“Rice Grandma”, fermented glutinous rice just like my own PoPo used to make, and in the background glutinous rice balls filled with black sesame paste. Both foods that bring me home.
What foods make you happy? Why?
In Disney’s 2007 film “Ratatouille”, the hostile food critic experiences an existential transformation after his first bite of the unsophisticated but sentimental title dish. His olfactory sense, the most primitive and tightly bound to long term memory of them all, triggers intense feelings of comfort, love, and security from childhood, when his mother served him ratatouille after he was hurt.
Sister and I bonded recently over the Asian food display at my local Costco. We found the pork sausage that Ma used to use in her fried rice, and egg yolk pies that we can almost never find in stores, even in Chinatown. When I gushed about it to a fellow East Asian friend, she pointed me to a new Chinese supermarket near me. Daughter and I went exploring today. …While I would not quite call my experience existential, it was intensely joyful, and our haul provided a unique satisfaction that moved me unexpectedly. I found myself texting photos to my parents, wishing they could be with us, recalling the flavors, sounds, and memories of growing up Chinese in white, suburban America.
I learned early in childhood not to bring food from home for lunch at school. Stares and disgusted facial expressions from classmates at the appearance or smell of my family’s cooking vaporized my appetite and made me unpleasantly self-conscious. It’s okay though, because I loved hot lunches at school—it was stuff I never got at home—overcooked green beans, spaghetti and meatballs served with an oversized ice cream scooper, and chicken fried steak—I had no idea what it was, but it tasted great—so different!
Authentic Chinese food was enjoyed at home only, especially the really weird stuff like preserved or salted duck eggs, fermented bean curd, and dried pork sung. Like most teens, I did not fully appreciate these foods at the time. In college I got to explore Japanese, Indian, Middle Eastern, and Thai food, all new to my naïve palate. But when I went home—when I go home still—Sunday mornings eating rice porridge with the small plates of colorful, multi-odorous, myriad-textured food really was (is!) comforting. Daughter saw today how giddy it all made me, and it excites her to try these foods for herself. Another generation bonded to cultural roots awaits its next awakening.
One of my goals this year is to live much more mindfully. This includes cooking more at home, and really appreciating and enjoying—savoring!—my food, rather than inhaling it while attending to a dozen other tasks or problems. My Chinese grocery acquisitions these last few weeks excite me more than I anticipated. Maybe I’ll start bringing leftovers for lunch again.
What lessons and mementos will you hold in front, what light guides you?
Tonight I consider the landscape and path ahead. What do I look forward to, and how do I want to be? How will I approach relationships, media, leadership, projects, and health? How will I challenge myself? On the last blog post of 2021, what do I want to look back and be able to write about what’s important to me in the year past?
Relationships: Always work to do here. Some will require more vulnerability, which is scary. In others I will work to overcome booth pride and self-doubt—maybe that is the ultimate paradox of imposter syndrome? At my best I exemplify curiosity, humility, generosity, honesty, and kindness. In the hardest moments I must cultivate non-judgment, empathy, and patience. I will scrutinize my inner narratives and assumptions, and look always to connect.
Media: Ask. More. Questions. What is the writer/reporter/source’s objective? What is their bias? What is mine? Where/how can I access primary data in full context? How should I be willing, and how willing should I be, to learn, change, and grow from what I take in? How will this make me better, and to what end? To practice thoughtful discernment—before, during, and after consumption—that’s the goal.
Leadership: What do people need from me, individually and as a group? How can I best also lead those who lead me? In 2020 I completed a 360 evaluation; the feedback has served me well, and I review it often. In 2021 I commit to stepping out of my default styles more often. I will nurture my I, S, T, and J sides and attune better to those who live at these frequencies. Goal: To help my people and organizations advance toward our full potential, always aligned with and in service of our deepest core values.
Projects: Assuming the invitations continue, this could be hard. Every new presentation, paper, group, conference, and class, in my mind, is another exciting opportunity to learn, synthesize, integrate, and connect! But I can’t do everything, and I must stop “screwing your future self,” as Ozan puts it, by overcommitting.
Health: Walk the talk. Sleep, Exercise, Nutrition, Stress Management, and Relationships. After all this time, defining health in terms of these five reciprocal domains continues to bring clarity and direction for both my patients and me. I’m learning about keystone habits, which I bet will help all of us in the coming year. Thankfully, not every domain goes to hell at the same time, and all behaviors are subject to change. Goal for 2021 is to fortify healthy habits in each domain, especially the weak ones, to make them less susceptible to derailers.
Coda – Some last thoughts for the year
Books: This week I started and finished Matthew McConaughey’s Greenlights on Audible in about 36 hours. I don’t know if his hoots and whistles are written in the book, but they and he are a riot to hear on audio. What a master storyteller! And the life lessons are valuable, too, offered with humor and confident humility—highly recommend.
Since I shared my 2020 book list last week, friends have made myriad suggestions that are now in the queue for 2021:
The Naked Now by Richard Rohr
Upstream by Dan Heath
Nonviolent Communication by Marshall Rosenberg
Who You Are: The Science of Connectedness by Michael J. Spivey
You’re Not Listening: What You’re Missing and Why It Matters by Kate Murphy
Thinking In Bets by Annie Duke
Out of Our Minds: Learning to Be Creative by Ken Robinson
The Coddling of the American Mind by Greg Lukainoff and Johathan Haidt
The Long Game by Mitch McConnell
I’ve considered reading that last two for a few years now, and always avoided it. Didn’t want to be uncomfortable. In 2021 I commit to training in discomfort, to learn and broaden perspective.
Songs: A friend solicited a playlist to bridge what has been to what can be. Here are my contributions.
COVID Vaccine: I recommend it. After reassurance that my colleagues at higher risk than I who wanted it have gotten it, I got my first dose of the Pfizer/BioNtech vaccine yesterday. 34 hours out now, I have minimal, focal, and superficial arm soreness at the injection site and no other symptoms. I did my usual HIIT workout tonight without limitation. Read this concise and user friendly guide to the mRNA vaccines by Pfizer/BioNtech and Moderna, with references to data on safety and efficacy. To see when you will likely be eligible to receive the vaccine, refer to this slide deck from the CDC, also concise and easy to read. There are many months yet ahead to stay vigilant and mindful, though. Cases and deaths will continue to rise before receding, especially with all of the people still traveling for the holidays. Please continue all of your best COVID exposure precautions, for all our sakes.
So much lies out of our control, friends. And yet we all still have all kinds of agency. We get to shape our future. Let us all use our personal power for good, shall we? At the end of each day may we look back and forward on myriad words and acts of kindness, generosity, humility, and connection, rather than judgment, ridicule, derision, and exclusion. That’s how we can make 2021 infinitely better than 2020.
I am not great!! Neck, back and head pain, insomnia, low mood, and the worst case of stress eating in a couple years—GRRRRRRRR! *deep breath* …So, like a good primary care doctor (she says with tongue in cheek), I evaluate and treat myself.
I ask patients to rate the stress and meaning of their work and then compare: Is work overall more stressful than meaningful, or the other way around? It helps me assess the sustainability of their work life, and gives me insight into their values and priorities. In recent years when I’ve asked myself, the answer is consistent: moderate stress, HIGH meaning. Today it’s high stress, less high meaning. For the first time in a long while, work is not necessarily more meaningful than stressful. Yikes.
Stress: It’s COVID.
Meaning: I ask patients how they derive personal fulfillment and meaning from work. I recently asked myself again. It’s twofold: Relationships and Efficacy.
Relationships: I am your primary care doctor. Sometimes I’m your therapist, your cheerleader, your drill sergeant, and your accountability buddy. I have always loved this, even on the hardest days. But this year, I am also a resolute public health advocate. Sometimes that rubs you the wrong way, because I tell you things you don’t like. I recommend against flying. Don’t eat at restaurants. Don’t gather with your family for the holidays. Don’t go to church. Stay home for 14 days after an exposure. I interrogate your COVID precaution practices. Then I dissect and judge them (not you), thank you on behalf of humanity, and admonish you to persist, longer and longer, for all our sakes. It kinda puts a damper on our relationship.
Efficacy: I. Help. People. It’s my calling! Hemorrhoids? No problem. Back pain? I’ got this (yer back, that is). Viral gastro? Migraine? Core instability, palpitations, paresthesia, GERD, thyroid nodule—even depression and anxiety—I can make a good plan for all of these things. I can walk you through it, reassure you, and help you feel better, even when I can’t fix the problem.
Not so with COVID. How did you get it, when you were so careful? If the test is negative there’s still a 20-30% chance you’re infected if the scenario is high risk, but I can’t say for sure. If you’re sick, how long will it last? Will it get worse before it gets better? How much worse? Will you have lasting symptoms or long term health problems? How long does immunity from illness or vaccine last? I cannot lie: I. Don’t. Know. I will stay with you through it, but I can’t even satisfy your most basic questions, while you sit alone at home coughing, short of breath, unable to see or touch your loved ones, sipping ginger ale because you throw up anything else. I can’t help. And it kills me.
On top of that, I’m not doing any good as a public health champion, either! Have I changed any of your behaviors? Have I made even an iota of difference in my community to stop the spread? All signs say NO. I’m failing left and right. No wonder I’m eating so much.
Burnout
Burnout is widely understood to have three key components: 1. Emotional Exhaustion, 2. Cynicism/Depersonalization, and 3. Reduced Personal Efficacy. Studies of physicians generally show that while we often score high on the first two, we do better with the third. I think not anymore. Burnout affected about half of all physicians in all specialties a few years ago, but had improved due to widespread research, awareness, and advocacy for systemic change led by professional societies such as the American College of Physicians and the American Academy of Family Practice. But think about 2020: Whatever emotional exhaustion my emergency medicine and critical care colleagues felt before, caring for the sickest of the sick, likely pales in comparison to the horrors of this pandemic. When their health systems ignored their pleas for PPE and then laid them off, making remaining docs work that much harder, and when they saw people partying and spreading virus all over the place, could you blame them for getting cynical? And though we’ve learned so much and fatality rates are lower now than in March, imagine going to work every day to watch patient after patient suffer and die alone, despite your and your team’s best efforts. We can no longer count on efficacy to save our morale.
Re-ignition
So how do we hold it together? Well DUH, it’s about connection! I had not felt this bad in a long time, but I’m better now, thanks to my peeps. They’re everywhere, and we hold each other up. Texting a meme here, venting (a lot) over there, and generally being present for one another, sharing, even embracing, the deep suck of the morass. Because this too shall pass… Like a kidney stone, as they say.
The only way out is through. The best way through is together.
I haven’t thought, said, or written that in a while. It’s not that I forgot. I got overwhelmed. Happens to the best of us.
Healing Through Connection 