Confidence and Humility

Mt. Tabor Park, Portland, Oregon, April 2025

Notes from a lunch conversation with dear friends:

Which is the thing and which is the modifier?

If I had to choose, I’d choose confident humility ahead of humble confidence.

But we don’t have to choose; they are both the noun and the modifier.
No more false dichotomy thinking!

And yet the distinction can be useful.
Depends on context, no?
They can switch and be fluid in real time.

Me in the room with a old white guy patients.
Power dynamics at play.
Relational reciprocity or not, friendly until not, ?undetected landmines.

One goal and its self talk:
Inspire confidence with competence.
Bring what ya got.
Boobs out.
I got this.
I care about you.
You are not allowed to abuse me or my team.
Respect is a requirement to be in this practice.
We will own our shit and you will own yours.

Be Nerdy About Your Thing!

My Insta story last week

“OK so:”

When you ask someone about something they love, that they’re expert in, and they get all excited to tell you all about it, isn’t this what they often say? Their energy is palpable, their smile wide, and you can tell they just can’t wait to get it out.

I love that feeling, as both the asker and the answerer. And when I come across someone who also appreciates this feeling, it’s another example of that exponential synergistic cosmic rocket fuel of connection that I live for.

In case you’re looking for folks who exude this, might I recommend:

Alton Brown. Specifically in his recent book of essays, Food For Thought.

AJ, Andy Wilson-Taylor. He nerds out on some of his Patreon posts, about music, noise cancelling, motorbikes, and so much else!

Keith Roach, MD. My first clinic preceptor, teacher, and mentor, we can all benefit from reading Dr. Roach’s columns answering medical questions. He isn’t effusive about the nerding, but you can tell he knows his stuff and loves to teach it.

Carolyn Mueller. My colleague and fitness professional, follow Carolyn on Instagram for her posts and stories on the science, psychology, and reality of staying fit and healthy.

Kasey McKenney. Director of Treatment at Ethos Training Systems in Chicago, Kasey integrates deep knowledge of the musculoskeletal system with expertise in Traditional Chinese Medicine. More often than not, our conversations circle from relationship to communication, to qi, and I always learn something new and relevant to my life and medical practice.

Who do you know like this? Please make your introductions in the comments!

Happy happy, friends–we’ got this!

The Leadership Skill That Matters Most

Photo from my patient who prefers to remain anonymous πŸ™‚

Ask more and better questions.

Here’s how:

Whenever you’re about to make a statement or directive, pause. Ask yourself, “What do I not know?” Be honest and humble, or prepare to be humbled. The mark of an excellent leader is the willingness to be schooled from ‘below’ for the sake of mission and team.

Once your ingnorance is identified, formulate a question. As well as you can, make it an open and honest question, the hallmark of which is that you truly do not know the answer and you are not attempting to lead it. Pause again. Is your question truly open, meaning it cannot be answered by yes or no? If so, proceed. If not, revise to a truly open question.

Listen to the answer without interrupting. Do not speak until the other person has stopped talking for at least two seconds. Resist the temptation to issue your previous directive anyway. Follow the thread of curiosity, however thin or faint, to explore what else you don’t know. Done well, one OHQ leads to multiple subsequent OHQs, often branching and diverging to adjacent arenas all interconnected and mutually influential to the central issue.

It can get overwhelming fast, and I suspect many of us do not engage in this kind of query because the emergent morass of complexity feels so daunting. Rabbit holes are to be avoided in leadership think.

If we ask more and better questions, however, we don’t get rabbit holes. We get ecosystem.

I do this every day interviewing patients. Regardless if it’s weight, blood pressure, blood sugar, insomnia, or depression, nothing occurs in a vacuum. Only by exploring the state of every domain of health (work, sleep, exercise, nutrition, stress, and relationships) can I see fully the interconnected origins and impacts of the issue I need to address (often multiple issues at once). Often about thirty minutes into the interview I say, “Wow, that’s a lot.” I sit with my patient a bit stymied at the muddle. Then we talk about their goals, their values, and what lights or dampens their spirit. Reliably, by the end of the day long exam, we get to an action plan that is both brutally realistic and fully aligned with their highest aspirations. It feels inspired an empowered, forward motion already initiated for the coming year.

The best questions help us survey the jungle, its density and pitfalls. It is only after querying the morass and seeing its wholeness that we can know where to act most incisively and effectively. We know we asked excellent questions when the answers provide the map that leads us through the jungle together and with confidence.

Humility. Honesty. Transparency. Safety. Clarity. Accountability. These are the imprints of leaders adept at asking more and better questions. Consider any organization in your experience; I bet these leaders stand out. How would you describe their presence? How do you feel when you’re with them? What effect do they have on the team and its operations?

In case it’s not already obvious, this practice of asking open and honest questions benefits all relationships. In a world of soundbites that continually overgeneralize and oversimplify, stoking judgment and othering, the more we can retain and protect our humility and curiosity, the more we can ask more and better questions that foster understanding and empathy, the better the world will be. We all lead. Let’s do it better, yes?