All Good Things Must End

moon path LOH

Setting moon, Sylvan Dale Guest Ranch, Loveland, Colorado.  Photo courtesy of Dr. Karen Cornell

Friends, Leading Organizations to Health has graduated Cohort 11, the Class of 2020.

Ten months ago I started at my Hogwarts, the leadership training program that has definitely made me a better leader.  But more importantly, it made me nine amazing new friends and a much better person.  Today, on the last day of the last retreat, it all came together in the most beautiful way, and I am beyond grateful.

These ten months were the best elective educational experience of my life—they really gave college and med school a run for their money.  We immersed in a curriculum dense with abstract concepts of interpersonal communication and organizational change management.  We then translated the theories into tangible skills in an experiential learning lab, applied to specific challenges brought by my 7 cohort mates and me.  Over four in-person retreats and monthly Zoom calls, we shared, supported, and coached one another in the tenets of relationship-centered leadership.

We bonded in a similar way to residents on call:  Gathered for training, bringing different backgrounds and perspectives, participating in a common curriculum but each with a unique learning path, eventually to disperse and practice in different settings across the country.  We eight now share a connection of stories and struggle that nobody else can know.  We are a tribe.

Thus, I grieved the goodbyes long before we arrived in Loveland this last time.  But I also trusted our master facilitators to help me manage this, by both their loving and authentic presence and the very structure of the program, which is founded on contemplation and self-awareness.  I also felt an abiding faith in the friendships we all grew this past year.  As with my best friends from college and medical school, I knew we would maintain contact and connection, just in a different way.  We can’t stay in the nest forever—now is the time to fly.

In thoughtfully constructed journaling exercises and discussion groups, we reflected, consolidated, and synthesized ten months of learning.  We also examined our personal and professional evolution over this time, growth and movement in fluidity and complexity.  We explored aspirations and imagined the future state of this work in our natural habitats.  Finally, we sat in a closing circle.   Having each shared our own reflections, the group offered each friend observations, affirmations, and well wishes in what I can only describe as the most loving communion.  Each person’s strengths were articulated and amplified.  We acknowledged one another’s challenges.  We celebrated each other’s engagement, perseverance, contributions and triumphs.  Finally, sustained mutual support was extended around the circle, wholeheartedly and without qualification.

In my opinion, we formed the kind of community that we all want to lead.  Tony and Diane led us all by example, deliberately, artfully, and mindfully.  They live the principles they teach; they lovingly and patiently showed us the way.  In the end we discovered our own capacity to each write our own next chapter(s).  By making us feel seen, heard, understood, accepted and loved these ten months, our teachers inspired us to do the same for others.  And that is the strongest foundation for building our houses of positive change agency.

Now we go forth.  We’ got this.

Onward from 2019: Learnings and Intentions

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Friends!  WHAT a year, no?  How are you feeling here at the end?

In this post:  3 key learnings, 3 high intentions, and my 6 recommended life readings.

What resonates with you?

What would you add?

For a thoughtful and inspiring look on the coming year, check out Donna Cameron’s post from yesterday.

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3 Key Learnings of 2019

Complexity

“When we try to pick out anything by itself, we find it hitched to everything else in the Universe.”  –John Muir

“All that you touch, you change.  All that you change, changes you.” –Octavia Butler

We all live in inextricable connection, like it or not, know it or not, want it or not.  Every interaction has potential for benefit and harm, and the scale is exponential.  Some may find this idea daunting, overwhelming, or untenable.  I find it reassuring.  The idea that some cosmic life thread connects us all, that we are made of the same stuff today as that which existed at the dawn of the universe—this gives me peace.  It encourages me that everything I do in good faith could make a difference.  You really never know how far a small gesture or sharing will reach for good.

The 3 Tenets of Relationship-Centered Leadership

Not so much learnings as a synthesis from LOH training, these are the current foundation statements of my personal and aspirational leadership tenets (iterations likely to evolve over time):

  1. Founded on curiosity, connection, and fidelity to a people-centered mission
  2. Attendant to the relational impacts of all decisions, local and global
  3. Respectful of norms and also agile and adaptive to the changing needs of the system

Having defined these ideals for myself, I am now fully accountable to them.  And I hold them as a standard for those who lead me.

Being >> Saying or Doing

Saying and doing compassionate, empathic, and kind things are necessary and noble.  And they are not enough.  These actions ring hollow without honest sincerity behind them.  People feel us before they hear our words.  Our authentic presence, positive or negative, originates from within.  It manifests in posture, facial expression (overt and subtle, intentional and subconscious), movement, and tone and cadence of voice.  Fake it ‘til you make it—saying and doing things because we know we ‘should’—only gets us so far.  We humans possess a keen sense of genuineness—it’s a survival instinct.  If we accept that a meaningful, productive life and effective leadership in particular, require strong, trusting relationships, then we must cultivate true compassion, empathy, and kindness.  That means suspending judgment, managing assumptions, and holding openness to having our perspective changed by all that we encounter (see first key learning above), among other things.  This may be life’s penultimate challenge—our role models include Mother Theresa and the Dalai Lama.

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3 High Intentions for 2020

  1. Continue to ask more and listen better for people’s personal and unique meaning making—not just patients but all people—attend to souls
  2. Let go perfection
    1. All relationships are not great, and it’s not all my fault
    2. Some people/relationships and circumstances challenge my best self and skills more than others
    3. It’s the honest, sincere, good faith effort, and the learning from imperfection and failed attempts that matter
    4. Some relationships are better ended
  3. Guard against judgment, arrogance, and cynicism

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6 Recommended Life Readings—the 6 most personally impactful books I have read in the last decade:

The Art of Possibility by Rosamund Stone Zander and Benjamin Zander.  Scarcity thinking, competition, and looking out for number one hold us all back.  Stepping fully into our central selves, claiming our full collective agency for creativity and collaboration, and manifesting all the good we are capable of—that is the discovery of this book for me.

Start With Why by Simon Sinek.  In my opinion, the most eloquent and resonant writing on the purpose-driven life.  The freedom and creativity that flows forth therefrom—it all just gives me goosebumps.  Sinek’s The Infinite Game may eventually make this list too, once I have integrated its content and learnings more fully.

Rising Strong by Brené Brown.  Strength and vulnerability, confidence and shame, individuality and belonging—these are the essential human paradoxes that Sister Brené reconciles with gritty aplomb through real life stories as well as grounded theory research.

Big Magic by Elizabeth Gilbert.  Be you, all you, all in.  Love thyself—flaws, failures, and falls all included.  Make things.  Because that is what we are put here to do, for ourselves and for one another.

Leadership and Self-Deception by The Arbinger Institute.  Perhaps no book explains the profound importance of being better in order to do better, better than this.  And it took me almost all year to really comprehend, and then begin to apprehend, the concept.

Being Mortal by Atul Gawande, MD.  I started and finished this one on vacation this past week.  Dr. Gawande is my favorite physician writer.  I consider this book required reading for all physicians for sure, but really for all people .  “The death rate from life is 100%,” a wise patient once told me.  In modern western society and culture, multiple intertwined and complex forces hamstring our ability to live and die well and at peace.  This book is a brilliant compilation of heartrending personal and professional stories, neatly folded with history, research, and practical information for improving this sad state of things.  It is also a guide to the hard conversations that we all should really have—now.  It has both validated what I already do in my practice, and profoundly changed how I will do things hereafter.  Thank you, Dr. Gawande.

*****

Best wishes for Peace, Joy, Love, and Connection to all.

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November 19:  Board Review Makes Me Better, For Sure

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NaBloPoMo 2019

Are you required to do continuing education for your work?

Since 2013, the Illinois Chapter of the American College of Physicians has run a weekly internal medicine board review webinar, MKSAP Live Online Study Hall.  We use questions that ACP publishes through the Medical Knowledge Self-Assessment Program, covering topics in general medicine and its subspecialties, including cardiology, pulmonary, infectious diseases, and rheumatology.  Every Tuesday night at 8pm Central time, two of us moderators and one webinar organizer get online and review about 14 questions, SAT-style.  We interact with audience members through a chat function on GoToWebinar, and we poll some of the questions each session.

I love this program for multiple reasons.

First, I was there when it started.  Gathered around then Governor Dr. Marie Brown’s dining room table, a handful of local ACP members brainstormed and created what is now an international, comprehensive internal medicine board review webinar series.  After some playful, off-topic, post-prandial banter between Dr. Sean Greenhalgh and me, our colleague across the table said wryly, “I’d watch that for an hour.”  Hence the dual-moderator, morning radio DJ style webinar was born.  That was in the fall of 2012, and the Study Hall is now halfway through its third two-year cycle.

Second, I get to hang out with my doctor friends online.  Besides Marie and a couple others, I did not know any of the dozen folks involved in the project before that night at her house.  We did improv workshops at the beginning to form our team and ease our communication skills.  Since then we have all become friends—a clique, even.  We have followed kids’ graduations, births of babies and grandbabies, and some personal challenges as well, all while getting together every few weeks to talk shop for an hour online.  We have even become celebrities of sorts—first at Illinois Chapter meetings and now sometimes at ACP National, people come up to us to say how much they like the program.  We’ve become a fixture in some colleagues’ lives.  We feel pretty proud and special about that.

The best thing about the Study Hall, though, is that just in the space of one hour on a Tuesday night, I am consistently humbled by the sheer volume of knowledge there is to absorb, just in internal medicine.  This is only one specialty of the whole medical profession!  And it’s not just the volume—it’s the complexity, the context, and the ever-evolving research, diagnostic and treatment development, and guidelines.  MKSAP publishes a new set of comprehensive questions every two years, and I do not envy the writers their colossal task of keeping us all up to date.  Without fail, every session I learn something that I will use the following week in clinic.

As this month of daily posts progresses, I feel increasing awe and gratitude for all of the people and opportunities in my life.  Thanks to all my colleagues, leaders, family and friends who make this life so full and loving.