Hold One Another Up

IMG_2158

Hello Friends!

How was your week?  I wrote in my last, very brief post that it had been a hard few weeks, but whoa-Nellie, these past 10 days or so have been a bit unbelievable.  But then again, almost nothing is truly unbelievable anymore.

When the news first came out about families getting separated at the border, I felt profound empathy for the parents, and then the kids, imagining their despair, grief, and lasting trauma.  But the administration is now targeting even naturalized citizens, looking for fraud on applications to deport people.  My parents, my husband, and all of his siblings are all naturalized citizens.  My son is currently abroad and it occurred to me to wonder whether he will be held up in customs and immigration on his return.  At this point I cannot know for sure that my own child, a native-born American citizen, won’t be kept from me, and even though it is unlikely, I now feel it fully in the realm of the possible.  I know I’m not the only one.  That is simply unacceptable.

It also occurred to me that any of my Latinx friends and co-workers could be stopped on the street or approached on a bus or train, and commanded to show proof of citizenship, as so many across the country have experienced, illegal and unconstitutional as it may be.  45 actually autographed photos of people who have been killed by illegal immigrants, while denying that native-born citizens commit proportionally more crime than immigrants, legal or illegal.   Right now, June 2018 in the United States, it feels to me that only straight, white, Christian, cisgender males are safe.  It all makes me want to vomit.

In the past year or so, people who know me call me an ‘activist.’  I take immense pride in this perception, and at the same time feel a little unworthy.  What have I done?  In 2017 I wrote a lot of letters to Members of Congress–even had Healing Through Connection stationery printed to do it.  I called.  I donated.  I marched.  2018 has been slower in action.  I’m still reading, keeping up, donating, and engaging on social media.  But I feel like it’s not enough, that I should be doing more.

Today I am more aware than ever that most of my colleagues and institutional leaders are white.  I am East Asian.  We are not the targeted groups.  However empathetic and outraged we may feel, we are likely only indirectly affected by current events.  So many of our support staff, however, are people of color.  They hold positions in the organization with the least autonomy, authority, and voice.

We are all expected come to work every day and do our jobs.  We take care of patients.  We put our personal feelings, stressors, and worries aside and meet our patients where they need us, and nobody knows what we might be dealing with ourselves.  But we do this now during a mind-bending crisis of national conscience.  Now is the time when our emotional and social support networks are called forth and tested.  As a physician, a default leader of the patient care team, how can I not acknowledge this profound disturbance of our collective consciousness?  How can I expect my team to perform optimally in a false vacuum?  The realities of our world are simply inescapable, and they affect us all, like it and accept it or not.

I may not be marching in front of Congress or the DHS.  I may not be writing legislators or calling them every day.  I am not a designated leader of my professional society, publishing op-eds on the long term health and societal consequences of our government’s actions.  But I can absolutely stand up in solidarity with and for the people closest to me.

So this week I expressed to my teams in no uncertain terms that whatever anyone is feeling or going through right now, they should know that their physician leaders support them, and we will be here for them however they need us, just like we are all here for our patients.  I made no overt political commentary.  I simply acknowledged the moral morass I see in our country and tried my best to make it safe for us all to experience it together, out loud and in person, and to help one another through it.

If there were ever a time for physicians to walk the talk as leaders, as caregivers for the caregivers, it is now.  I know now that I don’t have to be the loudest or most visible ‘activist.’  I just have to act in accordance with my core values.  And it starts with holding up the people right next to me every day.

Inaugural Intentions

estes-2011

Things are feeling a bit dark again…  Reminds me of October, when I got emotionally hijacked by current events and found myself anxious and angry, but wouldn’t admit it for a while.  On the eve of a new presidential administration taking office, tensions run high once again and I’m challenged to avoid a similar decent into despair.

It really helped to take the Holiday Break and write to my friends.  I did it by hand, with colorful pens, stickers, and rubber stamps (I love rubber stamping).  I intended to connect more personally, and that’s exactly what it felt like.  As I see and hear expressions of fright, dread, sadness, anger, and pessimism among them, I intend to continue corresponding by pen and paper.  There’s just something more tangible about it, more intimate and permanent than email, text, or Facebook.  I have included excerpts below—the ones that felt particularly inspired.  They represent my intentions for managing myself in the coming years, of reinforcing my core values and focusing on my highest aspirations.  As Simon Sinek posted once:  “Fight against something, we focus on what we hate.  Fight for something, we focus on what we love.”

To my friends who have expressed, “get over it,” and “stop whining,” I respectfully request that you try to empathize with those of us who feel despondent.  Nothing will improve if we keep ridiculing and belittling one another.  If you experienced this from ‘us’ before the election, remember how it felt.  Rise above our worst collective behavior and help us overcome our fears and disappointment by showing us that we really do share more love and connection than we might think.

Unity and true indivisibility require all of us to pitch in and reach out.  I hope that by one year from now, we can all look back and feel proud of the connections and relationships we strengthened, from left to right and otherwise.

***

What a crazy year…  All bets are off, no one can possibly predict what will happen now—so much anxious uncertainty surrounds us all over the place!  …And yet I feel hopeful and optimistic.  This is the time for our best selves to truly shine—the perfect opportunity to call on everything we have trained for—all of the grit, the kindness, the curiosity, the openness, the brave vulnerability~~~all of it, in service of connection, mutual understanding, and forging a way forward to a BRIGHTER future!  Because we now know, again, in humanity’s history, what darkness looks and feels like.  We can’t stay here, and we won’t—we can each shine a light.  And if we stand close, the light amplifies exponentially.

So thanks for being a fellow light shiner, (my friend)!  May we keep our connections with each other and our other fellows ever close—we need us—the world needs us—now more than ever!!  Keep it lit, my friend.

***

…Hope this card finds you well and HOPEFUL.

Because I have decided that that is what we all need to practice more now than ever—HOPE.  Those of us who strive for conscious living and more connection than the superficial have TRAINED for this moment in history—to PRACTICE OUT LOUD and IN FRONT of everybody—to lead by example and make the difference we were born to make!  We don’t need to do big things—we just need to keep the faith and stay the course!

’Small things with great love,’ I think Mother Theresa said?

Please know I am here to support your efforts, as I know you are for mine!  Let’s get together and hold each other up again soon!

***

…Because I know so many people whose core values represent the BEST of our shared humanity—equality, compassion, community, connection, love, and forgiveness.  The world needs these qualities and practices by us more now than ever—so if we hold each other up, we’ll all be able to do the work better—TOGETHER!!  So here’s to long friendships and deep love!

***

I received this handwritten response from an old friend today.  It warms my heart and holds up my hope:

“While we may snarl a bit at anticipated political shenanigans, let us remember we have strength in numbers and determination to keep life in this country respectful and fair—simply by the ways we live and interact.”

***

And finally, I’m also encouraged that our international leaders express a similar optimism:

Angela Merkel: “I am very much convinced that we as partners benefit more if we act together than if everyone solves problems for themselves, and that is a constant fundamental attitude on my part.”

Peace to all of you, dear friends.  Let us manifest our best every day.

On the Critical Importance of Self-Care

jeep-summit-north

NaBloPoMo 2016, Letters to Patients, Day 6

To Patients Who Feel Overwhelmed:

Put your own mask on first!

In my spare time, I go around talking to other doctors about how to take care of ourselves.  You may or may not be aware of physician burnout.  It’s quite the trendy topic in medical circles these days, and not in a good way.  Over 50% of physicians report at least one symptom of burnout (emotional exhaustion, depersonalization, or low sense of personal accomplishment), higher than the general population.  Physicians also kill themselves at much higher rates than the general population.  I’m grateful for the opportunity to study and speak on physician health and well-being, because it informs my practice in ways I had not anticipated.

To be clear, physician burnout is not a problem of personal weakness on the part of doctors themselves.  The healthcare system in the United States has evolved to such a dysfunctional state that some of its best and brightest find themselves despondent, depressed, and ready to quit.  And yet, we are called to persevere in the system as it is, even as we strive to improve it.

I see the same pattern in American society generally.  Technology and other advances have created a world of 24/7 hyper-stimulation, global comparisons of productivity and innovation, and immense pressures to be perfect, or at least appear so.  Men and women live under constant scrutiny and competition.  Do I make enough money?  Is my work impressive enough (to others)?  Are my children in the right activities?  Am I doing enough?  I see, hear, and feel it from my patients every day—the anxiety, the uncertainty, the angst.  The suffering is real, if not totally tangible.

For those of you whose exercise routines hold you up, how quickly do you abandon your workouts when things get really busy?  What about quality time with your friends?  What about your painting, knitting, writing, reading, skating, volleyball, music, and sleep?  Everybody recharges a different way, but I see a common pattern of ignoring the low battery alerts and pushing ourselves to empty—physicians and patients alike.

Our systems need to change, no doubt.  Medicine, business, education, politics…  We need to get clear about what and whom we really serve.  In medicine, I believe physicians should lead the movement toward a more humane internal culture.  There is no way we can take excellent care of our patients if we are not well ourselves, and we cannot wait for corporate leaders and policy makers to advocate for us.  The same is true for you, our patients.  What do you need to be healthy?  What can you change in your habits, environment, and relationships to meet these needs?  And in making such changes, what positive ripple effects could you have on those around you?  Can you lead by example?

If we all put our own masks on first, like they say on airplanes, how many other people’s masks could we help with?