Pre- and Post-op Election Care

Christine Gilmore, “The Path to Peace,” October 2020

Happy Fall, my friends!  Are the leaves near you as brilliant and wakening as they are by me?

This morning I had another Zoom call with my Braver Angels pals Mande and Sharon—we have met monthly since soon after the pandemic’s onset.  I come away feeling seen, valued, and loved every single time.  And we hatch plans to change the world, too—stay tuned. 😉

Mande’s rock star sister hosts “Jeffersonian Dinners,” where friends gather and discuss a meaningful question—a modern day salon—oh, be still my heart.  This week’s question, for the Jeffersonians and me alike:  “After the election, how can we come together?”

Coming together now means connecting and healing.  It means committing to this as work, no more blaming and playing victim.  It means each of us owning our part, because we are all active participants in all of our relationships, and the current state of our culture is the sum total of all of our complex, inextricable relationships. Coming together fosters peace, which I think we all yearn for, especially now.

I believe we cannot die at peace unless we live in peace first, and peace must be cultivated.  A life of peace necessarily embraces openness, curiosity, humility, vulnerability, patience, and generosity.  How lucky I am to know so many models in these domains, like Sharon, who teaches these exact skills—she helps us train.  It’s like prehab—getting the body healthy through clean eating and good sleep before surgery.  Then we build on this foundation in rehab, increasing range of motion as well as both core stability and mobility—think of this as a metaphor for interpersonal encounters and relationships.  It doesn’t just come, even if you’re a natural, and times like this will test your talent as well as your skill.   “If you don’t have the practice then you can’t show up consistently,” Sharon wisely explains.  So what are the practices?

How do you make people feel?

By now you must recognize Maya Angelou’s simple and profound words: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

In these coming weeks and months—actually for the rest of our lives—what if we each attended more to this?  What if we all take responsibility for at least half of how people feel after they encounter us?  And what if we all committed to making every encounter as positive as possible for the other person, ahead of ourselves?  Tonight I will review only two of the myriad practices for pre- and re-hab’ing our ailing culture. 

What are you already doing to make things better?

Listen More Deeply—Much More Deeply 

Listen through the words and beyond your own head. 

The most superficial listening level focuses on what I think of what someone is saying.  I listen to refute and proclaim, to be right, to dominate, to dismiss, and maybe even shame.  Conversations and relationships go south and disintegrate quickly in this scenario.  Yuck. 

We can connect, however, when we start listening holistically to the words, imperfect and inarticulate as they may be, to hear what people think.  How do they perceive, understand, and rationalize (we all rationalize)?  Where, intellectually, do their opinions and positions originate?  This kind of listening can lead to truly curious questioning and when done well, to important insights and deeper understanding.

At the third listening level, where we truly connect personally, we hear how people feel.  Humans are fundamentally emotional beings with the capacity for rational thought, NOT logically thinking beings who happen to have feelings.  If I’m able to hear emotions, then recognize, identify, relate to, and acknowledge them, I diffuse and de-escalate.  This is often the first moment of deep connection in an encounter. 

Lastly, listen for core values.  When conversations escalate and we suffer emotional hijack, often some core value (eg honesty, fairness, integrity, equality) has been violated.  When I recognize this I can then relate and connect, and this mutual understanding almost automatically further de-escalates a conflict.

Elevate Your Opponent’s Humanity

Some years ago driving to work, I saw a young man, maybe in his twenties, cross the street in front of me.  He looked fit, dressed casually, a little scruffy on the face.  Suddenly I saw him not as a pedestrian, or an office worker, or a fellow Chicagoan.  I saw him as a mother’s son.  I wondered to myself, is she thinking of you right now?  I bet she’s proud, no matter what you do.  I hope you carry her love around with you all the time.  I hope it sustains you.  I hope that for my own children.

Listen to Simon Sinek interview Bob Chapman on his podcast about leadership.  Chapman, a father of 6, likens leadership to parenting.  His Why is to make people feel cared for rather than used.  He sees each of his employees as someone’s precious child, and thus someone to be valued and loved, just like he would want his own kids to be treated.

How do we do this?  We recognize people’s strengths.  We acknowledge their core values, we validate their feelings.  We respect their opinions and engage in disagreement with understanding and not ad hominem attacks.  We aim for 5 positive interactions/exchanges for every negative one, to cultivate relationships of deep trust and safety. 

What if we did this with the people who disagree with us?  If we imagine debating someone with each of our parents watching, how would that change the dynamic?  If we truly cared for each other as members of one human family, how much better could this all really be?

I’m thinking hard (and soft) about how best to use my time, energy, creativity, relationships, and writing in these coming months.  We’ve dug ourselves into a great, big, muddy (sh*tty) hole, yes.  And we absolutely can dig ourselves out.  But it will take all of us.  I’ll try to keep reminding us.

The only way out is through.  The best way through is together.

Excavating the Dark Side of the Shitpile

Who’s ready to get off this roller coaster?

Bazinga, no dice!  We are strapped in like fat toddlers to professionally installed car seats and this hellish ride ain’t stopping anytime soon. 

What am I talking about?  COVID?  Racial injustice?  The economy?  Politics?  Riots and looting?  Wildfires?  Square dancing hurricanes?  Climate change?  Well, all of it, of course.  We are in it, my friends.  Oh. Yeah.

*sigh*

As always, my friend Donna enlightens me and I feel better.  In our recent conversation I recalled her assertion a decade ago that humanity pushes toward ever increasing consciousness and enlightenment.  Right after the 2016 election I may have laughed out loud (or cried) at this idea.  But today I take a different perspective.  How can I say this in the middle of all the tumult and crisis?  Because tumult and crisis are exactly the evidence of impending breakthrough.  Anyone who has done any truly deep, inner work knows that enlightenment cannot come without a whole shit-ton of pain and suffering.  We also know that on the other, light side, when we get there, the effort was always worth it.  My “Sh*tpile” post may be only the second or third I ever wrote on this blog:

Everybody has one.  We inherit large parts of it from our parents, whose parents passed theirs down, etc.  Life experiences add mass and odor as we grow up.  It sits squarely in the middle of the house of our existence.  For the most part, we simply live our lives around it, walking past every day, careful not to knock any pieces off.  The surface gets dry and crusty; we grow accustomed to the smell.  No big deal.

Once in a while, something moves us to start digging, like that sudden urge to clean out the closet.  We quickly learn that sh*tpile insides stay fresh and painful, like unhealed wounds when scabs suddenly get torn off.  Our eyes water, our senses are overwhelmed, and we want to escape, and fast.  Maybe we avoid that room for a while, or we come back driving a tank to flatten the pile, to the destruction of other property.

Then last year I wrote about the poop flinging that happens when somebody else knocks off a piece of our shitpile, in “All Hail Your Dark Side”: 

What triggers you?

I don’t mean your pet peeves (please, stop using “there’s” when speaking about anything in the plural).  I mean what gets under your skin and affects you viscerally, really hijacks you?  I’m talking about the thing that escalates you so fast or intensely it’s like an out of body experience—you know you’re overreacting, you know it’s irrational, and yet all you can do is sit by and watch it unfold, powerless to control or direct it.

I submit that we are at this moment, collectively, neck deep in our triggered societal shitpile. I’m thinking mostly about systemic American racism, but I also include our profoundly political, ideological, and cultural polarization.  We’ got some serious reckoning to do, my peeps.  How the hell did we get here, and how the f*** do we get out?

“What if this is not the darkness of the tomb, but the darkness of the womb?”  Valarie Kaur asks.  What if this is exactly the Work we all need to do to reach that higher plane of human relationship?  What if we are all called to participate—fully, both feet, deep end—with only one another as life preservers?  Brené Brown calls it “Day 2,” the messy middle between realization and resolution, where the Reckoning, Rumbling, and Revolution happen.  It’s the second act in Joseph Cambell’s hero story arc, after the hero has tried every way of avoiding, denying, deflecting, and averting the task, and finally resigns, and rises, to meet it.  The gripping, tense, thrilling part of any story is this messy middle, the part we dread and relish at the same time.

In the Shitpile post I assert that we can use our life manure to cultivate a life garden that brings joy, fulfillment, and peace.  I use the metaphor of wise gardeners and tools that we can recruit to make the Work easier and more meaningful.  The pile is deep, pungent, and squishy in that way that creates a vacuum, sucking you further in every time you move, apparently impossible to escape.  But we can do it.  Look for help from people who already wield the most effective implements—Curiosity, Humility, Respect, Openness, Non-judgment, Kindness, Empathy, Self-Awareness, and Self-Control.

I present below my hardware store of other tools, accumulated to date, that help me relish ‘way more than dread.  They inform, educate, challenge, and stimulate me.  Along with my pit crew, these resources and practices give me the vital energy and strength, and really the joy, to pursue the hard conversations, to engage ‘the opposition,’ and to make a God. Damn. Difference.  I hope at least some of it resonates with you.  What else would you add to the store?

The Books

Talking to Strangers by Malcolm Gladwell

Four Days to Change by Micheal Welp

How to Be and Antiracist by Ibram X. Kendi (still getting through this one—it’s the esoteric lecture)

Me and White Supremacy by Layla F. Saad (will revisit this one—it’s the life workbook)

But I Don’t See You as Asian by Bruce Reyes-Chow

Caste by Isabel Wilkerson

The Websites/Groups/Resources

Braver Angels—depolarizing America, one conversation at a time

Uprooting Inequity –Ayo Magwood—American history scholar teaches history of racism in America online.  I’ve taken two of her classes and recommend them highly.

The Root—“The Blacker the Content the Sweeter the Truth”

The Dispatch—conservative news

All Sides—news from left, center, and right organized around topic/issue

David French, The French Press

Chris Ladd, Political Orphans, and formerly GOPLifer

The Concepts and Practices

Technical vs Adaptive Challenges and Change—Heifetz and Linsky

PEARLS:  Fostering connection in communication—a copyrighted framework from the Academy of Communication in HealthcarePartnership, Empathy, Acknowledgement, Respect, Legitimation, Support

Asking truly Open, Honest Questions—Parker Palmer, Center for Courage and Renewal

Cone in the Box:  Perspective taking—Judy Sorum Brown

Managing Polarities—Barry Johnson

How to Do the Holidays Safely This Year

“Wear a condom!”

Asking loved ones not to be together for the holidays is like asking teens not to have sex.  People will do it no matter what we say, so we should help them do it as safely as possible.  Let’s talk about COVID condom-equivalents!  Below are my thoughts, here at the end of August, about how we can make holiday gatherings hotbeds for communion and connection, rather than infection and transmission. These are my own recommendations and do not represent the advice or policies of my employer:

Talk About It Now

If your family is anything like mine, people have varying degrees of comfort and anxiety about COVID, and these levels may themselves oscillate and evolve over time.  Before we even talk about gathering for the holidays, we need to know how people feel and what they think about it all, as much as possible.  Talk to your nuclear family.  How important is it for each of you to be with extended family?  What trade-offs are people willing and not willing to make in order to do so?  What are the deal breakers?  What are the must-haves?  Starting these conversations today gives everybody time to reconcile differing opinions and make the most accommodating and collaborative plans.

Contact your extended families.  What’s everybody thinking?   Who’s on the same page?  For those who are not, what will need to happen?  How can we all work it out so that these holidays bring joy and connection, however we can get it, rather than more separation and loneliness?

Isolate for 14 days in advance

The most effective method for preventing infection and transmission is isolation. The incubation period for SARS-CoV-2 is 2 to 14 days. If we have no contacts outside of our household in that time, the chances of us getting infected, and then passing the virus onto others, is very low. I know this is not possible for many, but if we really want to be together safely, this is what we should aim for. Everybody who will be together in the extended family needs to minimize contact with people who will not be with us, in order for us not to spread the virus rapidly between us.

Merge Bubbles SAFELY

Once we have decided to gather, we should follow precautions obsessively:

  1. DO NO PARTICIPATE IF WE HAVE SYMPTOMS.
  2. Check temperature daily; stay away/isolate if over 100.0 degrees Fahrenheit.
  3. Wash hands and sanitize surfaces like our lives depend on it—20 seconds with soap and water, or enough 60+% ethanol-based hand sanitizer to take many seconds to dry, no exceptions, early and often.
  4. DO NOT share anything: utensils, drinking vessels, implements, etc.  When it doubt, throw it out and get a new/clean one.
  5. Minimize close contact–consider masks if close contact is prolonged.
  6. Optimize ventilation.
  7. Spread out whenever possible.
  8. Mask up if it helps us feel safer—especially if anyone was not able to isolate.  Respect one another’s decisions on this—be kind and generous.  Nothing ruins a gathering, holiday or otherwise, faster than snide comments and passive-aggression.

Know the Risks

So many statistics abound, and depending on our particular perspective on the pandemic, we will focus on certain facts more than others.  The bottom line is this:  Populational statistics are not easily applied to individuals.  Nothing can predict your or your family’s outcome if exposed.  Some things to keep in mind:

  1. None of us, not even veteran infectious diseases and public health expert Dr. Anthony Fauci, have seen a disease with such a spectacularly wide spectrum of illness—from asymptomatic to rapid multisystem organ failure and death, and everything in between.
  2. Any person, regardless of demographic, could have any course.
  3. There is no way to predict what any given individual will have, and virtually no way to influence it, other than preventing infection in the first place.  Maybe you can increase your vitamin D level and decrease your risk (talk to your doctor about it).  But unless you’re in the hospital (which means you are very sick), where remdesivir and dexamethasone may shorten your hospital course, there is nothing you can take or do to make you better.  You could be ill for many weeks with symptoms that involve your lungs, gut, brain/nervous system, heart, and blood vessels.  And all you will be able to do is wait it out.
  4. If you get infected, even if you recover, we still don’t know whether and what long term effects the virus and the disease will have on your body and/or your immune system.  It’s simply too new.
  5. The local positivity rate where we are can help us assess the risk we pose to others.  Where are we and our relatives coming from, and what does the pandemic look like t/here?  Find out here

Stay vigilant

Let’s say Thanksgiving goes well and nobody gets (too) sick in the weeks following.  Are we getting together again in December or over the New Year?  If so, we will all need to follow the same preparations and precautions before and during all gatherings to make it into 2021 unscathed.  The good news is, if we have already merged bubbles and we all steer clear of contacts outside of this new cohort, we may continue to commune safely all through the season.

I may update this post as the holidays get closer. Maybe everything will get better and we will have much less to worry about… I seriously doubt it. The best thing that could happen is that we all draw closer, physically and/or otherwise, to take care of each other and appreciate all that we have; that we live more mindfully, kindly, and inclusively in all domains; that we pull together in every way and keep each other safe and healthy.

What will be your COVID condom-equivalents this holiday season?  How willing are you to wear them every time, no question, without fail, to protect yourself and your loved ones?

***

Coda:  On Testing

Below is a draft of information I have written for patients.  It reviews what constitutes an exposure, and guides decision making about testing.  Bottom line:  Negative testing does NOT guarantee the absence of infection or risk of transmission.  Know what the information means and how to use it before getting tested.  These are also my own recommendations and do not represent the advice or policies of my employer:

Definition and Degree of Exposure

Known exposure

–You spent more than 15 minutes within 6 feet of someone who was symptomatic with COVID-19 illness and/or tested positive ​within the two weeks prior or 48 hours after the time you were with them.

Possible exposure

–Same situation as above, but you and/or the other person were masked​.  ​Some would still consider this an exposure​, others would not.  If you were both masked for the entire encounter, the risk of transmission ​is significantly lower.

— You spent less than 15 minutes unmasked with someone who was symptomatic or tested positive within the two weeks prior to or 48 hours after the time you were with them.

–You attended a large gathering, flew on an airplane, rode a train, etc. where someone in the vicinity recently or subsequently tested positive. The risk in this situation is higher if anyone was unmasked and/or if it was indoors and/or in a small, poorly ventilated space. Avoid these activities if possible.

–Prolonged outdoor contact, unmasked, inconsistently distanced at 6 feet or more, eg outdoor dining.

Not an exposure

–Outdoors, consistently masked and/or distanced from other people at least 6 feet apart

Statistics of Infection

–Incubation period is 2-14 days

–Average time to symptom onset is 5 days

–By 10-11 days, 90% of infected people will have developed symptoms

–Viral load peaks 1-2 days before and after symptom onset—this is when the test is most likely to be accurate

Reasons for Testing

–Required for return to work/school, participation in structured activity, etc.

–Known exposure

–Symptoms:

  • fever
  • cough
  • any new shortness of breath or difficulty breathing
  • chills
  • shaking with chills
  • muscle pain or body aches
  • headache
  • sore throat
  • new loss of taste or smell
  • diarrhea
  • nausea or vomiting
  • congestion or runny nose
  • fatigue

–I do not recommend testing in the absence of symptoms, exposures, or a requirement. 

Timing of Testing

–After a known or possible exposure, the best thing to do is self-isolate ​for 14 days.

–If you develop symptoms, seek testing.

–If you do not develop symptoms, consider testing around day 5-10 and continue to isolate

–Check the turnaround time at your designated testing site.  Results can take anywhere from hours to weeks.  Note that if a result is reported many days after the test date, that result may not reflect real time infection status.  Thus testing may not be useful and 14 day self-isolation is the best course of action.

​-A negative test does NOT ‘clear’ you. Testing can be negative in up to 30% of people who have symptoms, and may be higher in those who are asymptomatic or early in infection. Therefore, you MUST continue to isolate for a full 14 days after a known exposure, even if you test negative.