Maurice A. Ramirez, DO, CNS, CMRO

The Year of Resilience

I had the occasion this New Years day morning to take notice of a piece of cross-stitched artwork. This simple treasure hangs in a place of honor in my kitchen.  The inscription is a simple poem, there is no author or citation, only three initials at the bottom.  The poem reads:

“There is no friend like an old friend
Who has shared our morning days,
No greeting like his welcome,
No homage like his praise

Same as a scentless sunflower
With gaudy crown of gold,
But friendship is the breeding rose
With sweet in every fold.”

The three initials at the bottom are those of my grandmother and this small bit of cloth sits behind the glass of a simple wooden frame.  It hangs in the same place in my home as it hung in hers so many, many years ago.  It hangs in a place that ensures everyone who enters my home sees it.

Grandma is gone now, the victim of one of the diseases that takes away grandmas and grandpas.  But grandmas and grandpas have a way of leaving us little messages, little reminders that no illness can take away, no amount of time can silence.

It is through these small reminders that we relive the sweetness of their company and the wisdom of their years.  It is through these gentle proddings that they continue to remind us what is truly important in life and how best to enjoy the time we have with our friends, our family and our grandchildren.

On this New Years day morning, as we all reflect on resolutions and goals, I find myself drawn to this simple bit of cloth and my grandmother’s wisdom. I have decided to make 2007 The Year of Resilience. A year of promoting resilience and the skills needed to create resilience in myself, my family, my colleagues and my clients.

I invite you to join me in making 2007 The Year of Resilience.

Happy New Year!

The Gift of Resilience

December 29, was an amazing, exhausting 45 hour day.  In the aftermath I had the opportunity first to take stock of everything that had happened, of how the corporations, companies, people and professionals and the resources of a nation come together to save one life.  After the euphoria had dimmed the fatigue set in.

The holiday season is stressful for all of us, this year for me, especially so.  My physical resilience had already been stressed by an unexpected encounter with influenza (H1:N1).  When I got the news a few days before Christmas that I had the Spanish flu, I actually had to chuckle.  Imagine an expert on pandemic preparedness that I had H5:N1. 

As with any influenza, the body aches and fever ensued. Laryngitis made it difficult to dictate my daily magazine column.  Patients would chuckle in the emergency department and then nervously after ask me if I was contagious.  I assured them that because of Tamiflu and the fact that I was beyond the infectious period, they had nothing to worry about. 

Christmas preparations had been hectic, but Christmas Day had been a joy.  The day after Christmas, my wife and children went onto my in-laws home for a visit while I stayed behind, both to work and to insure that I did not inadvertently carry an illness to my already sick father in-law.  This is the first time since we married that my wife and I did not spend the entire holiday season together and I found myself sipping from my canteens of relationship and emotional resilience. 

The laryngitis had also excluded me from four religious concerts for which I had prepared diligently.  Although I had enjoyed the beauty of the religious services, there was a twinge of disappointment in not lending my voice in praise and expression of my spiritual beliefs.

When “Glen” arrived in the emergency room all focus shifted to him.  As we worked first to stabilize him, then to find a place that could care for him and finally a way to get him to that place I transitioned from drawing on resilience for my personal needs to drawing on resilience to complete the mission. Taking “Glen's” wife on the transport meant that my own emotional resilience and even spiritual resilience would be sustaining not only myself, but “Glen” and her as well. 

Without realizing it, I was now drinking deeply, gulping, from my canteens.

Exhaustion taxed my physical resilience as I crossed first 24 then 36 hours awake and on duty. My relationship resilience was drained by separation from family and my inability to meet them at the airport as they returned home while I was on Coast Guard Rescue Flight 2114. Watching this couple hold hands for what may have been “Glen's” last day sapped my emotional resilience.  My only remaining reserve was my spiritual resilience.

My canteen of spiritual resilience was constantly refilled by the knowledge that it was only true Providence that “Glen” had come to the emergency department at all.  That it was only through the hand of Providence that there was a physical sign of his illness that could not be explained by any other possibility.  When a 49 year-old man comes to the emergency department with chest pain, the first thought is heart attack and the first treatment is one that would have killed “Glen”, but he had one physical sign, one thing, that could not be explained by heart attack and in fact could only be explained by the condition that he had.  Yet when his CT scan was reviewed, he should not have had that sign.  It was the knowledge of this Providence and the renewal of emotional resilience drawn from the waves of people who surged to save “Glen's” life that made it possible for me to complete the mission.

I had been awake for 36 straight hours by the time I arrived home.  My family was all at there, having arrived back earlier in the day.  They had sketchy information on where I had been and I was more interested in hearing about their trip then talking about mine.

My daughter Tiffany asked, “How do you do it? How do you work for 36 hours straight like that?” I told her that you pay a price. You trade a small piece of your life and health for a much bigger piece of theirs.

After a four hour nap, I awoke to find that the medical students, who had no way of knowing of what had transpired, had left me a present.

In the gift bag I found a snow globe, a miniature recreation of the place where they had volunteered their time.  There was also a pin, one like those that each of them had worn as a volunteer and a small leather bookmark embossed with the mission of the Give Kids the World volunteers.

“What Matters…
One hundred years from now,
It will not matter what kind of car I drive,
What kind of house I live in,
How much I have in my bank account,
Nor what my clothes look like.
But the world maybe a little better because I was important in the life of one child.”

The card enclosed read:

“Dr. Ramirez,
You are a real sunshine maker!
Thanks so much for your hospitality and kindness!  Gathering at your lovely home was a great way to start our unity project.  We look forward to seeing you in D.C.
Best wishes, Sally Murad & SOMA”

Sally and her leadership team had asked if I would be willing to address them in April, 2007 in Washington, D.C.  It was at the moment that I read the card and opened the snow globe that I knew what story I would tell. 

I would tell them the story of a group of young medical students who had given up their Christmas and inspired an old doctor. 

I would tell them the story of “Glen” a 49 year old man whose birthday present to himself was the manifestation of almost absolutely fatal condition and how a nation had come together to save this his life. 

I would tell them the story of being tired, of trading a small piece of your life and health for a bigger piece given to a stranger.

I would tell them the story of being close to drawing the last drop of resilience and how a card, a bookmark, a pin, and a snow globe refilled my 40,000 gallons of resilience.

As 2006 draws to a close and we all prepare to celebrate the renewal that 2007 represents,
I take stock in the things that I have (my physical resilience),
the people whom I share my life (my relationship resilience),
the joys, sorrows, triumphs and dreams of my life (my emotional resilience)
and the Providence that guides me (my spiritual resilience).

Happy New Year!

Will Social Isolation Work?

A comment posed by Peter in response to my December 17, 2006 post titled: "Setting The Record Straight on Pandemic Preparedness" opens the question of the effectiveness of Quarantine, Isolation and Social Distancing.

Unfortunately, the terms "Quarantine," Isolation" and Social Distancing" are often used interchangeably. This leads to significant confusion when trying to predict the efficacy of various pandemic plans. Further, both "Isolation" and "Quarantine" had ominous terms. To engage in an intelligent discussion, we must begin with a common vocabulary:

Quarantine - The separation of a potentially exposed group from a known unexposed population.

Isolation - The separation of a known ill group from a known healthy population.

Social Distancing - The process of maintaining both physical distance and physical barriers to decrease the probability of spreading a disease.

Examples of each of these are common in history.

Quarantine has been attempted since time immemorial. The most extreme example (and the one Hollywood likes best) is the method used during the second Black Death (plaque) in Europe. In this method of quarantine, an army would surround a village. Anyone attempting to leave would be killed. When most or all of the villagers were dead of the disease, the village would be burned. Unfortunately, the plaque carrying rats would escape and the disease spread.

Isolation is a daily event in hospitals around the world because is it is easy. A person who is sick is easy to identify among a group of well people. This  sick individual (or group) can thus be separated from the health group in an attempt to decrease spread of the disease. The problem with isolation is that many diseases (including pandemic flu) ware contagious before the infected individual shows symptoms. This makes identification far more difficult. Further, isolation is equipment and staff intensive owing to the need to treat the sick patient without contaminating staff or others outside the isolation area.

Social Distancing is the method used in Singapore and Toronto to slow and eventually stop the spread of SARS. This method worked for several reasons. First and foremost, the healthcare systems in both countries allowed for enforcement of Social Distancing of healthcare workers at home as well as at work. This meant that healthcare personnel maintained their N95 masks and a minimum 2 meter separation from everyone even when off duty. The penalty for violation of this public health rule was sanction or imprisonment. In the words of one Toronto nurse,

" Imagine smelling your own stale breath as you tried to sleep alone in a separate room with your N95 mask still in place. My child was 5 years old... do you know how often you hold your 5 year old? I couldn't hold my child for that entire time."

Peter points out a valuable piece of planning information, Social Distancing (which he referred to as isolation) worked in 1918 and in 2004. The conference video Peter recommends proposes solutions not unlike those proposed by panels and committees on which I have proudly served. The point missed by all of these individuals, committees and expert panels; the point I missed until it was illustrated for me by James Shultz, Ph.D. at the University of Miami's Disaster and Extreme Event Preparedness Center aka DEEP Center (http://www.deep.med.miami.edu/). Dr. Shultz points out that Quarantine, Isolation and Social Distancing are "Separation by Prescription" and thus have significant psychological and social impact.

Separating people from their support systems, both personal and societal results in a loss of resilience. Resilience is the one tool we each have to turn a disaster around; it is through resilience that we ensure our resources exceed our needs.

There is a famous saying that was born in the early 1900's, "Don't throw the baby out with the bath water." In my original post I urged common sense in our approach to pandemic planning. I recommended against stockpiling medication and food. I recommended for good personal and public hygiene. Now I urge that we not throw out the baby of resilience with the bath water of preparation.

My original post: http://www.disaster-blog.com/2006/12/setting_the_rec.html

Peter's comment: http://www.disaster-blog.com/2006/12/setting_the_rec.html#comment-26952586

Pardon Me Mr. President

As our nation pauses to pay its respects to the memory of former President Gerald R. Ford, the importance of this under appreciated leader and his service to the people of the United States is finally coming tot he fore. President Ford came into office at a time when Americans had lost confidence in the government and the Office of the President.

The Vietnam War had divided the nation along philosophical line like no war since the Civil War. The Watergate scandal had embroiled all levels of the administration and had brought down a president. The economy was suffering. In short, the United States of America was a political disaster area.

President Ford had never run for his office. Appointed Vice-President after Spiro Agnew, he ascended to the Presidency after Richard Nixon resigned. He would be in every way the reluctant hero.

Why a hero? Because he was everything his nation needed. The brief presidency of Gerald R. Ford represented a period of recovery, a time when our nation rebuilt and restructured itself and its confidence in its leadership. The pardon of Richard Nixon for which President Ford is best known and most criticized was but the first step in a necessary process of recovery our nation desperately needed. In the process of that recovery, we gained both confidence and pride.

Disaster recovery takes years, often decades, yet under the watchful eye and gentle guidance of President Gerald Ford, the nation found itself ready to advance in little over 2 years. Gerald Ford was our good shepherd.

By the end of the Ford presidency, the United States was ready to resume its place a world leader in diplomacy and humanitarianism. We chose a president consistent with this purpose, James Carter. President Carter would be followed by a president who would lead us as to international prominence, Ronald Reagan. Finally, our recovery would be completed by a president who would reconnect the presidency to the people, William Clinton.

But none of this recovery would have been possible without the foundation laid quietly and humble by a President and a man perfectly suited for his time, Gerald R. Ford. Pardon me Mr. President for not saying "Thank You" sooner.

Drinking Deeply of Resilience

On this second anniversary of the Indonesian Tsunami, the principles of resilience have a poignant significance. While those rebuilding lives and countries commemorated the event with religious services, memorials, events of state and moments of silence, I spent this day with a small group of medical students. These members of the Student Osteopathic Medical Association (SOMA) came to Central Florida to donate their time and holiday vacation to help severely disabled children and their families.

Medical school is a grueling experience. These students receive little or no time off during the four years while spending 50 to 60 hours per week in class and clinic. Without any conscious realization, these medical students found a way to rebuild their own resilience.

The greatest statement of resilience that I have heard in my years of nutrition counseling, medicine, or disaster for response and recovery are drawn from the daily prayer of Alcoholics Anonymous:

“Lord, grant me the strength to change the things I can change;
(physical resilience)

“The serenity to accept the things I cannot change;
(relationship resilience and emotional resilience)

“And, the wisdom to know the difference.” 
(spiritual resilience)

This simple prayer, or wise saying if you prefer, is not only itself a source of spiritual resilience, but the embodiment of the four canteens. 

Once we have filled our four canteens of resilience:  Physical, relationship, emotional and spiritual we are ready to deal with life’s adversities, but it is how we draw from our canteens of resilience that determine whether we will suffer a disaster (our needs will exceed our resources) or that we will actually remain resilient (our resources will exceed our needs). 

Although I have heard this prayer many times during my over quarter century of dealing with clients, patients and corporations, it was never brought home better than as I watched my own daughter go through her personal recovery.

Tiffany had been hospitalized with her own health challenge and at a time when I was deployed to a disaster scene.  Ordinarily I would have been released to go back home, however just the day before my daughter was hospitalized, the only other physician on the team had been called back also for an emergency and his was more grave than mine.

So, for the first time in her life, Tiffany had to face a challenge without daddy by her side.  Laura was there, as well as her older sister, Victoria and her brothers, Nicholas and Christopher.  My mother, Jean, was also steadfast at Tiffany’s side, but with all of this support and even if I had been there, Tiffany had to walk her road with only our emotional support.

Certainly the relationship resilience we provided, as well as the emotional resilience helped Tiffany’s resources, helped pace her needs at every moment.  Tiffany had been the only girl on an all boys’ football team in high school and was in excellent physical shape which provided her the physical resilience to bounce back from her hospitalization.

While Tiffany was well rooted in the spiritual and religious beliefs of her upbringing, they had never been personally tested for her.  Once more, being in her late teens and being like all other teenagers she had begun to question and challenge her own beliefs, internalizing was hers rather than a mirror reflection of what her parents had taught her.

It was during this period of challenging her own beliefs that she would be forced by necessity and by survival to believe, to state to herself that she believed even if she was not certain anymore and from that, draw her spiritual resilience.

I say with no modesty and with the greatest of pride that Tiffany is the embodiment of the four canteens of resilience.  She displayed physical resilience in the face of a life adversity.  She drew emotional, her relationship and emotional resilience from her family and friends. In the turmoil of early adulthood she found the inner peace and the well spring of strength that comes from believing that comes from the act of believing, from a full spiritual life that leads to spiritual resilience.

In the end, resilience is just that easy.  It is resilience that prevents an adverse event from becoming a disaster because it is through resilience that our resources always exceed our needs.

Your 40,000 gallon bathtub provides you the resilience to deal with any adversity that life or business may send your way.

(Excerpted from my lecture series and book Avoiding Business Disasters: Lessons from the Disaster Field Office)

Filling the Canteen of Spiritual Resilience

Of all of our sources of resilience, spiritual resilience, it is the only one that is self replenishing.  It is proven that the very act in believing adds to our resilience.  Like emotional resilience spiritual resilience grows when shared.  But unlike all other canteens of resilience it is spiritual resilience that refills itself.  Since we know that it does not matter in what we believe, but that we believe in some form of high order, high wisdom, or higher power a “God” or guiding force in life.  It makes sense that acting on our beliefs would add to our resilience.

It was spiritual resilience that sustained me during the multiple field response deployments of 2005. Hurricane Katrina was an absolute catastrophe in both humanitarian and a physical nature.  What the hurricane had not directly destroyed the levee breaches soon did.  Lawlessness and anarchy brought a few to the basis of human emotion and behavior.  But the tragedy also brought out the best in many people.  Like 9/11 before it Hurricane Katrina’s “ground zero” was dotted with signs that seem to reproduce like mushrooms each one declaring “God bless New Orleans” or we have faith, we will be saved.

These people not only publicized their beliefs (and their spiritual resilience), but they lived it.  These individuals shared not only their stories with us as we treated their physical ailments, they  told us that they would pray for us or that we were the answers to their prayers.  It is not unusual to receive perfunctory thank you’s in healthcare, but to be asked to pray with a group of survivors and then be the object of their prayerful thanks is both humbling and rejuvenating.

And for these wonderful survivors it was the act of expressing their spirituality that renewed them. Remember this is New Orleans, we are not just talking Christianity, Islam, Judaism, but Santorista and Voodoo.  Every form of religious expression both familiar and exotic and yet they all served a common end: they bound a people together and renewed them. The found the way to refill their own 40,000 gallon bathtub by pouring from their canteen of spiritual resilience.

(Excerpted from my lecture series and book Avoiding Business Disasters: Lessons from the Disaster Field Office)

Merry Christmas!

Filling the Canteen of Emotional Resilience

Emotional resilience is the product of our own experiences.  The unique thing about emotional resilience is that unlike physical resilience are experiences need not be the same as the adversity that we now face.

In the training environment this type of "cross over" is exploited to help create emotional resilience in a number of professions.  Airline pilots, the military, sales people, law enforcement officers and most recently healthcare professionals employ Immersion Simulation Environments to introduce controlled, simulated stress in a way that allows these professionals to develop emotional resilience.

The Internet abounds with software programs and even video games that allow a business person to "practice" their financial forecasting skills in their business management.  Computer games and board games even provide an opportunity for emotional growth and the development of life skills.

But there is no "Flight Simulator" for life... or is there?

The "Flight Simulator" for life adversity and business adversity however is experience.  The confidence that comes from encountering and overcoming the ebb and flow of daily life gently fills our canteen of emotional resilience.  It is in the dealing with the burnt dinner, the flat tire, the person in the ten item checkout line with 12 items, and the crying babies in the theater they give us the opportunity to build our emotional resilience.

Whether or not we in fact use these "life lessons" to fill or drain our canteen is entirely our choice.  We all know individuals who spend their lives complaining.  Every little set back is a major problem, every challenge an insurmountable object.  Some of these individuals when faced with a truly tragic adverse life event "rise to the occasion."  Everyone one around them is amazed that this individual is "managing so well."  Unfortunately this is the rare outcome of failing to build emotional resilience from everyday life.  In reality these individuals when studied (and they have been) are really drawing their resilience from the other three canteens and in fact most often from their spiritual canteen.  When studied objectively it is often discovered that these individuals are emotionally overwrought or emotionally numbed.  Their emotional canteen is bone dry and they are compensating from their other canteens.

On the other hand we all know people for whom life's little tragedies are nothing more than minor tribulations.  These individuals are lights in the lives of their friends and colleagues.  They are safe harbors when the emotional waters become stirred.  They are often described with phrases such as "unflappable" or "steadfast", or "strong."

With these individuals the trials of everyday life reassure them of their own strength and fill their emotional canteen.

It is not just our challenges that fill our canteen.  While our relationships fill our relationship canteen the emotions that are relationships create within us fill our emotional canteen.  That is right, we get a two for one return on our investment.  Even better, our emotional canteen is filled by the casual relationships we have at work.  While is true that some of these work relationships fill our relationship canteen by being friendships as well, the encouraging pat on the back from a boss, the applause or accolades of colleagues and even the camaraderie at the water cooler provides a sense of belonging and inclusion that quickly fills our emotional canteen to overflowing.

Our emotional canteen is also one of two that we can share with others.  During times of adversary we can actually help fill another person's emotional canteen by sharing the life experiences and the feelings that surround those experiences with that other person.

The beauty of this ability to share emotional resilience is that it does not take even one drop from own canteen.  In an almost miraculous fashion the sharing of the contents of emotional canteen allows us to pour almost perpetually into the canteens of others and yet retain a full canteen for ourselves.  It is not until we begin to sip or gulp from our own emotional reserve that we, ourselves, need to seek replenishment. Live richly, love honestly and fill the canteen of emotional resilience.

(Excerpted from my lecture series and book Avoiding Business Disasters: Lessons from the Disaster Field Office)

Filling the Canteen of Relationship Resilience

Keeping the relationship canteen full is more than just accumulating friends and acquaintances.  The relationship canteen is filled by the richness of those relationships and the connectedness created through the friendships and family.

It is said that a person with friends is never truly alone and when your resilience is tested a full relationship canteen is proof of that statement.

In my life I am fortunate to be blessed with a wonderful marriage.  My wife, Laura, is intelligent, caring, compassionate, supportive and beautiful.  She is a fantastic mother and my best friend. Laura is absolutely supportive of me in everything that I do.  No only my disaster response work but my every day life, my beliefs (even when she disagrees with them), my dreams, my goals, and even my desires. Laura and I share a relationship that is special and in modern society increasingly rare.

Because I strive for physical preparedness both in body and in resources we maintain family preparedness in the same realms.  We have a family plan in the event of an emergency and each of my children, as well as Laura, are well versed in every aspect of that plan.  I know that I can count on Laura to keep the family safe no matter where I may go, what kind of disaster I respond to, what may befall them in my absence, or even in the event that I should never be able to return home.

When I must call upon my resilience, I have a full relationship canteen.  Not only does my marital relationship contribute to this reserve, to this relationship resilience, but I have similar relationships with each of my four children and with my mother.  What is more, even though my father is now deceased,my relationship with him remains a source of relationship resilience.  I know that he is proud of me in the work that I do.

This limitless source of renewing strength ensures that I am able to endure and ultimately overcome any challenge ahead of me.

But again relationships are a two edged sword when it comes to resilience.

Several years ago my younger daughter Tiffany suffered challenges of her own and I was away to assist in response and recovery for a declared national disaster. As a result of Tiffany's hospitalization my resilience was seriously compromised. 

I was conflicted. 

I was physically strong and physically prepared.  I had all of the equipment and resources I needed to perform my disaster response duties.  But the challenges facing somebody who I cared about caused my relationship resilience to suffer significantly.  Rather than being a source of strength my need and desire to be home caring for my daughter sapped my strength.  I was no longer sipping from my canteen of resilience.  I was gulping deeply.  My 40,000-gallon bathtub had sprung a leak. 

The fact that I could do nothing even if I were at her side did not make a difference in how badly her needs affected my resilience.  The fact that I would not even be allowed to be at her side in the first week of her hospitalization did not change the impact of her needs on my resilience.

Relationships are a two-edged sword for resilience but this does not mean that we should limit our relationships based on their potential impact.  Quite to the contrary it means that we should expand our relationships. Make them as deep and rich as possible and share in providing for the resilience of those of whom we care most deeply. Are you growing relationships that fill your Canteen of Relationship Resilience?·

(Excerpted from my lecture series and book Avoiding Business Disasters: Lessons from the Disaster Field Office)

Filling the Canteen of Physical Resilience

Imagine being 50 pounds overweight, woefully out of shape, and recently discharged from intensive care after suffering an infection that devastated your liver and kidneys.  You've regained your physical health through the skill of your doctors and nurses, but you can barely walk across the room.  You are beyond couch potato... you're Jabba the Hut! 

This was my exact situation after a simple case of salmonella food poisoning resulted in severe dehydration and hepatorenal failure.  In essence, my liver and kidneys had all but shut down and my body spent two weeks using not fat, but muscle as it's primary fuel source.  While I had lost 15 pounds, but I had not lost more than a pound or two of my excess 50 pounds of fat. 

I had been a competitive swimmer in my youth as well as a competitive martial artist while in medical school. I had intended to begin exercising after the first of the year. The holidays had not yet passed, but it was clear that I had to do something to regain even the barest minimum of physical strength and stamina. 

Imagine jumping into your 40,000 gallon bathtub in December, literally.  Even in Florida, even in a heated pool, it is a shock.  Fortunately fat floats, so my risk of drowning was low.  The first few strokes were incredibly painful.  Not only had I not exercised at all during my extended illness, but these were muscles I hadn't used to any great extent in decades.  By the time I had swum the 200 yards it took me to warm up I was physically exhausted and panting like a greyhound after a race.  By 400 yards my now warm limbs were screaming and my face was hot and flushed.  I could almost feel steam rising from my body even while I was in the water.  By 500 yards I called it quits for the day. 

Not much of a story on physical resilience except that the next day I got back in the water and again the day after that and the day after that.  By February I was swimming two miles three times a week.  I had lost 35 pounds of weight and an estimated 45 pounds of fat.  My muscle mass was up and at the end of two miles I was not breathing any harder than when I entered the water.  My kidney and liver function were back to normal and I was in the best shape that I had been in since medical school.

Physical resilience is about dedication to repeated practice, to education, to creating resources needed for any event or situation. Physical resilience is the development of perseverance through perseverance.

Physical resilience is also the easiest resilience to develop.  In terrorism and disaster training it is simply the accumulation of knowledge and materials.  Five days of training, a 72-hour survival pack and four pocket handbooks shrink wrapped into a waterproof brick are sufficient to turn any healthcare provider into a proficient disaster response professional.  It is not the knowledge or the "brick of books" but the Four Canteens of Resilience that are key. What will you do to fill your canteen of Physical Resilience?

(Excerpted from my lecture series and book Avoiding Business Disasters: Lessons from the Disaster Field Office)

The Four Canteens of Resilience

What exactly, what is "resilience" and how do you build a 40,000 gallon bathtub in your soul?

If resilience is when your resources exceed your needs, then the key to resilience is to always have more resources than you need.  In life, these resources fall into four broad categories.  The first is simple physical resources:  food and water, shelter and, yes, money.  The second is relationships, friends and family; those people who count on us and those people on whom we can count for support. The third is emotional.  Although this may seem the same as relationships, it is far different.  This is the "inner strength," that reserve that we each possess that allows us to go on when we are alone, when we cannot tap into our relationships directly, when that lifeline is just not available. The fourth is spiritual resilience.  Contrary to what many believe, both scientific and theological research has proven that it is not the "what" of your belief, but the fact that you believewhich provides spiritual resilience. In short, it is the simple act of believing that provides you a renewing source of spiritual strength.

If our total resilience is a 40,000 gallon bathtub, then each of these four categories of resilience is a canteen.  They are our portable water supply carried with us at every moment. 

Ideally, when adversity strikes, it finds us with four full canteens. 

Through planning, we have all of the physical resources that we need to respond to any physical threat to our safety or security.  This includes knowledge as well as tangible objects and financial support.

Through our presence with family an friends, our relationship canteen is filled with  those we love; people who will lend a helping hand or shoulder on which to cry.   

Through our lifes experiences, our emotional canteen is filled with the high self esteem born of happy memories.  A child's first steps, a parent's encouraging words, the camaraderie of friends, the gentle "I love you" of that person most dear to us. 

Through our beliefs, our spiritual canteen is filled with the philosophy of the ages.  The beliefs that were passed on to us and those that we choose to pass on to those who will come after us.

When an adversity strikes, we will sip or even gulp from each of these canteens.  If we have prepared well, our 40,000 gallon bathtub is full. At the endof each day, at a moment of repose, we refill each of these canteens from that 40,000 gallon reserve. We are resilient.

(Excerpted from my lecture series and book, Avoiding Business Disasters: Lessons from the Disaster Field Office)