#AtoZChallenge: Journey More, Judge Less

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In college I had the privilege to learn from Professor Charles Yarnoff.  Mrs. Summers taught me to write in my sophomore year of high school, but Professor Yarnoff took it to a whole new level.  I think he would say I’m still too wordy, but hey, it’s my style.  I didn’t know at the time, but the essay I wrote on growing up Chinese in America would become a recurrent touchstone for me over the years—including now.

My cross-cultural education commenced early—I remember going to a friend’s house for a playdate in first grade.  I started to take off my shoes and she looked at me strangely.  Apparently her family wore shoes at home.  I looked at her strangely.  Over the years, I learned to pay attention to how my American friends did things.  I tried to follow suit and not appear ignorant.  When they came over, I found myself explaining to them how we did things in my house.  I considered myself very Chinese.

Then our family went to Taiwan in 1985, and I found out how American I was.  We visited my grandparents in Tainan, who still lived in the homes where my parents grew up.  That is where I learned that some people simply live with occasional ants and salamanders climbing the walls.  At first it was gross, then intriguing, and then, okay, that’s just how it is.  In my aunt’s modern apartment building, there was one drain for the whole bathroom floor, rather than just for the shower area.  You just stood on a wet floor until you were all done in there and it would dry off eventually.  That was a lot harder to abide than bi hu, or ‘wall tiger’ amphibians, for some reason.

bi hu 2011

 

At that time, my twelve year-old world view was pretty narrow.  I thought it was an interesting trip.  I liked some parts and definitely not others, and I was very happy to be back in the States where everything was normal.  I Judged America as clearly better than Taiwan—more advanced, cleaner, and with superior plumbing.

Since then I have Journeyed a little more.  In 1999 I went back to Taiwan on vacation, the first time since 1985. I got to visit Taiwan National University Hospital in Taipei.  I felt surprised at how modern it was—like I could easily have put on a white coat and cared for patients there myself.  Then my grandmother became ill and I flew back again in 2000.  She was admitted to the teaching hospital in Taichung.  She was already intubated when I arrived, but still awake and in the room she shared with another patient.  I was shocked—intubated patients in the US are almost always sedated, and transferred to private rooms in the intensive care unit.  She was soon transferred to the ICU, where we were given a shopping list.  While the staff settled her into her room, which resembled more of a sterile alcove with a bed to me, we the family walked across the street to the medical supply store to buy the towels, feeding tubes, syringes, and other items they would need for her care.  I remember thinking, You have got to be kidding me—seriously?  But I was with my mom and aunts, who reminded me that this was not America, and things worked very differently there.  They were patient with my young adult, young physician, American disdain.

Each day for lunch, we ate at a little hole in the wall, Tsai Duo Duo (Food Much Much).  It’s still one of my favorite places to eat, ever.  It was always crowded with people, in typical Asian fashion.  The two-level food console astounded me—laden with a hot food assortment so vast, it would take me a month or two to sample it all.  It was like the entire Whole Foods eatery packed into eight square feet.  We each picked up a small paper box, filled it, weighed, paid, and scrounged for seating.  When we finished, we dumped leftovers in one big waste basket, boxes in another.  My aunts told me that at the end of each day, the food waste was taken to local farms to feed the pigs.  How brilliant! I thought.  It made me reconsider my assumption that everything worked better in the US.

In the summer of 2006 I went back to Taiwan yet again.  This time my parents had their own place there, and everybody was healthy.  I gave a presentation on womens’ health (in Chinese—I was so proud of myself), and we got to see some historical sites in Tainan.  One night from my parents’ high rise, I heard music coming from the street.  It sounded like an ice cream truck—at 9pm.  It was the garbage truck.  My mom scurried to the kitchen, where she opened the freezer and pulled out a small, securely tied plastic bag.  It was their organic food waste for the week.  She explained that in that hot, humid climate, keeping organic waste out would wreak after a day or two, so people kept it cold.  Everybody brought their trash to the collector when they heard the familiar music.  The singing truck reminded me of that Monty Python scene—“Bring out your dead!”  Once again I was struck by how humans adapt to different circumstances, and how differently people live in other places.

The point of all this is that I think access to multiple, different points of view helps us understand one another more easily—if we let it.  I suppose it could just as easily make us more narrow and judgmental—“I don’t like this (you), it’s (you’re) not like what I know (me).  I don’t know how it (you) will change my way of life, it (you) scares me, and I don’t like it (you) even more.”

I find most of my well-traveled friends to be more open-minded and non-Judgmental.  The world can only get more connected, integrated, and small from now on.  The more readily we can see the similarities between us, the more willing we are to embrace one another, the better off we will all be.  I need to travel more!

#AtoZChallenge: Inspire. Imagine. Integrate.

Inspire.

Dictionary.com:  To inhale.

Breathing: We can’t live without it (duh)!  But we take it for granted, or at least I do, until I can’t do it very well, like when I have a cold.  Oh, how I appreciate clear nasal passages and an airway free of mucus during those times!  But let’s take a closer look at Inspiration, the function of breathing in.

During the in-breath, the diaphragm contracts.  The chest inflates.  To do it fully we must sit or stand up straight.  The spine elongates, the sternum lifts, and the ribs spread, to accommodate three dimensions of filling capacity.  Negative pressure sucks in not only air, but venous blood, returning it to the heart.  Inspiration, then, constitutes expansion, loading, and readying for the next phase in a beautifully rhythmic, life-sustaining cycle.  It is necessary and automatic.

Dictionary.com:  To fill with an animating, quickening, or exalting influence.

How and when are we Inspired?  What then, do we do with our bodies?  We breathe deep, straighten our posture.  We feel steady and resilient, and we get to work.  We discover previously dormant or untapped creativity, and gears start turning.  Ideas flow; actions flow; we flow.  In addition to expansion, loading, and priming, Inspiration stimulates openness, Inclusion, and possibility.  We can move Infinitely farther, faster, higher, and stronger with Inspiration than without it.  Inspiration Ignites.  And, under the right conditions, I would argue it is also necessary and automatic.

 

Imagine.

Fueled by Inspiration, fully oxygenated and standing tall, we can then truly start to Innovate.  We can ask questions that might otherwise seem too hard:

  • What would I do if I knew I could not fail (cliché, I know, but bear with me here)?
  • If I fail, how could that actually be cool?
  • If we collaborated rather than competed, what more could we accomplish?
  • What is the greatest good that could come of this Idea, how far could it actually get?
  • How does this relate to everything else that I am about and that I do?
  • How could I make this a win-win?
  • What needs to happen in order for this to really take off?
  • What if they’re not just fantasies, after all?

How Infinite is human Imagination?

 

Integrate.

Ironically, Inspiration and Imagination can feel Intimidating.  Too often we are held back by thoughts that resemble humility, such as, “Who am I to challenge the status quo,” and, “I’m only one person, what do I know?  The people in charge must know what they’re doing, I should trust their leadership.”  Or maybe it’s fear?  In a world that operates too often on an assumption of scarcity, we may mistakenly believe that our Ideas and Innovations might threaten others, and rocking the boat can have unInvited consequences.  Or, maybe, we simply cannot yet believe in our own greatness.

New Ideas and Innovations do not necessarily negate those that came before them.  Indeed, their evolution often depends on previous Iterations.  There is no need to disavow or Invalidate anything already existing in order to bring forth something Inventive.  Intoned with respect and proper deference, the new may be Integrated with the old—synergized.

If we can hold Inviolable our core connections, common humanity, and love, just think of how we could advance our world with Intense and unInhibited brilliance!

#AtoZChallenge: Humbling and Honoring

Though I was born in the United States, I grew up very Chinese.  Honor and respect for elders was one of the highest values in my family, as it is in the culture at large.  It would never occur to me to be on a first name basis with anyone in my parents’ or grandparents’ generation; they were all uncles, aunts, and surrogate grandparents.  Teachers, as well, always had a title.  In the presence of these zhang bei (senior generation), I would sit or stand up straight, pay attention, and never interrupt.  So it feels Humbling to find myself friends—equals!?—with so many of my elders—

Joe, my 7th grade math teacher,

Dawn, my 7th grade English teacher,

Kathy, Joe’s wife and the music director for the 8th grade play,

Barbara, my 9th grade geometry teacher and freshman volleyball coach,

Lisa and Jerry, my varsity volleyball coach and her husband, one of the football coaches,

Mary and Dan, my confirmation sponsors in college, pastoral associate and pediatrician, respectively, and

Keith, my clinic preceptor intern year.

I always wondered, what did they see in me, so young, naïve, and ignorant, that would make them want to know me as a friend?  Then about ten years ago I found myself befriending students and other ‘young people.’  I gradually realized the rewards of the exchange—new perspective, fresh ideas—connection across generations, cultures, experiences.  I felt a sense of mutual admiration and understanding, despite the age gap—an appreciation that bridged the separateness.

Somehow this reminds me of a morning I spent volunteering in a free clinic a few years ago.  As per usual, patients filled the waiting room and clinic workflow bore no resemblance to anything efficient or modern.  But the atmosphere pulsed with purpose and kindness.  First and second year medical students helped run this clinic, relishing the chance to hone their history taking and physical exam skills.  They saw the patients first, synthesized all relevant data, and presented a summary to one of a few attending physicians staffing the clinic that day.  After some discussion on pathophysiology and care plan, the attending led the team of students back to the exam room to finish the encounter.  If you have ever been a patient at a teaching hospital, it’s much like that, only much slower and often with profound technical barriers and almost no support.

That morning I walked in with my team to greet an elderly Pakistani man for follow up of his blood pressure and diabetes.  I knew he had been waiting a long time.  It was almost noon and he had not eaten all day, in preparation for fasting labs he knew he needed to have drawn.  Upon greeting him, I automatically apologized for the wait, put my hands together, and bowed slightly, while I thanked him for his patience.  I felt bad about the whole situation, and I wanted his pardon.  His face lit up and he immediately turned to the students and said something like, “See?  That is how you treat an old man!”  He was not angry or crotchety in any way.  He seemed honestly and happily surprised to be treated with Honor and respect—as if he suddenly felt seen and appreciated for who he was—a member of an older, wiser generation than all of us.

In Pakistan this gentleman had been a middle- to upper-class professional.  Here in the US his resources were drastically curtailed, such that he had no health insurance and depended on the free clinic to get treatment for his conditions.  I wonder if he was used to feeling like just another immigrant patient in a busy, understaffed clinic where there were few occasions for others to ask about and listen to his story.  Since I was a periodic volunteer, I had that chance.  I get to choose when I am willing to donate my time and energy to the free clinic—everything I do there is on my own terms.  The patients there have no such choices.  If they want care, they have to show up—early—on the day the clinic is open, regardless of what else is going on in their lives.  There are no appointments, and almost no continuity with providers.  It’s a completely different world from where I make my living, on the Gold Coast of Chicago.

I am Humbled by the opportunity to meet people from all walks of life.  Students arrive at medical school from diverse backgrounds.  Patients may hail from all corners of the world, many having come through experiences I can scarcely imagine.  It is my Honor to care for all of them, and I wish to maintain this perspective of respectful service.  I have those who support, teach, and guide me in life—older and younger.  So it is my privilege to give back—to offer my own knowledge, expertise, and maybe sometimes wisdom—and help make a positive difference in people’s lives.  I can’t remember exactly, but I think I said something to this effect to the medical students that day.

Physicians have power by default and design in the medical setting.  We can wield that power with more grace and efficacy when we remember Humility, and Honor our patients as whole, rather than broken or defective.  Be they students, friends, political opponents (yeah, stuck that in there), teachers, or patients, there is always something to learn from someone else’s perspective.  Cultivating the Humble and Honoring perspective, when I can muster it, makes all of my relationships infinitely richer.