An Early Resolution

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NaBloPoMo 2017: Field Notes from a Life in Medicine—Last Post

It’s December 1 here in Chicago, but I have almost 2 hours before midnight in California, and 5 hours in Hawaii, so I’m still counting this post as on time.  Meh whatever, it’s my blog and I can do what I want—last post for NaBloPoMo 2017, woo hoooooooooo!!

Okay so, when was the last time you gave another driver the finger?  I can’t even remember myself, maybe high school?  Definitely by the end of college I had stopped, and I can honestly say I probably only ever did it a handful of times.  In college I was in a car with friends and the driver cheerily wagged his finger at another car that had cut us off.  He didn’t get angry, but rather acknowledged the rudeness with humor.  At least I thought it was humorous.  So I’ve been doing it ever since—but with varying degrees of good humor.

Last week I was driving to work (you know what’s coming).  As I approached an intersection about 1.5 car lengths behind the sedan in front of me, where we had no stop sign but the cross street did, I could see a car inching out at the corner.  I anticipated that it would try to make a turn after the car in front of me passed, thereby causing me to have to slow down.  Sure enough that’s what happened, and I wagged my finger.  I suppose my intent was to shame, I’m embarrassed to write.  If I were that driver, I might have felt ashamed, and also annoyed at the gesture.  He, in turn, showed me a stiff, straight middle finger, accompanied by an unmistakable expression of the very same message—eye contact and all.

That hurt my feelings, I’m also embarrassed to report.  Not quite sure why I’m embarrassed—because I kind of deserved it, or because we’re not supposed to let stuff like this get to us?  Whatever, it felt bad and I didn’t like it.  After reflecting over the next mile or so, I decided that from now on I will simply treat other drivers with kindness first, regardless of the crazy antics they perpetrate on the roads (and let me tell you, in Chicago it can get pretty crazy).  That is the resolution that makes me feel the best.  And now I’m even more embarrassed and ashamed because this is pretty much how my mom treats all drivers (all people, really) since I can remember.  Well, better late than never.

I’m trying to remember how I came to this conclusion, because it took like quick-drying super glue, and I have abided by it firmly ever since.  I tried to imagine myself in that driver’s place.  What would make me in such a hurry that I would intentionally inconvenience another driver, who has the right of way, to get going just a few seconds sooner?  Was he really late for work, or to see a sick relative in the hospital?  Was he just an impatient driver in general?  Regardless, was my finger wagging helpful to either of us?  Would it make him less likely to do the same thing again?  Maybe it would have been better if I had waved, offered some grace and generosity of spirit?  If I were him, I would certainly appreciate that more than a pompous finger wagging.

Exercising patience and generosity on the roads is easier said than done, though, am I right?  Surely I cannot be the only one challenged by this?  Now that I think more about it, maybe my embarrassment at feeling hurt by his gesture relates to the fact that society tells us in a lot of ways that we’re not supposed to treat other drivers as human—and thus not be affected by them.  Jockey for position, don’t let ‘em in, fuck ‘em.  Stupid gestures should mean nothing, because we’re simply expected to treat one another like garbage.  It feels like this when I let someone in my lane and they don’t wave.  No acknowledgement, no appreciation.  That doesn’t feel good, and it’s not who I am.

Long ago I realized that I almost never need to get anywhere so urgently that I need to cut people off or risk my safety, or that of my passengers, in the car.  Whenever I see someone signaling to get in my lane, I almost always make space for them.  I try to avoid entering intersections I cannot clear, because I hate when cars do that and cause gridlock, especially at rush hour.  But somehow I didn’t see the finger wag as contrary to these other acts of driving courtesy—in this respect I guess I was stuck in the ‘fuck ‘em’ mentality.  So it makes sense that after experiencing the other side, and so emphatically, I realized that the only thing to do for my integrity is to reject that behavior altogether.

So, no more finger wagging.  Maybe I’ll take a deep breath and find some other, more neutral expression?  It feels necessary to acknowledge my own frustration, but not necessarily to project it on the other person.  Maybe I need a mantra.  *Deep breath* “You be safe now.”  *Deep breath* “You do you, I’ll do me.”  *Deep breath* “Thank you for not hitting me.”  *Deep breath* “I remind myself that you are a fellow human being, and we are all here doing the best we can.”  Maybe a more succinct version of that last one.  I’ll work on it.  I’m sure I’ll be working on it for a long time yet.

_ _ _

Thanks to all who have read along this month, it’s been fun!  Now onto holiday cards, each of which I will once again attempt to write by hand this year.  It just feels like the right thing to do, and I get to break out my fun colored pens.  In case I don’t make it back in time, Happy Holidays to all, and best wishes in 2018 and beyond!

Mom Love

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Somehow tonight I got to thinking about all my patients who are moms.  I am filled with love and admiration, and compassion for all of them.  Maybe it was because today that is what I did most—momming.  Chauffer, meal planner, shopper, meal preparer, science project thingy seeker, organizer of the week to come (meal planner, babysitter/transport arranger, meal planner, shopping planner, piano lesson re-scheduler)…

I feel so grateful that I can work part-time.  I accomplish most of these life tasks on days when I’m ‘not working,’ as I used to say.  Now I call them days on which I ‘don’t see patients.’  All moms work; it’s a full time job with intangible and transcendent benefits, as well as hellish hours, often disproportionately low appreciation, and obviously no financial compensation.  Some of you may have seen a popular article this year on the mental workload of moms.  I highly recommend the short read.  Here’s a slightly older article that also includes references to research on the ‘work-home gender gap.’  And I absolutely love this eloquent, hilarious, and heartfelt to tribute to moms from last year, which is basically encapsulated in the first sentence: “I am the person who notices we are running out of toilet paper, and I rock…”

What tugs at my heart the most sometimes are the moms who have chosen to stay at home, giving up, at least temporarily, a fulfilling and meaningful professional career.  So many of them feel conflicted over making this choice, and then shame over feeling conflicted.  Countless times I have heard some version of, “Please don’t think I don’t love my kids, because I LOVE my kids!  …But (sheepishly) being with them 24/7 is so tiring, and I really miss using those other parts of my brain, having conversations with adults, and solving problems that employ my education and training.  But I love my kids, really I do, and I love being with them and I chose this and I know I should feel so grateful that we can afford for me to stay home, I just feel so guilty for ever wanting to be away from them, what good mom wants that??  But I’m so tired, and sometimes (pause) I wonder if I should have kept my job, worked it out somehow?  I never thought I would feel so torn.”  In these encounters I do my best to validate my patients’ choices, to reassure them that in no way do I question their love for their children just because they long for the company of peers and colleagues, and to address the consequences of their inner conflicts on their health and relationships—with self and with others.  I feel sad and angry that anyone would shame a mom for wanting to have a meaningful life outside of momming.

There’s the guilt of the working mom, also—which springs from the same pathological thinking that no good mom would want to be away from her kids.  But somehow these women seem easier to console, in my experience.  They often derive significant meaning from their work, and even if that is not the case, they take pride in providing for their families.  They also often report seeing themselves as role models for their daughters.  Regardless, I hate that these women have to deal with the same social gremlins as their stay-at-home counterparts—that somehow being a mom and having a career are necessarily divergent ideals.  This is an example of a false dichotomy that serves no useful purpose, and causes many of us to suffer unnecessarily.  Thankfully, others have written extensively on solutions; I really like this article on 8 ways to overcome mom guilt, regardless of your W2 status.

In looking up the articles for this post, I also came across this one, addressing the invisible mental workload of men.  I’m so glad I read it, because it reminds me of another fallaciously dichotomous rabbit hole: when we start exploring and addressing women’s challenges, the discussion too easily devolves into man-hating.  I claim my own susceptibility to this mindset, and thankfully this article helps me rein it in.  The same antiquated social pressures that tell women they ‘should’ always want to stay at home also tell men that they ‘should’ always want to be at work, and GAAAGH, it just kills all of our souls, a little at a time.  The author, Josh Levs, writes:

“All women who notice and keep track of their families’ many needs deserve big props and respect for it. So do the men who do this work. It’s crucial, detail-oriented, and never-ending. It makes a home a home.

“For 2017, let’s resolve to put aside misguided gender assumptions and work together to achieve a better balance and healthy work-life integration—for the sake of women and men.”

I wholeheartedly agree.  Let us stop with the guilt trips and shaming, and give all moms, and dads too, all our love for the ‘momming’ we all do!

 

The Movies That Move Us

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NaBloPoMo 2017: Field Notes from a Life in Medicine

The weekend has gone by too fast, and I have done none of the tasks on The List.  Oh well, it’s all good.  I got up this morning and made the green onion pancakes that my daughter loves so much.  We had a very successful shopping binge at Trader Joe’s and Target, woo hooooo!  And in between, we had something of a Christmas movie marathon:

“Love, Actually” (2003)

“The Holiday” (2006)

“While You Were Sleeping” (1995)

I’ve seen each of these movies so many times that I anticipate my favorite lines with giddiness and delight.  But they often end up serving as background on theTV as I accomplish other things.  Today, though, I was able to relax, sit, and watch.  It was touching and emotional, something of a re-centering.

What I love about each movie is how human all the characters are—there is something to relate to for every aspect of humanity in these films.  No one is perfect but all are lovable, all are flawed.  The relationships between characters—siblings, spouses, neighbors, friends, coworkers, parents, children, boy/girlfriends, and ex-es—are all interconnected, interdependent.  Somehow, watching these three movies in a row today, I’m struck by the portrayals of vulnerability, honesty, humility, judgment, love, and commitment, as well as lapses thereof.  It’s all so real, so human.

The hero’s journey is real.  We are all called to our own adventure, inevitably facing challenges and conflicts against our will.  We search for the easy ways out, alternative paths around our problems.  We avoid the hard feelings, the discomfort, the morass.  And then, somehow, we find a way—we meet someone who can help, we marshal our resources, we find the inner strength to do what’s needed, to carry on.  It’s messy and awkward, meandering and stumbling, often also hilarious and worthy of eye rolls and head shakes.  Looking back we find ourselves thinking, “Well why didn’t I just do that in the first place?”  And we can also appreciate the inevitable, valuable learning from the missteps and wrong turns.

Movies are movies, of course, not real life.  They are an escape.  They are also a mirror, as most art is.  They tell our shared stories, remind us of our relationships and connections through time, across nations, between genders and generations.  They’re called “movies” because they are still pictures shown in series to give the illusion of movement.  But perhaps we can think of them as moving us at our core, drawing us nearer to one another through shared experience and imagination.  The best movie experiences leave us a little cracked, a little exposed, a little sensitive—or a lot.  They remind us of our core humanity, inviting us to bring it forth and live it in authenticity.

Many thanks to all those who create and contribute to this art form.  You make us better.

To You Who Hold Me Up

 

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October 27, 2017

My Dear Friend,

Thank you so much for hosting me this week!  Your home is a simple and inspiring space—you have clearly arranged and furnished it according to your core values, and its energy is palpable.  OF COURSE you’d orient the sofa squarely facing the big window and rising sun!

I am so grateful to know you, to enjoy welcoming access to your perspective, your experience, your generosity of spirit, and your willingness to explore the unanswered, the uncertain, the mysterious, the daunting.  Because of friends like you, I am a better version of myself.  I hope I can return the favor in your life.

Until next time—love and hugs–

🙂 ❤ Cathy

***

I wrote this to a particular friend today.  Then came the joyous realization that I have many friends to whom I could write the same.  They live their integrity every day, out loud and in person, with clarity, consistency, and discipline.  How lucky am I to be surrounded by such uplifting forces of nature?  Our shared curiosity saves us from cynicism.  Collective love emboldens us to ask the scary questions and stand strong facing the unknown.

None of us can know what’s coming around the corner.  It’s okay to feel afraid sometimes.  Things might suck rocks for a while.  And in the end, because we know we have one another, we also know we’ll be okay.  We walk together, laugh together, wonder together, and learn together.  We are truly stronger and better together.

How can I help but feel hopeful?

Applying the Wisdom of Atticus Finch

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“You never really understand a person until you consider things from his point of view—until you climb into his skin and walk around in it.”

–Atticus Finch

To Kill a Mockingbird, by Harper Lee

 

How do you practice and achieve empathy?  How do you notice others doing it?

It’s been on my mind a lot these last two weeks.  Current American politics resembles an interminable abscess, oozing ever more copious and putrid gobs of pus, from ever more unforeseen tracts of deep, diseased tissue.  How can we find any Healing Connection in the midst of all this?

Here’s my answer:  Role play and storytelling.

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Role Play for the Good

I used to hate role play, and now I jump at any chance to try it!  It all changed through a 7 week teaching workshop I did during my chief resident year, and I am forever grateful for the experience.  Now I regularly use role play to teach motivational interviewing, or MI, to medical students and residents.  Put simply, MI is a counseling technique that focuses on patient autonomy, and aims to reinforce intrinsic motivation for change.  My teaching method has evolved over time, due to my own unexpected experience of ‘climbing into the skin’ of others.

In the beginning I used to play the patient, letting students take turns practicing their MI skills on me.  After a couple of sessions I realized that even though I was pretending, I really felt like the students were earnestly trying to help me change my health habits, or making me feel bad about myself, depending on their proficiency.  So to give them the benefit of this perspective, I had them take turns playing both patient and physician.  The feedback revealed a richer, more insightful experience for all.

In 2015 I attended the Active Lives conference, where my technique was further enlightened.  I got to role play four times with a partner: first as patient, then physician, doing it the ‘wrong’ way (directive, authoritative, confrontational), and again in both roles doing it the ‘right’ way (collaborative, empathetic, nonjudgmental).  I felt the immediate contrast of the four roles emotionally and viscerally.  When all I heard from the doctor was, “Yes, I know you’re busy, but you have to find time to exercise,” and “Why don’t you do this…” and, “You should… You need to… If you don’t, then…” I felt absolutely no impetus to take any of this advice.  But questions like, “How important is it to you to…  How confident are you to… What would it take…what would need to happen in order for you to…” and, “What would life be like if…” invited me to explore possibilities, helped me to imagine and create my own future.  As an authoritative physician, I felt frustrated at my patient’s resistance to my evidence-based and well-intentioned advice.  By contrast, as a collaborative doctor, I feel freed to embark on an improvisational Yes, And adventure to reveal each patient’s personal path to healthier habits.  Now I offer my students the opportunity to experience all four roles.

I remembered this insight evolution last week when I came across a 1970 video of Jane Elliott’s classroom racism experiment.  She divides the class by eye color, asserts that blue-eyed children are better than brown-eyed children on one day, then reverses the premise the next.  While she makes privilege assignments that likely would not fly today, she also debriefs with the kids, helping them identify their assumptions, feelings, actions and reactions—much more authentically and directly than I think we are willing to do today.  She does it all without judging or shaming, pointing out biases and encouraging her students to examine them for themselves.  I admire her for pioneering this exercise, and I bet it affected her students in profound and lasting ways.

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The Importance of Story

Clearly, we cannot possibly depend on such academic practices to develop everyday empathy.  Luckily we now have infinitely easier access to one another’s stories than ever before, which is the next best thing.   Lately I feel a keen new appreciation of the importance of storytelling for conveying experience and stimulating mutual understanding.  Obligingly, the universe (read Facebook) has provided me with numerous testimonies of my fellow humans’ experiences and conditions, and this week they touch me even more acutely.  Here are some of them:

  • Former white supremacists talk about the importance of upholding others’ humanity, even as we denounce their beliefs.
  • A black writer recounts multiple instances of racism over her lifetime, inviting her white high school classmate to imagine and consider how they exemplify his white male privilege.
  • The head of neurosurgery at the Mayo Clinic in Florida tells his story of illegal, then legal immigration, and a subsequent life dream realized.
  • Neil DeGrasse Tyson shares stories of genitals on fire, educators’ responsibility to the electorate, pressure from his black classmate to contribute to ‘the black cause,’ realizing that he is doing just that, and why he wants to be buried instead of cremated (he has changed my mind, by the way).
  • David Duke’s godson credits the college friends who welcomed him despite his pedigree, with helping him defy and shed it.

 

What’s the Point?

The overarching goal here is to intentionally thwart the abstraction and dehumanization of people who are different from ourselves.  Stepping into another person’s shoes, ‘climbing into (their) skin,’ imagining how they feel, and actually feeling it—this is the best protection against bias, prejudice, and discrimination.  Empathy forms the sticky webs of connection that stymie the hymenoptera of hatred mid-flight, or catch us in the face and remind us to look where we’re going.  Where do we want our thoughts, words, actions, and relationships to take us?

I imagine a world of colorfully flawed humans, who acknowledge our biases openly and honestly; who recognize the risks that those biases carry; who accept ourselves, warts on soles and souls and all; who commit to a lifetime of extending that acceptance to one another; and who understand that it is our relationships, all of them, that kill us or save us.

So let’s play and tell—and feel and listen.  Really,  it’ll be good for all of us.

 

Only Love Can Win

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Holy hell, what a week.  How are you feeling?  Most people I know express some combination of shock, resignation, rage, disbelief, hopelessness, gloom, and resentment.  I’m trying hard to practice Radical Acceptance.  It’s similar to the second arrow principle, in that at the very least, it lessens my own suffering from our collective circumstance.  But more than that, it allows me to focus more on what I will do, than seethe around my negative reactions.

I’m thinking of the Twitter account named Yes, You’re Racist.  Apparently the owner wants to identify the white supremacists who marched in Charlottesville, to publicly shame them and possibly get them fired from work. At least one person has lost his job based on a photo posted to the account.  What do you think about this?  I admit, my first reaction was positive.  Yes, call them out, make them accountable, I thought.  But then I wonder what good will this do?  Will the guy who got fired from the hot dog place suddenly think it was morally wrong to attend the march?  Or will he interpret his employer’s action as further proof that the liberal left conspires to restrict free speech and assembly, thereby deepening his animosity toward anyone who opposes his views from the left?  Will it open any space in his mind to consider why white supremacy is wrong, or help him acquire empathy or compassion toward any marginalized group?  Or won’t it just drive his racist expressions underground?  Doesn’t public shaming like this run the risk of re-closeting these people, so their grievances foment in the dark, only to be released again under pressure, in some act of overt violence?

I think about the fights between marchers and anti-protestors—between those who wish to incite violence, and those who succumb to the provocation.  To be clear, the Neo-Nazi, white supremacist marchers who descended on Charlottesville represent a vile and unacceptable set of ideas.  They are the villains.  And, fighting violence with violence is never a good solution.

So, we ask, what can we do?  How do we respond?  Maybe it’s because I’m on vacation this week, communing with nature in the mountains and watching the annual Perseid meteor shower from 10,000 feet, on a clear, literally stellar night, surrounded and awed by our millennia-old universe.  It keeps me from stalking Facebook quite so many hours a day, and gives good perspective.  I feel somehow more capable of saying, This is how things are.  It sucks.  It’s wrong.  And I can still make a difference.

In the end, I believe Only Love Can Win.  Blaming, shaming, belittling, and otherwise demeaning people for certain beliefs, actions, or associations—hating them—does not help.  What does help is offering compassion and empathy, and listening to understand.  I know I have said and written it many times, and I know many will argue that now is not the time to ‘get soft.’  But believe me, practicing love in the face of hate is anything but soft.  Let me share some resources that illustrate this, and that hold me up.  This is a very long post, and I hope you will stick with me ‘til the end.

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Agape Love

Maria Popova, curator of the illuminating blog Brain Pickings, inspires me with her summary of Dr. Martin Luther King’s 1958 essay “An Experiment in Love.”  I refer to this article often since January 20.  Dr. King explores six tenets of nonviolent resistance (below).  It reminds me that while I vehemently oppose bigotry, racism, sexism, misogyny, xenophobia, and fascism, I can do it with a peaceful heart, full of love for humanity, and with faith that even my small contribution of said love can make a difference.  Here are the highlights of her piece, MLK’s words quoted:

  1. Nonviolent resistance is not passive cowardice. “For while the nonviolent resister is passive in the sense that he is not physically aggressive toward his opponent, his mind and his emotions are always active, constantly seeking to persuade his opponent that he is wrong. The method is passive physically but strongly active spiritually. It is not passive non-resistance to evil, it is active nonviolent resistance to evil.”
  2. The goal is connection. “Nonviolence … does not seek to defeat or humiliate the opponent, but to win his friendship and understanding. The nonviolent resister must often express his protest through noncooperation or boycotts, but he realizes that these are not ends themselves; they are merely means to awaken a sense of moral shame in the opponent. The end is redemption and reconciliation. The aftermath of nonviolence is the creation of the beloved community, while the aftermath of violence is tragic bitterness.”
  3. Separate the people from problem (as William Ury et al would say). “The attack is directed against forces of evil rather than against persons who happen to be doing the evil. It is the evil that the nonviolent resister seeks to defeat, not the persons victimized by the evil… [Regarding racial injustice:] We are out to defeat injustice and not white persons who may be unjust.”
  4. Be prepared to pay the cost. “The nonviolent resister is willing to accept violence if necessary, but never to inflict it. He does not seek to dodge jail.”
  5. Manage thyself. Do not allow yourself to descend to the depths of hate while you fight hate itself.  Cultivate love instead.  “The nonviolent resister not only refuses to shoot his opponent but he also refuses to hate him. At the center of nonviolence stands the principle of love…To retaliate in kind would do nothing but intensify the existence of hate in the universe. Along the way of life, someone must have sense enough and morality enough to cut off the chain of hate. This can only be done by projecting the ethic of love to the center of our lives.  This is Agape love…  Agape means understanding, redeeming good will for all men. It is an overflowing love which is purely spontaneous, unmotivated, groundless, and creative… Another basic point about agape is that it springs from the need of the other person… The Negro must love the white man, because the white man needs his love to remove his tensions, insecurities, and fears… Agape is not a weak, passive love. It is love in action… Agape is a willingness to go to any length to restore community… It is a willingness to forgive, not seven times, but seventy times seven to restore community.”
  6. Hope.  “Nonviolent resistance … is based on the conviction that the universe is on the side of justice. Consequently, the believer in nonviolence has deep faith in the future. This faith is another reason why the nonviolent resister can accept suffering without retaliation. For he knows that in his struggle for justice he has cosmic companionship.”

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10 Ways to Fight Hate

One of the first pieces I read after the events on Saturday was this article from the Southern Poverty Law Center, listing ten ways to fight hate.  So while I carry that peaceful heart full of Agape love, these are the concrete things I can do right now (highlights quoted):

“The good news is, all over the country people are fighting hate, standing up to promote tolerance and inclusion. More often than not, when hate flares up, good people rise up against it — often in greater numbers and with stronger voices.”

  1. Act
  2. Join Forces
  3. Support the Victims
  4. Speak Up

“Do not debate hate group members in conflict-driven forums. Instead, speak up in ways that draw attention away from hate, toward unity.

“Goodness has a First Amendment right, too. We urge you to denounce hate groups and hate crimes and to spread the truth about hate’s threat to a pluralistic society. An informed and unified community is the best defense against hate.

“You can spread tolerance through social media and websites, church bulletins, door-to-door fliers, letters to the editor, and print advertisements. Hate shrivels under strong light. Beneath their neo-Nazi exteriors, hatemongers are cowards and are surprisingly subject to public pressure and ostracism.

  1. Educate Yourself

“Most hate crimes…are not committed by members of hate groups; the Southern Poverty Law Center estimates fewer than 5 percent. Many hate crimes are committed by young males acting alone or in small groups, often for thrills. While these perpetrators may act independently, they are sometimes influenced by the dehumanizing rhetoric and propaganda of hate groups.”

  1. Create An Alternative

“Do not attend a hate rally. As much as you might like to physically show your opposition to hate, confrontations serve only the perpetrators. They also burden law enforcement with protecting hatemongers from otherwise law-abiding citizens. If an event featuring a hate group, avowed separatist or extremist is coming to your college campus, hold a unity rally on a different part of campus. Invite campus clubs, sororities, fraternities and athletic organizations to support your efforts.

“Every act of hatred should be met with an act of love and unity. Many communities facing a hate group rally have held alternative events at the same hour, some distance away, emphasizing strength in community and diversity. They have included forums, parades, and unity fairs featuring speakers, food, music, exhibits, and entertainment. These events give people a safe outlet for the frustration and anger they want to vent. As a woman at a Spokane, Washington, human rights rally put it, “Being passive is something I don’t want to do. I need to make some kind of commitment to human rights.”

  1. Pressure Leaders

Form relationships with community leaders before a hate incident occurs.

Encourage leaders to name the problem.

Push leaders when they show bias or fail to act. [And do it respectfully—ad hominem never helps.]

  1. Stay Engaged
  2. Teach Acceptance

“Bias is learned in childhood. By age 3, children can be aware of racial differences and may have the perception that ‘white’ is desirable. By age 12, they can hold stereotypes about ethnic, racial, and religious groups, or LGBT people. Because stereotypes underlie hate, and because almost half of all hate crimes are committed by young men under 20, tolerance education is critical.”

  1. Dig Deeper

“Look inside yourself for biases and stereotypes.

“We all grow up with prejudices. Acknowledging them — and working through them — can be a scary and difficult process. It’s also one of the most important steps toward breaking down the walls of silence that allow intolerance to grow. Luckily, we all possess the power to overcome our ignorance and fear, and to influence our children, peers, and communities.”

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Breathe Deep, Stay on the Path, and Engage

How would you confront a white supremacist in person, face to face?  Would you share a meal with him/her?  I saw this video clip on Facebook, of a young Chinese-American man, Eddie Huang, sitting down to dinner with Jared Taylor, an older, white nationalist man, and founder of American Renaissance, to discuss Taylor’s perspective.  The American Renaissance site espouses genetic differences in intelligence and the propensity to commit crimes between races, among other things.  Taylor states that historically, Europeans have “killed more people per capita” than any other group, and attributes this to them being “more technologically advanced.”  He voted for 45 because his policies would “slow the dispossession of whites in America.”  He says he wants to keep whites a majority in the United States, or else they “no longer control our own destiny.”

I imagined myself in Eddie’s shoes, and I could not fathom how I could stomach this conversation while eating.  Actually I think he stops, while Taylor continues to eat—Chinese food.  I don’t know anything about Eddie Huang other than what I see in this video, and I admire him.  He sits down and engages respectfully, thoughtfully, and firmly, with a person who basically thinks he does not deserve to be an American.  Could you do that?  I’m not sure I could.  And what would the world be like if we all trained to do exactly this?

Thank you for reading to the end.  My point here is that we can oppose and resist more effectively than with rage, shame, and violence.  I know I won’t make everybody put down their clubs and fists with my small words, but this is where I stand, and I commit to speaking my stance as much and as loudly as possible.  I pledge to do my best always to profess what I am for, more than what I am against.  I commit to a practice of Agape love, Radical Acceptance, Mindfulness, and Peaceful, Respectful Activism.  I would love your company on this journey.

 

Love You Into Being

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A couple of weeks ago I met my new medical students.  These 10-12 trainees will be my small group for the next two years.  We will meet monthly to discuss the soft stuff of medical training—hierarchy, tribalism, death and dying, medical errors, difficult patients, etc.  Some call it “third year medical student support group.”  This is my 6th year of the pleasure and privilege (I inherited my first group halfway through, when their previous preceptor moved out of state).

With each successive group I am ever more amazed at the students’ level of insight.  They articulate compassion, humility, and maturity that I don’t think I had at their level of training. Or maybe it’s because we did not have classes like this to explore such things when I came up (or maybe I don’t remember?).  More and I more I see my role as facilitator more than teacher.  I am not here to impart medical knowledge.  Rather, it is my job to stimulate exploration, conversation, and meaning.  It’s so freeing, really—there is no standardized test to teach to.  And yet I see it as my responsibility to help prepare these gifted young people to face the greatest challenge and reward of the profession: human relationships.

I feel no fear or trepidation.  We cannot ‘fail’ at this class, any of us.  Because the point of it is simply for everybody to participate, contribute, consider, and learn—myself included.  Each month the students are given questions to answer in the form of a blog post.  For example, “Recall an example of inspiring or regrettable behavior that you witnessed by a physician.  Describe the situation, and its impact on you, the team, and/or the patient.”  I read them all and facilitate discussion, tying together common themes and asking probing questions.  My primary objective is to help them maintain the thoughtfulness and humanity that led them to medicine in the first place.  Medical training has evolved in the past 20 years, for the better in some ways, not so much in others.  One way we do much better nowadays is recognizing the hidden curriculum, and shining light on its effects, both positive and negative, through classes like this.

We all have those teachers who made a difference in our lives—or at least I hope we all do.  I have multiple: Mrs. Cobb, 4th grade; Mr. Alt, 7th grade math; Ms. Townsend (now Ms. Anna), 7th grade English; Ms. Sanborn, 7th grade social studies; Mrs. Stahlhut, 9th grade geometry; Mrs. Summers, 10th grade English; Coach Knafelc, varsity volleyball; Dr. Woodruff, primary care preceptor; Dr. Roach, intern clinic preceptor; Dr. Tynus, chief resident program director.  My mom is one of these teachers, also.  She leads nursing students in their clinical rotations.  I have seen her student feedback forms—they love her.  And it wasn’t until I heard her talk about her students that I realized why they love her and what makes her so effective—she loves them first.  Teaching is often compared to parenting.  Our parents, at their best, see our potential and love us into our best selves.  They cheer us, support us, redirect us, and admonish us.  They show us the potential rewards of our highest aspirations.  If we’re lucky, they role model their best selves for us to emulate.

All of my best teachers did (do) this for me.  I’m friends with many of them to this day, and I still learn from them in almost every encounter.  I love them because I feel loved by them.  They held space for my ignorance and imperfections.  I always knew that they knew that my best self was more than the last paper I wrote, the last test I aced, or the last patient encounter I botched.  To them, my peers and I were not simply students.  We were fellow humans on a journey of mutual discovery, and they were simply a little farther along on the path.

This is my aspiration as a teacher, to live up to the example of all those who loved me into the best version of myself today.  This kind of love allows for growth and evolution, from student to colleague, to friend, and fellow educator.  This is not something attending physicians typically express to medical students, positive evolution of medical education notwithstanding.  But when I met this new group, I was overcome by love for them.  So I told them.  “If you take away nothing else from our two years together, I want you to have felt loved by me.  I wish to love you into the best doctors you can be.  That is my only job here.”  Or something like that.  It was impulsive and possibly high risk.  But it was the most honest thing I could say in that moment, my most authentic expression of my highest goal for my time with them.  I only get to see them once a month, and I want them to be crystal clear about what I am here to do.  We have lots to cover these two years, so much to learn and apply.  And love is the best thing I can offer to hold us all up through it.