E74: The Emotional Domain of Exploring

Kirtly: Welcome, and thanks for listening as we explore the 7 Domains of Exploring. I'm Dr. Kirtly Jones from obstetrics and gynecology at the University of Utah, and I've been an explorer into women's health. I think every birth is a scary adventure for Mom, the baby, and for me. Anyway, that's my exploring terror moments.

Anyway, we're going to talk about the emotional domain of exploring. The beginning of exploring is curiosity and novelty seeking. Are you a neophobe, meaning you don't really like anything to change and you like your oatmeal the same every morning? Are you a neophile willing to try out some arugula on your pizza? Or a neophiliac? I think my food analogy isn't going to take me to a good direction there, so let's just forget that. But you could figure out what neophiliac means. But what are the character traits that separate novelty seeking from true exploration?

Now, some studies have suggested that there are significant health and strength benefits for men and for women that come from being an explorer, whether you adventure worldwide or take a deep dive into new knowledge.

And this may come from the character traits that are seen in true explorers: curiosity, of course; persistence, a powerful positive character trait; and self-transcendence, the ability to be involved in something bigger than yourself, which takes you out of yourself.

So with me is my co-host and physical and cognitive explorer, Katie Ward. She has a doctorate in nursing practice. She is a world explorer, and she is well into the adventure that is a PhD in anthropology.

Katie: Yes, I am definitely an explorer in all kinds of realms. I was thinking about the emotional aspect of that and where it comes from, and sometimes, for me, exploring comes from being really attracted to something. For example, I took up playing the bagpipe because . . .

Kirtly: Katie, I didn't know this. Do you bagpipe at home? Oh my god.

Katie: Well, I gave it up when I was pregnant with my daughter. But I did play for years, and it was really just . . . I heard the bagpipe band play, and I'd always liked them, and they were there, and I was like, "I want to learn to play."

I didn't give much thought to the amount of dedication that was involved in learning an instrument and practicing, and then once I was able to play it, band practice and performances. But that grew from just that passion of, "I love this. I want to do it."

I've also explored because I was running away from something. So sometimes I'll plan a trip if I need to distract myself from a broken heart or something like that. So I think exploring, for me, comes from a different place of emotion.

Kirtly: Yeah, it's often an emotional drive, and you don't think about thinking about exploring. You think about how you're feeling and how it gets you going.

Well, to help us think big about exploring and the emotional aspects is Dr. Steve Boyer. Dr. Boyer is a capital E explorer. To me, he's a geologist, a mountaineer, a physician who specializes in emergencies, a nationally ranked runner in his mid-70s, and has bicycled all over the world.

The combination of his medical training, geology training, and his mountaineering skills have taken him to the Arctic and to the Antarctic and to the highest mountains of the world. He's traveled to provide medical aid to conflict territories and disaster-struck communities around the world.

I have known Steve for 50 years and have been on some mini adventures with him, including a backcountry ski day when I was sure I was going to die. But that beautiful day is now seared in my memory. Not the dying part, but just how beautiful it was. The billowy snow, the bluebird sky, I can still see it in my heart. So I had a little bit of an exploring adventure with Steve. He's a dear friend.

Kirtly: Welcome to The Scope, Steve.

Dr. Boyer: Thanks, Kirtly, for that introduction, and I hope I live up to that introduction.

Kirtly: I know. It's always hard when people give you big introductions. Well, Steve, I called you an explorer. How does that sit? Would you call yourself an explorer?

Dr. Boyer: Only in retrospect. We were so busy with very specific goals in most of the work and traveling I was doing. Like on the American medical research expedition to Everest, we were so focused on getting the route through the icefall, getting the camps, and doing medical research.

I was on disaster relief trips. We were worrying about patient care. We were worried about ongoing earthquakes in Haiti and Sumatra and our own security, and concerned about ex-combatants coming in, in Liberia and Congo. So we were really too busy focusing on what it was we needed to do to be thinking about whether or not we were explorers.

Kirtly: So this is what I've come to as I've been thinking about this deeply, is that the process of thinking about thinking is called metacognition. And that's what people like me do. But explorers don't think about thinking. They are thinking about doing. And so you don't think about being an explorer. You just go be one.

Well, when was the first time you were thinking and willing to be curious and persistent and maybe risk-taking? Did you think about when that started?

Dr. Boyer: Maybe from my parents telling me that at a very young age, when I was still a toddler, I wandered around our front yard picking up little stones and putting them in a cup. But I wasn't thinking about curiosity.

Kirtly: Oh, no. You were just being curious.

Dr. Boyer: Yeah. I think one of the risks I took, a long-term risk, was after starting a career in geology, switching over to medicine. So it was somewhat risky for me, I think, to jump into medicine. But one of the reasons that I was interested in that was my experience at high altitude. I realized that my physiology was different from people around me. And once we got up to 11,000 or 13,000 feet in the Colorado 14ers, people were lagging farther behind, and I was interested in that. That's not enough to decide to change your career into medicine, but it was there. So that would be a big risk for the long term.

Probably the riskiest adventure was on the south face of Annapurna. Before I left to go on this expedition . . . and it was centered in France. We were all on salaries from [inaudible 00:07:16] Computer. There were nights when I would wake up and think, "Am I really up to this? Is this out of my comfort zone?" But I decided to take the risk.

And the reason it was risky there was that we were on a 12,000-foot face that averaged 55%.

Kirtly: So for people who are listening, that's really steep with a big, long fall.

Dr. Boyer: And there was a section in the route between 23,000 and 24,500 that was reared up to about 85% grade.

Kirtly: That's straight up.

Dr. Boyer: Once we got the fixed line in place, we were climbing it on Jumars. Turns out that I was the only one who thought of wearing a helmet, despite the fact that little pebbles were coming down frequently. So risks I think were greater for the other climbers than they were for me.

But there was lots of snow coming down every day. I think the risk of an avalanche was pretty low. But the south face of Annapurna, doing the first American ascent of that route, was probably the most dangerous.

Kirtly: Well, you're here today. So of all the scary things or difficult situations you put yourself in, you have survived all of them. But at some point, did you say, "I think this is enough. Enough is enough for this particular kind of thing"? Emotionally, did you . . . So was there a time when your heart said or your emotions said, "I shouldn't do this anymore"?

Dr. Boyer: There was a very specific time. I was on an American expedition to K2 in 1986. And there were nine expeditions on the south side of K2 that year. Every expedition had a fatality, and we had the first two fatalities in an avalanche. And there was so much going on there, we became med central. There were people coming by seeking medical advice, and I was offering it. There was another physician with us as well, and we could help out.

But once that had happened, it actually didn't change me just then. I didn't really make the decision not to continue doing Himalayan-Karakoram climbing at that point in time.

But when I came home and spoke with Giselle . . . Al Pennington was one of the people who died, and he and I were the only fathers on the expedition. I spoke to her, and I asked her if she would like to see photographs we took of Al after the accident. I had taken these photographs because I thought she needed some closure, and she could decide to see them or not. She didn't want to see them. But their oldest son, who was 11 years old, Jed, told me he wanted to see them.

So I memorized ahead of time what I wanted to tell him before I put up each slide. And he came over, and we went through the whole thing. He went back and told his mom, "Mom, you've got to do this. It's very helpful." So she came by and did the same thing.

And they were seeing a group in Portland helping children and families deal with losses, the Dougy Center. But the Dougy Center was never enough, and Jed was spiraling the drain. He was angry. He was sad.

This is two or three years later, and he was involved in a drive-by shooting attempt that, thank goodness, failed. He ended up in the state penitentiary. And he was there for a year before he made the decision personally . . . He told me later that he was the one who was going to have to get himself out with his good behavior.

And after he got out, I sat down with him for lunch a couple of times, and he was in his early 20s by then. I felt like I was sitting across the table from someone who was in his 40s, what he'd gone through.

I eventually lost touch with the entire family, but I saw what his death did to his family, and it made me decide then that it's not what I should be doing. I stopped, and I never returned to the Himalaya or the Karakoram.

Kirtly: Oh, except for medical . . . I know you've been back for medical work. Oh god, having known what happened when my dad died young, and it tore our family apart, it brings me tears.

Well, Katie, you've been on adventure, and you've had some times when you thought it was just a step too far. What do you think about that?

Katie: Yeah, I have. I took a hike with my daughter that I thought I was prepared for. It was the first time I'd taken this particular hike, but I'd watched videos, and I even took a little training course at the place where we rented some gear, studied the route. There were three places where we had to rappel down, but we'd practiced that, and I thought I knew how.

It was a one-way-through hike, so once you got into it, you were committed. You couldn't really hike back out. It's the Subway in Zion. I don't know if you've done that, Dr. Boyer.

And the day we were there, there had been rain a few days back, but there was a lot of water in the Subway, and it was colder and wetter than I'd anticipated. We had to rappel down just a few feet into running water over our heads. So you had to rappel down and then unclip from the rope and swim.

And I was expecting a lot of people to be in the space, and we were the only people there. I really had a real sense of panic about who went first. We stood there for a long time just having a very hard time making that decision. We navigated it fine. Some other people came through, and so then I felt a little better because there was someone behind us. We had a great adventure and hiked out, and all's well that ends well, obviously.

But like you, I sort of sat with that anxiety afterwards a lot, thinking that could have gone much worse. In fact, weeks later, somebody did die in exactly in that same section, and I know exactly how.

And sometimes, you do things that you're doing just for fun, but there is some risk. And then later, that risk sort of seems like it . . . the anxiety about it, it compounds. I relate to what you're saying, Dr. Boyer, about it.

Kirtly: Well, I think this concept of what's an experience that's transformative, where you make a decision about who you are and what's important to you, and do you do this again, or do you seek for more difficult things, there is this self-transformation that's part of the exploring phenomenon.

When they've studied people who do exploring, that's being something/taking on something bigger than yourself.

And I don't know, Steve, if you've ever . . . Have you got some thoughts about when you felt transformed or an experience that has taken you out of yourself?

Dr. Boyer: Any one of the disaster relief missions, we were part of a team, and it took me out of myself. And if I was team leader, the first thing I would do when I hit the ground was assess the resources for referrals from our mobile clinics.

Usually, with medical teams international, we would set up mobile clinics in rural areas or out in the desert, and the resources were often in the city where we would arrive.

In Darfur in Sudan, we arrived in El Geneina in West Darfur. The first thing I did is I interviewed with all of the MSF people. They tended to be working in the hospitals. And in that case, there were other NGOs it was worthwhile knowing about. There was a Pakistani ophthalmologist that we could send trachoma patients to, for instance.

And so we got to know all of the NGOs, and then we went out in the desert and got to know the people running a minor hospital there. It turns out one of them was terribly corrupt, we later found out.

And then whenever we had a chance to assess other resources, we did. We drove across the border into North Darfur from West Darfur to evaluate the OB/GYN setup that was run by MSF as well.

But one of the problems having done that . . . because we wanted to refer people with GYN problems there. One of the problems was someone saw that we had crossed this border into another part of Darfur without their permission, and they said that if we did that again, they would renege our license for working there as an NGO. So that was a problem.

Kirtly: So that's definitely being a team lead in a very, very difficult situation. It takes you out of yourself, and you become part of something so much bigger. I mean, you're not just Dr. Boyer. You're now the team, and how does the team function? It's a total expansion of yourself. But you lose yourself too sometimes. You lose as you're trying to make a bigger team and cognitive explorer, meaning you don't just go do things, but you learn new things.

Katie: I think learning is its own exploration, right? And I would recommend learning at any time. I think some of the adventures we've been talking about are a kind of physical learning, but as those become maybe too risky to do, or just physically your body can't quite manage that, but continuing to learn, to take up something new, is a hugely rewarding kind of exploration. Whether it's learning a new craft or a new cooking technique. I'm not sure I'd recommend a late-in-life PhD to everybody, but it's been a lot of fun for me.

You're describing a vacation where you're . . . or not a vacation. Maybe it was more of an expedition, but you're seeing animals behave in a way that's maybe the opposite of what you'd been taught that they do. And so I think that that's remarkable. It's kind of exciting and energizing in the same way that perhaps mountain climbing is to other people.

Dr. Boyer: I am exploring one by one the medical trips I made to Africa and writing them up with the hopes and intentions of writing a book. I think that the easiest thing for me to do would be to just take out the interesting patients that I saw. They may be interesting because of the disease they had, or they may be interesting because of the story that came with the disease.

And this wasn't just in Africa, so I may do this for all the countries I've visited. It's over 100 now with counting territories.

One that jumps out, and I'd say it's atypical, was not in Africa, actually. It was in Nepal, where Priscilla and I . . . Priscilla is my wife. We set up a rescue clinic for the Himalayan Rescue Association in Manang at about 13,000 feet. And one of the patients I saw one day was this elderly woman who had come by, and she wanted me to remove three gangly, nonfunctional teeth that were probably interfering with her ability to gum chew anyway.

I had a complete dental kit with me, and I did the extractions and put her on a course of penicillin. But before I sent her on her way, I asked her, through an interpreter, where she was headed and why.

She was elderly, and she was on her way to a village called Pisang, about a four-hour walk each way for her. And it turns out that her son had been the head llama of Pisang, and he had died four years before. Now a young boy who was 4 was recognizing his clothing over someone else's clothing when presented to him, and he was recognized as a reincarnate llama.

And so she had come by the clinic to have these unattractive-looking teeth pulled before she went down to Pisang to meet her reincarnate son for the first time. I don't hear that sort of story in Portland emergency departments.

Kirtly: In your work as an ER doc in Portland, you're not going to get that story every day. But Steve, you have been a journaler. You have kept your journals. You've kept rocks from everywhere you've been, but you've written down . . . you've been quite conscientious whenever you've gotten back from some exploring in terms of keeping a journal so that you could go back to that.

Dr. Boyer: That's very helpful right now. I've just gone through my journal for Liberia. We were there right as the ex-combatants were coming in, and it's really been helpful to have the journal to make sense of the patients and the frightful political scene going on there.

Kirtly: Katie, do you keep a journal?

Katie: I don't. I was just thinking I should start that, but it has not been a lifelong habit.

Kirtly: Do you take photos?

Katie: I do take photos.

Kirtly: I mean, I think about as we get older . . . Thinking back, Steve, on this one day of skiing that we did when . . . I think I was in college, not in medical school yet. It was so scary for me, but it was so beautiful. There are lots of things I've forgotten about my four years at university before I went to medical school. But this day, this one day, is so powerful in my mind. There are lots of other things that I want to remember that my adventure memory might lose, so I think keeping a journal would be great.

I have a habit of if I've been on an exploration, either cognitive or physical, that's powerful for me, I go over it day by day, minute by minute, everything I can remember. Every day, I try to run through the entire series for the trip, and then I do the next day, and then I do the next day, and then I do the next day, trying to imprint those memories. But I think it would be a lot easier to write it down.

Katie: Or record it. I think, Kirtly, you were doing podcasting before it was such a big thing. And I think one of the things I admire so much about you is the effort you put into communicating and helping people . . .

Kirtly: Thank you.

Katie: I've known this about you for a long time, of being a teacher and making sure that people understand and take away the important information that they need out of their interaction from you.

Kirtly: Well, thank you, and thanks so much to Steve and to Katie. I think everyone listening to our "7 Domains" podcast is an explorer. They get three and a half hours in the "7 Domains" of topics and hopefully have taken a deeper dive into learning about some of them. You can use them as a jumping off place for more understanding, or share with friends and family and start a conversation.

You may travel far and wide, or learn deeply and broadly, or watch carefully and thoughtfully as you experience the adventure of parenting. It is never too early, and it's never too late to be an explorer.

Thank you all for being here and thanks for listening.