Tag Archives: health

On the Kindness of Strangers

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November Gratitude Shorts, Day 3

Today I give thanks for the kindness of strangers.

As I approached the entrance to a building this morning, a young man held the door for me. I walked a good fifteen feet behind him, so I was surprised that he even saw me.  And it was one of those almost awkward moments when he stood there several seconds holding the door—he actually stopped on his way somewhere to be kind to me, a stranger.  I noticed what he was doing and felt happy and warm inside.  Then I panicked just a little—there were 4 shallow steps leading to the door—do I take them two at a time, or shuffle quickly up each one?  What if I trip and fall on the way up, then it’ll be even more awkward, he’ll probably feel obligated to come back out and help me up, maybe regretting that he stopped in the first place…I chose the shuffle option, made it to the door unscathed.  We exchanged smiles, “Thank you,” and “No problem.”  It was just so pleasant!

I love moments like this because they remind me how we are all connected, and how everything we do affects others, no matter how small. I first saw a Travelers Insurance commercial illustrating this in the 1990s. Recently Liberty Mutual (link to the YouTube video) made something similar.  One person shows kindness to a second, a stranger.  This act is witnessed by a third stranger, who later shows kindness to a fourth, which is witnessed by a fifth, etc.  The idea goes one step beyond ‘pay it forward,’ where the person who received the kindness shows kindness to another.  I think we can assume that.  But likely more than one other person witnesses each of these acts, and if they are all inspired to act more kindly toward the next stranger they meet, how brilliant!

Exponential spread of kindness, one small act at a time. Yes.

Convergence

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Day 2, November Gratitude Not-So-Short

I commit to November Gratitude Shorts to practice daily writing and thanksgiving. Thank you for stopping by!

Today I give thanks for Convergence Experiences.

Last week I started listening to Brené Brown’s new book, Rising Strong.  If you have not already read or listened, I highly recommend it.  Early in the book she describes a conflict with her husband in which she openly acknowledges the story she tells herself about the origins of his behavior toward her.  Turns out it’s completely wrong, and the point is that by owning her own story, she invites him to tell his, and they can then communicate in love and the pursuit of mutual understanding.  I felt proud that this practice of recognizing and owning the stories I tell myself about others was one of the first things I learned in coaching years ago.  Then, days ago, my friend Donna Cameron published her post “Oh, The Stories We Tell!” on her blog, A Year of Living Kindly.  Bam, validated again!

Later in the book, Brown talks about why so many people fear ‘reckoning and rumbling’ with our feelings and emotional experiences. Feelings, especially negative ones, can be overwhelmingly uncomfortable, and thus intolerable.  So rather than engage with them, we repress or ‘offload’ them—bury them or project them onto others, often those closest to us.  I think she makes an analogy to going down a rabbit hole, and I know exactly how that feels.  I have spent the last two years spelunking in my deep emotional life (aka the Sh*tpile), and it scared the sh*t out of me at first.  And, it gets easier the more I do it.  Another endorsement, thank you, Dr. Brown!

Still later, she tells another story of her own experience reconciling other people’s wretched behavior. “Are people really doing their best all the time?” she asks.  Before hearing this I had just commented on another blog that we are all here doing our best, and if we could only see one another this way, even if only part of the time, things would be a lot better.  In her research, Brown has learned that those who choose to assume we are all doing our best tend to be the ones who, in her view, ‘live wholeheartedly.’  They exhibit more self- and thus other-acceptance, they sit more comfortably with vulnerability, and they judge themselves and others more gently than those who think we definitely do not try our best all the time.

Now I’m starting to feel a bit smug, thinking something like, “I got this. I’m a wholehearted, reckoning and rumbling, uber-intelligent emotional Rock Star.”  –Or at least a star student.  And I’m reminded of when I read her last book, Daring Greatly.  I got through the whole thing feeling and thinking something similar.  I have since learned that understanding a concept in one’s mind, such as that vulnerability is not weakness, and that in order to truly reach our potential we must be willing to risk failure and embarrassment, does not mean that one lives that understanding in a real emotional life.  True integration comes, like mindfulness, through continuous seeking, struggle, and a whole lot of grace.

At this point, I can both acknowledge the emotional progress I have made, and also check my pride. There will always be lessons to learn and practice, and I know that whenever I start to think, “I got this,” I need to look in my blind spots, because something is bound to show up there, sooner or later.

Convergence Experiences validate, encourage, and inspire me. They reassure me that I am on the right path, toward greater understanding, empathy, compassion and love, not just for others, but for myself.  They also remind me that only the journey matters; there is no destination other than how I choose to live today.  That’s a lot to be thankful for.

He for She, We for Us

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Ever since my presentation to the American College of Surgeons earlier this month on personal resilience in a medical career, I cannot shake the feeling that we need to do more of this work. Physicians from different fields need to talk more to one another, share experiences, and reconnect.  We also need to include other members of the care team as equals, and let go the hierarchical thinking that has far outlived its usefulness.

I do not suggest that physicians, nurses, therapists, pharmacists and others should play interchangeable roles in the care of patients. Rather, similar to the central tenet of gender equality, the unique contributions of each team member need to be respected equally for their own merits and importance.  As a primary care internist, I must admit that I have seen my professional world through a rather narrow lens until now.  I confess that I live at Stage 3, according to David Logan and colleagues’ definition of Tribal Leadership and culture.  The mantra for this stage of tribal culture, according to Logan et al, is “I’m great, and you’re not.”  Or in my words, “I’m great; you suck.”

“I’m a primary care doctor and I am awesome. I am the true caregiver.  I sit with my patients through their hardest life trials, and I know them better than anyone.  I am on the front line, I deal with everything!  And yet, nobody values me because ‘all’ I do is sit around and think.  My work generates only enough money to keep the lights on (what is up with that, anyway?); it’s the surgeons and interventionalists who bring in the big bucks—they are the darlings of the hospital, even though they don’t really know my patients as people…”  It’s a bizarre mixture of pride and whining, and any person or group can manifest it.

Earlier this fall, Joy Behar of TV’s “The View” made an offhand comment about Miss Colorado, Kelley Johnson, a nurse, wearing ‘a doctor’s stethoscope,’ during her monologue at the Miss America pageant.  We all watched as the media shredded the show and its hosts for apparently degrading nurses.  What distressed me most was the nurses vs. doctors war that ensued on social media.  Nurses started posting how they, not doctors, are who really care for patients and save lives.  Doctors, mostly privately, fumed at the grandiosity and perceived arrogance of these posts.  It all boiled down to, “We’re great, they suck.  We’re more important, look at us, not them.”  The whole situation only served to further fracture an already cracked relationship between doctors and nurses, all because of a few mindless words.

It’s worth considering for a moment, though. Why would nurses get so instantly and violently offended by what was obviously an unscripted, ignorant comment by a daytime talk show host?  It cannot be the first time one of them has said something thoughtlessly.  What makes any of us react in rage to someone’s unintentional words?  It’s usually when the words chafe a raw emotional nerve.  “A doctor’s stethoscope.”   The implicit accusation here is that nurses are not worthy of using doctors’ instruments.   And it triggered such ferocious wrath because so many nurses feel that they are treated this way, that they are seen as inferior, subordinate, unworthy.  Internists feel it as compared to surgeons.  None would likely ever admit to feeling this way, consciously, at least.  But if we are honest with ourselves, we know that we all have that secret gremlin deep inside, who continually questions, no matter how outwardly successful or inwardly confident we may be, whether we are truly worthy to be here.  And when someone speaks directly to it, like Joy Behar did, watch out, because that little gremlin will rage, Incredible Hulk-style.

I see so many similarities to the gender debate here. As women, in our conscious minds, we know our worth and our contribution.  We know we have an equal right to our roles in civilization.  And, at this point in our collective human history, we feel the need to defend those roles, to fight for their visibility and validity.  More and more people now recognize that women need men to speak up for gender equality, that it’s not ‘just a women’s issue,’ but rather a human issue, and that all of us will live better, more wholly, when all of us are treated with equal respect and opportunity.  The UN’s He for She initiative embodies this ideal.

It’s no different in medicine. At this point in our collective professional history, physician-nurse and other hierarchies still define many of our relationships and operational structures.  It’s not all bad, and we have made great progress toward interdisciplinary team care.  But the stethoscope firestorm shows that we still have a long way to go.  At the CENTILE conference I attended last week, I hate to admit that I was a little surprised and incredulous to see inspiring and groundbreaking research presented by nurses.  I have always thought of myself as having the utmost respect for nurses—my mom, my hero, is a nurse.  The ICU and inpatient nurses saved me time and again during my intern year, when I had no idea what I was doing.  And I depended on them to watch over my patients when I became an attending.  But I still harbored an insidious bias that nurses are not scholarly, that they do not (or cannot?) participate in the ‘higher’ academic pursuits of medicine.  I stand profoundly humbled, and I am grateful.  From now on I will advocate for nurses to participate in academic medicine’s highest activities, seek their contributions in the literature, and  voice my support out loud for their important roles in our healthcare system.

We need more conferences like this, more forums in which to share openly all of our strengths and accomplishments. We need to Dream Big Together, to stop comparing and competing, and get in the mud together, to cultivate this vast garden of health and well-being for all.  I’ll bring my shovel, you bring your hose, someone else has seeds, another, the soil, and still others, the fertilizer and everything else we will need for the garden to flourish.  We all matter, and we all have a unique role to play.  Nobody is more important than anyone else, and nobody can do it alone.

We need to take turns leading and following. That is how a cooperative tribe works best.  It’s exhausting work, challenging social norms and moving a culture upward.  And we simply have to; it’s the right thing to do.