November 23:  Range Makes Me Better

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NaBloPoMo 2019

One of my teachers in med school told me why he loves primary care.  He said at any time, he can decide he wants to be more expert in something and do it for a while, like managing all of his patients’ thyroid illnesses, rather than referring to endocrinologists.  Then when he gets tired of that, he can start referring again and do something else, like nonsurgical orthopaedics.  That was over 20 years ago…  The complexity of both medical knowledge and practice has expanded exponentially since then, so I wonder if he still thinks this way?

Regardless, I agree.  Being a generalist affords me tremendous flexibility and freedom to explore and apply from all fields of medicine.  While I could never approach the expertise of my specialist colleagues, I get to (and to a large extent am expected to) learn a little about everything.  That breadth of exposure and knowledge makes every workday unique and stimulating.  This week, I’m listening to Range by David Epstein, a book that validates everything about my generalist, boundary-spanning life.  From the book description:

Range makes a compelling case for actively cultivating inefficiency. Failing a test is the best way to learn. Frequent quitters end up with the most fulfilling careers. The most impactful inventors cross domains rather than deepening their knowledge in a single area. 

I feel validated about this because I’ve never been especially good at any one thing (except today I’d say I’m an exceptionally good communicator, though that’s a highly subjective and biased self-assessment).  I have, however, observed, explored, tried and experienced myriad things, and I have always seen this as an asset.  And now a New York Times bestseller affirms it. Yay!

Growing up bilingual and bicultural gave me a huge advantage for living and working in an increasingly diverse global society.  Before I started piano, I learned classical Chinese painting in two styles, as well as Chinese folk dancing.  I started skiing in elementary school, volleyball in middle school, golf in college, and in my 40s have picked up kettle bells, yoga, and TRX.  I learn coaching techniques from being coached.  I learn about leadership from reading and interrogating my patients who are leaders, and now actually leading some folks.  I interact with information through podcasts, audiobooks, paper books and journals, and online formats.  I read New England Journal of Medicine and Harvard Business Review, Annals of Internal Medicine and Fast Company, Journal of the American Medical Association and Psychology Today.  I prefer nonfiction, but I recently joined a book club and read my first novel in many years.  My music playlist includes Dierks Bently, Camila Cabello, Bruce Hornsby, Shawn Mendes, Miranda Lambert, Sara Bareilles, The Piano Guys, Mamma Mia and The Greatest Showman soundtracks, John Denver, and Pink.  I attend conferences focused on clinical medicine as well as communication.  I speak to audiences of physicians, business leaders, and designers. I make washi tape cards and moderate Better Angels communication workshops.  It’s kind of an eclectic list of activity; please forgive my self-centered navel gazing here.

If you make a similar list for yourself, I bet it will be more diverse than you think.  How does this help you, make you better?

Epstein posits that generalists’ advantage lies in their ability and propensity to see deep relational connections between diverse domains, use analogical thinking, and practice ‘active open mindedness.’  He also provides multiple examples of when specialists’ narrow perspective hinders creativity and innovation, and even effective problem solving.  Throughout, however, he acknowledges the complementary, yin-yang relationship between focus on the specific and wide-ranging view of the broad.  The book just makes my ENFP heart sing.

I honestly believe range makes me better…  For no other reason than giving me a life full of new and exciting experiences to write about on a blog.

 

November 17:  Elasticity Makes Me Better

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NaBloPoMo 2019

What was school like for you growing up?  Were you bored?  Confused?  Frustrated?  I had a pretty easy time, but many of my classmates did not, even the ‘smart’ ones.

In high school I was on the speech team.  One of my events was persuasive speaking.  I chose one year to advocate for teachers to broaden their teaching styles to match a wider variety of learning styles.  I used the Gregorc Mindstyle Delineator as an example of how styles can vary (mine is Abstract Random, go figure).  It was an interesting thesis and I sincerely believed what I wrote and presented in those 8 minutes each weekend.

Thirty years later, I wonder how much I walk this talk of meeting people where they need me.  Simply asking the question, raising my awareness, makes me better.

Parenting.  It doesn’t matter how many parenting books you read or how well you think your parents raised you.  General principles apply, of course.  But every kid is unique, and we parents do better when we realize that the methods we use for anything on kid #1 won’t necessarily work with kid #2, #3, an onward.  Flexibility is key to a happy and functional household, for getting out the door every morning without yelling.

Marriage:  According to the Dr. John Gottman, about two-thirds of marital problems are perpetual, meaning they will never actually resolve.  So how do couples stay together successfully?  Among other things, they learn to accept one another and work around the hard stuff.  At least partially, we have to soften our rigidities, learn to bend and sway, embrace the supple, intimate dance of commitment.

Teaching:  Not all students learn best by watching.  Not all learn best by doing.  Or by hearing, mimicking, or competing.  Luckily, medical education gives trainees multiple platforms on which to acquire the necessary knowledge and skills to care for patients.  For all its flaws, our profession actually does well here.  I’m happy that I realized this in my own experience.  When I precept students in clinic, they shadow, scribe, see patients alone or lead a joint encounter, so they can experience the work from different perspectives.  I think this mutual versatility and adaptability makes us all better.

Patient Care:  Over the years I have accumulated myriad articles and books to share with patients.  But not everybody’s a reader like me.  Not everybody wants to meditate or journal.  Some people do better with a personal trainer, others in spin class.  It’s my job to assess how each patient is most likely to succeed in health habit optimization, and present the most appropriate resources for consideration.  Primary care definitely does not work with a one size fits all approach.  So now I include audiobooks, podcasts, phone apps, and YouTube videos in my repertoire of medical information sharing.  I am blunt when it’s needed, and also gentle and diplomatic.  I can speak from the head and the heart, often both at the same time.

Speaking Engagements:  Here is where my elasticity has grown the most in recent years.  For the first decade of my career, I still used the expository presentation style I learned in high school.  Thankfully in 2014, I watched Nancy Duarte’s TED talk on transformative oral presentations, and then read her book, Resonate, in 2015.  Make the audience the hero, she says.  Tell a story, contrast what is with what could be, paint the vision of the blissful future clearly.  Engage people’s emotions and aspirations.

This is not easily done with Power Point decks full of words.  But words are my medium!  I had to add color, diagrams, cartoons, photographs.  I started making my presentations more interactive, between myself and the audience, and between audience members themselves.  Now I have people stand up and move their bodies.  I may bring raisins to my next talk and do a mindful eating exercise.  I need to learn how to embed music and videos into my slides.

What is the objective in all of these relationships?  It’s connection.  How do we best connect?  We reach out.  We extend ourselves to others—make ourselves relaxed, flexible, spring-like.  That is how we gather people closer.  It’s not formless or weak.  A strong elastic maintains its integrity even under high tension.  But it must be stretched often, or it becomes stiff, brittle, and ultimately ineffectual.

 

November 16:  Loving Subversion Makes Me Better

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NaBloPoMo 2019

Friends, do you already follow Seth Godin’s blog?  His post from Thursday stirred something a little irreverent in me.  It was about ‘allies and accomplices’:

To be an ally means that you won’t get in the way, and, if you are able to, you’ll try to help.

To become an accomplice, though, means that you’ve risked something, sacrificed something and put yourself on the hook as well.

We need more allies, in all the work we do. Allies can open doors and help us feel a lot less alone.

But finding an accomplice–that’s an extraordinary leap forward.

I thought immediately about my fellow Better Angels volunteers.  We have all committed time, talent, and treasure to the depolarizing of America.  We do it in public, in front of audiences and cameras, to reporters and members of our communities.  We openly challenge the prevailing culture of ad hominem, oversimplification, and overgeneralization.  We all come to it from our own internal optimism and hope.  But in the face of entrenched polarization and a culture of self-protection above all, we could never make any headway as individuals.  It is only together—as mutual accomplices—that we can truly claim and exercise our collective agency.

I feel even more buoyed by Ozan’s latest post.  He describes a series of well-known studies showing that people will organize themselves into in-groups and out-groups with remarkable loyalty, even around random and arbitrary distinctions like taste in abstract art.  This, of course, carries grave and important implications for prejudice and discrimination.  Ozan then points to two exemplars of the opposite, Dr. Martin Luther King, Jr. and Barack Obama.  In their most famous orations (see links), these remarkable leaders speak directly to what unites us as the foundation for solving our problems, rather than what divides us.

MLK:  The marvelous new militancy which has engulfed the Negro community must not lead us to a distrust of all white people, for many of our white brothers, as evidenced by their presence here today, have come to realize that their destiny is tied up with our destiny. They have come to realize that their freedom is inextricably bound to our freedom. We cannot walk alone.

Obama:  The pundits, the pundits like to slice and dice our country into red states and blue States: red states for Republicans, blue States for Democrats. But I’ve got news for them, too. We worship an awesome God in the blue states, and we don’t like federal agents poking around our libraries in the red states.  We coach little league in the blue states and, yes, we’ve got some gay friends in the red states.

I get goosebumps just reading the words.

It really feels like a loving subversion—of cynicism, scarcity, antagonism, and fear.

Who’s not better for that?