Good Doctor and Good Mom

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What do you sacrifice in pursuit of your dreams?

What does your calling cost you?

What are the returns on your investments?

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Last week I mentioned Dierks Bentley’s, “Woman, Amen”, a song I love.  After listening to it for many days on repeat this past week, I decided to tour his nine albums this weekend.  His songs vary in topic and form, and at the same time he has a consistent style and vibe.  I like it.  Yesterday I heard his song, “Damn These Dreams”:

Now honey I know you miss me, I feel it when you kiss me

Trust me when I say every goodbye hurts

Well damn these dreams

Playin’ my heart just like a guitar string

Pullin’ me away from you and everything I really need

Well damn these dreams

Chasing that same old whiskey melody

All up and down these Nashville streets

It’s hard to look true love in the eye and leave

Damn these dreams

 

Instantly I remembered two other songs with similar themes:

 

Goodbye Again”, by John Denver:

Other voices beckon me, and for a little while

It’s goodbye again, I’m sorry to be leaving you

Goodbye again, as if you didn’t know

It’s goodbye again

Have to go and see some friends of mine

Some that I don’t know

Some who aren’t familiar with my name

It’s something that’s inside of me

Not hard to understand

It’s anyone who’ll listen to me sing

…Lying by your side’s the greatest peace I’ve ever known

But it’s goodbye again…

 

And “I Play the Road”, by Zach Brown Band:

…She says daddy where to you go

When you leave me all these nights

With a suitcase and guitar in your hand

Kissing me and mom goodbye with a tear and a smile

Where do you go? 

Daddy where do you go?

I play the road

And the highway is our song

And every city’s like the same three chords

Been helping us along when the story’s told

And the crowd is done and gone

Shaking off the miles and trying to make it home

…Mile after mile… 

Baby, I’m comin’ home

Years ago, I think it was either Dana Carvey or Martin Short who said something like one can only tolerate the life of a comedian because s/he simply cannot do anything else—they must do comedy.  If anyone can find the reference, please share!

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As it is in music and comedy, so it is in medicine.  For many of us, we simply must do it; we have no existential choice.  These songs describe well our pain and conflict when we take call or have to work on weekends, or miss the kids’ school and sports events, and spend hours at home on the medical record or answering pages.

I recently read an article, “A Good Doctor or a Good Mom, Never Both”.  Early in this physician mom writer’s career, an elder colleague told her, “’You can be a good doctor, and you can be a good mother, but you can never be both at the same time.’”  The author disagrees, saying it’s either/or, never both, ever.  At once hearing Bentley’s song, I felt a moment of panic, mortified that I’m destroying my family for my job.  Am I totally selfish for choosing this career, and are my priorities so distorted that I so often put work before my family?  Have I chosen to be a good doctor and a horrible mom?

Thank goodness for Simon Sinek who, in his 2014 book, Leaders Eat Last, referenced a 2011 study that showed “a child’s sense of well-being is affected less by the long hours their parents put in at work and more by the mood their parents are in when they come home.  Children are better off having a parent who works into the night in a job they love than a parent who works shorter hours but comes home unhappy.”  This idea has saved me from countless episodes of self-flagellation and guilt.  It was so instantly redeeming that I recall the exact moment I heard it—I was at the airport, traveling solo, likely for a work related conference.  I can’t say I’m ecstatic every evening coming home, but I generally feel satisfied by a fulfilling day doing something I love.  I can confidently report that my husband feels the same.

I’ve attended one swim meet in two years.  I miss any school event that occurs during the workday.  I still get lost walking the maze that is the kids’ school, though we (they) have been there over a decade.  But I get to choir and orchestra concerts, and dinner potlucks.  I know my kids’ friends and am friends with their parents.  The kids’ teachers think they feel loved by us.  I think I do okay.

My kids hear me on the phone with patients and colleagues.  They know it takes time and understanding to take good care of people.  I’m confident they see and feel how meaningful this work and these relationships are to me.  And the science is pretty cool, too.  I would never pressure my kids to go into medicine, but I would not be surprised if they did.  I would absolutely encourage it, if it gives them the joy it gives me.

“You can be a good doctor, and you can be a good mother, but you can never be both at the same time.”  I respectfully agree and disagree.  You can absolutely be both, often at the same time.

 

Inclusion and Belonging

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What do diversity and inclusion mean to you these days?

Honestly for me, they mean different things depending on the context in which I think about them.  Cathy the Cynic thinks diversity initiatives too often feel trendy and superficial, like a knee-jerk response to the social pressure to check a box.  Cathy the Optimist believes that those who direct such initiatives honestly see the communal value in a truly diverse and inclusive work environment.

A wise friend recently pointed out to me that inclusion can be a challenge even in a homogeneous group.  “You could have 25 white men in a room and everybody may not feel included.”  So, he said, perhaps we should work on inclusion first, and diversity will come more naturally as a result.  Brilliant!  If we make it safe for everybody to be themselves, no matter who they are, then they feel free to bring their best, authentic selves—it’s a win-win for each individual and the organization.  An inclusive work culture supports and values each person for their unique contributions.  In such an environment, diversity is achieved because people value their differences as much as their similarities.  They live in curiosity and awe, always in a learning stance.  Inclusive cultures seek more perspectives, experiences, expertise, and backgrounds—they cultivate depth and breadth in the humanity of their workforce.  People from divergent walks of life seek to join such cultures, drawn to vibrant cohesion, synergy, and creativity.

This idea marinated in my mind for some weeks until an article from the Wharton School of Business crossed one of my online feeds last Thursday.  It says diversity and inclusion are not enough; we need to cultivate a sense of belonging in our workplaces.  The article quotes Sam Lalanne, a senior vice president of Global Diversity and Talent Management at Citigroup:  “…whereas diversity often gets linked to numbers and percentages, belonging ‘is about how you feel’ when you’re at work. ‘Do you feel valued? Do you feel like you should be there? Do you feel that your insights, commentary and perspectives matter?’”

“Rebekah Bastian, a vice president of culture and community at Zillow Group, said that the superior business outcomes often associated with having diverse teams can’t be achieved without a sense of belonging. It’s not enough to simply include people at the table, she said, but to ‘amplify everyone’s voices, clear barriers … and appreciate each other for our unique backgrounds.’ Both she and Lalanne said that a sense of belonging means that people can bring their full selves to work, and not feel like they’re a different person there than at home.”

A different person.  So what I described above as inclusion is really what these leaders define as belonging.  We want each person to feel they belong in the work tribe, that their presence and contributions are valuable and worthy, as themselves.  When we include, from our hearts, each person in their wholeness, only then will they truly belong.  And that is the sweet spot where teams thrive.

So what do we do?  How do we create such loving cultures of true belonging?  According to panelists quoted in the Wharton article (and we all know this), it comes from the top:  “Lalanne also commented on the importance of ‘tone at the top’ toward fostering a sense of belonging. ‘Our CEO, Mike Corbat, has really pushed us on our diversity, inclusion and belonging agendas. And it really comes from, what does he preach, what comes out of his mouth, how does he execute against the things that we see around us.’”  Simon Sinek calls us to live our values with clarity, consistency, and discipline.  So if you’re a leader who talks about diversity and inclusion, about belonging, then we workers have to see you, to feel you, living these values out loud and in front of us.

Belonging is more about how we are toward each other than how we act or what we do, which is inclusion.  This is the key to successful ‘diversity and inclusion’ initiatives—they must be sincere.  Humans are intuitively social animals.  We smell insincerity and reject it, because it is unsafe.  We cannot trust it.

A garden of belonging must be grown organically.  There are no shortcuts.  It takes time, and the gardener must tend it regularly.  Young seedlings require protection from weather and predators.  She must bring in pollinators and other helpers—one person cannot do it all.  So we can all pick up a trowel and participate.  We look to our leaders to set the path, and when we see the shining hope of our collective destination we follow willingly, eagerly, and together.

Humanity

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NaBloPoMo 2018: What I’m Learning

I have festered all day drafting this post in my head.  Procrastinating.  It’s still a jumble, so I’ll give it my best shot:

Donald Trump is a human being.  As much as I want to hurl epithets and lob rotten tomatoes at the television every time his face appears, or take a sledgehammer to whatever device I hear his voice on, I know these are unproductive responses to the emotions he triggers in me.  Breathe.  Must. Do. Better.

Ever since the 2016 campaign started in June of 2015, three and a half years ago already, I have felt an almost daily rage like nothing in my life yet.  I’m happy in some ways to report that it has not improved—I have not normalized this aberrancy of an administration.  But the constant animosity is not good for my health.  And the escalating divisions and vitriol between various groups of people, ever more visible on phone cameras and instant video, erodes our humanity every day.  I think I’m also increasingly sensitive to it all now.  On one hand I’m glad because awareness of humanity, and opposing those who diminish it, is good.  But again, it costs me.

Donald Trump is the personification of dehumanization (oh, the irony).  Some may feel this is an exaggeration, too strong a word to use.  It is not.  He is a hardened master of this insidious craft, and we are each capable of the same, whether we admit it or not.  It starts with making people abstractions—by seeing them, even very subtly, as less than whole people with feelings and needs equally important as our own.  Simon Sinek discusses it eloquently in his book Leaders Eat Last; you can read an iteration of his thoughts in this interview.  He describes CEOs like Jim Sinegal and Bob Chapman who, in hard times, gave employees raises and decreased workers’ hours, respectively, rather than laying anyone off.  I learned during a lecture, though I cannot find the citation (Boehm, 2015?) that only 17% of healthcare CEOs take the well-being of their employees into account when making decisions.  Sinegal and Chapman sacrificed some numbers to save people, Sinek says.  Too many leaders sacrifice people to save the numbers.  Turning people into abstractions is both akin to and a step toward dehumanizing them.

I have a friend who used to criticize people, ideas, or things by saying, “That’s (he’s) so gay.”  He would deny his negative attitude, deny that he was using ‘gay’ as a derogatory term.  He would also deny that he was biased against homosexuals.  I believe he would never treat anyone badly because they were gay, let alone commit any kind of hate crime.  But ‘being gay’ was a negative abstraction to him.  It was abnormal, something to be derided and shamed—to be scorned.  His objection to the idea of homosexuality made homosexuals, as a group in his mind, less than.  I think we all do this more often than we know.  I wrote about it last year, describing how doctors in different medical specialties talk about each other in pejorative stereotypes.  We dehumanize each other every damn day.

Brené Brown describes this clearly in her book Braving the Wildnerness:

Dehumanization has fueled innumerable acts of violence, human rights violations, war crimes, and genocides. It makes slavery, torture, and human trafficking possible. Dehumanizing others is the process by which we become accepting of violations against human nature, the human spirit, and, for many of us, violations against the central tenets of our faith.

How does this happen? Maiese explains that most of us believe that people’s basic human rights should not be violated—that crimes like murder, rape, and torture are wrong. Successful dehumanizing, however, creates moral exclusion. Groups targeted based on their identity—gender, ideology, skin color, ethnicity, religion, age—are depicted as “less than” or criminal or even evil. The targeted group eventually falls out of the scope of who is naturally protected by our moral code. This is moral exclusion, and dehumanization is at its core.

Dehumanizing always starts with language, often followed by images. We see this throughout history. During the Holocaust, Nazis described Jews as Untermenschen—subhuman. They called Jews rats and depicted them as disease-carrying rodents in everything from military pamphlets to children’s books. Hutus involved in the Rwanda genocide called Tutsis cockroaches. Indigenous people are often referred to as savages. Serbs called Bosnians aliens. Slave owners throughout history considered slaves subhuman animals.

Again, you may think that I over-exaggerate here.  What’s the big deal, you say, when surgeons say internists wear flea collars (stethoscopes)?  Or when Trump calls Mexicans criminals and rapists?  When he calls women dogs, Miss Piggy, and Horseface, you say, it has no real effect.  Sociology begs to differ.  It is a slippery slope from thoughts to words to action, and Donald Trump has poured oil on the Slip ‘n’ Slide by the bucketful.  Don’t believe me?  How else could we countenance forcibly separating toddlers from their parents when they arrive on our doorstep, fleeing violence and seeking asylum, sending the children across our country and deporting the parents, with no intention of ever reuniting them?  If that’s not dehumanization I don’t know what is.

Once again, Brené Brown says it much better than I:

Today we are edging closer and closer to a world where political and ideological discourse has become an exercise in dehumanization. And social media are the primary platforms for our dehumanizing behavior. On Twitter and Facebook we can rapidly push the people with whom we disagree into the dangerous territory of moral exclusion, with little to no accountability, and often in complete anonymity.

Here’s what I believe:

  1. When the president of the United States calls immigrants animals or talks about grabbing pussy, we should get chills down our spine and resistance flowing through our veins. When people call the president of the United States a pig, we should reject that language regardless of our politics and demand discourse that doesn’t make people subhuman.
  2. If you are offended or hurt when you hear Hillary Clinton or Maxine Waters called bitch, whore, or the c-word, you should be equally offended and hurt when you hear those same words used to describe Ivanka Trump, Kellyanne Conway, or Theresa May.
  3. If you’re offended by a meme of Trump Photoshopped to look like Hitler, then you shouldn’t have Obama Photoshopped to look like the Joker on your Facebook feed.
  4. When we hear people referred to as animals or aliens, we should immediately wonder, “Is this an attempt to reduce someone’s humanity so we can get away with hurting them or denying them basic human rights?”

When we engage in dehumanizing rhetoric or promote dehumanizing images, we diminish our own humanity in the process. When we reduce immigrants to animals… it says nothing at all about the people we’re attacking. It does, however, say volumes about who we are and our integrity.

Dehumanizing and holding people accountable are mutually exclusive. Humiliation and dehumanizing are not accountability or social justice tools, they’re emotional off-loading at best, emotional self-indulgence at worst. And if our faith asks us to find the face of God in everyone we meet, that should include the politicians, media, and strangers on Twitter with whom we most violently disagree. When we desecrate their divinity, we desecrate our own, and we betray our humanity.

So I resolve to stop participating in the erosion of humanity.  When I hear dehumanizing language from anywhere, especially among my own tribes, I must resist the urge to respond in kind.  I will look for opportunities to call it out.  It is so damn hard, I feel so often like a pressure cooker waiting for the valve to release.  So I must practice patience, kindness, mindfulness, deep breathing, and all of the habits I reviewed here yesterday.  I must find it in myself to always hold another’s humanity as sacred as my own, even (especially?) the people I despise the most.  It will be a lifelong exercise in discipline and agape love.  As the Obamas teach us, we must stay Fired Up, Go High, and Be the Change.  I can do this.  Donald Trump is a human being.

Playing My Part

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Hello again, friends! Feels good to be back…  3 weeks since my last post of the Blogging A to Z Challenge, holy cow!  At the end I thought, ‘Hey, I can do this!  One post a week, no sweat!’  …And then crickets…  How Fascinating!

Though I have not posted in three weeks, I have written like mad, mostly journaling. Today I suddenly realized how much I have missed corresponding with my friends on paper.  How long it’s been since I wrote by hand to someone other than myself!  As I sat this afternoon and wrote, on stationery, with colored gel pens and stickers, to some of my best friends, a tremendous sense of connection and gratitude filled me.  Much of this post was born of those spontaneous letters to my fellow conscious, cosmic journeyers.

Given the awesome support network with which I am blessed, I feel an impulse to do something more with my writing—to amplify and project all this love and connection back out onto the world for some positive purpose.  But how can my words possibly make a difference?

The A to Z Challenge showed me that I have the capacity to write often and much—and to produce better-than-crap results! It also taught me that I can take more risks with my writing, in both format and content.  Now I want to take my writing a little more seriously, lend more credence to my own abilities.  In the framework of Simon Sinek’s Golden Circle, I know my Why: to cultivate positive and constructive relationships in every realm of life.  This blog is another What to my Why.  But since the Challenge ended, I struggle with the How.

I think night and day about so many things:

  • My own individual relationships—spousal, parental, sibling, other familial; colleague, patient, student, friend, stranger.
  • Relationships I observe between others, and their impact on those of us around them.
  • Healthcare and medicine in general, and specifically at my own institution—miracles, bureaucracies, opportunities and pitfalls.
  • Leadership and organizational culture—examples of effective and ineffective models, and what makes them so.
  • Social justice and discourse—with an urge for movement toward acceptance, inclusion, mutual understanding, and cooperation.
  • Education, parenting and role modeling—integrity, walking my talk, inside and out.
  • Physician self-care and care of one another—individual and system issues, and their interface.

What am I called to affect? I live a conscious life in all these realms, or at least I try.  I have opinions and positions on various issues, some which I hold with deep conviction.  And I struggle with whether and how to express them—for what purpose?

Finally, I have an idea. Though I have opinions and positions that I hold strongly, I plan NOT to use this blog to promote those views.  There are plenty of people doing that already, a multitude of voices trying to win one another over, or, more precisely, trying to drive one another into silence with ever louder, brasher, and more vociferous language.  My voice can be one of moderation—of collaboration, connection—maybe a bridge for a few who seek one…  Or maybe just one stilt among many others, helping to hold up one such bridge.  I will strive not to criticize or proselytize, not to berate, blame, shame, incite, or inflame; and also not to concede or abstain.  I can, at the same time, hold my positions with conviction and passion, and also listen for the convictions and passions of others.  I can practice curiosity and openness.  I can question, explore, Hold the Space, and stand strong and tall, without feeling threatened.  I seek others who strive to do the same.

Voices of moderation are muted these days. The great orchestra of discourse has lost balance and harmony.  The most strident strings, horns, and drums play for their own promotion, rather than as a contribution to a symphonic collective.  The resulting dissonance makes us want to cover our ears and run away.  In order for a symphony to engage and inspire, each player must not only know her own part and play it well, but also listen carefully for other players and their movement.  Maybe we can all do this a little better: maintain our own distinct voices, while integrating with those around us.  The best orchestra functions as one entity, breathing and moving in a quintessentially integrated fashion.

My instrument is language. The past seven weeks have shown me my part in the online verbal orchestra.  This blog is where I will practice, record, and offer my contribution, not to overpower any others’ words, but to meet, align, and resonate.  The harmony of consonant contrast plays on, somewhere.  Maybe I can help find and amplify it, so more of us may enjoy the music of life among one another.