November 29:  Reflection Makes Me Better

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NaBloPoMo 2019

How was 2019 for you, friends?

Looking back, what stands out?  What gives you pride and joy?  Guilt and regret?  What’s the best thing you learned?  What do you look forward to the most in 2020?

In the first post of this month, I described my last role play experience, one marked by intensity around domestic violence and dense communication skills practice.  Dr. Orit Kalnieri-Miller led the workshop, and I will forever be grateful for her groundbreaking work incorporating reflective practice in medical education.

Wikipedia says reflective practice is

 the ability to reflect on one’s actions so as to engage in a process of continuous learning.[1] According to one definition it involves “paying critical attention to the practical values and theories which inform everyday actions, by examining practice reflectively and reflexively. This leads to developmental insight”.[2]A key rationale for reflective practice is that experience alone does not necessarily lead to learning; deliberate reflection on experience is essential.[3][4]

Regular reflective practice, I think, is mindfulness in action.

This whole month I have been reflecting.  Looking back, seeking patterns.  What really does make me better?  Better for whom?  For What?  How does it all help me going forward?  I have probed my habits, my relationships, roles, activities, ideals and attitudes.  Writing the reflections every night as a blogging challenge probably does not give each idea much time to sink in.  But now they are recorded.  They are a collection that I can review over time; I can revise, rewrite, and continue the reflection-learning-practice cycle of self-improvement.  Reading past posts reminds me of where I was then, which allows comparison and contrast to today.

I am, still and always, me.  I’m also always learning and changing.  Reflection helps me to know myself better and more deeply, to claim and exercise my authentic agency in service of the causes that matter to me.  Reflection keeps me focused on my Why.  In the coming year, it will help me identify, refine, and enact my next Just Cause.  Very exciting!

But maybe the best part is that reflective practice is not a solitary activity.  When I have any opportunity to get feedback from those whose perspectives I respect, the learning is that much deeper and more meaningful, even (especially) if it challenges and agitates me.  People mirrors do not always show the reflection I want, or the self-delusions I believe–they call me out.  But sometimes they show that I’m living exactly and fully in my integrity and values.  Both are equally valuable.

So I will continue looking for reflections everywhere.  They keep me honest, and that makes me better.

November 28:  Gratitude Makes Me Better

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NaBloPoMo 2019

Haha, DUH!

How cliché to write about gratitude on Thanksgiving, right?  Kind of feels like professing love on Valentine’s Day.  At the same time it’s nice that we have a day designated to acknowledge all that we are thankful for, it also feels a bit contrived, perhaps?

But seriously, gratitude really does make us all better.  Read more about this here and here.  In summary, practicing gratitude seems to correlate with improved physical and psychological well-being, better sleep, increased empathy and self-esteem, and decreased aggression.  But how do we feel this on a daily basis?

As some of you know, I started a daily thank you note practice in January.  I’m proud to say that on average, I have written at least one note per day since I made the commitment.  Occasionally a few days go by and I write none.  But many days I write multiple.  I love to use my washi tape cards, but sometimes it’s an email or Facebook message, other times I post on a website or in feedback comments to a company.  It’s become a habit now.  Every day I feel gratitude acutely.  I recognize the people who make a positive difference in my life, repeatedly, reliably, and without expectation of anything in return.  My expression of gratitude connects us further, holding us all up through days of mundane grinding.  If I use my washi tape cards there’s also a flourish of color in there.  This practice has given me leave to reach out to authors, companies, people and organizations who may not otherwise know the positive impact they have on any given individual.  It feels good.

Tonight I’m grateful for so many things—nature, the most meaningful work I can imagine, all of my first world comforts and resources.  But no question, I am most thankful for people. My parents, holy cow.  My sisters, husband, children, extended family.  My friends—the family I choose.  Colleagues, students, patients.  Fellow activists and volunteers.  Challengers and worthy rivals.

I will pay more attention and reflection to this last group in the coming year.  When I accepted my new leadership role two years ago, Coach Christine had me identify my ‘allies.’  Of course all of my loving, supportive friends and family came to mind first.  But Christine also pointed out the challengers—those who vex me, the thorns in my side, the dissenters–they are also allies.  Of course!  Some of my best growth and progress is born of struggle, interpersonal and otherwise.  So how can I be but grateful for the people in my life who make it a little harder?  Whatever doesn’t kill us, right?

I hope you all had a loving, delicious, and fulfilling Thanksgiving, friends.  May we all carry some of this warmth and connection forward through the holiday season and beyond.  We only have one another.  We will not always agree.  We will all struggle.  We can only do our best every day.  Grateful for each day to try to do better, again and again.

November 26:  Practicing Peace Makes Me Better

 

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NaBloPoMo 2019

What helps you find peace these days?

With so much tumult in the country/world and Thanksgiving gatherings fast approaching, what will get you through this season and the coming year with minimal suffering and relationships intact?

Lately my inner peace feels tested on multiple fronts.  Anxiety, guilt, fear, regret, and insecurity accelerate their rotations through my limbic brain.  Thankfully, with age, therapy, and loving, compassionate friends, I have let go of self-judgment for experiencing stress and distress.  I don’t resist negative feelings as much as I used to.  I wish I could say this makes them less unpleasant, easier to tolerate.  Sadly, no.  But I am better able to let them pass through me, to ease into peace.

The more I observe, the more I notice that rather than allow and release our emotions, we tend to either deny/repress or fixate on them.  The consequent suffering can be disabling.  I started wondering how peace comes so much more easily to me now than before.  Below is a partial list.  What would you add to it?

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Breathe

Rose may have saved my career.  One day in early in practice, running around exasperated and cranky yet again, I returned to my spot at the counter to find “TAKE A DEEP BREATH” posted in large font on the wall in front of me.  It was one of those immediate and profound, perspective-shifting, life-changing moments.  One. Deep. Breath.  Everything goes smoother and happier since that day.  Later I learned about tactical breathing, which trains inner peace both mentally and physically.  I’m not facing mortal combat (primitive stress reflex responses notwithstanding), but it helps me find peace all the same.

Smile (especially when I see my kids)

I was a dormitory resident assistant my senior year in college.  Though it was my job to serve as counselor and guide to college life for my fellow residents, it was wise freshman who taught me about exercising agency in the face of adversity.  I can still see her joyful, welcoming face and posture, feel her free and loving spirit.  I wish I had gotten to know her better.  She wrote on my message board, “Smile, Cathy, you’ll feel ten times better!”  Of course she was right.  Over the past 25 years I’m proud to say that I’m much better at finding my smile now.  Thank you, sweet girl.

Quote Michael J. Fox

MJ Fox worry

Focus on the Now

My daughter had an anaphylactic reaction while I was at work.  The sitter called and I could hear my preschooler stridoring in the background.  My son called 911 as I raced out of the office to meet them at the emergency department.  I was shaking and could barely see straight—how was I going to drive?  What if she died?  I still had to keep it together for my other kid.  That was a morbid turn, I remember thinking.  How quickly we catastrophize.  Thank God for the mindfulness training I had recently started.  Right now, everybody’s still alive.  Paramedics are on their way.  They already did the EpiPen.  Things are okay right now.  This mantra occurred to me as I pulled out of my parking space.  It carried me through that crisis and has held me up through numerous others since.  Mindfulness works, my friends.

Let Go Outcome

See quote by Michael J. Fox.  No matter how much we plan, what we expect, or how prepared we are, we just don’t know what will happen.  This practice is also an extension of mindfulness.  I can only control my own attitude and action right now.  I can cultivate relationships that influence others, attempt to enroll them in my ideas, and recruit them on my mission.  But I cannot control their reactions, their behavior, or the myriad circumstantial dynamics that facilitate or stymie our activities.  If we work steadily for our highest goals, stay on the path of honesty, integrity, and authenticity, and commit to ethical process, then we can deal with any outcome.

Stop Chasing Confirmation

Early in marriage and parenting, I used to fight.  I would flood my family with more and louder words, convinced I could prove my point and win.  The more I spoke (yelled), the more blank and silent my loved ones became, and the louder and larger I got in their faces, demanding understanding, agreement, acquiescence.  [Please feel free to laugh out loud while cringing here.]  These encounters inevitably ended in frustration for all of us.  Somewhere along the way I noticed people demonstrating the behaviors I demanded, even though they had never agreed to them.  Maybe there’s a better way?  Perhaps if I state my case calmly and lovingly, and let go of the immediate outcome, the doors in their minds might stay more open and I can still get what I want, without all the hurt feelings and wasted energy.  *sigh*

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Four more days, friends.  Almost there!  Thank you for your views, likes, and comments!

November 24:  Alone Time Makes Me Better

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NaBloPoMo 2019

How many hours do you get to yourself at a time?  I mean not just in the shower or commuting, or to work out. I mean how much time do you get to really, only take care of yourself?  When there are no kids to pick up or drop off, no meals to plan or prepare, no immediate work deadlines, no call, no commitments?

I had 36 hours this weekend—there are about 25 minutes left.

I realized at the end of Wednesday that my irritation at fellow drivers was probably a projection of anxiety and agitation about my kids being away this weekend, each to a different place, a first experience for both of them and me.  Anxiety often manifests as anger and irritability for me.  I called forth many of my cognitive behavioral and mind body practices to manage the fear and worry, so that I could actually enjoy this amazing alone time—the first such stretch since the elder kid’s birth.

And holy cow, I’ gotta do this more often.

I will spare you the list of restorative activities!  But suffice it to say that I managed to balance sleep, music, food, productivity, creativity, solitude, and connection.  It really was a perfect rhythm.  Deep breath.  And now I’m ready for the family’s return and re-entry into life as usual, a little more relaxed and peaceful.

This year has been intense, fast-paced, and dense with learning, both personal and professional.  I think we all appreciate the idea of alone time, and we understand its importance intellectually.  But like so many things, to actually experience it first hand, for real, is completely different and profound.  I finished listening to Range this morning.  In it David Epstein describes how teams do best when members have a balance between solitary and interactive, collaborative work, as opposed to all one or the other.  Coaches know that training for any skill, be it athletic, musical, or otherwise, requires alternation between periods of sustained, focused practice and rest, time away.  New neural pathways require downtime to fully integrate.  This weekend, I was able to synthesize ideas from Epstein’s book on diversity of experience, and assimilate them with what I’m reading in Ozan’s book, Think Like a Rocket Scientist, on combinatory play.  In the quiet of an empty house, freed from rushing off to the next activity, insights arose more freely, and I connected dots to previous experiences and learning much more easily.  Today I started The Infinite Game by Simon Sinek.  More transformative ideas (simple and profound) to start incorporating into my world view and leadership practice, and to write about later—Yahoo!

I wondered if I’d be lonely this weekend… Nope, not at all.  This time alone was exactly what I needed.  Loving thanks to the family for gifting it to me.

November 23:  Range Makes Me Better

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NaBloPoMo 2019

One of my teachers in med school told me why he loves primary care.  He said at any time, he can decide he wants to be more expert in something and do it for a while, like managing all of his patients’ thyroid illnesses, rather than referring to endocrinologists.  Then when he gets tired of that, he can start referring again and do something else, like nonsurgical orthopaedics.  That was over 20 years ago…  The complexity of both medical knowledge and practice has expanded exponentially since then, so I wonder if he still thinks this way?

Regardless, I agree.  Being a generalist affords me tremendous flexibility and freedom to explore and apply from all fields of medicine.  While I could never approach the expertise of my specialist colleagues, I get to (and to a large extent am expected to) learn a little about everything.  That breadth of exposure and knowledge makes every workday unique and stimulating.  This week, I’m listening to Range by David Epstein, a book that validates everything about my generalist, boundary-spanning life.  From the book description:

Range makes a compelling case for actively cultivating inefficiency. Failing a test is the best way to learn. Frequent quitters end up with the most fulfilling careers. The most impactful inventors cross domains rather than deepening their knowledge in a single area. 

I feel validated about this because I’ve never been especially good at any one thing (except today I’d say I’m an exceptionally good communicator, though that’s a highly subjective and biased self-assessment).  I have, however, observed, explored, tried and experienced myriad things, and I have always seen this as an asset.  And now a New York Times bestseller affirms it. Yay!

Growing up bilingual and bicultural gave me a huge advantage for living and working in an increasingly diverse global society.  Before I started piano, I learned classical Chinese painting in two styles, as well as Chinese folk dancing.  I started skiing in elementary school, volleyball in middle school, golf in college, and in my 40s have picked up kettle bells, yoga, and TRX.  I learn coaching techniques from being coached.  I learn about leadership from reading and interrogating my patients who are leaders, and now actually leading some folks.  I interact with information through podcasts, audiobooks, paper books and journals, and online formats.  I read New England Journal of Medicine and Harvard Business Review, Annals of Internal Medicine and Fast Company, Journal of the American Medical Association and Psychology Today.  I prefer nonfiction, but I recently joined a book club and read my first novel in many years.  My music playlist includes Dierks Bently, Camila Cabello, Bruce Hornsby, Shawn Mendes, Miranda Lambert, Sara Bareilles, The Piano Guys, Mamma Mia and The Greatest Showman soundtracks, John Denver, and Pink.  I attend conferences focused on clinical medicine as well as communication.  I speak to audiences of physicians, business leaders, and designers. I make washi tape cards and moderate Better Angels communication workshops.  It’s kind of an eclectic list of activity; please forgive my self-centered navel gazing here.

If you make a similar list for yourself, I bet it will be more diverse than you think.  How does this help you, make you better?

Epstein posits that generalists’ advantage lies in their ability and propensity to see deep relational connections between diverse domains, use analogical thinking, and practice ‘active open mindedness.’  He also provides multiple examples of when specialists’ narrow perspective hinders creativity and innovation, and even effective problem solving.  Throughout, however, he acknowledges the complementary, yin-yang relationship between focus on the specific and wide-ranging view of the broad.  The book just makes my ENFP heart sing.

I honestly believe range makes me better…  For no other reason than giving me a life full of new and exciting experiences to write about on a blog.

 

November 22:  Listening to People’s Stories Makes Me Better

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NaBloPoMo 2019

What a long, strange week.  I almost forgot to write a post, just wanted to relax and do nothing.

Looking back, overall it was good. And it was people who held me up, as always.  I had some pretty moving and meaningful conversations with patients, and I really helped some people, I think.  But it was a new acquaintance who really made my day today.

I finally had time to bring my car to the body shop this afternoon.  After an unfortunate encounter with a fire hydrant while backing out of a very poorly planned driveway, my front bumper has been partially detached for about 7 weeks.  Every single person at this shop was remarkably nice—from the lady on the phone, to the young man who so politely offered to move my car when I parked it in totally the wrong place.  The waiting area was clean, neat, and well lit, with comfy, non-holey chairs.  After a short wait, a petite and pleasant woman, maybe 40, introduced herself.  She would provide the estimate on my repairs.  We headed outside.  She pointed to the ledge at the doorway on which I had tripped walking in, so I would not do it again.

After I brought her to the car she said I could go back inside and wait, but I asked to hang out with her, because I like to see what other people do.  I know less than nothing about cars, and I loved that here was a youngish, friendly woman who clearly knew her way around them.  I admired her right away.  She was thorough and conscientious, looking inside and out.  She was also extremely knowledgeable and patient, showing me everything, talking me through the parts and functions, and answering my ignorant questions, down to how the VIN includes the paint mix of the make, model and year.  She stayed with me through the whole process, including walking me out to show me the key drop box, because they can’t fix my car for another two weeks.

Before we said goodbye I could not help myself.  I told her how happy it makes me to see a woman doing a job that I have only seen men do.  She seemed genuinely proud and thankful for the compliment, and I’m glad I said something.  I didn’t mean to make her stand outside in the cold any longer, but she started reflecting and telling me her story.  Turns out this was her first day on her own at this job—I thought she had done it for years already.  Nope.  She had done inventory for a railroad company, and programmed machines that cut industrial dies.  She had worked in shops and factories of various kinds, it sounded like, always surrounded by and holding her own among men.

I asked her if it feels different (and hopefully better?) being a woman in these male-dominated fields now, after all these years.  She thought for a moment (looking completely comfortable, while I had started shivering already).  It almost seemed like she had never considered the question before?  She concluded that her peers and coworkers have never been the problem.  It’s the customers.

She kept talking, as if the subsequent story had been waiting days for a sympathetic ear.  In her last days of training, a man brought in a car with severe rear body damage, clearly from a collision.  He gave her a history, she made her appraisal, and he was suspicious and dismissive toward her the whole time.  To assuage him, she brought her trainer to review the case, whose assessment and recommendations were the same as hers.  This time the customer told a different story—admitted to lying to her, basically—and accepted the trainer’s evaluation.  No apology, no remorse, no respect.  She was still affected by it today, and upset with herself that she had let him get under her skin.  Whatever, she said in the end, she’s here to do a job, and there will always be people who underestimate her because of her sex.  Thankfully her trainer was an ally, which made me proud of the good men in our midst.

This woman’s life experience, though clearly different from mine, felt relatable and real to me.  In those few minutes, in the waning daylight of a brisk fall evening in Chicago, surrounded by broken cars, I felt solidarity with and pride for her.  It made me better for reminding me once again of our shared humanity:  Hers, mine, my patients’, those crazy drivers on Wednesday, even her lying customer.

We’re all here doing our best with what we’ got.  I firmly believe this, but sometimes I forget.  Hearing folks’ stories always brings me back.  So I’m thankful for them.

 

November 21:  Cardio Catch-Ups Make Me Better

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Ummm, this may not be my photo!  It was on my phone from 2017 and I can’t remember where it came from–I usually ask friends for permission to use… If it’s yours please claim it!

NaBloPoMo 2019

Is there something you should do but you don’t always want to?

Exercise perhaps, or laundry?  Dishes?  Cleaning and decluttering?

Last year I listened to Better Than Before by Gretchen Rubin.  It was a fun, relatable, well-researched and –reasoned book on habit formation and change.  I have recommended it to many patients for its myriad practical strategies.  One that particularly resonated with me was the idea of pairing.  Basically if we combine the thing we should-but-don’t-want-to-do with something we like or do-want-to-do, we are more likely to form and strengthen the habit of the ‘sbdwtd’.

In one of those Eureka! moments of instant understanding and integration, I started saving my favorite TV show to watch while doing the interval program on my elliptical.  Thanks to the hubs for positioning the cardio machine right in front of the TV in the basement!  Sadly, The Big Bang Theory has concluded and there are no other 30 minute shows quite so compelling to get me moving.  Thankfully I have my favorite podcast and Liked Songs list on Spotify, so I’m not totally sedentary.  On days when I’m really motivated, I still do the 7 minute workout or a TRX program.

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Do you wish you could connect more often with friends?

Years ago I remember talking on the phone while unloading and putting away groceries or folding laundry.  My friend was in San Francisco, I in Chicago.  We knew each other’s days off and would just call when we had a moment, and talk if we were free.  Farther back, in college and med school, we could all just hang out at each other’s apartments, pretending to study, but really just eating and talking.  Now we text, which is nice, but it’s not the same.  Somehow it feels harder to get folks on the phone anymore, and even harder to meet in person…  I miss my friends.

I’m getting a little better, though.  Sometimes I make phone dates with people for my commute.  It can be challenging across time zones, but we make it work.  It’s finite and somewhat reliable—I have to spend 30-40 minutes in the car at some point on any given morning and evening on workdays.  I even managed to connect with two Counsel members for pep talks before important meetings recently.

This month my new friend Alex and I started a new connection method, the Cardio Catch-Up.  She lives in DC and has to walk her dog.  I still need to work out, which I usually do in the evenings.  So we arranged a call over exercise tonight.  It was perfect!  I had to commit to a certain time, and my friend held me accountable.  I got on the machine and didn’t even notice the time going by (okay it just went by a lot faster), while we bonded over our LOH learnings, musings on human behavior and tribal dynamics, and our shared progressive values and aspirations for the planet.  I got my workout in, check.  And we both alighted on themes for future blog posts.  Tonight’s nascent idea:  Is the contagion of urgency the best vehicle for motivation?  Who knows where it will lead, into what it will grow, with what it will merge?  Regardless, it was born of an optimal pairing.

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The Cardio Catch-Up is the perfect multi-win:  Move the body, release stress and tension, connect with another beautiful human, exercise the mind, and inspire the spirit.  Who wants to do it with me next week?