Collegial Love And Then Some

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Audible Narrator Hall of Fame Class of 2018 and 2026 Inductees

Who are your colleagues?
What connects you?
What do you share with these people that others do not and cannot understand or relate to?

Last week Audible celebrated their second cohort of Hall of Fame narrators, including a couple of my favorites, Andrew Eiden/Teddy Hamilton, and Steve West/Shane East. Andi Arndt, Hall of Fame Class of 2018, gushed about her colleagues on Instagram the night before, reminding me of that deep collegial love that I feel every day in medicine. My impromptu comment on her post stuck with me all week.

The photos of celebration and connection, the joy and energy of the Audible event moved me, too. I haven’t been to an American College of Physicians national meeting since 2019 (it was this weekend in San Francisco, but I came to Portland, Oregon instead, to visit with friends–hence this delayed post), and I miss seeing my colleagues from all over the country, going to sessions and learning together, having coffee, sharing stories, catching up.
Voice acting can be very solitary work, so I imagine these artists relish opportunities to gather and commune, especially when it centers around celebrating their shared love of the work.

I wrote to a VA acquaintance once, “I hope (imagine) that you get enough positive feedback, validation, and reinforcement for your work! 😀 I also hope you get enough contact and connection with your colleagues. I can always walk down the hall and consult mine on challenging cases or difficult encounters. We are friends. My professional support network is at my elbow and fingertips; I hope yours is too!”

I spent time this weekend with Christine, my life coach and friend of 20+ years. She described her experience of ‘supervision,’ wherein she was required to debrief with elder colleagues during a segment of her training, exploring potential personal pitfalls and blind spots that client work may uncover, and how to beware of and manage it all. As coach and physician, our conversations weave in and out of mutual support and informal ‘supervision’ in organic and collegial ways. Our work overlaps with that of therapists, nurses, and probably any other helping profession. Walking along the Willamette River with Grant today, we reflected on how easily we can apply our professional training and skills in any domain where humans interact.

Back in 2017, the night before presenting at general surgery grand rounds (unusual for an internist), I wrote about tribal pride and tribalism:
“We all need our tribes. Belonging is an essential human need. To fit in, feel understood and accepted, secure—these are necessary for whole person health. And when our tribes have purpose beyond survival, provide meaning greater than simple self-preservation, our membership feels that much more valuable to us. But what happens when tribes pit themselves against one another? How are we all harmed when we veer from ‘We’re great!’ toward ‘They suck’?”

Nine years on, how do we assess the relationship between tribal pride and tribalism in any given domain on the current geopolitical landscape? Surgery vs. medicine, staff vs. leadership, conservatives vs. progressives, advocates for vs. against AI… How can we maintain our human connections above all, no matter what our divergence? I have often thought of myself as a ‘lumper’ as opposed to a ‘splitter’–always looking for connection, commonality, and relationship everywhere, among all people. In the same message to my VA acquaintance:

“Acting and medicine: What do you imagine are the overlapping aspects of our respective work?  I see it mostly in story—empathy for and holistic understanding of the full human experience, from the euphoric highs to the most sorrowful lows.  For both of us, to be truly excellent at our work, we must call forth real and sincere empathy from our own depths, which is vulnerable and courageous in a lot of ways, don’t you think?  For you, the stories are complete, and you get to interpret and bring them to life, to present them for our benefit.  I get to elicit the stories, coax them to emerge in real time, and interpret them along with my patients.  What stories do people tell about their health, their lives, their agency to influence it, and the outcomes they can/not achieve?  We get to dissect and discuss and then act on our shared interpretation.  We edit and revise together over time.”

So this weekend I communed with two of my coaching friends. I spent quality time with Phara who has a degree in psychology, and Heather, a fellow writer. We bonded over parenting–the unique mental load of moms, especially working moms. This theme has emerged powerfully in my medical practice, no matter the moms’ day jobs and no matter our kids’ ages.

Colleagues share language, training, experience, and perspective. We compare notes, tell stories, and connect. But we do this not just in professional circles. Our tribal memberships intersect and overlap, often in ways we could not predict or design. So really, we can find love in commonality anywhere, with anyone, if we just open up and ask, no?

What a fun exercise to come across an idea on social media, feel it in my heart, react in real time, then process it for days and see what arises in stream-of-consciousness blogging while stuck at the airport! Tomorrow I get to co-present on health and wellness to the Illinois Judiciary–another esteemed tribe of helpers, as I see them. What a privilege.

My tank is so full from a long weekend of deep and thick connection with my amazing friends here in the Pacific Northwest. I missed this year’s chance to commune with my fellow internists nationally, but I’ll get back to the office this week and soak it all up locally. How lucky I am, truly. I hope whatever your profession, whomever you call colleagues and friends, that you get to enjoy this deep, collegial love born of shared humanity. And if you can recognize and strengthen it across domains, even better. That’s what will save us all, I am convinced.

30 Days of Snail Mail and Reflections on Writing

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Paper Source, Instagram

Friends, this is going to be FUN.

It’s National Card and Letter Writing Month! Apparently the United States Postal Service invented it back in 2001, expanding their annual celebration of handwritten greetings sent from a distance from one week to an entire month. And I am HERE FOR IT!

My favorite stationery and craft store, Paper Source, posted 30 pen pal prompts on their Instagram last week and inspiration has flowed freely since. I pulled out a small stack of washi tape cards from their storage and mentally prepared the recipient list. The first two cards are in the post to Son and Daughter, which I thought was a nice way to kick off this month of handwritten notes. So grateful for these two amazing humans in my life.

Then it occurred to me to invite friends to request notes! I’ve received two so far, and will continue to solicit all month. Meanwhile, the crafting bug bit me this weekend and after a great HIIT workout at Ethos yesterday morning I’ve basically been sitting, cutting, taping, stickering, and writing for two days (and listening to Of Prophecies and Pomegranates by TC Kraven–highly recommend!).

Front section from c.2022, back two sections made this weekend
My Audible review for Of Prophecies and Pomegranates by TC Kraven

It reminds me of the year I wrote one thank you note a day for 365 days–turns out I blogged about that, and my washi tape card making was already well underway by then, 2019. Huh. We are who we are, I guess.

I realized recently that when the pandemic started, I had only been writing this blog for five years. It’s eleven years old this month. Looking back, it’s been both an intentional and unintentional (more unplanned for this duration) exercise in consistency and practice, a clear and strong What to my Why. This post marks 777 in the library, and I have no plans to stop anytime soon–148 drafts and infinite impromptu new posts await.

My morning pages practice stutters along. I carry that journal with me everywhere so I’m ready when new ideas strike. I write brain dumps, emotional processes, blog ideas, and any other words that occur to me in these A7 size books, and my stash of empty ones continues to grow–plenty of back up and capacity. I have now filled four pretty journals since March 2023 with writing and media I want to keep for posterity and inspiration. I traffic in words, people, and I fully embrace it!

I started another weekly writing project in January, which will eventually organize into Book. I will share more about that in time. Suffice it to say I have finally found it, after these eleven years, and it feels absolutely right. Every book idea before now has felt boring, formulaic, nebulous, or otherwise slog-like. With each outline or proposal attempt, “This could be great!” quickly devolved into “Ugh, I do not want to write that book.” But with continued weekly blogging, voracious reading/listening that has expanded from psychology to memoir to fiction, science fiction, romance and erotica, another decade of clinical practice, and now a newly empty nest, the essence of Book has finally emerged, and I am convinced it just needed to take this long. Big thanks to Grant Gosch, whose insightful and patient questions and reflections have helped me distill the myriad, disparate yet intersecting book ideas into this initial, unified project. I look forward to each writing session with curiosity, love, and excitement! In the end, whatever the project outcome, I will have had fun and connected to people in some meaningful way–another, bigger, What to my Why. When people read it, I wish for them to feel inspired, empowered, activated, and connected. I feel confident I can accomplish this, because that’s how I feel when I write it.

Ever since I learned about writing and mailing letters in second grade, I have relished written correspondence with disproportionate fervor. Even my clinical summaries for patients at the end of an executive physical feel like love letters–here are all of my wishes for your best health until we meet next year!

What is your relationship with snail mail, or just a handwritten note, card, or letter?
When and what was the last piece you received? Sent/given?
How did it feel?
To whom would you write today if you had a fun card, some nice stationery, or even just a Post-It and a few minutes?

There are so many ways we humans find connection, love, belonging, and peace. Giving and receiving personal, handwritten messages stands out to me as one of the most special. I hope you may enjoy more of it this month and beyond.

The Quadsection of Life Epiphany

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Chojun Textile & Quilt Art Museum, Seoul, Korea

FRIENDS! Don’t you just LOVE when you have a fun new idea that helps you think of life and humans more clearly?

This quadsection idea came to me completely fluidly and wholly about two or three weeks ago, a natural confluence and consequence of everything I have studied and learned in life to date. SO gratifying, I say! And as I share with friends and patients, It’s mostly validated so far. Now I look forward to seeing how it evolves in application and practice hereafter.
OK so:

We can frame life as an intersection of four things:

  1. DNA: Our inherited genetic predispositions. We can know much of these tendencies intuitively, and now objectively with advancing genetic testing. This influences possibly everything, but only in rare cases truly determines anything.
  2. Personal history: Our lived experience to date, including family of origin, culture, time in history, past traumas, world events in our lifetime, and all of our choices, actions, relationships–everything!
  3. The current moment: Environment, circumstances, mindset–down to this second or heartbeat, infinitely dynamic and fluid. This is the confluence of a multitude of factors; wow, it just occurred to me right now that this moment itself could be the multiverse convergence, no? Our perceptions and thus thoughts, feelings, words, and actions are formed in real time, in this moment, and depend, arguably, on the other three things.
  4. The innate human need for safety, security, connection, and belonging: In the end, what else do we live for?

What fascinates me about this framework is that we have no control over any but the second of the four–our own lived experience. We create it. And even then, all we have is agency, not actual control. In any given moment, depending on my mindset, physical state, and external circumstances, I have free will and choice, and yet much of my perception, response/reaction/action will be determined in advance by bias, pattern recognition (accurate or not), and automatic reflex before intentional cognition. And all of my past actions were the same–somewhat volitional, much not.

Additionally, each of us brings both totally unique and shared human experience to any given moment. Isn’t it a wonder, then, that we can actually agree on so much, and doesn’t this also explain how our experiences can and should be so wildly divergent?

If we accept this premise/framework, just for a moment, what do we then do with it? On one hand I can imagine responding with a victim mindset–seeing how little I actually control among these four determinants of life, I think of myself as simply an object of my genes, everything that has happened to me in life, and anything that will happen hereafter. I become passive and disengaged. On the other hand, also seeing how little I control, I exert disproportionate energy to achieve that control in those few domains. Personally, I land in the space of acceptance and agency (somewhere along this spectrum, no?): Recognize what I do not and cannot control, where I can act with influence toward my goals, in service of and in integrity with my values, and seek and/or create opportunities to maximize that agency and advance those goals.

Very soon after the framework occurred to me, I felt something akin to relief and elation. It was an epiphany, really. I had found the relationship between these four things–they intersect. So are they best drawn as lines? Vectors? Or could they be better represented by a Venn diagram? No, not Venn, because that would imply that some parts of life do not include one or more of the four aspects… But then again, is that true?

I still like the image/idea of intersection, but we could define the intersecting parts differently–ropes of variable size and thickness? Rope intersecting with light, with sound waves, and then with quantum energy? I imagine the intersection itself as dynamic, existing with an energy of itself, pulling on any of the four aspects more or less heavily in any given situation. We can intuitively imagine that genetics or past trauma may be more or less salient at this moment, in this enviornment, than in another. This ‘intersection’ is always at play, shifting and emerging in real time, influenced by infinite factors that still fall neatly into the four categories (or not?), creating our lives with each breath, each heartbeat, each quantum packet of spacetime. It’s a four dimensional configuration–I have no true understanding of relativity, but something like that image of the flexible spacetime grid fabric with indentations and protrusions comes to mind. Maybe a physicist reading this can confirm and/or refute the applicability of this image to my theory? Like I said, FUN!

So how does this all land on you, dear reader? Does it pique your interest in the slightest? Thank you for reading, as always. I have now documented my nascent idea, and if it grows into anything more interesting or significant, I can look back and see where and when it started.