party in the 1960s that addressed the intersection of poverty, malnutrition, and institutional racism—mainly their grocery giveaways and Free breakfast for Children Programs. I realized that historically marginalized communities were still dealing with many of the same problems in regard to food access, so in 2001 I founded a non-profit called b-healthy to raise awareness among young people about the politics of food and give them the tools to improve access to nutritious foods in their communities.

2. How does that inform how you approach healthcare?

I think health ‘care’ system is a misnomer since it often doesn’t refer to caring for people’s health. Mostly we see this medical system responding to illness. I’d like to see a system that is putting more resources into giving patients tools to prevent chronic illnesses and truly “care” for themselves and their families.

3.You had an experience with being challenged with your well-being not that long ago? Can you share more about that?

While working on my last book a few years ago I had lots of time and space to disappear in the writing and recipe testing, which was really exciting. At that time I didn’t have kids and was newly married, and it was all about the hustle. Raising my children and working on my forthcoming book was hard because writing and testing was limited to weekends, holidays, and times when my kids were out of the house. So the struggle of balancing it all felt overwhelming. Things I used to rely on to stay balanced, like my meditation practice, fell away. So now that the book is done I’m preparing to spend the better part of 2020 touring by spending lots of time working on self-care.

4.What does thriving mean to you?

It means different things at different points in life. As a husband with two daughters now, thriving means taking care of my family, preparing my children for the future, and creating space for them to have an enjoyable childhood.

5.What are you most looking forward to in 2020?

I’m very excited about further inspiring people to work towards a more healthy, just, and sustainable food system.

Interview Series: Roger Holzberg

Roger Holzberg is the co-founder, along with Leonard Sender, MD, of Reimagine Well, a company that designs and builds immersive healing programs for hospitals and treatment centers. The Infusionarium™ platform empowers patients to receive treatment in the place they believe will best heal them, then empowers them with enhanced educational “Learn Guides” and a safe support community for their patient journey. He served as the first (consulting) Creative Director for the National Cancer Institute (NCI). The “evolution” of, the NCI Facebook, Twitter, Mobile and YouTube channels are all projects that his creative team took from concept through launch. Previously, Roger spent 12 years as an award-winning Creative Director / Vice President at Walt Disney Imagineering where he had the opportunity to lead the creative development for a broad portfolio of projects ranging from PlayStation® games to theme park icons and multiple Disney World Celebrations; from mass audience interactive experiences and rides to the MMOG Virtual Magic Kingdom. In “classic media,” he has written and directed feature films and television, but is genuinely proud of researching and writing the IMAX film “The Living Sea” (Academy Award nomination for documentary). Roger is a father; a 15-year cancer survivor; and a competitive triathlete (3 events yearly), using the sport to raise research dollars for causes he supports.

1.What prompted you to start Reimagine Well?

Roger Holzberg

As a cancer survivor I had a firsthand look at how “unhealing” the patient experience was in the US. At the time I was diagnosed I was a Vice President and Creative Director at Walt Disney Imagineering. I put together a group of volunteers from Disney that were either cancer survivors or caregivers and we worked on projects that ranged from a support platform to contributing to the redesign of the lobby at Children’s Hospital Los Angeles, and then doing the “living with” stories for the launch of and adapting a Disney attraction called “Turtle Talk with Crush” for use with pediatric patients at Children’s Hospital of Orange County. I was then recruited to be the first (consulting) creative director at the National Cancer Institute, redesigning and taking the institute into social media and story telling. All of these experiences planted seeds in their own way for re-envisioning the healing environment.

2. You had an interesting journey as a Disney Imagineer, what was that like? And How does that inform how you approach healthcare?

Back in 1964 in Flushing Meadows New York, when I was eight years old, I attended the Worlds Fair and saw “Great Moments With Mr. Lincoln”, the first audio animatronic figure and nearly tore my dad’s jacket sleeve off when I asked ‘how did that happen?’ His response stuck with me: “A man named Walt Disney invented that.” That was the beginning, and since then I have been drawn to what’s known as “experience design” (as opposed to film and consumer product design). Experience design is so much more powerful when a medium is multi-dimensional. I ended up taking college courses in design and finishing up at the California Institute of Arts. In my early career in the entertainment industry I worked in special effects and production design, and wrote large format IMAX films. The educational expansion of the Imax films led to an opportunity to help build “Knowledge Adventure” and the “Jumpstart” brand. I was then recruited to Disney Interactive to be their first creative director. The Imagineering division of Disney recruited me to work on the Millennium Celebration and lead the creative teams on the 100 Years Of Magic project at all four Disneyworld theme parks. After 9/11 we saw a big retraction in vacation travel and I had the opportunity to build a team and lead a project called Virtual Magic Kingdom. This had 5 million children interacting with children in brick and mortar parks and sometimes during the experiences that followed. So the seed was planted around blending the things that hadn’t been done before. I spent a total of 15 years with Disney. Walt Disney coined the phrase the “architecture of reassurance.” Disney parks were designed to be a safe place for families to play. At Reimagine Well we try to create an ‘architecture of healing’, creating a safe and special place for patients and families to heal. So my 15 years at Disney informed what I did to create an emotionally engaging space for people to play. I realized the same tools could be used for patients and families to experience the patient journey.

3.You had a health scare of your own not that long ago. Can you share more about that?

Cancer has been a ribbon throughout my life, from losing one of my best friends as a child to pediatric cancer and losing my mom to cancer in my 20s. For me, as a competitive athlete I got to know my body really well, and in 2004 I began noticing that something subtle was off. I’d gained weight without changing my diet or exercise regimen, I hit an energy wall in the afternoons. On the anniversary of my mother’s death I remembered her saying ‘don’t pretend nothings wrong as that’s what I did.’ I spoke to my doctor, had an MRI of my neck, and it was clear that I had thyroid cancer. One in three American women and one in two men hear the words “you have cancer” during their lifetime, but in that moment the world becomes a rush of white noise. You see a physician across from you speaking a language you don’t understand. I call it the “terror moment.” When you’re in shock you don’t make the most rational decisions since you are operating out of fear. You’re staring your own mortality.

It wasn’t until I was undergoing radiation treatment when the healing environment aspect hit me. The walls in the hospital hadn’t been painted since 1980s and this was the most un-healing experience I could imagine. I came from a place where the architecture of reassurance is what we practiced. It didn’t even smell right! It hit me like a ton of bricks that the patient experience, even though I didn’t know that term yet, was something to be worked on.

4. What were the things that helped you get through the cancer diagnosis?

I told very few people about the diagnosis, and actually didn’t tell my kids until after the surgery, when the pathology results came back. I remember going online and seeing 70 million hits for my search — I was in overload!

But I spoke with a good friend of mine who was a cancer survivor who advised me to just focus on one thing at a time. Effectively, the patient journey has different phases, from diagnosis to treatment, then healing and well-being. So the biggest thing that helped was when I realized I only needed to focus on just one of those phases at a time, suddenly I could catch my breath again and look at phase relevant to me at that point was enormously helpful. This then informed our social platform for Reimagine Well, which helps patients set achievable health goals and use the wisdom of the healthcare community (which includes healthcare professionals) to navigate the patient journey..

5. What’s the most misunderstood aspect of cancer and dealing with a diagnosis/living with cancer?

There are a few things.

The first is that unless it’s critical, take the time to let yourself get the information you need. More often than not you have time before you need to jump into treatment. Take the time to find the right care team, do the research and get informed and get a second opinion.

The second myth is that all cancer treatments are the same: that’s not the case. A small community center may not include the clinical trials that may be available at a larger center. You owe it to yourself to do the research if your odds for survival are potentially better at a larger center.

The third is that clinical trials turn patients into guinea pigs. This is a big misunderstanding. Clinical trials often provide the best, most attentive, cutting edge clinical care someone can get, and if a clinician recommends a trial you qualify for, don’t be afraid to consider it.

The last is the role of diet and exercise. A healthy BMI can significantly reduce the chance of cancer recurrence and there are recommendations for 45-75minutes of exercise daily. Unfortunately very few doctors are trained in these lifestyle factors. Find a credentialed Registered Dietician to help you design the best program for you and your specific health goals and medical needs.

6. What does thriving mean to you?

Thriving in my new normal means having an emotional, spiritual, and physical health balance. Compared to 15 years ago, I can honestly say my work, family, and active lifestyle are so much better today than it was before my cancer diagnosis. I think it was because of my approach to the disease, my new career with Reimagine Well (which happens to be very rewarding) and adopting a healthy and active lifestyle. Thriving also involves having a supportive community, we hold each other accountable for our health goals as well as providing emotional support and friendship.

7.What are you most looking forward to with Reimagine Well and in general?

Right now I’m teaching a Healthcare by Design course at the California Institute of Arts. Last year we delivered a pilot project to Children’s Hospital Los Angeles and this year we will create a pilot program for the Henry Mayo Newhall Hospital in Valencia, so helping to educate and train the medical experience designers of tomorrow is super rewarding. At Reimagine Well we are launching a new experience design program, which involves reducing the need for excessive sedation in several pediatric medical centers, and using virtual reality as part of this program. With the proof of concept pilot program we were able to reduce the mean age of sedation from 10 to 3; a formal clinical study (with research ethics approval) is now underway with Nebraska Medicine on this. In 2020 we will also be expanding into pediatric behavioral programs, and adult oncology.

**Originally published on ThriveGlobal**

Resolving to Be Coached

Resolving to Be Coached

The secret to sticking with your resolutions may be having a coach to help strategize and cheer you on.

My teenage patient looked nervous as I reviewed her glucose readings from her glucometer and her glucose logbook, which people with diabetes use to track their blood-sugar test results. There were a lot of high levels — ranges in the 12’s and 14’s, when the goal was around 7 or 8. The peaks were mostly in the middle of the day and on weekends. (This was in Canada; blood glucose readings of 12 to 14 are equivalent to 216 to 250 mg/dL in the United States.)

“What do you usually eat at home?” I asked. She said that her mother was careful to make her a breakfast that balanced carbohydrates with protein. Her dinners were similar.

“What do you usually eat at lunch?” I asked. My patient started tearing up. She ate whatever her friends were eating in her high school’s cafeteria that day — like spaghetti, hamburgers or pizza, and something like a cupcake for dessert. This was probably what led to her readings being so high.

She had met with diabetes educators before, and she knew what uncontrolled glucose does to a person with diabetes, from speeding up nerve damage in the feet to hastening blood vessel damage in the back of the eyes and the kidneys, to increasing her risk of heart disease.

I knew she could have told me all of that, so lecturing her wasn’t going to help.

Instead my patient needed empathy and the tools to help her make healthier decisions, and part of that required understanding what was important to her, specifically “fitting in” with her friends in high school, the ones who didn’t have a chronic disease. It also would have involved helping her find the motivation within herself to make the change.

But my skill set for helping her was limited, especially on top of everything else I had to cover within our allotted time of 45 minutes.

Research suggests that behavioral and lifestyle factors are a big part of what contributes to chronic disease. In medical training, we learn a lot about the body and how to prevent and treat disease, but little about how we can motivate a patient to change old habits or even stick with a current management plan.

It struck me that what my patient really needed was a coach. At this time of year when many of us have made resolutions to get healthier, working with a health coach might be one way to reach those goals.

A health coach is someone trained in behavior change, who primarily uses an interview style called “motivational interviewing” to help patients see their ability to make change. While some may have clinical training in fields like nursing or medicine, they hail from a wide variety of disciplines or train in health coaching as a secondary career.

As a relatively young field, it’s still finding its footing — for instance, a systematic review found that the definitions of “health coaching” varied widely, though the authors recommended that health coaches take a patient-centered approach to help with goal setting while encouraging self-discovery and accountability.

The evidence that health coaching may spur general lifestyle changes is mounting. A 2018 study looked at clinical trials for coaching for nutrition and weight management and found that over 80 percent of these studies found improvement. And a 2017 study found that coaching can lead to increased physical activity in older adults. Studies suggest that health coaching may also provide benefits for conditions such as obesity and diabetes as well as attention deficit hyperactivity disorder, chronic pain, hypertension and high cholesterol. A recent review found that health coaching can improve quality of life and reduce hospital admissions among patients with chronic obstructive pulmonary disease, and it may help patients to become more engaged in the health care system.

It may even improve health outcomes through encouraging patient adherence to medication.

“Health coaching recognizes that we cannot help people by expecting them to act if that person is not ready to act,” said Leila Finn, a health coach based in Atlanta. “We help people take big goals and break them down into accessible, bite-size pieces — not by telling clients what to do but by helping clients figure out what will work for them.”

Health coaching gets to the heart of what providing good health care is about: acceptance, partnership, compassion, and helping patients feel respected and understood.

Though my clinical training is in pediatric medicine, inspired by what I had read, I recently completed a certificate in health coaching myself. The experience was eye-opening and humbling. I learned new ways of communicating with my patients, specifically ways to encourage them to see their own ability to make lifestyle changes while setting manageable goals. I also learned ways to cheer them on when they reach their goals, without shaming them if they relapse: Both pieces are critical to the process of making sustainable change.

While research is beginning to show the value of health coaching, the principles of communicating with the intent to inspire and motivate are transferable to all health professions — and could reap dividends if taught early on in the training of nursing students, medical students, pharmacy students, and other allied health professionals.

And when I think back to my teenage patient with diabetes, while I was empathetic, that was only half of the solution. The second half could have involved coaching her to see which small changes she could begin to make moving forward. I’m hoping that choosing my words more effectively, even within the pressures of time, may make all the difference for my other patients.

**Originally published in the New York Times**

Interview Series: Kashiwa Hang

Interview Series: Kashiwa Hang

Kashiwa Hang (real name: Iwao Mano) is a 38-year old handpan musician based in Tokyo. In 2016 he experienced what many of us in North America call “burnout,” except it’s arguably more difficult in Japan, where many companies expect their workers to work over 16-hour days. This is one major contributor to what’s known as ‘karoshi’ ((過労死) or ‘death due to overwork.’ Often on the Japanese subway/train I would notice men and women in suits, often late at night, sleeping on the train, clearly only just heading home after work. In my hotel I once saw someone in a suit, with a briefcase, sleeping in the lounge, possibly too tired to even check in after a late night at the office. A Japanese friend explained to me that it’s common for some workers to find a capsule hotel (inexpensive hostel-like accommodation) to sleep after a late night, and go back into the office the next day, and the sad thing is that very few talk about the burden of this ‘overwork culture’ openly, despite efforts by the Japanese government to institute workplace policies to combat it. Recently the Atlantic covered why it remains so challenging for young people in particular to speak out about depression in the workplace.

While in Japan as an Asia Pacific Media Fellow reporting on artificial intelligence and healthcare, I happened upon Kashiwa Hang performing on the sidewalk. I snapped a quick photo of his CD and promptly downloaded his album. A quick web search later on, in an effort to find more of his soothing music, led me to learn that his story was a truly remarkable one. We were able to find time to speak at a café in Tokyo, about what led him to leave a demanding but lucrative architecture position to become a musician full time. It turns out it was a decision he made for his well-being, and is hopeful that other young people in Japan may have the courage to place their health first as well.

1.Thank you so much for finding the time to share your journey. Why don’t we start at the beginning. What led you to your initial job in architecture?

Growing up I was always interested in computers, math and design. Architecture seemed like a natural fit, and I enjoyed my classes in architecture. I ended up working for a few different architecture firms – from large ones to smaller boutique firms. I enjoyed the variety.

2.While you were working at one firm in 2016, you experienced something challenging but transformative. Can you share this with our readers?

I had been working at a medium-sized architecture firm in Tokyo and, as one of the youngest architects there, was given a larger proportion of the tasks. The mentality here in Japan is “if you’re young and healthy, you can handle more work.” And I did handle it for a period of time, all in all about 10 years. But I was getting into the office by 7 or 8 am and staying well past midnight with not much time for breaks. I skipped lunch often. I was on my feet a lot, and always looking at a computer screen. It was cognitively demanding work as well, so over time my body and mind just became exhausted. I began feeling anxious, and would notice heart palpitations often. One day, while at a standing desk, working through a design, I just collapsed. I don’t remember all the details, but I was taken to a local hospital and the doctor told me I needed more rest. I didn’t have a diagnosis per se, but when I explained it to my boss, he didn’t understand. I had no choice but to go back to work the next day, and act as though nothing had happened. And so, not knowing what other options I had, I just did it. A few weeks later I was walking home from the train and saw a man playing the guitar on the street. The sound was so calming, so I stopped to listen for awhile. For the first time in a long time my heart felt happy, and I felt calm. In that moment I thought: why don’t I learn an instrument?

3. Do you think you were on your way to ‘karoshi?’

In a short answer: yes. There’s no doubt that would have happened had I not made a change.

4.Let’s talk about that change. Clearly you took that hospital visit seriously – you ended up picking a different instrument and leaving the industry of architecture all together. That sort of 180-degree shift career-wise, is not common in Japan is it?

That’s right. First I thought back to an instrument I really loved in high school – on a trip to Barcelona I had first heard about the handpan. The sound was beautiful, and I had learned that it was a relatively new instrument, having been invented around the year 2000 in Switzerland. But I couldn’t remember the name of the instrument! I ended up searching things like “UFO music pan” and finally found it, and the name, “handpan.” Then I searched online for classes, but couldn’t find any, and I couldn’t even buy one in Japan! So I found a company in Switzerland and ordered one directly. Then I began to teach myself through YouTube. Overtime, with practice, I travelled to France and learned directly from local artists there. My English improved as well, and I ended up finding a community to tour with. I recently completed a tour in Taiwan, and plan to go to Europe soon. In terms of your second observation, you’re right: freelancing of any kind isn’t common in Japan. There is real fear around financial stability and most people would rather have a steady job, even if they are overworked, compared to the uncertainty. At first my parents were very concerned, but now I perform (and get paid), and teach students, so I’m able to support myself.

5.That took a lot of courage. So what about architecture? Will you go back?

A lot of my friends say I’m brave. I just think I had not choice if I wanted to keep living and if I wanted to have a happy life. I don’t have plans to go back to architecture now. I enjoyed it, but the costs to my health, at least in Japan, were too large. I’m much happier as a musician. I’m more in control of my health, I sleep well, and overall feel calmer and more at peace.

6.What does thriving mean to you?

If you asked me that question in early 2016, I would have described the sense of feeling ‘rich’ financially, working hard, making lots of money, etc. Now I see it as richness of the heart and mind, along with having good friendships.

7.What are you most looking forward to with your music now?

I’m working on another album, and am teaching more. I hope to do another tour soon as well, and there are lots of opportunities to perform around Japan as well. But reminding myself that right now I’m living the dream. Thinking back to a few years ago, right now I’m so grateful to really be thriving.