To my colleagues.
I’ve been asked to talk to you about why family physicians should “Rule the World”.
To start, I’d like to read something from Glennon Doyle’s Love Warrior: She writes,
“The canary’s body was built to be sensitive to toxins, so the canary became their lifeguard. When the toxin levels rose too high, the canary stopped singing, and this silence was the miners’ signal to flee the mine. If the miners didn’t leave fast enough, the canary would die and, not much later, so would the miners.
….
I tell Mary Margaret that I don’t think we’re crazy, I think we’re canaries.
“Could it be,” I ask, “that we aren’t making any of this up – we’re just sensing the very real danger in the air!”
I tell Mary Margaret that I think the world is more than a little poisonous and that she and I were built to notice that. I tell her that in lots of places, the canaries are appreciated. They’re the shamans and the poets and the sages, but not here. … [Here] They don’t want to know how broken the world is, so they just decide we’re broken. When we stop singing, instead of searching the air, they put us away. This is the place where they keep the canaries. “
Now, I still consider myself to be relatively new at this, which is pure delusion really, but I have been watching a lot of canaries stop singing recently or at least come very close. The canaries I’m talking about? Our patients. They are so increasingly unwell. Physically unwell, with no road signs to follow to get better. Mentally and spiritually unwell, whatever that word means to you and them, with no hands reaching out. Our patients are wandering through this world and health care system with their songs getting quieter and quieter. What’s worse? The “system” is so blindly far behind, it isn’t ready to understand this yet, it is NOT searching the air, and it is not and CAN not help them catch a fresh breath.
But you can and are, aren’t you? Every minute in your office and likely most days when you are out of it – it’s your focus. You get it entirely. You are trying to get them the hell out of that mine and into fresh air. Your work is never just medical, though your expertise in its breadth is astounding, it is always medical and a something else. That is your exquisite gift. In isolation, filling out a form, making a call, listening, looking in an ear when you know it’s fine, reviewing again that your thyroid is fine – but it might be that your boss is a real asshole, sometimes doesn’t seem like expertise, does it? Wrong. The beautiful ballet of acts you do every moment in your office, without even realizing it, is what keeps people singing. I cherish my other colleagues absolutely, I don’t think any ill will towards those in other places in the system, and I am well aware that it takes a very large proverbial village, but I believe with all my heart that it is only us, here, that have the precise skillset needed to walk people out of mines.
Don’t believe me? Pick any single patient that you’ve seen recently and then imagine what it would be like for them if you didn’t exist. What would health care look like for them? What would it cost them? What would it cost the system? If you vanished, who would replace you?
Still don’t believe me? Think of a patient that you’ve worked with to get them “better” – whatever that meant in that circumstance. Once they were “better” what did they then do? Did they start playing music again? Did they sponsor a refugee? Did they show up better for their partner? Were they able to keep this baby and break the cycle? Did they make choices based on kindness instead of anger? When someone is made to feel “better” they do better in places we can’t even imagine. We know that. We see that.
We, here, were trained to notice ALL the dangers out there and to help people walk away. We don’t walk them out of one tunnel only to let them turn the wrong way down another, we get them right OUT. We do so not only with expertise, ethic, and kindness, but also a firm understanding of the system as a whole and when a lever in it needs just a little finesse or a large yank. We do this better than anyone. We do “better” better than anyone. And we’ve been doing this for a very long time. Unfortunately, in mines that are becoming deeper with ever more complicated networks and harder to find resources. This has consequences. The consequence that drives me to write to you is that I see another group of canaries going unnoticed:
US.
“I tell Mary Margaret that I think the world is more than a little poisonous and that she and I were built to notice that. I tell her that in lots of places, the canaries are appreciated. They’re the shamans and the poets and the sages, but not here. … [Here] They don’t want to know how broken the world is, so they just decide we’re broken. When we stop singing, instead of searching the air, they put us away.”
Sadly, I think this may resonate with a lot of us.
We’ve been voicing the alarm for so long. But instead of being brought up out of darkness, we are being told that we are the broken ones. You need to delegate more, you need to be available more, you need to become more efficient, you are spreading yourself too thin, you are asking for too much, you need to take on more technology, you are at risk of burnout, you need to care more, you should be grateful like them over there, why don’t you feel grateful? We are being put away. If the canaries stop singing, the miners don’t get out. Our patients are sounding the alarm about a toxic world. We are sounding the alarm about a toxic system. And we are here tonight because now the alarms must be heard. I, personally, don’t want to work in a system where your songs don’t exist. Without you, then everyone behind is the next to go, and then there is no “better”, anywhere.
“Ruling the world” may be a bit tongue in cheek or reek of ego and pomp, perhaps. And if I were talking to a group of lost world leaders or social media CEOs then even its insinuation would be inane – the flame of their ego needs no gasoline. But I’m not talking to them, I’m talking to you. You are kind and moral. You search the air for people. You set them free. You are the shamans and the poets and the sages. Tonight, is about making your songs heard far and wide. What you are feeling isn’t “crazy”, no you aren’t making this up. The feeling of being put away is real. But, everyone in this room hears you and sings with you. We know, change needs to happen, there are some who don’t hear yet. For them to hear, we need to believe in our songs like we’ve never believed before. We need to believe that by sounding the alarm we are doing good. We need to believe that if we are allowed to walk out of the mine and take a fresh breath, then we allow thousands behind us to do the same. This is not about ego or money or power, this is about the truth and what is right. Please believe that your song has importance and worth and virtue. When you do, you will get out, everyone behind you will get out, and “better” will be spread far and wide. This world needs a lot of “better” right now. So yes, my friends, please do, go forth, sing, and lead this world.
Xo J