Decide in Advance

be the lighthouse

NaBloPoMo 2018:  What I’m Learning

It’s the first Sunday of November of an election year.  The political ads are ramping up.  Tension rises; the agitation is inescapable.  Some media would have you believe that one outcome or another is all but inevitable, the world will positively end if one side or the other wins.  I admit, I have felt my share of darkness and despondence at the words and actions of some (many), not just the last two years, but for a long while now.  It’s hard not to feel sucked into an inexorable downward spiral of animosity and rage.

Thankfully, I still hear voices of uplift, words that speak to the optimist and idealist in me.  Let me share some of those voices and words with you here.

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My friend Donna Cameron, an expert on kindness, reminds us that we have a choice, not just on election day, but every day before and after, about how we conduct ourselves with one another:

We have to ask ourselves now, before we know the outcome of the election: Do we want a united country? Are we still capable of coming together to productively and positively address the complex issues that have divided us?

Civility and compassion are not weak. It takes strength to accept loss and move forward with resolve rather than bitterness. It takes strength not strike back when our buttons are pushed or our values are derided. It takes strength to recognize the pain someone else may be feeling and not belittle those feelings or dismiss their right to grieve.

Don’t look to the politicians or pundits to lose—or win—with grace. They’re going to be gloating in victory and blaming in defeat. It’s up to us to model what constructive behavior looks like and to demand it of our elected officials.

But what can we actually do?  How will we know when to act, and what to do in any given circumstance?  Isn’t it just too abstract to say, “practice empathy,” or “be compassionate?”  Maybe.  But if these are values for us, then we can translate them into actions and practice.  Empathy manifests as active listening, holding one’s tongue while hearing someone else’s story, resisting the urge to interrupt and tell our own story.  It means relating to their feelings and expressing understanding and solidarity.  “That sucks, I know that feeling, Me, Too.”  Empathic listening, validating words, and simply sitting with and holding space are good practices to start with.

The Southern Poverty Law Center offers 10 concrete steps to fight hate.  Examples include:

Repair acts of hate-fueled vandalism, as a neighborhood or a community.

Use whatever skills and means you have. Offer your print shop to make fliers. Share your musical talents at a rally. Give your employees the afternoon off to attend.

Report every incident.  Pressure your representatives.

Finally, look for role models.  If you have not read Ari Mahler’s personal account of caring for Robert Bowers in the ER, please click on the link now.  He is ‘the Jewish nurse.’  What would you have done in his place, called to the trauma bay to care for the man who may have just killed members of your family for their religion?

I’m sure he had no idea I was Jewish. Why thank a Jewish nurse, when 15 minutes beforehand, you’d shoot me in the head with no remorse? I didn’t say a word to him about my religion. I chose not to say anything to him the entire time. I wanted him to feel compassion. I chose to show him empathy. I felt that the best way to honor his victims was for a Jew to prove him wrong. Besides, if he finds out I’m Jewish, does it really matter? The better question is, what does it mean to you?

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Sometimes I wonder if my posts are redundant.  I have decided to think of them as iterative.  Looking back, I found a couple of posts relevant to today, written in similar periods/mindsets of portent, reflection, and seeking.  Right before January 20, 2017, I shared words I had written to friends.

They represent my intentions for managing myself in the coming years, of reinforcing my core values and focusing on my highest aspirations.  As Simon Sinek posted once:  ‘Fight against something, we focus on what we hate.  Fight for something, we focus on what we love.’

Months later I connected with conservative friends in an attempt at mutual understanding. It was not as comforting as I had hoped; I did not really feel heard or understood.  And I learned a lot about managing expectations.

I admit that I felt a little defensive at times, as if anything I said about the origins of my distress would be met with, “You’re overreacting,” and “You’re worried about nothing, please…”  We later agreed that it is never helpful to invalidate someone’s emotional response to a stressor, regardless of whether or not we can relate.

Last week I had a new opportunity to hear a colleague’s conservative point of view on gender.  With practice, I have become so much more comfortable sitting back, listening for understanding, quieting my inner debater.  My urge to counter and convince did not escalate.  I heard earnestness, confusion, some fear, and mostly a desire to understand and integrate, to find balance and peace.  I was not asked for my opinion, and this time I was okay with it.  I hope we can engage again and again in the future.

Today, two days before we all head to the polls (if we have not already—please please vote), we can decide what kind of neighbor, colleague, friend, parent, child, coach, teammate, employee, boss, coworker, and American we want to be.

What if we choose to be the kindest, most empathetic and compassionate ones we have ever known?

Walk a Mile

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NaBloPoMo 2018:  What I’m Learning

These last 5 years, I have had the privilege of caring for designated leaders of all kinds—business leaders who also lead their families, their faith communities, their professional societies, and myriad other entities. I have studied and presented on the intersection of health and leadership, the reciprocal relationships between self-care and care of others.  Each day I ask probing questions of my patients’ habits of thought and action, and they answer with honesty and candor.  It’s particularly fulfilling when I hear, “Huh, that’s a good question, I’ve never thought of that before.”  In those moments, I feel I bring value beyond interpreting blood pressure and cholesterol results.

I’ve been interested in leadership for a long time, and had opportunities to lead in various small ways through the years.  In January 2018, I was given a more visible title and designation than I had ever had—YIKES.  I was surprised and unsuspecting, though not totally unprepared.  And, like parenting, nothing can quite prepare you fully for the experience.  I spoke to a leader in my organization about a year ago, who expressed loneliness in his position.  I admit that I half dismissed the idea, thinking there should just be a way to balance collegial, friendly, and leader-led relationships.  I think I was about a week into my new role when I fully, viscerally, understood his perspective and humbly admitted my own loneliness.  I felt guilty and a little ashamed for my reflexive disregard for his confession of vulnerability—because even if I did not fully dismiss his experience, I did judge it.  And that speaks more to my own fear of loneliness and isolation than it says anything about him.

Thankfully, I did not wallow in guilt or shame for long.  “How fascinating,” I thought.  Being judgmental like that is not consistent with my core values.  These ten months have been a practice in navigating and managing that loneliness—cultivating relationships in new ways to maintain connection while simultaneously practicing the required discretion in information sharing.  Often I have felt profound humility (and now more embarrassment than shame) at how I thought I knew so much about effective leadership, mostly from the point of view of being led, and only sometimes as a leader myself.

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This fall Brené Brown saved me from further self-flagellation over my lack of skills and understanding of what it takes to be a good leader.  The thing I admire most about her is how she walks the talk of vulnerability and courage.  She shares her mistakes, missteps, and learnings so openly, and anyone who reads her books or sees her presentations gets to profit from it all.  I will always remember where I was, because I laughed out loud in sheer relief, when I heard her read from her latest book, Dare to Lead:

Over the past five years, I’ve transitioned from research professor to research professor and founder and CEO.  The first hard and humbling lesson?  Regardless of the complexity of the concepts, studying leadership is way easier than leading.

When I think about my personal experiences with leading over the past few years, the only endeavors that have required the same level of self-awareness and equally high-level ‘comms plans’ are being married for twenty-four years and parenting.  And that’s saying something.  I completely underestimated the pull on my emotional bandwidth, the sheer determination it takes to stay calm under pressure, and the weight of continuous problem solving and decision making.  Oh, yeah—and the sleepless nights.

I thought, well, if Brené Brown still had stuff to learn after assuming a new leadership role, then I’m doing okay!  I am both freed from self-imposed, unrealistic expectations of perfection, and also still responsible for continuing to practice self-awareness, humility, and honesty.

I have learned to look harder at the cynical stories I tell about my leaders, and seek to understand better the divergent and competing interests they must balance every day.  I can withhold judgment of their motivations until I have more information, and if I’m not entitled to all the information, I can decide how much I trust my leaders to act in my best interests, or at least in the best interests of the organization.  I can hold myself accountable to my own standards of honesty, candor, and integrity.  I can ask and challenge, inquire and resist (or accommodate), all with curiosity and respect, and making the most generous possible assumptions of others.

How lucky am I to have this remarkable learning opportunity?  To practice the skills I have observed, admired, and studied in others for so long, to own them.  I have walked a mile in these new shoes.  I have a few shallow blisters for the journey so far.  But the shoes are the right size, and the leather is softening.  I’m still feeling fit.  The path will wind and climb, and that’s okay.  I don’t walk alone; I have mentors and role models walking ahead and by my side.  So bring it!  We’ got this.

From Meaning to Mission:  Finding Your Voice and Speaking Up for Change

Fairmont workshop room

Have you ever felt like you have no voice in your workplace, your community, or the world at large?  When have you felt you do have a voice?  What made the difference?

Two esteemed colleagues, Liz Lawrence and Eileen Barrett at the University of New Mexico, and I presented the above titled workshop at the International Conference on Physician Health on Friday.  The objective was to give participants an opportunity to recognize and rally their strengths, claim their value and agency, and practice the words to advance an idea or project for improving physician health and well-being.

The idea for the workshop came from a conversation Eileen had with a young physician who felt he had no agency to improve his work situation, due to his junior status.  This prompted her to ask, who has agency, and how do they get it?  She concluded that agency is an active skill, not a passive state of being.  Thus it can be learned/acquired, and everybody has/can have it.  Furthermore, we apply it most effectively when we combine it with our strengths, in service of projects that are personally meaningful.

We presented the reciprocal triad of finding meaning in work, feeling empowered, and inspiration and motivation, as the foundation of agency and action.

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Identifying Strengths

The first exercise had participants pair up and describe their strengths to each other.

What are your strengths?  Imagine describing them to someone, out loud, in person.  How does this feel?  Our attendees reported feeling uncomfortable, not used to it.  They also felt confident, connected, and encouraged speaking to someone they knew was listening supportively.

Defining the Project

Second, we asked participants to think for a few minutes about their own projects.  It could be something they had been working on for a while, a new idea they recently came across, or something from a sample list we provided, related to Culture of Wellness or Efficiency of Practice.  We asked:

  • Is your idea “Big Enough to Matter, Small Enough to Win?” quoting Jonathan Kozol.
  • Is it Specific, Measurable, Achievable, Relevant, and Time-bound (SMART)?
  • How will your strengths apply?
  • What else do you need? Who can help?

Partners met again to share and discuss each other’s ideas.

Afterward they reported elevated inspiration, excitement, and mutual support.  Positive energy in the room rose palpably at this point, with lots of gesturing, smiling, and engagement.

ICPH 2018 workshop

Communication and Relationship

We didn’t call it an elevator pitch, but that’s basically what we asked attendees to attempt.  In 90 seconds, each participant was to distill and express their idea into words that would convey its essence and enroll their partner in its goal.  Having advanced to this segment of the workshop in less than twenty minutes, and now asking them to perform a pitch on the fly, I gave a pep talk (modified here to include some words I wish I had said):

“Now it’s time to PRACTICE.  If we are to make progress in our projects, we must enroll other people.  It’s all about relationships.  Relationships kill us or save us, and they live and die by communication.  A previous presenter said, ‘Language is the vehicle through which all interactions take place—both verbal and nonverbal.’

“You never know when or where you will meet your champion, or who it will be.  The easier and better you can pull your idea out of your back pocket and present it cogently and impromptu, the higher your chances of success.  Know your ask—be as clear as possible.  Know your audience—what about your project is meaningful to them, what will they relate to?  Make them the hero:  Don’t come at them with demands.  Come alongside them with open-ended questions; help them appreciate the power they have to help.

“You will have to be persistent.  Practice will be key.  Our keynote speaker, applying complexity theory to the work of physician well-being, invoked the image of a grain of sand dropping onto a pile.  One grain may stick on impact and nothing happens to the pile.  Another may cause a small section of sand to tumble just a little.  Yet another grain can trigger the avalanche that alters the sand pile landscape entirely—and no one can predict which grain will be which.  I posit that you are not a grain of sand.  You hold an idea—a whole bag of sand—and each time you pitch it, you drop a grain (or a handful) on the pile.  If one grain makes no immediate change, drop another one, and another, and another.  This is the essence of the Growth Mindset—practice.  Practice is Creation.  Practice is Evolution.  Practice is Progress.  Your job now as speaker is to try with abandon.  There is no such thing as a bad try.  Pay attention to how it feels, where you get stuck, and where you shine.  As the listener, your job is to make it safe for your partner to let go of fear and judgment, to lay it all out.  Support, encourage, and critique with love.  What moved you, what did you observe in words and body language that drew you in or put you off?  What did you want more of?

“Make the most of this time.  Dig in the bag and pull out a few grains to drop.  Take advantage of your partner for feedback and support.”

The room was positively buzzing.  And participants’ comments made our day (paraphrased here):

“Sticking with the same partner throughout was helpful; we could really connect each other’s strengths to our respective ideas and help each other develop them.”

“It was fascinating to see the energy change between talking informally about the idea and then having to present it as a pitch.  She was so much smaller and hesitant the second time around.”  (Partner):  “The first time I was just talking to a colleague.  The second time I pictured presenting to my board.”  The experience was enlightening and curiosity-provoking.

“It’s different and easier talking to a supportive stranger, someone with whom you don’t already have relationship baggage.”  How else, then, might we approach our stakeholders—how could we practice awareness of our assumptions and relationship dynamics, and perhaps modify them positively?

“Hearing someone else’s ideas informs my own.  I like how he conveyed something, I saw how I could do the same; it gave me more insight.”  Taking turns both presenting and listening engaged both people in mutual support and encouragement—both roles were helpful.

The Takeaways

Liz, Eileen and I have collaborated on physician wellness since 2015.  We share meaning and mission around inspiring our colleagues to claim their value, recognize and stand both confidently and humbly in their power, and participate in a global movement of positive change.  Our strengths and styles complement one another and the work flows naturally, synergistically.  What a privilege and an honor it was to have this opportunity to present to and commune with our tribe members in physician health.  May the processing and integration of all of our new learnings continue to sustain and connect us for the long road of work ahead.  As Barack Obama says, “Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change we seek.”

Onward, my friends.

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