A Time to Try New Things

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My friends:  What’s happening for you these many weeks?  What are you noticing (again, still, and newly)?  What do you miss most, least, and/or not at all from pre-COVID life?

What’s been the best thing that’s happened for you in this time?

Many of us are out of our depth here; we have no map.  As NASA says, we must “test as we fly and fly as we test.”  That necessarily means putting aside what we usually do and how things usually work, and trying new things–experimenting.  What a fantastic opportunity for learning, growth, and connection!

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The Alphabet Workout

How has the pandemic affected your physical activity?  How have you adjusted?  After the New Year I realized I needed workout buddies to strengthen my workout resolve.  My colleague and I started exercising together after work a couple days a week, and then the pandemic hit.  Almost right away I came across various alphabet-based interval workouts, perfect for the newly shut in.  My siblings and friends and I started meeting on Zoom to try it, first spelling our names.  We moved on quickly to our heroes’ names, and now to sayings we like.  Exercise, accountability, variety, fun, and connection—yay!

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Baking

My daughter may single-handedly make our whole family diabetic.

Spring break started a week early, then the kids transitioned to distance learning, with minimal direct, real time interaction with teachers.  With so much more time to complete homework and a recently developed fascination with any and all things French, we now have a baker in the house.  And with anaphylactic allergies in the family, recipes are necessarily converted to vegan and nut-free.  To date she has succeeded with macarons, beignets, fruit turnovers, cupcakes, and red velvet cake.  But by far I’m proudest of her opera cake, completed tonight and surely damaging to my waistline.  It’s worth it, though, to watch her experiment, fail, redirect, and succeed (mantra = “It’s edible!”), gaining confidence with every attempt.

The sibs had better not abandon me on those Zoom workouts, though!

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Photo courtesy of Dr. Karen Cornell, January 2020, Loveland, CO

Circadian Loosening

I always knew I was a night owl, but holy cow, left to my own devices, I am practically nocturnal.  I never pulled all-nighters for school.  The first time I stayed up all night reading was for one of Rick Riordan’s Percy Jackson books—I had not even done that for Harry Potter!  I have discipline when I need it.  I get up for morning calls now; I even look forward to them, as a sailor looks for the buoy thrown by his shipmates when he has fallen overboard.  I will readjust to a regular work schedule when the time comes.  But for now I can truly enjoy my owl self.

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Connecting with Friends

Maybe you’re missing your friends the most.  Somehow I’m not, which is a bit shocking and disconcerting.  But maybe it’s because I’m still connected, in some cases better than ever.  I miss meeting Donna for breakfast at our usual egg and toast place.  But I love that we now talk weekly on the phone while walking outside.  I continue to send and receive snail mail from friends across the country.  Perhaps I’m FaceTiming more with the Colorado sister and my parents, in addition to our sibs Zoom workouts.  And finally yesterday, blogging friends Nancy and Donna and I got together, after talking about it for at least three years.  Of course it was over Zoom, but without COVID-19 who knows how long it would have taken us to meet in person, living in Washington, Illinois, and Michigan?  Now we plan to ‘meet’ monthly—so much to share!

Writing Out of My Comfort Zone

Thanks to sister member Christina Guthier from Ozan Varol’s Inner Circle, I accepted a 5 day mindful writing challenge set by Nadia Colburn this past week.  Free, only five days—why not?  Nancy, Anne, and a few other friends agreed to try it with me—they accepted my Facebook invitation.  After a short meditation and poem, each day Nadia offered a prompt, followed by ten minutes of writing dotted with serene reminders to stay with the breath and remember to smile.  In these brief, structured and yet freeform sessions, I stretched existing ideas and queries farther than usual.  I quieted the inner critic sometimes and not others.  I learned a little more about my style and preferences for writing.  And I wrote a poem.

Based on “I Am Offering This Poem” by Jimmy Santiago Baca, Day 5’s prompt asked us to write a poem entitled, “I Am Offering This ______ to You.”

Onward, my friends.  Let us try new things, learn, grow and connect.

 

I Am Offering This Love to You

So imperfect

So flawed

So human

Yet honest, earnest, real

How can I make sure

You feel it the way I intend?

Or do I even need to?

Who would that be for?

What’s the best way for you to feel

Loved by me?

According to whom?

What is the best outcome

Of all this love

We carry for each other

In our families

Between friends

For our country

For the world

For humanity?

How can we live into this now

Today?

I am offering this Love to you

Now

On this day

In this moment

With this breath

What will you do with it?

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.

 

Our 5 Fundamental Needs

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To Feel:

 

Seen

Look what I can do

This is how I can contribute

See me achieve

 

Heard

Hear my concerns

Take me into account

 

Understood

Validate me

Normalize my feelings

Say you can relate

 

Accepted

Tell me I belong

 

Loved

Participate in the Messy with me

Commit to sticking with me through the hard shit

Let me be my whole self with you

Be your whole self with me

 

Children by parents

Patients by doctors

Students by teachers

Workers by managers

The led by their leaders

Spouses

Friends

 

What if?

 

 

Good Doctor and Good Mom

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What do you sacrifice in pursuit of your dreams?

What does your calling cost you?

What are the returns on your investments?

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Last week I mentioned Dierks Bentley’s, “Woman, Amen”, a song I love.  After listening to it for many days on repeat this past week, I decided to tour his nine albums this weekend.  His songs vary in topic and form, and at the same time he has a consistent style and vibe.  I like it.  Yesterday I heard his song, “Damn These Dreams”:

Now honey I know you miss me, I feel it when you kiss me

Trust me when I say every goodbye hurts

Well damn these dreams

Playin’ my heart just like a guitar string

Pullin’ me away from you and everything I really need

Well damn these dreams

Chasing that same old whiskey melody

All up and down these Nashville streets

It’s hard to look true love in the eye and leave

Damn these dreams

 

Instantly I remembered two other songs with similar themes:

 

Goodbye Again”, by John Denver:

Other voices beckon me, and for a little while

It’s goodbye again, I’m sorry to be leaving you

Goodbye again, as if you didn’t know

It’s goodbye again

Have to go and see some friends of mine

Some that I don’t know

Some who aren’t familiar with my name

It’s something that’s inside of me

Not hard to understand

It’s anyone who’ll listen to me sing

…Lying by your side’s the greatest peace I’ve ever known

But it’s goodbye again…

 

And “I Play the Road”, by Zach Brown Band:

…She says daddy where to you go

When you leave me all these nights

With a suitcase and guitar in your hand

Kissing me and mom goodbye with a tear and a smile

Where do you go? 

Daddy where do you go?

I play the road

And the highway is our song

And every city’s like the same three chords

Been helping us along when the story’s told

And the crowd is done and gone

Shaking off the miles and trying to make it home

…Mile after mile… 

Baby, I’m comin’ home

Years ago, I think it was either Dana Carvey or Martin Short who said something like one can only tolerate the life of a comedian because s/he simply cannot do anything else—they must do comedy.  If anyone can find the reference, please share!

* * * * *

As it is in music and comedy, so it is in medicine.  For many of us, we simply must do it; we have no existential choice.  These songs describe well our pain and conflict when we take call or have to work on weekends, or miss the kids’ school and sports events, and spend hours at home on the medical record or answering pages.

I recently read an article, “A Good Doctor or a Good Mom, Never Both”.  Early in this physician mom writer’s career, an elder colleague told her, “’You can be a good doctor, and you can be a good mother, but you can never be both at the same time.’”  The author disagrees, saying it’s either/or, never both, ever.  At once hearing Bentley’s song, I felt a moment of panic, mortified that I’m destroying my family for my job.  Am I totally selfish for choosing this career, and are my priorities so distorted that I so often put work before my family?  Have I chosen to be a good doctor and a horrible mom?

Thank goodness for Simon Sinek who, in his 2014 book, Leaders Eat Last, referenced a 2011 study that showed “a child’s sense of well-being is affected less by the long hours their parents put in at work and more by the mood their parents are in when they come home.  Children are better off having a parent who works into the night in a job they love than a parent who works shorter hours but comes home unhappy.”  This idea has saved me from countless episodes of self-flagellation and guilt.  It was so instantly redeeming that I recall the exact moment I heard it—I was at the airport, traveling solo, likely for a work related conference.  I can’t say I’m ecstatic every evening coming home, but I generally feel satisfied by a fulfilling day doing something I love.  I can confidently report that my husband feels the same.

I’ve attended one swim meet in two years.  I miss any school event that occurs during the workday.  I still get lost walking the maze that is the kids’ school, though we (they) have been there over a decade.  But I get to choir and orchestra concerts, and dinner potlucks.  I know my kids’ friends and am friends with their parents.  The kids’ teachers think they feel loved by us.  I think I do okay.

My kids hear me on the phone with patients and colleagues.  They know it takes time and understanding to take good care of people.  I’m confident they see and feel how meaningful this work and these relationships are to me.  And the science is pretty cool, too.  I would never pressure my kids to go into medicine, but I would not be surprised if they did.  I would absolutely encourage it, if it gives them the joy it gives me.

“You can be a good doctor, and you can be a good mother, but you can never be both at the same time.”  I respectfully agree and disagree.  You can absolutely be both, often at the same time.

 

Theory and Practice

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Does anyone become a great skier or volleyball player by just reading books and watching videos of other people doing it?  Of course, not.  And even if you have the best coach, with the most knowledge and expertise, you still have to get out on the trail or the court and do it yourself, find your own groove, create your own style and habits that work for you and your team.

I realized this over the past week, as once again I found myself calling forth everything I have learned about leadership from books and observations of other leaders.  Leading people is hard, and I often feel at the same time that I do it well and that I totally suck at it.  I worry that because it feels mentally and emotionally exhausting, I must be doing it wrong—like if I really knew what I was doing it would just be easy.  But that is perfectionism and fixed mindset talking, I’m pretty sure.

Knowing theory is key, no question.  If you don’t understand in advance what it will be like to stand up on skis (they don’t stop themselves and if the tips are pointed downhill that is exactly where you will slide), you will fall and risk injury to self and others a lot more than if you are prepared with a few pointers in advance.  It’s the same with leadership.  Remembering how it feels to be led well, versus poorly, allows me to have empathy for those I lead.  Mastery of, or at least proficiency in, some key communication tools such as reflective listening, nonjudgmental questioning, and objective feedback, makes the skills easier to access under stress and pressure.  Holding core values and principles in front, and exemplifying them, rather than just professing them, earns trust and credibility.

I wrote to a mentor recently, “I find myself repeating language from the books, inventing analogies and using examples from the team’s lived experience to show how the theories apply.  Words like empathy, curiosity, generosity, non-judgment, deep breathing, and ‘How fascinating!’ exit my mouth a lot, as well as, ‘It’s all about relationships!’ People must see me as a broken record…”  He reminded me that we need these mantras to keep ourselves focused and also to repeat out loud and invite accountability in our actions.  I wholeheartedly agree.  Maybe I will take a misstep here or there (no maybe—it will happen!).  It won’t be because I’m not trying or I don’t care—it will be because I’m human and we all make mistakes.  It’s because I’m out there practicing.

When I think back to high school volleyball practice, residency, personal training, and the early days of parenting (hell, every day of parenting), it’s not the easy days that stand out in memory.  It’s the hard days, the days when I really struggled, but came out having grown, even in a little, in my learning.  It’s the days when I can say, hey, I know better now, and I will do better next time—bring it.

So yes, leading well is hard.  It’s exhausting.  It costs inordinate amounts of energy, self-awareness, -monitoring, and -control.  It makes me hypervigilant of my words, posture, and actions.  Theory and practice go hand in hand; they are the twin pillars of learning, application, and success in all realms.  I will keep reading for theory (I highly recommend Legacy by James Kerr and Big Potential by Shawn Achor).  I will keep showing up every day ready to do my best in practice.  I feel confident in the trust and credibility I have already earned, and that people can see that I’m honestly doing my best, for all of us.

 

Ode to My Dawn Simulator

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NaBloPoMo 2017: Field Notes from a Life in Medicine

Did you notice the photo on my post Gratitude Again?  That was the view out my office window around 5:30pm last week.  These days I appreciate the winter dusk a lot more than years past, mostly because the physically hardest years of training and my kids’ lives (for me) are over.  My intern year I rotated in the medical intensive care unit (MICU, or MICK-you, or just ‘the unit’ for short) in November.  Usual days started by 6am, and finished whenever my patients were stable enough for me to leave, usually past 7pm.  I really never saw the sun that whole month—not from outside, anyway.  Every third night on call, my resident and I covered the whole place.  The longest I ever spent in the hospital was 5am until 10pm the following night—41 hours straight, only to be back again the next morning at 6.  And that was nothing compared to the generation of doctors who trained before me.  Thinking back on it now, I can still feel the saturating fatigue, the utter hopelessness of ever seeing the call room, let alone lying down on a bed.  Thank GOD those days are over.  They weren’t all bad, though.  Residency was one of the hardest things I’ve done, and it was also intensely rewarding.  The friendships I made those years, the unique shared experiences—I carry these with me also.  They made me strong and gave me confidence.

But if I thought getting up in the dark during intern year was hard, somehow doing it as an attending with two little kids was even harder—go figure.  The sleep deprivation of working motherhood is a completely different animal from that of residency, its toll multiplied on family.  The blaring alarm clock, the utter blackness of the bedroom, the contrast of cozy warmth under the blankets with the cold still air above.  They all conspired to make me peevish, sullen, and supremely unpleasant to be around every morning—an additional cost to my soul every time I lashed out at the kiddos out of my own exhaustion.  To borrow a phrase from Vee over at Cute Kids, I might well have died of a bad mood or something worse if that situation continued.

So Husband staged an intervention: He bought me a dawn simulator for Christmas.  It’s an ingeniously simple device: An alarm clock with a built-in light dimmer that comes with its own full-spectrum light bulb.  All you have to do is connect it to a bedside lamp.  Then you set sunrise time, as well as duration of rise (I set mine to 6:45, 15 minutes).  Every morning for the past 7 years I wake up naturally from a steadily brightening, gentle and warm glow from one corner of the room.  It’s infinitely more pleasing; no blaring involved.  Of course now I have my iPhone ‘by the seaside’ alarm as back up, especially for this month as I stay up too late writing blog posts.  And I’m not a morning person in general, so no Mary Poppins songs bursting forth with domesticated mechanical birds on my windowsill.  But life is infinitely more tolerable between Halloween and Easter each year now—for all of us.

Thanks, Husband.  Ya done good.

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!