Sonny Miles, MD

01/07/2024

I’m excited to have this published on kevinmd… and grateful for the work that allows me to reflect deeply on what matters…

A palliative care physician reflects on helping a metastatic cancer patient navigate the emotional complexities of living while knowing she is dying.

10/05/2024

If you have a moment, check out my newest blog post!

Noticing that you’re dysregulated is the first step in being able to change what’s happening. Your body is in some version of the fight or flight response. Your brain senses a threat and your body is being flooded with stress hormones. While those hormones are helpful in certain settings, we don...

09/05/2024

This article reminded me of one of my favorite practices that I first learned from Roshi Joan Halifax at the Upaya Zen Center in Santa Fe during a program called Being with Dying. In the practice we did, you imagine your death some number of years in the future (say death at 80 years old) and you contemplate the things you would want to do to make your life feel well-lived. Then you move it backwards... dying in 10 years, dying in 5 years, dying in 1 year, and continuing on. In this article, the author asks you to contemplate dying in 5 minutes. Thinking about our own death so clearly illuminates what matters and where we need to do our own work.

By contemplating our deathbed regrets, we learn that the secret to the art of dying well is right under our noses in how we live our lives.

09/05/2024

Yesterday, I was watching a little bit of the docuseries "Remedy: Ancient Medicine for Modern Illness" talking about herbal medicine. Dr. Low Dog is one of the featured speakers and a favorite of mine. She said (and I'm paraphrasing) that we all want balance. She said to forget about balance because life is messy. She said that what we want is resilience.... we want to be able to return to center quickly and that plant medicine is a wonderful ally to help us do that.
I've spent a lot of time thinking about balance and what it looks like, balance over a day, over a week, over a month and trying to create balance in my own life. I've found though that it's constantly shifting... that as soon as I create something that feels balanced, then something in my life shifts, and I have to then try to create a new balance. I think being mindful of balance is important and yet it is always in flux and life is messy. I love this idea of trying to create balance (and by that I mean making sure that the most important things in our life actually have some time and space - I love Dr. Lissa Rankin's whole health cairn as a tool to think about what to include in a balanced week or month) while also recognizing that life is messy and the balance will constantly shift and sometimes there won't be any balance at all. And when life does get messy - whether it's a super busy time at work, a health crisis, or a fun trip that takes us out of more balanced space - resilience is being able to return to center more quickly....

10/07/2023

This is such an important book, and I encourage everyone to read it. Anyone who works in the healthcare system or receives care from the healthcare system benefits from understanding what is happening to our system and our clinicians. We desperately need change so that we can truly put people first in medicine. 117,000 physicians left medicine in 2021. 117,000 people who spent years of their lives training to take care of other people left medicine... we need a system that values the people providing care and the patients we all train to serve. I have no idea how to make that happen but I'm grateful for these authors and others working to help create awareness and ultimately change.

28/06/2023

I love summertime. I love warm weather. I love the feeling of slowing down a bit, of sitting outside and drinking my favorite beverage while watching the birds or looking at my trees and flowers. I love being in and around the water. In Northern Colorado, it feels like summer just arrived in the last week or so. Up until this week, we were getting a lot of rain and cooler temperatures so it didn’t really feel like summer. However, with the warmer days and realizing that we are approaching the end of June, I want to be intentional about how I’m spending my summer. I started to really ask myself how I want to spend the time with my kids (they go to preschool/camp most days). I wanted to take them to some of the museums in Denver this summer, camp, play in the splash pad, and swim. For me, I wanted to spend more time with my horses, get in more hikes, and really be present and enjoy the land where I live. If we aren’t intentional about what matters, we run the risk of time going by without us actually making the important things happen. So now that I'm clear about what I want, I can figure out how to schedule it and make it happen. What is important to you in the next month or two? Make it happen… and enjoy whatever summer is to you!

12/06/2023

A beautiful soul that nurtured and cared for me as a Peace Corps volunteer in Paraguay and beyond left her physical body last week. I am so grateful for her kindness and awed by her strength.

Where there is sorrow, there is holy ground.
~ Oscar Wilde

08/05/2023

Reflections on getting kicked, part 2.

Several days after getting kicked by my horse, my mind was chewing on what happened, why it happened, and how I could "fix" the behavior and my relationship with this horse (our relationship has been a bit rocky of late so the kick was on top of other challenges we've had over the last 6 weeks or so). Is she in pain? Am I not being a "strong enough leader"? Am I "good enough" to "fix" this? Do I need to send her for training? and on, and on, and on. (you get the picture)

I saw two things that I was doing that I also see my patients and families doing. First, my mind was trying to solve an unsolvable problem. It did not matter how many times I posed the questions and thought through the answers, this wasn't a problem I was going to solve in my mind. We often get stuck in these thought loops, especially when something is going on with our health that we're worried or upset about. We ask questions that don't really have answers, over and over. I tell my patients when they realize they are doing this, to pause and thank their mind for trying to solve the problem. Every time the mind starts to solve that problem again, interrupt it, thank it and let it go.

Secondly, I came to understand that these repetitive thoughts in my mind were actually keeping me in a head space instead of allowing me to be in a heart space and feel all the stuff that the kick brought up... the sadness, the anger, fear, feeling betrayed by this horse... all the emotions. Until I stopped the incessant questions in my head, I couldn't feel the emotions that I needed to feel and process. I also see this quite frequently, especially when someone is in the hospital and quite ill. Sometimes the patient or their loved ones ask for more information and more data... and often the answers they want don't exist and often it's a way of protecting themselves from feeling the pain of what is happening. If we stay in our headspace and stay with information, we think we can protect ourselves (at least momentarily) from the emotions and the pain. My job is often to help move them towards the emotions.

Even knowing how we protect ourselves didn't stop me from doing these things and it took time and someone else reflecting my own behavior back to me, to see what I was doing.

I invite you to pay attention in a difficult situation and see if either of these coping mechanisms pops up for you.

25/04/2023

Yesterday morning I sat down to plan out my week - my fitness goals, my work goals, the tasks I needed to get done this week. I also looked at my schedule and tentatively planned when I would try to accomplish those things. Then I went outside to get my horse ready for our lesson, and I got kicked. And I was shocked and in pain.

I'm sharing because I think there is so much for me to reflect on in this moment. One is the importance of being mindful and present in our lives, which is so hard, and yet so important. I wasn't as present as I usually am with my horses or as I strive to be. I might have still gotten kicked even being mindful but I definitely wasn't present in the moment and getting kicked certainly brought me back to the present.

Another is the balance of being grateful that I wasn't seriously injured and also allowing myself to grieve getting kicked - the pain, the disappointment that I got hurt, the grief that because I got hurt I wasn't going to be able to do all the things planned. I am grateful that body is strong, that I got kicked in my thigh which hurts a lot but wasn't a serious injury, grateful that I have tools to help myself heal and a community fo healers that I can lean on for their skills. So much to be grateful for and I wish that it didn't happen... and both emotions are true and both are valid at the same time.

This experience was also a reminder in flexibility and allowing myself time and space to heal. I was able to take things off my calendar yesterday afternoon and allow myself to rest more and sit with an ice pack. If this had happened to a patient of mine, I would have recommended they slow down, rest, and be gentle with themselves.

I would invite you today to be gentle with yourself wherever you're at... and to give yourself whatever you need - rest, kindness, space to grieve - whatever it is.

Below is one of my favorite winter pictures of said horses:)

24/04/2023

I heard this quote in a book I was listening to and it rings true for me... The journey I've been on is the journey to greater and greater understanding and acceptance of me...

10/04/2023

Tomorrow, April 11 there is a free training with Dr. Richard Schwartz and Thomas Hubl on trauma healing. Dr. Schwartz is the founder of Internal Family Systems. I learned about Internal Family Systems as a participant in Dr. Lissa Rankin's Whole Health Medicine Institute and it has changed the way I understand myself and understand my patients. Dr. Lissa Rankin also really changed how I understand what trauma is and the role it plays every day in how each of us shows up in the world. Trauma profoundly affects our health and well-being. I look forward to learning more...

https://thomashuebl.com/event/expanding-the-map-of-trauma-healing/

20/03/2023

Happy Spring! I just returned from a spring break road trip with my family, and I feel so ready to welcome spring. We drove through the mountains of Colorado (which still felt very wintery) to Las Vegas and then to Southern California to visit family. We returned via the Grand Canyon. It was lovely to see the beach in the rain, visit botanical gardens full of colors in California, travel through the desert with all of its beauty, and return to Northern Colorado where the grass is beginning to green. I love traveling through the Southwest and am so grateful for this week to reconnect with important people in our lives and with the lands we passed through. The flowers below are from my dad's house and the bouquet lovingly created by my son. May spring bring you vibrancy, color, and many blessings.