Category Archives: gratitude

The Best Thing That Could Happen

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What do you think is the best thing that could happen out of the COVID-19 pandemic?

I think it’s Connection.

How ironic, as the current best solution to mitigating illness and death is physical (not really social) separation.

Connection won’t come easily, though.  Today I felt all kinds of yuck:  Conflicted.  Unsettled.  Angry, Cynical, Fearful, Guilty, Annoyed, Confined, Enraged.  Not exactly connecting emotions.  The people going about their usual routines, disregarding distancing guidelines, and claiming it as their right to ‘live free’ agitate me the most.  When they get sick, and after they have infected numerous others, some gravely, my colleagues and I will care for them the same as for those who followed the guidelines and acted unselfishly for the greater good.  We will put ourselves in harm’s way, and more of us will pay with our lives for their false freedom.  Because when your ‘right’ to ‘live free’ puts others’ lives at risk, that is not freedom.  That is negligence.

That said, I’ve not lost all hope.  Through Facebook, Zoom, email and snail mail, I am now better connected with some folks than before, and I’m grateful.  They have helped me consider and envision the best possible New Normal on the other side of COVID-19.  I share my wish list below, as well as links to my favorite articles from the past week.

Also, join me this Wednesday, April 8, at 6pm Chicago time for an Instagram live chat.  Owners Tim and Victoria at Ethos Training Systems will host a fireside-style session on COVID-19.  You can join by finding me, chenger91, or Ethos, at the time above.  Please know that I do this public event as a friend of Ethos, and not as a representative of my employer or any medical professional society.  I claim no expertise in infectious disease or epidemiology; I’m just one doctor doing my best to share relevant information and practical advice.

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To Create Our Best Post-COVID Future, Let Us:

Continue to connect earnestly with people near and far.

Advance toward universal healthcare in some form, and shore up our social safety nets.

Reclaim our collective mindset—temper extreme individualism with more altruism and empathy.

Slow down—maintain more flexible work schedules, better childcare options.  Generate less pollution, decrease unnecessary production and consumption.

Live more mindfully and in the present:  Enjoy the good more and dwell less on the bad.  Increase both awareness and appreciation of all that is well in life.

Hold rigorous science and medicine far above opinion and ideology.

Practice Learning, Flexibility, Agility, and Resilience, in all domains, large and small, individually and as a collective.

Recognize our shared humanity, maintain that recognition, and act consistently from that recognition—bake it into our cultural norms henceforth.

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Pieces that helped me the past week:

An excellent review of the evolution of and rationale for universal masking:  https://www.vox.com/2020/3/31/21198132/coronavirus-covid-face-masks-n95-respirator-ppe-shortage?fbclid=IwAR237JXMUy94AcI_4uigdP3ZZUfoNd1c_4tyRDi-A8u2BYm7YZmSJ0f3ii8

A summary of current knowledge of SARS-CoV-2 and COVID-19, written accessibly and with practical recommendations, by my teacher and colleague, Dr. Alex Lickerman:  https://imaginemd.net/blog/coronavirus-april-2020-part-5/?fbclid=IwAR20m7QfOSUlZlAZuTaytKDaw210j_wWuqd6xgGBeTbIHAEfZeASfDnYTac

Dr. Lickerman doing a similar review as a guest on a podcast, also excellent: https://www.larryweeks.com/ep-36-coronavirus-qa-with-dr-alex-lickerman-m-d/?fbclid=IwAR077iOtNkCGcyjJdjVWZWKW6RWgtNhVgdN7cYvrnd2bQcbaStrRvTjdqAE

From Maria Shriver’s Sunday Paper:  But today is Palm Sunday, and Easter Sunday is a week away. This week is the beginning of Holy Week, a time of spiritual renewal and rebirth. So, I’m taking that as a sign that we aren’t meant to go back to what was. We are meant to go forward both individually and collectively. Each of us will come out of this time a different person, a changed human being. How could we not?
What a double tragedy it would be if we went back to the way we were. To a time when we didn’t care for our planet. To a time when we were so mean to one another. To a time when we were so divided in every way. To a time when we didn’t know our neighbors. To a time when so many only cared about themselves and saw others as the “other.”

A diagram shared on social media of our human responses to the crisis (I don’t know who created it—if you do, please give credit in the comments and tell them thank you).  I think it’s normal that we should find ourselves doing things in each of the nested circles every day.  We can exercise compassion for ourselves and others at the same time:

covid nested circles

Finally, a poem, also from Maria Shriver’s Sunday Paper, shared by her niece, who died with her 8 year-old son the very same day:

covid after poem maria shriver niece maeve

Things will likely feel worse for at least a few weeks before they feel better, my friends.  Hold tight to those you love and who love you.  Count your blessings.  Take perspective.  Consider deeply our inextricable and undeniable interconnectedness.  Be kind.

Caring for One Another

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Last Saturday a patient cared about me.

He had severe abdominal pain that had kept him up all night and he needed advice.  By the time we agreed on a plan he had apologized, at least three times, for ‘bugging’ me on the weekend.

I explained that it’s okay to ask for help on weekends. I’m happy to help if I can, and the relationship is the most meaningful part of my work.  I also thanked him for not abusing that relationship—for not taking me for granted, for seeing me not as a transactional service provider, but as a person with a life outside of work.

When we feel seen and appreciated, life is easier to take and we function better.

* * * * *

Recently I’m thinking about organizational values and mission statements.

For the most part I find them superficial and unhelpful, wordy and convoluted.

As I consider the team I have led the past two years, I feel proud that although we have not formally written mission or values statements, we are nonetheless clear on both.  We define them in succinct language, gauge how we manifest them through action, and reconcile behaviors, conflicts, and initiatives against them regularly.

Our values, collectively adopted one year ago:

  1. Fun, joy, creativity
  2. Collaboration and Connection
  3. Accountability
  4. Kindness and Compassion

Reviewing the list, I see that caring for one another serves as the foundation for this house.  This applies both to the team’s inner work, as well as anything facing outward toward patients.

It is of course our responsibility as professional caregivers to manage ourselves and show up our best for our patients.  I expect patients to treat our team with respect, but we should not necessarily feel entitled to their caring about us, per se.  It is our job to care for them; the relationship is inherently imbalanced in that way.  In order to do that well, we the team must also care for and support one another in service of our vocation.

So every once in a while, when a patient expresses genuine caring for me or a member of the team, in addition to appreciation for a job well done, it really brightens our day.  It keeps us going.  It makes all the unappreciative, and even abusive, encounters worth it.

Thus, we march on.  We remember why we do this work and we hold each other up.

* * * * *

Please know how much your expressions of affirmation matter to your medical team.

We’re all here caring for each other in this life.  The more we can remember that and act on it, the better off we will all be, no?

What I’m Learning About Equity

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My friends, I am humbled this weekend.

A year ago I agreed to present on culture change to the inaugural WEL cohort, a group of 18 amazing women physician leaders.  I had no idea at the time what an honor and privilege this would be.  This would be the last in person meeting of their 18 month training on Wellness, Equity, and Leadership.  Having just completed my own 10 month leadership training, I empathized acutely with the bittersweet bonding and pending farewell among these sisters.

For two days I received infinitely more than I offered, and I saw again how membership in a mutually respectful, supportive, and empowering tribe can transform any individual from star to superstar.  Truly, these women were superstars before this tribe was formed; but whereas before we probably only needed dark sunglasses in their presence, now we need welder’s masks.

Gender, race, socioeconomic status, mental health status—these factors among others are all subject to unconscious bias and thus discrimination, in all arenas of society.  These WEL women will have a hand in changing that for the better, of this I am certain.  I’m so proud to know them all.

The night before my presentation, I messaged my friend who has helped me think more deeply about these issues in the past year.  I wrote, “It reminds me of your idea of approaching inclusion first, which I now see as wide psychological safety.  As you said, there can be a room full of white men and all may not feel included. And in my mind, that precludes true, open and honest collaboration and productivity.  It prevents any forward movement toward diversity or equity. When we don’t feel safe we revert to scarcity and survival thinking.  We look out only for ourselves.  Nothing good happens here.”

What about the one Old White Guy (OWG) among women, how does he feel?  Dr. Clif Knight, Senior Vice President of Education for the American Academy of Family Physicans and WEL steering committee member, owned this distinction this week.  He reported his recent self-identification as ‘a HeForShe.’  My heart leapt for joy.  Later I took him by the lapels and shook him (gently), practically yelling that I was so excited, and wished for him to recruit all of his OWG friends to the cause.

I thought again about my friend above, also an OWG.  I know him to be kind, generous, respectful of women and a genuine ally.  What about his idea of working on inclusion first?  After a long, deep conversation with one of my new WEL friends, with whom I’m also thinking about equity issues for Asian-American physicians, a new insight dawned on me, and I wrote to her: “Practicing inclusion INCLUDES the OWG ‘oppressor’! 😱  If we talk only about him needing to include others, while we make him feel excluded himself, how can we ever expect to enroll him in our cause or even behave in the way we ask? We do how we feel. And when we feel threatened and marginalized, especially from a place of loss, we act accordingly…”

Another new WEL friend, Dr. Dawn Sears, has already taken this idea to heart and made an impact in her community, elevating women’s and men’s awareness of gender disparity in medicine, and helping them fight it together.  Check out her powerful presentation to colleagues here, full of evidence as well as unsettling personal stories.  In it she directly and kindly addresses the men in the audience, informing and inviting them to join the fight, for all our sakes.  She names the contrarian men who have held her up on her professional journey, defying gender bias and paving their own HeForShe way for others.  She includes men in order to enroll them in the movement.  I encourage all to view the talk—find out how you, as colleague, patient, and all around good citizen, man or woman, can help improve the system for us all.

Once again I thought about my friend.  I wrote to him again:  “I wonder if I inadvertently made you feel excluded, or at least ‘other’d’ when I asked you to read Feminist Fight Club*.  DUH, the intended audience for that book is women.”  He was gracious and encouraging in his response, and I look forward to continuing our conversation for a long while.

Tonight I feel wildly optimistic.  So many strong, visible, articulate, creative, powerful and loving people all over the place, all working to make the world better for all of us, WOW.  We will make a difference, my friends.  We are not only allies; we are accomplices.  If we go together, we can do anything.

Onward, friends.  We’ got lots to do.

 

*He made an earnest, good faith effort, and did not finish the book.