be still

Yesterday, I was brewing on a blip with the system that we’ve encountered since moving to Vancouver.  The school’s daycare refuses to consider Aaron for before/after school care unless he ‘secures his own funding’.  And the wait list for government funding for childcare for kids with disabilities is months, even years, for a kid his age.  This lack of care, of course, affects our work schedules in a dire way.

Ruminating on this stupid fact sent me spiralling into a rage.  This rage started to border on outrage, and I began furiously texting my (one) friend here about this great injustice, and feeling meanness wash over me.  I started fixating on all the things that were wrong in my life, like being far away from my beloved Ella, and missing her deeply every day.  I started fretting about my eldest son, who is in scarce email touch and somewhere in America on tour with his band.  The thought started creeping in that I wasn’t creating change fast enough in my new job.  That I had to practice my talk for an upcoming conference.  That the toilet upstairs wasn’t flushing properly.  Then I looked down at my jiggly thighs.  You know that this thread of negative thoughts was going nowhere fast.

I didn’t like feeling that way.  I know of some people who are permanently in a state of rage, and I’m sad for them.  But I also see how easy it is to push over that edge.

So in the midst of my self hate-talk, I laid on my bed and did this:

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be still

Not ironically, I won this picture in a door prize at a special needs mom spa day that my (one) friend here kindly invited me to last month.  It was a lovely day of pedicures, massages and nice food.  And bonus, I even won a coveted door prize that is now hanging in my office at work.

Wait, I have an actual office at work?  With a window?  And a walls to hang pictures up on?  Yes I do.  And I have a job with flexible hours and wide autonomy, where my arrival from Edmonton was trumpeted by a great welcome from the staff?  Uh-huh.  And this job brought our family to Vancouver, land of blossoming cherry trees and mountains and excellent sushi and infinite beauty?  And we are now living close to my only brother and his wonderful family, including my little two year old niece Olive?  And I am now closer to my mom and dad on Vancouver Island than I have in 20 years, and I’m awfully happy about that because we are all getting older?  Yes, yes and yes.

All this occurred to me when I was being still on my bed.  I remembered all the kindnesses that have been bestowed on us over the past month – how other moms that I barely know have given me hugs, so easily welcomed me into their circles, taken me for coffee, and helped me figure out the lay of the land.   When I was still, I could feel that rage about the daycare dissolving away.

Then yesterday my brother took Aaron out for his 12th birthday gift.  I should note that Aaron is obsessed by luxury cars.  He tells me he’s going to work at a Mercedes store when he grows up.

His Uncle Geoff took him to a Porsche dealership, where Aaron took a tour, was feted by the sales staff there, and given a Porsche hat and model car.  Geoff’s friend James whisked Aaron off for a speedy drive through the streets of Vancouver in his brand new red Porsche.  Aaron arrived home very pleased after his birthday experience.  At dinner, I asked him:  How was the tour of the dealership?  How was the ride in the Porsche?

Aaron looked at me, his mouth full of pizza, and said:  Lucky.

I said, lucky?

I am lucky, he repeated.

He is a lucky kid.  I am a lucky mom.  We are all lucky. The next time I am starting to forget that, I’m just going to be still for a while.  I think that’s when I find the peace in my heart.

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aaron not touching the $1.4 million Porsche.

 

girl in a band – the book

girlinabandI bought Kim Gordon’s Girl in a Band book in the futile hope that I would understand my eldest son.  He’s a boy in a punk band in LA and is currently on tour somewhere in the midwest.

I have never been a girl in a band, although I was once married to a man in a band, and spent many evenings sitting at a bar at 2 am with the other band spouses waiting for the band to take the stage.  I was their occasional studio accordion player and co-wrote songs like ‘How Does it Feel to Be Neil’ (this was a song about my own dad, who is a very interesting guy).

I do stand on stage now, sometimes, but my audience isn’t a mosh pit.  It is a room full of  Emergency Room doctors or pharmacists.   What Kim says about performing was fascinating to me:

Greil Marcus says, “people pay money to see others believe in themselves.”  Meaning, the more chance you can fall down in public, the more value the culture places on what you do.

Kim says that performing is fearless.  Regarding public speaking, I always say there’s a fine line between being stupid and brave.  I try to err on the brave side of things but don’t always succeed.  But yes, the awe bestowed on people who step on a stage is due to that risk that we might fail in an epic, very public way.  This is everybody’s worst nightmare (and in fact, I have my own recurring nightmare that I’ve forgotten my speaking notes at an important presentation, and that I can’t remember what I wanted to say).  Allowing yourself to be vulnerable in front of a group of strangers is a high risk, high reward thing to do for a living.

I did glean one insight about my son from the book.  He’s a boy who left home at age 18 and then moved even farther from home, thousands of miles away, two years later.

Kim Gordon says:  I couldn’t find out who I really was until I left LA and my family.  Until that day arrived, I was just waiting, suspended.  Families are like little villages.  You know where everything is, you know how everything works, your identity is fixed, and you really can’t leave or connect with anything or anybody outside, until you are physically no longer there.

To me, this says to those hanging onto your adult children, it is time to let them go.  It will be the most painful thing you have ever done and it doesn’t mean you will stop being a parent. But, as the inspirational saying says, you’ve given them roots and now it is time to grant them their wings so they can fly.

I stopped writing book reviews many years ago.  (Here’s a real review).  I will say that Girl in a Band is a factual and chronological book.  I was craving to discover how it felt to be a girl in a band, but I didn’t ever find out.  I learned the steps it takes to become a successful band, and Kim did provide passionate descriptions of Kurt Cobain and the sad break up with her husband.  But it was as if she was still in the thick of things with the dissolving of both her band and her marriage, and she hadn’t been given the space yet to reflect.  Perhaps her next book will provide those insights.  In the meantime, if you are a girl in a band, or a Sonic Youth fan, you will like this book.  For the rest of us, I’d say garnering one or two nuggets from any writing, as I did, is reason enough to pick up a book and just read.

 

sacrificing empathy for efficiency

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(This gorgeous canvas was gifted to my gentle daughter, who is going into nursing school this fall).

Six years ago, near the beginning of my career in the world of patient and family centred care, I was at a Family Centred Care Conference hosted by a pediatric hospital.  I was in a session that was facilitated by the wonderful Peter Rosenbaum.  He broke us into small groups, and asked the question:  Family Centred care is….  Each group had to fill in the blank.

One nurse stood up and said, rather angrily, I don’t have time for family centred care.  I was sitting at a group of family representatives.  We all audibly gasped.  No time to introduce yourself?  No time to smile?  No time to make eye contact?  Family centred care is all those small gestures that mean a lot to patients and families.  It is these small demonstrations by health professionals that show us that you care.

However.

One element of family centred care that does takes time is listening.  Making space for people.  Listening with your whole self.  Minimizing distractions. Not rushing or appearing rushed.  And yes, sometimes you can effectively listen to what patients need in thirty seconds.  But many times listening means slowing down, pulling up a chair and sitting down for a while.

Alas, our health system does not compensate for this types of kindness or compassion.  Our Canadian system is either based on fee-for-service (see as many patients as possible) or it is driven by the need for efficiencies.  I’ve always been wary of philosophies in health care that are modelled after processes in car factories.  For human beings are not cars.  An interaction with another human being includes taking the time to get to know each other.  This is the only way to create a relationship that is built on mutual trust.

Dhruv Khullar wrote a poignant essay in the New York Times earlier this month called The Importance of Sitting with Patients.  In it, he laments a system that is so focused on the ‘altar of efficiency’ that it forgets the importance of sitting with patients.  Should hospitals really be run like businesses?  Does the race for efficiency sacrifice empathy?  I concur with Dr. Khullar and say yes, in its current form, it does.

But here’s what I think.  Visionary health leaders can add measures for compassion in performance reviews,  hire based on both heart and brains, share patient stories at committee meetings (or even better, invite patient reps to committee meetings), and celebrate acts of kindness in their hospitals.  If they can somehow figure out a way to compensate for listening, well then empathy can indeed function alongside efficiencies.

I read an unattributed quote on Twitter, and I think it is brilliant:  health care should be less about the care, and more about caring for people.  Less about services, more about serving people.  And caring and serving does take time.  Having worked in health settings for the past six years, I now feel for that nurse who stood up at that conference and said she didn’t have enough time to practice family centred care.  Because the health system has slowly but surely stamped out her passion for caring for people.

As Dr. Khullar says, there is tremendous value in having more time to spend with patients.  Let’s continue to build our own altar of empathy.  Six years later, I believe now, more than ever, that love always wins.  I know that it is the gentle people, like my own daughter Ella, who are going to change the world.

settling in

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Our little family of three moved to the Vancouver area from Edmonton on March 1.  Many kind folks have asked:  how has Aaron’s transition been?

One month later, I have time to catch my breath and reflect.  One of the many thoughts that washed fear over my body when I thought about moving was the notion that we were pulling Aaron from the middle of his grade 6 school year to move across provinces to an unknown school.  Although we vetted the school district and the schools carefully, we did not know how he would respond to this great transition.  Plus, he was having a good year in his old school – most stories about switching schools in the disability world come from yanking kids from awful school settings.  This is was not the case.

We arrived a week before our school district’s two week Spring Break.  I am thankful to have a family-friendly work place, and I did not begin work until mid-month.  So Aaron ended up having a month long break before his first day of school.  This slow and steady transition was purposeful.  We wanted him to get used to Vancouver and our neighbourhood before his first day of school.

We simply hung out.  We walked along the beach.  We ate sushi and fish and chips.  He met the kids living in our cul-de-sac.  We admired the view from Burnaby Mountain.  We fed the ducks at Burnaby Lake.  We went for walks to the grocery store and I put him in charge of mailing letters.  We visited the library to apply for a library card.  We ventured to the big mall.  We played chess at the Burnaby Village Museum.  We picked Gramma and Pappa up from the ferry.  We walked along the boardwalk at White Rock.  We took cousin Olive to the Farmer’s Market.  We had newly-near aunties and uncles over for dinner.  We drove up to Whistler to eat Aussie pies.

When Aaron began school on March 23, he was happy and relaxed.  I think he also was sick of being with us and was ready to interact with kids his age.  He’s on his second week now.  The great thing about not having a special ed/program option in this province?  The school is like, ‘meh, of course he’s welcome here.  We have all sort of kids in our school.  We will make it work.’

I love this can-do attitude.

In the end, Aaron was fine with the whole transition thing.  Terrified about switching your kid’s school for whatever reason?  True, it is risky and the devil you know might be a safe bet.  But what if the new school is BETTER?  What if the geographical fix ACTUALLY WORKS?

I spent a bucketload of time worrying about Aaron’s school transition.  I could have spent all that energy thinking about more useful things, like what brand of raincoat should I buy?  What’s the best route to drive to my new work?  Where is the best sushi?  What are all those different birds coming to our bird feeder?  And, most importantly, how do I get the fallen cherry blossoms off my car?

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after birth

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Elisa Albert strips all the posturing and candy coating off motherhood.  Her novel After Birth is the punk rock gospel of being a mom – the fuck you to everybody who wants to hear a chirpy ‘everything is fine!’ after a woman gives birth.

Everything is not fine.  Early motherhood (in particular) is messy and leaky and cranky.  It is unbearable loneliness complemented by sleep deprivation,  It is also full of so much love that your heart actually does burst inside the cavity of your body.

After Birth talks about how motherhood actually feels.  What I found astounding is that Elisa Albert wrote a book about a time when in my journal I have scribbles like:  rt side, nursed x 12 mins.  2 BMs.  40 min nap.  bananas, oj, milk.  What do I recall about early motherhood?  Nearly nothing.  One kid couldn’t latch on and I endured excruciating pain every time he chomped down on me.  Another baby never slept and nursed all night long.  And yet another one sent me into deep grief with the diagnosis of his disability.  And yet I loved (love) these children with every cell in my body.  Eventually I came out of these dark places.  BUT THIS IS ALL I CAN REMEMBER.

Captured in the fading passages of Elisa Albert’s testament to motherhood is this:
So whose gonna write about it if everybody doing it is lost forever within it?

After Birth somehow transcends this sleep-deprived, life-changing, nipple-chomping memory loss.  Send it as a gift to every new mom you know.  Let them know they are not alone.

 

speaking about speaking

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One of the funny things I do for a living is speak in front of audiences.  This is a curious job, which peaks in the spring and fall, the busy time for health conferences.  I spoke last Friday at the Canadian Society for Hospital Pharmacists Banff Seminar, and I have five more scheduled talks until September (Pharmacists, Emergency Room Staff, Pharmacists, Rehabilitation Nurses and University Academics, in that order).  It is an honour for me to be asked to tell my stories.

It is also an odd line of work.  I’ve had speaking engagements when I was awash with cold fear right up until I stepped up to the microphone.  I could feel my heart beating in my throat, and it took a couple minutes of talking in a shrill voice until I actually found my groove and calmed down.  I vividly remember sitting in a pool of public speaking terror for sixteen hours crammed into an economy seat on a flight on my way to a consumer conference in Melbourne.  I’ve spent many a white-knuckled drive to a hotel, thinking:  why do I do this to myself?  (Note:  the fear has faded with time and practice, but I know it is always there lurking inside.  It keeps me on my toes).

These are my top ten truths about public speaking that I’ve gleaned over the years.  All of these lessons are hard-fought.  I’ve learned them from other speakers, watching TED Talks, and reading Presentation Zen.

1.  Yes I still get nervous.  It is good to have nerves.  I don’t want to sound like a scripted robot.  Nerves give you adrenaline which gives you energy.  This is good.

2.  Once I asked my eldest son, a musician – do you ever get anxious when you get up on stage?  He looked at me, totally dumbfounded and said, very slowly:  Mom, I don’t get anxious.  I am excited.  An epiphany – how you frame things is everything.  Your new public speaking mantra should be:  I am excited.  I am excited.  I am excited. This helps. A lot.

3.  Know thy audience is my biggest rule.  I never give a ‘canned’ speech.  I do my best to talk to organizers (or even better, potential audience members) so I understand where they are coming from – what are their challenges, what would they do if they had a magic wand, what would they say if they were me, what are the three key messages they want me to share?  Having this inside knowledge turns a lecture into a conversation.

4.  It is not about you.  Another lightbulb moment:  it isn’t about me;  it is about the message that I’m giving.  Nobody cares about if my hair is fuzzy or that I say ‘um’ too much or what I’m wearing.  And if you are passionate about your message, then, well, you can get excited about your talk (see #2) and share that passion with your audience.

5.  Rehearse with a timer.  If you ramble (as I do), be prepared to drop some speaking points as you go along.  I try never to go over time – otherwise I’m creeping into another speaker’s spot, and I think that’s kind of disrespectful.

6.  Accept and embrace the speaker you are.  I wish I could wander around the stage with a lapel mike without any speaking notes.  I can’t.   I like to stand behind the podium with my 16 point font notes in front of me.  Having the written word there gives me great comfort (even if I don’t look at them), and that’s ok.  Besides, I don’t read bullets off slides (see #8), and I’m a terrible memorizer, so I need my beloved notes.

7.   Watch for the ‘nodders’ in the audience.  These are the kind people who nod and encourage me to continue on.  I love those people.

8.  For the love of god, please don’t read bullets off of slides.  That means don’t put all your speaking notes up on the slides.  You are there to speak, not read.

9.  Come to think of it, don’t create a slide deck full of bullet points, either.  I use images and quotes and lots of white space, but that’s just my style – a few choice words or infographics would work too.  I truly think your slides should compliment your talk, not actually be your talk.

10.  Take some deep breaths.  I use my little meditation app before I leave for a presentation.  Andy, the Headspace narrator, calms me down.

Remember:  Everything’s going to be ok. You can do this.  (And it isn’t about you anyhow, silly).  Also:  Do the thing you are most afraid to do.  You aren’t doing anybody any favours by living life small.

Now go out there and tell your stories.  This is the only way the world is ever going to change.

my soft spot for pharmacists

I have a soft spot for pharmacists.  There, I said it.  They are one of only a handful of health professions who actively recognize the value of the patient voice.  They have not forgotten that patients are the people that they are working to serve.  Pharmacists organize conferences and invite patients to share their experiences.  That’s pretty profound, and I think they are true visionaries.  (Talking amongst yourselves all the time doesn’t make for a revolution in the health system, folks).

I just had the great honour of co-presenting with Allison Wells, who is a fabulous mom and pharmacist at the Canadian Society of Hospital Pharmacists in Banff.  Allison did an exemplary job of sharing the story of her son’s adverse drug reaction in a hospital setting.  She eloquently gave pointers to the pharmacist audience, and stressed that they had to use their own voices to  speak up to ‘stop the line’ when errors are made.  I was so impressed with her passion to share her son’s experience in order to make change in the health world.

Dr. Peter Zed before her gave some pretty terrifying statistics about patients presenting to hospital with adverse drug reactions, experiencing adverse drug reactions while in the hospital, and also after discharge.  It made me want to stay as far away from the hospital as possible.  But it was also heartening to know that pharmacists are looking at the issue of errors with great seriousness and transparency, and that they make a huge difference in making sure that the hospital makes people better, not sicker.

My take-away from Dr. Zed’s talk was this – he showed research from Hong Kong that said that patients adhere to treatment plans better if they receive follow up care from pharmacists.  And I might be stretching this a bit, but what I heard is this: patients will care for themselves if they themselves feel cared for.

And as far as my presentation, which followed Allison’s?  My talk was about this:

IMG_6486I know in my heart that pharmacists get this.  The standing ovation Allison and I received afterwards was proof.  (My first one ever, wow).

This was an awesome, engaged audience of health professionals, with big brains and even bigger hearts.  Bravo to my noble pharmacist friends – carry on doing the good work that you do.