Help On the Path to Better

IMG_2610

Okay, let’s talk about your eating!

What about your eating habits is already good, that you want to maintain, that you’re proud of?

And where is there room for improvement?

Sometime in the last five years, I started querying my patients about nutrition this way.  It seems to put people more at ease talking about their eating habits, for some reason.  Culturally, we are so judgmental and defensive about food and eating, weight and appearance.  So one day, I decided to start with the positive, and it makes the conversation easier for everybody.  Fascinating!

I did not realize until the past week that this is my personal version of appreciative inquiry (AI).  I have started including AI in my presentations this fall, which is very well received so far.  I got feedback from the talk I gave to my design friends two weeks ago.  They liked focusing on the positives of work before problem solving.  This week I presented to a mixed audience of physicians, from all specialties, early career to retired, on burnout.  I chose to make it similarly workshop-like, a very ambitious undertaking in 45 minutes, but we did it!  In the last segment I invited audience members to identify the first step they might take to address their own sources of burnout, or improve their self-care.

One generous physician shared her plan, initially stated as, “Just commit to doing it,” talking about exercise.  After a few more questions, we arrived at her actual plan: figure out what she will do (treadmill); decide how long she can carve out (30 min); find time on the calendar; write it on the calendar; know how she will be held accountable.  Turns out she had already succeeded at executing–5 times a week for 20 weeks this year—STRONG WORK, MAMA!  I wonder if there are other arenas where she applies this same, stepwise approach to making something better in her life, or the lives of her patients.

When I ask patients what needs to happen to improve their health, we inevitably start at the abstract (“Just Do It”) and must work to get to the concrete, granular action steps that will actually result in successful behavior change.  It’s gratifying for both of us to arrive at a plan that the patient him/herself has an active hand in creating.  Then s/he feels ultimate ownership and agency to execute.

These days I also always ask about help.  Who else can keep you on track?  Can your spouse eat healthier with you?  Can your assistant eliminate junk food from lunch meetings?  Can your kids be your food police?  My best friend in college agreed to do this for me our junior year, and I lost all of my freshman fifteen, God bless him (and yes, we are still friends).  When we go shopping and I look tempted to buy yet more of something I already have piles of, my daughter asks, “Do you want me to be your conscience?”  Usually I reply with a hedonist, “No,” but I’m always grateful for the offer, and it does make me think twice.

Often patients return the next year living healthier in one way or another.  Sometimes the plan works; many times they find another way.  Sometimes plans are executed and then derailed.  So we get to work on a new plan, asking all the same questions over again.  It doesn’t have to be a slog!  It’s just what we’ gotta do—keep getting help on the path to better.   It’s my privilege to serve as helper.

These last two weeks (months?), I’m definitely not sleeping enough.  Exercise is hit or miss.  Eating is pretty erratic and unhealthy.  Stress ebbs and flows with travel and events.  But my relationships are thriving and I’m doing some seriously fun and amazing sh*t.  Next year maybe the eating and workouts will be on autopilot and I’ll have to lean on folks to get through rough times.  The path to better always gets blocked, takes detours, and makes us reroute.  Those twists and turns are so much more fun, and we notice so much more beauty that we might otherwise miss, when we take them with good friends, no?  I’m so grateful to have such loving help on the journey, and also honored to offer it.  Onward.

 

The Importance of Peer Support

IMG_2151

What a privilege to present again to a group of smart, creative, fun, and engaging designers on Friday.  This time I was asked to address burnout, as so many folks are feeling overwhelmed and stressed.  I did my homework on stress and burnout in the creative fields, and found enough similarities in medicine to feel like a credible speaker.  “It’s not just a job, it’s a way of life,” seemed to capture how we see our respective vocations.

I presented a brief mini-lecture on self-care practices, including habit formation and maintenance in the 5 reciprocal domains of health, and narrative awareness.  The latter is always something we can do when we find ourselves in untenable circumstances:  Ask ourselves what story we tell about the situation, how that story compounds our suffering, and then tell a new story that does nothing to change the objective reality, but can dramatically improve our personal experience of it.  I have learned from work in physician burnout that people don’t just want to be told how to fix themselves.  They want someone to address the problems of the system that oppresses them.  So that’s where I tried to go next.

I started with an Appreciative Inquiry (AI) exercise.  In small groups, I asked participants to share team success stories, and listen for recurring themes around what’s already great about their teams, their work, and their organization.  Words like openness, flexibility, and “we have leaders, not bosses” made the Post-It easel list.  Then, in this headspace, I asked the groups to identify issues they wanted to address.  Instructions were to find important, urgent, and solvable challenges.  Guiding questions included, “Why will the organization be better if it’s addressed?” and “What does better look like?”

Similar to the AI results, common issues arose from multiple groups.  There was general consensus, reviewing the list at the end of 20 minutes, that overall work satisfaction would improve with less digital and more face to face communication, better project clarity, and taking better care of the shared spaces.  I would meet with team leaders and show them the list later in the day.

IMG_1939

When I opened the floor to questions, a self-proclaimed ‘Debbie Downer’ presented a query that I will ponder for many months as I prepare upcoming talks:  “When you ask someone how they’re doing and they say they feel like they’re drinking from a firehose, telling them to adjust their attitude is probably not helpful…  How can we change things that are not in our control?” The Universe had prepared me for this question by sending a new mentor who taught me to ask, “Who owns the things we don’t control?”  Thank you, my loving Cosmos.

I only partially answered Debbie’s question by suggesting she think about how she might influence the owner(s), how she might impact decisions being made in those spaces.  I segued too quickly, I’m afraid, to the question that I wanted to ask the group:  “When someone asks you how you are and you express that you are overwhelmed and drowning, what is a helpful response?”  I thought the discussion that ensued was productive…  It seemed to stimulate people’s intrinsic empathy and compassion.  We recognized the importance of feeling connected, that I’m not the only one feeling this way.  People recognized the relief found in just speaking aloud the list of stressors to a sincere and empathic listener.  We also talked about being prepared to hold space for any potential answer when we ask, “How are you?”  Even if we have no control over the flow out of the fire hose, maybe we can take turns holding the nozzle steady, and at a slightly oblique angle for each drinker, so it doesn’t have to knock us all over when we try to take a gulp.

I had a chance to talk to Debbie a little later (Cosmos offering me a second chance, Thank You Again), and we agreed that stress and burnout, in both medicine and design, are best addressed at both the individual and systems levels.  We can each start with personal accountability for our own experience of the system.  Then we can decide how we show up in the system each day.  We can choose, at any time, to either participate passively in the status quo (which is what we all need to do sometimes), or find a way, however small, to advocate effectively for change.

The latter is much better done with peers, with friends.  Take time to connect (no lunch meetings, let’s just eat together!).  Share stories.  What do we love about this work?  What’s already great?  How could it [realistically] be even better?  How can we help one another, including our leaders, envision and pave the way there?  Who else needs to be enrolled?

My meeting with the team leaders was less structured.  I worried that they left feeling disappointed because I did not offer more concrete advice on personal resilience practices for leaders, and ‘how to lead’ teams in burnout.  But over the hour, I felt no desire or need to lecture.  I queried various aspects of their self- and team awareness, personal resilience practices, and communication.  We briefly reviewed the issues list from the morning workshop, and I left with confidence that they would take it seriously.  It also occurred to me that these designated leaders were already supporting one another in their efforts to lead intentionally, effectively, and compassionately.  Maybe they have also felt overwhelmed sometimes.  Maybe it was also good for them just to talk it out with each other this day.  Maybe we can all do this for one another a little more often.

 

A Community of Champions

IMG_1161

Spoiler Alert:  Big Bang Theory Series Finale!

* * * * *

When was the last time you felt totally safe, at work, to address the central relational challenges that hold you and your team back from your best performance?

How often at work can you really assess and evaluate your own interpersonal skills, their impact on those around you, and on the organization as a whole?

How much time and energy do your teams waste being stymied by relational issues, stuck in redundant, dysfunctional power struggles up and down the organizational hierarchy?

How do you feel in your body just reading these questions?  Perhaps tense and frustrated?

* * * * *

We, the eight participants and two faculty members of Leading Organizations to Health Cohort 11, reported palpable heaviness upon convening for our second training retreat last Tuesday.  Despite the Colorado spring bursting with blooms, wildlife, and vast clear blue skies, dark clouds hung over our collective consciousness, each for our own reasons.  Throughout the week we shared stories of successes, challenges, conflicts, power and powerlessness.  We practiced appreciative inquiry and relational coordination, and explored the insidious impact of unearned privilege.  We spent three days in intense skills training, supporting one another through viscerally gnarly role plays and open, honest feedback about how we impact the group.

In the midst of all this deep work, we also shared meals, walks, a horseback ride, and life stories around a fire pit and drippy s’mores.  As we debriefed around the circle on the last day, something had shifted:  overall we now felt refueled and energized.  The air buzzed with the anticipation of learners on the verge of integrating our emerging skills, excited to bring it all home to practice.  The clouds had parted.  We will keep in touch through peer coaching groups—our newly established, intense-support network.  In my heart, I feel we are really becoming a family.

 

IMG_1176

I headed to the mountains straight from the session, for 24 hours of processing and decompression (and more washi tape card-making).  More and more I marveled at what a rare opportunity I have in LOH, to be led and learn to lead in this relationship-centered way.  For these ten months I am immersed in a professional learning lab, experimenting with different ways of speaking, acting, and being, safe among fellow professionals also grappling with this skill set.  It just does not get any better than this!

IMG_1110

On my way down from the mountains, I listened to an interview with Bonnie St. John on Ozan Varol’s podcast, Famous Failures.  She is the first African-American to win medals in Winter Paralympic competition as a ski racer; she is a lower extremity amputee.  She is also an author, an entrepreneur, and a former member of the Clinton administration.  Her story is inspiring, please take a listen!  At the end of the interview she describes asking a former coach about how he built champions.  He said he never built individual champions; rather, he built communities of champions.  You can only push one person so far, he said; but an allied group of people will hold one another up, push each other harder, make each other better, take one another farther.

That is exactly how I experience LOH—my best self is challenged and called forth in the most loving and professional way.  We hold space for all our struggles, allowing the learnings (epiphanies, in my experience!) to emerge.  It is deeply and literally inspiring.  Though I already do so much of this inner work on my own, there is a profound and unparalleled synergy from learning in this group—we serve as one another’s pit crew for the journey toward our better selves at work and in life.

IMG_1089

Nobody succeeds alone.  In the series finale of The Big Bang Theory (my favorite TV show of all time, which I missed while at LOH!), Sheldon (the obliviously self-centered genius) finally realizes this.  During his Nobel Prize acceptance speech, he acknowledges his sudden and profound appreciation for his family and friends, crediting his success to their unconditional love and support, and recognizing them in front of an international audience.  LOH made this finale even more meaningful to me than it already would have been.

It is always through the struggles that we grow.  When struggle together, any and all successes are amplified exponentially.  My nine new friends will make me immeasurably more successful, both professionally and personally, than I would ever be without them.  God bless them all, and may the work we do together ripple out for the benefit of all whose lives we touch.

IMG_1185