Self-Efficacy, Ethos Session 1

Ya kinda had to be there, my friends.

And it was all my friends who came to my first ever wellness presentation at Ethos today. For two easy and loving hours ten of us engaged in openness, curiosity, reflection, thought, and connection. After outlining the general themes and objectives of my past wellness presentations, General Manager Elena landed on ‘self-efficacy’ as the all-encompassing concept when we discussed our plans earlier this year. It felt immediately right. This was to be the first of four sessions throughout the year.

Self-efficacy: “an individual’s belief in their capacity to act in the ways necessary to reach specific goals.” (Bandura, 1977, 1986, 1997)

I have presented to academic surgeons on national stages and judges of the Federal Circuit Courts. Still, speaking to the Ethos community made me a little nervous. There would be fitness experts in the audience–what could I ‘teach’ them on the topic of exercise? This was a new and potentially very diverse group; one that did not necessarily know my credentials or professional expertise. My highest goal was for all of us to leave the session feeling inspired, empowered, connected, and thought-provoked. My intent was not to simply lecture or convey, rather to offer, invite, and receive in fluid exchange and mutual engagement. I had to give msyelf pep talks all week, calling forth my confidence in attuning, listening, asking good questions, reflecting, paraphrasing, as well as presenting.

What a real-time practice in self-efficacy, no? Walk the Talk, Chenger!

Dry erase before: “Of health and wellness: Domains, Practices, Attributes”

I planned today to introduce my ‘5-3-5’ framework of health: 5 domains, 3 core practices, and 5 atrributes. It’s a work in progress, which makes it a fun and high-potential foundation for discussion with any audience. After sharing our respective thoughts and experiences of self-efficacy, we explored how it applies in health and wellness.

“What are important domains of health?” I have written about ‘the five domains of health’–sleep, exercise, nutrition, stress management, and relationships–on patient action plans and this blog for many years. It’s relevant, reliable, and comprehensive for the purposes of an annual physical exam. But I wanted to learn from this audience how they see ‘domains of health’ in life as we live it. The brainstorm and discussion that ensued showed us all how layers of complexity and interconnected relationships at both individual and collective levels impact our experiences of both health and un-health.

Self-awareness, self-regulation, and effective communication: in my mind, these are the three core life practices that help us assess, adjust, and adapt to whatever life brings. The group’s suggestions of key health practices, we could argue, could all fit under one or more of the three. And it also emerged today that there may be a missing element of movement–that to be healthy we must not only attune inwardly, but act–we must both be and do–or not–there’s something here about intention and volition, about agency, I think. I invited. My friends offered. We noodled, played, exchanged, and documented. And now I have so much more to mush around with, to dig into and mine for treasures!

“When I am healthy, I feel…”

By now folks had caught on. I ask the open-ended question, record the responses, and when one of my own words comes up, I write it under the heading. Brother-in-law Kinnier compared the process to playing Family Feud and we all laughed. When I think of how I want us to feel in health–in body, mind, spirit, work, and relationship–these five words top my list today: Stable. Strong. Flexible. Agile. Resilient. The words my friends offered in this section represent sensations, emotions, and states of being, among other things. What words would you add? How besides words would you express/explain what it means to you to be healthy?

When I look at the ‘after’ state of the board (I did not take a picture of the whole due to glare, but I wish now that I had), I feel so gratified. I successfully offered my framework for health, developed organically and in collaboration with patients, colleagues, friends, and fellow life journeyers over decades of medical practice and living. We agreed at the end that next time we can include non-verbal expressions such as emojis, diagrams, symbols, and pictograms, to further deepen our exchange and discourse on these ideas.

*sigh*

The openness, curiosity, safety, warmth, connection, and love I felt today, friends. Ohmygoodness. I had to encourage myself in advance, reassure myself that I had what was needed to lead a discussion, to facilitate this opening, and invite and allow all of our wisdom to emerge and mingle. The energy in the Den vibrated today. It had a temperature, a depth. We all both contributed and benefited (I think), offered and received. The outcome felt elevated and synergistic–immensely greater than the sum of its individual parts.

This presentation series is part of my project to broaden my reach, to expand my contribution in health and wellness to more audiences, and to facilitate engagement, empowerment, and agency for individuals and organizations. Elena and I had orginally planned four quarterly sessions this year. Today’s session lasted thirty minutes longer than scheduled, and many of us wanted to keep the energy flowing, to continue the conversation sooner than three months from now, as we looked at the ‘after’ state of the board and saw so much possibility for future conversations!

YES. THIS. This is what I live for, my friends!

I write this summary so those who could not attend today might get a feel for what it was like. But I could only capture here a fraction of just my own experience. There is just something about a gathering, an intentional meeting when and where we choose to spend (give?) our time, energy, and resources together in service of lifting ourselves and one another.

There are simply not enough words to express my gratitude and appreciation for my friends who showed up today. Their unwavering presence and love made it safe for me to be BOOBS OUT, all me, all in, open and honest, curious and confident. We agreed today to all go home and let it sink in, to saturate in the connection, and see/feel what emerges that calls us to gather and commune around next time.

I. cannot. wait. Hope to see you there!

The Flow of Friendship

30 years this October.

Janet and I met at our white coat ceremony in 1995, sat two seats apart, alpha by last name. Walking home from school days later, I learned her family lived in Denver for a while when we were kids. We exchanged parents’ names and went home to call our respective ones. And get this: Her dad was my grandfather’s student, and stayed at the Cheng family home in Tainan, Taiwan one summer while studying engineering. He was one of Yeh-yeh’s favorites. We went to their house for dinner once (neither Janet nor I remember). When Ba recounted the evening, he got most animated about the concrete foundation that Janet’s dad had laid for the playhouse in the backyard (both dads are civil engineering PhD’s).
Positively. Cosmic. Sisters.

We were joined at the hip in school. We sat at the back of lecture halls, Janet doing crosswords and I writing letters. As anatomy partners we created mnemonics with gestures to remember the cranial nerves and their exit points from the brain. We learned interviewing and physical exam skills together, went to the gym, cooked, and basically grew up together in the final stages of adult brain development. Some of our teachers could not tell us apart. We rotated on pediatrics together when she met her now husband, an intern then, eating French fries and drinking ginger ale on call every fourth night. We attended each other’s weddings (I got to stand up in hers). Our kids are similar ages.

As an executive health internist and academic neonatologist, our professional worlds overlap little, yet we still speak multiple languages in common (including American English-accented Mandarin). As we, our parents, and our children have all aged these three decades, contact has fluctuated and our bond remained intact. This weekend Janet came to Chicago and we spent three days together cooking and yapping, our longest in-person time in fifteen years. We made a menu in advance and headed to the grocery store on her arrival. These three days we cooked Vietnamese spring rolls, green onion pancakes, fried rice, potstickers, and curry beef pastries, all steeped in nostalgia and yumminess. Doctoring, momming, daughtering, wifing, teaching, leading, citizening–we covered it all while mixing, rolling, wrapping, frying, steaming, baking, and of course eating.

Our class stays connected on a What’s App chat and we are impressive, I must say, many of us leaders in our fields, making an impact. And yet when we gather, we still meet as the people we knew then: eager, optimistic, young students. We reach out with news, requests, and just to say hi. That easy connection is just so special. How have 30 years passed already? Will we still be around to celebrate another 30? It’s possible, and I will revel in every year we get with one another in the interim.

Dear readers, I wish for us all to have friendships like this–the ones that persist with easy and steadfast confidence, that we trust implicitly, that validate and support, that endure and mature in mutual respect, admiration, growth, and evolution. It’s these meaningful relationships that will hold us up in life, no matter what happens.

Chengerisms and NaBloPoMo 2024

“Hey friend, favor?
“When you think of me, what things do you hear me say all the time that signify to you who I am and what I’m about? 🤔
“…Collecting ‘Chengerisms’”

The compulsion overtook me Thursday evening, when I should have been finishing clinic notes and packing for LA. I texted a slew of people in a flurry with the question above, intending to assemble their answers into backbone for National Blog Posting Month in November. For those who don’t know, NaBloPoMo challenges bloggers to publish 30 posts in 30 days, all written in real time. It coincides with NaNoWriMo, National Novel Writing Month, a sprint to write a 50K word manuscript in the same time.

This will be my tenth consecutive NaBloPoMo challenge–BRING IT, I say!

My “Chengerisms” query, I see now, was actually me gathering validation and support for showing up all me, all in, BOOBS OUT at the Writers Rising retreat this weekend. My subconscious intuition knows what I need; I sense, trust, and follow better with age. Replies rolled in with speed, earnestness, and so much love it positively bowled me over. Highly recommend!

The strongest messages I perceived throughout the conference reinforced all of my highest writing and living values:
Let loose your curiosity
Take risks
Tell the truth
Honor your Central Self
Own Your Shit
You are enough
Assemble your pit crew
Connect, connect, connect!

How tightly these correlated with the Chengerisms my friends mirrored to me:
What is that about?
How fascinating!
Tell me more…
Hey friend
How did that feel?
Love you love you
Yaaaay!
One breath
Walk the talk
BOOBS OUT (apparently catching on in my small circles–yaaaayy!)
Tribe
Sooo human.

This spontaneous, subconscious-driven exercise shows me the profound importance of good, loving feedback and the absolute value of meaningful relationship. My response to almost every reply was a sincere and heartfelt, “I feel seen!”

While I continually noodle on content and structure of Book (I’m getting closer, really!), I feel a limbic and visceral certainty about how I want readers to feel throughout and especially at the end–seen, validated, inspired, empowered, and convicted. This NaBloPoMo, I aim to color in and sharpen that vision, saturate my thinking and writing brain with it.

At the end of an executive physical, I want my patient to feel thoroughly understood. I show that I know them, even if I only see them once a year, by reflecting their stories back to them, interpolating and extrapolating what’s not said, checking in, and providing what I know patients need from their doctors: personal connection in service of self-efficacy for health. So this year for NaBloPoMo, I commit to the theme:

What I Wish For You

Thirty things I want patients, readers, or anyone, really, to experience after encountering me in person or in print. Chengerisms in action. I will resist wallowing in guilt and shame when I notice how often I fall short of these aspirations. When I see perfectionist self-loathing approach I will divert it to the nearest off-ramp. All part of the process.

This could be both fun and enlightening! Let’s see what happens, eh? Ready, set, let’s go.