Live (barely) from Vancouver

I'm at a conference in Vancouver, BC the first part of this week on redesigning the clinical office practice. There was a time in my life, not too long ago, when if you'd told me I'd be at this conference, I'd have responded unpleasantly. But this is actually really fun for me.

Brooke and I had planned a fun weekend in Vancouver with the girls in advance of the conference. Brooke got a great deal on a one-bedroom suite at the Sutton Inn in busy downtown Vancouver, and we made plans to play outside in Stanley Park and visit the aquarium. Brooke got sick with a very painful sinus infection, and was pretty miserable, but we figured she might feel better, and if she didn't she could sleep while the girls and I played.

She did not feel better.

And then Zoe did not feel well. The poor child came down with a 103-degree fever on Saturday and was knocked out. She had about as much energy as a wet noodle. She was only a little low in the morning, so we (minus Brooke) made it to the park to ride the train and visit the petting zoo, but she clearly was just going through the motions. By afternoon (tipoff time for the Huskies second round loss), she was noodle-like, flat out on the couch. Brooke pretended to feel better and took Elliott out for a while, because she was neither ill nor lacking in energy.

By Saturday evening, we were kind of down (not Elliott), feeling like the weekend was a bust, and worried about Zoe.

Sunday rolled around and Zoe's fever broke, and we rejoiced briefly until she began puking. After some debate, we decided that I would accompany us all back to Seattle and drive back up to Vancouver later in the day, in time for the conference. This was fine with me, because I love road trips. By the time we got home, Brooke was better, Zoe was improving, and Elliott was still Elliott, but slightly unstable due to lack of nap--so, high energy, stroppy, and unpredictable.

And I had a little cough, but I deemed it a sympathy cough, so I drove back to Vancouver. At the border, I wondered if they had any way of knowing that I'd crossed three times in four days and how would I explain that without a long story. Knowing what I think I know about complex systems, it seemed unlikely they would know or care. It wasn't a problem.

But my car developed a sympathy cough. As I sat in line, the engine began to sputter and lurch. I don't know the first thing about cars, but I decided this must be some simple obstruction, like a kidney stone, and that it would pass. But I am stupid and prone to denial about things I don't understand, and my Honda pointed this out to me with a flashing "check engine" light.

And I wondered, as I sputtered forward in line ten feet at at time, if your car dies in that limbo between countries at the Peace Arch border crossing, what happens? Is there some intergovernmental towing authority to rescue you? Do they take visa or honor my AAA card? And how would I alert anyone without making a seemingly hostile pedestrian approach on the Canadian border?

Fortunately, this did not come to pass. I sputtered through customs uneventfully, and decided I would just drive until something bad happened. The check engine light became un-illuminated, and the sputtering became less pronounced, but did not stop. I arrived at my hotel in downtown Vancouver, left the shuddering hunk of metal with the valet to be parked and rest and overcome it's affliction.

Sometimes denial gets you where you need to go.

So the car has been convalescing in the garage and I have been walking in the rain between my hotel and the conference center and the pharmacy, where I've stocked up on NyQuil and DayQuil to aid in my own convalescence. I spent last night with fevers and chills and a painful cough, and today pretending I was fine while learning about LEAN approaches to primary care clinic transformation. And enjoying it. Really.

Though I did forget my coat. And it is both cold and wet.

And windy.

Tomorrow I will attemp to drive from Vancouver to Seattle in a car in need of service, in some stage of viral suffering, under the unpredictable influence of sinus decongestants and caffeine, and without much reliable cell phone coverage.

And I'm just certain it will be fine.

Leading like a child

I had the opportunity recently to attend a three day class in facilitative leadership, and it has re-shaped the way I think about almost everything I do. And really what it was...was...kind of a review of kindergarden, but with grown up examples from work. Very cool.

The basic idea was that we get things done--our work--through other people, and so it's probably a good idea if we all have some shared understanding of our work, even better if we all feel like we got to say how we think we should do it, and we would all like to hear that we did a great job.

In my daughter Zoe's pre-kindergarden class, the curriculum is the same. But Zoe comes home with art, and rocks in her pockets.

In the past few weeks, I have re-approached my responsibilities in at work with my new AP-kindergarden skills. In clinic, we created a vision--together--of what makes a good day. A really good list of about twenty things. Share, help each other, smile...a lot of these things are very basic, but in the chaos of a primary care clinic, they can get lost.

We also have identified things that get in the way of having a good day every day, and I've made it my job to guide us through ways to overcome those obstacles.

For every problem, we look at everyone who is affected (the stakeholders) and might want a say in creating a solution. We consider what a good solution would look like for them (a win). And we create the simplest possible plan we can all agree on.

So far, so good. I've been going for the easy "wins" first. There are bigger obstacles to having a good day every day, but we'll find our way. Together. Kindergarden-style.

Rambling Ambition

It's six o'clock in the morning. I've spent my morning "quiet time" working on a meeting agenda and not writing, as I'd hoped. I'm going to try to squeeze this in, though when Brooke's hairdryer goes on, that's my signal to sign off and move upstairs. Squeezing things in is how things have been, lately. Everything is manageable, but there is never quite enough time to do EVERYTHING I'd like to do. I've been learning a lot in most areas of my life: medicine, family, leading others, being efficient. But I think I trip over my ambitions. I want to be an excellent doctor, a competent leader, a thoughtful, patient, and present father and partner, and I want to do it all effortlessly.

Ha.

And I'd like to be in better physical shape at 40 than I was at 30.

The hairdryer is going.

I've been working a lot recently with methods for clarifying just what all those ambitions actually mean to me. What would it look like if I achieved all those goals? How can I plot a course from here to there? Am I already there in some respects? Is it really important to fret about it?

Am I trying to hard? As Yoda says: "There is no try, only do."

Is it wrong to look to a muppet for guidance?