#AtoZChallenge: Withhold Judgment

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My brain is so tired. All month I have racked it trying to figure out what to write next, how to render it most authentically, and finally get it out looking close enough to how I intended.  On top of that, I have also engaged in multiple exchanges on Facebook around gender identity, public restroom use, vaccine rationale, and presidential politics.  It really has been shang nao jin, as we say in Chinese—literally wounding the mind.  I realize these are all activities that I choose, and none of them have significant bearing on the world at large.  And, I would do it all again.  My mental exhaustion is the hurt-so-good kind, like the muscle soreness after a particularly strenuous workout, when I know I have pushed myself to my limit and maybe extended it a little.  The writing and conversations are ways that I engage with my world and practice what I preach—open-mindedness, curiosity, and cultivating connection.

After all of this exploration, conversation, debate, research, and observation, once again I conclude that one of the most important practices for inner peace is to Withhold Judgment. Not all judgment, and not indefinitely, but much and for a while.  Here are some illustrations from the past week:

I shared this post on my Facebook page on Saturday.  I agree with the author’s sentiments, basically that discrimination is wrong and we should open our minds and bathrooms to all people.  I also thought her writing was cogent and forceful.  One of my friends pointed out her name calling, as she labeled supporters of the North Carolina HB2 legislation, and people who boycott Target as a result, as hateful.  He then asserted that the left “can’t argue a point without calling people who disagree with them hateful,” or at least they choose not to. At once I see both sides generalizing in ways that preclude any possibility of meaningful mutual understanding.

After this I became more sensitive to name calling in articles I read. Even ones with relevant data and useful information can be tainted, as I found here, in which the writer calls bigots the same people that the previous author called hateful.  Why must we stereotype and label like this?  Is it just to get published, for attention?  Can we not convey our message just as effectively without all this vitriol?

Finally I read and shared this article, in which the author does not call anyone names directly, but writes a brilliant and searing piece of satire that also inflames and incites.  I suppose that is the point of satire, after all?  It was the comments on this last article that really drove home to me the perilous state of assumptions and judgment that drive many of our interactions these days.  If you support this law, you’re hateful.  If you oppose it, you’re irresponsible.  Perform one act that is, superficially, inconsistent with your professed beliefs, you are forever a hypocrite.  Commit one lapse in judgment and you are instantly unworthy of respect, now or in the future.  Snap judgments can degenerate our encounters to a series of sound bites of rhetoric and aggression.  They seriously inhibit, if not completely destroy, our connections, and they consign us to echo chambers of isolation.

The doctor who rushes me through my 15 minute appointment for a sinus infection, after making me wait 30 minutes already, is uncaring and just wants to make more money. Actually, she just spent the last 45 minutes telling her patient of 10 years that he has metastatic cancer and answering his questions, and she is anxious to get to her son’s school play tonight, his first lead role.

The woman who yells at the receptionist and makes a scene with the nurse is just another angry, entitled patient. Actually, her son was killed by a drunk driver last year, she lost her job and her home, and her mother is dying.

Fellow blogger and talented artist Jodi posted this beautiful piece today, including these words:

Skip the religion and politics,

head straight to the compassion.

everything else is a distraction.

— talib kweli

It really spoke to me, because compassion lives at the core of human connection. If we can remember compassion for one another more often, no matter our circumstances and state of mind otherwise, we can probably also remember to Withhold Judgment and listen for the rest of the other person’s story.  Listening more, yelling less, moving slower to the keyboard, showing up in person, asking more questions for understanding—these are the practices of Withholding Judgment.  Please, let us make the effort; it may save us all.

#AtoZChallenge: VAGINA! No Fear of Words, Please.

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Sexuality can be hard to talk about.  I think this is true for adults far more than for children.  Children are naturally curious and nonjudgmental.  They just want to know, what is that, what’s it for, why are yours different from mine, and why does he have one of those and I don’t?  It’s we adults who squirm and dodge, deflect and bolt.  From a very early age, children learn that it’s not okay to talk about certain things because it makes the grown-ups uncomfortable.  I want to change that.

My kids have known formal names of body parts forever—breast, vagina, penis, femur.  They also know what the parts do, how they ‘go together,’ etc.  Anytime they ask a question, I try to answer as honestly as possible, in an age-appropriate way.  For instance, I have had to clarify that babies do not come out of a woman’s ‘butt.’  First I had to clarify the general use and meaning of ‘butt.’  Then I explained that men have two holes down there, and women have three, and the baby comes out of the middle one, between where pee and poop come out.  Maybe it’s because my husband and I are both doctors and science nerds—we say these words all day long and never think twice.  I think also it’s because I’m a terrible liar, and everybody can tell.  It’s just not worth telling one story now, only to recant and revise later.  Moreover, even if they don’t challenge the fib I’m telling today, their intuition that I’m not being fully forthright undermines my trustworthiness.

There are important parallels here for physicians and patients, too.  In medical school we learned how to take a sexual history.  I think most of us handled it fine, but there was some blushing and gnashing of teeth at times.  Again the key is repetition and getting comfortable with saying the words without embarrassment or judgment.  “Are you sexually active?  With men, women, or both?  How many partners do you have now?  How many in your whole life?  Ever have anal sex?  Receptive, insertive, or both?  Do you use condoms?  Every time?”  It also applies to other aspects of the social history.  “Do you or have you ever used recreational drugs, such as marijuana, cocaine, heroin?  Acid, mushrooms, PCP, MDMA?  Anything else?”  The underlying implication is, ‘tell me anything, I really want to know, and I will only judge the risks to your health, not you as a person.’  Once I get to the end of these lists, patients can see and feel that I am comfortable talking about anything related to sex, drugs, and whatever else, and I make no assumptions.  They are much more likely, then, to tell me honestly about their behaviors and experiences.  I can then make a more accurate assessment of their health risks, and give more relevant advice.  As a bonus, we often establish a deeper connection, because that sense of safety now likely extends to other things they may want to disclose.  This is often when stories about sexual assault and relationship abuse surface.

I want my children and my patients ask me about sex, drugs, cancer, death, Alzheimer’s, depression, anxiety, and all kinds of other things.  All of these topics can render us deaf, dumb, and blind so often, just by virtue of the acute discomfort they induce.  But if we as parents and physicians cannot tolerate them, despite our responsibility in these relationships, how can we expect our children and patients to navigate them successfully?  Yes, there is a plethora of information on the internet.  Much of it is actually accurate and helpful, and I Google as much as anyone.  But when it comes to such personal and emotional topics as these, people need more context and interaction than a screen can provide.  Google does not know your unique situation.  It cannot help you sort through your emotions, your family dynamics, or the implications of your decisions today on your future and the future of your loved ones.  We all need a human connection to do that—a safe, trusting, and loving connection.

When parents and physicians share freely our knowledge and expertise, in words that children and patients can understand and apply to their own experiences, we empower them to make decisions in accordance with their core values and highest goals.  We partner with them in service of their own self-determination.  Our role is supportive, guiding, ancillary.  We help demystify the process.

My goal is to help my children and patients be responsible, autonomous individuals who exercise good judgment for their own health and that of those they love.  Since words are my primary mode of communication, I cannot afford to be afraid to use any of them.

 

Of note:  My family and I recently discovered the book, It’s Perfectly Normal, by Robie H. Harris and Michael Emberley, and I (sing-song voice) loooove it!!  We own the 20th anniversary edition, updated to include information on sexuality for this digital, online, social media age.  This book appeals to me because it totally demystifies the body and sexuality, and does so with objectivity, openness, inclusion, and good humor.  We highly recommend it!

 

#AtoZChallenge: Unraveled, Unbound, and Unified

 

CO trip May 08 080A dear friend and fellow blogger texted me two days ago, saying she’s been enjoying my posts. Yay!  Even the smallest positive feedback makes me feel so good—I think if they looked, psychologists could actually see dopamine squirting out of its various reserves in my brain. My friend texted, “Hope all is well. :)” I love my friends who love emojis.

I texted back, “…I’m holding it together, kinda barely—I think that will be the U post!! ;P”

To which she replied, “Unraveling?” I love even more my friends who can read my mind.

So I procrastinated. I wanted to describe, artfully and with great insight, the struggles of the past week: Feeling shameful and inadequate for falling behind on the alphabet posts, the Unexpected and acute trauma of a negative patient encounter, moral conflict over staying at a Trump hotel later this year, new presentation deadlines, and how my friends United to help me though it all. This morning I realize that the details are boring and pretty irrelevant. Here is what I learned:

At first I was feeling Unraveled in a bad way—coming apart, losing function. Then I realized the unraveling was more like an Untangling—an opportunity to explore between the fibers, to see what’s gotten mushed in there, like batter accidentally smeared on baking twine. I rediscovered my own triggers of ‘not doing enough,’ ‘not good enough,’ and ‘just not (f*ing) enough.’ It kinda sucked, which is probably also why I didn’t want to write about it. AND, I sincerely believe that each time I recognize this deep-seated fear, I move ever closer to freeing myself from it—I’m slowly getting Unbound.

I started listening to Presence by Amy Cuddy this week. It’s the second or third book in recent memory that references Carl Jung’s philosophy of integration and individuation. I loved Cuddy’s TED talk. I have used her strategies before presentations and also yesterday before I met the patient again who I felt abused me last week. I have referenced it to patients, colleagues, and friends. The whole book is so dense, full of insights and stories, research and synthesis—I highly recommend it! Anyway, it really hit home for me this week because this is exactly what I’m after—Unification.

My aim in life is to integrate all that is me—the good, the bad, the gorgeous, the ugly—to the point where those labels don’t even matter anymore. Because I have a calling, which is to make the world better. And I can only do that if I am my whole self. One does not become one’s whole self easily or without struggle. It’s not baking twine, it’s that giant rope that I could never climb in PE class at Highland Elementary. Maybe I don’t have to Unravel the whole thing.  Maybe I can live Unbound by the memory of repeated failure to touch the big wooden disc at the top. I can still aim to live this life in the most Unified possible way, one day, one moment, one breath at a time.