Rallying for Reentry

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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.

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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.

Where Is the Light?

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Photo by Tobias Baumgaertner, Fairy penguins near Melbourne, Australia

*deep breath*

I always wonder about you, dear reader.  Where does this post find you, since we last connected?  How are you?

It’s a good practice to check in with ourselves regularly.  These nine weeks of sheltering in place have exercised my patience, awareness, and identity, among other things.  What have they done for you?  How are you?

For a couple weeks now I have felt all but overwhelmed by darkness.  Infection and death rates have slowed, but they will continue to accumulate indefinitely.  I worry that we will become inured, calloused, to the human toll.  PPE is still in short supply at hospitals across the country. Thousands of my colleagues continue to risk both their physical as well as mental and emotional lives to care for gravely ill patients.  They leave their families and support networks to become the sole supports for patients alone in the hospital, whose own loved ones may not visit, even in the hour of death.

Mostly I have felt burdened by the fighting.  The shouting, protesting, mean memes, and ad hominem all around me, directed both by and at my friends and colleagues.  Important reflections and insights arose this week that helped me see clearly the internal origins of my distress.  I re-accepted and re-integrated these parts of myself.  I was able to laugh out loud, exclaiming, “How fascinating!”  I know I will necessarily repeat this discovery exercise ad nauseam, ad infinitum—such is life, karma says, also laughing.  But for now I feel lighter, unburdened, more at peace.

So I thought about role models for peace.  I feel so lucky to have so many.  But one in particular shone in my consciousness this week:  Dr. Vivek Murthy, our 19th Surgeon General.  He has published a book, Together, in which he “makes a case for loneliness as a public health concern: a root cause and contributor to many of the epidemics sweeping the world today from alcohol and drug addiction to violence to depression and anxiety. Loneliness, he argues, is affecting not only our health but also how our children experience school, how we perform in the workplace, and the sense of division and polarization in our society.”

I recently watched a live interview with him conducted by Dr. Lucy Kalanithi, widow of Dr. Paul Kalanithi, who wrote When Breath Becomes Air.  I listened with one earbud, watching in my peripheral vision, while hurrying around my kitchen, preparing chicken and assembling a salad, all before rushing to host a Zoom workout.  It struck me that in stark contrast to my frenetic energy at that moment, Dr. Murthy presented only calm and serenity.  He answered every question with love, joy, conviction, and equanimity.  I noticed and marveled.  Then I rushed around some more and got on with my evening tasks.

Looking back, I have felt this serene and loving presence every time he speaks.  He has a way of making everybody in the room comfortable, welcome, and included.  Even if he’s interacting only with a moderator, it feels like he’s speaking to me personally.  He sees me, he gets me.  He cares about me.  In searching for the Kalanithi interview, I came across this lecture and discussion he gave at Stanford University in 2015.  I hope you will take the time to watch (or at least listen).  Notice how he shares stories of his parents, his patients, and people he met during his national ‘listening tour’ at the beginning of his tenure as Surgeon General.  Hear how he sees and knows every one of these people in their whole humanity.  Abraham Verghese, physician, author of Cutting for Stone, and another hero of the profession, moderated the Q&A, and also named Dr. Murthy’s equanimity—his peacefulness.  Notice how Murthy validates questions asked by students and faculty alike.  Observe his humility, juxtaposed with a resolute, unwavering point of view.  Do you feel it?  Does he not inspire you to be a better person?

Dr. Murthy and his wife, Dr. Alice Chen, have written an open letter to us medical professionals, in the midst of this global pandemic.  Reading it, once again I feel seen, understood, and comforted.  I feel true belonging in a proud and humble tribe of professionals, committed to service.  They shine their light on all of us, so we may see the path before us more clearly and walk more confidently, knowing we’ got our peeps holding us up.  This, in turn, gives us the strength and love to hold up others along the way.

I see the light tonight.  It emanates from my fellow and sister humans, and it saves me.

For a little more light, check out this Jon S. Randal Peace Page post with the picture of the penguins.  In it you will read about gems like John Krazinski’s “Some Good News” YouTube series, and Chris LaCass, founder of Pandemic Kitchen, feeding New York City’s homeless.  You can also share your own stories of inspiration and light in the darkness.

Where is your light today?  How will you keep it in front, as we travel this long road together?

 

 

A Time to Try New Things

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My friends:  What’s happening for you these many weeks?  What are you noticing (again, still, and newly)?  What do you miss most, least, and/or not at all from pre-COVID life?

What’s been the best thing that’s happened for you in this time?

Many of us are out of our depth here; we have no map.  As NASA says, we must “test as we fly and fly as we test.”  That necessarily means putting aside what we usually do and how things usually work, and trying new things–experimenting.  What a fantastic opportunity for learning, growth, and connection!

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The Alphabet Workout

How has the pandemic affected your physical activity?  How have you adjusted?  After the New Year I realized I needed workout buddies to strengthen my workout resolve.  My colleague and I started exercising together after work a couple days a week, and then the pandemic hit.  Almost right away I came across various alphabet-based interval workouts, perfect for the newly shut in.  My siblings and friends and I started meeting on Zoom to try it, first spelling our names.  We moved on quickly to our heroes’ names, and now to sayings we like.  Exercise, accountability, variety, fun, and connection—yay!

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Baking

My daughter may single-handedly make our whole family diabetic.

Spring break started a week early, then the kids transitioned to distance learning, with minimal direct, real time interaction with teachers.  With so much more time to complete homework and a recently developed fascination with any and all things French, we now have a baker in the house.  And with anaphylactic allergies in the family, recipes are necessarily converted to vegan and nut-free.  To date she has succeeded with macarons, beignets, fruit turnovers, cupcakes, and red velvet cake.  But by far I’m proudest of her opera cake, completed tonight and surely damaging to my waistline.  It’s worth it, though, to watch her experiment, fail, redirect, and succeed (mantra = “It’s edible!”), gaining confidence with every attempt.

The sibs had better not abandon me on those Zoom workouts, though!

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Photo courtesy of Dr. Karen Cornell, January 2020, Loveland, CO

Circadian Loosening

I always knew I was a night owl, but holy cow, left to my own devices, I am practically nocturnal.  I never pulled all-nighters for school.  The first time I stayed up all night reading was for one of Rick Riordan’s Percy Jackson books—I had not even done that for Harry Potter!  I have discipline when I need it.  I get up for morning calls now; I even look forward to them, as a sailor looks for the buoy thrown by his shipmates when he has fallen overboard.  I will readjust to a regular work schedule when the time comes.  But for now I can truly enjoy my owl self.

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Connecting with Friends

Maybe you’re missing your friends the most.  Somehow I’m not, which is a bit shocking and disconcerting.  But maybe it’s because I’m still connected, in some cases better than ever.  I miss meeting Donna for breakfast at our usual egg and toast place.  But I love that we now talk weekly on the phone while walking outside.  I continue to send and receive snail mail from friends across the country.  Perhaps I’m FaceTiming more with the Colorado sister and my parents, in addition to our sibs Zoom workouts.  And finally yesterday, blogging friends Nancy and Donna and I got together, after talking about it for at least three years.  Of course it was over Zoom, but without COVID-19 who knows how long it would have taken us to meet in person, living in Washington, Illinois, and Michigan?  Now we plan to ‘meet’ monthly—so much to share!

Writing Out of My Comfort Zone

Thanks to sister member Christina Guthier from Ozan Varol’s Inner Circle, I accepted a 5 day mindful writing challenge set by Nadia Colburn this past week.  Free, only five days—why not?  Nancy, Anne, and a few other friends agreed to try it with me—they accepted my Facebook invitation.  After a short meditation and poem, each day Nadia offered a prompt, followed by ten minutes of writing dotted with serene reminders to stay with the breath and remember to smile.  In these brief, structured and yet freeform sessions, I stretched existing ideas and queries farther than usual.  I quieted the inner critic sometimes and not others.  I learned a little more about my style and preferences for writing.  And I wrote a poem.

Based on “I Am Offering This Poem” by Jimmy Santiago Baca, Day 5’s prompt asked us to write a poem entitled, “I Am Offering This ______ to You.”

Onward, my friends.  Let us try new things, learn, grow and connect.

 

I Am Offering This Love to You

So imperfect

So flawed

So human

Yet honest, earnest, real

How can I make sure

You feel it the way I intend?

Or do I even need to?

Who would that be for?

What’s the best way for you to feel

Loved by me?

According to whom?

What is the best outcome

Of all this love

We carry for each other

In our families

Between friends

For our country

For the world

For humanity?

How can we live into this now

Today?

I am offering this Love to you

Now

On this day

In this moment

With this breath

What will you do with it?

What Emerges from Crisis:  Connection, Learning, and Contribution

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“What observations/discoveries/learnings have you noticed in these weeks?”

In phone calls, emails, and snail mail to friends, I find myself asking this question repeatedly.  This exercise yields two wins:  1) I’m connecting to my people all across the country; 2) I get to answer for myself, and new insights emerge each time.

How are you connecting with your people in these weeks of physical separation?

What have you had to reframe, create, and experiment with to make life work in our sudden new reality?  How does it feel?  What are you learning?

* * * * * *

 Inconvenient Emotions

Very early in the pandemic, when I realized my clinical volume would drop to practically nothing, I started to feel something akin to survivor’s guilt.  I still feel it—I am not on the front lines; I myself am not in harm’s way, as so many of my colleagues are.  I feel relief for not having to be there (yet).  Then I feel guilty for feeling relieved.  So I try to make myself useful, giving Zoom presentations on wellness to colleagues and firesides on Instagram for the public.  Life has settled into something of a routine.  I do video calls, helping with operations management and team organization from an armchair (standing desk).  Turns out I enjoy working from home!  And I feel guilty for enjoying anything about this time of unprecedented global disruption.  Hello, mental and emotional whiplash, my inescapable human companion.  Thankfully, self-compassion practice keeps me sane.

* * * * * *

Acceptance with Agency

“The first step to changing your circumstances is to accept them.”  Wut?  I have grappled for years to understand this concept; today I think I finally got it (thank you, Donna!).

Today I choose to define acceptance as a state of possibility, rather than of resignation or victimhood.  Sometimes it helps to describe something by pointing to its opposite:  What happens when we refuse to accept what is?  Often we cling to what we think should beWhat should be is a narrow set of unmet expectations that keeps us anchored to the past, or at least to an unreality that simply does not exist.

What happens when we finally accept what is?  We are liberated to ask some important questions:  How do I feel about what is?  What are the best and worst potential outcomes from here?  What do I want to be different?  How can I effect that change?  What is my work here?

Accepting what is brings us over the threshold from the narrowness of what should be to the wide possibility of what could be, where our agency is what we make of it.

* * * * * *

Optimism + Cynicism = Peace

Some days I get so excited, reveling in human ingenuity and resilience!  Look at the transitions we all made, practically on a dime, moving healthcare and education online, organizing COVID testing and creating treatment protocols, constructing hospital wards in convention centers, initiating clinical trials, and sharing experience and data internationally at breakneck speed!  All this learning and application, holy cow, how could we not be smarter, more connected, and better after all of this?

By being human, that’s how.  Despite our great capacity for survival and adaptation, we are creatures of habit and products of our environments and relationships.  We revert more easily than we convert.  On cynical days I think, “Nothing will change.  We will stay the same stupid species we have become, just a couple hundred thousand deaths closer to our own stupid, eventual extinction.  And we will deserve it.”

Here’s the fascinating thing, though:  I vacillate in this false dichotomy lightly, even though the emotions on both sides can get intense.  We humans are such a complex enigma, capable of profound love and selflessness, and also unfathomable hatred and destruction.  That’s simply what is—we are all of these things, intricately complicated in our nature.  Each one of us possesses an infinite set of potential vectors for connection and/or destruction.  But I still get to choose what to do with my time, energy, and resources in this lifetime.  It’s my call.  So I’m okay; I’ got this.

* * * * * *

Co-Creation:  The New Normal

The last two years I have had the privilege to work with colleagues around our vision, mission, and values.  I have studied various work cultures, observed and interviewed associates and teammates.  LOH taught me the language and framework to synthesize my own, evolving style of relational leadership.  During this downtime—this unearned vacation—I have time and space to consider a bigger picture.  What about our culture best manifests our mission and values?  How did this facilitate our successes in reorganization and mobilization?  What held us back?  What needs to happen (change?) in order for us to emerge from this crisis in learning and growth, rather than in fear and trauma?  These questions apply professionally, personally, and societally.

My strengths lie in relationship and connection.   Throughout this long journey to flatten the curve (and it will be months), I can contribute my insight, observations, and talents at synthesis, creativity and vision, to make our new normal as mindful, intentional, collaborative, and functional as possible.  I can paint a vivid picture of where we could go.  I can embrace dissenting voices and find alignment in apparently divergent interests.  I can help us be better.  This is the contribution I can make.

What will your contribution be?

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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 PaperBut 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:

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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:

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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.

Attune and Differentiate:  One Week’s Synthesis

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Friends, don’t you just love when an idea you resonate with recurs in your consciousness from disparate sources in short order, further deepening its meaning?  I share three pieces with you this week, which all deepened my commitment to embracing the paradox of attunement and differentiation.

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First, I listened again to Brené Brown’s Braving the Wilderness.  I highly recommend this book to help us all, conservatives and progressives alike, engage (not avoid) one another this election year with a lot more compassion, civility, and mutual respect.  Throughout the book Sister Brené shares personal stories as well as evidence from her research that define true belonging, which I think of as another expression for self-actualization and self-transcendence.  In her words:

True belonging requires us to believe in and belong to ourselves so fully that we can find sacredness in both being a part of something, and standing alone when necessary. But in a culture that’s rife with perfectionism and pleasing, and with the erosion of civility, it’s easy to stay quiet, hide in our ideological bunkers, or fit in rather than show up as our true selves and brave the wilderness of uncertainty and criticism.

Attune and differentiate:  these two practices are not only not mutually exclusive, they are essential and integral for whole person and societal health and well-being.  Read the book to adopt her four practices to advance true belonging, for yourself and for all of us:

  1. People Are Hard to Hate Close Up. Move In.
  2. Speak Truth to Bullshit. Be Civil.
  3. Hold Hands. With Strangers.
  4. Strong Back. Soft Front.  Wild Heart.

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Second, I met Massimo on Ozan’s last Inner Circle Zoom call.  He is a designer and facilitator from Italy—thank you again, Ozan, for connecting so many of us all around the world!  Massimo has launched a blog, which resonated with me because he also advocates finding your voice (differentiating) as well as finding a community of belonging (attunement) as a reason to write:

…Meet new people and to interact with them

Learning adventures can make you feel on a solitary path, too much unbalanced on the input, reading and digesting side without much interaction. Expand your network, look for more interactive exchanges with whom might provide an alternative, critical point of view compared to yours. Exposing your opinions leads self-selecting people to network and resonate with you. Find your tribe. We need many and none at the same time. You need different communities where to manifest and explore your interests. On the other hand, you need to better focus on creating those which are more fertile ground to nurture your continuously changing interests and aspirations.

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Third, I read David Brooks’s article in The New York Times on the ethos of Scandanavian education.  Eloquent as usual, he synthesizes a complex set of ideas into language we can all understand:

19th-century Nordic elites…realized that they were going to have to make lifelong learning a part of the natural fabric of society.

…(Their system) is devised to help (students) understand complex systems and see the relations between things — between self and society, between a community of relationships in a family and a town. 

…Nordic educators also worked hard to develop the student’s internal awareness. That is to say, they helped students see the forces always roiling inside the self — the emotions, cravings, wounds and desires. If you could see those forces and their interplay, as if from the outside, you could be their master and not their slave. 

…Their intuition was that as people grow, they have the ability to go through developmental phases, to see themselves and the world through ever more complex lenses. A young child may blindly obey authority — Mom, Dad, teacher. Then she internalizes and conforms to the norms of the group. Then she learns to create her own norms based on her own values. Then she learns to see herself as a node in a network of selves and thus learns mutuality and holistic thinking. [See Changing on the Job by Jennifer Garvey Berger for more on this theory of adult development.]

Scandanavians…have a distinctive sense of the relationship between personal freedom and communal responsibility.

(Meanwhile, in the United States…) If you have a thin educational system that does not help students see the webs of significance between people, does not even help students see how they see, you’re going to wind up with a society in which people can’t see through each other’s lenses.

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In 2020 more than ever, we need to cultivate much stronger relationship skills.  We must identify and honor our core values and stand up for them, even when attacked by those closest to us—perhaps even especially then.  How we honor our best selves determines how we honor others.  When we show up at our most honest and authentic, we can call forth the same in others to meet us.  We can relate as fellow humans, inextricably connected, mutually interdependent, and all in it together.  Once we realize this, we can know in our hearts that we truly belong to ourselves and to one another, and we can more easily get on with the world’s most important work—connecting humanity in health, safety, and love.

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.