National Blog Posting Month (NaBloPoMo) was an annual November thing back in 2015, when I started this blog. Apparently the person who started it no longer claims it or formally facilitates, but many of us still practice. This year a small cadre of women physician writers may join me in the challenge, woohoo!
The theme for this, my 7th year, emerged over the summer. As some of you know, Son is a senior in high school, applying to college right now. On a walk through the neighborhood one sunny evening in August, I ran into parents of two different classmates, kids he’s known since preschool. We compared our respective parental experiences of contemporary college apps—fascinating! In both conversations, I asked my counterparts what they wished most for their kids to learn at college, and then in life. As usual, the question arose from outward curiosity, and before I could finish asking, I really wanted to answer for myself, too.
In short order, three primary ‘adulting skills’ came to mind:
Self-awareness
Self-regulation
Critical thinking
Over subsequent weeks the list grew quickly, as I sought additions from other friends and family. I noticed it was mostly nouns, which started to feel listless and uninspiring. Simon Sinek points out, in Start With Why, that posting static concepts such as ‘Honesty’ as organizational values is too abstract and unmotivating; it doesn’t tell people what to do. He recommends converting such nominal platitudes to verb statements instead: Isn’t ‘Always Tell the Truth’ a much clearer and more activating expression? And bonus: it also makes us accountable.
So this November, I intend to post one ‘action mantra’ each day, that I hope for my children to practice, to live a good life. I have chosen the theme title: Do Good, Kid. I like that play on words, too. 😉
This year’s theme is, perhaps, more personally meaningful and coherent for me than previous ones. I imagine it as the lifelong learning To Do list that could persist as my kids’ ethical earworms when I’m not around to remind them. It’s also a record of my own personal aspirations. How can I ask them to do anything I’m not willing to model myself? I have 30 days, and well over 30 practices to choose from. This could be fun.
So let’s see how it goes, eh? Can’t wait can’t wait!
Do you not just love when insights occur in rapid and acute succession?
I had ‘Rubik’s cubed’ the last post for a few weeks before finally sitting down to write and publish it last Tuesday. The smoke signal idea came to me while typing—it felt almost tingly, like the most pleasant and rewarding epiphanal effervescence. And here just now I’m only describing that sensation for the first time. How fascinating. Little did I know last week that my own smoke signals have long smoldered in the distance. Since musing about the physical sensations of meaning, I’m suddenly noticing my own, left and right.
I’ve had two prolonged absences from in person clinical work these two years. The first was 2.5 months externally mandated by pandemic lockdown in 2020. The second, ending as of 10 days ago, was a 5 month personal leave. In each case I did my homework prior to returning, reviewing charts and schedules, contacting colleagues for sign out (the verbal transfer of care between clinicians who share patients). Both times I felt ambivalent, missing the nearly 24/7 control over my own schedule (or the illusion of it, anyway), and also anticipating the gratifying interactions of in person clinic.
In June last year, the joy of return enveloped me like the warm, welcoming hand of a soft spring breeze. I had completed the interview part of my first face to face visit since March. We got to the exam room and I did my usual head and neck assessment. I put my stethoscope earpieces in and placed the diaphragm against the patient’s chest. That first heartbeat may have been the most soothing sound I had heard in years. The soft, rhythmic, unobtrusive yet vital thudding of the heart of a live person—a person in my care—wow. I can’t remember if I actually got goosebumps then. But I get them now just thinking of that moment. I had not realized how much I missed hearing it, or how much it meant to me. I lingered an extra second or two just listening, feeling a deep joy and relaxation, a settling of my soul even, maybe. It was profound and totally unexpected.
This time it was a conversation. It’s such a privilege to know people in the intimate space of their health, to appreciate them as whole people, body, mind, and often spirit. In executive health we get the bonus of relating our patients’ whole person health to their roles and responsibilities as designated leaders at work. This intersects also with relationships in their families and personal tribes, just as it does for all of us. Toward the end of an interview last week, once again I felt overwhelmed by a deeply grounding, relaxed and yet energizing sensation. My patient and I were talking, engaging, exchanging ideas and observations, relating, as fellow humans. It felt paradoxically expansive and distilled at the same time, like I had dropped right into, and was operating directly from, my core, best self. I was right where I was supposed to be, doing and saying exactly what I was meant to do and say, right in that moment. I could only marvel inwardly and briefly in real time, as the encounter moved on. It was not until later in the day that I was able to name the emotion as sheer joy. I was lighter on my feet, uplifted in my chest, feeling positively buzzed.
Wow, it’s already the end of October. NaBloPoMo is almost upon us (well, upon me, I guess, as there is no longer an official November event–but this will be my 7th consecutive attempt), and I feel ready! The theme this year is personally meaningful to me (stay tuned for the reveal), and I look forward to the challenge. So good to be back, friends. Onward.
What kind culture do you wish to perpetuate? What specific actions, policies, behaviors, and outcomes would it manifest?
I learned the term ‘cultural perpetuity’ this past week, from a thought-provoking article on how Maslow’s Hierarchy was influenced by and also misrepresented Blackfeet Nation teachings:
Self-actualization. Where Maslow’s hierarchy ends with self-actualization, the Blackfoot model begins here. In their view, we are each born into the world as a spark of divinity, with a great purpose embedded in us. That means that we arrive on earth self-actualized.
Belonging. After we’re born, imbued with a divine purpose, the tribe is there to love and care for us.
Basic Needs & Safety. While in Maslow’s model, we find love and belonging only after attending to our basic needs and safety, the Blackfoot model describes that our tribe or community is the means through which we are fed, housed, clothed, and protected. The tribe knows how to survive on the land and uses that knowledge and skill to care for us.
Community Actualization. In tending to our basic needs and safety, the tribe equips us to manifest our sacred purpose, designing a model of education that supports us in expressing our gifts. Community actualization describes the Blackfoot goal that each member of the tribe manifest their purpose and have their basic needs met.
Cultural Perpetuity. Each member of the tribe will one day be gone. So passing on their knowledge of how to achieve community actualization and harmony with the land and other peoples gives rise to an endurance of the Blackfoot way of life, or cultural perpetuity.
I also listened this week to the Building an Anti-Racist Workplace episode of Adam Grant’s podcast WorkLife. It’s an insightful, enlightening, and empowering interview with John Amaechi, whose work I will now explore further. In their discussion on allyship, Amaechi points out that we upstand against racism and sexism not just to help our individual friends or coworkers, but because we uphold certain core values. Thus, we speak and stand up to defend and disseminate a certain culture—to perpetuate it:
Adam Grant (21:43): I wanna talk a little bit about sort of the- the ally perspective here. Just thinking about my own failures in anti-racism and other people who I know, recognize the problems and care about the problems, but haven’t done much about them, I keep coming back to this literature on psychological standing.That sense that, you know, it’s- it’s not my place, it’s not legitimate for me to speak up because I’m white. What are your thoughts on overcoming it and getting those people who are by-standing for those kinds of reasons on board?
John Amaechi (22:13): There’s a couple of things that I’m trying to do. One of them is to stop the alignment of allyship with black people as individuals and start the alignment of allyship with their own principles or with their organization’s values. So racism is an incivility. Sexism is an incivility. I do not require sisters nor a mother, nor a wife to be against sexism and misogyny because it is an incivility. If I’d intervene on something that’s racist, it’s not on my behalf or another one of my black colleagues. It’s because it’s an incivility against the values that people say they share. Today it’s not about an individual. It’s about standing up for your values and understand that you don’t need to have a black person in your team for that to be important because the presence of a black person has never been required for racism to occur. The presence of a woman has never been required for sexism to occur. As men, we know that the absence of woman reveals sexism and misogyny.
What culture do you lead?
In my role as interim clinical director of a small practice, I see myself as a steward. My best contribution to most places I inhabit is to highlight and foster relationship and connection. At work, this manifests as effective teamwork, high engagement, and positive morale. Last year as we recruited for a new medical assistant (MA), I got to listen on the phone as our current MAs interviewed a candidate. Through my own questioning, the candidate’s responses were short and sedate. Then each MA on the team met with her, describing with energy and conviction how they live out our core values of collaboration and accountability, as well as our mission of providing compassionate, holistic patient care. With each encounter, I heard the candidate’s responses lengthen and deepen. I heard her own energy and engagement rise to match that of the team. It was one of my proudest moments as director—I could see (hear) and feel how far our culture of connection has come, and how it could persist after I pass the baton to the next director.
What is the dominant (perpetual) culture in America?
Do not underestimate the complexity of this question, and its profound implications. The first answer is, of course, it depends whom you ask.
For far too many, the dominant American culture is white male supremacy. For the past year, I myself find it inescapable. Increasingly, every time I consider what to post to this blog, or jeez, every day and in almost every domain, the primacy of white men pervades my consciousness like smog on a hot, humid day. Let me be clear: White men are not each and all bad; I do not assume every one is a racist sexist, even the actual assholes. But whenever American systems are examined, we find that they are primarily designed, favored, empowered, and perpetuated by and for white males—it’s baked into our societal structures, hence the terms ‘systemic’ and ‘structural’ racism and sexism. If you are a white male, it may be hard for you to see the barriers that have not impeded your life journey (Amaechi discusses this in the podcast as well). You may have answered that dominant American culture is one of success with hard work, of equal opportunity, and of individual freedom. Of course that is a culture we’d all love to perpetuate. How could we achieve it for everybody?
What culture do you work to perpetuate?
I think it’s about the values and commitments we hold highest and manifest most in our daily activities. What do our daily encounters say about our priorities? What do we want more of, and thus work for every day, for ourselves, our friends, our colleagues, patients, parents, and children? I want mutual respect and unqualified acceptance. I want sincere valuation of diversity and real, wholehearted inclusion and integration of that diversity—of thought, experience, wisdom, and perspective—into a coherent, synergistic mosaic of strengths, engaged in service of elevating every individual to their highest potential. I want to perpetuate a learning culture, one that operates with a growth mindset, founded on kindness, generosity, humility, curiosity, and resilience.
None of this happens automatically; even well-established gardens of inclusive culture require regular tending. I have to renew my commitment every day, in every encounter. I fall down regularly. And I give thanks every day for loving companions who help me up. I try also to appreciate the challengers, to see them as allies rather than enemies or hindrances. That is walking my talk, no? To value those whose goals and values don’t align with my own, to find a place for them—for everybody—in my world? I’m strengthening my practice of self-assessment. How did I walk the talk today? How can I do even better tomorrow? The more concrete and specific, the better—words, actions, and attitudes. It’s my own version of “trudging the road of happy destiny.”
On that note, I leave you with two more resources that hold me up this weekend:
First, Hank Azaria’s conversation with Dax Shepard and Monica Padman on the Armchair Expert podcast. They discuss addiction, privilege, and racism, among other things. What an inspiring example of vulnerability, courage, humility, connection, and lifelong learning and growth.
Healing Through Connection 