70 Years Married

 

 

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Dear Mr. and Mrs. Wonderful,

Hello and hugs to you both!  How are you feeling?

I received a message from Wonderful Son this weekend, and it made my day!  He said you have settled in a place where you are both happy and getting the care you need.  You live near Wonderful Daughter, whom you see often, and everybody is happy and doing well.  I’m so glad!

More importantly, Son said the family will celebrate your 70th wedding anniversary soon!  He invited me to contribute a short video selfie to the well wishes.  Wow, what an honor.  I only got to serve as your primary care doctor a couple of years before you moved.  In that time I had the privilege of witnessing not just each of you as my patients, but you both as a couple, and your Wonderful family.  Please allow me to share my observations?  Here is my experience of you:

Ease.  Whenever I saw you two together, there was a peace and ease about your dynamic.  Patterns of relation were established long ago, and it worked.  I witnessed friction at times, but it was transient.  The vibe of our encounters was never agitated; it always felt to me that I had stepped respectfully into your well-oiled routine, and I tried my best to not disrupt it.

Patience.  Nobody rushed anybody when we were together.  Questions were answered, sometimes right away, sometimes after a while.  But you always gave each other the time and space to get where we were all going.

True Acceptance.  The Gottmans tell us that about 2/3 of marital problems are unsolvable.  This fall I will have been married half my life, 23 years.  This summer I think I may finally understand in my limbic brain, possibly, how to be in a marriage—something to do with really accepting the other person for who he is, like really, honestly, and wholeheartedly.  It was clear soon after meeting you both that you had figured this out long ago.  If I can get to 70 years, maybe I don’t have to feel bad that it took me 23+.

Devotion.  Medically, it has not been all lollipops and rainbows these few years, for either of you.  But whatever was happening for one of you, the other was right there, attending, caring, waiting, loving.  What more could any of us ask for?  And the Wonderful Children learned from your example; knowing them and seeing their devotion to you, their loving parents, inspires me deeply.

Learning, Growth, Adaptation.  Even at your age, there were things you did not know or understand.  Your bodies betrayed you in some ways we could not have predicted, and in others that you may have anticipated but were still a challenge to accept.  With the help of the medical team and your Wonderful Children, you have both managed to adapt to successive new normals with grace.

Loyalty and Commitment.  In it together.  That’s how you two roll.  I know it’s not easy, and we have discussed the challenges.  But you stick with each other through thick and thin, I’ve seen it.  You set the bar for the rest of us.

Love.  I think you, Mr. and Mrs. Wonderful, show us what true love lives like.  After 70 years I imagine you have some colorful stories to tell, some that belie all of the idealistic descriptions I write here.  But that is the point, no?  If we stick with it and do The Work, all of us hope to be rewarded with that deep, peaceful, reliable, and resonant love that transcends even what we innocently and earnestly vowed to each other at the altar.

Science, technology, and social convention have evolved beyond anyone’s imagination, and the pace only accelerates.  But the lifelong human need for love and belonging will never change.  Thank you for showing us how it’s done in a marriage.  Congratulations!

Sincerely, Cathy

Agency and Emergence

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When do you push forward, and when do you step back?

How do you decide, or is it decided for you?

How does this reciprocal rhythm oscillate and dance in your life?

*****

Modern western culture tells individuals and organizations alike: Grow! Move! Push! –Or die!  Competition and scarcity dominate the collective psyche, if not consciously then subconsciously, no question.  Even on vacation we are pressured to do something socially noteworthy, lest we have nothing to report upon return.  There is a palpable, frenetic, explicit and implicit drive—to keep driving.  I’m not complaining, necessarily.  Growth, innovation, evolution, improvement, advancement, development—I pursue these with as much fervor as anyone.  It has served me well!  My whole life the hard work (and a lot of luck) has paid off in spades, in school, work, and now leadership in multiple realms.  I have accomplished as much as I could have imagined at this age, and I’m just getting started!  How exciting and rewarding, living a life of audacious acceleration, of claiming agency, of “Yes, AND!”

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Tara Donovan, Chicago IL July 2019

Yet, lately I feel another energy emerging.  It came on unexpectedly, and I welcome it like my oldest friend.

I only realized it as I wrote about ‘Aunt Rachel,’ Dr. Rachel Remen, last month.  “I am called to slow down, to be still, more than I have been (have allowed?), for a very long time,” I wrote, quite spontaneously.  Those words forelighted a month of ‘settling and recharging… awareness and fulfillment,’ as I wrote to my friend, when I realized what was happening.  This meta-awareness always fills me with awe and gratitude, as if the cosmos lets me in on a secret, conspiring to prepare me for what lies ahead. Remen’s My Grandfather’s Blessings reminds me of the importance of human connection at the deepest level.  Big Magic by Elizabeth Gilbert makes me confident and brave to create, to make things to share, like this blog or a new oral presentation.  The Art of Possibility helps me dig deep, in a different way every time I reread it, for fundamental relational skills when I need them the most.

The week I wrote about Aunt Rachel, Maria Popova’s post on friendship as rendered by Kahlil Gibran crossed my email inbox.  The Prophet was one of my favorite books in high school.  I found it moving, inspiring, and reassuring, like a lovingly personal counselor, in those emotionally tumultuous adolescent times.  Popova’s post brought that comfort back, similar to how Remen’s book did in recent weeks.  I felt compelled to follow her sequential links to writings by Seneca, CS Lewis, David Whyte, and John O’Donohue, all on friendship.  She quotes Seneca, the stoic: “Ponder for a long time whether you shall admit a given person to your friendship; but when you have decided to admit him, welcome him with all your heart and soul. Speak as boldly with him as with yourself…”  Something within me was deeply moved, activated to seek more.

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Tara Donovan, Chicago, IL, July 2019

How fascinating, what is with this fresh call on my attention?  I’m not sure, but I trust it fully, and have embraced it.  I found To Bless the Space Between Us by John O’Donohue, a book of the most eloquent blessings, and Consolations: The Solace, Nourishment, and Underlying Meaning of Everyday Words by David Whyte.  Both books quench my thirst for beautiful language that articulates the deep longing for meaning and connection, with myself as well as with others.  They call to me.

Between caring for patients, leading work teams, proposing new projects, LOH training, speaking engagements, wife-ing, parenting and friending, life could hardly be more challenging or fulfilling (I should also call my parents more often!).  I see every meeting, every letter, every message as a chance to show up all in, fully present, at my best.  To be my Best Self in all realms, I push myself to learn, practice, and excel, to exercise my agency in service of relationships and connection.  So sometimes the universe approaches me lovingly, jogging alongside, inviting me to slow down.  Take a break, he says, enjoy the view.  Soak it in.  Relish how far you’ve come, what you’ve built thus far.  Breathe deep, stretch out.  Rest a while.  What do you see, she asks, how does it feel? What have you learned, they say, what can you synthesize and integrate, before you march on with resolve and conviction once again, in the direction of your biggest dreams?

The word pairs below emerged, with a little nudging, over the past week.  I see them not as dichotomies, not at all in conflict.  Rather, they are each separate and inextricable sides of the same multifaceted polyhedron of life, necessary counterbalances for a healthy, fulfilling, and meaningful existence.  I started wearing my Yin-Yang ring in January.  It is meant to remind me that opposites are more often complementary than oppositional.  Our society values agency over emergence.  We endorse doing ahead of holding.  But practicing emergence is by no means passive, weak, or unproductive.  It is active, enthusiastic participation in the dance of life, the reciprocal movement of ebb and flow.  Childbirth and heartbeat are quintessential examples of the balance of Agency and Emergence, giving and receiving, contracting and relaxing.

What other word pairs would you add?

I commit to fully inhabiting, savoring this deliberate time and open space, however long it lasts.  Energy will shift again, as it always does.  I have the next self-improvement books and task lists in queue.  I’ll get on the blocks again, ready for the starting gun, soon enough.  But for now, I breathe deeply and look around in appreciation and learning.

 

   Agency                           Emergence

Control                             Relation

        Action                          Observation

Power                        Capacity

Acceleration                          Momentum

      Focus                         Zoom Out

Contraction                       Relaxation

Tightening                      Stretching

Exhale (blow)                     Inhale (smell)

  Intention                        Possibility

  Strength                        Elasticity

Telling                        Asking

             Make this happen                         What’s trying to happen?

            Tap the system                       Watch it spin a while

               Grip                        Hold loosely

Drive                      Ride

Take up space                          Hold space

Yang                     Yin

  Heartbeat

  Childbirth

The exhibit where I took the art photos:  https://smartmuseum.uchicago.edu/exhibitions/tara-donovan-fieldwork/

Our 5 Fundamental Needs

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To Feel:

 

Seen

Look what I can do

This is how I can contribute

See me achieve

 

Heard

Hear my concerns

Take me into account

 

Understood

Validate me

Normalize my feelings

Say you can relate

 

Accepted

Tell me I belong

 

Loved

Participate in the Messy with me

Commit to sticking with me through the hard shit

Let me be my whole self with you

Be your whole self with me

 

Children by parents

Patients by doctors

Students by teachers

Workers by managers

The led by their leaders

Spouses

Friends

 

What if?

 

 

Good Doctor and Good Mom

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What do you sacrifice in pursuit of your dreams?

What does your calling cost you?

What are the returns on your investments?

* * * * *

Last week I mentioned Dierks Bentley’s, “Woman, Amen”, a song I love.  After listening to it for many days on repeat this past week, I decided to tour his nine albums this weekend.  His songs vary in topic and form, and at the same time he has a consistent style and vibe.  I like it.  Yesterday I heard his song, “Damn These Dreams”:

Now honey I know you miss me, I feel it when you kiss me

Trust me when I say every goodbye hurts

Well damn these dreams

Playin’ my heart just like a guitar string

Pullin’ me away from you and everything I really need

Well damn these dreams

Chasing that same old whiskey melody

All up and down these Nashville streets

It’s hard to look true love in the eye and leave

Damn these dreams

 

Instantly I remembered two other songs with similar themes:

 

Goodbye Again”, by John Denver:

Other voices beckon me, and for a little while

It’s goodbye again, I’m sorry to be leaving you

Goodbye again, as if you didn’t know

It’s goodbye again

Have to go and see some friends of mine

Some that I don’t know

Some who aren’t familiar with my name

It’s something that’s inside of me

Not hard to understand

It’s anyone who’ll listen to me sing

…Lying by your side’s the greatest peace I’ve ever known

But it’s goodbye again…

 

And “I Play the Road”, by Zach Brown Band:

…She says daddy where to you go

When you leave me all these nights

With a suitcase and guitar in your hand

Kissing me and mom goodbye with a tear and a smile

Where do you go? 

Daddy where do you go?

I play the road

And the highway is our song

And every city’s like the same three chords

Been helping us along when the story’s told

And the crowd is done and gone

Shaking off the miles and trying to make it home

…Mile after mile… 

Baby, I’m comin’ home

Years ago, I think it was either Dana Carvey or Martin Short who said something like one can only tolerate the life of a comedian because s/he simply cannot do anything else—they must do comedy.  If anyone can find the reference, please share!

* * * * *

As it is in music and comedy, so it is in medicine.  For many of us, we simply must do it; we have no existential choice.  These songs describe well our pain and conflict when we take call or have to work on weekends, or miss the kids’ school and sports events, and spend hours at home on the medical record or answering pages.

I recently read an article, “A Good Doctor or a Good Mom, Never Both”.  Early in this physician mom writer’s career, an elder colleague told her, “’You can be a good doctor, and you can be a good mother, but you can never be both at the same time.’”  The author disagrees, saying it’s either/or, never both, ever.  At once hearing Bentley’s song, I felt a moment of panic, mortified that I’m destroying my family for my job.  Am I totally selfish for choosing this career, and are my priorities so distorted that I so often put work before my family?  Have I chosen to be a good doctor and a horrible mom?

Thank goodness for Simon Sinek who, in his 2014 book, Leaders Eat Last, referenced a 2011 study that showed “a child’s sense of well-being is affected less by the long hours their parents put in at work and more by the mood their parents are in when they come home.  Children are better off having a parent who works into the night in a job they love than a parent who works shorter hours but comes home unhappy.”  This idea has saved me from countless episodes of self-flagellation and guilt.  It was so instantly redeeming that I recall the exact moment I heard it—I was at the airport, traveling solo, likely for a work related conference.  I can’t say I’m ecstatic every evening coming home, but I generally feel satisfied by a fulfilling day doing something I love.  I can confidently report that my husband feels the same.

I’ve attended one swim meet in two years.  I miss any school event that occurs during the workday.  I still get lost walking the maze that is the kids’ school, though we (they) have been there over a decade.  But I get to choir and orchestra concerts, and dinner potlucks.  I know my kids’ friends and am friends with their parents.  The kids’ teachers think they feel loved by us.  I think I do okay.

My kids hear me on the phone with patients and colleagues.  They know it takes time and understanding to take good care of people.  I’m confident they see and feel how meaningful this work and these relationships are to me.  And the science is pretty cool, too.  I would never pressure my kids to go into medicine, but I would not be surprised if they did.  I would absolutely encourage it, if it gives them the joy it gives me.

“You can be a good doctor, and you can be a good mother, but you can never be both at the same time.”  I respectfully agree and disagree.  You can absolutely be both, often at the same time.

 

The Status of Women, 1999-2019

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What happens for men when women speak Feminism?

I intend to ask this question to more men in my life from now on.  What do you hear as Feminism?  Where do you think it comes from?  What do you think women are trying to accomplish by talking about equity and representation?  What moves a man to ally with women in this movement?  What keeps him from doing so?  What are the risks, costs, and benefits for us all when he does and does not?

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Women in Sports

The US Women have just won their fourth World Cup Soccer title, kicking balls and ass, I like to say.  What an accomplishment, and how far they’ve come since winning the first ever Women’s World Cup in 1991, the year I graduated high school.  I don’t follow soccer, but as an American woman, this victory carries meaning for me.  At halftime this morning I read about Brandi Chastain, the 1999 US World Cup champion midfielder who famously, spontaneously, took off her jersey in unadulterated celebration after firing the winning penalty kick in double overtime against China to win it all.  The New York Times featured her story yesterday, commenting on the evolution of our perceptions and treatment of female athletes over these 20 years:

In that pivotal moment of arrival for women’s team sports in the United States and around the world, viewers saw Chastain removing her jersey and twirling it like a lariat, spinning around and falling to her knees, pumping her arms in exultant triumph. What resulted was perhaps the most iconic photograph ever taken of a female athlete, a depiction of pure spontaneous joy.

It was a moment of freedom and liberation, Marlene Bjornsrud, a longtime women’s coach and an influential sports executive, once told me. She called it a “casting off the burden of everything that kept us down and said, ‘You can’t do that because you are a woman.’ It was a moment that screamed, ‘Yes, I can.’”

Title IX was signed into law by President Nixon in 1972, one year before I was born.  So I took it for granted that girls could play sports just like boys in school—not every sport, but most.  I also took for granted the inherent assumptions about women in athletics—that we cannot be as fast, as strong, or as competitive as men.  I have so much more appreciation now for icons like Billy Jean King, Martina Navratilova, and Pat Summitt. I think about the WNBA, and women coaching in the NBA, NHL, and NFL, and I marvel at how far we have come.  Take a look at this timeline of women’s sports in the US to get a fuller perspective.  I know many will say we have a long way yet to go.  But today, let us joyfully celebrate all that we have accomplished already.  Wahoo!! [fist bump and dancing woman emojis]

 

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Journal of Bone and Joint Surgery, January 2012

Women at Work

I’m thinking about the culture of orthopaedic surgery.  In the twenty years since I graduated from medical school, I see more and more women in this field (as well as other surgical specialties), which makes me proud.  While women comprise only 5% of practicing orthopaedic surgeons, 15% of American orthopaedic residents are now women, which is roughly double the percentage in 1999.  But what’s it like to be a woman in orthopaedics?  How do these women present, perhaps differently, at work compared to in their personal lives?  Is it truly safe for them to be themselves as surgeons?  The American Orthopaedic Association held their annual meeting recently.  My orthopod friend returned from the conference and commented that the rare women leaders in his field seem ‘fierce’ and ‘tough’—but in a good way?  It struck him to wonder if they are just like that in general, or do they have to be that way to navigate their male-dominated specialty.  He wondered how they would be seen if they displayed sensitivity and emotion, “because a man can be seen as sensitive and kind” and not only does it cost him nothing, his social status is likely to be elevated because of it.  My friend was not sure this is the case for his female colleagues, and he seemed both empathetic and powerless at the idea.  Looks like gender parity may take a bit longer in medicine than in sports.

At work in general, women’s status varies considerably.  But research points to common issues such a 22% pay gap and too few women in leadership (5% of US corporate CEOs), though these are improving.  One need not look far for abundant evidence that having more women on the corporate team improves earnings and morale.  Much is also written on strategies for improving gender equity at work.  Two of my favorites are exit interviews and work-life balance initiatives for all employees, not just women.  But as I wrote last week, it’s not just about including women as participants in the workforce.  It’s about truly appreciating the diversity of experience, biology, and contribution that women bring to any group they serve.

 

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Women and Men

There is no way I can do justice to this topic in the remainder of this post.  So let me just share some ideas and resources I will continue to explore in the months and years to come.

I asked at the beginning what happens for men when women speak Feminism.  A corollary question is what happens for all of us when we hear the words ‘toxic masculinity’?  My guess is men get defensive and women get aggressive.  Personally I love the phrase because it’s so incisively descriptive.  But it can also be a flashpoint phrase, one that immediately incites conflict and emotional hijack.  Let me be clear: toxic masculinity does not imply that men and manhood are toxic by nature.  Quite the contrary, the phrase refers to a culture of expectations of men that is just as toxic for men as it is for women.  Male surgeons may well benefit from being sensitive and kind, but not too much so, lest they be seen as weak.  This is a vast oversimplification, by the way; the history and complexity of toxic masculinity are explored articulately here.

Readers of this blog know how much I love Brené Brown.  Her explanations of how shame (where toxic masculinity is born) manifests and organizes around gender—and why it is toxic for both men and women–are the most poignant and real.  Read her first hand comments to Ms. magazine here, and a stay-at-home dad writer’s interpretation of them here.  If you seek a nonjudgmental, objective, and real-life exploration of the complex dynamics between men and women, read The Gifts of Imperfection and Daring Greatly.  Sister (she’s not old enough to be Aunt) Brené’s books are the most accessible form of evidence-based, all-around relationship advice I have ever read, and I’m so grateful for her.  From the Ms. Interview:

What role do you think vulnerability played in the #MeToo movement?

Know what I love about the #MeToo movement?—and, me too—I thought until I was 25 or 30, that sexual harassment was just the price of entry.  The greatest casualty of trauma is the ability to be vulnerable. So this #MeToo movement is re-defining and re-claiming vulnerability, and putting vulnerability in the context it belongs in, which is power and courage. 

 What gives you hope?

The thing that scares me about the world today is the same thing that gives me hope. I believe we’re witnessing white male power over. It’s making its last stand right now. And it’s scary because last stands are dangerous, and people get very backed into a corner. I think this is the last stand, and that we’re going to see a shift, mercifully, from white male power to inclusive power with it too. And I think from that paradigm, we can do anything, change anything, and be anything. 

And it’s not just women who can claim agency against misogyny and sexism.  Men who identify as feminists serve as allies for gender equity and respect.  But men can also help themselves and each other break free from the restraints of machismo and chauvinism.  Movements like The Good Men Project and Evryman give men a forum for honest, vulnerable emotional expression and connection.  Just like women surgeons and corporate executives, all men need inclusive spaces where they can feel true belonging, where they are free to be all of themselves—hard emotions and all—for all our sakes.

Men I admire in this space include Nate Green, Ozan Varol, and David Brooks.

* * * * *

To lift my spirits here at the end of this long post, I’m listening to a song on repeat: Woman, Amen by Dierks Bentley.  It’s such a shining anthem of a man’s unabashed love and appreciation for his partner.  I can also imagine modifying the lyrics and hearing Faith Hill singing about her man Tim McGraw.

Thanks for reading to the end, friends.

Our relationships kill us or save us, and we really need to be better at taking care of each other, locally and globally.  We, men and women alike, are all in this together, inextricably, in sickness and in health, forever.

Only Love can save us.  Let’s get on it.

 

Inclusion and Belonging

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What do diversity and inclusion mean to you these days?

Honestly for me, they mean different things depending on the context in which I think about them.  Cathy the Cynic thinks diversity initiatives too often feel trendy and superficial, like a knee-jerk response to the social pressure to check a box.  Cathy the Optimist believes that those who direct such initiatives honestly see the communal value in a truly diverse and inclusive work environment.

A wise friend recently pointed out to me that inclusion can be a challenge even in a homogeneous group.  “You could have 25 white men in a room and everybody may not feel included.”  So, he said, perhaps we should work on inclusion first, and diversity will come more naturally as a result.  Brilliant!  If we make it safe for everybody to be themselves, no matter who they are, then they feel free to bring their best, authentic selves—it’s a win-win for each individual and the organization.  An inclusive work culture supports and values each person for their unique contributions.  In such an environment, diversity is achieved because people value their differences as much as their similarities.  They live in curiosity and awe, always in a learning stance.  Inclusive cultures seek more perspectives, experiences, expertise, and backgrounds—they cultivate depth and breadth in the humanity of their workforce.  People from divergent walks of life seek to join such cultures, drawn to vibrant cohesion, synergy, and creativity.

This idea marinated in my mind for some weeks until an article from the Wharton School of Business crossed one of my online feeds last Thursday.  It says diversity and inclusion are not enough; we need to cultivate a sense of belonging in our workplaces.  The article quotes Sam Lalanne, a senior vice president of Global Diversity and Talent Management at Citigroup:  “…whereas diversity often gets linked to numbers and percentages, belonging ‘is about how you feel’ when you’re at work. ‘Do you feel valued? Do you feel like you should be there? Do you feel that your insights, commentary and perspectives matter?’”

“Rebekah Bastian, a vice president of culture and community at Zillow Group, said that the superior business outcomes often associated with having diverse teams can’t be achieved without a sense of belonging. It’s not enough to simply include people at the table, she said, but to ‘amplify everyone’s voices, clear barriers … and appreciate each other for our unique backgrounds.’ Both she and Lalanne said that a sense of belonging means that people can bring their full selves to work, and not feel like they’re a different person there than at home.”

A different person.  So what I described above as inclusion is really what these leaders define as belonging.  We want each person to feel they belong in the work tribe, that their presence and contributions are valuable and worthy, as themselves.  When we include, from our hearts, each person in their wholeness, only then will they truly belong.  And that is the sweet spot where teams thrive.

So what do we do?  How do we create such loving cultures of true belonging?  According to panelists quoted in the Wharton article (and we all know this), it comes from the top:  “Lalanne also commented on the importance of ‘tone at the top’ toward fostering a sense of belonging. ‘Our CEO, Mike Corbat, has really pushed us on our diversity, inclusion and belonging agendas. And it really comes from, what does he preach, what comes out of his mouth, how does he execute against the things that we see around us.’”  Simon Sinek calls us to live our values with clarity, consistency, and discipline.  So if you’re a leader who talks about diversity and inclusion, about belonging, then we workers have to see you, to feel you, living these values out loud and in front of us.

Belonging is more about how we are toward each other than how we act or what we do, which is inclusion.  This is the key to successful ‘diversity and inclusion’ initiatives—they must be sincere.  Humans are intuitively social animals.  We smell insincerity and reject it, because it is unsafe.  We cannot trust it.

A garden of belonging must be grown organically.  There are no shortcuts.  It takes time, and the gardener must tend it regularly.  Young seedlings require protection from weather and predators.  She must bring in pollinators and other helpers—one person cannot do it all.  So we can all pick up a trowel and participate.  We look to our leaders to set the path, and when we see the shining hope of our collective destination we follow willingly, eagerly, and together.