Category Archives: gratitude

November 12:  Edits and Revisions MMB–Fierce Optimism 2.0

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NaBloPoMo 2019

24 hour learnings:

  1. Unfocused thoughts lead to unfocused writing
  2. I tend toward word vomit when I’m excited

Note:  Hereafter, I will use “MMB” as the abbreviation for “Make(s) Me Better” if the title gets too long.

My deepest gratitude to lovingly honest friends whose feedback on last night’s post inspired me to attempt it again!  Let’s see how this goes—

***

Last Saturday, as I prepared for the Better Angels workshop, I thought of Dr. Martin Luther King Jr.’s inspirational words:  “The arc of the moral universe is long but it bends toward justice.”  I have referred to this quote many times over the years, and a phrase that I often add goes something like, “Bend that arc!  Hang on it with all your might!”  Meaning the arc bends toward justice only because we make it so, by working tirelessly for it, by consistently walking our talk.

Preparing for the presentation, I thought about friends who express hopelessness at any possibility for connection between opposing political sides, that we can actually work together to get anything done.  Some might even say that the Better Angels mission is futile, a waste of energy and time.

Then I felt something akin to a tidal wave rise within me, and I texted a friend, “I intend to make today a day of fierce, infectious optimism.”  At that moment I knew my goal was to take every experience of kindness, connection, empathy, openness, generosity, magnanimity, conviction, and hope, and channel it to the workshop and its participants.  Because though it was to be a skills workshop, teaching a way of doing, what we really need are all of the qualities I just listed—they are the way of being that bring true meaning and connection to the skills.

Google Dictionary defines fierce:  “showing a heartfelt and powerful intensity”; and optimism: “hopefulness and confidence about the future or the successful outcome of something.”

Yes, and:

Fierce Optimism Is:

Urgency with Patience

All important social movements occur (and continue) over generations.  Confrontation and revolution are necessary sometimes, but they are not enough.  It’s consistent, slow, grass roots change on the local level that sustains progress.  Fierce optimism gives me faith that even the smallest actions I make in service of my cause have impact.  I can set realistic expectations for how much I can move this mountain today.  Pacing myself, practicing persistence with patience, conserves energy and prevents burnout.  I can feel empowered and liberated at the same time, confident in my individual agency.

Patient urgency also allows me to look up every once in a while, notice my surroundings, and adapt to subtle changes, like when someone starts to soften.  The bulldozer of impatient words and heavy dogma plows through the door of someone’s mind that might have swung open freely, had I taken a more gentle approach.

Strength with Flexibility

Fierce optimism roots itself in core values, and also allows for learning and adaptation.  It confers the confidence to challenge our own beliefs and values, perhaps reinforcing them, grounding us in and strengthening our own personal truth.  But this confidence also helps us hear others’ stories, which broadens our perspective.  Standing in our core values while reaching out in curiosity, we learn about each other, and curtains open on a vast landscape of understanding that we may never have imagined.

Bruce Lee’s life philosophy included a metaphor of the bamboo and the oak.  Both are admirably strong, but under intense forces of nature, the great oak may break irrevocably.  The bamboo bends; it maintains its integrity, standing straight and strong again after the storm.  Listening with openness and curiosity is not weakness.  Allowing for nuance and the possibility that my mind may be changed is strength.  It makes me calm, agile, adaptable, and more effective.

Conviction with Generosity

Our assumptions matter.  They show up in our presence.  Let us check our attitudes toward the ‘other’.  Assuming and speaking only to their presumed selfishness and malevolence, we make ourselves small.  We become exactly the narrow minded and prejudiced enemy we deride.  How ironic.  Now more than ever, we need generosity.  This encompasses empathy, vulnerability, sincerity, humility, and a willingness to allow the complete humanity of every person.  Extending this grace to others in no way undermines my own cause.  It opens my heart to attract allies from everywhere.  Conviction without generosity too easily becomes tyranny; I want no part of that.

Fierce optimism choreographs an intimate dance between agitation and peace.  It holds tension without anxiety, potential and kinetic energy.

When I live in Fierce Optimism, I can hang on that arc and bend it like a badass.

November 9:  Steady Pacing Makes Me Better

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NaBloPoMo 2019

*sigh*

I’m not a swimmer or a runner, but isn’t there something in these athletes’ training about breathing, pacing, and strategies for long distance endurance?   The last 22 days have felt like a physical, mental, and emotional marathon of sorts.  I’ll spare you the list of meetings, engagements, and tasks—you may have already read about them!  Looking back, I realize I have had to live every day in acute mindfulness, attending to whatever was right in front of me in the moment, including the unexpected.  Prioritizing was key, completing one task/event/conversation before moving onto the next.  I had to put my head down for some parts, come up for breath and a brief aerial view, then dive deep again.  Today I crossed a finish line, and I feel proud.

I started my journey with Better Angels in May of this year, at a skills workshop.  Since then I have attended two additional workshops, one that was featured on the Van Jones Show.  I committed to moderator training, and today I led my first skills workshop.  I had the honor of working with the three Wonder Women who ran the workshop back in May.  They prepared me so generously, so kindly, and I am forever grateful.

There was a hiccup, though.  When we initially arranged with the Wilmette Public Library for the event, we mistakenly told them the event would last two hours.  The workshop is designed to last 2.5 hours.  We could not change the website or registration, so we meticulously shaved 24 minutes from the schedule.  We warned participants of our impending heavy handedness on time, and dove in.  Mande and I set timers on our phones for each segment.  Mary Lynn gave me hand signals from the back of the room (though I did not always look or see).  I had the handy timeline that Sharon typed out for us all.  We ran ahead at times and behind at others, and ended right at 4:06pm, as planned.  We kept pace.  Engagement and discussion was lively, and attendees gave overwhelmingly positive feedback.  Many people stayed afterward to talk more, explore ways to get involved, and exchange information.  We were invited to present at other organizations.  Overall we felt it was a wild success.

Workshop timeline 11-9-19

Everything was a group effort these last three weeks. Each meeting, workshop, video call, or presentation, whether for the American College of Physicians, my clinical practice sites, or Better Angels, required a team of people, each with delegated and specified roles and task lists.  We all had to agree on timelines and deadlines.  Text, email, Zoom; more email and text—it felt like running through a Venn diagram of relay races, passing batons in and out of each circle as I crossed from one to another.  I had to pace myself, and also match the pace of others as I came alongside.

Having a calendar with everything written in one place definitely helped.  I keep a checklist of every task, no matter how small, and carry it with me everywhere.  Excellent hydration is key for optimal mental and physical performance—I’m always reminded when I forget.  Timely, frequent, and clear communication—need I say more?  All of these practices help me plan and maintain a steady pace, checking off the list, completing each day, each trip, each week, slowly, surely, and competently.

Now I can slow down, breathe deep, and tread more lightly for a little while.  Every athlete, even an amateur, requires rest and recovery between races.  Once again I dedicate this month of daily blogging—a quintessential practice in steady pacing—to all those who go before me, showing me how it’s done.  Thank you.

 

 

November 6:  Caring For the Team Makes Me Better

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NaBloPoMo 2019

“How does he treat you?”

I don’t only ask this question of women whom I suspect of being abused at home.  I also ask my medical assistants.  Not about their domestic partners, but about our patients.

In my first practice, I sat/stood to the left of my medical assistant every day for six years.  It was a cozy (cramped) little counter space stacked with charts from end to end, with a couple of high-wheeley chairs.  Each chart stack had a laminated cover on top:  “For Cheng to Review/Sign,” “For Rose,” “Labs,” and “Messages.”  Charts journeyed from my left to my right/Rose’s left, to the bin under the counter to be filed.  It was incredibly efficient, actually.  I had a handwritten emoji system for indicating (dis)satisfaction with cholesterol and diabetes results.  Rose knew all of my patients and how to communicate sentiments and instructions clearly and lovingly.  She had been an MA since I was a kid; she knew what she was doing.  If a patient had a question on the phone, she could put them on hold and clarify with me, or I could just get on the phone and speak to the patient myself.  We were busy and happy, a well-oiled team-machine.

One day as I came up to my spot at the counter, I noticed an unusual sound next to me, like a distant, scratchy loudspeaker.  I turned and saw Rose holding the phone receiver about an inch from her ear.  The sound was my patient, yelling profanities at her so loudly I could hear his words from two feet away.  I can’t remember what the issue was, but he was obviously upset, and taking it out on her.  It surprised me because I had only known him to be sweet, respectful, and grateful.  Maybe he was just having a bad day?  I looked at Rose, who rolled her eyes and exhaled heavily.  I asked her to put him on hold so she could catch me up.  Apparently this had been going on longer than I knew, and she had not told me.  Had I not come upon it in real time, she may never have told me.  She would have simply tolerated it.

I picked up the call and declared myself.  He was the usual, respectful and calm patient I had always known.  I answered his medical questions.  Then I told him firmly that he did not have the right to treat anyone in my office the way he had just treated Rose.  I think there may have been some excuses and then an apology.  I made it clear that if he abused my team again, he would be discharged from the practice.  He agreed and apologized again.

That was my first opportunity to stand up for my team as an attending.  I will forever remember it.  I was a petite, young, Chinese woman doctor, speaking to a white man decades older than myself.  I stood up for my medical assistant, a woman of color and a couple decades older than me.  She had felt powerless to stand up for herself to his verbally vomitous abuse.  All I had to do was pick up the phone and say, “Mr. Soandso, this is Dr. Cheng.”  He never yelled at Rose or anyone in the office again, to my knowledge.  How could I have this much power, and why had nobody asked me to wield it in their defense before?  It was just accepted that patients could yell and scream at our staff, with no consequences?

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We recently discussed abusive patients during our regular doctors’ meeting at my current practice.  Immediately I thought, HELL NO.  The good news was that our team members feel safe reporting incidents to our managers and physicians.  My partners and I have all had to call patients to clarify our expectations of respect.  We understand that illness is stressful.  We understand that our healthcare system, especially at a large, bureaucratic institution, causes frustration, even rage.  However, none of that ever justifies or entitles a patient, or anyone, to belittle, dehumanize, or otherwise degrade another person, and especially not a team member who is doing their best to help–ever.  At this meeting, gratifyingly, we all voiced definitive confirmation that we fully support our team, and we will, without hesitation, educate and/or discharge any patient who violates our team’s right to a collegial and non-threatening work environment.

Even as I write this, I shake a little with rage and outrage at these patients’ behavior.  I can feel tightness and tension in my chest and abdomen, my breath quicker and shallower than its usual resting state.  I wonder if this triggers me because my mom is a nurse and I have seen how patients in the hospital abuse nurses.  I also know how women physicians are mistaken for nurses and thus ignored or dismissed, even by female patients.  I have known racism and sexism first hand.  But as a physician, I’m in a position to not have to tolerate it.  By virtue of two letters after my name, I have the power to protect my team, with authority.  And I work with other physicians who also recognize both this power and its attendant responsibility.

I hope our team feels protected, defended, and loved by us docs.  We may be the default work unit leaders, but they do the lion’s share of work that allows our practice to run as smoothly and successfully as it does.  They are who let me do my work as well as I do.  I depend on them every day.  So caring for them absolutely makes me better, makes us all better.