Went to a great Georgetown Alumni Coaching Conference this week and one of the wonderful breakout sessions that all dealt with resilience, showed us this video by Soul Pancake.  This gratitude practice is a simple, yet powerful way to increase your happiness by up to 22% and make a memorable difference to someone in your life.  Watch and see.... and then tell me what you did!

Simon Beck is a snow artist.  He creates works of art and beauty that can be erased in a matter of seconds with the next snow or windstorm.  He spends hours creating these works of art.  He doesn't use any technology. It is only him, the snow, his footprints and his amazing vision.

I found out about Simon through my sister-in-law's posting on Facebook.  While part of my new year's commitment is to be less intimate with my smartphone, tablet, computer........  you get the picture....., there are some uses that serve my spirit.  I knew when I read about Simon, that I would write about him and his work.  In doing so, I'm imagining that part of his purpose has been fulfilled:  to inspire others to what is possible through dedication, inspiration, purpose, and vision.

To look at Simon's trails above, you start to wonder what he sees that we don't.  What is it that drives his painstaking footsteps in the snow?  One misstep, one off- balance footprint could destroy hours of work.  Virgin snow is just that:  once tampered with, the system is changed; the design is altered.  There's no going back.  Yet as I look at Simon taking each step with purpose and passion, I know he's not thinking of what may ruin his design.  His only thought is on creation.  He is focused on his goal and he is pursuing it with relentless abandon.  His companions are only his snowshoes, ski poles, goggles, and stamina.  He is driven by his passion to create beauty, and to share that beauty through photography.

As a coach, we tend to seek metaphors in our work with clients and in our lives.  So, what I choose to see is someone honoring his passion and 
purpose: Someone whose inspiring goal transcends the "work" it takes to fulfill it.  I see someone who moves into his purpose and passion, with full presence, realizing that it can all change in a heartbeat.

My prayer and commitment for 2014 is that my clients' experience of our work together can be just that:  fully present, focused, with vision, passion and purpose.  As leaders, that we can put one foot in front of the other, moving constantly closer to our goal: that we have the energy and commitment to withstand the inevitable challenges, and continue onward.

People often ask me about my career path and my purpose.  What I always say is that my purpose began with positively impacting a hospitalized patient and that purpose has not changed.  I don't practice as a "nurse," as we may rigidly define that role; and I do hope to inspire physician, nursing and healthcare leaders to be the best they can be in service to patients and families.  Each person reading this blog will be somehow impacted by our healthcare system.  Lives will be saved or lost.  The quality of our lives will be improved, maintained or disintegrated by the care we receive.  That care has to provide quality, respect, hope and peace.  

Perhaps we in healthcare should start calling ourselves "Health Artists!"

My heartfelt thanks to Simon for his inspiration, and wishes to all for a "health-filled" 2014!

For a Christmas 2013 video of Simon, click here.

Recently, I've been putting much thought into the impact of "expertise" in healthcare.  As a leadership and physician leadership coach, I very often work with my clients on their habit of problem solving, knowing "the" right answer, judgment, and intellect. 

In my personal journey in dealing with my husband's life-threatening brain disorder, I find myself torn between wanting to look to my physicians for "expertise" and "hope," while also being aware of the limitations of medicine and my need to define my own reality... my own story.

It is an interesting perspective to be a consumer of healthcare and practitioner within healthcare at the same time.  I've been reading, with avid interest, the differences between the medical model and patient-centered model, as defined within "Escape Fire's" movie and facebook page (that is where all the "expert information" is, right??). As the authors describe, the patient-centered model  requires a shift from "physician dominant," to "physician collaborates:"  From "care is disease-centered," to "care is quality of life centered;"  From "physician does most of the talking" to "physician listens more and talks less." 

As I read various related literature, like "The Four Habits" that was created by the great folks at Kaiser Permanente, I think about tools that help shift this paradigm.  As they describe,  The Four Habits are: Invest in the Beginning, Elicit the Patient's Perspective, Demonstrate Empathy, and Invest in the End. The goals of the Four Habits are to establish rapport and build trust rapidly, facilitate the effective exchange of information, demonstrate caring and concern, and increase the likelihood of adherence and positive health outcomes.  What I find fascinating about this model is that it parallels the framework of a coaching model perfectly! 

In coaching, the client is the expert, holding all the wisdom, strength and courage that a capable, wise, and powerful being possesses.  A table succinctly describes the four habits and associated skills:  "elicit patient concerns;" "ask for the patient's ideas;" "be open to patient's emotions;" and in "investing in the end," "deliver education and diagnostic information and then involve the patient in the decision making process."  It reminds me of a dance that is more of an interplay between leader and follower with those roles being flexible and dynamic, rather than fixed and unchanging.

All of this requires a perspective that is quite different from doctor, or nurse, or any other discipline as "expert."  It requires a vulnerability that allows us to say: "I don't know everything" and most importantly, I don't know what matters most to my patient.  Therefore, while my breath and depth of knowledge is vital, I'm also a learner along this journey of wellness with my patient/ client.  Now there's a thought!  What impact would it make if we were to start labeling the "patient" "client?"  Better yet, how about "health partner?"  Whatever term would convey the essence of each individual's wisdom and insight to direct their own health, and their own wellness, even if that includes dying.

There are two resources I use repeatedly in my work with clients: Marilee Adams' "Change Your Questions, Change Your Life," and David Emerald's "The Power of TED."  Ms. Adams describes her simple, yet powerful "Choice Map," which helps the reader consider a shift in perspective from judger to learner.  It requires us to recognize when we are making judgments about others (which she describes as landing us in the pits) and intentionally shifting that perspective to one of learning and desired outcomes.  It's less about blame and who's right or wrong, and more of "what do we want, what assumptions am I making, and what are the options open to us?"

Mr. Emerald describes the empowerment dynamic as moving from victim to creator.  As a creator, I have choices in how I deal with life's challenges, and I can seek the help of coaches who can appropriately challenge me to discover my wisdom and help me move toward health and success.

Can we make that shift in healthcare?  Can we use our great strength in problem solving and science/ medicine, while also making room for art in more fully engaging our health partner on their journey to wellness?  Can we notice and abandon our own egos and judgments, in service to the patient?  I, for one, would love to be part of that journey!

I welcome your perspective!

I am an Iron Girl!

August 19th was a cool, partly sunny day in Columbia, MD and close to 2,000 women and their guests showed up at 5:15am to get ready to participate in the Iron Girl Triathlon.  Our bodies were marked with our race number and our age (yes... no hiding from public scrutiny, or the pressure of possibly seeing those older than us surpassing us in the race!).  Team Fight, supporting the Ulman Cancer Fund, hosted a dedication circle where 100 women held hands at sunrise and declared for whom they were racing.  I had the privilege of announcing my race in honor of my husband, and my two fellow Iron Girl buddies.  I will admit to having tears in my eyes when my husband ceased his "official photographer" duties, and came behind me to put his hand on my shoulder.  If you've read my prior postings, you know that a life threatening brain disorder could have easily prevented him from being with me for the race.

The National Anthem was played and then it was time for the swim to commence!  Three weeks ago, I totally panicked during a dry run at this same lake so I was "a bit" nervous going into the swim, yet felt that I had prepared as much as I could to be successful.  I had my ritual planned which was to "bob in the water" six times (dunk my head and practice breathing) before taking off.  As I did that, my goggles leaked and I feverishly adjusted them as my friend swam off to commence her race.  I re-centered, bobbed again (no leakage) and took off!  Me, and 156 other 50-55 year old women, with the next age group six minutes behind me.  To make a long story short, I spent much more time than during the dry run, using the freestyle than backstroke, and managed to complete the swim in 45 minutes, 25 minutes better than previously!  I went on to complete the 17.5 mile bike ride and 3.4 mile run, and realized my vision of running straight into the arms of my waiting husband.

Amidst the congratulations from friends, I've also been greeted with: "What's next?"  Isn't our culture amazing?  Are we always looking forward to the next "thing" or can we be content, for just a few moments, with staying in the present and savoring what is?  As I rest my pleasantly tired body, and reflect on the journey, I am so grateful to be part of several communities:  the community of "Iron Girls;" the community of Team Fight;" and the community of women who summoned the courage, passion, purpose, discipline, and fortitude to say: "I can do this," and achieved their goal.  We put in the time; we endured the pain and discomfort; we asked for help; we embraced the loving support of our friends and family; we admitted to being "beginners" and learned whatever was needed in technique to endure with minimal injury; we set a vision and we achieved it. 

Many, including myself, initially looked at other triathletes and said: "Not me.... I could never do that!"  How many times in life do we say the same thing and prematurely relinquish our dreams in service to our fears?  What are you denying yourself because of self-limiting beliefs?  What's the first step you'd have to take to move toward your goal and what's it worth to you?  I'd love to hear from you!

Above you will find a picture of Vicki Hess completing the Iron Girl in 2010.  I took that picture as I watched her complete one of her, soon to be four Iron Girl races.  Vicki is an ovarian cancer survivor and a great friend who inspires me every day with her positive attitude and energy.  It's safe to say that Vicki's been challenging me to join her since 2010, if not before.  Mind you, completing a triathlon has never been something I've longed to do, despite having completed some long distance bike rides (metric century) in the past.  Another good friend of ours, Dana Slater caved to Vicki's challenges last year and completed her first Iron Girl in 2011.  So now, both Vicki and Dana were ganging up on me!

As I wrestled around New Year's eve with signing on the dotted line to commit to doing the race, I was thinking about how it may serve me in the coming year of 2012.  My only way to get in to the already sold out race was to join Team Fight, which I was proud to do given the desire to support young adults and their families dealing with life threatening illness.  While not cancer, my husband and I had been struggling with a life threatening neurovascular illness for close to two years and at that New Years eve, it seemed like we were not winning the battle.  My husband has a dural arteriovenous fistula (DAVF) in his brain; a rare disorder which puts him at risk of stroke or death.  His was large and complex and he has had countless neurosurgeries to block off some of the abnormal vessels in his brain.  Unfortunately, until this fistula is totally obliterated, it recruits other vessels, so it can feel, and did feel like we were living in a science-fiction novel and were losing the battle against the aliens.

I'll get back to New Year's eve in a moment.  In March of this year,  we were told that the doctors could not do anything else for what may be two years and it was now a waiting game.  We knew that Robin was still at risk for stroke or worse since he still had backflow drainage into the brain and the radiation he had takes years to work.  We were also told that if Robin started to develop symptoms again (he previously suffered with periodic dizzy spells) that we should go to an emergency room. 

If you know anything about neurosurgeons, you perhaps know that humility is not amongst their strengths.  Their work requires painstaking detail and expertise... one wrong move and someone's life can be dramatically altered.  As I struggled with accepting what these experts were saying, yet not wanting to accept a diagnosis that would bring disability and death to the most significant person in my life, I started researching the web for another possible answer.  I found that possibility in articles that had been written about skull based surgery, and the Barrow Neurological Institute in Phoenix, Arizona.  Dr. Robert Spetzler has his name on one of the grading scales used for Dural AV Fistulas, and for $100, he would examine records and images and let you know if he thought he could help.  That seemed a no brainer to me (pun intended.....), so I mailed records out, and received a call shortly thereafter saying Dr. Spetzler believed that surgery could help, if not cure my husband.  Hearing this felt like finding an oasis after wandering for days in a blistering, dry desert.  And, that news was punctuated by the fact that Robin started to have dizzy spells again, which meant he had vessels close to rupturing.

All of this would have been enough, yet as fate would have it, my 80 year-old mother, who was living in a single family home in Boston, had a mild stroke, necessitating her being moved out of her home and into some sort of continuing care community.  So, to make a long story short, I drove up the end of April, packed her up and moved her from her home; drove her here to a temporary apartment in a continuing care community, got her as settled as I could for about 6 days before I said: "see you later-- I need to go to Arizona for Robin to have major brain surgery."

What was supposed to be a one day surgery and 3-4 day hospital stay, turned into a two week hospitalization and three week stay in Phoenix.  There were complications every step of the way, including blood loss requiring a staging of his craniotomy; six hours of endovascular work and radiation exposure (where they go in through an artery in the groin, thread their way all the way up to the brain, locate abnormal vessels, and insert a glue-like substance to block off the abnormal feeders, making sure that none of the glue leaks to block off normal vessels), a second craniotomy to seal off one of the major feeders, temporary psychosis and difficulty expressing himself, and the final assault which was his acquiring deep vein thromboses due to being immobile for so long.  I would spend 10-12 hours/ day by his side, leaving the hospital around 10p feeling like I was walking in a fog and was only moving by putting one foot in front of the other.  I had amazing support from family and friends, while I was out there and also knew that I had to force myself to exercise (swim or jog) for my mental health and to not lose the ground I had gained in my training for the race.

So, back to New Year's eve......   as I let the completed form stare at me from my computer screen for at least 24 hours before hitting the "send" button, something told me that I would need this race to serve as a positive goal for me; to help keep me fit and strong, and to help me experience and face my fears, realize my ability to overcome them and to be successful at something I previously thought was impossible.  I honestly believe that my ability to disagree with what some of the most arrogant of surgical providers said was "true," and to persist in finding my own truth, which has prolonged, if not saved my husband's life, has been, in part due to my training and participation in this race.  As I fantasize about the 19th and crossing the finish line, I imagine myself pausing just prior to entering the final gate and walking away.  I am sure that sounds crazy, for isn't it about that final announcement of "Joy, YOU are and Iron Girl!?"  And while I will probably choose to finish the race and go through the gate, that isn't what it's about for me.  It's more about the journey; it's about what it has taken to endure pain and discomfort, and persevere; it's about courage; it's about asking for help; it's about being cut down to the core and putting one foot in front of the other; it's about every young adult's fight with cancer and regardless of whether they win their race for life, or die, they are winners.... they are Iron Girls, because of their strength, their courage, their commitment to ALL life has to offer. It's been about companionship, faith, laughter, tears, and spirit. 

With just over one week to go, I am feeling strong and confident (despite my total panic at the open swim dress rehearsal.....).  My vision of seeing my husband standing at the finish line will come true.  And, as I set foot in the water, waiting for that whistle to blow at 7:04am to start my wave, I will smile with gratitude for the many blessings preparing for this race has afforded me. There will be light within the darkness of Centennial Lake; there will be friends by my feet as I push up Mt. Albert, and there will be wings of angels lifting me up as I run/ walk my way home to the finish line.