Developing a Habit of Reflection: What You See Is What You Get, with Dr. Kimberly Dyan Manning

February 05, 2021

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February 4, 2021

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00:00I am Anna Reisman.
00:01I am director of the Program for
00:04Humanities in Medicine and I am so
00:07happy to welcome you to the 2021
00:10John P McGovern Award Lecture,
00:12which is given annually to a
00:14physician who excels at being
00:16both a scientist and humanist,
00:18and a knowledgeable,
00:19Humane and caring position.
00:21John McGovern was a Texas
00:23based medical humanist,
00:25an allergist investor and philanthropist
00:27who established a number of
00:29lectures bearing his name at Med
00:31schools throughout the country,
00:33and I'm thrilled to present
00:35this award this year to a truly
00:38wonderful humanist physician,
00:39doctor Kimberly Manning.
00:40Many of you know Doctor Manning
00:43as Grady Doctor on Twitter,
00:45where she tweets about medical education,
00:47diversity and inclusion,
00:49and medical humanities as she told us.
00:52Earlier today, among many other things,
00:54it's been a day of soaking up
00:56much wisdom from Doctor Manning,
00:58she revels in finding the extraordinary
01:00in the ordinary and in telling those stories.
01:04Her writing on Twitter and elsewhere
01:06is reflective and lively and deep.
01:08Her love for what she does.
01:10Caring for patients,
01:11teaching trainees reflecting on
01:12the briefest of interactions
01:13at unexpected encounters,
01:14is infectious.
01:15She embraces her own vulnerability.
01:17She shows us how to be comfortable
01:19with our discomfort and she teaches
01:21us how we can learn from it.
01:23You may have seen her newest Twitter
01:26series called Black Wise Matter
01:28Conversations with people about
01:29their concerns about vaccination.
01:31These are beautifully told,
01:33but more importantly,
01:34they're accomplishing something
01:35critical through her friendliness.
01:36Through her ability to listen
01:38and connect with people to show
01:40so much respect for everybody
01:42she encounters and to turn those
01:44moments into micro stories,
01:46Doctor Manning is doing a
01:48huge service for all of us.
01:52Doctor Kimberly Manning grew
01:54up in Englewood, California.
01:56She received her BS degree from
01:58Tuskegee University and RMD
02:00from Meharry Medical College.
02:01She completed her residency in
02:04combined Internal medicine Pediatrics,
02:05at Case Western Reserve University.
02:07She's a general internist and hospitalist
02:10and professor of medicine who serves
02:13as associate vice chair of Diversity,
02:15Equity and inclusion for
02:17Emory's Department of Medicine,
02:18where she serves as well as
02:21residency program director for
02:23the Transitional Year Residency.
02:25She has been awarded numerous institutional,
02:27regional and National Teaching awards,
02:29including the AC GME, Parker J,
02:32Palmer, Courage to Teach Award,
02:34which is given to only 9 program
02:37directors across all AC GME
02:39residency programs in the US.
02:41She's published many personal
02:42narratives in places like JAMA,
02:44Annals of Internal Medicine,
02:46Academic Medicine, The Lancet, and elsewhere.
02:49Her research interests center around
02:51innovations in medical education,
02:53humanism, professionalism,
02:54and the interface between
02:56medical education and diversity.
02:57Equity and inclusion.
03:00I'll use Doctor Manning's own words
03:02to capture what I think is part of her
03:05secret to her success as a writer,
03:07storyteller.
03:08Collaborator connector.
03:08Someone who is accomplished and
03:10continues to accomplish great things
03:12for all who come into contact with her.
03:14She applies her lived experiences
03:16as a black woman, mother, daughter,
03:18wife, and community member to all
03:20that she does professionally.
03:21We are so grateful that you were
03:24here with us today.
03:25Doctor Manning.
03:26Welcome and congratulations on this award.
03:30Thank you so much.
03:33What a kind introduction.
03:36I don't really know what to say to that.
03:39I just feel like wow, who's that?
03:42But it's my pleasure to have
03:44spent the day with Yale.
03:46Wow, what a great day and will be
03:48wrapping this up with one of my
03:51favorite things which is talking
03:52about reflection and today or this
03:55evening I'll be talking about
03:57developing a habit of reflection.
03:58What you see is what you get.
04:04I have no financial disclosures,
04:06but my disclosure is the same as it
04:08was this morning and it is that I
04:11cry every single day. I am a crier.
04:14It is highly likely maybe I might
04:18be all cried out from earlier.
04:21But I'm very likely to cry during
04:24this session and so just be
04:26prepared for that should it happen.
04:29I always like to start every
04:31talk with a moment of gratitude.
04:34And my gratitude today is
04:36specifically for this man.
04:37His name is Doctor Bill Branch.
04:40And he was my division chief
04:42in general internal medicine.
04:44When I joined the faculty at Grady in 2001.
04:47And it was Bill who actually
04:49invited me to participate in a
04:52faculty development program where
04:53we focused on reflective writing,
04:56reflection and building us as humanists,
04:58an I and introducing me to humanism
05:01in medicine. But it was also.
05:04Bill, who really taught me to learn
05:06how to see the extraordinary in the
05:09ordinary to take like a picture,
05:11mental picture or a real picture and
05:14stare and stare and stare at it until
05:17I can get deeper meaning over and over again.
05:20This is an image of me,
05:22my grandmother,
05:23and my son, Isaiah.
05:24My grandmother is a graduate
05:26of Tuskegee University,
05:27her mom before her was
05:29a graduate of Tuskegee.
05:30This is me and her at Tuskegee Homecoming.
05:33And that was my son's first time
05:35going to a Tuskegee homecoming.
05:38And then here's just another image of my son.
05:41The first time I took him to
05:43Tuskegee's campus when he was
05:45old enough to appreciate it.
05:47And so you know,
05:48this could just be a snapshot
05:50of the back of my son's head.
05:51But see when you develop a
05:53habit of reflection,
05:53that is not what you see
05:55in an image like this.
05:57You see, what is he seeing?
05:59Does he know how his legacy
06:01is tide into this place?
06:03Does he know the meaning behind
06:04this and then look again,
06:06right?
06:06And you think about the times
06:08that we are in now,
06:10the things that happened in Macon County,
06:12Alabama beyond just the development
06:14and of my family and the education
06:16of my family but so much more right?
06:19This is Booker T Washington
06:21lifting the veil of ignorance,
06:22which is what the this is
06:25called this statue but.
06:26But just an example of how you can
06:28continue to look at images over
06:30and over and over again and see
06:33something that you never saw before.
06:35I'd also like to thank my iPhone
06:36because a lot of my reflection
06:38happens through images that I snap,
06:40and then I go back and look at them
06:42and I look for deeper meaning inside of them,
06:45and both of these images count is that.
06:48So just to kind of take you on a
06:50journey through a moment of reflection,
06:53right?
06:53And this is how I really operate
06:55in trying to be really present
06:57in a moment in an feeling it
06:59in appreciating it and making
07:01sure no moment of
07:02it is lost. So here is a
07:04piece of the flyer for this.
07:06This talk I'm giving a talk here
07:09at Yale School of Medicine,
07:10which you know you all know you're here.
07:13But let's just say when I
07:15was graduating from college,
07:16I'm not so sure you would have been
07:18looking at me to their medical school.
07:21But yet I'm still, I'm here, right?
07:24And then you know,
07:26I did some some hunting around right?
07:28Because in this moment you know
07:30here I am a graduate of two HBC
07:33use a black woman from Inglewood,
07:35CA and I wanted to know what the
07:38history was of people like me.
07:40A Yale School of Medicine.
07:42Well, in 1857,
07:43which is wow a long time ago that
07:46was when Yale, as you all know,
07:48had their first graduate of
07:50the School of Medicine,
07:51but it wouldn't be until 1948 that the 1st.
07:54Black Woman would graduate from the
07:57School of Medicine at you that isn't
07:59lost on me and I'm thinking about that
08:01right now as I'm here with you, right?
08:04I think about this man.
08:05This is my father in 1961 my father
08:07sat down across from his college
08:09counselor and he was really excited
08:11because my father had applied
08:13to two colleges and he had been
08:15accepted to Tuskegee and also
08:17to another College in Alabama.
08:18And he was very excited to be the
08:21first in his family to go to college.
08:23One of 11 children, the 7th of 11 children.
08:26And this was going to be his
08:28chance to go to college.
08:29And he loved people.
08:30And he loved science just like me.
08:32And so he told that college counselor.
08:34I think I want to be a doctor.
08:36I'm going to major in biology and that
08:39counselor looked at my father and said,
08:41you know?
08:42This is a big chance for you to
08:44get out of the Jim Crow South.
08:46This is a big chance for you to be
08:48able to help your family financially.
08:50If you don't get into mehari
08:52or you don't get into Howard,
08:54then you're going to end up back
08:55here in Birmingham Teaching School
08:57and not that there's anything
08:59wrong with teaching school,
09:00but but this counselor,
09:01who looked like my father and
09:03who really was a caring person,
09:05didn't have any black doctors that they
09:07knew to point my father to to talk to.
09:10There wasn't a person like me
09:12and the community to talk to him,
09:14and so will my father did was.
09:17He went to Tuskegee and he majored
09:19in mechanical engineering.
09:20It took him six whole years to graduate.
09:22He was not a good math student,
09:24but he did get his first job
09:26out on the West Coast.
09:27He followed the Great Migration like
09:29many African Americans did at that time,
09:31and he would build his family in California.
09:35Like my father,
09:36I attended Tuskegee University
09:38on one of four or four of us
09:41attended Tuskegee University.
09:42And when I looked ready
09:44to graduate from Tuskegee,
09:45I apply to Emory University School of
09:46Medicine 2 hours away from Tuskegee thought
09:48it would be a great idea to go there.
09:51I didn't even get a secondary application.
09:53Winter resident went to medical
09:55school at Meharry Medical College,
09:56which I loved by the way and
09:58apply to Emory for residue.
10:00Nancy didn't even get an interview,
10:02but as it turns out, full circle.
10:04I would end up building Mycareer at
10:06Emory University School of Medicine,
10:08and here I am today speaking at Yale now,
10:11something that really I
10:12think I ever expected.
10:14And as I reflect on my father
10:16and all that he wanted to do,
10:18this is a really important moment and
10:20this is what a habit of reflection does.
10:23In fact, is you even dig deeper?
10:26The first black man to graduate from Yale,
10:29his father before him actually
10:30wanted to be a doctor too,
10:32but at that time there was no
10:34chance for him to be admitted,
10:36and so none of this is lost on me.
10:39And this is what a habit of reflection
10:41does for you back to build branches.
10:44We think about reflecting should
10:45also mention that it was Bill Branch
10:48who invited me to join a workshop on
10:50writing and the art of medicine for the
10:52Society of General Internal Medicine
10:54at their national Conference in 2009,
10:56when I was an assistant professor
10:58and it was there.
10:59That I would meet Anna Raisman,
11:02who would then become my friend,
11:04colleague,
11:04and someone who have stayed connected
11:07to as someone who also loves
11:10narrative and loves the humanities.
11:12So I'm reflecting on sponsorship and
11:14I'm reflecting on connectedness in
11:16this moment and if you think it's
11:18exhausting to do all this reflecting
11:20just know that it's like the synapses
11:22that work in your brain so quickly
11:24that if you just allow it to happen,
11:27it isn't so much work.
11:29So we'll talk a little bit about
11:31what is reflection,
11:32why you should care about it,
11:33and how can you develop a habit
11:36of reflection.
11:37So reflection is really a thought or an idea,
11:39or an opinion that's formed
11:41or remark from a remark made,
11:43or as a result of meditation.
11:45And so as we as we see things
11:47happening around us as we walk around,
11:49teach our residents,
11:50interact with our patients.
11:51If we pause for a moment and think a
11:54little bit about what is happening around us,
11:57that's reflection,
11:57that's all there is to it.
11:59It's not really that hard to do.
12:02Now we say reflection,
12:03especially when I'm talking to my residents.
12:05There's a few residents who you know
12:07if maybe a group of people who are at
12:10a 5:00 o'clock meeting talking about this.
12:12Maybe you guys might be like this too,
12:14but some feel this way,
12:16but I have to say there's many times
12:18that there are people who are skeptics.
12:20They think reflection isn't that
12:22what I used to call my hair.
12:25There's people who don't want to see this.
12:27Oh my gosh, please, no, not that again.
12:29Downright hate it.
12:30And then the ones who want
12:32to run out of the room.
12:34And it happens a lot, right?
12:35But all of us could benefit from
12:37a habit of reflection and we just
12:39have to find the way that works for us.
12:42It isn't only about writing.
12:44As educators and also as patient care givers,
12:47reflection is a way really to help
12:49us take better care of our patients,
12:51but also to be more effective teachers.
12:54There's plenty of literature that supports
12:55this, and I won't even go into all of that.
12:59Instead, I'll just tell you a spoiler.
13:01Reflection is a good thing.
13:03You can search the literature.
13:04Trust me, it's true.
13:05The thing about reflection is that
13:08for those of us who are educators,
13:10it allows us to be intentional
13:12as role models.
13:12It allows us to have meaningful
13:15influence on those around us.
13:16It's great for professional
13:18growth and development,
13:18allowing us to see those things
13:20that can be read in books, right?
13:22But also as we always think
13:23about the the hidden curriculum,
13:25we always tend to think about all
13:27the bad things that can happen
13:29with the hidden curriculum.
13:30But there's some positive sides
13:32of the hidden curriculum too.
13:34But especially, and in a time like
13:36this in the middle of a pandemic,
13:38we're so disconnected.
13:39I believe that reflection
13:40helps us to combat loneliness.
13:42This is a very,
13:43very lonely time for a lot of us.
13:45Many of us are used to hugging
13:48each other or used to seeing,
13:50you know our acquaintances.
13:51And right now the people that we're
13:53seeing the most in spending meaningful
13:55time with are those people who are
13:57in our becomes a very lonely period.
13:59So let's talk a little bit about
14:01loneliness when I think about loneliness,
14:03one of the most.
14:05Lonely times I ever experienced was when
14:07I first started my internship in Cleveland,
14:10OH in 1996 and I had just left Mhairi Medical
14:13College and just to provide context for you.
14:17You know I grew up in Englewood, CA.
14:19My neighborhood was probably 80% black,
14:2120% Mexican, zero percent.
14:23Anybody else from there?
14:24I want to Tuskegee University,
14:26Tuskegee is a historically black institution,
14:28as is Mhairi.
14:29And so I was 25 years old.
14:32The first time I ever went
14:34anywhere where I was dealt with.
14:36As am,
14:37I was always a person who was
14:39amongst people who look like me.
14:41So coming to Cleveland was rough.
14:43This was my first time being other.
14:46This was my.
14:47First time being an only,
14:48this was a really strange time for me,
14:51but even though I was surrounded by
14:53people and smiling and seeming happy,
14:55I was very,
14:55very lonely and I wish that I had
14:58outlet away to in my solitude.
15:00Explore the things that were
15:02happening around me because there
15:04was a lot that was happening.
15:06I love this quote from Martha
15:08Beck that says loneliness
15:09is proof that your innate
15:11search for connection is intact,
15:12and I think that reflection is something
15:15that really helps us with this.
15:16A lot's changed in the
15:18context of how medicine works.
15:19You know, back in the day,
15:21you know everybody was always in one room.
15:24Together they lived in the hospital together.
15:26We call him house officers because they
15:28all lived in the house at the same time.
15:31Right from there we had the
15:33pre duty hours reform period.
15:34Where are residents work in the hospital?
15:37All the time I remember those
15:38times where you could just work
15:40and work and work and work,
15:42and we spent all this time together,
15:44but that evolved after 2002 with duty
15:46hours reforming people really weren't
15:48spending as much time together,
15:49but still a lot of time because we didn't
15:52have an electronic medical record.
15:54But then even back then we also had
15:56doctors lounges you probably some
15:57of you probably remember those.
15:59If your parents are doctors, my norm.
16:01But if your parents or doctors or
16:02if you know some doctors from way
16:04back when these doctors lounge is
16:06where all the places where doctors
16:08convened and there was this social
16:10network that happened there.
16:11But now with so much an electronic on
16:13an electronic medical record and so
16:16much communication happening electronically,
16:18alot of that is lossed and there's
16:21a loneliness that reflection can
16:23really help us to pull together.
16:26This paper in the New England Journal
16:28talked a little bit about this very
16:30thing about how technology has
16:32really boosted physician loneliness,
16:34and so this quote from that paper says,
16:37I think we need uninterrupted time to
16:39reflect to converse and to grapple
16:41with the downsides of the unrestrained
16:43embrace of technology.
16:44Such steps could be the beginning of
16:46a journey to reclaim our profession
16:48and recapture our most treasured
16:51relationships which,
16:51if you ask me or with our patients.
16:56Now there's a difference between
16:58loneliness and solitude, right?
17:00So lonely is being without company
17:03an cut off from others.
17:05To be isolated though,
17:07is to be set apart from others.
17:09So thinking about loneliness
17:10and isolation together,
17:11but recognizing that sometimes we do
17:13need time alone and it's important to
17:16understand that there's a difference
17:17between solitude and loneliness, right?
17:19So this time that we're having to
17:22spend by ourselves not able to touch
17:24people in the way that we could not
17:27able to spend time laugh on patios,
17:29clink wine glasses.
17:30There has to be a time to connect.
17:33Dig deeper into appreciate what's happening,
17:35especially in a time such as this.
17:38Loneliness is marked by a sense of isolation,
17:40but solitude, on the other hand,
17:42is a state of being alone without being
17:45lonely and can lead to self awareness.
17:47And so I want you to kind of sit in
17:49that for a moment and think about your
17:52reflective time as a time in your solitude,
17:55where you can actually
17:56become more self aware.
17:57That's one of the most powerful
17:59things about reflection.
18:00OK, so we're going to get a
18:02little bit more specific now.
18:04OK, and so are more specifics will
18:06be there will talk some more about.
18:08Some concrete examples of
18:10reflection and action.
18:10'cause I like to be concrete.
18:12I mean I like these sort
18:14of lofty discussions,
18:15but there's a point where I'm like OK,
18:18but tell me what you actually do every
18:19day and then will participate in
18:22some painless reflection exercises.
18:23Yes, even over soon and then
18:25I'll help you to create a plan
18:27for daily reflective practice,
18:28recognizing that everybody isn't the same.
18:30Some people like to write.
18:32Some people like to tell a story by mouth.
18:34Some people like to do both,
18:36so people like to look at a picture.
18:39Some people like to listen to music.
18:41There's so many ways to reflect and find
18:44deeper meaning in the extraordinary
18:46ordinary happening around you.
18:47So if we think of what reflection is,
18:50it's the larger context.
18:51Plus the meaning plus implications, right?
18:54So, thinking about something
18:55happening in front of you, so?
18:57But what does this mean in a larger context?
19:00And then how does this apply to
19:03the things happening around me?
19:04How will this change what I do?
19:07What kind of learning can I gain
19:10from this right?
19:11So if you think about this moment here,
19:14right?
19:14If you know,
19:15I could just sort of come to yell and say,
19:18hey,
19:19it's really cool and put it on my CV,
19:21but how much cooler is it to sit
19:23in this moment and reflect on the
19:25deeper meaning of me of African
19:27American woman from Englewood?
19:29A descendant of slavery whose
19:31father wanted to be a doctor?
19:33And who and who is is a direct
19:35reflection of this amazing woman.
19:37Beatrix Hamburg,
19:37who probably wanted to be a
19:39full professor too, you know.
19:41A graduate of a historically
19:43black college and,
19:44and so we didn't even get into Emory's
19:46medical school or residency, but is here now.
19:49There's deeper meaning.
19:50And going through this habit of
19:52reflection really allows you to
19:54appreciate a moment much more.
19:55But what it all really comes
19:57down to if you ask me, is this.
20:00And that is a simple question and it is.
20:04What's getting your attention?
20:06Because as we go through our days right
20:08there so much that gets in the way,
20:10right?
20:11There's so many things that we have to do.
20:13There's list.
20:14There's patients we have around.
20:16Oh, and there's evaluations to fill out.
20:18There's letters to write,
20:19but but we have to figure out.
20:21What will we let get our attention
20:24in the middle of a day?
20:26So I have a little question for you
20:28all now since we're all here on zoom,
20:31we want to let it have to let
20:33everybody be able to chime in.
20:35But this is more for you to reflect
20:37upon and see where you fit in this.
20:40So I called this the reflection spectrum.
20:42Either you are over here with my husband,
20:44where you rarely cry and you don't
20:46really want to have a conversation
20:48or or read any of my narratives.
20:50Love him dearly, but he doesn't
20:52want to be my narrative she call or
20:55you're all the way over here with me.
20:57Cry on the drop of a dime and
20:59want to reflect about everything.
21:01Think about what you think about.
21:02Think about what you thought about
21:04what I think about. Then talk about it.
21:06Then talk about that and think about it.
21:08Then write about it. Take a picture of it.
21:10Think about it again.
21:11And write a poem about it.
21:12That's the other end of the
21:14reflection spectrum.
21:14So let me help you figure
21:16out where you are on it.
21:17OK, so let's ask you a few questions.
21:19I notice when someone gets a new haircut,
21:21loses weight or isn't there.
21:24I think about my patience, learners,
21:26peers when I haven't seen them in awhile.
21:30I remember things that my patients,
21:32my learners,
21:33and my peers tell me about themselves.
21:36I can notice when something is bothering
21:38one of my learners or colleagues.
21:41I share what's going on with
21:43myself within reason and my teams.
21:46Situations with patients,
21:47their families and or learners
21:50have moved me to tears.
21:52I think about how lucky I am
21:54to be in patient care often.
21:57So as you reflect on those questions.
22:00Think about where do you fall
22:03on the reflection spectrum?
22:05Me, I'm over here, but it's OK if you're not.
22:11There's good news, y'all.
22:13No matter where you fall
22:15on the reflection spectrum,
22:16you can nail this without
22:17any special training.
22:17There's a way for all of us to
22:20reflect in the way that works for us.
22:23But how so?
22:24The first thing to do is just to look.
22:27Just look look at something
22:29ordinary when you walk from
22:31your car into the hospital,
22:32keep your head forward.
22:33Don't start looking at your phone,
22:35just look at what's going on around you.
22:38Look at the people passing.
22:39You feel the air on your face.
22:41See what's going on.
22:42Then look again and then see if you
22:45can notice something that you had
22:47notice before and then put it in context,
22:49right?
22:49So an example I gave someone earlier
22:52is every time I walk into the
22:54hospital somebody stops me and ask
22:56me for directions somewhere and so.
22:58I decided that I would reflect on why
23:00I always get stopped and I decided
23:02that it's because I think I have
23:05a stoppable face and that is good
23:07to be someone who might help you,
23:09right?
23:09And so that's an idea of just a little
23:12simple reflection that can change
23:13the way I think about being interrupted.
23:16Connect meaningful dots, right?
23:18It's a meaningful dot connection
23:20to me to be here at Yale.
23:21An in this in this moment of
23:24Black History Month, right?
23:25Take a mental picture or a real one.
23:28And then return to it.
23:29These are some simple ways
23:30and I have this picture
23:31of this shell because I think that
23:33when you pick up a shell and you
23:35turn it over in your hand and look
23:37at it every time you turn it over,
23:39you can see and notice something different,
23:40and I think that can be said
23:43about our experiences too.
23:44So reflection and action looks a lot of ways.
23:46Of course, as we know from
23:48the Writers Workshop,
23:49it can be writing and journaling.
23:52It can be storytelling and sharing
23:53something as simple as you calling
23:55up one of your friends and saying,
23:57Oh my goodness,
23:58let me tell you about my day or
24:00telling your kids or having a
24:02storytelling time at your dinner table.
24:04That's what my family does.
24:06Photos I'm a big fan of using my photo
24:09collection in my iPhone just to remind
24:11me of moments because I can often
24:13because of develop this habit of reflection,
24:16I can remember exactly what was going
24:18on in a moment and there's also been
24:21times where I didn't have a picture
24:24of something and I wish so bad that I did.
24:27Meditation and mindfulness just sitting
24:29alone in solitude and just soaking
24:31up a moment and thinking about it.
24:33No writing, no talking,
24:35no photos, just thinking.
24:37Right?
24:38So just to show you an example
24:40of photos for reflection,
24:42this is a reflection on that.
24:44I had that through photos.
24:46This is an image that was taken.
24:48I know for sure on November 15th,
24:512019, 'cause on November 15th,
24:532012 my older sister Deanna
24:55died of a sudden cardiac death.
24:58On my phone is an image of her.
25:00My younger sister took this picture
25:02of me because holding my phone with my
25:05favorite picture of my sister on it.
25:07So think about my sister Deanna is
25:10she was an amazing cook like she was
25:12the person who could bake and cook
25:15all the all of the family recipes
25:17and her sister Kimberly bless her.
25:19I never really enjoyed cooking very much,
25:21but one of the things that Deanna
25:24made that was amazing was she
25:26made these homemade yeast rolls.
25:28Every Thanksgiving in every Christmas,
25:29so she also on my wedding day gave
25:31me this box that was filled with
25:34recipes and every recipe in there.
25:36Believe it or not is 30 minutes or less.
25:38They're all super easy recipes.
25:40So after my sister passed away,
25:42we realized no one in our family
25:44knew how to make those rolls and
25:46it wasn't in my recipe box 'cause
25:48it was too hard of a recipe.
25:51So this is me.
25:52This year, on Thanksgiving when
25:53I was looking for that recipe.
25:55And of course it wasn't there.
25:58So I said,
25:59and I thought about my sister
26:00and I wasn't missing her.
26:02How was really missing her?
26:03In fact,
26:04that's her shirt that I'm
26:05wearing an I'm just missing her,
26:07so I decided that I am going
26:08to try from memory to make
26:10her yeast rolls and my son,
26:12who now has developed a
26:13habit of reflection too.
26:14He took this picture of me because
26:16he thought it was hilarious
26:18that I was even trying this.
26:20And I really put in work and try to
26:23remember what she did and this was my
26:25rolls when they came out of the oven.
26:27And then this is just me
26:29sitting with that box,
26:30remembering and thinking about my sister.
26:32And I know exactly how I felt in that moment
26:35and every time I look at these images,
26:38I'll probably see something
26:39deeper that I hadn't seen before.
26:41And that was really an example of
26:43an appreciative inquiry exploring
26:44something that is good and finding
26:46the extraordinary in the ordinary.
26:48Now I moments where I'm very
26:50sad about the loss of my sister.
26:52We were only 20 months apart.
26:54But this habit of reflection
26:56has allowed me to elevate and.
26:57Amplify the most extraordinary
26:59ordinary moments about us,
27:00and one of those ordinary's
27:02was me sitting next to her,
27:05watching her make those roles and
27:07just talking junk and not helping.
27:09But I realize a lot of it's soaked in.
27:13Appreciative inquiry also helps
27:14you to let nothing be lost on you.
27:17Let's you dig deeper and find
27:18new lessons in old experiences.
27:20So this image here was taken in
27:212013 after my sister passed away,
27:23I decided that I will become
27:25a runner out of the blue.
27:26I'd never run in my life and just
27:29impulsively signed up for the army.
27:3010 mile are a person who had
27:32never even run a mile,
27:33so this image was taken right after
27:35I finish the army 10 milers and
27:37I could just leave the picture at
27:39that and say hey that was really
27:41cool that I accomplished this thing.
27:43I ran in my sister's honor.
27:45And that was really cool, right?
27:46But as I look at the pictures
27:48at always find deeper meaning,
27:50deeper meaning, deeper meaning.
27:51So that's my sorority.
27:53Across the front of that shirt,
27:55my sister and I both were in the
27:57same sorority, Delta Sigma Theta,
27:58and I was really excited to be out
28:01there to run this race in my sister's honor.
28:04So while I was running the race,
28:06I get to like Mile 8 and I turn
28:08a corner and there's this big
28:10steep Hill going straight up,
28:12and it looks like that thing is
28:14gonna go for another 2 miles, right?
28:16And I'm running and I see that heel
28:19and I just say no way I'm done.
28:22I have come this far.
28:23I was a person who had never run before.
28:26This was really good.
28:27I mean I had a lot to be proud of,
28:29so I just started walking and
28:31I should mention that I signed
28:33up with this race by myself.
28:34There was nobody there to run it with
28:36me and I had flown up to DC to do this race.
28:39So here I am walking and I had
28:41taken maybe walking about 500 feet,
28:43but all of a sudden out of the blue I
28:45see this blur coming toward me and I
28:47look and it's this person with this
28:49crew cut and this little tank top on.
28:52And and this this this this person
28:55comes up to me and she says.
28:57Deanna sister, let's go,
28:59Deanna sister and she looped
29:02her arm into mine and she said,
29:05let's go and she starts running.
29:09Beside me and gets me running now.
29:11I started crying because I'm part crying
29:13'cause she's running way faster than I run,
29:16but also crying because I was so
29:18moved by this and she's amping up the
29:20crowd saying come on Deanna sister
29:22sort of crowd is like Dana says there
29:25and I am Boo Hoo crying running this
29:27race she ran two full miles with me
29:30chanting Go Deanna sister you got
29:32this Dana sister and when I got to
29:34that she ran me all the way in and
29:37we got to the end she just stopped.
29:40Instead, we to go,
29:41Deanna sister just kind of walked off.
29:44No hug, no nothing else.
29:48But the deeper meaning in this is that.
29:50How powerful was it for a stranger
29:53to choose to run beside me?
29:55Clearly she could have run much faster,
29:57but she chose to run with me and help.
30:00We win.
30:01All because she saw the back of my shirt,
30:05all because she saw me trying and saw
30:07me slow down and I think a lot about
30:10that when I think about learners,
30:12my colleagues students I think
30:14about her yelling hey, Deanna,
30:16sister,
30:16what's the equivalent of that that
30:18I could do for someone else?
30:22This is an image taken of the front of
30:25Grady Hospital and sometimes as we reflect.
30:27What will happen is that overtime,
30:29the more we we play the story
30:31over and over in our head we
30:34can get new lessons as we grow.
30:36So I had a resident once who happened to be
30:38a black woman from Southern California who
30:41had gone to a historically black college.
30:43So I'm like wow, you know what?
30:46This is great.
30:46She's in my residency program.
30:48I'm thinking that while this is a
30:50mentorship match made in heaven, right?
30:52Well, as it turns out,
30:54this resident did not feel that way
30:56and she had no problem trashing
30:59me on evaluations and letting me
31:01know all things that she didn't
31:03like and and it was pretty hurtful.
31:06And the more she didn't like things,
31:09the harder that I tried.
31:12And so I had sort of decided in my
31:14head that she was the problem right?
31:16And kind of looked back on it for
31:18years as she was just a person
31:19with a chip on her shoulder.
31:21I don't know what her problem was and
31:23that was it. But then I grew older.
31:26And as I grew older,
31:27I started to reflect on some of
31:29the things that happened when
31:30I first met that student,
31:31that resident and what happened was
31:33when she got there and I realized
31:34she was a black woman from an HBCU
31:36and from Southern California.
31:37I let her know that I had high
31:39expectations of her and that you know,
31:41if she if she doesn't look good,
31:42I don't look good and that she needs
31:44to come to me for anything she needs.
31:46But she needs to make sure
31:48that everything is tight.
31:49That's not a lecture that
31:50I gave to other residents,
31:51it was just something that I gave to her.
31:53And you know what?
31:54That made it harder for her as a resident.
31:57As I look back on it, I think wait a minute.
32:00Maybe she wasn't the only problem.
32:02Maybe I was part of the problem.
32:04Maybe I laid the minority tax on her as
32:07soon as she got here without her even
32:09having a chance to just be an intern,
32:12right?
32:12And so with time you played the
32:14stories over and over again and
32:16you see them new new meaning.
32:18New lessons come from all of our reflections,
32:20so it's never too late to continue
32:22to reflect on the same story.
32:24You may see something new and may
32:27completely change your perspective on it.
32:29So I asked you guys to look
32:32at this image for a moment.
32:35And think about what do you see
32:37in this image? What do you see?
32:46So the cool thing about a picture like
32:48this is you can look and you can see
32:51something and then you'll see something
32:53else and you can create a narrative and
32:55you can create a story in your head, right?
32:58Looks like a father's with his son.
33:00Looks like they're walking in the
33:02father's trying to encourage his son.
33:04Maybe it's just a cold day in there walking.
33:07Maybe the team lost.
33:08Maybe the sun is sad.
33:09Maybe it's the end of the season.
33:11Maybe they lost the big game.
33:13It's hard to say.
33:15I know the story because I was the
33:18one who took the picture and it
33:20was exactly what I just told you.
33:23My son's team had just lost a really
33:25really big game and he was really sad
33:27and my husband was encouraging him.
33:30But I love this picture deeper
33:32meaning in it for me now is in this
33:34world that has this narrative about
33:36black fathers not being present right
33:39about our sons not having people
33:41cherishing them as they grow up.
33:43It counters every narrative that
33:44I hear about my people.
33:46Love this picture because it captures
33:48love and support and many of the
33:50things the world thinks isn't there.
33:54Look at this picture.
33:59These are my sons.
34:02And I love staring into this picture too,
34:04because I can see all of the
34:06emotion all of the support.
34:08Everything that as a parent I fight
34:11for for those kids to stay connected.
34:13And that's the beauty of
34:16pictures for reflection too.
34:17This is an image taken in a hallway
34:20at Grady Memorial Hospital in this
34:22hallway separates the CD Wing from
34:25the YD Wing and Grady Hospital was
34:27built in an H formation because it
34:29was a segregated hospital and so
34:31this very hallway was the hallway
34:33where they integrated the hospital
34:34where they first started moving those
34:37patients down the Hall from the air
34:39conditioned side with all the nice
34:41sheets over to the other side where
34:44everybody all of the black patients
34:46had been and kind of made it.
34:48A well integrated hospital after that.
34:50But years ago it was segregated
34:51and on one side somebody like me
34:53would have to have wouldn't have
34:55been able to use the good sheets.
34:58Wouldn't have had air conditioning and
34:59maybe wouldn't have even gotten care right?
35:01So this is an image that just helps
35:04me to think a little bit about
35:06how far times have come and what
35:08it means for me to even have the
35:10opportunity to be a doctor at Grady.
35:15I see this image all the time on my runs.
35:18This little path runs through my neighborhood
35:21and I just thought it was a little path
35:23for people to be able to, you know.
35:26Get from one street to the other.
35:28I would later learn that it is what's
35:30called a servants path in a servants
35:32path was because people who look like me
35:35and this is right in my neighborhood.
35:37I like less than you know,
35:39a block from my house.
35:41People who look like me could not walk down
35:44the street in Druid Hills where I live,
35:46they had to take these servant paths
35:48in order to get to a Main Street
35:50so that they could be picked up
35:53or catch public transportation.
35:54And these paths are still there
35:56in my neighborhood,
35:57which used to be segregated.
35:58But as I see them,
36:00I stop and I stare and I look
36:02at the ground and I think what
36:04does each layer represent?
36:05What was going on when that
36:07bottom layer was there?
36:09And then I can kind of see the women
36:11who look like me who were surely as
36:13smart as me with their uniforms on and
36:16tired and really wishing they could just
36:18take the way that was the straight shot,
36:20right?
36:20But having to take this way
36:22because of segregation,
36:23we've come a long way and
36:25that isn't lost on me,
36:26a habit of reflection affords me the
36:28chance to see it and feel it and
36:31understand what's going on around me.
36:34This is a cake. As you can see.
36:37But it's not just any cake,
36:39this was a cake that a medical
36:41student baked for me a few years ago,
36:43and this was a medical student that was very,
36:46very quiet in one of my students,
36:48small groups say very little,
36:49never really seemed to be too impressed
36:52with anything going on with the group
36:54always was prepared and did her work.
36:57But at the very last small
36:58group that we had when they were
37:00graduating from medical school,
37:02she made me this cake and I cut
37:04into the cake and I tasted it.
37:06And it was perhaps the most delicious
37:09cake I have ever had in my life.
37:12In the caller,
37:12then I ask her about this cake.
37:14What was the recipe?
37:15What kind of cake is it in?
37:17This is what she said.
37:19She said this is a cake that is
37:20made up of all of your favorite
37:23flavors over the year years.
37:24You see,
37:25this student always would bake for the
37:27small group and would bring in these
37:28these cakes to the small groups, right?
37:31And so some days,
37:33she said,
37:34you seem to like chocolate with Banana.
37:37You like nuts,
37:38you like coffee flavored things.
37:41So it is a banana dark chocolate
37:44espresso dusted nut cake.
37:46That I made from scratch using
37:48all of your favorite flavors in.
37:49I have to tell you all she was right.
37:52They were all my favorite flavors.
37:54But she can't paid attention,
37:55so sometimes the habit of reflection can
37:57come through something that you give
37:59an active service to another person,
38:01because clearly she reflected
38:02on what she could do to honor
38:04this time that we had together.
38:06And this image here is just some.
38:08An image of three of our chief residents,
38:10and they had all snuck to be in
38:12the back of the room as one of
38:15our Deans was getting an award.
38:17At the medical school and it was
38:18really hard for them to be there.
38:20They were very, very busy people,
38:22but the fact that they were there just
38:24saying so much and I love the looks
38:27on their faces during that moment.
38:29What do you see when you see this picture?
38:36This is a picture of my father.
38:39Anne, my brother.
38:43And I'm not sure what was going on then,
38:45but I did capture this picture just to
38:47reflect on what could be happening then,
38:50but I love looking at the picture as a
38:52counter narrative again to all the things
38:55people say about black men and black fathers.
38:57So some props for you to be
39:00able to reflect in your life.
39:02Pretty simple.
39:03Imagine any ordinary experience
39:04that you've had involving an
39:06interaction with a patient or learner.
39:08What was going on?
39:09Who was there?
39:10What was the context?
39:11Find the good or the lesson in it.
39:14The moment the relationship,
39:15the situation, the big picture,
39:17it's up to you to choose the focus.
39:20Think about what's going on.
39:21Jot down notes or write it longhand.
39:24Speak it in your into your voice memos,
39:26or tell someone.
39:27Find a song to accompany the moment that's
39:29another one of my favorite things to do.
39:33And so I'm going to share with you
39:36something that I wrote about this
39:38very moment on this on this very day.
39:41So.
39:43It starts by me reflecting on
39:45a poem by Langston Hughes that
39:47says hold fast to dreams.
39:48For if dreams die,
39:50life is a broken wing of
39:52bird that cannot fly.
39:53Hold fast to dreams,
39:55for if dreams go life is a
39:57barren field frozen with snow.
40:00It was a random.
40:01Hallway conversation I saw this
40:02student standing there in the
40:03lobby in the medical school.
40:05One day,
40:05I realized that I'd seen
40:07her many times before,
40:08but it didn't really know her and that
40:10will be very transparent in saying
40:12I feel like it's my responsibility
40:14to know most of the medical students
40:16at Emory who look like me.
40:18The discussion was mostly light,
40:20and in it I asked her questions about
40:22who her mentors were and what kinds of
40:25career aspirations were in her horizon,
40:27and she told me all of these things.
40:30But when she did I notice this
40:32inexplicable emotion coming through.
40:33I couldn't place it,
40:34but instead of subjecting her
40:36to some analysis instead,
40:37we just agreed to get to
40:39know each other better.
40:40And as we did I got to understand more
40:44of what that heaviness was about.
40:47Around the same time,
40:48my friend and fellow Grady Doctor
40:49Stacy and I had begun Co mentoring
40:51a colleague and and in those
40:53tag team meetings we recognize
40:54that we were a hell of a team.
40:57So from there we became her
41:00ragtag mentoring team.
41:01And no,
41:01we are not responsible for any of the
41:03things she is successfully accomplished,
41:06but we do stand ready,
41:08willing and able to remind
41:10her of who she is we do.
41:12Here's the best part.
41:14Every affirmation we give to her is
41:16an affirmation we give to ourselves.
41:18I see her and I think this is
41:20what it looks like when someone
41:22holds fast to dreams and doesn't
41:24let them die and being involved
41:27in her medical journey
41:28has been has gives that same gift back to me.
41:32We remind her of who she is when she hits it
41:35and it hits us right back like a boomerang,
41:38telling us of who we are on a day when
41:41I was tired as hell and wanting to
41:43crawl out of the hospital on all fours,
41:45I saw her while walking into the entrance
41:48of Grady with Stacy and we enveloped her
41:50in a group hug and all of us in that moment
41:53knew that it was symbolic of soul so much.
41:57Things hard to put fingers on.
41:59But that you want to grasp tightly
42:02and that all of that made me really,
42:04truly want to hold fast to what
42:07I'm supposed to be doing.
42:10All of this is so much bigger than us.
42:12My dad always told me that,
42:13and now more than ever, I believe it.
42:16What good is any talent or accomplishment
42:20or opportunity if it only is about you?
42:23I guess my point is nothing ever really is.
42:26Yeah, so I look at this picture
42:29and I feel myself wanting to cry.
42:32Taken just right, yes, yesterday,
42:33right in front of Grady Hospital
42:36on a beautiful,
42:37warm yet cool and autumnal afternoon.
42:39A young woman of color who is
42:41striving to become a doctor flanked
42:43on both sides by two of her mentors,
42:46both of whom not only look like her but
42:49believe in her and are already doctors.
42:52The light in her face in hours to
42:55his triumphant and hopeful and I
42:57swear I stared at this photo forever.
43:00Just imagining us,
43:01her two mentors lifting her straight
43:04off of the ground and casting her high
43:06into the heavens to soar like an eagle,
43:09and her doing just that.
43:11Support is everything.
43:12Belief is everything and with
43:14both dreams never die.
43:16They simply expand to include more than any
43:19of us realize they ever could any of us.
43:26This is on the day that I
43:28hooded her at commencement.
43:29This is match day in graduation.
43:31She's board certified and doing great.
43:35So pointers to help you with moments
43:37like this is just to ask who you are.
43:39What are some unique features that affect
43:41your perceptions of the experience?
43:42What was going on with you that day in
43:44the moment and who was involved and what
43:47unique factors affected that person?
43:50Your homework is you can take a
43:52photo or a few photos of something,
43:54someone or an experience this week.
43:56Find a photo from a special
43:57moment and stare at it.
43:59Take a few moments to look at it again.
44:01What do you see?
44:02What did you appreciate about
44:03the moment or the person?
44:05Write it down or tell someone
44:06about it and then do it again.
44:10My last story is this. At Grady,
44:14a finished along day rounding and I looked
44:16to one of my patients who was an Octo
44:18generi and said to her what questions do
44:20you have for me and my patients said to me.
44:24Do you know the words to the national anthem?
44:27And I said Oh my gosh, 'cause I was.
44:30This is around the time that there was a lot
44:33of controversy around the national anthem.
44:35And I kind of took a deep
44:37breath and prepared. You know,
44:38'cause I'm not going, you know, disrespect.
44:40One of our Grady elders and she
44:42sees it in my face and she go.
44:43Oh no, I ain't talking bout that
44:45star spangled one now I'm talking
44:47bout the national anthem.
44:48And I kind of sit up tall
44:50'cause you know y'all?
44:51I went to Tuskegee so of course
44:53I know the national anthem
44:54or the Black National Anthem.
44:56Lift every voice and sing of course.
44:58And so I tell her just that.
45:00And she looks at me and says.
45:02But do you know all three verses now
45:04at some point in my life I did know
45:06all three verses in middle school.
45:08I had to learn it for Black History
45:10Week came home.
45:11My parents made me learn all three
45:13verses which greatly helped me.
45:15Later when I was at Tuskegee,
45:16standing on stage of convocation and
45:18needed to sing all three verses.
45:21But it had been like 30 years
45:23since they happened,
45:23so I was not really in a point where
45:25I could remember all three verses.
45:28So I was honest.
45:29I said I don't remember the other
45:31two verses and she said you need
45:32to know to other verses because
45:34see the first verse tells you to
45:36make a joyful noise for all that
45:39your people have been through.
45:40The second verse helps you to remember.
45:44All that your folks have gotten through how
45:47resilient people are that you come from,
45:49and that if you feel like
45:51you having a bad day.
45:53You probably can get through it.
45:56But that last one is her,
45:57she said is my favorite because that's
45:59the one that tells you to give glory and
46:02to know that there's nothing nothing
46:03you can't stand through and nothing
46:05that you can't make it through next.
46:07And so I pulled out my phone
46:09and I was just like OK.
46:10Well do you want me to play it for you?
46:13She goes now I want you to read it.
46:16Read read all the lyrics to
46:18me don't sing it read it.
46:20And I did.
46:23By the time I got to the last verse,
46:25I was crying.
46:26The nurse on the floor with me was crying.
46:29The person on the other side
46:31of the curtain was crying too,
46:32and I have never heard that
46:34song the same since then.
46:36I go and I listen to every version
46:38I can get my hands on him every time
46:41I hear the words in a different
46:43way and I'm really grateful for
46:45that patient, really slowing me
46:47down into something so every day
46:49and to me that lift every voice
46:51and sing is an ordinary in my life,
46:53but it has now become so
46:54extraordinary because of that moment,
46:56and because of that reflection.
46:57And now I get to reflect even
47:00deeper by telling you that story.
47:03So I'm going to share this
47:04with you and these are.
47:06Black women faculty at Emory University
47:09School of Medicine and in honor
47:11of my patient we are savoring the
47:13words to lift every voice and sing.
47:22Lift every voice and sing till
47:26earth and heaven ring ring
47:29with the harmonies of Liberty.
47:31Let our rejoicing rise high
47:34as the listening skies let it
47:37resound loud as the rolling see.
47:41Sing a song full of the faith
47:44that the Dark Pass has taught us.
47:47Sing a song.
47:49Full of the hope that the president
47:53has brought us facing the rising
47:55sun of our new day. Begun let us
47:59March on till victory is 1. Stony
48:03the road we trod bitter the chesaning Rod
48:07felt in the days when hope unborn had died,
48:10yet with a steady beat.
48:13Have not our weary feet come to the place
48:16for which her father side?
48:20We have come over away with tears
48:22has been watered.
48:24We have come treading our
48:26path through the blood of the
48:28slaughter out from the gloomy
48:30past till now we stand at last,
48:33where the white gleam of
48:35our bright stars cast. God
48:38of our weary years.
48:40God of our silent tears.
48:43Thou who has brought us thus far
48:45on the way. Dial who has BI di
48:49might lead us into the light. Keep
48:52us forever on the path we
48:55pray lest our feet stray
48:57from the places are God where we met the less
49:01our hearts drunk with the
49:04wine of the Lord we forget
49:06shadowed beneath my hand may we
49:09forever stand. True to our God.
49:13And true to our native. Land.
49:29Some closing there is always
49:31deeper meaning if you look.
49:34And you look. And then you look again.
49:38Reflections an opportunity for growth
49:40and for more meaningful teaching,
49:42it helps us to find deeper meaning in
49:44our work and what gets your attention
49:47matters personally and professionally.
49:49Reflection isn't just for writers,
49:51is for anybody with eyes and a soul.
49:55And who wants to feel connection?
49:57Seeing things in larger
49:59context changes perspective.
50:02And what you see is what you get.
50:06And remember, it's many times with
50:09those around you get to. Thank you.
50:20Thank you so much.
50:26That was wonderful. Thank you,
50:28Kimberly. Doctor Manning
50:34I am happy to have a little time too.
50:39Answer or present questions to you along
50:43with Amanda Calhoun who is a resident
50:46in the Solnit combined Adult and Child
50:50Psychiatry Program here at Yell so.
50:55So far I think we just have one question,
50:58Amanda, do you want to?
51:00Take that one. Sure,
51:03and thank you so much Doctor Manning.
51:05Another round of applause for you.
51:08Just amazing amazing delivery
51:09and presentation and loved it.
51:11So our question is from Dana done.
51:14She says we actually
51:16have delivered build
51:17branches, humanism faculty
51:18development curriculum here at Yale.
51:20What are your thoughts about faculty
51:22development for reflection and making
51:24purposeful communities of practice
51:26and also given Emery has been doing
51:29this faculty development for awhile,
51:31has it translated into a
51:33different culture of reflection?
51:37So I think faculty development
51:39is always a good idea.
51:41It transformed Mycareer just signing
51:43up for that faculty development.
51:45So I absolutely do think that an I
51:47think faculty development communities
51:49arrest centering around reflection.
51:52We've done several and and it's
51:54really been powerful. You can,
51:56you can pull in some of the biggest skeptics,
52:00so I'm a big fan regarding our culture.
52:03Yes, you know, you know.
52:05So what happened?
52:06After bills mentorship,
52:08you know I became a leader in our
52:10Department and in our resident conferences.
52:13We have storytelling conferences
52:14where instead of you know a lecture,
52:16we have four residents get
52:18up and tell stories.
52:20You know, during the time after Mr.
52:22George Floyd's murder,
52:23we had a Black Lives Matter,
52:25storytelling,
52:26noon conference and it wasn't only you know,
52:29black residents,
52:29it was all different residents and we
52:32coach them on how to tell a story.
52:35You know, kind of following them.
52:37The moth format and really you
52:39know residents now we're sort
52:41of used to people showing up
52:43and giving these like Ted like
52:45talks and storytelling and such,
52:47so I think that says a lot about our culture.
52:58I'm going to read the next.
53:00There was a comment from
53:01somebody who wrote thank you.
53:03I've used that issues I had with me.
53:08And here is another question
53:10from Doctor Andrews Martin.
53:12This crybaby salutes you Doctor Manning.
53:14I hope your example will inspire others.
53:18Men in parentheses to follow suit.
53:20Good job and not crying.
53:21I cried for you, flattering imitation,
53:23being what they are and hope we can
53:25copy your beautiful him at Emory.
53:27Let's include not just us docs,
53:29but everyone who touches a patient.
53:31Thank you.
53:33So I have a related question that
53:35I will just pop in there which is.
53:41People who are here listening to
53:43now and pretty much anybody who
53:45experiences a conversation with you.
53:47I think you can talk them into the
53:49value of reflection and make it
53:52just crystal clear how much meaning
53:55and enjoy can come from that.
53:57But there are those who are reluctant
53:59and who hear the word reflection
54:02and kind of run the other way.
54:04And here at the medical school we have
54:07required reflective writing workshops for
54:09the students on their clinical year and.
54:12Many of them love it and there
54:14are always a few who are.
54:17Just are not.
54:18It's not their thing and they can't.
54:21They can't.
54:22They can't make it their thing or.
54:25How do you? How do you deal with those?
54:28People who don't see how great it is.
54:32Well, I think that part of the problem
54:34is us to, you know, a lot of times
54:37when something isn't going well.
54:38I you know, again, kind of like the
54:40story I told you about the young woman
54:43who who sort of hurt my feelings.
54:45I was so focused on what she was doing
54:48wrong that I really think about myself
54:50and I think that sometimes you know we
54:52have to present people with other ways
54:55to reflect other than just writing.
54:56Some people don't want to write,
54:58so I've done quite a few things.
55:00I've had. People compose a tweet.
55:03280 characters, 55 horror stories.
55:05I know you all do those.
55:08The 55 war story then
55:10distilled down to 6 words.
55:12Pictures so with my war teams,
55:14if I have somebody who doesn't really
55:16want to, do you know a writing drill?
55:18I'll have people you know,
55:19take a picture of something HIPAA
55:21compliant that they see in that they
55:23noticed and then show it to the team.
55:25And in fact I even show them
55:27how to use photo editors.
55:28I'm like here you could do it on Instagram.
55:31You could do it on Pic,
55:33smart pix art or something like
55:34that to really deep in it so that
55:37we can see more detail in if you
55:39notice a lot of the images I have,
55:41they have filters put through them.
55:42So that I could really appreciate
55:44the picture even more,
55:45and some of the people that are
55:47the the the biggest like against
55:49reflecting find a way to reflect.
55:51So I think we have to offer
55:53people more than writing.
55:54I just think some people it's not their
55:57jamman it's OK for it not to be your jam.
56:03Thank you, that's a great answer. Amanda.
56:08So I see another question here and
56:10it says this morning I saw some
56:13hospital stairwell pictures in your
56:15presentation and I picture many stairwells
56:17in my own training and career path.
56:19I wonder if you have a particular story
56:22or particular reflection about the
56:23important role for stairwells for us,
56:25for privacy and taking breaths
56:27at times, great question.
56:29So Laura was um Co.
56:31Chief resident with me in an old
56:34friend so hey Laura, hey girl.
56:36But beyond that you know you know
56:39I think back to when I was in
56:42Milpitas resident and I remember
56:44I got very good at resuscitating
56:47patients and I remember running and
56:49resuscitating this patient a baby
56:51without knowing what the dates were
56:53and I and I feel really bad about
56:57about that resuscitation because.
56:59For about 10 days that baby was
57:01tortured pretty much in the in the
57:03Nick you and ended up passing away
57:05and I remember just feeling like I
57:07was going to suffocate and I made it
57:09into a stairwell an I mean woo I was
57:12Boo Hoo crying and nobody came in there.
57:14I just got to get it all out and I
57:17think about residents calling me from
57:19stairwells and me trying to gather my
57:22thoughts in a stairwell so I I find
57:24them to be you know a nice little
57:26place to kind of gather your thoughts.
57:29Sometimes I'll just walk the stairs
57:31to knock myself out of breath so I
57:33can take my mind off of something.
57:35So yeah,
57:36I think there's a like a a sacred
57:38thing about stairwells in hospitals.
57:40They all kind of look the same,
57:42don't they?
57:50And then there's another question.
57:52This is from Doctor Jose Pius, who is
57:55a child psychiatry trainee at Yale,
57:57and his question is,
57:59have you seen any downstream
58:01effects of your initiatives of
58:03the hospital such as or resident,
58:05such as resident Wellness,
58:07patient outcomes, or allyship?
58:11Yeah, you know culture is a hard
58:14thing to put your finger on,
58:16but you know you know it when you see it.
58:20I think. I think we we really do have a
58:23culture of cultural humility and of you know,
58:26creating spaces for people to
58:28have a soft place to land.
58:30I mean, I think that translates
58:32on into both patient outcomes.
58:34An resident Wellness.
58:35I I can't really give you our data.
58:38You know Doctor Pius, but what I will say.
58:42Is that I'm in terms of resident Wellness.
58:44You know, if you have have gotten people
58:46kind of reflecting and noticing things.
58:48If you're flying on one wing and it
58:51is the culture of your program to to
58:53see over zone that you just look a
58:56little bit off and somebody asks you,
58:58you know that can go along way that can.
59:01That can lead to an intervention
59:03and some some some major support.
59:05And then in terms of our patient outcomes,
59:07I think right now the best example
59:09is our patients. Who are, you know.
59:11Not sure about accepting the chobit vaccine,
59:13you know?
59:14I think that this idea of us building
59:16patience and respect and understanding
59:18that every black patient who says no to
59:21you is not somebody who is worried about you.
59:23You know,
59:23injecting them with something.
59:25Sometimes they just have a reason
59:26and you didn't ask them what it was.
59:29And so I do think that this culture
59:31of us trying to give to our patients
59:33where we will want given to us.
59:35I think I feel like that's sort
59:37of permeated and I believe that
59:39you know our residents.
59:40They're better than us, their generation.
59:42This generation they are such good people
59:44and I'm just trying to be like them.
59:46To be honest.
59:46You mean I don't care what
59:48anybody says they think that oh,
59:49they just want to get out of hospital,
59:51not the ones I work with.
59:52They want to take care of patients,
59:54an honor them and I think it's
59:56a lot we can learn from them.
59:59Here's the question.
01:00:01From Alanna Gregory Iolani.
01:00:03She was in the Writers Workshop.
01:00:05A handful of years ago,
01:00:07and it's at another institution now.
01:00:09Thank you for this excellent talk.
01:00:11I've enjoyed your reflections
01:00:12tonight as a primary care doc.
01:00:13I spent a lot of time trying
01:00:15to encourage my patients to use
01:00:17tools to help them cope with
01:00:18life's challenges and reflection.
01:00:20Seems like a great tool to use.
01:00:22Do you also encourage your patients
01:00:24to practice a habit of reflection,
01:00:26and if so, how do you do this?
01:00:29I mean, probably the same way that
01:00:30I do when I'm talking to anybody.
01:00:32I mean, you always say patients are people,
01:00:35so you know to some degree
01:00:36there's some formality.
01:00:37If I don't know to patient that, well,
01:00:39this will probably be something that
01:00:41would do more with patients that I know.
01:00:43But I was just telling this lady a
01:00:45few weeks ago that every day I take
01:00:47a selfie of some moment in my day,
01:00:49based on my emotion that I feel
01:00:51and I was showing them to her
01:00:53and we were laughing about it.
01:00:55And I was like, you know,
01:00:56that's the way you can kind of like
01:00:59just capture how you were feeling like
01:01:00what was going on in that day like.
01:01:03This was the day that I had just voted.
01:01:05This was the day that I just
01:01:07saw the results of the voting.
01:01:09This is the day, and so I,
01:01:11I think that there are lots of ways that
01:01:13we can offer to our patients to reflect.
01:01:16I think photos are one.
01:01:17I do encourage people to take photos of
01:01:19their loved ones in the moments that matter.
01:01:22You know I didn't take very
01:01:23many pictures of my sister and
01:01:25I actually really regret that.
01:01:27And so if you're not going to write about it,
01:01:30capture pictures so that you know you can
01:01:32save them somewhere and savor them later.
01:01:35So I think I do that.
01:01:41And then our next question is from Seonaid
01:01:44Hay and says thank you so much Kimberly.
01:01:46I feel so lucky to have spent the
01:01:49day with you. Your talks have
01:01:51been so moving and inspirational.
01:01:52My question is how to connect
01:01:54with patients and people from
01:01:56a different cultural heritage.
01:01:57You seem to connect so well with
01:01:59so many people so effortlessly
01:02:01and that makes you so effective.
01:02:03Is mission any tips?
01:02:07You know, you know,
01:02:08I think some there's some really basic
01:02:10things that I try to think about,
01:02:12and I just think everybody wants to be seen.
01:02:14It doesn't matter who you are.
01:02:16So for example, if I met you the first
01:02:18thing I would probably ask you is to
01:02:21teach me how to say your name and I would.
01:02:23I would ask you questions about oh wow,
01:02:26what a beautiful name.
01:02:27I don't know another seonaid can
01:02:29you tell me more about your name?
01:02:30What does it mean?
01:02:31Does it have a meeting and asking more
01:02:34and get to know more about you Anne?
01:02:36And listen and pay attention.
01:02:38You know, not be waiting to say something
01:02:40back to you when you're talking,
01:02:42but actually listen.
01:02:43And then the next time I see you call
01:02:45you by your name in the proper ways,
01:02:47pronounce it correctly.
01:02:48Don't change it into something else.
01:02:50Don't say hey,
01:02:51I'm I just call you CEO or
01:02:53something like that.
01:02:54No, I'm gonna I'm gonna call you
01:02:56by your whole name and so layering
01:02:57these moments where we we we start
01:02:59with the most basic thing which is
01:03:02respecting someone's name or some very
01:03:04simple thing is a place to start.
01:03:06And then, you know,
01:03:07broadening your life lens.
01:03:09I mean,
01:03:09if you if everybody that hangs
01:03:12around you looks like you.
01:03:14You know you gotta do something about that.
01:03:16I mean,
01:03:16we all do and I I looked I looked up
01:03:19at 1 moment and realized that all of
01:03:21the people that I call my good friends.
01:03:23They were black and anybody who
01:03:25was my friend who was not black.
01:03:27They worked with me and I and I was like,
01:03:29you know,
01:03:30I know some really cool people
01:03:31who aren't black.
01:03:32So I'm going to actually work
01:03:33at some of these friendships so
01:03:35that I can kind of brought in
01:03:36my life lands and have a deeper
01:03:39appreciation for other cultures.
01:03:40And I think that just starts to spill over,
01:03:42right? It leads to what we notice an.
01:03:44Who were willing to protect when
01:03:46we get on the hind legs about?
01:03:48You know, when I befriended a trans woman,
01:03:51my friend Chloe a couple of years
01:03:53ago is totally changed the way
01:03:55that I interact with trans women
01:03:57and trans individuals.
01:03:58I just think like wow,
01:04:00you know,
01:04:00I never all these things I was missing,
01:04:03but that's because my life was was
01:04:05broadened through a relationship.
01:04:06So I think relationships and
01:04:08then the basic thing.
01:04:09How you greet people and calling them
01:04:11their name and using their pronoun.
01:04:13I think those are really.
01:04:15Great places to start and can take you far.
01:04:24And I'll close it
01:04:26out by asking you a question.
01:04:27Since I'm hosting this,
01:04:29I'll just slide in and ask.
01:04:32So I'm I'm a resident.
01:04:34As you know an my question for
01:04:36you is what advice would you have
01:04:38for sort of physician writers?
01:04:40No matter our age that are
01:04:41that are starting out,
01:04:43maybe not starting out writing,
01:04:44but maybe starting out
01:04:45writing in the physicians,
01:04:47fear and kind of balancing that just.
01:04:49What are some pearls of
01:04:50wisdom you would give us?
01:04:54Well, my first Pearl of wisdom about for
01:04:56resident writers is their journals and
01:04:58this is what I say to our residents.
01:05:00I hope this is not offensive to anybody,
01:05:03but I always tell our residents and students
01:05:05that journals love the kids they do.
01:05:07I mean, they they love
01:05:09anybody who is not out yet.
01:05:11So look if you have not graduated
01:05:13from residency or medical school,
01:05:14submit show narratives to the
01:05:16annals and tajama because they
01:05:18just love the kids and us.
01:05:19They'll reject us,
01:05:21but they're like you.
01:05:23So number one know that people will
01:05:25want to read what you have to say and
01:05:27some of the most powerful things are
01:05:29written by you know people who are
01:05:31still like emerging in their careers.
01:05:33So that's one thing I'd say.
01:05:34And then you know.
01:05:37Finding different ways to write
01:05:38I think are good way to.
01:05:41Kind of you know,
01:05:42strengthen that muscle up some more.
01:05:45The the more you ride,
01:05:46the faster you right and the better
01:05:49you are right and it doesn't have
01:05:52to be a 1500 word essay every time.
01:05:55You can just write with no destination.
01:05:57You know when I stunned myself at
01:06:00how much I enjoyed writing on in
01:06:02240 character aliquots for Twitter,
01:06:05it just changes a whole different.
01:06:07Need to write an and something
01:06:09that caught me off guard,
01:06:11so I strongly urge you to
01:06:13just try different things.
01:06:14Sometimes just write 240
01:06:16characters and that's it.
01:06:17So something that can allow you to regularly,
01:06:20you know, work that muscle,
01:06:21then it won't be so hard when
01:06:24you get ready to try and then
01:06:26ask yourself you know Amanda,
01:06:28we were talking about this earlier,
01:06:30but I'll share with this group this
01:06:32question of what is what have you
01:06:35not read that you want to read?
01:06:37What story have you not been told?
01:06:39That you're like Dang I have
01:06:41not heard this story yet.
01:06:43Nobody has said this to me.
01:06:45And you know when I wrote that
01:06:46piece for The Lancet recently,
01:06:48I was like this isn't what I have
01:06:51not heard anybody say in the two
01:06:53things I wanted to come out of.
01:06:55That is one I wanted people to know,
01:06:58that Tuskegee is an institution
01:06:59of academic excellence.
01:07:00For for African Americans in
01:07:02is where my family comes from.
01:07:04Stop using the word synonymous
01:07:05with medical mistrust.
01:07:06'cause that ain't the only reason
01:07:08people don't want stuff so.
01:07:10That was one thing that was I hadn't
01:07:12seen it written anywhere and I
01:07:14wanted to put it somewhere where a
01:07:16whole bunch of people would see it
01:07:18and then also understanding that
01:07:20sometimes it's complicated why people
01:07:21feel like they want to say no to things,
01:07:24because when you think about what
01:07:25our people have been through,
01:07:27there's just a piece of you that
01:07:29like treats it like you know
01:07:31your sister on the playground.
01:07:32Somebody was mean to her,
01:07:34you don't wanna do nothing for them,
01:07:36no right.
01:07:37And so it becomes that and I wanted
01:07:39to tell that story so.
01:07:40Ask yourself, you know, I ask everybody
01:07:42who's been a part of the workshop before.
01:07:45Ask yourself what is the story that
01:07:46you wish somebody would say? Like?
01:07:48Where do you wish somebody would go
01:07:50but they haven't gone there yet?
01:07:52You'll be shot.
01:07:52There's a hot whole lot of things
01:07:54that people haven't said yet.
01:07:56Black Wives Matter was just something
01:07:57that I hadn't seen written,
01:07:59written anywhere, and I didn't want
01:08:00to wait for a Journal to publish it,
01:08:02so I said I'm putting it
01:08:04straight on Twitter and it.
01:08:05And it did what I wanted it to do.
01:08:08And I've been promoted so
01:08:10needed from a CD anymore.
01:08:12So Hallelujah.
01:08:18Thank you so so much.
01:08:19This is been a fantastic over an hour
01:08:23and a wonderful day with you and.
01:08:26I'm so glad that you're
01:08:27active on social media,
01:08:29so we can kind of keep all of these
01:08:32conversations going and continue
01:08:33to learn from you and you're just.
01:08:36Amazing and wonderful and thank
01:08:38you so much for everything
01:08:40wise to you and I'm glad that we've
01:08:43remained connected after all these
01:08:45years and I charge everybody during
01:08:47this this Black History Month too.
01:08:50Since you heard those words to all three
01:08:53verses of the black National Anthem,
01:08:56lift every voice and sing really take
01:08:58some time to listen to different versions
01:09:01of it that the the Ray Charles version,
01:09:05the choir singing it.
01:09:06Franklin on there so many versions and
01:09:09it's just a whole new experience of
01:09:11reflection every time you hear them.
01:09:13So I challenge you to all take a listen to
01:09:16that and reflect on what those words mean.
01:09:20Well, thank you so much. Bye
01:09:24everybody, thank you for having me.