Diversify Your Network

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NaBloPoMo 2018:  What I’m Learning

Are you friends with a plumber?  My friend Dennis is, or was, as of c.1997.  I forget his friend’s name, let’s call him Frank; they knew each other in high school.  Dennis and I were both medical students when I met Frank.  Looking back he must have thought I was a little strange.  I asked what he did for a living, and when he told me he was a plumber I interrogated him, hard.  “What’s that like?  How do you train, is there a school (I was a straight-through biology pre-med who knew next to nothing about trade schools)?  What are your hours like, are there days when you don’t work?  How do you figure out what the problem is?”  I was just so curious—I had never met anyone who did that kind of work, and it was so different from anything I knew.  He didn’t talk to me for long.  We were at Dennis’s birthday party and Frank quickly found other friends to connect with.

I’m so grateful to work in medicine, where I get to meet people from all walks of life every day.  In the exam room I have met coders, lawyers, teachers, construction workers, professional dog walkers, stylists, food critics, financial columnists, hedge fund managers, engineers, HR directors, leadership coaches, musicians, and myriad others…but I can’t remember any plumbers.  I love when I have time to ask, “What’s that like?” and “What do you spend your days doing?”  I always learn something new, and the best days are when I find some parallel between our work lives.  My husband the orthopaedic surgeon remembers patients by their x-rays.  I remember them by their social histories.

The Harvard Business Review sent an article to my inbox today entitled, “How to Diversity Your Professional Network.”  It cites studies that show “people who are connected across heterogeneous groups and who have more-diverse contacts come up with more creative ideas and original solutions.”  Reading it triggered an avalanche of memories and cognitive dot-connecting, hence my story about Frank.

First, I’m reminded of my first coaching call after accepting my new role at work.  Coach Christine asked about my ‘allies,’ the people whose counsel I value and who will hold me up and accountable through the growth process and pains that are leadership.  She pointed out that allies are not always people who agree with me.  They can be my challengers, my opposition, my rivals.  Through them, I am forced to grapple with my own integrity; they serve as the crucible for my values.  This idea helps me stay open to people whom I might otherwise dismiss.  Diversify.

Second, I remembered of The Big Sort, by Bill Bishop.  It’s thick with data and research, but the part that struck me hardest was the idea that our ideology becomes more extreme when we spend time with like-minded people.  I suppose you might think, well yeah, duh.  But when you consider how this affects decision making on the individual, community, and policy levels, it’s a little scary.  In his description of research by Cass Sunstein and colleagues, Conor Friedersdorf writes:

But for all the benefits of agreement, solidarity, and spending time with like-minded people, there is compelling evidence of a big cost: the likeminded make us more confident that we know everything and more set and extreme in our views. And that makes groups of like-minded people more prone to groupthink, more vulnerable to fallacies, and less circumspect and moderate in irreversible decisions they make.

Groupthink.  That reminded me of Originals by Adam Grant, a book I have listened to at least twice now.  As I have thought incessantly about culture and how to nurture a healthy one where I work, Grant’s advice on hiring for contribution rather than fit holds my feet to the fire:

Emphasizing cultural fit leads you to bring in a bunch of people who think in similar ways to your existing employees. There’s evidence that once a company goes public, those that hire on cultural fit actually grow more slowly because they struggle to innovate and change. It’s wiser to follow the example from the design firm IDEO, and hire on cultural contribution. Instead of looking for people who fit the culture, ask what’s missing from your culture, and select people who can bring that to the table.

So what does all this mean?  I have decided to take it as validation of my curiosity and desire to learn as much as I can from a vast array of different people.  Whether I know them socially or professionally, whether our diversity is race, culture, politics, religion, or music preference, there is always something that connects us.  The search and exploration are what make life colorful and fun.

I wonder whom I’ll get to meet tomorrow?

The Hard Conversations

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NaBloPoMo 2018:  What I’m Learning

Life is about learning.  Learning requires acknowledging lack of skill, knowledge, understanding, or all three and more.  Boundaries, curiosity and non-judgment make it so much easier; too bad we tend to lose these natural traits (or they are trained out of us) early in life.  Then we have to relearn them as skills.  What happens when we reacquire boundaries, curiosity and non-judgment?  We get much better at having the hard conversations.  What makes conversations hard?  Not sure?  Just think of the conversations we avoid.  What are we actually avoiding?

I resist apologizing when I don’t want to admit that I misunderstood, that I made wrong assumptions that led to behaviors that hurt people, that I was not my best self.  I worry that people will think less of me and not trust me, not include me in the future.

I avoid giving negative feedback because I don’t know how the other person will take it.  Will they crumble in a heap of self-flagellating despair?  Will they lash out and attack me, verbally or physically, threatening my safety?  Will they disparage me to others, try to split our colleagues between us, sow discord and undermine our culture?  I worry that I will lose control of the situation.

We resist conversations about politics, religion, and issues like abortion because they can escalate in a nanosecond, filled with emotional tumult.  These are precisely the exchanges during which we blow past all of our boundaries for civility, language, tone of voice, and rhetoric.  We lose all interest in understanding what the other person thinks or, more importantly, how they feel.  We stop relating.  We judge everything out of their mouths as oppositional, ignorant, and unworthy.  We worry that we will lose our status, self-efficacy, agency, or our friends.

* * *

My friend Earnestine * has migraines.  Over the years she has worked out their patterns: timing, location, aura, duration, and triggers.  She hydrates, protects her sleep, and, most importantly, manages her stress with vigilance.  This way she generally avoids medications and keeps her symptoms under good control.  Recently she got caught in an unavoidably stressful situation with family.  A migraine hit her like a Mack truck out of nowhere.  She could barely walk, stumbling around, hanging onto walls and railings.  Her speech may have been slurred.  Thankfully she was able to escape to a friend’s house.  Her childhood friend, also a sufferer of headaches, offered her a handful of pills—her own prescription medications.  Earnestine struggled for the right words, and not just because her head was splitting.  If she refused, would she offend her friend, who has just rescued her from serious family chaos?  Would she trigger indignation, anger, resentment, rejection?  E found her personal values and boundaries tested, unexpectedly.  She felt ambivalent, as the core values of connection with a friend and right use of substances clashed.  She desperately desired relief from her pain, and she also needed to set an example for her boys, who were watching her response—what would she want them to do if one of their friends offered them ‘relief’?  Somehow through the fog, she found a way to acknowledge her friend’s generosity, and also explain that she was not comfortable taking someone else’s prescription medication.  She maintained her boundaries and stayed curious to monitor her friend’s and her boys’ responses.  Since that time, she continues to hold her friend in non-judgment, understanding that although she would not ever do the same, her friend’s intentions were loving.

I tell this story because I see it as a perfect example of boundaries, curiosity, and non-judgment in action:  Holding space for one’s own needs while attending to the needs of others and our relationship with them (both her friend and her sons).  Earnestine practices honoring her boundaries, which can, in some ways, be equated with her core values.  When they are challenged, she can stay in curiosity and explore the feelings that get triggered. She can withhold judgment on the feelings and simply experience them in the present moment, asking what they are trying to tell her.

This combination of boundaries, curiosity, and non-judgment, practiced regularly in small, everyday things, prepares us to face the harder situations and conversations with greater confidence.  We can trust ourselves, even if we don’t walk into any given situation knowing the right answer, to find it when we need it.  On the other side, these skills help us look back with fewer regrets, because we brought our best selves at the time.

I have learned to recognize opportunities to practice these skills, and now I resist apologizing, giving negative feedback, and talking about politics a lot less.  In fact, these are precisely the scenarios in which I can really test and hone my skills—sharpen them and improve my relational dexterity.  I almost look forward to them—sometimes.

It’s all a continuous journey, is it not?  Will we always face our fears with heroic courage and the perfect words and behaviors?  Hell. No.  AND, every day is a new chance to try.  What hard conversation might we come closer to doing better tomorrow?

*Not her real name

Walk a Mile

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NaBloPoMo 2018:  What I’m Learning

These last 5 years, I have had the privilege of caring for designated leaders of all kinds—business leaders who also lead their families, their faith communities, their professional societies, and myriad other entities. I have studied and presented on the intersection of health and leadership, the reciprocal relationships between self-care and care of others.  Each day I ask probing questions of my patients’ habits of thought and action, and they answer with honesty and candor.  It’s particularly fulfilling when I hear, “Huh, that’s a good question, I’ve never thought of that before.”  In those moments, I feel I bring value beyond interpreting blood pressure and cholesterol results.

I’ve been interested in leadership for a long time, and had opportunities to lead in various small ways through the years.  In January 2018, I was given a more visible title and designation than I had ever had—YIKES.  I was surprised and unsuspecting, though not totally unprepared.  And, like parenting, nothing can quite prepare you fully for the experience.  I spoke to a leader in my organization about a year ago, who expressed loneliness in his position.  I admit that I half dismissed the idea, thinking there should just be a way to balance collegial, friendly, and leader-led relationships.  I think I was about a week into my new role when I fully, viscerally, understood his perspective and humbly admitted my own loneliness.  I felt guilty and a little ashamed for my reflexive disregard for his confession of vulnerability—because even if I did not fully dismiss his experience, I did judge it.  And that speaks more to my own fear of loneliness and isolation than it says anything about him.

Thankfully, I did not wallow in guilt or shame for long.  “How fascinating,” I thought.  Being judgmental like that is not consistent with my core values.  These ten months have been a practice in navigating and managing that loneliness—cultivating relationships in new ways to maintain connection while simultaneously practicing the required discretion in information sharing.  Often I have felt profound humility (and now more embarrassment than shame) at how I thought I knew so much about effective leadership, mostly from the point of view of being led, and only sometimes as a leader myself.

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This fall Brené Brown saved me from further self-flagellation over my lack of skills and understanding of what it takes to be a good leader.  The thing I admire most about her is how she walks the talk of vulnerability and courage.  She shares her mistakes, missteps, and learnings so openly, and anyone who reads her books or sees her presentations gets to profit from it all.  I will always remember where I was, because I laughed out loud in sheer relief, when I heard her read from her latest book, Dare to Lead:

Over the past five years, I’ve transitioned from research professor to research professor and founder and CEO.  The first hard and humbling lesson?  Regardless of the complexity of the concepts, studying leadership is way easier than leading.

When I think about my personal experiences with leading over the past few years, the only endeavors that have required the same level of self-awareness and equally high-level ‘comms plans’ are being married for twenty-four years and parenting.  And that’s saying something.  I completely underestimated the pull on my emotional bandwidth, the sheer determination it takes to stay calm under pressure, and the weight of continuous problem solving and decision making.  Oh, yeah—and the sleepless nights.

I thought, well, if Brené Brown still had stuff to learn after assuming a new leadership role, then I’m doing okay!  I am both freed from self-imposed, unrealistic expectations of perfection, and also still responsible for continuing to practice self-awareness, humility, and honesty.

I have learned to look harder at the cynical stories I tell about my leaders, and seek to understand better the divergent and competing interests they must balance every day.  I can withhold judgment of their motivations until I have more information, and if I’m not entitled to all the information, I can decide how much I trust my leaders to act in my best interests, or at least in the best interests of the organization.  I can hold myself accountable to my own standards of honesty, candor, and integrity.  I can ask and challenge, inquire and resist (or accommodate), all with curiosity and respect, and making the most generous possible assumptions of others.

How lucky am I to have this remarkable learning opportunity?  To practice the skills I have observed, admired, and studied in others for so long, to own them.  I have walked a mile in these new shoes.  I have a few shallow blisters for the journey so far.  But the shoes are the right size, and the leather is softening.  I’m still feeling fit.  The path will wind and climb, and that’s okay.  I don’t walk alone; I have mentors and role models walking ahead and by my side.  So bring it!  We’ got this.

My Sleep Evolution

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NaBloPoMo 2018:  What I’m Learning

How often do you look back and really appreciate how far you’ve come in a short time?  It could be a skill, an understanding…  Maybe lightning struck and you made a sudden, significant transformation, or maybe it was a slow, plodding trudge to the current state.  For me it started out small and organic, and grew with increasing momentum toward a sort of AHA! confirmation today.

I can honestly say that 5 years ago I did not pay much attention to sleep.  I have always been a night owl, often staying up late reading or writing.  When I started this blog, I routinely published posts around 2:00am.  But when I started talking to patients in more detail about their health habits, I started to learn the importance of sleep.

Here is the timeline of my Sleep Evolution, c.2014-present day.  Where along the arc live your thinking  and habits on sleep?

Personal Evolution

  • 2015: Regularly staying up past 1:00 or 2:00am posting to blog
  • Feeling the cost of this in my body more and more
  • 2017: 11:00pm bedtime commitment kept on and off, not staying up as late, as often posting to blog
  • Early 2018: Recommit to 7 hour goal after accepting new leadership role at work. “Put your own mask on first before helping others.”
  • (Read) Gretching Rubin’s Better Than Before, in which she lays out the evidence for the Foundation Four habits, in order of importance: Sleep, Exercise, Nutrition, and Order (decluttering)
  • Recommit (again) to protecting my own sleep because this helps me maintain healthy habits of exercise and nutrition (this was a small epiphany of the obvious)

Professional Evolution

  • 2016: Observation: Young healthy men who eat healthy and exercise but who have elevated glucose levels tend also to sleep less than 6-7 hours per night, average.
  • Start structuring patient interviews around “The 5 Realms of Health”—Nutrition, Exercise, Sleep, Stress, Relationships
  • Presenting to groups on physician health and well-being using the same framework for self-care
  • Patients asking, “Should I get up an hour earlier to work out or stay in bed?” Not sure how to answer
  • Reading more about myriad downstream effects of chronic sleep deprivation
  • 2017: Start calling them the “5 Reciprocal Domains of Health”
  • Understanding that though the 5 habits affect one another inextricably, sleep deprivation impacts all of the others disproportionately negatively
  • 2018: Resolve to tell patients: Stay in bed.  Because you can only sleep when you’re sleeping, and you can always move more while you’re awake
  • Start to wonder if I should reprioritize the list–rather than Nutrition, Exercise, Sleep, Stress, Relationships, maybe Sleep, Exercise, Nutrition, Stress, Relationships?
  • (Read) Gretching Rubin’s Better Than Before, in which she lays out the evidence for the Foundation Four habits, in order of importance: Sleep, Exercise, Nutrition, and Order (decluttering)
  • Decide to change the order of my list
  • (Read) Brené Brown’s Dare to Lead, in which she labels “rewarding exhaustion as a status symbol and attaching productivity to self-worth” as one of 16 examples of ‘armored leadership,’ whereas ‘daring leadership’ “models and supports rest, play, and recovery.”

What makes this the most exciting for me, though, is to hear real results from others.  I spoke to an acquaintance today, a fellow leader.  About a year ago he decided to take control of his sleep habits.  He started going to bed at a regular time, minimizing screen use at night, and making a nightly wind-down routine.  He adopted a brain dump practice with a diary at the bedside to keep ideas, challenges, etc.    Now he notices that he is able to focus better in the mornings.  He feels more alert, more relaxed in his outlook, and more resilient to acute stressors.

Most importantly, his relationships at work are improving.  A couple of times a week he notices a transformation in his interactions.  When frustrated with another’s mistakes or lack of engagement, he used to come at them with criticism and blame.  These days, he is able to notice this escalation in real time, and redirect his thoughts, words and actions to come alongside others instead, staying in curiosity and compassion.  With better sleep he is able, in real time (the key), to see how his needs are not the only ones worth meeting.  He can hold the space to ask what the other person needs to engage and perform better.  He sees more clearly opportunities to be his best self, to reach those around him at a deeper level.  This fosters self-fulfilling confidence in his leadership skills, not to mention trust and loyalty among his direct reports.

All of this simply from better sleep?  I imagine he has also done work in other domains (stress management, relationships).  But they are reciprocal domains, remember, so as habits in one area improve, others soon follow.

What benefits do you notice when you get enough sleep?

Here are some articles that explain more about consequences of sleep deprivation and how to foster better sleep habits:

You Need More Sleep. Here’s How to Get It, Harvard Business Review

The Simplest Way to Drastically Improve Your Life: Get More Sleep, New York Times

How to Get a Better Night’s Sleep, New York Times

Time to go to bed.

Who’s On Your Pit Crew?

 

Who helps you succeed?

Who checks in with you regularly and gives you feedback on your performance?

Who rushes to your side when you need help?

Who can tell not only when you have a lugnut loose but also how to help you tighten it again?

Who is on your pit crew?

I can’t remember the first time I started using this analogy.  I do recall, of course, it came about in a patient encounter.  For a long time now I have consistently asked patients about their emotional support networks, their connections.  As I get older, I feel increasingly aware of and grateful for all the people at every phase of life who have helped me learn, improve, succeed, and become.  Nobody succeeds alone—hell, all but a rare few of us can even survive alone.

My friend Jeremy Topin, a critical care physician, husband, and dad, writes a heartfelt and honest blog about life as all these things—because he is at once all of them and more—there is no way to truly separate one role from another in life.  His recent post on depression among physicians reminded me of the pit crew idea.  Medical culture does not encourage pit crews for its workers.  It’s evolving, painfully slowly, and I hope to have a hand in that evolution.  But for now, far too many physicians and other caregivers suffer burnout, depression, anxiety, and other work-related heaviness in silence, and it can cost us our lives.

Thankfully, many of us have intact and well-functioning pit crews.  46% of physician respondents to the most recent Medscape survey reported talking to friends and family as a coping mechanism, second only to exercise, and right above sleep.  I count my trainer, my therapist, my life coach, and my Counsel of Wisdom, my closest friends, as my core crew.  I have become more and more open about having a therapist and a coach—ya gotta walk the talk if you’re going to be credible about your work.

Full disclosure, I am not a car racing fan.  Pretty much all I know about pit crews is from Disney’s “Cars” and admiring Lightning McQueens’ motley one.  But that’s how it happens, right?  We acquire and accumulate relationships and connections along the winding way in life.  Who knows when or where it might happen?  I met mine in school, in the exam room, at meetings, and I was introduced by mutual acquaintances.

As I consider further, though, having a pit crew is only part of the success story.  Research shows us time and gain that serving on someone else’s pit crew fulfills a profound human need, also.  I suggest works by Adam Grant and Kelly McGonigal if you wish to read more about this.  But maybe you don’t need to read or hear the research evidence to understand this concept?  How does helping others help you?  On whose pit crew do you serve?  To whose Lightning McQueen are you Mater or Luigi?

If your pit crew is sparse, people who study and do this work recommend finding something meaningful or someone you love to serve.  It could be something simple and non-committal, like serving at a soup kitchen or collecting winter coats for shelters.  It could be reading or playing piano at a senior center.  Or it could be mentoring a junior colleague over many months or years.

Imagine a music teacher who accompanies her cello student at recitals.  She plays piano, fingers and hands moving lightly and nimbly over the keys as her protégé plays her heart out during each performance.  I went to my son’s school this afternoon for a music concert, where this pit crew idea struck me again.  I don’t know if the accompanists were the performers’ teachers, but that’s how I saw them, as they were all clearly middle aged adults playing alongside teenagers—surely they had some wisdom to impart in this relationship?  It occurred to me that ‘accompanist’ may not fully accredit these adults’ roles in the kids’ lives.  The music they contributed not only supported the students’ performances.  These adults integrated their music making with the primary performers’, lifting it beyond where it could go alone.  They contributed their own advanced skills and supportive presence to help these young people succeed.  It was a team effort.  And that’s the point, I think.

How widely could we apply this pit crew metaphor?  How does it resonate with you today?  How else is your life like a racecar driver’s?  What’s exhilarating about it?  How is it faster and more intense than other drivers’?  Is that okay with you?  How much longer can you sustain this work, and what do you need to maintain the joy and reward?

Lastly, what did you think of this post?  It’s much more stream of consciousness and impromptu than I’m used to.  I’m trying to get more efficient with my time—three hours per post finishing at 2am on a weeknight is no longer an option.  Your feedback is welcome!

One more weekly post and then the 30 day marathon that is NaBloPoMo, my friends!  Woo hoooooo, ONWARD!

From Meaning to Mission:  Finding Your Voice and Speaking Up for Change

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Have you ever felt like you have no voice in your workplace, your community, or the world at large?  When have you felt you do have a voice?  What made the difference?

Two esteemed colleagues, Liz Lawrence and Eileen Barrett at the University of New Mexico, and I presented the above titled workshop at the International Conference on Physician Health on Friday.  The objective was to give participants an opportunity to recognize and rally their strengths, claim their value and agency, and practice the words to advance an idea or project for improving physician health and well-being.

The idea for the workshop came from a conversation Eileen had with a young physician who felt he had no agency to improve his work situation, due to his junior status.  This prompted her to ask, who has agency, and how do they get it?  She concluded that agency is an active skill, not a passive state of being.  Thus it can be learned/acquired, and everybody has/can have it.  Furthermore, we apply it most effectively when we combine it with our strengths, in service of projects that are personally meaningful.

We presented the reciprocal triad of finding meaning in work, feeling empowered, and inspiration and motivation, as the foundation of agency and action.

EB triad

Identifying Strengths

The first exercise had participants pair up and describe their strengths to each other.

What are your strengths?  Imagine describing them to someone, out loud, in person.  How does this feel?  Our attendees reported feeling uncomfortable, not used to it.  They also felt confident, connected, and encouraged speaking to someone they knew was listening supportively.

Defining the Project

Second, we asked participants to think for a few minutes about their own projects.  It could be something they had been working on for a while, a new idea they recently came across, or something from a sample list we provided, related to Culture of Wellness or Efficiency of Practice.  We asked:

  • Is your idea “Big Enough to Matter, Small Enough to Win?” quoting Jonathan Kozol.
  • Is it Specific, Measurable, Achievable, Relevant, and Time-bound (SMART)?
  • How will your strengths apply?
  • What else do you need? Who can help?

Partners met again to share and discuss each other’s ideas.

Afterward they reported elevated inspiration, excitement, and mutual support.  Positive energy in the room rose palpably at this point, with lots of gesturing, smiling, and engagement.

ICPH 2018 workshop

Communication and Relationship

We didn’t call it an elevator pitch, but that’s basically what we asked attendees to attempt.  In 90 seconds, each participant was to distill and express their idea into words that would convey its essence and enroll their partner in its goal.  Having advanced to this segment of the workshop in less than twenty minutes, and now asking them to perform a pitch on the fly, I gave a pep talk (modified here to include some words I wish I had said):

“Now it’s time to PRACTICE.  If we are to make progress in our projects, we must enroll other people.  It’s all about relationships.  Relationships kill us or save us, and they live and die by communication.  A previous presenter said, ‘Language is the vehicle through which all interactions take place—both verbal and nonverbal.’

“You never know when or where you will meet your champion, or who it will be.  The easier and better you can pull your idea out of your back pocket and present it cogently and impromptu, the higher your chances of success.  Know your ask—be as clear as possible.  Know your audience—what about your project is meaningful to them, what will they relate to?  Make them the hero:  Don’t come at them with demands.  Come alongside them with open-ended questions; help them appreciate the power they have to help.

“You will have to be persistent.  Practice will be key.  Our keynote speaker, applying complexity theory to the work of physician well-being, invoked the image of a grain of sand dropping onto a pile.  One grain may stick on impact and nothing happens to the pile.  Another may cause a small section of sand to tumble just a little.  Yet another grain can trigger the avalanche that alters the sand pile landscape entirely—and no one can predict which grain will be which.  I posit that you are not a grain of sand.  You hold an idea—a whole bag of sand—and each time you pitch it, you drop a grain (or a handful) on the pile.  If one grain makes no immediate change, drop another one, and another, and another.  This is the essence of the Growth Mindset—practice.  Practice is Creation.  Practice is Evolution.  Practice is Progress.  Your job now as speaker is to try with abandon.  There is no such thing as a bad try.  Pay attention to how it feels, where you get stuck, and where you shine.  As the listener, your job is to make it safe for your partner to let go of fear and judgment, to lay it all out.  Support, encourage, and critique with love.  What moved you, what did you observe in words and body language that drew you in or put you off?  What did you want more of?

“Make the most of this time.  Dig in the bag and pull out a few grains to drop.  Take advantage of your partner for feedback and support.”

The room was positively buzzing.  And participants’ comments made our day (paraphrased here):

“Sticking with the same partner throughout was helpful; we could really connect each other’s strengths to our respective ideas and help each other develop them.”

“It was fascinating to see the energy change between talking informally about the idea and then having to present it as a pitch.  She was so much smaller and hesitant the second time around.”  (Partner):  “The first time I was just talking to a colleague.  The second time I pictured presenting to my board.”  The experience was enlightening and curiosity-provoking.

“It’s different and easier talking to a supportive stranger, someone with whom you don’t already have relationship baggage.”  How else, then, might we approach our stakeholders—how could we practice awareness of our assumptions and relationship dynamics, and perhaps modify them positively?

“Hearing someone else’s ideas informs my own.  I like how he conveyed something, I saw how I could do the same; it gave me more insight.”  Taking turns both presenting and listening engaged both people in mutual support and encouragement—both roles were helpful.

The Takeaways

Liz, Eileen and I have collaborated on physician wellness since 2015.  We share meaning and mission around inspiring our colleagues to claim their value, recognize and stand both confidently and humbly in their power, and participate in a global movement of positive change.  Our strengths and styles complement one another and the work flows naturally, synergistically.  What a privilege and an honor it was to have this opportunity to present to and commune with our tribe members in physician health.  May the processing and integration of all of our new learnings continue to sustain and connect us for the long road of work ahead.  As Barack Obama says, “Change will not come if we wait for some other person or some other time. We are the ones we’ve been waiting for. We are the change we seek.”

Onward, my friends.

EB LL CC ICPH 2018

Hold One Another Up

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Hello Friends!

How was your week?  I wrote in my last, very brief post that it had been a hard few weeks, but whoa-Nellie, these past 10 days or so have been a bit unbelievable.  But then again, almost nothing is truly unbelievable anymore.

When the news first came out about families getting separated at the border, I felt profound empathy for the parents, and then the kids, imagining their despair, grief, and lasting trauma.  But the administration is now targeting even naturalized citizens, looking for fraud on applications to deport people.  My parents, my husband, and all of his siblings are all naturalized citizens.  My son is currently abroad and it occurred to me to wonder whether he will be held up in customs and immigration on his return.  At this point I cannot know for sure that my own child, a native-born American citizen, won’t be kept from me, and even though it is unlikely, I now feel it fully in the realm of the possible.  I know I’m not the only one.  That is simply unacceptable.

It also occurred to me that any of my Latinx friends and co-workers could be stopped on the street or approached on a bus or train, and commanded to show proof of citizenship, as so many across the country have experienced, illegal and unconstitutional as it may be.  45 actually autographed photos of people who have been killed by illegal immigrants, while denying that native-born citizens commit proportionally more crime than immigrants, legal or illegal.   Right now, June 2018 in the United States, it feels to me that only straight, white, Christian, cisgender males are safe.  It all makes me want to vomit.

In the past year or so, people who know me call me an ‘activist.’  I take immense pride in this perception, and at the same time feel a little unworthy.  What have I done?  In 2017 I wrote a lot of letters to Members of Congress–even had Healing Through Connection stationery printed to do it.  I called.  I donated.  I marched.  2018 has been slower in action.  I’m still reading, keeping up, donating, and engaging on social media.  But I feel like it’s not enough, that I should be doing more.

Today I am more aware than ever that most of my colleagues and institutional leaders are white.  I am East Asian.  We are not the targeted groups.  However empathetic and outraged we may feel, we are likely only indirectly affected by current events.  So many of our support staff, however, are people of color.  They hold positions in the organization with the least autonomy, authority, and voice.

We are all expected come to work every day and do our jobs.  We take care of patients.  We put our personal feelings, stressors, and worries aside and meet our patients where they need us, and nobody knows what we might be dealing with ourselves.  But we do this now during a mind-bending crisis of national conscience.  Now is the time when our emotional and social support networks are called forth and tested.  As a physician, a default leader of the patient care team, how can I not acknowledge this profound disturbance of our collective consciousness?  How can I expect my team to perform optimally in a false vacuum?  The realities of our world are simply inescapable, and they affect us all, like it and accept it or not.

I may not be marching in front of Congress or the DHS.  I may not be writing legislators or calling them every day.  I am not a designated leader of my professional society, publishing op-eds on the long term health and societal consequences of our government’s actions.  But I can absolutely stand up in solidarity with and for the people closest to me.

So this week I expressed to my teams in no uncertain terms that whatever anyone is feeling or going through right now, they should know that their physician leaders support them, and we will be here for them however they need us, just like we are all here for our patients.  I made no overt political commentary.  I simply acknowledged the moral morass I see in our country and tried my best to make it safe for us all to experience it together, out loud and in person, and to help one another through it.

If there were ever a time for physicians to walk the talk as leaders, as caregivers for the caregivers, it is now.  I know now that I don’t have to be the loudest or most visible ‘activist.’  I just have to act in accordance with my core values.  And it starts with holding up the people right next to me every day.