Category Archives: leadership

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?

 

 

 

November 11:  Fierce Optimism Makes Me Better

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NaBloPoMo 2019

On Ozan’s Inner Circle forum today, another member posted about his admiration for Dr. Martin Luther King, Jr.  It reminded me of a favorite MLK quote, which came to mind on Saturday as I prepared for the Better Angels workshop:  “The arc of the moral universe is long but it bends toward justice.”  I have referred to this quote many times over the years, and a phrase that I often add goes something like, “Bend that arc!  Hang on it with all your might!”  Meaning the arc bends toward justice only because we make it so, by working tirelessly for it, by acting visibly in accordance with our core values, and by consistently walking the talk.

I texted my friend the morning of the workshop: “I’m 90% excited, 10% nervous…Maybe 15%…”  Then I thought about the people I know who like the idea(l) of Better Angels, but don’t want to participate.  I thought about my friends who express hopelessness at any possibility that people on opposing political sides can ever connect, that we can actually work together across our differences to get things done.  I thought about the pushback I might get, that the Better Angels mission is futile, a waste of energy and time.  I felt something akin to a tidal wave rise within me, and I texted my friend again, spontaneously, “I intend to make today a day of fierce, infectious optimism.”  At that moment I knew my goal that day was to take every example and experience of kindness, connection, empathy, openness, generosity, magnanimity, conviction, and hope, and channel it to the workshop and its participants.  Because though it was to be a skills workshop, teaching a way of doing, what we really need are all of the qualities I just listed—they are the way of being that brings the skills to bear in the most meaningful ways.

This idea marinated for a couple of hours while I pictured the venue, reviewed the workshop content, made notes about delivery.  I thought again about my friends who feel like our world is crumbling around us, that so much progress made the last century is being eroded.  I completely empathize with this perspective, and I understand how it makes us feel we have to fight, to be aggressive and confrontational, to come at the opposition full force, like a bullet train.  Do they think listening and speaking skills focused on curiosity and openness too passive and ineffective?  Does optimism, the hopefulness and confidence that things will be okay, make me lazy about the issues that matter to me?

Below are the words I texted my friend to describe what I mean by ‘Fierce Optimism’.  Normally I would not share such nascent ideas on the blog, but whatever, it’s all an experiment, who knows what better ideas may come from this early sharing?

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Fierce Optimism Is:

Urgency with Patience

Or should it read, “Urgency without Impatience”?  What I mean here is simply that most things worth doing take a very long time.  All important social movements occurred (and continue) over generations.  At times confrontation and revolution are necessary.  But they are not enough.  Consistent, slow, organic, grass roots change on the local level is what sustains consistent progress, keeps it from regressing.  The acute urgency I feel to address my deep concerns (for instance, the profound rifts in our relationships) drives me to action.  But when that action is directed at another person, I must attune.  I have to set realistic expectations for how much I can move this mountain today.  Pacing myself, practicing persistence with patience, conserves energy and prevents burnout.  It also allows me to look up every once in a while and adjust to my surroundings, adapt to subtle changes, like when someone starts to soften.  If I’m bulldozing with strong words and heavy dogma, I am more likely to plow over and through any crack in the door of someone’s mind that might have swung open freely had I taken a more gentle approach.

Strength with Flexibility

Better Angels does not seek to make everybody—anybody—a moderate.  Rather, the goal is to hold our positions firmly and with principle, and practice seeing why someone else may hold a different position with equally strong principle.  In doing so, two things often happen:  First, by challenging our own beliefs and values, we can reinforce them.  Telling stories about the experiences that led us to our core values reconnects us with their origins, grounds us in and strengthens our own personal truth.  Second, hearing others’ stories helps us broaden our perspective.  Most of the time we only see things from our own point of view—this is our default setting.  But when we share personal experiences, really learn about each other, the curtains open on a vast landscape of understanding that we may never have imagined.  So while I may still hold my goals and objectives firmly, I can more easily release the rigidity of my method, tolerate setbacks with less suffering.  Earlier this year I listened to The Warrior Within by John Little.  He describes Bruce Lee’s life philosophy, which included a metaphor of the bamboo and the oak.  Both are admirably strong, but under intense forces of nature, the oak may break while the bamboo simply bends, sometimes to the ground, but without breaking.  Both stay rooted where they are planted, but one is more resilient.  Listening with openness and curiosity is not weakness.  Allowing for nuance and the possibility that my mind may be changed in some ways, while holding steadfast to my core values, makes me calm, agile, adaptable, and, I think, more effective.

Conviction with Generosity

This is about the assumptions we make.  Too often we cast ‘the other’ in abstract as sinister, evil, less than.  We hold up the most extreme members of the opposing group as representative of a dull and dumb monolith.  We oversimplify and overgeneralize, and then approach any individual we identify as belonging to that group as an assembly line package, a completely known entity.  We think we know all about them already, even if we have never met them, just because they identify today as “Red” or “Blue.”  In so doing, we make ourselves small.  We become exactly as narrow minded and prejudiced as the folks we accuse on the other side.  How ironic.  Now more than ever, we need generosity.  In my mind this encompasses empathy, vulnerability, sincerity, humility and a willingness to allow the complete humanity of every other person, regardless of their political, religious, racial, cultural, or any other persuasion.  Conviction without generosity too easily becomes tyranny, for individuals as well as organizations and governments.

*sigh*

Well, like I said, these ideas were just born two days ago.  Have I expressed them at all coherently?  Have I shown you intuitively apprehensible paradoxes?  Can you feel the dynamic balance of agitation and peace?  Tension without anxiety?  Potential and kinetic energy?  If not, that’s okay.  I’ll keep working on it.  That’s the essential outcome of Fierce Optimism, after all—we keep working, steadily, to bend that arc.

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November 6:  Caring For the Team Makes Me Better

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“How does he treat you?”

I don’t only ask this question of women whom I suspect of being abused at home.  I also ask my medical assistants.  Not about their domestic partners, but about our patients.

In my first practice, I sat/stood to the left of my medical assistant every day for six years.  It was a cozy (cramped) little counter space stacked with charts from end to end, with a couple of high-wheeley chairs.  Each chart stack had a laminated cover on top:  “For Cheng to Review/Sign,” “For Rose,” “Labs,” and “Messages.”  Charts journeyed from my left to my right/Rose’s left, to the bin under the counter to be filed.  It was incredibly efficient, actually.  I had a handwritten emoji system for indicating (dis)satisfaction with cholesterol and diabetes results.  Rose knew all of my patients and how to communicate sentiments and instructions clearly and lovingly.  She had been an MA since I was a kid; she knew what she was doing.  If a patient had a question on the phone, she could put them on hold and clarify with me, or I could just get on the phone and speak to the patient myself.  We were busy and happy, a well-oiled team-machine.

One day as I came up to my spot at the counter, I noticed an unusual sound next to me, like a distant, scratchy loudspeaker.  I turned and saw Rose holding the phone receiver about an inch from her ear.  The sound was my patient, yelling profanities at her so loudly I could hear his words from two feet away.  I can’t remember what the issue was, but he was obviously upset, and taking it out on her.  It surprised me because I had only known him to be sweet, respectful, and grateful.  Maybe he was just having a bad day?  I looked at Rose, who rolled her eyes and exhaled heavily.  I asked her to put him on hold so she could catch me up.  Apparently this had been going on longer than I knew, and she had not told me.  Had I not come upon it in real time, she may never have told me.  She would have simply tolerated it.

I picked up the call and declared myself.  He was the usual, respectful and calm patient I had always known.  I answered his medical questions.  Then I told him firmly that he did not have the right to treat anyone in my office the way he had just treated Rose.  I think there may have been some excuses and then an apology.  I made it clear that if he abused my team again, he would be discharged from the practice.  He agreed and apologized again.

That was my first opportunity to stand up for my team as an attending.  I will forever remember it.  I was a petite, young, Chinese woman doctor, speaking to a white man decades older than myself.  I stood up for my medical assistant, a woman of color and a couple decades older than me.  She had felt powerless to stand up for herself to his verbally vomitous abuse.  All I had to do was pick up the phone and say, “Mr. Soandso, this is Dr. Cheng.”  He never yelled at Rose or anyone in the office again, to my knowledge.  How could I have this much power, and why had nobody asked me to wield it in their defense before?  It was just accepted that patients could yell and scream at our staff, with no consequences?

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We recently discussed abusive patients during our regular doctors’ meeting at my current practice.  Immediately I thought, HELL NO.  The good news was that our team members feel safe reporting incidents to our managers and physicians.  My partners and I have all had to call patients to clarify our expectations of respect.  We understand that illness is stressful.  We understand that our healthcare system, especially at a large, bureaucratic institution, causes frustration, even rage.  However, none of that ever justifies or entitles a patient, or anyone, to belittle, dehumanize, or otherwise degrade another person, and especially not a team member who is doing their best to help–ever.  At this meeting, gratifyingly, we all voiced definitive confirmation that we fully support our team, and we will, without hesitation, educate and/or discharge any patient who violates our team’s right to a collegial and non-threatening work environment.

Even as I write this, I shake a little with rage and outrage at these patients’ behavior.  I can feel tightness and tension in my chest and abdomen, my breath quicker and shallower than its usual resting state.  I wonder if this triggers me because my mom is a nurse and I have seen how patients in the hospital abuse nurses.  I also know how women physicians are mistaken for nurses and thus ignored or dismissed, even by female patients.  I have known racism and sexism first hand.  But as a physician, I’m in a position to not have to tolerate it.  By virtue of two letters after my name, I have the power to protect my team, with authority.  And I work with other physicians who also recognize both this power and its attendant responsibility.

I hope our team feels protected, defended, and loved by us docs.  We may be the default work unit leaders, but they do the lion’s share of work that allows our practice to run as smoothly and successfully as it does.  They are who let me do my work as well as I do.  I depend on them every day.  So caring for them absolutely makes me better, makes us all better.