#AtoZChallenge: Assumptions and Appreciation

Welcome to my first attempt at the Blogging A to Z Challenge!  26 posts in April, one for each letter of the alphabet (I get one day off per week).  I will explore meaningful words to apply to perceptions, attitudes, behaviors, and relationships. It’s a personal journey, part of my mission of self-assessment and development through writing.  Thank you for stopping by, and please feel free to comment! 🙂

 

Yoga instructors. Football players.  ER nurses.  Asian college students.  Old white men.

Hold these likenesses in your mind’s eye for a moment. Who do you see?

Was the yoga instructor a man or woman? The football player?  It’s impossible not to make assumptions, to apply stereotypes.  Such constructions help us make sense of the world.  They allow us to move through countless human encounters quickly and automatically.  And, they can limit us far more than we realize.

One spring day my kids and I sat in the car, waiting to exit the parking lot after church. Three men, Caucasian, in their 60s, crossed in front of us.  They were well-groomed and overweight—grandpas, likely.  Their expressions were neutral, absorbed in conversation.  One of them looked a little winded from walking.  They were perfectly unremarkable, and they did not notice us.

I felt an acute flash of fear.  It was visceral, as if, at any moment, they could decide that my kids and I were not worthy of being at that intersection, and that they somehow had the power to impact my life in ways that I could not control or influence.  Three apparently unassuming white men.   Fascinating.

I remembered this story when a friend and colleague recently shared this blog post on our assumptions about surgeons.  I realized that despite being married to a surgeon, having multiple surgeon friends, and trying every day to live with an open mind, I still ascribe to the stereotype of the mean surgeon.  It comes out when I hang up the phone after a pleasant conversation with an ENT fellow.  “Wow, he was so nice,” I think, surprised.  Or when I feel righteously annoyed after a terse and condescending interaction with his attending.  “What do you expect,” I say to myself, “he’s a(n old, white, male) surgeon.”  Nobody would ever say that about a pediatrician.

I don’t shame myself for harboring the mean surgeon and old white men stereotypes. They were born of a certain reality and make me appropriately cautious in new situations.  I don’t think I behave badly because of them, and I readily acknowledge when the stereotypes are broken.  But the realization that I hold these assumptions so deeply—subconsciously—gives me pause.  What other assumptions do I carry, and how do they limit my relationships?  I think it’s fair to say that we all carry shards of racism, classism, and other forms of blatant prejudice.  Here’s what I also think:  It’s okay.  We can’t help it, that’s just how it is.  Denying it just makes it that much more insidious, subversive, and toxic.  I’m prejudiced, you’re prejudiced, we’re all prejudiced.  The more we say it, the less scary it gets.  The first step is acknowledgement without shame.

But we cannot, and must not, stop there. We can’t only say, “We can’t help it, that’s just how it is.”  We must take the next step, which is to manage it better.

I think an excellent antidote to toxic assumptions is appreciation.

Dictionary.com includes the following definitions of appreciate:

  1. To regard highly; place high estimate on: to appreciate good wine.
  2. To be fully conscious of; be aware of/ detect: to appreciate the dangers of the situation.

Let us first fully appreciate (be aware of/detect) the scope of our prejudices: Their cultural, familial, or experiential origins, their subtle influence on our perceptions, and the covert ways they manipulate our thoughts, words, and actions toward others.  Awareness is key.  It is also hard.  It’s hard because we know we shouldn’t be prejudiced, it’s bad.  Prejudiced people are bad, they do bad things, we don’t want to be like them; if we admit our prejudices then that means we are bad, that we are not worthy.  STOP.  The only way to keep from acting on our negative stereotypes and perpetuating racism and xenophobia is to fully acknowledge their existence and confront them, head on.  They do not define us.  They are not all of who we are and what we stand for.  Their presence does not negate all that is good, generous, and inclusive about us.  AND, they are part of us.  We cannot escape them by way of denial.  If we can call ourselves out honestly, lovingly, and with forgiveness, we can then integrate our prejudices, and put them in their place.  Appreciation does not mean approval of, or abject subjugation by, our biases.  It is simply the first step to living wholly, to knowing and owning all of ourselves, and moving with intention and mindfulness.

Then, let us apply the other definition of appreciation to others. Let us regard more highly those whom we may automatically, however subtly, belittle in our subconscious.  How might we do this?  Look for that which we share.  She is a mom.  She must love her kids as much as I love mine.  What are their circumstances, what lessons is she trying to teach them, and what would I do in her place?  Why did he become a doctor?  He must want to help people like I do.  I could never do what he does, so high risk, so much responsibility.  God bless him, we need people like him.

Let us then solidify the process with words, out loud. “I can tell you really love your son.”  “Thank you for caring so much about our patient.”  It may sound trite, even silly, at first.  But we can never underestimate the impact of a few kind words, not just on others, but on ourselves.  When I acknowledge myself in you, I make a connection.  I see you, I recognize you, I appreciate you, as I do myself.  Prejudice thrives in silence and denial.  It cannot long survive being spoken out loud and it certainly withers in the presence of true connection.

We will always make assumptions.  Tempered with some well-placed appreciation, though, perhaps we can get through life with a little more love and a little less suffering.

Lessons From Middle School Drama

November Gratitude Shorts, Day 15

Grateful for the arts today, and theater in particular. This is unusual for me, as I am generally not a theater-goer. But the middle school’s first production of the year occurred this weekend. My son served on crew, so I was excited to see the show!

The students positively awed me with their performance. They adapted three books in what I would describe as visual narrative. The players took turns speaking and acting lines from the books, with minimal props and costumes. The depth of expression these preteens acheived far surpassed my expectations. 

They chose Brown Girl Dreaming by Jacqueline Woodson, Between Shades of Gray by Ruta Sepetys, and Boy by Roald Dahl. The first two blew me away. As I watched and listened to the autobiographical narratives of one girl’s coming of age during the civil rights movement, and another’s harrowing trauma of Soviet subjugation, I found myself trying to imagine myself in their shoes. 

It makes me wonder, do I do this enough in my work? When I hear my patients’ stories do I try to take their perspective and understand their decision making? I believe I do, mainly because I take the time to ask about their stories. I know this is the best way to counsel them on health behavior change. We make decisions emotionally, and rationalize afterward. So I need to speak to whatever holds meaning for each individual, which I can only know by listening to each person’s story and taking his/her perspective.

A study of medical students by Blatt  et al in 2010 showed that perspective taking can be taught, and can positively impact patient satisfaction. I would argue that it also improves physician satisfaction, and the benefits ripple out to the whole system. 

Where I need to practice perspective taking more is outside the exam room, when I interact with my support staff.  I need to learn more about their workflow, to understand the impact of my frequent and often impromptu requests of them throughout the day.  I need to verify that the stories I tell myself about their behavior at work are accurate (or, likely not–then I need to get curious). I need to ask for and listen to their stories in order to know best how to integrate the team.  I’m so grateful to the middle school drama club and my blogging challenge for helping me uncover this insight tonight. Now to put it into practice tomorrow morning!

Gathering

November Gratitude Shorts, Day 14

(I’ll write a make-up post for yesterday.)

“I’m always grateful when we gather to educate one another.” –Mark Silver, MD

The last two days held a gathering that filled my mind and my heart. The annual meeting of the American College of Physicians Illinois Chapter brought together almost 200 internists from across the state.  National leaders in cardiology, adult vaccination, physician well-being and numerous other fields spoke with passion and inspiration.  We learned, discussed, and communed.  I reconnected with friends from college, residency, teaching, and practice, and made several new friends. 

In this era when we can look up any information on the internet, the chance to meet in person to share ideas and learnings feels exceptional.  We humans require connection to thrive. Too often we allow the daily grind to interfere with this, and we slowly wither away inside. 

My most sincere thanks to all of my creative, dedicated, and generous colleagues who made this meeting possible!  May we keep our flames lit and hold one another in the light of purpose and caring.