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.

Friendsourcing Motivation

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Sunrise, Sylvan Dale Guest Ranch, Loveland, Colorado. Photo courtesy of Dr. Anne Dixon

Greetings, friends!  How goes it, halfway through January of the New Year?  How are you doing with those resolutions?  I always feel conflicted about announcing such commitments, preferring to call them ‘intentions’ (see here, here, here, and here!).  I’ve read too many articles dismissing resolutions as mindless, unhelpful, and ultimately a waste of energy.  And yet, the start of a new year naturally prompts reflection and renewed motivation for self-improvement, which are good things.

Once again, taking a more nuanced view helps here.  It’s not that resolutions are bad.  It’s that we need to be thoughtful and realistic about them, as the linked article above suggests.  Whatever we call them, commitments to behavior change can lead us to transformation.  But it’s anything but simple or easy!

My post on experimental questions got a boost in views this past week.  I wonder what prompted that?  I wish I knew who was reading it and why, what they think, and what it means to them?  Since that post was published, I have continued to ask my 4 newest questions, of both patients and myself.  The recent traffic on that post parallels the evolution in my own reflections and answers:

In the coming year, what do you see as the biggest threat to your health?

My hedonist impulses, no question:  Ice cream and office sweets, mostly, but also online washi tape sales and paper, clothing, and shoe stores.

What is the biggest asset?

My friends, also no question, my pit crew.  They encourage me, keep me honest, and lend perspective.  They teach me and inspire me.  They hold me up.

One year from now, what do you want to look back and be able to say about what’s important to you?

In January 2021, I want to look back and say that I got fit again, that I regained the exercise discipline I lost in 2019.  I got control of my eating, decreased my sugar intake by at least half.  I put my phone down and was more present with my kids.  I was more intentional and executed better on how I spend my time and energy overall.  I exercised agency over my life better than ever before.

What support (external to yourself) do you already have and/or may still need to recruit, in order to make that vision a reality?

On November 10 when I posted these questions, I honestly had not answered this one yet.  It was harder than I had anticipated.  Since then, as I continue to ask patients, I see that I’m not the only one stymied.  My first response resembled my patients’, something akin to, “Well, I just have to do it.”  We type-A, independent peeps often rely first and foremost on ourselves.  We don’t ask for help.  And even though I have written and spoken ad nauseum about the importance of support, I found it difficult to identify my own need for it.  This is why I have added the ‘external to yourself’ clarification to the question.  Support comes from somewhere or someone else.  And we all do better when we have it.

***

Friendsourcing Motivation

The whole time, the answer was right there in front of me.  The biggest asset to my health is my friends.  We know that social support (sometimes in the form of peer pressure) can be the key to success in behavior change.  Why else would people attend Weight Watchers meetings, or to go AA?  I need a workout buddy and a healthy eating buddy, I realized—I can tap my assets!  Eureka!

Easier said than done, however.  Who should I ask?  What should it look like?  Over a month or so, I worked out my specifications:

  • I need support from friends, not strangers (thus fitness classes will probably not be my jam)
  • I don’t want to be constrained by schedules with my buddies—flexibility is key
  • I need a two-way arrangement—someone who also has a goal that I can support them in
  • The arrangement must be concrete and accountable, but not feel oppressive

Tadaaaaah—Habit Share*!

On our sunrise walks in Loveland last weekend, two friends from LOH and I agreed to be one another’s buddies.  It was perfect—we all wanted the same things; we just needed an easy way to connect.  One of us, the youngest, most tech-savvy one, found the Habit Share app.  It’s free and perfect.  We each define our own goals, and simply share them with each other online.  We receive notifications when our friends check in, and we send messages of encouragement and solidarity.  It’s perfect!  I have already shared the app with patients and other friends, and am now connected to two more friends.  Our habits range from exercise to reading, to flossing.

Holy COW, what a difference!  Just knowing that I’m tracking my goals, and that my friends are seeing and supporting me, it’s been exponentially easier to motivate and execute these seven days than the entire past year.  It’s easy, aesthetically pleasing, costs no money, and connects me with people I love.  It is–wait for it–PERFECT!

I know, I know, it’s only been a week.  Who knows what all of our app screens will look like in another week, a month, or three months from now?  Will we all still be connected and holding each other up in a year?  Who can say?  But what’s the utility of thinking that far ahead?  Yesterday I set the new goal of getting up early once a week to write.  Today I can check it off.  I still have a chance to say no to ice cream, work out, turn off my phone apps by 10pm, and floss!  My friends will know when I do it, and they won’t judge me if I don’t.  It’s all good, and we can all take it one day at a time.

So, what support (external to yourself) do you have, or may still need to recruit, to make your best-self vision a reality?

*I have no financial or other interests in this business.  In fact, I want to contact them to give them feedback about how to make it better, but I cannot find a ‘contact’ page on their website…