When someone is diagnosed with a deadly illness, I think we can all agree that the only focus should be on the patient and ensuring they receive the best care possible.  The fight should be against the disease, not corporate bureaucracy.

When my late husband Patrick landed in the hospital after his first seizure, we had no idea what we were in for.  Aside from absolute ignorance of the disease of glioblastoma, we were about to face what was sometimes equally daunting: Patrick's insurance company.  At the time of Patrick's diagnosis, I was in my fifth year as an insurance defense attorney.  I had practiced in various fields (medical malpractice, insurance coverage, personal injury, workers' comp, etc.) so I was well-versed in insurance company policies and objectives.  I knew that denying requests for treatment was par for the course and that most of my job was essentially saying "no."  I was aware that keeping costs as low as possible was incentivized for claims adjusters.  Even with all this first-hand knowledge, it never occurred to me that the corporate behemoth would apply this model to someone battling a brain tumor with a five-year survival rate of around 5%.  No, the insurance company would do right by him... wouldn't they?

Just three short months before Patrick's seizure that eventually led to his GBM diagnosis, I woke up one Sunday morning to find him sweating with his head between his knees on the edge of the bed.  His face was ghost-white.  He was barely able to speak, but was able to get out that he was dizzy.  I tried to help him stand up and he stumbled to the ground.  I was terrified.  I asked if I should call 911, and became even more alarmed when he said yes.  That was the first of what would be innumerable ambulance rides, with me following closely behind in my car and frantically calling family on the way. 

When we got to the ER, Patrick's symptoms seemed to have subsided somewhat.  He continued to have severe dizziness when he leaned his head back or forward, but his cheeks had started to redden and he was not perspiring so much.  They did basic blood tests and when those came back normal, although there was absolutely no explanation of what happened, the doctors simply diagnosed him with vertigo and sent him home with a prescription for Meclizine, which is essentially an over-the-counter medication to treat motion sickness.  They did no CT scan, MRI, or any other diagnostic study to find out what caused his symptoms.  If they had, I suspect that they would have found the lesion that would be diagnosed as GBM soon thereafter, and realized that he was actually experiencing a focal seizure.  But no - this time, they shooed us out as quickly as possible, and I did not even realize that I could insist on more being done.  

Patrick was a life-long Kaiser member, so that was where he was first taken to the hospital in 9/2014 when he had his first grand mal seizure.  As I shared in an earlier post ("From Disaster to Tragedy"), his initial hospital trip resulted in a 72-hour medically induced coma to stop the seizures.  At that time, the doctors collaborated and decided that what they were seeing on the MRI was not a tumor and sent him home directly from the ICU after four days.  Less than a week later, he returned in another ambulance and this time a tumor was clearly spotted.  We were told that he would need to be immediately scheduled for brain surgery at another Kaiser campus in the Bay Area to remove the tumor.  And so it began.

Because of Patrick's psychotic episodes following his seizures, Kaiser's best idea for treatment was tying him down like an animal on his hospital bed and sedating him to the brink of unconsciousness.  It was absolutely barbaric.  On one occasion, his blood pressure dropped so low that it nearly killed him.  Had I not been sitting at his bedside constantly observing the beeping of the monitors, it probably would have.  I watched his numbers plummet and ran to his nurse, requesting immediate assistance.  I was brushed off but I did not back down, demanding she come look.  She looked at me, clearly irritated, before following me back to his room.  When she looked at the monitors, her eyes widened, and she ran for the doctor who hurried in and halved the dose of the sedative.  They all stayed close for the next few minutes while Patrick's pulse and blood pressure returned to normal.

I was not without sympathy for the nurses, doctors, or anyone within earshot of Patrick's room during his episodes.  He was extremely loud, violent, and as strong as the incredible hulk.  I remember when he bent the metal rail on his hospital bed like it was made of clay after waking up in restraints.  After he broke the bed, they brought in a replacement, and I watched three large male staff try to force the bent rail back into place to no avail.  (Patrick was quite proud of the picture of the bent frame that I took.  It was his favorite conversation piece with visitors.)

It was after the near-death episode with Patrick's blood pressure that I knew that we had to get Patrick out of Kaiser.  They refused to start his radiation until the seizures were under control, and no matter what combination of medications they tried, he continued to have them.  This was when I started requesting that Patrick be transferred to UC San Francisco, only 30 minutes away and one of the leading facilities in the country in treating brain tumors.  I was convinced that the doctors at UCSF could either figure out how to stop the seizures, or at least start his radiation while they tried.  Even with what little I knew about GBM at the time, I was aware that a delay in starting his radiation would make a quick recurrence all the more likely, and I did not want to take any chances. 

Even Patrick's care team was in agreement that they could not help him and recommended sending him to UCSF.  The insurance end of Kaiser, however, refused to allow Patrick to transfer, telling me that they would only pay of out-of-network treatment if there was some specific type of treatment or care that Patrick needed that Kaiser could not provide at their facilities.   This was the first of many experiences where Patrick's doctors and I conspired on how to get the care he needed provided by his insurance company.  His Kaiser doctor said that UCSF would have the ability to hook Patrick up to a continuous EEG machine to monitor his seizure activity, but there was another Kaiser facility in the Bay Area that had that type of machine.  Patrick was shipped off to that location where he remained for another week, enduring the same cruel and inhumane treatment all the while.

This was the third occasion where Kaiser hospitalized Patrick for at least eight days and discharged him in "stable" condition only to have him return after another seizure within 48 hours.  I had had enough.   I sat down and wrote a letter to Kaiser chronologically laying out Patrick's sub-par treatment course.  I used every single legal buzz word in my arsenal, from "bad faith denial" to "gross negligence," to lay out my case for Kaiser approving his transfer to UCSF.  It finally worked, and within 6 hours of giving the hospital the letter, Patrick was on a waiting list for a bed at UCSF.  

After three days on the list, a social worker came in and told me that Patrick could not get approved for the bed at UCSF because he had no insurance.  Apparently, Patrick's employer had mailed his COBRA healthcare materials, but we had not received them and did not know that he needed to elect to convert from group to individual coverage.  So, his insurance lapsed and he was kicked off the waiting list at UCSF.  I spent the next 36 frantic hours talking to his employer, their insurance company, their intermediary third-party administrator, the hospital administrators at Kaiser and UCSF, and Lord knows who else doing paperwork and overnighting checks to get his insurance reinstated and back-dated to the day it had been dropped.  All the while, Patrick was in the middle of an episode, screaming bloody murder every time I left the room.  Finally, it was sorted out and Patrick got back on the waiting list, but it was another six days before a bed opened up and he was able to transfer. 

I wish I could say that once Patrick got to UCSF the fight with Kaiser was over, but it was far from it.  Patrick's care team at UCSF was constantly having to justify why he needed to stay there instead of going back to Kaiser.  I remember once having a phone call with Kaiser's out-of-network manager who was telling me that Patrick would be transferred back to Kaiser the following day because their doctors could manage his care from now on.  Never mind that the UCSF physicians did not consider his seizure condition stable, or that they stated it would be detrimental to him to force another change in location where he would experience more confusion and likely compromise his already precarious mental state.  This manager was the coldest woman I had ever spoken to.  There was no empathy in her voice as I cried and pleaded for her to do what the doctors at UCSF were recommending.  It was not until I pulled the lawyer card and started using those buzz words again that she relented and agreed to approve him to stay for another week, when we would inevitably have to repeat this same drama again.  Which we did.  Over and over.

One of the cruelest abuses by the insurance system came about two months before Patrick died.  We knew that Patrick had life insurance through his employer, and I realized that we had never gotten any paperwork about it.  I contacted his employer, who again referred me to the TPA managing their insurance.  I was informed that along with the package of COBRA documents that had never arrived, there was information about how to maintain Patrick's life insurance  policy which had a hard deadline that had long since passed.  I was stunned, but was sure that there must be something that could be done about it.  Wrong again.  Even though we had not received the documents, the only duty of care that the insurance company had to meet was to prove that they put the materials in the mail.  After that, their responsibility was extinguished.  It did not matter that we lived in an apartment complex where the mailman frequently put things in the wrong mailboxes.  There was no requirement that the mail be sent certified so that there would be some sort of record of receipt.  It did not matter that Patrick had brain cancer and even if he had received the mail, would not have been able to read it or understand its contents.  All that mattered was their record of an envelope going out, and that's all it took to eliminate their liability for the three years of Patrick's substantial salary that should have been paid to his two adult children.  The absolutely callous lack of heart disgusted me.   

From the very beginning it struck me just how difficult it was to navigate the ins and outs of the insurance system.  It was sometimes almost impossible for me to know what to do, and I had been working for insurance companies for years!  It made me angry that claims adjusters were making decisions about Patrick's care instead of his highly specialized physicians.  What business did they have holding his life in their hands when they had no medical training?  Why did they not care what was best for him?  And what about all of the patients who did not have a loved one who was not only a lawyer but able to take a leave of absence from work to sit at their bedside day in and day out, advocating for their care?

After Patrick died, going back to work for insurance companies and defending their constant decisions to deny care became incredibly difficult.  Every time I found a technicality that would allow a client to refuse to pay for a CT scan, I thought about that visit to the ER when the doctors did not order one for Patrick and how that might have changed the course of his illness.  What if my winning brief defending a surgical denial was the reason that someone was never able to go back to work?  What kind of impact would that have on the patient's family and loved ones who were bearing the financial, emotional and physical burden of caring for the injured worker?  Don't get me wrong - there are plenty of people making fraudulent claims and treatment providers who overprescribe and scam the workers' compensation system, so the insurance companies rightfully need defense attorneys to operate as a check on these abuses.  I just could not stomach being one of them anymore.

Initially, my grief was so thick that I could not do anything outside of basic functioning and pretending to still be human.  After the veil started to lift a little bit and I began to process all that had happened, I decided I needed a way to channel all of the energy associated with the experience.  I started looking up brain tumor organizations and came across the website for the National Brain Tumor Society.   There was a brain tumor walk benefitting NBTS the next month and I contacted the regional director to find out how I could get involved.  

It was love at first walk.  NBTS is a wonderful organization which is doing everything possible to advance research and advocacy for the brain tumor community.  I attended their annual gala in Boston in 11/2016 and was completely inspired by the passion and dedication of its members and those living with brain tumors.  I became a member of the planning committee for the Bay Area Brain Tumor Walk.  In 5/2017, I attended my first "Head to the Hill" event in Washington D.C. where more than 300 volunteer brain tumor advocates from all over the country converged to meet with our state government representatives to push for additional funding for research into GBM and all other brain tumors.  I became a member of the Pacific West Regional Advisory Board who assists NBTS with the development of strategies, initiatives, and programs that grow the organization's presence in California, Oregon and Washington.  I attended their annual Scientific Summit in Boston in 10/2017 where I learned so much (often way above my pay grade) about NBTS' Defeat GBM Research Collaborative.  Additionally, I volunteered at the Society of Neuro-Oncology's Scientific Summit in San Francisco which afforded me not only the opportunity to share about NBTS with the wider brain tumor community, but to see some of Patrick's doctors who became like family in the months we lived in the hospital. 

Most recently, I became a stakeholder with the Brain Cancer Quality of Life Collaborative, where we are focusing on optimizing palliative care for those with brain cancer.  I was also selected to attend the American Association for Cancer Research's Scientist Survivor Program in Chicago this May, a unique program designed to build bridges and unity among the leaders of the scientific and cancer survivor and patient advocacy communities worldwide.  I am looking forward to learning to become a more effective advocate and bringing much-needed attention to the brain tumor community.

What Patrick went through was horrible on every level.  I found it absolutely unacceptable that the insurance companies involved throughout his illness and death did nothing but make things worse for not only Patrick, but those who wanted nothing more than to ease his suffering.  When someone is fighting to live, the last thing anyone should be having to worry about is paperwork, deadlines, and denials of reasonably recommended care.   ​I am constantly plagued by the question of how to incentivize insurance companies to become part of the patient care team so that they are motivated to fund not only standard of care treatment but clinical trials that will eventually provide an end to the suffering of the thousands of people diagnosed every year.  No one dealing with a terrifying and deadly illness should be treated like Patrick was.  We can, and must, do better.

Like every other area in my life, I don't know where my advocacy road will lead me.  I do know, however, that I am built for this kind of work.  Nothing has given me a greater sense of purpose than sharing my experience with those who find themselves joining a community that none of us ever asked to be a part of.  If all of the years in school and the hundreds of thousands of dollars in student loans were for the sole purpose of making Patrick's journey a little lighter, it was worth it.   But I have a feeling it is bigger than that. 

My involvement with NBTS has brought both purpose and meaning to a sometimes desolate existence.  I have forged friendships with those living with brain tumors who fuel my fire for finding better treatments and ultimately a cure.  I have been touched by other care partners who are currently walking along side of the diagnosed, as well as those whose journeys sadly ended like ours.  Is it difficult to grow to love incredibly beautiful, brilliant, talented people whose futures are as uncertain as Patrick's was?  Yes.  Is it worth it?  Absolutely.  

For those of you who are grieving the loss of a loved one, or a marriage, or a job, or whatever other transformational change life has thrown your way that leaves you feeling lost, my advice is this: find your people.  Fight for them.  Show them, and in turn yourself, that none of us is in this alone.

I don't know about you, but I am pretty tired of trying to live up to expectations.  They come from everywhere: public opinion, social media, our friends and families, and ourselves.  When I say this, it does not mean that I am lazy, nor does it mean that I intend to sell all my worldly possessions to move to an ashram.  (Not that I haven't thought about that.  I have.  Regularly.)  What it means is that I have spent almost my entire life trying to be the person I think I am supposed to be with very little concern for who I actually am.  And you know what?  I'm OVER IT.  

When my husband Patrick passed away, I found myself smack dab in the middle of a scene from "Runaway Bride."  In that movie, Julia Roberts plays Maggie Carpenter, a lost, chameleon-like woman who has no trouble finding a man to marry her, but repeatedly dashes away from the aisle at the last minute.  Richard Gere's character, Ike Graham, is a reporter who is doing an up close and personal deep dive into her character after being fired for writing about her without any actual investigative facts to back up his claims.  In getting to know Maggie, Ike interviews all her ex-fiances about who she is and immediately recognizes a distinct pattern: Maggie morphs herself into whoever she thinks her partner-du-jour wants her to be.  An example of this is the fact that when Ike asks each of the former flames about how Maggie prefers her eggs prepared, every one of them answers that her favorite is the same as their own, which of course are all different.  Finally, Ike confronts Maggie, and shouts in exasperation "You don't even know what kind of eggs you like!"  Maggie sets out on her journey of self-discovery and tries all different kinds of eggs before settling on which is her favorite.  Just like any good rom-com, Maggie triumphantly announces her selection to Ike, and they live happily ever after.

If only finding out who you are were as simple as sampling six different plates of eggs.  Sigh.

I have often used this silly but useful story to explain what it was like for me after Patrick was gone.  We had become such an "us" that my individuality was all but completely absorbed into a life of "we."  When he died, it didn't just feel like I lost my husband, best friend, lover, and confidante.  It felt like I died as well, because it appeared that without "us," I was nothing.  I wished over and over that God would take me quickly so we could be reunited, not just because I loved and missed him, but because I needed him for my life to be meaningful.  

I had nothing but the best intentions when I poured myself into our love story.  I was single for a long time before we got together and I had worked HARD to find self-love and acceptance.  When we started dating, I did not even see those bits and pieces of "me" fading into "us."  I have always worn my heart on my sleeve and prided myself on being devoted and loyal, so neglecting my individuality in favor of defining myself by the love of someone else felt natural.  There were times when I realized we had become so intertwined that perhaps we were pushing the co-dependent barrier, but I was too happy to have finally found my person to care.  It never once crossed my mind what I would do if suddenly he was gone, whether it be by death, break-up or otherwise, and I was left with just me again.

All of this might sound sweet, romantic even.  It did to me.  But the truth of it was that it was not healthy, and when that abrupt end came, I was totally screwed.
​
It wasn't just my relationship with Patrick that defined me, though being loved by someone certainly felt like the most tangible evidence that I was enough.  It was my career as an attorney.  If I am being honest, I went to law school because I thought I was stupid my entire life.  I was diagnosed with a severe learning disability when I was 19 years old, during my sophomore year in college.  I had been able to compensate during my adolescence (because, it turns out, I actually am pretty smart!) but I always felt that I had to work so much harder than everyone else just to keep up.  I did horribly on standardized tests because I always ran out of time and got confused.  So, when the opportunity came to attend law school, it fit really well into my quest for external validation.  I thought if I just had the right job title, with the right initials after my name, then I would no longer feel that way about myself.

It turns out that my ingenious plan for overcoming my academic insecurities did not work.  I graduated second in my class from law school, but I was always convinced that it had somehow been a mistake.  When I struggled to find a job, it did not occur to me that perhaps it was because it was 2009 and the economy had completely tanked - no, it was because I did not go to the right school, or because people could tell that I was not as intelligent as my transcripts might suggest.  

Aside from romance and academic prowess, I was definitely defined by how physically fit I was (or, more accurately, how I perceived I wasn't - even when I had the makings of six-pack abs!)  I could go on about this one forever, but if you want more detail, take a look at my last post called "When Your Inner Child Is an Asshole."  The point is, no matter how many of my goals I attained, or how much outside confirmation was thrown my way, it was never enough.  I still constantly compared myself to my loved ones, and don't even get me started on what I would see on TV and social media.  I saw my friends getting married, having babies, getting promotions, buying houses, and doing all the things that our culture suggests are essential landmarks.  By those standards, I was an abject failure.

Within a couple of years of Patrick's death, I began to realize just how deeply rooted my feelings of inadequacy were.  They controlled everything I did.  They kept me in a job I hated.  They kept me living in a geographic area that made me feel like I was drowning in concrete.  I was surrounded by similarly exhausted people who seemed to be living miserably in order to have the "American Dream."  It felt like a nightmare to me.

I find that my greatest spiritual and emotional growth is always ignited by serious pain.  I was in some real, dark, might-not-make-it-out-alive discomfort.  Finally, instead of berating myself for all the ways my checklist looked incomplete, I was led to ask a different question: What if we measured our worth not by our achievements, but by our willingness to live outside of society's mandated list of "accomplishments?"  What if instead of checking off the boxes  - go to college, get married, have children, etc. - we actually took the time to get to know ourselves well enough to decide whether the items next to those boxes were what we actually wanted?  If that is what society valued, I hardly think that I would stay in a situation that left me waking up daily with a sense of impending doom.  

It was through a massive leveling of the ego that real change started to happen in my life.  I let go of the career that might have made it acceptable for me not to have the marriage/babies/white picket fence.  I moved home with my parents.  I stopped treating the meals I ate like some sort of emotional reward, and conversely every workout like a punishment.  I surrendered to the fact that I could no longer forcefully use my will to make my life look like what it "should."  I started to see that, for whatever reason, my soul has different things to accomplish in this life than those around me.  I began repeating a mantra given to me by one of my many spiritual guides who said "God's first priority is your healing and progression, not your resume."

The second I stopped depending on people, places and things to be "okay," life began to look a little brighter.  I started to feel like I was able to get small breaths above water.  I began to plug into the energy of the Universe to guide me, and let me tell you, it is showing up for me in ways that leave my mind boggled.  I am doing things that I never thought I could because of fear of judgment by the world, including writing this blog and teaching my first spin class yesterday.  For the time being at least, I am no longer motivated by the need to control my destiny and check the right boxes.  There is so much freedom in letting go of what others, or even that scared little girl in my head, might think.

I realize now that I am not on a journey to get back to who I was before "I" became "us" with Patrick.  It is so much bigger than that.  I am discovering who I am and what I want for the very first time.  I am laying a foundation of being grounded in the seat of my higher self instead of being crushed under the weight of that inner asshole who tells me I alone am not enough. 

Whether or not I am ever led to a loving partner again is not my primary concern.  Neither is my job title, my address, or the number on the scale.    What matters is that I know how I like my eggs.  And this time, I won't forget it.

I have a problem.

There is this person in my life who is constantly trying to steal my joy and drag me down.  She talks to me in a way that I would not dare speak to another human being.  She berates me, tells me why I am not good enough/smart enough/skinny enough, and never misses an opportunity to compare me to others, always letting me know that I am "less than."  She is more or less the definition of a jerk.

Now, I know what you're thinking.  Why on Earth would I allow someone like that in my life?  Cut the cord!  Tell her to kick rocks and leave you alone!  Her behavior is despicable and altogether inexcusable.  Be done with her already!

But here's the problem - she lives inside my head.  Unfortunately, evicting her is not that simple. 

There are a lot of names she goes by.  Some call it the ego, others the inner child or the small self.  I not-so-lovingly refer to her as my "inner asshole" because, well, the shoe fits.

My inner asshole is not an actual person in the human form sense, but she is just as real as the person sitting next to me in the coffee shop.  Some of my very first memories involve her.  When I was in 7th grade and my ballet teacher told me I was too muscular to be a dancer, my inner asshole told me that what she meant was I was fat.  That same year (apparently not a good one for me), I had a math teacher who literally told me I would never be good at math.  My inner asshole told me that I was stupid in every subject, not just math, and I don't think it's any coincidence that I never, ever was able to understand math throughout the rest of my schooling.  When I gained my "Freshman 15" (okay let's be honest, more like 25) in college after quitting competitive swimming, my inner asshole told me I was a disgusting embarrassment and that the best solution would be to start throwing up my food.  This led to years of bulimia and brought me more than once to the brink of suicide when I was too ashamed to look myself in the eye.  In a desperate effort to just SHUT HER UP, I engaged in years of high-risk behavior, which often took the form of drinking until I blacked out to get some relief.  That's what alcohol and drugs did for me - they gave me a brief respite from the agonizing chatter of my inner asshole whose entire purpose seems to be to convince me I will never, ever be enough.

Since I got sober in 2008 and chemical sedation of my inner asshole was no longer an option, I have spent years of my life and thousands of dollars on self-help books, experts, support groups, and anything else I could think of to try and control her.  I thought if I just spent enough quiet time in meditation, or learned the right affirmations, or lost enough weight, or [insert other behavior here] ... then I could be rid of her.  I would finally be able to kick this villain out for good, who has been living rent-free in my head for 34 years.  I have wanted desperately to figure out how to make her behave.  I have pleaded with her to be kind, and when she wouldn't listen, turned to the Universe to ask for relief.  "Please God," I would say, often aloud on my knees.  "I beg you - please make her leave me alone."  

Sometimes, my inner asshole quiets down long enough for me to enjoy myself.  That's when she is the trickiest, because I actually think I've finally outsmarted her and she's gone.  I start to stand a little straighter, engage with people around me more, and do things that she has told me I'm incapable of.  And boy, does that feel good!  So I push myself a bit more to step outside of my comfort zone, little by little.  I feel empowered even more!  I have won! 

That is, until something happens that hits a nerve that has not yet healed from my past.  Suddenly, she's back.  DAMN IT.  She's telling me how clearly I haven't worked hard enough because if I had, this wouldn't be happening.  She would be gone if I wasn't such a failure.  Just like that, it's as if she never left.

This cycle has repeated itself for as long as I can remember.  It is exhausting.  But, there is some good news to be had - I think I have finally discovered the most effective tool in my arsenal for dealing with my inner asshole.  It is not what I expected it to be, namely some forceful use of the will to eradicate her from my life.  In fact, it's the exact opposite.

When my inner asshole starts to rage, the best thing I can do is absolutely nothing.

I know that sounds ridiculous.  It seems counterintuitive, at least to me.  I have always been a "do-er," not a "be-er."  Society tells us that our value is measured in our accomplishments, and mastering my inner asshole has been a seemingly unwinnable battle.  But the truth is, I have no greater chance of shutting up my inner asshole by exerting my dominance over her than I do of beating a world-class fighter in a boxing match armed with nothing but sheer willpower, having never gotten in the ring.  

The truth is, I have to give my inner asshole space to exist.  It is like a little boy who starts sobbing when his favorite toy is taken away - would it be effective to start shrieking over him, telling him he has to be quiet?  I am sure there are some that would say yes, you have to show him who's boss, and if that works for you, great.  For me, I would say absolutely not.  Sometimes, he just needs to cry it out.  Would I judge his character and think that he is weak, foolish, and undeserving of love and support?  Never.  I would allow him the space to have his moment, knowing it will pass.  I would accept the tantrum for what it was without judgment.  If he needed it, I would console him.  So why is it so hard to do that for myself?

When I lived in Italy after college, I was an indoor cycling instructor and absolutely loved it.  Over the years I got more involved in weight lifting and cross training, but after a series of injuries I was forced to find something lower impact that would not involve constant pounding on my joints.  A couple of months ago, I decided to get back into spinning, and fell head-over-heels in love with a boutique cycling studio in San Luis Obispo.  The vibe is amazing and the owners have truly cultivated an environment based on support and self-care that makes me feel safe and honored.  So, when they told me they were going to be piloting a new instructor training program, my initial reaction was excitement - how awesome would it be to get back up on the podium and encourage other riders?  I signed up and was so looking forward to getting started.

And then, my inner asshole decided to attend the first training with me.

As soon as I saw the other five girls who were to be going on this journey with me, my inner asshole saw her opening.  They were all younger than me.  They were all skinnier than me.  They were the girls I had always aspired to be but could never quite measure up to.  What the hell did I think I was doing there?  "No one wants to look like you, Lisa!" she told me.  "You're like the bad "before" picture on an Instagram fitness journey!"  I conjured up mental images of my wedding day less than three years earlier, remembering that I was many sizes and pounds smaller than I am now.  Never mind that I was quite literally starving to death at the time of my wedding.  For the eight months before, during my husband's brain cancer journey, I was living on Red Bull, protein bars, and anxiety, because the stress made it almost impossible to eat.  No, somehow the fact that I had "let myself go" after he died conjured up all of those old feelings of uselessness and embarrassment.  

Normally, my inner asshole's tantrum would have either directed me to make up an excuse to leave immediately, or to bow out for the rest of the program.  I would have felt perfectly justified, and given myself permission to not put myself through the inevitable mind-f*ck that would follow if I completed it.  Honestly, if that had felt like the right thing to do, I would have.  But it didn't.  I knew that this was the next act of radical self-care that would be required of me on my path to self-acceptance.  So, I strapped in for the ride, knowing that it would at times be excruciatingly painful. 

Throughout the program, I gave my inner asshole permission to feel however she needed to feel, without getting attached to those emotions.  When some photos were taken of me on the podium and posted online, I cringed as she told me how fat I was.  When some of my song profiles did not go exactly according to plan, I allowed my heart to sink and I heard her when she called me a loser.  She told me that I am a lawyer, not a fitness expert, and I had better just knock it off and get back to what I know whether I hate it or not.  But this time, I didn't tell her to shut up or try to out-shout her.  I acknowledged her feelings, and let them pass.  And pass they did, every time.  When I felt that tightness in my gut that is so often intertwined with a tantrum by my inner asshole, I made a conscious effort to relax and release them.  I started to realize that the feelings were not real.  Finally, the saying "feelings aren't facts" was making some sense. 

Over the weeks of the program, I started to feel more and more confident, realizing that I can bring more to the room than a perfect body.  I can bring kindness.  I can bring strength.  Every one of the challenges I have faced, whether real or imagined, makes me more well-suited to inspiring people to become the best version of themselves because that is what I am trying to do in my own life.  The truth is, I have overcome far greater obstacles than the fear of being judged for my imperfections.  (I will note here that every single one of the beautiful women in this training group also brings SO MUCH MORE than a tiny waist - they are each kind, incredible people who I have had the pleasure of getting to know!)

Today was the last day of our training.  My inner asshole showed up at the end, because all of a sudden the possibility of really getting up in front of a class full of strangers instead of my supportive ladies became real.  She told me, again, that I am not good enough - that maybe if I lose 20 pounds I could consider teaching.  She had me in tears before even walking out of the studio.  So, on my way home, I let her cry.  I recognized that underneath all of her bluster, a greater part of my soul wants nothing but the best for me and my physical, emotional and spiritual health.  That is the part of me that I am interested in nurturing.  

I used to say that I hoped someday my inner asshole would be nothing but an unpleasant memory, like the first time I tried oysters and they made me violently ill.  I have started to feel, however, that the concept of hope simply means that I am refusing to accept circumstances as they are today.  The more that I search for external validation, whether it be a certain number on the scale, the right feedback from riders in a spin class, or the "perfect" job, the less likely I will ever be happy.  I have spent my lifetime subscribing to the belief that I have to earn love and respect from not only other people but from God, because Lisa in and of herself is not enough.  The more that I understand that my presence on this planet gives me inherent worthiness, the better off I am. 

For now, my inner asshole is still a part of my experience.  As long as she is, I am going to work on allowing her to do what she needs to do to work out her issues rather than trying to shove her face in the sand.  And the next time she has an opinion, I will simply thank her for sharing.