Tag Archives: communication

A Dawdler’s Triumph

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I am a master procrastinator! It’s starting to show on this blog, but oh well, now you know me better. In high school I always wrote my English papers at the last minute, up late in the basement office, typing furiously, feeling giddily anxious under the pressure. In the end I always knew it could probably be better had I started sooner, but it was always good enough.

This time, though, I surprised and alarmed even myself.

Two weekends ago, while hiking happily through golden aspen groves in Silver Plume, Colorado, I realized my presentation to the American College of Surgeons Annual Clinical Congress was only ten days away. Rather than work on my slides that weekend, though, I spent my waking hours trekking through beautiful trails of my home state, with dear friends and family. I returned to the routine of life in Chicago only to realize that my blog post deadline had snuck up on me, too. I had every intention of writing on the camaraderie of friends, sharing stories, questioning, and challenging, all in loving, mutual respect and curiosity. I spent that weekend steeped in tribal love! No presentation slides materialized.

The trail to Pavilion Point, Silver Plume, Colorado

The trail to Pavilion Point, Silver Plume, Colorado

Last weekend I was scheduled to present a poster on physician wellness at the Society of General Internal Medicine, Mountain West regional meeting in Denver. Darn, I had to go back!  But as if my Unicycling post had foreshadowed, I overslept, missing my 6:00am flight and the poster session. The presentation was flung from my lazy Susan, thudding gracelessly to the ground. I felt terrible, as my colleagues in New Mexico had toiled to get the poster done on time, and because of my mistake, their work could not be presented.

You’d think the guilt from Friday morning would motivate me to get working on the ACS slide deck, but no. I spent that evening and the next day with my parents, seeking yet more autumn aspens among which to commune. This took us to the blue skies, crisp air, and vibrant foliage of Vail, and then back to Silverthorne, where instead of working I then proceeded to make greeting cards and bookmarks with my brilliant new leaf collection. I had come prepared with cardstock and packing tape, and I basked in procrastination heaven.

It wasn’t until 9:30 Saturday night that I finally opened PowerPoint. I chose a design and color scheme. I scoured files and Pub Med for data and citations. I consulted my outline, framed weeks before, and sifted through photos to represent main ideas. As usual, I felt an exhilarating mixture of, “Why do I do this to myself,” and, “Man, this could be really good.” By 4:30am, with eyelids of lead and a fair bit of pride, I could finally go to bed, 35 hours before the scheduled presentation.

Along I-70, Eagle County, Colorado

Along I-70, Eagle County, Colorado

So holy cow, what happened? This was a very big deal, I was going to speak to an entire audience of surgeons, for Chris-sakes, and they are no easy crowd! How could I put off preparing for THIS long? For my last original talk, at the Chicago Medical Society Midwest Clinical Conference in March, I had prepared weeks in advance, even allowing time to practice in front of friends before the big day. That was pretty uncharacteristic, but it was also a very big deal. For the first time in my professional life, I was not only presenting data and evidence, but also my own personal thesis on physician resilience—practices that I myself assert as fundamental to our professional well-being. WHY did I not take the same solemn approach this time?

Here’s the answer: FEAR. While not paralyzed, I certainly felt stymied. In my experience, surgeons tend not to think very highly of internists, as a group. Our training is shorter (think, ‘easier’), our hours often more forgiving, and our acute impact on people’s lives less (concretely) measurable. We are deemed less worthy, or at least that is my perception of surgeons’ perception (based on personal experience). So the idea of talking to this group on the ‘soft stuff’ of self-care and overcoming personal adversity made me feel more than a little vulnerable. On top of that, I lack the credentials we all look for in academic speakers: research publications, professor status, institutional titles. Who was I to speak with any authority to people who literally hold our patients’ lives in their hands every day?

By the time the slides were first done, I had determined that everything would be fine if I could just be myself behind the podium. After all, they invited me for a reason—someone had seen my CMS presentation and thought I was a good speaker. I’d better be, after nearly 30 years of practice! I’m relaxed, passionate, and articulate. So hopefully, the audience would just forget about my thin credentials and simply be awestruck by my superior presentation structure and style. Oh and I thought the content was pretty good, too.

I finally discovered my core confidence, of course, through writing. On the plane back to Chicago, I took out my freshly crafted aspen leaf notecards to write to my friends. Having just spent such quality time with them, I wanted to stay connected. It’s what I do. They knew about my upcoming talk, and I wanted to thank them for their encouragement and love. I also needed to confess my apprehension—get it out where it was safe. And I found myself writing, “I may not be the one designing the studies, and I may not have the fancy titles. But I’ve dedicated my whole professional life to helping people find their own agency, no matter who they are or what their circumstances. I know this shit; I live it. I’m the perfect person to talk about this, to anybody!”

Aspen leaf notecards and bookmarks, Vail, Colorado, 2015

Aspen leaf notecards and bookmarks, Vail, Colorado, 2015

Thanks to my remarkable tribeswomen, who hold me up even when I’m 37,000 feet in the air, I no longer question my own worthiness among colleagues in the American College of Surgeons, or anywhere. As long as I am my authentic self, and I do my homework, I can speak to anyone. In the hours prior to the talk I did a fair bit of power posing, just to be sure, and everything went swimmingly. I should also mention that three other women spoke at our session. They told personal stories of adversity and how they overcame. It was truly a privilege to be among them.

I sincerely hope that the ACS will invite more speakers from the ‘cognitive’ fields. I encourage the leadership of the American College of Physicians, the internal medicine professional society, to reach out to our surgery colleagues and collaborate on physician wellness initiatives. I read recently, “The only way to survive is by taking care of one another,” attributed to Grace Lee Boggs, 1915-2015.  Just as nobody overcomes personal adversity alone, and no physician can care for patients without an entire team of dedicated staff, no one specialty will hold the patent on physician wellness. Surgeons’ needs differ from internists’, to be sure, but we can all learn from one another, and the sooner we recognize that, the better for us all.

So, I procrastinate. It’s who I am. And I trust myself to get the job done–well, even. I have a chance at redemption for the SGIM blunder. I will represent my UNM colleagues at the podium of another conference in Washington, DC, in 10 days. I have the outline… Planning to create another PowerPoint file in the next day or two…

‘Perfectly Dreadful. How are YOU???’

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Friends, please read this piece by fellow blogger Pam Kirst, and visit her blog, also. In this post she addresses the central tenets of self-awareness, emotional intelligence, and relationship cultivation. An excellent reminder for all of us!

pamkirst2014's avatarCatching My Drift

A hot, sunny Labor Day morning: I pull up in front of Kim’s entry bower. Our friend Larry has planted her trellis with morning glories; their leaves are richly, deeply green and glossy, although, Kim says, the plants have never bloomed.

“What’s up with THAT?” she asks rhetorically, noting that Larry has never seen such a thing happen: morning glories always bloom. But not these, not at Kim’s house, not this year.

There are pots of brightly crisp annuals; there is an old, lazy cat basking in the sun.  There is Kim,–the day after her 60th birthday–lifting slowly from her shaded seat inside the bower, turning to pick up her purse and a book we’ve shared, and starting the slow trek to the passenger door.

I open my door into traffic, bound out quickly, and run to hug her.

“How ARE you?” I ask, exuberantly.

She gives me a look that…

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Blessings of the Renter from Hell

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“Please come right away, I cannot live here.” May*, the new tenant in our rental apartment, called Tuesday, pleading desperately. The previous tenant, let’s call him Lucifer*, had left the place in complete shambles, and she was overwhelmed. They had made arrangements directly that he would leave a few things in the apartment while transitioning to his new place. He told her it would be out of the way and ‘not affect your living space,’ and she could get the keys from the sub-letter. As they were both from China, May thought this was reasonable—help out your fellow countryman, out of courtesy. Since they had made their own transfer arrangements, my husband and I assumed he would prepare the apartment for the new tenant—clean up, basically. None of us could have imagined the wretched mess he would leave her when she arrived.

His stuff was everywhere—bookshelf crammed tight, closet fully hung with clothes. Dirty dishes and half-used remnants of ginger and garlic lay on the kitchen counter. A five foot-high pile of boxes and bags cluttered the far corner of the living room. The opposite corner housed a broken vacuum cleaner and another tangle of cables, trash, and more empty boxes. A vast array of shoes and slippers occupied seven square feet of living room floor. The hallway carpet had acquired a three inch border of decorative dirt on either side, and the kitchen floor looked as if someone had writhed on it after bathing in 5000 mile-old motor oil.

Lucifer’s kitchen

The more I looked the more offended and angry I felt. This had been our home for eight years. My best friend from college helped to install the hardwood floor with my husband when we first moved in, after hubs took out the old, gross, green carpet himself. We shared our hardest years of training here. I watched TV coverage of 9/11 while my husband was on call, hoping Chicago would not become another target. Hubs had laid the kitchen tile himself, freeing cherry hostages from the refrigerator for me every day because I was too pregnant to fit between the repositioned appliances. We lived out of the living room for three weeks and had new, plush carpet installed after the main water pipe burst behind the master closet—also while I was pregnant. It was our son’s first home, where not just his formative memories were made, but ours, as well. How could someone treat it like this? How did we let this happen?

On Wednesday I called my friends’ cleaning lady, Saint Anne*, who agreed to come Thursday. After 5 hours she could only make a small dent in the grime. She spent all day again on Friday, much of it on her hands and knees, sweating through her shirt and inhaling noxious fumes of the cleaning products she donated to the project. I brought lunch between errands and made arrangements for Stanley Steemer to come the next day. May stood by, still shocked and appalled at the conditions of her first home in the US. Saint Anne and I could both see the abject horror in her demeanor, wondering if she should stay another night or board the next flight back to China.

Saint Anne was a woman on a mission. She did not see this as just another cleaning job. She was contributing to the reclamation and restoration of my home. She was helping a poor, young student, new to this country, find her bearings in untenable conditions. She established a bond with both of us, instantly, through her dedication and unwavering commitment. I stand forever grateful to her for this, and will call upon her for any and all cleaning needs as long as I live.

I tried to reassure May that I would do whatever was necessary to make the place livable again. The stove was broken. The air conditioning unit had died. I found myself saying to her, “Please know, whatever I do, I do as if I were living here myself.” On Saturday I waited with her for Stanley Steemer to come, that tedious four hour service window. Saint Anne had done all of the heavy cleaning, GOD BLESS her, and there were still some stains on the kitchen walls. May and I found one pair of rubber gloves, each took one and a rag, and started to wipe things down together. It was the least I could do, to help her feel more comfortable and cared for.

She told me how rudely Lucifer had treated her on the phone, saying he would sue if she threw out any of his stuff, and interrupting her as if she were the nuisance for calling him on his vacation. We agreed that he had taken advantage of both of us, and we would look forward to having him out of our lives forever. We shared stories of growing up, and discussed the differences in lifestyle between America and China. We talked about respect, courtesy, and helping out your fellow human.

That’s when it dawned on me. Of course, it’s about relationships. Everything is. I let Lucifer trash my place because I saw my relationship with him as merely transactional. I never knew him as a person in the two years he destroyed my apartment; he was just ‘the tenant.’ He never knew me beyond the stranger to whom he paid rent. He had no idea that this was my home, and he had no reason to care. Granted, I think he is likely an exceptionally slovenly and oblivious individual, but still, I played a role in this mess.

Relationships take work to establish and maintain. I realized this week that this apartment is not merely a unit that we let out for extra cash. Our tenants are not just strangers who happen to live there and pay rent. The place is our home and the renters its caretakers. Beyond the terms of the rental agreement, if I really expect tenants to take care of my apartment, I have to give them a reason. They must know that I care about them, too.

On Friday I had offered to take May shopping, and invited her to my house for dinner. I wanted to make up for the horrible state of things, which I had a hand in creating. She politely declined. I sensed that she felt uncomfortable with the offer, despite her desperate and forlorn situation. Of course. Shopping and dinner are not things that tenants and landlords do together! But we can choose to define ourselves as more than this. Through this experience, I had started to see her as a little cousin. I felt compassion and empathy for her, and imagined how I would feel in her shoes. Our mutual mistreatment by Lucifer connected us.

By the time the Stanley Steemer guys had finished on Saturday, the place was not quite shining, but infinitely more pleasant and livable than just 48 hours before. She had told me about an upcoming conference gala, and we agreed she needed a dress, in addition to bedsheets and a box fan. We picked up my kids from their friends’ house, got dinner in the oven (she had her first shortcut cooking lesson—seasoned-chicken-thighs-over-frozen-vegie-bake with rice), and headed to Ross for a very successful, if brief, shopping trip. Dinner tasted great after all that work, and we had watermelon for dessert. She borrowed our box fan and took some leftovers to tide her over until the new stove arrives next week.

I made some mistakes in dealing with Lucifer these past two years. I paid the price this past week—several hundred dollars and a lot of time and energy. I also made two new friends, and gained important insights. We may think of landlord/tenant relationships as strictly transactional, and that may work in many cases. It failed this time, and it felt bad. Why not make a new friend if I have a chance, and why allow anyone I would not be friends with to live in my home? When it comes time to find a new tenant, now I know better how to look. I will meet people in person, and tell them the story of the apartment and how much it means to me. I will assess their sincerity in agreeing to treat it as their own. I will convey to them that I see myself and my place as contributing to their pursuit of their dreams. The new people may still trash it—this is always a risk. But at least I will know that I did my best to connect, and the potential human payoff from that makes me positively giddy with joy.

*Not their real names