Onward from 2019: Learnings and Intentions

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Friends!  WHAT a year, no?  How are you feeling here at the end?

In this post:  3 key learnings, 3 high intentions, and my 6 recommended life readings.

What resonates with you?

What would you add?

For a thoughtful and inspiring look on the coming year, check out Donna Cameron’s post from yesterday.

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3 Key Learnings of 2019

Complexity

“When we try to pick out anything by itself, we find it hitched to everything else in the Universe.”  –John Muir

“All that you touch, you change.  All that you change, changes you.” –Octavia Butler

We all live in inextricable connection, like it or not, know it or not, want it or not.  Every interaction has potential for benefit and harm, and the scale is exponential.  Some may find this idea daunting, overwhelming, or untenable.  I find it reassuring.  The idea that some cosmic life thread connects us all, that we are made of the same stuff today as that which existed at the dawn of the universe—this gives me peace.  It encourages me that everything I do in good faith could make a difference.  You really never know how far a small gesture or sharing will reach for good.

The 3 Tenets of Relationship-Centered Leadership

Not so much learnings as a synthesis from LOH training, these are the current foundation statements of my personal and aspirational leadership tenets (iterations likely to evolve over time):

  1. Founded on curiosity, connection, and fidelity to a people-centered mission
  2. Attendant to the relational impacts of all decisions, local and global
  3. Respectful of norms and also agile and adaptive to the changing needs of the system

Having defined these ideals for myself, I am now fully accountable to them.  And I hold them as a standard for those who lead me.

Being >> Saying or Doing

Saying and doing compassionate, empathic, and kind things are necessary and noble.  And they are not enough.  These actions ring hollow without honest sincerity behind them.  People feel us before they hear our words.  Our authentic presence, positive or negative, originates from within.  It manifests in posture, facial expression (overt and subtle, intentional and subconscious), movement, and tone and cadence of voice.  Fake it ‘til you make it—saying and doing things because we know we ‘should’—only gets us so far.  We humans possess a keen sense of genuineness—it’s a survival instinct.  If we accept that a meaningful, productive life and effective leadership in particular, require strong, trusting relationships, then we must cultivate true compassion, empathy, and kindness.  That means suspending judgment, managing assumptions, and holding openness to having our perspective changed by all that we encounter (see first key learning above), among other things.  This may be life’s penultimate challenge—our role models include Mother Theresa and the Dalai Lama.

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3 High Intentions for 2020

  1. Continue to ask more and listen better for people’s personal and unique meaning making—not just patients but all people—attend to souls
  2. Let go perfection
    1. All relationships are not great, and it’s not all my fault
    2. Some people/relationships and circumstances challenge my best self and skills more than others
    3. It’s the honest, sincere, good faith effort, and the learning from imperfection and failed attempts that matter
    4. Some relationships are better ended
  3. Guard against judgment, arrogance, and cynicism

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6 Recommended Life Readings—the 6 most personally impactful books I have read in the last decade:

The Art of Possibility by Rosamund Stone Zander and Benjamin Zander.  Scarcity thinking, competition, and looking out for number one hold us all back.  Stepping fully into our central selves, claiming our full collective agency for creativity and collaboration, and manifesting all the good we are capable of—that is the discovery of this book for me.

Start With Why by Simon Sinek.  In my opinion, the most eloquent and resonant writing on the purpose-driven life.  The freedom and creativity that flows forth therefrom—it all just gives me goosebumps.  Sinek’s The Infinite Game may eventually make this list too, once I have integrated its content and learnings more fully.

Rising Strong by Brené Brown.  Strength and vulnerability, confidence and shame, individuality and belonging—these are the essential human paradoxes that Sister Brené reconciles with gritty aplomb through real life stories as well as grounded theory research.

Big Magic by Elizabeth Gilbert.  Be you, all you, all in.  Love thyself—flaws, failures, and falls all included.  Make things.  Because that is what we are put here to do, for ourselves and for one another.

Leadership and Self-Deception by The Arbinger Institute.  Perhaps no book explains the profound importance of being better in order to do better, better than this.  And it took me almost all year to really comprehend, and then begin to apprehend, the concept.

Being Mortal by Atul Gawande, MD.  I started and finished this one on vacation this past week.  Dr. Gawande is my favorite physician writer.  I consider this book required reading for all physicians for sure, but really for all people .  “The death rate from life is 100%,” a wise patient once told me.  In modern western society and culture, multiple intertwined and complex forces hamstring our ability to live and die well and at peace.  This book is a brilliant compilation of heartrending personal and professional stories, neatly folded with history, research, and practical information for improving this sad state of things.  It is also a guide to the hard conversations that we all should really have—now.  It has both validated what I already do in my practice, and profoundly changed how I will do things hereafter.  Thank you, Dr. Gawande.

*****

Best wishes for Peace, Joy, Love, and Connection to all.

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Less Phone, More BOOKS!

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NaBloPoMo 2018: What I’m Learning

Hi, I’m Cathy, and I’m addicted to my phone.

Last month I finally decided to do something about it, mostly so I could be more present to the kids.  It’s been a fascinating journey so far, and I’m proud to say I’ve already made progress.  First I banned Facebook after 6pm.  That went well until I traveled.  Then I took the Facebook app off of my phone.  The withdrawl continues to spike at times.  I also notice that I use other things to substitute—New York Times, email, Washington Post, email, WordPress Reader, email.  I notice an anxiety, a frustration, a kind of crazed, darting hankering– I crave that dopamine hit.

The awareness of it all, however, and the commitment to get disentangled from my screen, has cleared space for a recently dormant impulse to surface afresh:

READ!

* * *

At the conference last month I was turned on to the idea of complexity (or chaos) theory and how it relates to fixing physician burnout and turning our whole medical system around.  It was positively mind-blowing (for me—most others did not seem quite as lit).  The speaker was Anthony Suchman, my newest hero.  Some highlight ideas:

  • Every system is perfectly designed to get exactly the results it gets. Our current healthcare system evolved to this point precisely from serial and cumulative decisions made over years, even though the current state was never the intent.
  • We think of organizations as machines, with predictable, linear consequences of adjustments in one part or another. This is rarely how organizations (of people) actually work.  Rather, we can think of organizations as conversations, and let go our expectations of particular outcomes, the illusion of total control.  We can let things unfold and go where the outcomes lead us, all while holding to core values and goals.
  • Patterns are (re)created in each moment, and also self-organizing. So at the same time that a pattern (eg culture) seems inevitable and self-propagating, sometimes small, almost imperceptible perturbations can create new and dramatic cascades that lead to transformation (the butterfly effect).
  • Emergent Design thus embraces the approach of “finding answers we are willing to not know,” trusting that we will get where we need to go simply because we are paying attention (or that’s how I interpret it today).

This theory that everything within a system both results from and also contributes to the whole system (a fractal) validates an idea I have been advocating to my patients for years, and that I continue to personally relearn ad nauseam: It’s all connected.  The most concrete examples are Sleep, Exercise, Nutrition, Stress Management, and Relationships—I used to call them the 5 Realms of Health; now I call them the 5 Reciprocal Domains.  Each one is inextricably connected to every other one, and they all move in concert, with subtle or dramatic dynamics.

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I browsed around my local bookstore a couple weeks ago and came across a colorful title on the shelf: Emergent Strategy by Adrienne Maree Brown.  So of course I snatched it up.  The blurb says:

Inspired by Octavia Butler’s explorations of our human relationship to change, Emergent Strategy is radical self-help, society-help, and planet-help designed to shape the futures we want to live.  Change is constant.  The world is in a continual state of flux.  It is a stream of ever-mutating, emergent patterns.  Rather than steel ourselves against such change, this book invites us to feel, map, assess, and learn from the swirling patterns around us in order to better understand and influence them as they happen.  This is a resolutely materialist “spirituality” based equally on science and science fiction, a visionary incantation to transform that which ultimately transforms us.

Holy cow, YAAAAS!!  I could not wait to read it!  So I bought it, along with Make Trouble by Cecile Richards, What If This Were Enough? By Heather Havrilesky, and The Dharma of “The Princess Bride” by Ethan Nichtern.  I had also ordered Leading Change in Healthcare, coauthored by Dr. Suchman and two others.  That copy arrived last week.

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I feel this as all part of a slow turn, getting off my phone and diving into books again.  I’m so excited.  I have done this before—buy a bunch of books and never read them.  They occupy whole shelves in my bedroom.  But I honestly feel a transformation coming on.  Yesterday I spent a couple hours reading, researching, and writing the blog post, then I turned off the computer and opened Brown’s book.  I read through the long introduction and resonated with sentences like, “Emergence is the way complex systems and patterns arise out of a multiplicity of relatively simple interactions.”  This is a quote from Complex Adaptive Leadership: Embracing Paradox and Uncertainty by Nick Obolensky (which I have also now ordered).  I also love (ha!), “Perhaps humans’ core function is love.  Love leads us to observe in a much deeper way than any other emotion.”  Also:

all that you touch

you change

all that you change

changes you

the only lasting truth

is change

god is change

That is a quote from Parable of the Sower by Octavia Butler.

Then before bed I opened Suchman et al’s book and found these words, also in the introduction:

Complexity theory here is enriched by the focus on relationships [Hallelujah!], rather than the more traditional reference to science.  “Relationship-Centered Care” is a way of thinking that brings love and all that is personal into a world, the world of healthcare, that is mostly interested in more control and more data-based, evidence-based practices.

The point is made throughout that administrators cannot bring real change into their healthcare institutions without going through change themselves.

(The book describes) the relationship-centered social dynamics that are at the heart of Lean and a major source of this method’s success.  Unfortunately, these social dynamics are overshadowed or even displaced by the analytic technique in some Lean implementations, compromising results.

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So I’m learning about new ways to think on change.   It’s changing how I approach trying to change my patterns, how I see my relationship to them, how I see all relationships.  Wow.

All of this to say, I feel a deeply personal, yet global and cosmic impulse for growth, for transformation—a shift into more mindful and intentional use of my time and energy, and how I manifest it outward.  Less distraction, more focus.  Less incidental information consumption, more integrated learning and coordinated application.  Less phone, more BOOKS.

What will be the outcome?  I have no idea, that’s what makes it so exciting and wonderful!  Onward!