What Would Francis Do?

I'm not sure how to start this post.  I'm sitting on my patio in the bright sunshine, at 3:00 pm on a Monday afternoon.  I took today off, knowing I would be exhausted and jetlagged from my recent travels to Italy.  I'm not sure how to feel now that the trip is over; I have looked forward to this trip for the last 3 years and its promise of a spiritual renewal guided me through many tough times at St. Fozzie's during the last couple years.  

I keep telling myself to not be sad that it's over but to be happy it happened.  

And boy, did it happen.  

There were 13 of us colleagues who traveled to Rome on pilgrimage.  Plus two Sisters and a priest who has served as shepherd of our leadership group since December 2011.  It was the most natural thing in the world to tour the religious Church sites in Rome with this group (and without our spouses). We became family.  We became Church.  

Last week at this time, I was walking up the stairs at St. Peter's, to the top of the cupola.  Last Monday was intense and it covered everything I saw the first time in Rome as a college student.  We started with an in-depth tour of the Coliseum, then the Imperial Forum, then a picturesque lunch at Piazza Novona (complete with caprese salad, excellent red wine, gelato, and an accordian player).  After lunch, with our tour guide, cut to the front of the line at St. Peter's and toured the Vatican museum (and Sistine Chapel).  Part of the deal with the pilgrimage was that we attended daily mass.  Which, given our surroundings, wasn't exactly a sacrifice.  The Vatican museum tour concluded at 3:45pm and we had an hour to blow before mass at 5:00 in St. Peter's basilica (the chapel of the Chair).  Ambitiously, a few of us thought we could hike the 525 stairs to the top of the cupola and return before mass (even though we stood in line until about 4:15).  

The first 300 or so steps are pretty routine.  But once you get into the upper part of the dome, the stairs wind to the side and are dangerously steep.  Braving them in my sandals, we reached the top around 4:45 pm.  After taking a couple million-dollar-shots at the outstretched arms of St. Peter's, we ran back down the stairs, arriving in the main church at 4:58!  The Sisters, glancing at us across the chapel, silently laughed at our tired, out of breath, sweaty presence.  Yes, we made it to mass.  It was in Latin.  But I sat in that pew at St. Peter's, struck by the sheer universal existence of the mass.  Even though I do not understand Latin, I knew the points of the mass and could follow along in English.  The same mass we celebrate in Indianapolis or Chicago occurs at the Vatican, too.  

Those thoughts kept occuring throughout the week.  So many experiences were wonderful and truly life-changing.  We landed in Rome at about 9:30 am Sunday morning.  By 11:30, we were at our hotel (two blocks from St. Peter's...you exit the hotel, look left, and the radiant dome of St. Peter's awaited us...beautiful).  By noon, I was standing in the crowd in St. Peter's Square receiving the Angelus blessing from Pope Francis.

I didn't waste any time getting to St. Peter's and the Pope.  Pope Francis reminds me of my deceased grandpa.  

We ate like kinds and queens; after small breakfasts, we relished 4-5 course lunches and dinners each day (By some miracle, I only gained .8 pounds).  Rich antipasto of Italian proscuitto and panchetta, basil and mozzarella, pasta carbonara and veal.  Each person was "budgeted" a bottle of wine at each meal.  While the alcohol content of Italian wine is lower than in the States, it was strange to drink so much wine.  And have it condoned by the Sisters (who readily joined in.  I had no idea how popular and refreshing cold, white Italian wine is at lunch.  Can I have cold white wine for lunch every day?)

On Tuesday, we started the day with a private mass in one of the cypt chapels at St. Peter's Basilica.  I was asked to serve as lector for that mass.  Despite my lengthy bucket lists, I never even thought of wishing I could serve as lector at St. Peter's.  I HATE reading at mass.  And yet, the reading was about the first Christians at Antioch and we *felt* like neophyte Christians in a new world.  The week's readings matched our collective experience perfectly.  

After mass and breakfast, we toured San Clemente church and San Sebastián catacombs, interrupted by two meetings at the Vatican with Roman Curia.  One of the meetings consisted of a set of Cardinals informing us about the upcoming priorities in healthcare.  The other meeting involved US telling the Cardinals how things were in America.  They wanted to know the state of Catholic healthcare in America and we were the ones to inform them.  How crazy is that?  I had another out-of-body experience thinking, "Am I really in the presence of Cardinals representing the Roman Curia?  How in the WORLD did I get here?!"

That thought kept hitting me.  How in the world did I get here?  Why me?  Why me?

On Wednesday, we had an audience with Pope Francis and even though we were a few of the 100,000 crowd, he passed within about 7 feet of us.  I could see his mannerisms and facial expressions.  That man is revolutionizing the Church.  Before the audience started, the atmosphere was electric.  It felt like a U2 concert or Notre Dame football game, with everyone in collective waiting for his presence.  He did not disappoint!  The homily for the day was about the gift of Fortitude (through the Holy Spirit) which fit us all perfectly.  The only way to survive in Catholic healthcare is through and with fortitude.  The Pope's homily gave us two days' of dinner fodder as we digested that message.  With a rare two hours off that afternoon, three of us trekked back to Piazza Novona for some Lambrusco and Spirit-filled conversation.  Everyone had that same reaction: "why me?  Why am I here and how am I supposed to lead Catholic healthcare into its next phase?" 

On Thursday, we bussed to Assisi to connect with St. Francis.  After seeing the basilica, the church of St. Clare, the tomb of St. Francis, and real San Damiano cross, I *felt* Franciscan.  The San Damiano cross hangs in all of our conference rooms, offices, and patient rooms.  But it hit me to my core when I saw the *real* San Damiano cross in Assisi.  I felt as though St. Francis was there, receiving his call and vocation in the present.  We celebrated mass at the  tomb of St. Francis, an experience that started me with its simplicity and powerful commissioning.  It was Franciscan "Ground Zero," akin to visiting Ireland's Aran Islands if you like Irish music.  Or Germany's battlefields to better grasp the World War II battles.  There was no place on earth more Franciscan than Assisi.  The placed breathed Francis.  And I needed more.  I recently received my first job offer of a CEO position.  In a non-Catholic, non-Franciscan organization.  I declined without even thinking twice.  My job/vocation in Catholic healthcare will never be easy.  Nor will it always be joyful.  But it WILL be meaningful.  Each day bears more meaning than a huge paycheck could garner.  Nope, not interested.  

It was in Assisi that I caught one of the head Sisters for a few moments on the side.  I asked if Jack and I could accompany the Sisters on the 2015 pilgrimage to Assisi (you spend 9 days in Assisi).  She enthusiastically agreed.  Then she asked if Jack and me had ever discerned becoming Third Order Franciscans.  I didn't even know women could become Third Order but I promised her we'd discuss it and the associated discernment process.  That type of a decision takes years (decades?) but a trip to Assisi with Jack could shed some clarity on that invitation.  

After a 1.5 hour traffic jam in Rome, we arrived back at our hotel at 9 pm.  Four of us braved the Roman dinner scene to find the neighborhood's best pizza.  After antipasto of pesto calamari and swordfish carpaccio, we shared two pizzas: pancetta and shrimp/arugala/corn.  Bacon pizza?  Seafood pizza?  Does life get any better?  We felt especially proud that we found this pizzaria by speaking to the locals; every other meal was organized by the knowing eyes of a Roman tour guide.  Heck, we even had a "nighttime guide" who ushered us around the Roman night scene.  Which consisted (mostly) of limoncello and gelato.  How much trouble could we truly get into when all we wanted was Rome's best gelato?  

On Friday, we visited the Holy Steps and St. John Lateran.  I knew very little of St. John Lateran...one day, about 10 years ago, I went to weekday mass because I felt helpless and sad in my life.  It just happened to be the feast of St. John Lateran Basilica.  I had to look it up - there's a feast day dedicated to a basilica??  But yes, the time at the Basilica itself was magical.  We celebrated mass in a side chapel and afterwards, received a "reconfirmation" of our service to Catholic healthcare in the US. I couldn't help but cry...while the masses at St. Peter's were wonderful and bridged the universalness of the Church, this one spoke to ME.  I can't put a finger on it yet but I was commissioned.  The sense of vocation was placed squarely, heavily upon my shoulders.  To say no is to deny God's will for my life.  That point came across very clearly...that Catholic healthcare really is my vocation.  I've felt smatterings of it before, where I sort of guessed I was destined to serve in Catholic healthcare, but never had I sensed such a certainty to it.  It's as though my entire education and professional existence led me to that exact moment.  

I couldn't stop the tears.  I'm SO not a cryer and cry (on average) about once a year.  And that's usually because I have to lay off hard workers or just cannot fathom the blessings granted to Jack and I in this life.  But this time, I cried out of realization.  Out of fear.  Out of a dedication to service.  How can I say no to such a defined, deliberate calling?  I'd never sensed my vocation so clearly.  It wasn't even a question.  The weight of my calling again settled heavy on my shoulders....I knew I'd never have an easy job.  But my job will be meaningful - as meaningful as it gets.  

St. John Lateran broke us all in some way or another.  So much so that our priestly shepherd varied from the set lunch agenda and took us out for Rome's best pizza.  Seriously.  If I thought Thursday's pizza was stellar, Friday's was in a class by itself.  Porchini mushroom pizza with fresh basil?  With crust so thin it was more like Indian naan...oh man...I cannot even describe that pizza.  I'm not sure why America even bothers with pizza.  And Domino's?  Um, no.  The only pizza we have will now be homemade.  That is our only prayer of somewhat capturing the magic deliciousness of that pizza.  

We went to "Last supper" that evening, knowing we were all flying back to our respective homes and families the next day.  A melt-in-your-mouth veal in marsala sauce with potato flan, followed by a magical tirimisu and Italian custard topped with dark chocolate raspberry.  It was as much a gastronomic pilgrimage as it was a religious experience.  We sort of thought we should be having bread and water but thought maybe the Sisters wanted to feed us spiritually and physically.  

Did I mention I only gained .8 pounds?  No idea how that happened!  

But the experience was one that I will be forced to unpack for the coming months and even years.  It's one of those experiences whose gravity you realize a few months into your "regular" life, when some great insight crystallizes before your eyes.  I'm still too exhausted and sick to reflect with much efficacy (I brought home a nice European cold.  It's not MERS.  I checked the symptoms).  But know that, in my daily life at the hospital, this experience will ground me in the most Franciscan of healthcare service.  I will look to Francis when I struggle or find myself lost in operational or strategic decisions.  

Most of the world asks, "What would Jesus do?"  I find myself asking "What would Francis do?"

I'm not sure what Francis would do.  But I'm willing to learn and integrate it into my life.  

I Saw My Brain Today

I complain a lot about my job, I know that.  This Lent is proving to be a challenge!

Today, I experienced one of the 492 perks of my job in Radiology.  Whenever we buy a new piece of imaging equipment, Imaging staff and radiologists get to be guinea pigs so the technologists can train on the applications.  They solicit people with ailments so they can test their new toys.  This time, it was MRI and I was approached last week to see which test I wanted to try.  Not IF I wanted to try one, but WHICH ONE I wanted to try.  

Being the eternal masochist that I am, I picked a brain MRA/MRI.  I was the first person to have a brain MRA in the hospital and our healthcare system.  Heck, why not.  

Have you seen the movie "Gravity" yet?  You will not be disappointed.  The cinematography was awesome; you actually feel dizzy when you see the bottom side of the earth from space.  Anyway, there are multiple scenes where people [Sandra Bullock and George Clooney] are floating around space in the constricting space suits.  You almost want to hyperventilate watching the movie, knowing you shouldn't breathe in space.

I wore a space suit today.  In MRI.  On a Wednesday.  At 3 p.m.  The team leader called my office and said "Table for 1, no waiting."  After giggling at that and doning the biggest metal necklace I could find, I entered the MRI department (the suite, not the scan room itself).  The metal necklace was a joke, of course (you can't take metal anywhere near the magnet), and I wanted to make the techs laugh.  

For a brain MRI, you lay on the table and rest your head in the head coil (it's like a little plastic vice that holds your head still).  Then they close the coil over your head, so you have a small window of vision the size of a visor.  Then they put the headphones on you so you can listen to whatever radio station you want.  Then they wrap you in blankets so that you stay warm in the 58 degree room.  Then, mummified in a space suit, they raise up the table and into the bore/tube you go.  

It was then that I realized why 90% of brain scan patients require valium as a pre-treatment to relax.  It's a tight fit.  I promised myself that I WOULD make it through this scan.  Very few people can make it thorugh 30 minutes as a mummy, in a small casket-like tube, with loud sequencing sounds bouncing through your head.  At one point, my head became hot.  I don't want to insult your intelligence but magnetic resonance imaging "works" by bouncing radiofrequency (RF) waves back and forth between the magnet.  The RF waves cut through you.  I swore I could feel them.  And my head did get physically warm [that is when you picture your head exploding in a gory mess and the CSI people have to come to investigate your untimely death].  I also experienced head-rocking waves of RF that physically moved my head millimeters at a time.  3 Tesla is a very powerful magnet.  

So I am encased in the MRI tube, possibly enshrined forever [Seriously, your head does some funky stuff when you know you physically can't get out of the restraints you're in.  I get the whole Valium thing now.].  Classic rock is piping through the earbuds and I try to picture myself on the beach.  It's warm, loud, and I challenge myself to keep my eyes closed the entire time so I don't freak out.  It's EXTREMELY hard to keep your eyes closed for 30 minutes when you're nervous and mummified.

But I had no choice...I had some serious props to earn with the MRI staff.  They cannot handle being in the bore for brain MRI/MRA.  Claustrophobia is a very real illness.  Once I figured out that I would truly be encased in my classic rock-wired space suit, I knew there was no going back.  Turns out that I earned some great respect from not only the MRI technologists but also a few of the radiologists.  They tried out GE's new silent brain scan technology on me and a whole gaggle of radiologists reported to the control room to watch my scan.

Good thing I grabbed my pink sequined slippers for the exam.  Seriously.  Picture me, encased in my space suit, covered in blankets (in scrubs), and so far into the tube that all you could see of me was from my knees down.  And my fancy sequined pink slippers, peeking out from under my blankets.  I'm sure there are pictures of that gracing the social media sites.  It's not technically a HIPAA violation (LOL).

So once my heart rate slowed and I calmed myseff down, I actually relaxed in the scanner.  I dozed for a while.  I debated dinner options.  I said one very slow "Our Father."  I listened to the words of Steve Miller Band's "Joker" and caught myself wiggling my feet to the beat of the music when Journey's "Separate Ways" came on.  Which was followed by about 9 people laughing at me over the intercom.  

But I did it.  28 minutes and I did not open my eyes.  Talk about self control (that I didn't think I had).

After the scan, I looked at my images and it was creepy.  CREEPY.  To see the ridges in my brain, my vasculature, and the backs of my eyes.  I could even tell I had contacts in.  In one very surreal black and white 3D front-on image of my whole head, I could see the fusions of my skull and then the blood vessels under my scalp.  That was eerie, as I was looking at myself and could see THROUGH myself.  I tend to feel somewhat invincible but when you see your own skull as though you're looking in a mirror, it's unsettling.  I also kept thinking, "Is my nose really that big?"  

One of the techs chided me about having 8 dental fillings and tiny flecks of metal in my eye shadow.  There are no secrets in my head now and not surprisingly, I am very relieved that I have a normal brain anatomy and physiology.  Ever since my bout of vertigo, I sort of wondered if I had something brewing.  Guess not.  It's just stress.

So I put my suit back on and headed to my office.  On the way, I ran into my interventionalist.  He asked me what I was up to and I mentioned that I just had a diagnostic brain MRA/MRI in the new 3T.  

His response was, "you did that for fun!?  You need to get out more!"

Touche.  But at least I survived my first brain scan without requiring Valium!  

Angels Among Us...

Sometimes, you have to come home from work and watch "America's Funniest Videos."

You know, while you're waiting for the news to be over so that you can watch the Olympics.  

Actually, the Olympics are pissing me off.  Indianapolis too closely resembles Russia (Siberia) these days.  Yesterday, we hit the snowiest day in the history of mankind in Indianapolis.

Do me proud, Indy!  Our freaking snowblower broke during the "freak" blizzard of January 5-6, when it was -40 degrees. The first time.  Jack and I reasoned, "Hey!  We live in Indy now!  This was a once-in-a-hundred-years storm!"  

The first time.

We should have fixed that #*@&^#&! snowblower!  I'm still sore from shoveling the other night.

I'll admit it...I'm over it.  Like, forever.  If I ever complain even once about 93 and humid this summer, you can dump my margarita over my head.  And then roll me into an ant hill. 

*************

I started the above post a few days ago, meaning to return.  If it helps, it's now 65 degrees, the snow melted in a scant 30 hours, things are flooding, and oh, now we have a tornado watch.  Why not!?

So today was easily in the top 10 of worst days ever.  Raging weather-related migraine aside, I lost my first patient.  Well, my first real patient.  We have lost a few patients but their deaths were a result of last-ditch efforts or hospice care that eased them peacefully into the next life.  

This one was an outpatient.  She was walking and talking when she arrived.  She did not go home. 

At the time of the Code Blue, I was standing in one of the main hallways.  We always freeze when we hear "Code Blue" paged overhead.  Especially when we hear "Code Blue, Outpatient Services," there is a 95% chance it's my department.  I stand there like a mime, waiting for the shoe to drop, so I can dash off in the right direction of the Code. 

This time, it was "Code Blue, Outpatient Services, CT Scan."

Off we went.

I arrived about 20 seconds after the Code was called and saw my staff already initiating chest compressions to restart the patient's heart until the ER team arrived to help.  I'm not at liberty of sharing any more details since the case is going to formal review, but many silver linings came out of this one.

The team responded so gracefully.  These radiology staff are not trained in emergency or trauma medicine.  They are not used to seeing projectile bleeding (well, for that matter, neither am I).  They're not used to physically feeling a patient grow cold, knowing that individual is dying in their arms.  They've never witnessed repeated, unsuccessful attempts at shocking a patient to restart their heart.  It's tough stuff and no amount of training prepares you.

Another first for me today, I had to go with the ER doctor to talk to the family.  They had no idea things had turned so grim.  When I spoke, someone else's voice came out of me.  She sounded calm, professional, and together.  I felt a big disconnect because inside, I was shaking like a leaf.

After the incident cleared and the staff cleaned the patient up so that the family could visit her one last time, I called a formal debriefing (more of a de-stressing).  One of my colleagues is a trained debriefing professional and I knew I needed a pro for this one.  In a group setting, she asked everyone how they were and what they were feeling.  It was the first time many, even the ER nurses, had a debrief.  While I don't want to have too many Code Blue's in Radiology, I will definitely continue that practice. 

It's so hard to see my staff struggling with this.  And I realized, driving home, that I felt a growing heaviness on my own heart.  While we had no negligence in this case, it's my job to keep patients safe.  It's my job to make sure that when they walk in, they are able to walk out.  I felt a deep stabbing of yuckiness at the terrible direction this one case took.  It wasn't our fault and still, we were helpless in changing that patient's end.  

I kept hearing the phrase "Maybe God needed her more than we did" come out of my mouth.  I'm not really sure what that means but I think it was me, trying to make some sense out of a terrible situation.

The upshot to this was the intense teamwork I saw, not just in Radiology, but across hospital management.  People came out of the woodwork to support me and help me make calls (when you have an unexpected death in a hospital, there's a ton of paperwork and phone calls.  You have to notify everyone from the CEO to Risk Management to Public Relations - in case someone starts a media firestorm).  When I finally stumbled back to my office, several directors had left voicemails, offering to help me.  Once word started to spread, some took it upon themselves to help me notify the necessary individuals.  

I felt like they were angels, swooping in to take some of the burden off of these weary shoulders.  

So while the outcome of one of our procedures today was awful and totally unexpected, I found solace in the fact that our team did the very best they could.  And that I'm really not alone out there; that in the moments when I most need support, there are angels hiding in the wings to come to my assistance.    

It's a Wonderful Life

I'm trying to get into the swing of blogging again (seriously helps to do so from my ipad- and the picture function isn't working well) and might jump around from topic to topic.  My apologies.  

Anyway, I've been in this weird land of Radiology for 10 months now, where I'm the leader of 12 hospitals and outpatient facilities and 500 employees.  I still vacillate between having a complete grasp on my position and its awesome demands and sitting in my office, sort of zoning out to old Duran Duran songs on Pandora while I stare at the piles of radiology "stuff" needing attention.  How do I even edit a Nuclear Medicine Isotope policy without having to google things?  Eek.  

I was out of the office for 11 days and in the Tampa airport, on the way home, I caught up on email.  Yet, by the end of today, I was tapped out again, dreaming of our 85 degree pool at night, with Christmas lights draped on our Floridian railing.  

That didn't take long.  

I *loved* those Christmas lights.  I always travel with them now. 

Anyway, a few things shake me from my relative security or downright stagnation- and it's the huge generosity of the radiology staff.  A few years ago, the department started sponsoring some families and charities for Christmas.  They would raise $1000-1200 for the families and it was such a striking gesture.  This year, the "Christmas Committee" came to me in August, requesting a formal meeting.  They wanted to start a "12 weeks of Christmas" program across Radiology, where each department would take one of the weeks of Christmas.  The departments would create baskets for raffles or sponsor potluck luncheons for modest fees.  Then, as we spaced out the requests for money, we might get a better response for the charities.

Why would I object?  Of course this sounds great.  The management team was assigned "Four Calling Birds" and we created an Alfred Hitchcock-themed Birds basket.  With Christmas movies included!

Gotta include Kevin MacAllister with your Hitchcock movies!

So this whole "12 Weeks of Christmas" idea started in October and so far, with 2 weeks to go, has raised $5800.  It's stunning.  We actually had to find MORE charities to support this year; what a novel problem to have.  

We very well may surpass $7000 raised and it's so humbling to me because this is all staff-driven.  I've learned that I have employees who volunteer at soup kitchens in the city every Saturday night.  I've learned that I have MRI staff who gather at 5:30 am each Wednesday morning for Bible study.  I found out that the Diagnostic Xray department does spontaneous blanket drives throughout winter.  

The sense of charity, generosity, and kindness is truly humbling.  I look around and all these people want is perrmission to keep doing what they're doing.  And they refuse any kind of recognition.  They are spreading God's presence around the hospital and other departments outside Imaging and Radiology are starting to participate because they are so moved.  

It's so humbling.  I can't believe I work and with for such wonderful people.  

What a blessing.  For us all.   

  

Tears for Fears

I cried on the drive home from work today.

It wasn't the first time I've cried on my commute home.

The last time I remember commute-crying, I was still in Chicago and felt so overburdened by the weighty projects sagging my weary shoulders. The tears were more of the "How in the world will I EVER accomplish this?" type versus today's tears.

Today's tears were of the "I'm so sorry I had to do that to you today" type.

Leadership is never easy. Sometimes people regard leaders as managers who sit in board rooms, discussing hypothetical policy changes, immune to what's REALLY happening on the front line. I've been accused of such, that I have "no idea" what the "real world" is like; that I sit in my plush office and collect my lucrative paycheck without feeling any pain.

Most days hurt. Today flat-out sucked.

As part of a system-wide layoff today, I had to tell 14 people that I was wrecking their lives. I had to take six badges away from people, escorting them out of the hospital forever. I had to tell four more that I was making their full-time employment half-time (slashing pay and benefits). The rest? They went from regular, comfortable 8am-4pm shifts, to graveyard, midnight to 8 am shifts.

I was popular today. Whenever my staff see me coming, they immediately assume someone's getting laid off or fired. It's great.

I traveled to four of my seven campuses, delivering terrible news to employees. What's funny is that I didn't truly realize what I was doing. I mean, I knew I was eliminating peoples' jobs, a-la "Up in the Air." But I got through each employee meeting with dry eyes and a moderately-upset stomach.

It wasn't until I was on the way home, on the busy Chicago-like interstate, that I read the press release from our healthcare system.

[Relax, I was in standstill traffic. We hadn't moved an inch in 4 minutes.]

But something strange hit me when I read that press release. It talked about the terribleness of Obamacare on the nation's hospitals, that we are forced to do more with less, provide healthcare access for the formerly-self insured population, and do it with less reimbursements and at higher quality. Then it said one painful line........."Those affected by the layoff have been notified today."

Today?

That's what I did today? I "notified" several people in my wonderful staff that they no longer had jobs. Or full-time employment. Or even regular employment.

Cue the "I can't believe I did this to you" tears. It was brief, but new territory for me. I'm used to shedding a few tears every now and then about the mounting, heavy responsibilities of hospital management, uncertain of how my measly shoulders will handle it all.

Today? I guess I felt some humanity as I shattered several lives.

It's so different to fire an employee. They bring it upon themselves and force you into that position. This time, I had to tell innocent people that they're done.

Humanity. Humanity is a good thing. My stomach is still upset and the future's uncertain.

I'm going to be grateful for my humanity today...and hopefully, the good that I have been able to do today for our overall healthcare ministry.

See the Tatas

Today's the first day, oh, since this time last year, where I came home from work and actually felt like publicly sharing my day. Progress!

Last night, at 10:39 pm, I finished my Franciscan Leadership program work. Nineteen essay questions, in the midst of my usual 250+ email Hades and operational madness that always arises each day. I "celebrated" my success in fully completing the two-year program this morning by allowing myself to sleep in past 6 am. I'm not sure where the days and weeks have gone. The old rumors are true- never go into an area of the hospital and say, "Man! It's QUIET!" It's an evil curse; once someone utters the "Q" word, it's all over. Then all of the sudden, it's Sunday night and time to start the madness all over again.

Like, today. I have seven total campuses and visited one of the smaller, community hospital settings to A) catch my breath, B) visit with my second-favorite radiologist (who kind of reminds me of an older rockstar), and C) help out during the employee Mammothon. This is where we open up the Breast Center and allow walk in appointments for the community. Local media usually visits and we have enough freebies to overwhelm a used car salesman. Our community Mammothons are in October but we wanted to highlight the staff and offer them the same opportunities. After all, most of the healthcare workers in the US are women. So off to "Gonzovent" I went. It's not uncommon to actual see episodes of Andy Griffith playing in the cafeteria- the pace of life is far slower at Gonzoville. I spend most of my waking hours at the primary St. Gonzo campus so the break was welcome.

After visiting with my second-favorite radiologist (after all, my most-favorite radiologist gives us free tickets to huge concert events...don't worry, each "free" ticket is paid for a lot of problem solving and conflict resolution- ugh!), I rounded on the department's employees and had a great one-on-one chat with the manager.

Then I got an urgent page that St. Gonzo's imaging department (the main one across town) flooded. Noah would've been proud. I was then treated to text message pictures of used linen and old towels baracading the water from the VERY expensive CT and Nuclear Medicine panels. After a few calls, I got the right people to respond but I don't like to risk about $12M in imaging equipment because of a faulty toilet (or three). Soon after, I received a 911 that not one, but two of our three MRI's went down at the primary campus.

Back at Gonzoville, I relaxingly talked with the Breast Center employees who were preparing for Mammothon. Our delightful conversation was interrupted by an urgent page from another imaging department reporting a bed bug infestation.

Bed bugs? Seriously? What's next, an interview with 20/20? Maybe just a plague of locusts?!

Returning to my Breast Center conversations, I succumbed to at least three employees peer pressuring me to get my annual mammogram, too. I shrugged it off, uncertain of whether I wanted one of my technologists to see my tatas. I soon realized that it was a unique opportunity to 'walk the walk.' By letting them run car tires over my girls, I could influence others to get their mammograms, too. And I did! I had my exam and then was able to convince six other imaging employees to get theirs. Strange, violating, exposing mission accomplished.

And now I can never look that technologist in the eye again. Yikes.

I have a strange hang-up about being too vulnerable in front of my staff. Yes, I want them to see my humanity and relate to me as a fellow human. But I'm very protective of my off hours. I don't like going to church with my staff. It's too intimate. I dislike going to the store and seeing employees. They peer into my shopping cart, analyzing my food choices and counting my servings of veggies. And the gym? Forget it. I rock out to my music and pound through my workout and really don't want to sweat with colleagues. It's just gross.

But I finally conceded and agreed with Jack that it was time to move into an actual house. After moving to Indianapolis (as renters!) over eight months ago, we had completely transitioned to our new home, new dentist, new friends, new Meijer, new church, etc. I even found a primary care provider I can stand. So what will we do? MOVE! It's a nice house and I'm proud that I finally got over myself and my vulnerability phobias. Dangit, I will soon have to pray, shop, and sweat with my colleagues.

So I came home tonight to a list of pre-new-house activities from Jack. I again lamented my fear that the contents of my Meijer cart were going to be public knowledge again and he looked directly at me and said, "REALLY? Are you kidding? Your employee saw your breasts today and your radiologist saw INSIDE your breasts today! You have no excuse as to why you can't go to the gym with your employees now!"

Touche.

So much for a relaxing day at Gonzoville. Maybe tomorrow will resume the busyness?!

(And that's what I've really been up to! In the last eight months, I have stricken the word "normalcy" from my vocabulary!)

An Airport Metaphor

Last weekend, after listening to me vent about my current workload and stress for a breathless 38 minutes, Jack suggested that I return to blogging. Even if my entries are quick or incomplete, he reasons that I like seeing my growth and progress as reflected in my own writing.

So I will try. Blogging takes a lot of time but I'm willing to get back into the habit.

************

My brain lately has felt like an airport; it is the closest metaphor illustrating my stress and chaos. There are constantly planes taking off and landing, with thousands of people running between terminals, each following their own itinerary. Much like that age-old metaphor discussing stress in terms of rocks and sand in a jar (rocks are the "big things"- health, family, friends, faith, etc. Pebbles are the smaller stressors- work, house, cars. Then there's the sand- the rest of our experiences that fills in our life.) For me, the airport is a perfect metaphor. The gates all represent different areas of challenge for me. The new job, the new city, new house, new hospital, lack of anything familiar (Meijer, church, dentist, etc.), and distance from Jack. Jack is now 160 miles and 3 hours away from me. I can't address any of the gates together; each gate needs its own space for discovery and subsequent adapting. Luckily, my friends and family accompany me to the various gates as I visit them, supporting me as I muddle through yet another huge life change. Jack's just a saint.

I then consider the airplanes. Planes, arriving and departing, represent the big projects and "things" weighing on me...the tasks and worries that wake me up at night and instigate my brain into an Indy 500-ish tizzy. I think about my big construction projects, a lingering management agreement, overdue contracts, threshold capital for 2014, festering employee issues, lawsuits, difficult physicians, homework for school, my practicum for Franciscan Leadership, leadership of the corporate radiology group (yes, somehow, that is falling to me even though I have exactly six business days' experience), painting of the old house, selling the old house, unpacking the new house, getting back into some sort of exercise routine, taxes...oh, the list keeps going. The airspace above my head is full with worries. Some planes are little Cessna's while others are jumbo jets. I need to land some of the planes to keep a sense of sanity.

But that's what transition is about. All of the people traveling through the airport have a purpose. I liken these to the small actions, behaviors, and choices that occur during the day. They all play some part in it- in advancing the overall wellbeing of the airport. They'll all eventually get to their destinations and at the end of the day, the airport will settle into a routine quiet, when all of the flights have departed.

I'm grateful for the terrific support and understanding of my family and friends. So much of my life has become survival; I'm so tired at night that I have yet to watch the fancy new television that Jack installed simply for my relaxation purposes. I turned it on one evening just to pass out cold before the commercial even ended.

Which brings me to my next airport metaphor: fuel. There is only so much gas to fuel the airplanes; once that supply is gone, the fleet is grounded. So I am trying to be cognizant that I only have so much time and energy. When I get out of bed each day to help advance a mission and serve our patients, the fuel supply lasts longer.

Last, I feel safe and secure in the knowledge that I do have a flight control deck at my airport, with God at the helm. He's going to keep all of my planes in the air, on schedule, and properly maintained. I don't like the expression "God is my co-pilot," so I'll say that "God is my air traffic controller."

Flashing Back to '09

I found this a while back and thought it extremely appropriate...

I dreamt about how I was going to write this post. Should I start with "I got the job!" Or something more demure such as, "I somehow survived to the finish!"

Or maybe just, "I'm completely sidelined with labyrinthitis and it's forcing me to stop and be sick and reflect a bit on the craziness and drama of the last 3.5 years..."

Whatever the opening line may be, I am moving to Indy. I accepted a wonderful promotion at one of our flagship hospitals and I keep having to pinch myself to make sure it is actually happening.

And the inner ear stuff? It hit me instantaneously at one of my Franciscan leadership retreats. Here I was, sitting, absorbing the astounding lessons from America's foremost expert in Catholic Social Theory and the room started spinning...

...Not spinning as in, merry-go-round...

...but spinning as though I'd had 6 cocktails...

...and I was on a pitching boat, far out to sea....

It was fun. Really. I had no idea I was experiencing my first bought of vertigo.

It ended up with two medically-trained fellow retreat colleagues, leading me up to my hotel room while I staggered down the hallway and tried to not yarmit on them.

Pretty picture, eh? Humility lives!

Luckily, one of my colleagues is an ED physician who pronounced me free of serious cardiac or stroke-related symptoms. Whew.

[Now, could y'all please leave so I can yarmit in peace???!?]

After a harmless visit to the ED the next morning and several IV meds, Jack drove me home so I could lay still in a dark room with Downton Abbey on in the background.

Husbands rock. So does Downton Abbey if you haven't yet discovered it.

Anyway, BEFORE the inner ear infection hit me like a sledgehammer, I solidified my transition to St. Gonzo's. Remember St. Gonzo's? I have gone there for many a meeting in the last few years and interviewed for a dream position. It's the position all my training, stress, and stomach acid prepared me for. When the offer was finalized, I could hardly believe my luck, blessing, and opportunity.

The job is huge. Massive. Way bigger than my experience prepares me for. But somehow, I know it's a good fit and that I will have a whole lot to keep me busy in the coming years. Honestly, I can't wait. A new city. Several new hospitals. New politics, new physicians, new employees. A new house. Again. Sigh!

It was very difficult breaking the news to my employees earlier this week. We've grown together and in some cases, grown up together. Yet, everyone seems happy that I have the opportunity to move on- but only verifying that my email and texting will still work in Indy. It makes me feel extremely humbled...I had no idea people leaned on me like this. I feel like this tiny part of something so much bigger than myself and we're all trying to advance the same Mission.

That's why I get out of bed each day. And when I'm leaving, it becomes even more concrete to me.

So, four weeks from today, I will lock my office door for the last time. I will bid my beloved employees and managers goodbye and throw one last joke my boss's way. I will walk out of Administration and drive out of the parking lot, thanking St. Fozzie's for the unbelievable experiences. I cut my managerial teeth at St. Fozzie's and the leadership team is second-to-none.

Yet, I will drive away and not look back. I'm getting rather practiced at this- leaving and only looking forward. The drill will be much the same: Jack will stay behind and sell our house and finish up his work commitments. I will go ahead to Indy, secure a residence, and start the new job. We'll enter into a commuter marriage again, but this time we know it is only for a few months and not a year like last time.

Wow. I could copy-and-paste the first 50 blog posts I wrote back in 2009.

Here's to the future...whatever terrifying and wonderful adventures await.


[It just makes me laugh that my last post on the blog was about normalcy. Ha!]

My First Post in 30 Days

I'm not sure what happened, but I forgot about ol' Blogville here. One measley post in November!

Well, November was fabulous. I survived a massive lawsuit and depositions, Jack and I went to Anna Maria Island for a beautiful week in the sun (we got a stellar deal on a house a block from the beach with its own pool. I suddenly became a Bob Marley fan on that vacation), and I've been rather happy lately.

Did I just say the "H" word? Holy cats! Reminds me of that 90's movie, "French Kiss." One of the greasy Frenchmen says, "when people say they are happy, my arse begins to twitch." LOL.

But Anna Maria was phenomenal. The Edge came down for a few days and while she and I sat by our own pool, Jack took sailing lessons. Our largest decision of the day was, "pool or beach first?" And the second decision was, "wine spritzer or diet coke!?" Jack became known as "Captain Jack" because of his innate sailing skillz. He took me out on Tampa Bay in a Trimeran (sp?), a small sailboat that he steered with ropes.

Ropes. We're splashing through 5 foot waves on Tampa Bay, probably going 20 mph (really fast when you're scared!) and I didn't die!! My knuckles were stiff from holding onto the boat so tight and I must admit that I knelt down and kissed the beach when he dropped me off at the pier. He crossed off two bucket list items by learning to sail and then taking me sailing. I crossed off a bucket list item by not dying!

I liken my white-knuckled sailing to life at work. Work is never going to be easy. But compared to how I felt a few months (years?) ago, things are markedly better. I don't have to hold on, white-knuckled, anymore. Corporate bureaucracy is always going to erect obstacles. Personalities and egos are always going to delay progress. And it's my primary job to make people want to be the best versions of themselves.

My role as a manager of managers makes me reflect on management this time of year. I have eleven performance evaluations to still complete but this year, I am not dreading them. Instead, I now LIKE having those conversations with my employees. I like stretching them, challenging them. I want them to excel and even surpass me; that's the best sign of strong coaching.

Maybe I'm becoming part of the "establishment." Maybe I'm just being overtaken by a sense of joy and patience that is bigger than myself. I am making an intentional effort this Advent to let some patience permeate my daily existence.

[C'mon, you road rage too, right? That's what I'm trying to stop. Even if I'm nicer on the road, I will contribute to a positive Christmas spirit.]

[Have you MET the Chicago drivers?! The highways around here are the last Christian frontier.]

So while I haven't blogged lately, things are still moving forward. Finals week is in full gear and while it could be a mistake, I signed up for TWO classes in the spring. Time to get a move on and finish this degree program!

If I somehow don't check in between now and then, have a terrific Christmas season. Celebrate with light, joy, and patience!

Freud and Goat Cheese

I successfully survived midterms this past week and anxiously await my grades. I still feel that pesky 9-year old inside, her whole sense of good and evil, right and wrong hinging upon a grade decided upon by a (no-doubt) exhausted teacher.

Or maybe a double PhD'd-professor. I still love school like the gigantic school nerd I am and still relish the feeling of a nice "A" in the inbox.

We'll see on this one. It wasn't my best work only because I haven't had as much time as I'd prefer on this coursework! I'm looking forward to this very trying Ecumenical Councils class being complete.

However, I received some terrific news late on Friday afternoon, after I returned from a state department of health meeting downtown Chicago on Friday. I was going to do the proverbial escape after the meeting and go home to do some online FEMA education and to start studying for another certification exam. Then Nurse Jackie texted me and asked me to come in after the meeting and I'm glad I did. Not to be dramatic or anything, but she reinflated me and in 60 seconds, made me feel like the past three years of stomach acid and Nexium were worth it.

It appears that my job title and responsibilities are changing again. For the better. I think my position in operations is becoming more of a "patient safety" position. I've been thinking this for years- if we only provide excellent, safe, quality patient care for our patients; the patient satisfaction (and money!) will come. We would not have such a dire financial picture if we provided safe, quality care in the first place.

And now I get to put my money where my mouth is...

This is the FIRST Sunday in ages where I haven't felt the "Sunday's." And I took a huge step back to gain some perspective.

[To be completely, utterly honest, I was **this** close to accepting a position at a competing hospital. Talk about the 11th hour. Actually, it was 11:58.]

As a result of this change and several other realizations, we're making a pledge. From now until Thanksgiving, we are verbally stating 3 things for which we're grateful. It can be something as bottom-line as great insurance benefits or something as little as a functioning wine corkscrew. But we're taking a grateful stance these next few weeks and I invite you to do the same.


For what are you grateful?

How far have you come on your life journey?

What have you achieved that you never thought was possible?

How would things be so very different without your friends or family?


We've been reflecting on our St. Fozzie's family this weekend. We had great times both Friday and Saturday with people we never would have met if we didn't take the plunge to move out to Chicagoland. On Friday, we hosted Jerry, the Finance Guy, who spent no fewer than 8 hours with me on my budgets, using creative accounting to allow the flourishing outpatient areas to avoid budget cuts. He singlehandedly helped me keep certain service lines available to our communities. So we had he and his wife over Friday night for excellent food (Jack cooked, obviously!), good wine, and great stories. In fact, they challenged us to visit Istanbul in the next few years, after hearing about my angst in Ecumenical Councils!

Then last night, one of the physicians and her husband invited Jack and I to a play downtown, called "Freud's Last Session." It's basically Freud arguing against God and for atheism and C.S. Lewis fighting Freud's ideas with sound, theological logic. Before the play, we dined at Sola, a restaurant on the north side, where three miracles occurred. One, Jack had the best lamb chops he's ever experienced. Two, the table made me eat brussel spouts and they were simply phenomenal (This is big; I once got grounded for a WEEK from my BIKE for not eating brussel sprouts!). Three, Jack ate goat cheese and Szechuan-pepper ICE CREAM.

The pepper part was actually pretty good. The goat cheese? It tasted a little like "barn!" Nonetheless, we would never had either experience with either couple if we hadn't had the courage to try something new.

So today, I'm thankful for our opportunities, our friends and beloved co-workers out here in Chicagoland, and for (gulp) goat cheese-pepper ice cream!

Kool and the Gang

Sometimes you have to stop and celebrate.

I’m not very good at stopping to celebrate my successes. I usually just finish one project, inititative, department, etc. and plow on to the next one.

And lately, I’ve wanted to act on my long-held fantasy of driving to Midway airport and hopping on the first plane going anywhere decent (knowing my luck, that first flight out would be to Detroit. Or maybe Tulsa. So I would hold out for Bahamas, Miami, Vegas, or even Maine. I hear Maine lobster is worth the flight). The stress at work has been just terrible (and that IS being optimistic) and I’m not quite sure how I continued putting one foot in front of the other.

However, everything seems to have changed dramatically in the last few days. Maybe my brain chemicals were shaken up and corrected. Or maybe I finally realized that I get to celebrate a few things.

• I won another employee lawsuit!
• I am (knocking on wood) still undefeated!
• I spent probably 20 hours in the Finance department with the Number Gurus and they helped me finagle my budgets to meet hospital goals.
• I owe said Finance people filet mignon, lobster, and caviar.
• Too bad that stuff isn’t in the budget!
• I successfully completed my budgets, had them approved, AND met hospital targets of 10% decreases in expenses and staffing!
• I cut said budgets WITHOUT impacting patient care, quality, or outcomes!
• I went around the system and hired an emergency preparedness manager!
• And my security badge still works!
• I helped hire a new nursing manager for our large Telemetry unit!
• I wrote my first academic review on an ethics book!
• Three of five Lean projects are complete!
• My CEO actually called me to thank me for my hours, dedication, and success!
• When asked by the new VPMA for a status update on our accreditation survey (and I gave it to him), he told me that he “had no doubt about our readiness” the moment I took over the project.
• THAT actually affected me deeply and just now realized how much I respect him.
• For the first time in seven weeks, I did not have a supreme sense of impending doom when considering our upcoming accreditation survey!
• For the first time in months (years?), I do not have a supreme sense of impending doom when I think about my job and all that is expected of me!
• I feel like I survived a tsunami.

It has been so HARD these last few months. I was in a perpetual state of exhaustion and while I hate the expression, if I had a dollar for every time someone said, “you look tired,” well, I wouldn’t have to work anymore this year. And I do look tired. My massage therapist actually tried to sell me some tea tree oil (?) to help alleviate the black circles and puffiness.

Hey, at least I don’t look 24 anymore. I think I easily pass for 27 now.

And I'm finding ways to insert more humor. Ted took over for me today:

So the whole “living for the weekend” thing is tough…we work our tails off all week in a crazy grind and decided that we are GOING to enjoy our weekends.

Jack and I attended the annual hospital gala at the end of September. I lollygagged until 3pm when I finally decided to shower, throw on a ball gown, and head downtown. I was glad I did because that’s some of the best hobnobbing one can get. Plus, surf and turf and unlimited Chardonnay is never a bad deal.

This past weekend, I channeled my DIY, nesting tendencies and spent WAY too much money at Lowe’s. I could not stand “contractor brass” for one more week. Filling up 2 shopping carts, we sought to replace all the light fixtures, hardware, and faucets in one swoop. I even painted my bathroom a nice, warm candlelight color (which does NOT look dingy, despite my initial fears). I learned a few things while painting on Monday and Tuesday:

1. I get vertigo when balancing on a ladder, trying to reach the corners of 11 foot ceilings.
2. Singing U2’s “Vertigo” does not really help.
3. I totally have a fleet (flock?) of guardian angels as I almost fell off the ladder four times (paint sloshing precariously around my pan).
4. That all this DIY leaves me so sore I felt I was in a car crash!

Otherwise, we tend to measure our weeks by the Notre Dame football schedule. This week? Soldier Field (as it is forecast right now, in the freezing cold rain). Next week? Hopefully a “PR day” as we take our good friends to their first ND home game- Stanford. Yoshi is in town for the game and we’ll have approximately 7 tailgates to visit. I cannot wait. Screaming at the Notre Dame running backs just isn’t as fun in my living room as it is at the game.

So, for now, I will work hard, celebrate what I can, and live the HECK out of the weekends.

Fun @ Work

Do you ever look around and wonder how in the world is it mid-September?

Do you ever look around and wonder, how in the world do we have more fun here?

I haven't looked up from work in weeks now. Ever since I fired that manager, I've been in a tailspin. I haven't had that illusion of control in probably five or six weeks. On Thursday night, I studiously toiled away on my laptop (with B-rate college football on in the background) from 7-9 p.m.

Sighing with relief and closing my laptop with gusto, I got my inbox back under 100 messages. Thank goodness!

But then, at 6 a.m. the following morning, I signed in on my iphone to find 18 new messages. From overnight. I was mad that all my colleagues seem to get caught up on email at night, too. I felt like throwing my iphone through the iwindow and watching the itelevision in a rage blackout.

(By the way, iphones are terrible for business purposes. My contacts, tasks, and reminders don't sync and even though Siri is cool, she can't remember what time zone she's in and I end up confused. Then she calls me rude!)

Things ARE getting better, though. Two other directors offered me time with their administrative assistants, so I have about 30 hours of assistance per week. I had to get re-organized so I could delegate some of the stuff to the wonderful assistants. One of the assistants is more of a rock star than Bono and she's saving my sanity. Type A, OCD, and organized to a fault, she's my favorite person on earth right now.

Last Saturday, I asked a team of six to work so we can get caught up with our Epic EMR go-live. The scheduling fell way behind during the transition and the office managers freaked at the lack of control over the physicians. I feel bad asking employees to work when I'm at home, eating bon bons, so I went in and then picked up lunch for everyone. Spirits were high, no one wore make-up, and I overlooked the Kenny Chesney music I heard a hallway away. I kept wondering why they played "It's Five O'Clock Somewhere!"

Yesterday, two managers from Finance gratefully helped me with a huge budget gap in one of my recent operational consolidations. It's really nice to have people on your side who want to see you and your work succeed. In my world, money is key and if I'm showing a $400k budget deficit, I am ripe for filleting by senior leadership. I'm thankful that others try to save you from said filleting!

And I'm finally starting to see the light of day on my state survey project and have been delegating the responsibilities. I feel like a conductor of a big orchestra. Luckily, Elvis named a new Chief Medical Officer who believes in preparedness and he's been a HUGE boost to the initiative.

Work is work. But despite the hours and commitment required from my position, I've got to make it somewhat fun.

Half-way

Again, I struggle with the notion that I should be as positive as possible here in Blogville. Sometimes, though, it's tough.

Last week was awful. And that's putting it positively! I made myself physically sick again with stress from work. I worked too many hours and whittled away too many nights on work; by the time Thursday night/Friday morning rolled in, it was just too much for my merely human body.

[Ugh.]

I went into work later on Friday morning, giving myself an extra hour of sleep, all the while wondering what I was doing to my body with the insanity.

It forces one to ask, "Is this really worth it?" To be honest, I'm still discerning whether it IS worth it.

I have to start celebrating my wins along the way. After I terminated that manager a week ago Friday, I made an SOS call to an external contact, asking him to take over immediate management of the department. I assembled two teams to prepare for the next site surveys from the state of Illinois. I had explosive HR issues to deal with in my largest physician practices. And the Epic go-live was rocky and I think my staff were *this* close to jumping out a ground-floor window!

Heck, I was ready to LEAD them out of that window. What bummed me out the most was that I could not spend any meaningful time with my managers. I couldn't be present to them and actually wrote a short apology to them for that. I hate when I can't be the director I set out to be each morning.

So things progressed and I survived it. However, the interim management of that one area is coming up with SO many improvement opportunities and he wants to use the urgency of the transition as a grenade to blow it all up. And I'm in so far over my head with the federal grant requirements that I'm not sure how we'll justify our $400k in funds. And the Epic go-live usually ushers in a valley of despair while staff, providers, and patients get used to everything.

All I can do is tell my staff that I understand their stress and that we're in this together. I can't do much for them when I'm doing my darndest just to survive, too!

But on the upshot, I had a new position approved for a physician practice manager, allowing me to delegate some of the compliance and regulatory items. The interim department management (that I contracted out) is strong and that program WAS compliant with state and federal regs. My life is shifting more from micro-management of people to the management of managers (to help THEM get their crap done).

And I feel confident for my big corporate presentation on Tuesday. I can't wait to rock that in the room full of the highest-level system execs.

Most importantly? I finished my four ethics papers detailing my Ethics certification and am now able to apply that coursework towards my Master's in Theology. My degree is officially half-way complete and I COULDN'T be happier that the "ethics papers" monkey is off my back!

Maybe I'm half-way through the other stress, too. It is unacceptable that work EVER make someone physically ill....so I'm spending the rest of today playing!!

Laughing

I really wanted to entitle this post "Exhaustion" but thought better of it when I considered the concerned family and friends that would probably reach out to me in my vortex of terror and stomach acid. When I'm tempted to get REALLY annoyed or ticked, I force myself to laugh. Oddly, it usually works to dispel some of the annoyance.

I've been pounding the keyboard for the last couple hours, trying to dig out of Email Hades, while Jack's put on an acoustic guitar concert. "One," "I'm Yours," and "Hotel California" never sounded better- he finished HIS big go-live today and is celebrating his new found freedom from the confines of his office.

It's all about attitude, right? So instead of focusing on the litany of CRAP that happened today, I instead choose to focus on the funnies. I offer you this picture that my Diabetes Center manager randomly posted all over the Center on the same day we had our big go-live and a new doctor starting:



He added a little Post-it with "3" on it, suggesting that our last velociraptor attack was on Friday.

I was chatting with our IT support staff in the break room and one of them looked quizzically over my shoulder and asked, "Is that a dinosaur?" Thinking it was some announcement about Franciscan leadership or the annual HIPAA education, I shrugged it off. Walking through the practice, I saw three more dinosaur signs. Arriving back at my office (in a busy hallway of Administration, I might add), I saw another dino sign. I couldn't help it, I laughed until I cried.

I love how my great managers know when I'm really struggling and they somehow buoy me with laughter. Like the time another manager squeezed pixy stix under my office door and still another manager "pranked" me with a fake emergency that ended up being a surprise party. While it's risky, I like being vulnerable with these people; I think it's okay that they see the real me and see that I struggle with stuff, too.

It's the same with "the awesome people," the core group of directors at work who get each others' backs. As soon as I sent out the termination notices on Friday evening, I immediately had six directors call me and offer to do whatever they could to help. THAT is friendship.

That's why I am taking time out of the longest work day in recent history to record some of the gratitude I feel in a very dark, bleak, scary, and overwhelming situation. It's so overwhelming that my CNO gave me carte blanche to clear my schedule for the rest of the week so I can, well, not die. I only have 29 meetings this week, a road trip, and a presentation in front of all the system CEO's, COO's, CNO's and VPMA's next Tuesday at Muppet Corporate. It's been a dream of mine to present to that group and it's finally happening- but I'm too stressed to even worry about the presentation yet. Figure I can do that the night before!

It's all about optimism, right? I'm trying to keep a positive attitude about this whole situation with the manager I fired on Friday. He wrote a letter to a Board member, assassinating my character and leadership style. Every where I look, I find another deficiency in his work. I feel bad; this shouldn't have happened...but last time I checked, grown men didn't need babysitters.

I also chose to IGNORE the frustration and crap of Friday by working on ethics papers for 12 solid hours over the weekend. I had to write three ethics papers and I FINISHED decent drafts of them all. Another hour or two and I'm done. Halfway through this master's degree! That was enough to really lift my spirits; those papers were the biggest monkey on my back. My pastoral theology class is over and I'm now onto a Church history class studying the Ecumenical Councils and their effect on the formation of the Catholic credo. I'm technically a seminarian now and I have the option of buying a shirt that says something to the effect of "I study theology and I'm cool."

Theology IS cool...but so is forcing yourself to laugh when it matters most.

Tugboats and Wine

I felt the need to write tonight. I’ve been writing in various forums over the last several weeks, but not so much on the blog here.

Today sucked. In a weird, makes-you-look-at-things-harder sort of way and in that unique way where something great rises from the ashes. I feel like the little tugboat we spotted off the coast of Cozumel while on the cruise ship a while back.

That doesn’t mean I like it.

For one, budget workbooks for the 2013 fiscal year close at midnight tonight. Enter numerous managers and directors, huddled in their offices, streaming the Pandora Adele channel while they try to cut another 10% in staffing and overall expenses. Each person I called this evening, I could hear little snippets of some after-hours radio. It seems appropriate that budget time ushers in some Stones and White Snake.

What the heck? Why not?

So amidst the budgets, I have a massive Epic (our electronic medical record) go-live on Monday. I have superb managers in those areas and luckily thought ahead to order a hot breakfast for the staff, physicians, and IT support gurus. I also have a brand new doctor starting in that same area on Monday (a terrible coincidence- luckily she takes food bribes!). I am just hoping they don’t quit, kill me, or throw food at me, making me hide behind my office door! That go-live and its processes created some 1,428,304 emails. I’m ready to take “reply all” off the toolbar options.

I guess the toughest part of today was the crucifying we receiving during a state and federal survey for our emergency preparedness. We have been preparing for months (or so I thought) and the manager overseeing this area completely and utterly avoided the ball. It’s not that he dropped the ball, he never picked it up. He fed us lines about how ready we are and how the binders and opening presentation were all set.

He made the hospital leadership looked like asses. I got called out on “denying” him resources when all I’ve tried to do is help him. I wasn’t sure whether I should be livid or disgusted at the performance and reflection on the hospital.

The surveyors, embarrassed at our lack of organization, actually paused the survey and then cut it short. We’ve never had that happen in the history of St. Fozzie’s, where a survey is suspended because we’re not prepared to BE SURVEYED.

[You try explaining that to your CEO when he steps out of a CEO meeting at Corporate to ask you about the survey’s failure. That was fun. ]

Luckily, my leadership team was behind me and we knew what we had to do. After flitting between budget meetings, I pieced together the documentation needed to term this manager. I talked to my boss who unquestioningly supported me and kept checking in on me throughout the afternoon. It was my first time terming a manager and I am very grateful for the TUMS that my friend Vera supplied! After meeting with my VP of HR and COO (remember EVOO?) We did the term with a grace and panache I’ve never seen in a termination before. I had one of those out-of-body experiences. I then had to suspend another one of the managers who had an equal part in the survey’s failure. It’s serious. When we look bad to the state, we look double-bad to the feds.

Who wants the feds pissed off at you?

But in an unexpected way, this event made our team closer. My boss supported me like I’ve never seen or felt before. My VP of HR and COO mobilized my decision-making. My CEO told me he has absolute faith in my ability to rectify this pigsty of a survey. My friend and colleague Mary took extensive notes during the exit interview and is supporting my leadership of this endeavor. Plus, she hugged me when I wanted to puke. And I took over a completely new area of the hospital in the process and must start from Ground Zero in my understanding of its operations. We’re going to emerge stronger from this experience and as God as my witness, when those surveyors come back in November, they will tell us it’s a 180-degree improvement from today’s wreck of a survey.

One more step.

I just hope I get to sleep this weekend. I am on call now until Wednesday morning at 7am! Wish a girl luck, please, and send me some wine.

GREAT

This is my favorite quote for the YEAR. Maybe this decade. Isn't it funny how you get exactly what you need when you need it most?

I usually approach motivation in terms of perseverance, endurance, a little "just keep swimming" through the crap people throw your way. I tend to think of experience as something I get when I don't get what I really want.*

I recently returned from a lung-clogging conference in Chicago at the Four Seasons (no, not from the 110 degree heat index and smog combo, but because I've somehow come down with a bad case of bronchitis that progressed to walking pneumonia. Seriously? Who the HECK gets pneumonia in July when you're NOT 92 years old and in a nursing home? Sigh). This was one of those 'executive summits' where you find yourself brushing elbows with hospital presidents and system execs. Hey, at least they knew who I was- but that didn't stop me from feeling like the kid at the dinner table when they waved me over to join them at lunch on Tuesday. One half of the table discussed the neophyte accountable care organization and physician alignment. My half? Your favorite vacation memories and how much everyone hated the asparagus soup they served us.

Some conferences serve to reinforce what you know. They strengthen your resolve to advance patient safety and process improvement. Other conferences stretch every brain cell in your head and address high-level strategic planning techniques designed by nerdy PhD's so that you're left wondering how you can possible boil it down enough to do something with the knowledge at home.

I felt the temptation to feel beat down. Defeated. Young. Green. Outta my league.

[I really hope part of that temptation was from my July bronchial nightmare!]

However, I'd like to think those hospital presidents feel insecure sometimes, too.

[Right?]

Last month, my mentor told me to start thinking of myself as a top executive. If I don't project that image, they won't think of me as that either. However, several points are coming together, challenging me to NOT seek upward mobility as an end in itself. My Franciscan Leadership course, my pastoral theology class, and my friend "Joe" all said the same thing- that true, true leadership is not about upward mobility. It's about downward mobility- to serve your employees. To let them know you and your vulnerabilities. To let them forgive you when you make mistakes. And to reflect upon these experiences to discern God's hidden voice in all the mind-clutter of daily life.

True leaders abandon power and authority and focus on service. Power and authority are meaningless without a spirit of service behind them.

It's a HARD pill to swallow and a personal battle I have almost every day.

But when I attend events like this Summit in Chicago, I am unfortunately reminded of who I don't want to be. I don't want to be that seasoned exec, whom, when the young Dorrie strikes up a quick conversation, I dramatically check my watch. I don't want to be the exec who is sure to tell me about the national award he's receiving for operational excellence. I don't want to be that exec who name-drops to increase his own perceptions of his own importance.

Your ego doesn't impress me, buddy.

I'm not throwing stones here. Mistakes happen. But these actions seem to betray that sense of humility true leaders are called to embody. That's the tough part- I cannot plead ignorance and sometimes, it stinks!

However, I appreciate these conference experiences, the story-sharing with colleagues, and opportunities to eat our way across the city (Gibsons, Check! Jilly's, Check! Signature Lounge, Check!). All of these lessons add up to influence me for the better and for that, I'm grateful.



*That strike of brilliance wasn't me, I read that quote a while back and cannot recall the author. Ethics first!

Growth

I’m trying to sum up what’s happened in my world since the last post (almost two months ago!). The one word is “growth.”

[Luckily, it’s not just my pant size!]

I missed blogging. While it’s quasi stressful at the time (one more thing to DO), it helps me reflect upon my life and the lessons I’ve learned personally and managerially. So you’re stuck with me until I self-impose another fast from blogging!

Back to growth…

Work and career discernment lately has taken a big toll on my emotion and mental wellbeing. I was up for another executive position at a sister hospital (requiring a relocation to another city). Then I was immediately rejected for the position- because that hospital tried to “recruit” me from my current hospital. They actually got in trouble for tapping me on the shoulder. I’m still digesting the whole situation- usually when THEY call YOU, you’re in. But all it really did was increase my stock value at St. Fozzie’s and at the same time, make me feel caged in and as though I was a marionette puppet whose strings were moved by another power.

Feeling both lost and powerless over my own career, I caught Elvis for a spontaneous, hour-and-a-half discussion. I left his office relieved to hear they DO have plans for me and part of those plans is to keep me a “generalist” in administration so I can avoid being pigeonholed. They also want me to try a bunch of different things so I become a well-rounded leader. It all makes sense now, but I could have used that explanation 4-5 months ago!

So I grew- in my trust, in my faith, in my confidence, and in my frustration that my calling is to continue being that voice of change. I’m supposed to become the change I want to see in healthcare.

I’m going to have to keep swimming upstream.

[Insert "growth" here.]

[Perhaps I should change the title of this blog to “Just Keep Swimming, Dammit” ???]

There are lots of work issues right now- fighting consolidations and outsourcing, implementing mergers and igniting cultural change, programmatic developments, and process improvements. My work-BFF, Mary, took over the Quality department and since she’s schooled in Lean, we’ve been working together a lot lately to improve our delivery of care to our patients. THAT is fun and quite rewarding.

Sometimes professional growth is fun, too.

On a personal note, I am halfway through my summer Theology class, which is a pastoral theology class. It’s “fluffy” as far as theology classes go, but it’s hitting me to my core. I always considered pastoral theology a joke; now I see how it fits into the mature theologian’s world view.

For instance, my old pal Bewley visited this past weekend with her 16 month-old son. Who is attached. At the hip. To the point where when Bewley leaves the room for even 10 seconds, he breaks out in an inconsolable bloody murder scream. This was *really* fun after the first couple hours. As soon as she was out of eyesight, even to grab a Kleenex in the bathroom, he’d quickly well up with alligator tears and run screaming into the night.

The old Dorrie would have gritted her teeth and invented some business emergency by which to escape (Kidding! Well, sort of). The new, pastoral theology-schooled Dorrie, chose to {gulp!} embrace the difficult situation and practice some Franciscan hospitality. Without muttering TOO MUCH under my breath!

See? I’m growing. Painfully but certainly.

Finally, Jack and I have taken to cycling for a nice summertime hobby. It's a great diversion from the usual stress, but is also serving to develop me some "dude legs" as my calves are huge from all the pedaling. We're up to 25-30 miles a weekend (not an easy feat in Chicagoan wind- it is ALWAYS windy here) and having a great time at it. Plus, our usual route takes us by one of the region's best breweries, so we afford ourselves the chance to stop, all sweaty, for a cold brewski.

That's what summer's all about so far: growth (and beer!).

Ripples

I'm completely, 100% convinced that there's a God. And He's good.

Have you ever had years of life experience, random quotes, plotlines from books, stories from friends, and testimonies from others' faith that all converge, from all directions, into one singular brilliant point of light?

And then it changes your entire life, its direction, and makes you forget the past, all in one instant?

Well, I have. And for as much as I detest discernment (only because I'm not very good at it!), I cannot ignore these moments.

My good friend and cousin, Yoshi, reminded me that the teacher is always quiet during the test. And the past few months have seemed the biggest test of my adult life, with insane schedules that won't stop, mounting responsibilities, and unsympathetic, uncaring people erecting obstacles whenever possible.

I was really starting to wonder if I was barking up the wrong tree. Me, in healthcare and hospital leadership? Maybe I misread the memo. Maybe God was instead directing me to something far less heady and stressful. Maybe I overestimated my abilities and this whole "swimmming against the current" thing wasn't just me trying to enact change...maybe the tension was supposed to stop me and I was just too stubborn to see it. Did I miss my true calling as a stay-at-home mom? Was I supposed to have stayed in SB, toiling away at jobs for which I didn't care? Did my life incorrectly veer off on an opposite track and God was just waiting for me to recognize my foible and go running back to the safe life I once knew?

There were about 24 hours of weird coincidences that I now know were not coincidences. It's humbling to look back and see I'm only a ripple in that pond. Someone else threw the big rock into the pond to create all the ripples- and it was God who hoisted that rock into the water.

On Thursday evening, I was supposed to have attended an employee recognition banquet. I had several employees being recognized for their years of service. But Thursday afternoon was brutal, after about 4 hours of calls and stress that are going to result in me missing three months' revenue in one of my departments, my brain was going to leak out my ear like last week's decaying Chinese leftovers. I called my friend, Mary, and asked if she wanted to grab a quick drink before heading to the banquet.

Mary was ripe from a church retreat and glowing from her experiences. I hadn't had a chance to ask her about her time away. Over a glass of wine, she shared her entire story and some key experiences that seemlessly connected with her work at the hospital. That touched me- the way she interpreted her faith experiences in light of her work. THAT's a connection I've been missing lately. Needless to say, when I looked at my watch, we were an hour late for the banquet and decided to have dinner together because the employee recognition obviously wasn't happening for us.

But that's where we needed to be that evening. We both knew it.

On Friday, 12 hours after that conversation, I had a couple experiences that changed my life. I had an opportunity to serve patients in new ways I hadn't tried, let alone thought of, in the past. It opened my eyes and I now know healthcare's where I'm supposed to be. I can't elaborate, but it was a moment of clarity I'd been fighting, and I would have completely missed it had it not been for the spontaneous conversation and dinner with Mary.

I felt light. Empowered. Happy. Peaceful. Emotions I haven't truly experienced at work lately, if ever. All the past confusion, fear, bitterness, anger, and uncertainty no longer existed. And it was though those emotions never existed in the first place! At the greatest level of peace in my professional career, I went home on Friday night, eager to see Jack, walk several miles, and kick back on the 70 degree evening with tiki torches blazing and Jimmy Buffet blaring from our patio.

As I settled into my Friday night vibe, my cell phone rang. Looking down, I saw that it was Ra, my friend from St. Gonzo's. She was on the brink of quitting her job, over an intense situation that unfolded this week. She lamented the exact same issues with which I had been struggling the last few months (years?). Into my newfound peacefulness by a whole five hours or so, I listened to Ra and then offered up Mary's story, and then my story. She immediately saw how she could add her story to our stories, building another chapter into the testimony.

I was a ripple in the pond...affected and then was asked to affect another person. It's so far beyond me. But I'm grateful to play a part in helping that wave of energy reach the other shores of the pond. We're all in this together and that's the true meaning of Church- getting each other where we need to go and spreading the right kind of energy and joy as we journey onward.

God is good. Do not be mistaken.

So at this point, I'm holding on, while the roller coaster whips around hair-pin turns with hair-raising speed. Instead of closing my eyes and wishing it'd all be over soon so I could start my real adventure, I'm going into it, eyes-wide-open, fully aware that this roller coaster is only going traverse stomach-dropping hills while increasing its speed.

But this is where I'm supposed to be. Someone please get my picture on the roller coaster cam as the coaster rushes by!

Leisurely Swim

Here we are, almost in mid-May, and I'm wondering where the heck time's going again!

But, more importantly, I've had some time to catch up, stop swimming against the current, and actually throw in a few leisurely backstrokes. Well, I'm not sure if I HAD time or MADE time, but you get my drift. There was a big corporate meeting today that I skipped and I knocked through a one-page to-do list before 3pm. Priorities!

I've forced myself to make some changes in my life. Historically, Jack and I always do this "nose to the grindstone" thing from January-May, where we don't go out much, we save money, we work hard on school and work, and emerge in mid-May hungry for a beach vacation and Jimmy Buffet.

[Vacation's in June this year. We decided to rent a beach house on Lake Michigan and, believe me, I'm counting the milliseconds.]

I'm tired of my wellbeing suffering because of work. Even Elvis pulled me aside and said he was worried about me. I will do anything to make the care better for our patients, but I've been increasingly stepping out of political turfwars or battles of the will that just complicate everything and make everyone tired.

Plus, I piloted the "Ra Project."

Remember my pal from my Franciscan Leadership program, Ra? She works a zillion hours and after a week in the Cayman Islands, decided to turn off her laptop, pager, and blackberry at 6pm every night. She reported better focus, better sleep, and (gasp) time with her boyfriend. It's so counter-cultural for anyone in administration.

Amazed, I tried the same thing. I shut everything off by 7pm and (bigger gasp) actually relax most evenings now. Believe it or not, the work is still there in the morning and I have 100% more gusto to hit it all first thing.

[Don't act so surprised, this is truly new to me!]

I've only been able to institute the "Ra Project" this week because my massive department closure, construction, move, and re-opening occurred last Friday. The biggest project so far in my career is complete and it was an amazing success. It wasn't me- the whole team stepped up and acted as one unit for the entire transition. The whole way home Friday night, I beamed ear-to-ear, happy to relish this one success.

Hey, if we don't celebrate our successes, who will?

But on Monday morning, we finished planning and crews started demo on the other two projects. I became primary oversite on a $2M renovation. Another department cropped up needing reorganization and interim management. I was contacted by our affiliated physician group asking if I would please, oh please, accommodate the optometry practice in an already-tight clinic space. We had a CSI moment in the morgue that required hazmat intervention (will spare you the details on that one!) and a patient stumble into Occupational Medicine with his ear hanging off his head.

And so on goes the hospital gravy train. But y'know what? It'll all still be there when I'm rested and refreshed tomorrow morning.