The Mark You Make

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Friends, Ozan has written another book!  I know it may seem like it, but he’s not paying me to promote his work, really!  He has offered perks for Inner Circle members, however, like an advance digital copy for preordering, and signed copies when the book is released next April.  In considering what I would ask him to inscribe to my friends in the books I will give them, I realized yet another evocative dimension of my relationships.

If you were to describe your friendships to a third party, or make a meaningful introduction in service of connecting two amazing people, what would you say?  I call it ‘connecting fellow Awesomes,’ and it’s always a pleasure and privilege to serve in this capacity.  I thought to ask Ozan to write to one friend something like, “Cathy thinks the world of you—happy to make such a positive new connection!”  Then I thought, this friend has really made a mark on me.  Then I thought of the mark Ozan has also made, in just 9 months of virtual contact.  And then my mind was blown with the realization of my cosmically marked-up self—the finger, hand, and footprints of all those whom I have contacted.

Years ago I attended the orthopaedic surgery resident graduation dinner with my husband, a happy and fun annual event.  At the end, mingling with faculty and trainees, one of the graduates looked at me and his eyes widened.  “You’re Dr. Cheng!  You were my teaching attending during my third year medicine rotation [7 years prior] at [the hospital where I used to work]!”  I was gratified that his expression was cheerful, rather than distressed or awkward, surprise.  He went on to tell me that I held the team to a high standard of discussion, and that he appreciated my presence and teaching.  I will always remember this encounter with pride and appreciation.

In the past year three patients from my past have resurfaced and told me the positive difference I made it their lives.  I remembered two of them so clearly, both their faces and their names (after 20 years and thousands of patients, I can usually only remember one or other).  Talking to each of them reminded me of all that we had been through together, and I was glad that I had done my job well.

But what about those for whom I have not been a great doctor?  I have had my fair share of patients who left me, for various reasons.  I know I have been seriously disappointing for many.  I wonder how many times I have contributed to patients’ negative overall experience of medicine, and further widened the divide between doctors and patients in our fraught and flawed healthcare system?  Sometimes I look back on my early years of practice and cringe a little—all the writing I do now on empathy, compassion, curiosity, openness, and humility results from years of lessons learned in real time, on real people.  I’m definitely much more adept at it all now than in the beginning.  And I’m still learning—I still get triggered, still fall into old, counterproductive thought and behavior patterns.  Sometimes it feels like I will never be good enough, or enough in general.

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I also think about the people whose marks on me were/are hurtful, dismissive, and otherwise wounding.  It reminds me of carvings I see in the trunks of the beautiful aspens I walked among this weekend.  Did the folks who made them set out to harm the trees?  If they thought the tree might die from their knife marks, would they think twice?  Maybe they were overcome with their profound experience in nature and just wanted to mark it in some way, especially if they shared it with someone they loved (so may initials with plus signs and hearts)?  Sometimes we just want or need to be right, competent, respected, and acknowledged.  So we mark our encounters with stubbornness, aggression, or even violence (in its many forms, overt and cloaked).  Like the strong and flexible aspens, I bear scars from such encounters and still continue to thrive.  Such marks have taught me how to care for myself, and also how not to be toward others.

In the end, how do I reconcile these relationship phenomena?  Sometimes we can see and know the mark we make on others.  Many times we cannot.  Nobody is perfect.  My whole life I will scrape and nick those around me, hopefully never with malicious intent.  I can only hope for their generosity and grace, and forgiveness.

Sister Brené Brown, once again, helps me continue.  In her book Rising Strong, she describes a choice, a mental attitude, that can help us all suffer less.  If you have not read or heard the book, I highly recommend it—it’s my favorite of the 5 of her books I have read.  Assume, she says (with the help of her pediatrician husband), that we are all doing the best we can.  That’s it.  We are all imperfect.  Our circumstances mess with us, our patterns mess with each other, and sometimes it can feel like a strange and inexplicable miracle that we have not all killed one another already.  But choosing to give each other this one, simple, and at times colossally difficult benefit of the doubt, could be what saves us all.

We simply cannot extricate ourselves from each other.  So we can just do your best to take care of one another.  And be prepared to apologize, early and often.

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70 Years Married

 

 

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Dear Mr. and Mrs. Wonderful,

Hello and hugs to you both!  How are you feeling?

I received a message from Wonderful Son this weekend, and it made my day!  He said you have settled in a place where you are both happy and getting the care you need.  You live near Wonderful Daughter, whom you see often, and everybody is happy and doing well.  I’m so glad!

More importantly, Son said the family will celebrate your 70th wedding anniversary soon!  He invited me to contribute a short video selfie to the well wishes.  Wow, what an honor.  I only got to serve as your primary care doctor a couple of years before you moved.  In that time I had the privilege of witnessing not just each of you as my patients, but you both as a couple, and your Wonderful family.  Please allow me to share my observations?  Here is my experience of you:

Ease.  Whenever I saw you two together, there was a peace and ease about your dynamic.  Patterns of relation were established long ago, and it worked.  I witnessed friction at times, but it was transient.  The vibe of our encounters was never agitated; it always felt to me that I had stepped respectfully into your well-oiled routine, and I tried my best to not disrupt it.

Patience.  Nobody rushed anybody when we were together.  Questions were answered, sometimes right away, sometimes after a while.  But you always gave each other the time and space to get where we were all going.

True Acceptance.  The Gottmans tell us that about 2/3 of marital problems are unsolvable.  This fall I will have been married half my life, 23 years.  This summer I think I may finally understand in my limbic brain, possibly, how to be in a marriage—something to do with really accepting the other person for who he is, like really, honestly, and wholeheartedly.  It was clear soon after meeting you both that you had figured this out long ago.  If I can get to 70 years, maybe I don’t have to feel bad that it took me 23+.

Devotion.  Medically, it has not been all lollipops and rainbows these few years, for either of you.  But whatever was happening for one of you, the other was right there, attending, caring, waiting, loving.  What more could any of us ask for?  And the Wonderful Children learned from your example; knowing them and seeing their devotion to you, their loving parents, inspires me deeply.

Learning, Growth, Adaptation.  Even at your age, there were things you did not know or understand.  Your bodies betrayed you in some ways we could not have predicted, and in others that you may have anticipated but were still a challenge to accept.  With the help of the medical team and your Wonderful Children, you have both managed to adapt to successive new normals with grace.

Loyalty and Commitment.  In it together.  That’s how you two roll.  I know it’s not easy, and we have discussed the challenges.  But you stick with each other through thick and thin, I’ve seen it.  You set the bar for the rest of us.

Love.  I think you, Mr. and Mrs. Wonderful, show us what true love lives like.  After 70 years I imagine you have some colorful stories to tell, some that belie all of the idealistic descriptions I write here.  But that is the point, no?  If we stick with it and do The Work, all of us hope to be rewarded with that deep, peaceful, reliable, and resonant love that transcends even what we innocently and earnestly vowed to each other at the altar.

Science, technology, and social convention have evolved beyond anyone’s imagination, and the pace only accelerates.  But the lifelong human need for love and belonging will never change.  Thank you for showing us how it’s done in a marriage.  Congratulations!

Sincerely, Cathy

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?