YOUR HAPPY PLACE A good day is a state of mind.

You know those books full of advice on positive thinking, karma and the secret to getting what you want? Don't you hate those? Me too. I read a couple of them earlier this year, to get a good laugh and report back that the authors were nutcases just trying to make a buck off the desperate. I mean, nothing is going to control the crap that we so often have to deal with in the OR, and as you know, this has made me very cynical about the majority of everything over the years.

Then something interesting happened: The advice worked.

A behavioral experiment
I wanted to know if I could control the kind of day I was going to have. So I decided to arrive at work with the attitude that I was going to have a good day in spite of whatever the higher-ups threw at me. And I can report that after 7 months I have had more good days than bad. I've enjoyed doing what I do more than I have over the past 30 years. Stressful situations seem more manageable and I feel better than I have in a long time. It's bizarre, but it worked.

Do I still have difficult days? Yes, of course. Can I control my colleagues' behavior? Unfortunately, no. Am I still rolling my eyes, shooting icy glances or spiking sarcastic remarks at those who deserve it? Yes. I'm still Paula, not St. Pollyanna the Stepford Wife.

What I can tell you is that a change in attitude is a change for the better. I go to work every day now thinking that it's going to be a good day. If I'm scheduled to attend to a less-than-desirable case and work alongside Dr. Very Undesirable, at the very least I'm assured of a good day. The way I see it, negative behavior or a negative reaction on my part would only serve to invite the possibility of disaster to my door.

Be the change you want to see
It's true, this doesn't change the behavior of those around me. (What could? A Taser, maybe. Can I get my hands on one of those?) And I'm not suggesting you bow down and get steamrolled. But changing my approach to the day simply by resolving that it's going to be a good one affects how I choose to respond to the idiotic behavior I sometimes encounter.

• Do I believe that the particulars of a challenging case warrant cursing, wailing and gnashing of teeth? No. They deserve competency, control, concentration and a confident leader of a skilled team. A surgeon who throws a hissy fit is only exhibiting his insecurity with the situation. Am I going to run and hide? Am I going to get my knickers in a wad? No, I came to work expecting a good day and am not going to join Dr. Devil in his bad attitude.
• Does the arrogant surgeon who chewed me out over some minor issue that wasn't my fault in front of a roomful of peers think that whispering "Good job" to me after the case excuses him from an apology? If so, he's an idiot. Am I thinking about some point in the future when he gets what's coming to him? You bet I am. Did his tirade ruin my day? Not a chance.
• Will I continue to suffer a co-worker who has been uncooperative with me, inappropriate with the tech and uncompassionate towards the patient? No, I'm going to tell him to shut it and get to work. Bad influences can adversely impact the quality of a day.

A change of attitude affects how you adapt to external events, and in the OR, this is a critical skill. If I can realize this, then maybe the real bad apples should, too.