I play saxophone in a combo – I’m the only horn. I come in with the melody – after we’ve improvised – with authority and confidence. My teacher tells me, “come in strong whether or not you’re right. The band will adjust. Better than hesitating and coming in weak.”
I thought about this when I was in a meeting the other day with a labor lawyer and benefits consultant. They both sounded authoritative and confident – and had opposite opinions. I spent as much time watching the strength of their presentation as thinking about whether their advice was right for the agency.
I recall that my 17-year-old cousin recently expounded about the biology of memory with authority and confidence: “You sure speak with authority and confidence,” I noted. “Sure,” he said with a proud smile, “I’m on the debate team!”
Authority and confidence and being right – not necessarily connected.
As a nurse I watch the expression of authority and confidence often from professionals and see how it affects people at the center of care and their caregivers. It’s hard to separate strength from right. One of the reasons I’ve chosen my doctors is that they can sound authoritative and confident, but they engage me in the question of what’s right for me.
A wise person once advised me, “when someone speaks to you with force, either positive or negative, imagine blue smoke coming from their mouth. Let the blue smoke pass you by before you consider the words generating that smoke.”
I’m watching the Olympics a lot this week. These athletes are so focused and consumed with their event. Many of us committed to participatory health have a similar focus in our health journey or the health journey of those we support – head down, training, grinding, overcoming the next obstacle. Eventually, periodically we can take a moment or an hour or more to look up and take in the landscape. Our outward attention is dear. What’s the road map for expanding the circle of a participatory health care culture? How do we make best use of those moments to engage others? I’m a person who likes to have an impact and enjoy myself in the process. I think about the culture of health care pretty broadly. We can impact our homes, our extended families and networks, our communities, our clinics and doctors’ offices, our institutions, and our government. Remember, while most chatter is about health care within institutions and government, in balance most happens outside in families, networks, and communities. So, list those scenarios, locations, subjects that you have a passion for. Show up. Find others you meet who are trying to have an impact – for me its this blog, the Society of Participatory Medicine, HIMSS’ Connected Patient Committee, PCORI, and now my town’s Disability Commission. Note those you see as a role model – engage them, copy them, join them. The good news is that there’s so much opportunity. If you try something that doesn’t feel right-no impact, not fun – there’s always something else to try. Move along-again your energy is dear. Meanwhile, take care of yourself – you’re dear to us. This is a marathon, not a sprint.
How is it that people develop and learn to drive their own life, their own health care journey? Our 5-year old grandson usually gets picked up from school on Thursdays by my wife – a highlight of his week. We were on vacation. The email notification from his dad to the school of the change in schedule was never received. My grandson noted the expected change, rearranged his after school routine with his teachers. Presence, confidence, comfort, acceptance. Environment, self-confidence nurtured. Driving his own life. Some don’t have my grandson’s fortune. They have tenacious, dogged, self-preservation - I’m driving my own life, dammit! Some have one of these characteristics, but are unfamiliar with American culture and language or American health care culture or language. They may find themselves in dire straits. They benefit from guides with a road map and interpretation. But can the desire to drive your own journey be created with classes and tools? Probably not. Plenty of need and opportunity for guides, classes, and tools for those whose fires are banked and need stoking.