Love Letters for My Soul

Taking a break from COVID, racism, equity and other heavy things this week, my friends.  It’s too much, what with RBG’s recurrent metastatic cancer and John Lewis’s death.  I’ve been glued to my phone and computers all week, reading, digesting, observing, integrating, posting, connecting and conversing.  I had at least three important ideas for the blog, and they all need to marinate longer.

But I still had to write!  I owe letters to three friends, and they can wait.  What needed doing tonight were five love letters to strangers. 

Sometime this spring, while sheltering at home, I discovered More Love Letters.  Their mission is simple:

Deliver hand written letters to people who could use some extra love via snail mail.

People submit nominations for letter recipients, and every month the MLL team selects five to post.  Each recipient’s nominator writes a heartfelt request, and supplies an address.  Letters are requested to be postmarked by the last day of the month (but I bet they’d take some tardy ones, because they are sent with love?).  Tonight I wrote my second ever set of love letters, on washi tape stationery, of course.  I may have more cards and tape than I will use in my lifetime, so I’m more than happy to share!  Maybe next month I will include a blank card and envelope as a gift for the recipient to pass along—I’ll even put a stamp on it!

In this time of tumult and conflict, of heaviness and stress, reaching out to offer some light to others heals me.  They will not know who I am (well, unless they happen to read this post, I guess), and I will not get a card back in reply.  I get to write some encouraging words that might brighten someone’s day.  But I do it for myself as much as for them.

Maybe you could use a mutual pick-me-up, too?  Each one took less than five minutes.  The words came easily, organically, and happily.  “Holding you in light,” “Sending love and support,” “Wishing you everything you need in this crazy time.” Easy peasy, written sincerely–it feels so good.  You don’t have to write to all five nominees—do what moves you.  Maybe you’ll be inspired to also drop a note to your best friend, your colleague who’s challenged, or someone who recently crossed your mind, who’d probably love to know you were thinking of them.

Now is exactly the time to connect, don’t you think?

Oh and I have no financial or other interests in this organization. I just love that they encourage connection and snail mail, two of my favorite things.

Not Just Words

IMG_5293

Friends, it’s been another week of observing, processing, learning, and integrating.  Holy cow, I really need this vacation.  I need nature, time with family away from work, away from the news.  I need to take a breath.

Things feel different this time.  I think this cautiously; I allow it—hope.  Change will be incremental and slow, but I feel a real acceleration today.  Equality is an infinite game, and we who play to advance it find ourselves in a moment of palpable solidarity and purpose.  But what comes next?  What will the field look and feel like at the end of the summer?  In a year?  In ten years?  When my kids are my age? What progress will we look back and see, initiated in this movement of 2020?  How can we make this a turning point?

IMG_5367

Stories

First, we must seek to understand the scope and nature of the challenge.  For many of us this means listening.  “Facts don’t change our minds.  Friendship does,” James Clear writes.  We humans are not rational, logical beings at our core.  We change our minds when we can relate to someone else’s experience, and the best way to do that is to listen to their stories.

Here are some stories that moved me this week:

Reflections of a Token Black Friend by Ramesh A. Nagarajah:  I think back to when my friends never understood why I wasn’t allowed to play with water guns — or any toy guns, for that matter — when I was a boy. I’d be so excited to visit a friend’s house and use their airsoft gun in the backyard. I used to get so frustrated when my mom told us it was “too dangerous” for black boys to do that and that someone would mistake it for a real gun. When I was 16, 12-year-old Tamir Rice was shot and killed while playing with a replica toy airsoft gun. I realized my mom was right.  …I think of the way the black girls were treated as second rate in high school. Guys rarely tried to talk to them romantically, and if they did, others discussed it with an undertone of comedy. I never felt this way, personally, but didn’t realize until college that my silence was compliance. I was participating in denying dignity to the black women around me.

A passionate and powerful video by Kimberly Jones, author of I’m Not Dying With You Tonight, which is now in my queue.  Listen and watch to the end.  Embrace the discomfort.  Whatever you experience in these few minutes is nothing compared to what Black people have suffered for generations.  Then mull over her last sentence.

A heartfelt and important essay by Dr. Marie Ramas, on her role as a Black woman primary care physician during a pandemic:  Once again, as a healer working in a system seemingly based more on economics than wellness, I felt forced to make an impossible ethical decision. Then, I realized that the underlying question for me to answer was not whether I would treat individuals at the risk of my own self. Rather, I needed to pan out my scope of view and ask, “How can I help rebalance the scales of justice to reflect the inherent worth of the black and brown lives that I both serve and represent?”

Sensational six FB Humans of St Louis 1 of 7 June 2020

The Sensational Six:  Six Black women graduated from the pediatrics residency at Washington University St. Louis this month.   Follow the link to read the 7 consecutive posts about these remarkable women, and look for their mark on our future.  Their names are

Fehintola Olaiya, MD
Stephanie Diggs, MD
Frances Annan-Fohtung, MD
Mia Henderson, MD/PhD
Olivia Beaubrun, MD
Tobi Olayiwola, MD

IMG_5273

Connection, Action, Accountability, and Togetherness

The goal of all this seeking and listening, of course, is Connection.  The only way to get to shared humanity—true connection—is stories.  And the only way to stay in the infinite game fighting against structural racism is to play together, team members rotating on and off the field.  The metaphor of a choir holding the prolonged single note, strong and clear, by staggering each person’s breaths, applies here.

The team is huge—every one of us has a role to play and a contribution to make.  What Actions can we each take?  Here is a list of 75 to choose from.  Start now.  No action is too small.  Do it sincerely, consistently, and with integrity.

How will we hold each other Accountable?  Company after company declares their opposition and intolerance to racism.  “It’s all words,” as one Black woman told me bluntly.  We need metrics, goals, and transparency.  Medical schools must recruit more students of color.  Companies must promote more people of color to designated leadership roles.  Citizens must demand of our legislators to address systemic and institutionalized discrimination, to give it tangible consequences that motivate change.

Most importantly, we must do the deep work of ferreting out where bias hides in our institutions, understanding clearly how it impacts our practices for the worse, and then reworking our systems to eliminate, or at least moderate, those negative consequences.  The legend of the Boston Symphony Orchestra’s blind auditions can instruct us here.  We can claim success when we see people of color represented proportionally in leadership, policymaking, and all of the most influential and impactful aspects of our culture.

We have so very far to go.  But at least it feels, for the time being, that more of us have opened our eyes to the path ahead.  And rather than turning (running) away, we turn toward—Together.  We find each other’s hands and grab on, holding tight.  We take one tentative step, then another, and another.

If we keep walking, together, we will make progress.

Rallying for Reentry

IMG_3205

We’re baaaaaaack…  Sort of.

After ten weeks sheltering and working mostly remotely, the primary care team I lead will phase back into regular office hours this week.  What a long, strange trip it’s been!  And it’s nowhere near over!  But the next chapter begins, and we are ready.  We return with limited staff, all spaced, masked, and sanitized.  We have planned for weeks and done our best to anticipate hiccups and pitfalls.  Now it’s time to dig in and execute.  Exciting!

And maybe a little scary?  We will have minimal face to face appointments in the beginning, but as with businesses and services across the country, we will ramp up over time.  How will this affect and be affected by coronavirus infection and illness rates going forward?  What will flu season look like, while we continue mitigation efforts for COVID-19?  Despite the multitude of models, nobody can say for sure.  And still we must move.

So what’s a leader’s role here?  How can I best serve my team as we step boldly back onto the path, besides planning and execution of operations and logistics?  Now more than ever, I must be both clear and adaptive about my leadership—its meaning, influence, and potential.

This weekend some strong feelings emerged to center, ground, focus, and guide me.  Interesting, isn’t it, for my professional peace to rest so surely on emotions?  The cognitive knowledge that my own leaders have my back gives me confidence and reassurance—I trust them.  I trust us all to flex and adapt as our collective situation evolves.  One could argue that trust itself is, by nature, more limbic than rational.  And such is the human condition—we are emotional beings who think, not the other way around.

So I embrace and anchor to my positive emotions.  I can moderate turbulence with solid intellect and steady spirituality.  I believe good leaders do this visibly and vulnerably—they lead by example.  Right now we all need to manage through a morass of complex feelings—to identify, accept, and allow their passage through us.  This is how we take care of ourselves and each other, and get the work done.

IMG_3442

Pride

I could not be more proud of our team.  Like so many cohesive teams in an emergency, we pulled together, reorganized, and mobilized like champions.  Computers were set up at home, schedules rewritten, tasks redistributed, and personnel reallocated.  Folks overcame fear and anxiety, at times severe, to help other departments, learn new skills, and grow into leaders themselves.  They made connections across the health system and broadened perspectives that will now benefit our whole team.  We supported one another through semiweekly touch points, instant messaging, photos, stories, and some tears.  I have no doubt that we can not only navigate but crush this crisis arc, and emerge a stronger, even more cohesive version of ourselves.

Protectiveness

As clinical director, I appoint myself chief cheerleader and den mother.  Through various channels, it’s my job to keep a finger on the pulse of morale and engagement.  And while I hold the team up to its own standards of integrity and accountability, I also keep a vigilant eye for assailants from outside.  As we prepare to reopen, I consider how I will protect my team from abusive patients.  I think the risk is low, but what if someone refuses to mask or submit to temperature screening?  What if they become aggressive or belligerent?  Our team has cultivated empathy and compassion, especially for patients who feel anxious and sick.  Still, I will not compromise our safety for someone’s angry outburst or agitation.  We have a plan for handling such situations that will never tolerate physical confrontation or humiliation.

Loyalty

We’ve been through a lot together the two years I have been back on this team.  Turnover was high in 2018, and engagement low.  We’ve since built a culture based on connection and accountability, and this complex work continues—culture work never ends.  Technically I hold an interim position; I am a steward.  But I will not leave until the right successor is identified and groomed.  I’m in for as long as this takes, as long as I am able, as long as the team will have me—I will not abandon ship.

Conviction

Our team has a particular, holistic approach to patient care and relationship.  In order to live this approach for ourselves, we defined our core values a year ago:  Kindness and compassion; connection and collaboration; fun, joy, creativity; and accountability.  I see now that we have an opportunity in this moment to further clarify our mission and vision.  Nothing like a global, existential pandemic to make us reorient and reclaim our raison d’être!

Vision and Execution:  It is the leader’s role to manage both—to host the ball and move fluidly between dance floor and balcony, as Ronald Heifetz and colleagues say.

Let’s get this party started.