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?