Nurse logs as nature's innovators

I used to refer to my daily outings in the woods as walking the dogs or as getting exercise.  A couple of years ago I realized that my walks in the woods were really about me finding ways to regularly access the extraordinary wisdom of nature.

Every walk in the woods is a first.  It does not matter how many hundreds of times I've covered the identical terrain or the same old path; the opportunity to experience the brand new unfolds.

And yet, as I spot newly carved spaces and contours along familiar tracks I am mindful that nature's path through change shows no anxiety, no fretting.  The forest is alive and dying in the same moment.  It is light and dark and whole in its non-duality. 

Lovely is the only way to describe the sweet comfort of nature's divine reliability.

It's in the woods that even negative sentiments invite a positive re-framing.

I mention the epic beauty of the nurse log in the post title because lately I am fascinated with the pageantry of lifeforms thriving atop of nurse logs I spot along woodland edges.

The nurse log plays dead when in fact she is facilitating the emergence of delicate and determined lifeforms.    

The paradox of the nurse log is her stillness; it is in stillness that she activates her ultimate reinvention.   

I am not convinced that a nurse log's capacity to facilitate wildly different life forms is an inevitability of biology.  It seems more an act of consciousness with a corresponding one-of-a-kind outcome.  

Next time you walk the woods, take a look at a nurse log and notice for yourself her wildly creative innovations:

Consider her a healing symphony; the song dormant within all of us life forms.


The shape of me and other stuff

One of the most beloved health communicators of all time was (and will always be) Dr. Seuss.

Long before going green was fashionable and we understood the social determinants of health, he gave voice to big ideas in such tales as The Lorax and The Sneetches.

Today, in the supermarket discount bin, I discovered yet another sweet classic Seuss tale:  The Shape of Me and Other Stuff.  It's a book celebrating the differences between forms; human, inanimate and otherwise.

I wish it were longer... With just eleven stiff board book pages to turn, one can hardly scratch the surface of body image narrative diversity.  And yet, in the single illustration to the left, one can notice how Dr. Seuss subtly subverts boy-girl pairs.
Dr. Seuss stood for the truth and that is why he could say,  

Just think about the shape of strings ... and elephants ... and other things. 

That is why he ends his book elated, saying:

  Hooray for the shapes we're in! ...


A simple story about shifting work and family balance

I was cruising along with a singular focus on my professional development when BOOM my soul reminded me to pay attention to a deeper idea.  I heard:

Wake up, lady! This year isn't JUST about professional development.  

You've embarked on a Master Class in Heart Awakening too. 

What? A Master Class in Heart Awakening?

Haven't I been caregiving with compassionate focus?  Haven't I made strides as a mother, as a friend, and as a humble soul making its way on the planet?  I really hate to appear overconfident, I argued in my head, but since I just earned Professional Health Coaching credentials from Duke Integrative Medicine, I really want to capture the momentum and get to work.  But now you're saying that it's Master Class time?  Sheesh.

Hold on now.  You will take the next steps with ease.  In fact, we envision great adventures and a wonderful health coaching career for you, given your capacity for compassion and healing.  But advancing to your fullest expression will still require you to embody what we call, "self-fullness".

Oh good, I thought, at least I don't have to stop this momentum!

Then I asked about self-fullness.  Is it similar to #gratitude? 

No, it is not gratitude.  It is about acceptance and taking steps towards big goals without striving.

Self-fullness is a state of being; a state that energizes and activates a rewarding professional life while also protecting you during challenging times.  Do you understand?

Yes, so I kept listening: 

We think you have the courage and influence to make a difference supporting the lives of others but we want you to start by giving yourself much more support. Unconditional support.


You must learn to make commitments from your heart, health and soul, not from your head.

That made sense to me since my head is often ahead of my heart.  What's the first step?

We want you to practice saying No to people you care about when saying Yes hurts your heart, health and soul.  It's simple but it is not easy for most women.  Especially women like you.

You mean it isn't easy for women like me to disappoint people?  And that we often say yes when we mean no?  Guilty.  But won't it be selfish to practice saying No to people I care about?  

A long time ago when we valued groups over individuals we viewed a No from a woman as selfish or as some kind of violation of the social order. Now we know better.

We understand and teach that it is only a woman who is self-full that is able to contribute to the health of a group (a marriage, a family, a community, a nation, planet, etc.).  

That sounded true to me so I kept listening: 

Self-fullness is not selfish, it leads to a greater awareness that all of life is precious and worthy: yours, others', the world's.

Self-fullness is that quiet, subtle shift in energy; a stance with roots underneath that support and grow the blooms up above. 

 . . . As you learn how to experience self-fullness you will be growing the muscle of compassion and the strength of a rooted soul. 

And that's when I realized that this Master Class in Heart Awakening was going to be both exciting and highly challenging at times.   There would be a need to stay connected to gifted teachers and friends as I worked through professional goals with an open heart. This gentle reminder brought a lovely sensation of alignment and I realized with an Aha! that I had been preparing to be invited into this master class my whole life.  I knew that there would be no turning back, so  I exhaled then heard the teacher say:

Well done with the first lesson ... now for Lesson Two. 


Mindfulness and a skin biopsy

Have you noticed how your own emotional reality creates ease or obstacles when a health concern comes up for you?

I am learning about this topic first hand, again, even and in spite of years of mindfulness practice and a thorough knowledge of "the benefits" of early intervention.   I am riding a learning edge related to how the emotions of vulnerability and surrender can help healing.  Here's the story:

In late November I spotted a reddish dot on the side of my nose.  It was ugly but painless and flat. It concerned me only when I noticed it growing gradually.  At first I attributed this red dot to wearing glasses all day long.   As my concern upticked -- and I felt that I should call for an appointment -- I noticed how easy it was for me to keep NOT calling.

Selfie with skin spots and biopsy, February 2015

Somehow, I felt safer protecting my not-knowing than opening up to a new-knowing; the newness of illness.

This internal process carried on mostly sub-consciously for six weeks or so.  Whenever concern about the dot showed up, I drew on thoughts and stories (or actual cover-up!), telling myself:
  • I have a ruddy complexion full of freckles, flushing and other fun stuff so there was nothing to worry about (FALSE);
  • That indoor-outdoor temperature changes of the cold winter were causing capillaries to expand and contract and making the dot more pronounced (FALSE); and
  • That as I aged and hormones shifted, it was natural to expect skin changes like a growing red dot (FALSE).
Finally, I called the dermatologist.  She is popular so I expected a 3-week wait for the appointment.  Instead, as a sign of Divine Right Timing, the receptionist said she had just received a cancellation for the same week.  My heart sank right then, however; I was so scared to learn more about the red dot that I secretly planned to have the whole three weeks to build up my courage!  I joked then shared my fear about coming in with the receptionist who said she understood.  She hurried to confirm I would take the appointment, blessed woman.  I've since thanked her for that push...

I showed up for the appointment feeling nervous.  Just fifteen minutes later, reassured that the spot on my face was not a concern to the doctor, she was lazering my red dot ("hemangioma") with my eyes protected tightly.  Now the growing red dot is a much larger dark spot (visible in the selfie below) but it is not an energized problem for me. The spot will fade.

Next came the stinging-cool sensation of Cryotherapy (liquid nitrogen),  freezing off seven other spots on my sailor's face.  

These spots are now blistering or peeling in relation to how heavy the treatment was.
(You can see one spot on the selfie above, the others are hidden.) 
Lastly, I showed the doctor another mark I had noticed on my upper right chest (where the band-aid now is).  No sooner did she glance at the spot than she had injected a numbing agent into the area and got right to work biopsying.  What was of no concern to me really, is now the subject of a biopsy.  My self-care flipped; I thought it was dermatitis or eczema from a new favorite scent.

A few days of perspective have allowed me to start healing these spots and prepare myself for whatever comes next.

Would it be corny to report that I am already comforted to have received a great teaching: that fear is mastered by surrender, not courage?  I have seen this unfold for me and I feel lucky for that.

Had I waited for courage to come -- to will it up using the unskilled mind -- prior to advancing into the real walk inside of the fear of skin cancer, I could still be stuck preparing ... perhaps hosting a cancer to boot.


I am aware that I have experienced some fresh healing, even while waiting to receive the results of the biopsy.  

I have learned how healing energy is the gift of humility and surrender, the gift of Beginner's Mind and Non Striving.  I have known this through work with friends I love, but to know and understand it in myself is a great gift of health.  I feel good, even with the uncertainty and the spotted face.  I have received some help already and I am grateful.


Chapters of the Heart: Torah study with Rabbi Sue Levi Elwell

Today marked a special day of celebration and a bittersweet ending to a Wednesday morning ritual I'll remember fondly: Rabbi Sue Levi Elwell's Torah study at Washington Hebrew Congregation.

If you are wondering how I got to Torah study at temple ... I admit I am too.  But like every kind of heart journey I've taken, one thing led to another and to the temple I traveled.  I am a very lucky soul to travel this way so often.

By way of a brief intro, Rabbi Elwell is Washington Hebrew Congregation's Scholar-in-Residence.  She led a Wednesday Morning Torah study using her wonderful book, Chapters of the Heart: Jewish Women Sharing the Torah of Our Lives.

The book, which Rabbi Elwell co-edited with Nancy Fuchs-Kreimer is fascinating.  I highly recommend it to anyone interested in women's stories.  According to Rabbi Elwell:
For much of history, women’s histories were not recorded, but women’s stories were still being told. They may not have been the conversations of record, but women have always been sharing their stories with each other and with their children. So this is not new. What is new is the number of women with access to the study of classical Jewish texts. We represent the first generation of women who can easily acquire the necessary tools. So our book is composed of stories, but stories inflected with a sophisticated understanding of foundational Jewish texts.  (Read the full post here)
My friend Amy, a member of Washington Hebrew Congregation, was my link to the class.  Although I was a bit nervous entering the group, I had read several chapters of the text prior to my first meeting and was excited to be part of the discussion.  Even as a non-Jewish woman, I quickly resonated with the narratives and questions the text put forth.  How can we overcome grief and loss?  How can we become the mothers we yearn to be?  What are the prayers and ancient stories of healing power that are most helpful during deep challenges?  I admired the creativity and honesty the stories portrayed.

Most women reading Chapters of the Heart will feel at home in the stories, regardless of faith and tradition.  But if you had asked me ten years ago -- make that just one year ago -- whether I would enter a temple to study sacred texts with a Rabbi and a group of Jewish strangers, I would have assured you that it would be highly unlikely.  I hadn't been called or made curious yet.  But being a seeker, I am forever opening up to learning, whenever the season comes.  What I didn't expect is to takeaway a curiosity to keep learning more. ... We shall see.

So, thank you Amy and Rabbi Elwell.  The warmth and intelligence of the group, the stories, the teachings are forever mapped into my heart.   I hope our paths for peace and justice in the world cross again soon, at temple and beyond.


The Arena of Beautiful: Publish, speak and reflect a more loving image of women in 2015

When Elizabeth Lauten criticized President Obama's daughters, my heart broke for women.


As the harsh story played out in November, I buffered, diffused, tried to accept, forgive, and -- most of all -- tried not to add suffering to the situation with gossip and mindless chatter.
By day three of abstaining, what I understood clearly is the extent to which the story was about me (and you), not just Ms. Laurent and the young Obama ladies.  The latter were just the latest casualties in the arena of women bashing women.

Enter the ring

What are your stories from the arena of bashing?

Did you pass through the arena in your youth or are you still playing there?  Were you hurt or were you more the one doing the injuring?
Were there bosses, mentors, mothers, sisters, friends, strangers fighting you in the arena?  How bad did it feel?  Was your skirt short or too long? 

There's a narrow zone for peace and calm inside this arena.

Were you someone who injured or were you hurt by another women in power?  If you did the injuring, be honest and tell us how it worked out?  Did you cause enough pain to get her out of your way? Or did she ultimately recover and move into her power anyway?

And to the spectator in the bleachers of the arena -- too removed from the action to believe that you yourself have any power to stop the blows -- what are you thinking from way up high?  Quite a good show, isn't it?

Heart, soul and consciousness

This is a complex arena and hard to cover in a blog.  My sense is that we are all in the arena, until we consciously remove ourselves from it.  We are all connected to the Laurent event and the suffering it caused.  Take a spin through the rings of suffering she set in motion:
  • The shame triggered in the young ladies, followed closely by the outrage and secondary defense reactions of family and public officials;
  • The shame Ms. Laurent felt for her injuring, followed by the fear and anxiety she experienced in her grand tumble down the backlash;
  • The cold hearted eagerness of the media syndicating the story across channels with dispatch, on deadline, and without a note of tenderness;
  • Then touch the energy of the millions of networked bystanders ingesting and metabolizing the details again and again, adding personal projections, prophecies, and pebbles to the signals hitting we women and our daughters.
On some level, this suffering is so totally socially acceptable it is nearly invisible to us.  We don't see it as our problem. Rather, many of us have a "What's the big deal?" reaction when someone behaves badly.  We gawk and then move on.

But that's the role of the bystander, the most fascinating character in the story.  It's also the seat of power in a social network.


Who are the bystanders? Am I a bystander if I don't say anything about the conflict?  Or am I a bystander because I don't say anything?

And, more importantly, what is the call to bystanders to help heal the nasty dynamic between women?

Are we bystanders awake enough to help? To bother shifting our consciousness?  Or is this right of passage better defaulted to another woman in America? A younger one? An older one? A more powerful, successful woman?  Someone with more time. 

The notion that we are all bystanders hits me hard ...

It is like crashing into an awareness of just how vast and connected the ecosystem of women's consciousness is and that it is time for me to clarify and cleanse my own tolerance for female bashing.

Why are we squandering a wonderful natural resource with infighting and violence against one another?  Celebrities, Politicians, Authority figures; it's everywhere today.

Healing the closed heart

To dismiss another woman's choices mercilessly and without compassion, limits one's own life and closes one's heart another notch.  This is true across the lifestages.  We need young pretty energy and risk taking just as much as we need the power of grandmothers. 

But a closed heart is so tempting, many of us believe it is worth fighting for.  I mean that a closed heart can help us feel safe by giving life more predictability, something many of us desperately desire.

In order to heal, the closed heart has to open.  The open hearted way is guaranteed to bring vulnerability and rawness inside.  It will rock your world with unpredictability and, ultimately, a sense of aliveness too.  But it is a true crossing to get there.  (See Brene Brown's amazing work if you want a deep dive in those lessons.)

A spiritual approach to loving other women

Observed from a spiritual perspective, the Laurent event reveals a call full of hunger and longing: hunger for a bigger role, a wider circle; hunger for community and hunger for more permanent contributions to the world.  These are universal longings that just need a better channel. 

Instead of attempts to shrink the young ladies she could learn how to seek authentic power by using a more mindful approach.   She could start by noticing herself reacting viciously and tune in to inquire.  She could slow down and ask herself spiritual reflections such as:

I am noticing her.  What is it that I see in her?  Why am I drawn to it? Can I name it?  Do I have that trait too? Why? Why not?  How are we alike? How are we different?  How is this inquiry making me feel? What else am I noticing?

Then the inquiry can move into a richer place.  She could learn to consider her reflections then query herself with:

Can I love her?  Is she worthy?  Am I worthy too?

The answer is always and forever, YES.

This is the path to compassion and power, the path to The Arena of the Beautiful.

Flipping the switch, updating the social code

This event gives all of us an invitation to curb our unconscious bystanding of women bashing women.  It is an invitation to  Play Big, as Tara Mohr encourages in her work and her writing. 

My experience is that the most powerful pain and shame triggers are transmitted woman to woman.  Because women hold so much of the social code, updating this out-of-date algorithm makes sense.

We will only do it by updating our consciousness and raising our vibration.

Why continue to watch and wait on ideas that keep women isolated and separated instead of together and collaborating -- or even better, dancing? Flip the switch to Conscious.

Publish, speak and reflect a more loving image of women in 2015

I get dinged for being too sensitive, too contemplative ...  it's part of my wiring and I let it out in my writing.  To push myself to put skin in this game, I commit to hitting the publish button on this post as an active step to publish, speak and reflect a more loving image of women in 2015. (I have been keeping the post in draft mode for more than a week!):
In fact, I have more than 50 draft posts I am too chicken to post so hitting PUBLISH is a big step into THE ARENA of Beautiful for me.
Further, I promise that in 2015 I will seek out -- thoughtfully -- ways to celebrate and acknowledge the variety of great women in my midst.  This is one way I will deepen my practice of acceptance.

When another woman says something that makes me feel disparaged or ashamed about how I look or how I am dressed or how I behaved, I'll do my best to mention it to her.  To keep it real and find out what the trouble was.

AND, I'll notice when she is disparaging herself so that I may step in for the Divine.  I'll stick up for her and invite her into The Arena of Beautiful where there is plenty of room and lots of networking opportunities.  Join us?


The Myth of the Professionalized Patient

A sneaky business narrative has wound its way into health innovation. It's stolen the spotlight; taken our attention away from complex problems and made us fall in love with its  futuristic approach. 
Sol LeWitt - Wall Drawing 999 (Mass MoCA)

I'm naming this sneaky little narrative. I'm calling it The Myth of the Professionalized Patient.  A myth is powerful and sells transformation. A myth is always at the heart of any product we desire. That's precisely why the Myth of the Professionalized Patient is such a powerful one for industry and for government interests.

What traits does the Professionalized Patient possess?   
An archetype consumer, a master of health, the professionalized patient:
  • Demonstrates a sublime use of administrative tools
  • Gracefully tracks key data while complying with doctors orders (dispensed online in real time)
  • Is a model patient; he doesn't mind reading fine print online
  • Is highly literate and can negotiate the complexity of health care products and systems for self and others
  • Effortlessly adapts to (some say thrives on) change 

    You get the picture...

What's missing from this myth? 
We covet a clean, state-of-the art health system, but cold, clean, technical care is just one of many healing modalities appropriate to our system today.  It isn't the only one within reach.  

And yet now all all swept up into a tidal surge to become professionalized patients; expected to handle our burdens with dispatch and optimism, atop the desktop or mobile device.  No crying, no hugging, no eye contact allowed. 

Commentary aside, I believe that the Myth of the Professionalized Patient is accelerating us unconsciously toward adoption of a system that does not look out for our interests.  We won't even know what hit us when we wake up. 

Will patient engagement metrics (page views per month, number of e-mail messages sent, lab reports viewed online, etc.) be misconstrued and marketed as evidence encouraging the growth of online channels?  

With this will there come a potential to swiftly promote expansion of the electronic nurse-caregiver persona ... before we even meet her?

What about the big picture?  Do you find it alarming that the the more responsibility industry and government places on individuals to act like Professionalized Patients - to achieve desired health measures - the less responsibility these sectors will have for legitimately uprooting the social determinants of health that trap many of us at some point in our lives?

Pay attention. Since we are a fee for service system, the more these sectors are positioned to fine and/or penalize consumers for coming up short and not measuring up to the archetypal professionalized patient, their authority over us  grows. 

The story around the Professionalized Patient is bound to get more traction. It is futuristic, sexy and efficient. Who wouldn't want to partner with such a character? 

But impulse control has merit too. Without it we'll wake up and realize that the story we bought into helped certain interests profit, but didn't help us lean into the most challenging aspect of our health care system: human fallibility. 

Humans in the raw are not sexy. We age and don't like change.  We don't tell the truth, get sick and then have a hard time following doctor's orders.  We're busy and think we're right. We are distracted and want to feel better, have a good time and not work too hard.  It's not a selling story, really. It's just the story of health in 2013.


Making STEM education tasty

STEM education (Science, Technology, Engineering and Math) is being promoted as the cure for what ails American education and economic growth.  A parallel trend sweeping across our counties and cities is a push toward wellness and health activation, especially around movement and diet for overweight and obese children as young as preschool.

While these two distinct health programming trends are positive, I'd like to see the two campaigns commit to working together in service to the nation's children.  What power is there in science, technology, engineering and math alone? Without a healthy food system and ample consumer savvy for kids to steward their bodies and minds appropriately, we cannot advance the health, wealth and consciousness of our nation.  We will continue to invent outside of authentic social contexts, short-cutting some of the more challenging structural problems families face when trying to eat healthy while putting more pressure on children to do so on their own (while advancing their tech degrees).

How to adjust the current imbalance and inject the food context into the campaign to promote STEM education? I am not sure, but one super simple idea that keeps hitting me over the head is this: what if we consider adding the letter E for "Eating" to the STEM acronym? Could such a simple addition add STEEM to the health of our future world leaders? 

Sounds silly? Could be. But the idea that food and eating are captured in the existing STEM movement is misguided. Just Google the term STEM and check out the images that come up.  Or, have a conversation with a middle school-age girl and she and her peers might admit that it is much, much easier to excel in Math class than in self-care and nutrition, especially when much of a day is spent sitting and both parents work full time.

When we unite hard and soft science in a national promotion of science, technology, engineering, EATING and math, we re-frame the essential benefit of STEM disciplines. We give the conversation context and ... flavor.  The results could even be delicious. Here's why:

Envisioning the future requires a somewhat clear out-picturing of a social idea. The existing STEM narrative is missing a key social idea: food and table culture. My opinion as a mother and as a cook is that kids need more time at the table united by good food and restorative social connections.  They need their minds and their bellies fed with a better story than just Science, Technology, Engineering and Math. They need a North Star that tells the American Tale in a fresh new way. That excites them, that entices them to carry forth, to invent, and to honor the earth and themselves as living things in the process. Eating should be an explicit part of the new American narrative ...

So, if STEEM isn't the right acronym, pick another one -- or another way to emphasize what we're losing when we don't actively promote eating healthy to our children in the race to advance the sciences.

In other words, if a five-letter acronym feels exponentially more unwieldy than a four-letter acronym, remember that the Pentagon's strength comes from five modalities.  Whatever we call it, let's put eating into the strategy so that we may remove it from crisis-management mode. Because we won't win the "war on obesity" ...  but we can teach healthy eating that is pleasurable while leading the next generation into a more equitable nutritional landscape.  Kids can and do learn to respect their bodies and minds when we teach them how.

Ultimately, one of the top goals of STEM will be to dismantle -- not reinforce -- the current disconnect between the chem lab and the kitchen.  With eating integrated into the STEM framework, my hope is that resulting solutions will have much greater appeal.


Krista Tippett's On Being Challenge

Last week on American Public Radio's On Being, Krista Tippett closed her interview with Seth Godin with an experiment.  She asked her listeners to spread the word about her show to help grow her audience.

I'm willing to serve as an anonymous node in Tippett's online network this one time because I've been listening to On Being broadcasts for years and can vouch for the quality.  Tippett, along with the show's producers and editors, covers topics in depth and with sensitivity. She pushes me to examine my beliefs -- spiritual and otherwise -- in an engaging way.

It's said that the measure of engagement in a site/show is related to a viewer/listener's next steps. In other words, after one visits a site, was one engaged enough to take a next step? To follow along?  In health we call that activation.

After many On Being shows, I notice myself taking that next step.  I either purchase a book, check out a site or an idea online, refer others to the idea I was introduced to on the show, or in some very extreme cases, spend a half hour penning a blog post to help grow audience.  ...

I consider Krista Tippett an independent influencer and I wouldn't want her style to get too commercial. But a bigger audience for her show would be a good thing for the radio ecosystem, a system that is often subject to pro-growth metrics instead of more meaningful measures of engagement or "next steps" her audience members take when the show is over. 

On Being is uniquely positioned between big ideas and quiet conversations.  If you are interested in the next wave of thoughtful, contemplative communications, listen in.  Recent broadcasts include: 

Encountering Grief: A 10-Minute Guided Meditation with Joan Halifax
Elizabeth Alexander on Words That Shimmer
Brene Brown on Vulnerability

Oh, and don't miss scanning the blog posts. Without Senior Editor, Trent Gillis' quick post about photographer Ian Ruhter, I would never, ever have had the chance to cheer for his amazing work in Silver + Light.


Consumer experience makes it to the future of health!

"The Qualcomm Tricorder X PRIZE is a $10 million global competition to stimulate innovation and integration of precision diagnostic technologies, making reliable health diagnoses available directly to "health consumers" in their homes." source
Finalists for this grand competition will be only those teams earning high scores for consumer experience. Specifically, guidelines state:   

"To emphasize the importance of consumer use and adoption, only the five highest scoring teams from the consumer experience evaluation will be eligible to win."
With such clear context in the guidelines, congratulations are due to competition organizers. By putting a priority on patients and their experiences they are promoting a future health care transaction that leverages technology and human intelligence. The final paragraph of the competition guideline reads:

"The winners will be the (up to) three solutions achieving the highest diagnostic score regarding a set of 15 distinct diseases in a group of 15-30 people in three days (see Guidelines for full details). This diagnosis must be performed in the hands of a consumer, independently of a healthcare worker or facility." 
Learn more:
Read an overview about the Qualcomm Tricorder X-Prize
Get competition guidelines
Sign up to compete


Love needs a billing code

It's the simplest of ideas in health innovation: Give love a billing code.

I tweeted this in the spring of 2008 at Health 2.0 Conference in Boston.  Since then these words have been echoed, referenced and morphed by many friends and even by some I've never met in the industry.   

Love needs a billing code brings the idea of care and healing back to simple.  It rallies good people working in this space, reminding us why we started in health care in the first place.  The expression is activating too. It makes explicit a core value "To Love" that most of us presume is already present as an under layer in health transactions.

Love is not an industry standard.  The presumption that love is integrated into most health care transactions is flawed.  I am tempted to be flip and to say that profit is the reliable standard at work in the industry. While there is good reason to utter such a phrase, I know my tired soul is talking and I don't want to give voice to broken things.  I continue to dream the possibility of a more loving system end to end. One that is as big for love as it is in love with big data.

There are moments of love in today's health centers, doctors’ offices, and hospitals.  We see miracles and extraordinary feats of humanity so great that we cry every time we encounter them.  But my experience is that our health care ecosystem is unloving and … quite frankly … unlovable.

So why is there not a billing code to measure the caring potency of a health care encounter? Why is this idea dismissed as silly, as lacking gravitas, or as poorly matched with western medicine? Is love considered a downstream transaction? First see the doctor and then find the love you’ll need to heal?

We have walked on the moon, created unmanned drones to hit micro-targets far away, spent millions on challenges and prizes promoting health innovation, and yet we turn away from measuring the impact of love on the doctor and the patient. Why? This is a crime of omission.

Pink paper with question handwritten in black ink
  My question since 2008
Many consumers unconsciously approach medicine as if it were God's work.  Imagine what might happen if the industry - including insurance - actually caught up with us and started thinking of itself as doing God's work?  Not God 1.0’s work, but God 2.0, the caring, concerned, tech savvy and adaptive God who functions like a safety net?

What would happen when love met medicine? Would it lead to nefarious intent and abuse of power? Or would it perhaps be instrumental in creating a shift in consciousness? A shift inviting us to learn how to tolerate the unbearable losses and unexplained graces life, death and medicine bring into our lives. 

What if love had a billing code?


Final days on the road with Obama - Photo essay by Brooks Kraft

Black and white image of President Barack Obama
"After months of nearly non-stop campaigning, President Obama and his team have spent the last two weeks crisscrossing the country to make their final appeals to voters. Veteran political photographer Brooks Kraft has been there to document the campaign’s final days.

This was the eighth presidential campaign that Kraft has photographed, and his sixth for TIME. Over the years, he has honed his approach to shooting some of the most photographed men and women in the United States. Kraft rarely takes his pictures from the press platforms, preferring to move around, searching out unique angles and small details. "

View Brooks' shots and Alissa Ambrose's complete post to Time Lightbox here


Play like a girl

I played a cut-throat competitive volleyball game at my community rec center last night. The weekly session was advertised as "Adult Co-Ed Pick-up Volleyball", so I thought it would be fun, as well as a great workout.

I showed up with three humble expectations; dust-off my game, burn some calories, have fun.  My daughter wanted to spend an hour+ in the nearby weight room, so it was a family exercise "win-win" of the best kind.

I love to play volleyball and know the fundamentals well. I have a mean serve, a steady bump (that can handle a lot of heat), and once in a while I even manage to make a winning set.  When considering whether I'd be able to keep up with the others, I estimated that my game would be about 80% Rec-League ready.   I was wrong. 


I forgot that I should have measured my abilities according to the "fit male with no kids" standard of play.  Oops, right away my score went down.

When I arrived at the gorgeous, state-of-the-art gymnasium, delighted by the low price of admission and the opportunity to play for a couple of hours on two regulation-sized courts with a diverse group of adult players, I was surprised to observe only a few other women in the mix (out of approximately 25).

Before my play could be evaluated fairly, I felt already like an "undesirable", given my age and gender.  They meant business; no one took time for intros, no one smiled at me, no one wanted to mix.  Two of my male teammates sandwiched me out of adequate positioning repeatedly, until I earned acceptance into the "fit male without kids" tribe.  Silly me to forget that of course they assumed I couldn't make an impact. 

It took a muscle of a different mother to stay in that game and persevere.  But I did. I stayed in and won and lost shots not to prove myself and my abilities, so much as to train myself how to endure this kind of hostile energy when it threatens one's core confidence and freedom to play. Volleyball at a rec center is play.

After 90 minutes of consistent, winning serves, feeds and set-ups, our match broke with the side I was on the obvious overall evening winner.  It was time to reassemble. The play was fast and I still knew no one's name when it was time for me to go.  Although I was drenched with perspiration and had a few "gym burns" as badges, I didn't think the evening was much "fun".  It felt like I was on trial.

... But I just might go back next week. Here's why:

That 90 minute volleyball session taught me and perhaps my middle-school age daughter who stood watching for the last twenty minutes, so much more than the lighthearted play session I had envisioned.  What happened on that court happens at every meeting. It is the real deal and whatever my invisibility was at minute one on "the court of fit males", my daughter saw me playing and succeeding 90 minutes later.  Plus, seeing one's daughter fist-pumping for her mom provides an unnamed health benefit no mother should live without!


So ... play like a girl. Don't quit, ever. Play in all ages, shapes and sizes and stay in the game. Because this IS the game.  This is the ONLY game and by playing we stay relevant; we show up; we join teams and win points; we contribute to society.  Cardio-lifts are a mere bonus. 

And while I would never ask any of my male compadres from last night's game to stay home next week (their level of play was exciting!), I would like to give them a maternal scolding of sorts to nudge them.  Guys, a winning team at the rec level is a balanced team; think screaming spike shot meets consistent, well-placed serve.  Let's play together ...

Later on at home,  after I had recounted the experience to my son he said it sounded  "like life with a bully on the fifth grade playground". Maybe he's right.


Maybe I should expect this, but I am always surprised.  Perhaps it would be better if I treated these encounters like those always-engaging recycled plots from Animal Planet; the ones about tricky rodents and pests interrupting domestic bliss.  Rodents and encounters with invisibility are just part of our lives and we have to defend against them.

Something to consider. But with the convention in Charlotte underway, I didn't want anyone at our house, neither my son nor my daughter, to miss the First Lady's speech to the American people. We shifted our focus and settled in for the evening, just as we had a week earlier to listen to Ann Romney's address.