Being Mortal: Medicine and What Matters In the End

I recently finished the book Being Mortal: Medicine and What Matters in the End by Atul Gawande. Dr. Guwande clearly articulates what I have pondered and then through a compelling and personal narrative, provides concrete solutions. Even if you think you are not interested in end of life issues, you should read this book. Each of us will eventually face the dilemma of quality versus quantity of life — certainly for ourselves, but most likely also for a loved one. Read this now. Before you are in the crisis.

Dr. Guwande’s book is a call to change the medical and caregiving community from a goal of long-term survival to instead long-term well being.

Remember when you first got your driver’s license and your parents had all type of rules about when you could drive and where you could drive and who could drive with you? It was annoying and frustrating. They did it though because they cared and wanted you to live to see adulthood.

Then you became an adult. And some things you did may have been good decisions. You got an education. You didn’t get arrested (or maybe you did… but hopefully you grew up enough that eventually those type of things stopped happening!)

Some things you did though were not the best actions for a long life. Perhaps you smoked. Or drank. Or gasp… drove a car in traffic! You had the right then though to make those decisions. They may not have extended your life but they did make you happy to live that life.

Then slowly as you progressed through life, the people you cared about starting taking away the ability to make those decisions. You may have heard things like, “you can’t have a dog Mom. He may trip you and you might break a hip.” Or “That bourbon is not good for your health Dad.” Slowly, the right to make decisions that affect our quality of life are taken away and that is not necessarily a good thing. Compounding the problem is the lack of education for doctors working with end of life patients. They are taught to extend life, not enhance it and it is difficult for them to discuss end of life issues or suggest hospice or palliative care.

Dr. Guwande strongly advocates that not everyone can be cured but everyone needs comfort, kindness and the chance to have purpose in life. He recommends bringing pets and children into senior living communities to give the residents purpose. He gives specific suggestions on how to talk to the seriously ill. In particular, I love his approach of asking them what their goals are for the rest of their life and what their fears are. You may be surprised by the answers and the answers can help guide how you help the person in those last years or days they have left.

I highly recommend this book.

ASHES TO ART: Finding Joy and Purpose in Adversity

In 2012, Lori Joseph was driving back to her home in Nebraska from Colorado with the devastation of wildfires in her rear view mirror. Lori recalls, “there was smoke in the sky and what I remember is how much the locals were taxed with the burden of trying to move their livestock and help their families and their homes were burning. Some of the firefighters lost their homes while they were fighting the front lines.” The next morning she went for a walk and was struggling with finding a way to help. She was not in a financial position to just write a check so came up with an idea to use charcoal from the fires to create art. Artists throughout the country made art from the charcoal and the auction proceeds were sent to the Poudre Canyon Fire Department.

The concept eventually evolved into a workshop of the same name. Participants use sensory exploration using fire, art and a “dress up” box to explore fear and adversity to find purpose and joy. The “playfulness of the workshop gives people permission to play because we take ourselves so serious as we grow up and we forget that it’s important that we give ourselves recess so that we still go out and play.

Lori said there are three levels of empathy:

  1. The first is to be able to relate to the person or the situation.
  2. The second is that you relate because you had a similar situation
  3. The third is where you feel a call to action

The third level is what Lori hopes participants at her workshop discover.

“When we set our fear aside, that is when we really grow into who we were meant to be.”

We discussed so much more in our interview including Siegfried the Elephant (her giant stuffed elephant who helps at her workshop) and how our connection to the environment helps us connect to one another. Her book, My Embrace, is part of her journey to face her own fears and how she uses nature and service to continue to find positivity and purpose. The back page of her book wraps up her life philosophy well, “Today’s a good day to list all of your accomplishments, big and small. After all, you took baby steps, then ran and leaped and oh yes, you took flight!”

 

Upcoming Suicide Prevention Learning Series

I need your help! Well as always … God pushes me in directions where I need to go. I never know where my morning “waterside chats” will lead me and today it was to discuss suicide prevention and my lack of understanding on how to help. And so based on feedback … I am going to host a series of learning talks on Facebook Live and YouTube so I can learn and you can learn alongside me. I need your help! Please share this video with those that may want to share their story and help us learn (survivors, families, and professionals). They can speak to me privately or share their story in a live interview… I don’t know where I am going exactly on this but I know its a topic that needs attention and I need to learn more about… come along for the journey!

Making the Most of a Modified College Social Life During a Pandemic

A quote from a parent on CBS’s Sunday Morning on August 9, 2020 really touched home to what I’ve been hearing from other parents and what I have been thinking as well… “I’m more concerned about her not having her college experience with her friends than I am anything.”

No one knows exactly what campus life will be like…  and it may even change throughout the year so students need to be prepared to make the best of it and come with an attitude of flexibility and adventure. As a parent of a college age student, I want to know how they connect with fellow students and get involved safely. Kelly Shannon (Director of Campus Recreation at University of Mary Washington) Dr. Kim Leisey (Associate Vice President for Student Affairs at UMBC) and Aisha Rivers(Director of Student Engagement at Goucher College) joined me for a panel discussion. 

Ms. Shannon suggested weeding through all the options offered by the college to find the one or two things that really drive their passion. All the options “can get overwhelming.” For this reason, “think about what are the things I am passionate about? Because if you get involved in ten things, it’s going to not feel manageable, but if you choose a couple to get started with and make connections that way” it will help students find “their people”.

Dr. Leisey suggested students to ask themselves, “how do you imagine your college experience? What is it you want to explore? And how do you want to be different than when you were in high school?” College can be a time to “shed some of the stuff from high school and do something new and different.” Once you know the answers, you can get on the college website and look to see what clubs and organizations meet those goals.

One thing students may struggle with is how to create informal connections outside classes and clubs. Ms. Rivers conceded this will be more difficult than in prior years and it is important to manage expectations that it will be the same but that it can be a meaningful experience. Using provided tools like Microsoft Teams to have game nights and other activities is a good start and one example of how to create relationships is to share contact info after structured activities with like-minded individuals. “Be thoughtful to not try to replicate everything you have in person because that is not possible, but do use the tools you have at your disposal to have organic community building.”

I recommend parents and students watch the full video together to discuss expectations and ways for students to connect. The video is just 30 minutes but the suggestions from our panelists were insightful and meaningful.

 

Five Point Plan for a Child’s Success from a Mother of Five

Danielle Davis raised five children to successful adulthood. She currently teaches high school English but has worked with kids of all ages… both professionally and as a volunteer.  She takes parenting seriously but she is a ton of fun – even her kids would probably agree.

Danielle frequently gets asked for parenting advice and so she created a five point plan for success she shares with her friends and with us.

  1. Celebrate where they are – If a child is good in sports but they are not good at reading, then celebrate their athletic skills. When you celebrate a child where they are, it gives them the confidence to be where you want them to be. Celebrate the small steps.
  2. Did you have fun? – Danielle starts conversations with her kids with this question to ground and remind herself that her job is to be the cheerleader, not the coach.
  3. Be your kid’s cheerleader — There are going to be plenty of people who criticize or tell them they are doing a task incorrectly, so each kid deserves at least one person who is always going to be their support person.
  4. Be a role model — If you want your kid to have a certain behavior, then you need to do it yourself. If you want them to read, you should read yourself. If you want them to eat healthy, you need to do the same.
  5. Make a plan and stick to it — There are many ways to parent and many books or resources that will tell you how. Decide your priorities and style and stick with it.

In the video, Danielle shares her experiences and stories on how she came to create this 5 point plan – including that she practiced and learned from watching her nieces. We also answer questions from the audience about how to talk to your kids about sensitive issues like race and sexism. It’s definitely worth the time to watch!

When you celebrate a child where they are, it gives them the confidence to be where you want them to be.

My Favorite Things…

Since I sold my business in 2018, my business life has drastically changed including that I am nearly always working from my home office and so this post is to share some of the things that make my office work well for me.

The first is my Audio-Technica microphone. At $119 it didn’t break the bank but people comment all the time on how great my sound is and the boom keeps it out of my way when not being used and easy to put in place when I need it. The separate small tripod is great too for when you are traveling as the microphone and tripod fit easily in my laptop backpack.

Audio Technica ATR2100X-USB Microphone Set

Streamyard is a broadcast studio that allows me to broadcast simultaneously to both Facebook and YouTube. It pulls the live comments from both so we can address the questions while we are live and automatically schedules and posts the upcoming interviews on both platforms. It has all kinds of cool functions like banners and tickers so I look like a professional broadcast without a staff. The link to their site gives you a $10 discount off their services. I’ve tried a couple of other systems and by far like this one the best.

Next is my second monitor – a Samsung 32 inch curved monitor. It’s big enough that I can put up to four different screens on it at the same time. I rarely do though.. honestly I love just having one screen showing because its big enough for me to see and read even when its at the far side of my desk and so it leaves me lots of room for paperwork in front of it. It uses little energy and takes up nearly no desk space. On Amazon it currently has 1,237 ratings and nearly all of them are a 5 star so others must agree too.

Samsung 32 inch curved monitor

I use a Boyata laptop stand to lift my laptop and place it at the height I need. This serves a couple of functions — first, when on live video, its important that I am at eye level with my camera and this makes it easier. I used to use a pile of books but being able to adjust to the height I need exactly with a laptop stand is much better. It gives me more room on my desk and let’s me have a small fan behind it that is able to blow air right on me under the stand which keeps both me and the laptop cool.

This Dell wireless keyboard and mouse work great, don’t break the bank and I’ve had it for years without any issues. Its light enough and small enough I can take it with me when traveling.

One thing I don’t have but have had on backorder since the pandemic started, is an external webcam. I have narrowed it down to two and am waiting until one day supply catches up to demand. I’ll take whichever comes into stock first — either the Logitech Brio or the Logitech 930e.

Not tech related but important for my health and ability to work is my little wooden block that I was introduced to by Rachael Aberle in this interview I did with her. It has helped relieve the little balls of stress that develop in the base of my neck after sitting at my computer all day. You can find more information about Block Therapy on this website.

And then some books that I have found to be extremely helpful:

The E-Myth Revisited: Why Most Small Businesses Don’t Work and What to Do About It — this book truly changed my life. I realized after reading it, my business was running me, instead of the other way around. I wasn’t going to be successful as either an entrepreneur, nor would my company be successful, until it no longer needed me.

Good to Great: Why Some Companies Make the Leap … and Other’s Don’t — the small things that can take your company from good (not a bad thing) to great. Surprisingly, there is not much difference in effort, but the rewards from the change can be phenomenal.

The One Minute Manager Meets the Monkey — how many times has someone come into your office with a problem and the result is that you have something added to your “to do” list? This book is a quick read that gives you concrete help to get other people’s “monkeys” off your back.

The Exceptional Presenter: A Proven Formula to Open Up and Own the Room — I have highlighted and notated this book over and over. Awesome advice on how to give a great speech or presentation from where to place your hands to how to write your speech.

The Checklist Manifesto — I am reading this one because I absolutely love Being Mortal: Medicine and What Matters in the End by the same author, <a rel="noreferrer noopener" href="http://<a target="_blank" href="https://www.amazon.com/gp/search?ie=UTF8&tag=retreatandlea-20&linkCode=ur2&linkId=21a9d9f32da34b461288928277d0b0b4&camp=1789&creative=9325&index=books&keywords=Atul Guwande">Atul Guwande</a>""Atul Guwande. The concept he lays out seems simple but yet we don’t do it…. checklists prevent human error and create better communication among teams. He not only tells us why it is a good concept but explains how to achieve it.

Talk to Me: How to Ask Better Questions, Get Better Answers and Interview Anyone Like a Pro — this is one I just purchased and can’t wait to start reading. I have migrated some of my work to interviewing very interesting subject matter experts on a variety of topics and want to do the best job I can at making sure their knowledge is properly shared with my audience. I’ll update with what I think of it!

Sex Over 40: Why Is It Different and How Can I Make It Better?

Remember sex ed back in middle school? You were super interested but also embarrassed and they really just taught you how not to get pregnant or contract an STD… it certainly was NOT about how to enjoy sex. Even as adults, discussing sex is not easy.

Before this interview with Raylene Taskoski, I posted an anonymous survey where you could post questions and wow! We got some great questions….. Everything from “how do I approach my husband about spicing it up in the bedroom” to “how do I deal with vaginal dryness and low libido”?

We discussed all of this and more. Raylene makes it feel like you are talking to a girlfriend over some cocktails. I learned a lot and hope you will as well. The main thing I hope you take away from this talk is that whatever problem or issue or question you have, you are completely normal. I guarantee you that someone else is having the same issue. And whatever if working for you and your partner (or you solo!), is normal. If that is sex every day — great. If it’s no sex at all — equally great if it is work feels right for both of you.

I encourage you to watch the video. And I even better, watch it with your partner so it sparks some good conversation.

Here are some of the topics we discussed:

  • Lubrication – by far this is the question Raylene gets more than any other and the one answer that is a big game changer. We discuss what kind to use and how to use it.
  • Foreplay – Raylene shared a clitoris model so we could see how little of the clitoris is exposed and why it takes a woman longer to achieve orgasm.
  • Communication – You can’t expect your partner to know you like something unless you tell him. We discussed how to better communicate to your partner what works and what does not.

what you gotta do is starfish

What is Palliative Care and When Is It Appropriate?

Recently speaking with a friend whose mother was sick, I suggested she should look into palliative care. The response was a look of shock and surprise. “She’s not dying.”

Deborah Araya, Physician Assistant at University of Maryland Charles Regional Medical Center (CRMC), said she gets the same response when she talks to patients because “they don’t really understand that palliative care is not hospice care. They are two different medical sub-specialties.” They both have a “holistic approach that helps both the families and the patients”. The founder of palliative care recognized that if hospice care “worked so well at end of life, why would you wait to end of life to provide this care? So let’s move it back to the time of diagnosis of a life threatening illness…. So palliative care is holistic patient-centered care that can be provided while the patient is being treated for the illness and long before they are ready for hospice.”

In the video interview below, we also covered how to discuss advanced care directives and how to approach end of life care with family and caregivers. Mary Hannah, CRMC Manager of Population Health, said it’s best if families discuss this well in advance of being at the hospital and the “conversations happened outside the acute care environment, not once they are in the hospital in distress or when the patient can no longer make their own decisions. …. sit down prior to that point, around your own kitchen table, rather than waiting for your family to make those decisions in an ICU waiting room, which is the hardest time.” Mary conceded that, even then, the conversation can be difficult so she suggested a number of resources including The Conversation Project.

Other resources Mary suggested are:

I read the recommended book, Being Mortal, a few years ago and it was truly life changing. I wish I had read it prior to caring for my mother when she was being treated for pancreatic cancer. I think I would have done a better job being her caregiver and also helped relieve some of the stress and guilt I had as a caregiver.

Palliative care can be helpful to not just the patient, but to their entire care giving team — and in many cases will not only improve the quality of their life, but also the quantity. I hope the video interview helps you start important conversations in your family and provides some understanding on how palliative care can help you.

palliative care is holistic patient-centered care that can be provided while the patient is being treated for the illness and long before they are ready for hospice

STRATEGIC STORYTELLING FOR PUBLIC SPEAKING

Danielle Dardashti taught me and a very engaged live audience about how to discover, write and tell a story that engages your audience and retains their attention so you can move people and get results.

“Storytelling is the best way to sell a product or make a friend and connect people because it’s a way for us to make sense of everything that is happening around us and create a narrative around it using emotion, and conflict and transformation. Everyone experiences similar emotions, similar conflict, even if they are dealing with life in a different context. Stories allow us to relate to other people’s experiences versus just facts, figures and data.”

Danielle said there are three steps to creating a great story and the first two are before you ever start to write it:

  1. Understand your audience
  2. Mine your life experiences to find great stories
  3. Craft the story

Other topics that we discussed were:

  • what makes a great story
  • how to use emotion to help your audience feel what you felt
  • how to remember great ideas and use them in your story
  • how to get over fear and embarrassment when speaking
  • the difference in how to tell a story in a live versus virtual speaking event
  • how to encourage youth to develop the art of storytelling

And great news… Danielle will be teaching a five part workshop on Strategic Storytelling for Public Speaking which includes one-on-one time to craft your individual story. At the end of the workshop you will have your own complete 5 minute story ready to tell for your audience. If you sign up between now and June 23rd, we are offering a $75 discount…. yeah!

Storytelling is the best way to sell a product or make a friend and connect people because it’s a way for us to make sense of everything that is happening around us and create a narrative around it.

Core Values of Management – Discipline, Affirmation and Tools

Over the years of owning and managing companies, I’ve narrowed the core values of management down to three main concepts. These core values apply whether I am managing an individual, a team, a project or my entire company. They are discipline, affirmation and tools. Let me explain…

Discipline

Discipline comes in many forms. The first and most important is setting the rules for people to work within. Inherently employees want to do a good job and clearly stating WHAT you want gives you the best chance of achieving that goal. I’ve seen too many projects go poorly because the manager at the END of the project expresses what they want and their dismay that their staff did not deduce what they wanted. Clearly stating the end goal gives you the best chance of getting there. In addition, giving the rules of the road makes sure your staff has the best chance of success. For example, if you don’t want them to work overtime to complete a project, they do and then your project’s budget is blown, it’s not your staff’s fault… it’s yours.

Affirmation

Just as important as telling your staff what they should and should not do, is reassuring them that they are in indeed on the right path. People want to hear they are doing a good job and telling them helps ensure they continue to do so. Employee recognition through “pat on the back” type awards, “employee of the month”, and public recognition at employee events are all good ways of making sure your employees know them and the work they are doing are valued. Simply encouraging your managers to tell employees on a regular basis they are doing a good job is even better. Don’t assume they know… tell them.

Tools

Give your employees the tools they need to do a good job. You can’t expect them to dig a hole if you haven’t given them a proper shovel. Frequently tools are tangible items like a computer or cell phone. For example, as a software engineering firm, it’s important that employees have up to date computers and software that help them produce quality products fast enough to meet their customers time constraints and budge

Having all three elements will ensure you have productive employees who stay with your company and feel good about the job they perform.

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