November 22:  Listening to People’s Stories Makes Me Better

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NaBloPoMo 2019

What a long, strange week.  I almost forgot to write a post, just wanted to relax and do nothing.

Looking back, overall it was good. And it was people who held me up, as always.  I had some pretty moving and meaningful conversations with patients, and I really helped some people, I think.  But it was a new acquaintance who really made my day today.

I finally had time to bring my car to the body shop this afternoon.  After an unfortunate encounter with a fire hydrant while backing out of a very poorly planned driveway, my front bumper has been partially detached for about 7 weeks.  Every single person at this shop was remarkably nice—from the lady on the phone, to the young man who so politely offered to move my car when I parked it in totally the wrong place.  The waiting area was clean, neat, and well lit, with comfy, non-holey chairs.  After a short wait, a petite and pleasant woman, maybe 40, introduced herself.  She would provide the estimate on my repairs.  We headed outside.  She pointed to the ledge at the doorway on which I had tripped walking in, so I would not do it again.

After I brought her to the car she said I could go back inside and wait, but I asked to hang out with her, because I like to see what other people do.  I know less than nothing about cars, and I loved that here was a youngish, friendly woman who clearly knew her way around them.  I admired her right away.  She was thorough and conscientious, looking inside and out.  She was also extremely knowledgeable and patient, showing me everything, talking me through the parts and functions, and answering my ignorant questions, down to how the VIN includes the paint mix of the make, model and year.  She stayed with me through the whole process, including walking me out to show me the key drop box, because they can’t fix my car for another two weeks.

Before we said goodbye I could not help myself.  I told her how happy it makes me to see a woman doing a job that I have only seen men do.  She seemed genuinely proud and thankful for the compliment, and I’m glad I said something.  I didn’t mean to make her stand outside in the cold any longer, but she started reflecting and telling me her story.  Turns out this was her first day on her own at this job—I thought she had done it for years already.  Nope.  She had done inventory for a railroad company, and programmed machines that cut industrial dies.  She had worked in shops and factories of various kinds, it sounded like, always surrounded by and holding her own among men.

I asked her if it feels different (and hopefully better?) being a woman in these male-dominated fields now, after all these years.  She thought for a moment (looking completely comfortable, while I had started shivering already).  It almost seemed like she had never considered the question before?  She concluded that her peers and coworkers have never been the problem.  It’s the customers.

She kept talking, as if the subsequent story had been waiting days for a sympathetic ear.  In her last days of training, a man brought in a car with severe rear body damage, clearly from a collision.  He gave her a history, she made her appraisal, and he was suspicious and dismissive toward her the whole time.  To assuage him, she brought her trainer to review the case, whose assessment and recommendations were the same as hers.  This time the customer told a different story—admitted to lying to her, basically—and accepted the trainer’s evaluation.  No apology, no remorse, no respect.  She was still affected by it today, and upset with herself that she had let him get under her skin.  Whatever, she said in the end, she’s here to do a job, and there will always be people who underestimate her because of her sex.  Thankfully her trainer was an ally, which made me proud of the good men in our midst.

This woman’s life experience, though clearly different from mine, felt relatable and real to me.  In those few minutes, in the waning daylight of a brisk fall evening in Chicago, surrounded by broken cars, I felt solidarity with and pride for her.  It made me better for reminding me once again of our shared humanity:  Hers, mine, my patients’, those crazy drivers on Wednesday, even her lying customer.

We’re all here doing our best with what we’ got.  I firmly believe this, but sometimes I forget.  Hearing folks’ stories always brings me back.  So I’m thankful for them.

 

November 20:  A Little Profanity Makes Me Better

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NaBloPoMo 2019

I swear I was surrounded by idiots today.  Not at work or home…  Mostly on the roads.  It started early, my friends, and they were everywhere.  Is the moon full?  Maybe there’s a toxic gas leak somewhere?  I found myself aggravated before I even got to the office, where usual hiccups in schedule and daily operations continued to poke my inner rage monster.

*deep breath*

Thankfully, I have learned a few helpful strategies over the years.

One is to vocalize.  There is a reason babies and little kids cry and scream at the drop of a hat.  It’s the most efficient way to discharge an acute emotion.  Then it’s over and they can get on with playing and learning.  As adults, this isn’t socially acceptable most the time.  But in the privacy of one’s own car, it can help.  After the fourth or fifth encounter with the truly insane on my morning commute, I growled.  It was not a planned, but I’m doing it more often over the years, perhaps.  It was spontaneous, and I noticed instant release and relief.  Then I literally chuckled a little.  I continued on my way and forgot about those vehicular fools.  I even found a little charity—must be the weather, or that toxic gas.

A dear friend recommended a book this year, The 15 Commitments of Conscious Leadership, which I love.  The third commitment is ‘Feeling all the Feelings’.  The authors explain: “Feeling a feeling all the way through means letting that feeling have its full life cycle (less than 90 seconds) by breathing, moving and vocalizing, resting in calmness, and riding the next wave through to completion.”  In other words, rather than repressing, denying, or wallowing in our emotions, we can acknowledge, identify, accept, honor, and release them.  Then they don’t rule us, driving us to hurtful action, damaged relationships, and toxic work environments.

Here is their method:

When a feeling arises, pause and…

  • Locate the sensation in your body. What are the ‘bits’ doing?
  • Breathe and allow the bits to simply do what they do.
  • Move and/or make a sound to match what the bits are doing.

Sometimes the bits need something more than private growl.

Recall the daily work hiccups.  Most of the time, I can roll with them easily.  I am blessed with a truly amazing team—flexible and smart, able to anticipate patients’ and my needs with keen precision.  But today was a true aberration for me—my already tenuous mental state (apparently not yet resolved) unraveled quickly in the first hour of work.  So, in the safety of the workroom, surrounded by the team I knew could hold the space, I let loose at least two or three sonorous f-bombs, accompanied by some appropriately expressive full-body gestures.  Not only did the team tolerate the outburst, they offered loving support and encouragement.  “Let it out,” one told me.  Once again, I felt instantly better.  I took a deep breath, thanked them, exited the Cave of Camaraderie, and faced the rest of my day with exponentially more grace and generosity.

It was not my best moment.  I should apologize for making anyone feel uncomfortable—cursing in the workroom is not the example of professionalism that I aspire to set.  Still, I don’t regret it.  And it will not become a recurring pattern, I can say with confidence.

Some evidence suggests that swearing raises pain tolerance and relieves stress.  I didn’t lash out at anyone, I didn’t destroy any property.  But my little episode helped me regroup, get my head on straight, and show up my best for my patients today.

Looking back, there were probably no more insane drivers out today than any other day. I will reflect more on what I brought to this day that created my experience. I attribute my ability to approach this reflection with calm and intention to the freedom from emotional tumult that vocalization and a little swearing affords me.

Recent research has shown that swearing while exercising increases physical strength and power.  I may test this self-improvement theory in my workouts this week—in the seclusion of my home gym, of course.

November 19:  Board Review Makes Me Better, For Sure

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NaBloPoMo 2019

Are you required to do continuing education for your work?

Since 2013, the Illinois Chapter of the American College of Physicians has run a weekly internal medicine board review webinar, MKSAP Live Online Study Hall.  We use questions that ACP publishes through the Medical Knowledge Self-Assessment Program, covering topics in general medicine and its subspecialties, including cardiology, pulmonary, infectious diseases, and rheumatology.  Every Tuesday night at 8pm Central time, two of us moderators and one webinar organizer get online and review about 14 questions, SAT-style.  We interact with audience members through a chat function on GoToWebinar, and we poll some of the questions each session.

I love this program for multiple reasons.

First, I was there when it started.  Gathered around then Governor Dr. Marie Brown’s dining room table, a handful of local ACP members brainstormed and created what is now an international, comprehensive internal medicine board review webinar series.  After some playful, off-topic, post-prandial banter between Dr. Sean Greenhalgh and me, our colleague across the table said wryly, “I’d watch that for an hour.”  Hence the dual-moderator, morning radio DJ style webinar was born.  That was in the fall of 2012, and the Study Hall is now halfway through its third two-year cycle.

Second, I get to hang out with my doctor friends online.  Besides Marie and a couple others, I did not know any of the dozen folks involved in the project before that night at her house.  We did improv workshops at the beginning to form our team and ease our communication skills.  Since then we have all become friends—a clique, even.  We have followed kids’ graduations, births of babies and grandbabies, and some personal challenges as well, all while getting together every few weeks to talk shop for an hour online.  We have even become celebrities of sorts—first at Illinois Chapter meetings and now sometimes at ACP National, people come up to us to say how much they like the program.  We’ve become a fixture in some colleagues’ lives.  We feel pretty proud and special about that.

The best thing about the Study Hall, though, is that just in the space of one hour on a Tuesday night, I am consistently humbled by the sheer volume of knowledge there is to absorb, just in internal medicine.  This is only one specialty of the whole medical profession!  And it’s not just the volume—it’s the complexity, the context, and the ever-evolving research, diagnostic and treatment development, and guidelines.  MKSAP publishes a new set of comprehensive questions every two years, and I do not envy the writers their colossal task of keeping us all up to date.  Without fail, every session I learn something that I will use the following week in clinic.

As this month of daily posts progresses, I feel increasing awe and gratitude for all of the people and opportunities in my life.  Thanks to all my colleagues, leaders, family and friends who make this life so full and loving.