Whitewater paddlers make it look easy—staying upright in raging waters, navigating huge swells, and leaning and cutting at the right time to avoid dangerous obstacles. And when they do flip upside down, they can pop themselves right back up. It’s a marvel. But no matter how expertly they paddle, they always have to respect the power of the water. They can make careless and costly mistakes when they let their guard down and get too comfortable. We, physicians, do the same. We take an inherently dangerous, complex, and difficult discipline and learn to practice it as an art. We learn how to navigate tricky diagnostic pathways, respond rapidly to changing clinical conditions, and try to stay emotionally upright while riding successive waves of an ongoing pandemic. On our best days, we glide through the whitewater of medicine with style and grace. But if we let our guard down and get sloppy, we can make a careless and costly mistake. Who isn’t fatigued by constantly being on guard in the whitewater? I have been thinking a lot about paddling lately. Since residency, getting out on the water has remained a source of wellness and renewal. I enjoy just about all paddle craft. Sometimes it’s sitting inside a skirted kayak at the water level and flipping upside down only to pop up again—a natural baptism that puts us in fellowship with the ducks and the turtles. Or maybe it’s hopping on a stand-up paddleboard on Lady Bird Lake here in Austin, Texas, and immediately feeling carefree, relaxed, and untethered. Other times it’s paddling a gracefully-curved canoe with a friend, such a timeless and grounding adventure of shared effort, striving, wonderment, and sometimes shared suffering! My current kayak is unusual—a black, open-hull, lightweight carbon-fiber downriver racing boat. It is super tippy at nineteen and a half feet long and twenty-one inches wide, with gunwales just a few inches off the water. I have unintentionally flipped and flooded it many times. This boat was designed for racing down the San Marcos River, but I am still just trying to keep it upright in still water. To do so, I am constantly learning to engage my core and work on balance. No false or careless moves. It forces me to slow down and focus on my breathing and movements in ways no other boat has. I am enjoying the challenge. Regardless of paddle craft, I have yet to spend a day on the water with a friend without fantastic conversation and deep connection. Hours on the water in nature together steadily take us to unhurried and thoughtful exchanges, along with potent periods of shared silence. Neither have I spent a day alone on the water that didn’t result in greater inner peace and calm. Meditation, gratitude, joy, wellness. Here in central Texas, I feel blessed to be surrounded by water. Is there water near you? Can I recommend getting out on the water if you need a new wellness strategy? Whether it’s Lady Bird Lake, the San Marcos River, or a quiet section of Barton Creek, the water always buoys me, helps me find balance, refreshes me, and draws me into deep connection. It can do the same for you. There is even growing neuroscience to show that bilateral alternating movement (like paddling) can help our brains process trauma. And we all know the countless benefits of time in nature. As thrilling as whitewater can be, I find myself seeking still waters these days. Even while at work, amid busy whitewater days, I am coming to find moments of still water. Suppose I seek out and recognize these moments, slow down, and work on breathing. In that case, I re-discover the balance and form to keep me paddling downstream, staying upright in the everchanging waters of practicing medicine. I hope to see you on the water. Source