Blog

At work, two thoughts are top of my mind this week – creating a compassionate workplace, and hiring people with ‘lived experience.’ Both are terms that have been rising in mainstream media and both deserve some deeper discussion. 

This has been a tough couple of months for me and my family. I lost one of my sisters at the end of 2021, and lost my oldest brother in January, the day before we started our Partner Convening. This past week, I had two nephews in separate ICUs, one recovering from a stroke, and the other passing away. I’ve been struggling in some moments, and fully functional in others. I come from a large family, the fifth of six children. My parents had 22 grandchildren, and the great grandchildren list keeps growing. I grew up in poverty, and to this day I can’t imagine how my parents supported us all on my dad’s salary. (When he retired after 33 years working for the federal government, his salary was less than mine in my first year after college.) I’m trying to grapple with my older brother dying in the same time frame as one of our nephews. Our worlds and experiences are that different.   

My nephew struggled with addiction and alcohol, and yet, even as we knew he was burdening his physical self, we never imagined that his body would give out on him so young. I’m reminded of the book “The Body Keeps the Score.” My nephew carried years of accumulated physical and emotional trauma and even when he was ‘well,’ those years took a toll on his health and well-being. 

There was a recent opinion piece in the New York Times that has also been on my mind – When Someone You Love is Upset, Ask This One Question? It suggested asking “do you want to be helped, heard, or hugged?” I tried that with my team this week to see how it would play out. I shared about my two nephews, my brother facing a decision about taking his son off of life support and how that was weighing on me. I knew that they would feel sympathy for me and my family, empathy for what I’m going through, but I knew I didn’t want to tell them everything about my life and my family in that setting. They could not help me or my nephew with this pain, but they could surround me with compassion. Standing on a street corner in La Conner after a meeting, being hugged by five people who I know are also going through their own struggles, was medicine that I needed at that moment.

For our teams, I want to offer space where they can bring their whole selves to the table, but that doesn’t mean they have to share their whole stories with strangers or co-workers. Their lived experience is their own, and they get to choose if, how, and how much they want to share with others. My job is to create a space that allows them to feel safe in what they have to give on any given day. We all bring our experiences with us – family history, personal experiences, laughter, seriousness, and trauma. We don’t need a trauma-filled workspace, but we do need space that recognizes that my mood, my affect, my willingness to lean in, my attention span, my level of engagement that can and will be altered by things that my coworkers can’t see, and I may not want to bare all to them.  I want no assumptions made about why I am behaving in any certain way. Curiosity yes; judgment and assumptions no. Asking if there is anything I need, yes. Assuming I need to be fixed, no.

I share with colleagues that I’m always amazed at this emoji – 😂 – wondering if it is laughing while crying, or crying while laughing. It sounds silly, but when I am at my most vulnerable, some things can still bring me joy, or make me laugh. And when I am feeling joyful, parts of me still feel pain and tears at the underlying emotions that sit around our stories. It doesn’t mean that I am “fine” or that I’m “not fine.” I can be both at the same time. So if you stop me and ask me how I’m doing, my answer depends on how large of my own eco-system I’m responding from. “I’m doing well.” “Nanc and I are doing great.” “Our kids and their families are doing fine.” “I am grieving and suffering.” “My nephews lived really challenging lives, and we are all hurting around them.” All of those sentences can come forward at the same moment and all be true, and I never know which one will come forth first. At the same time people are being shot for knocking on doors, for pulling into a driveway, for rolling a basketball on a lawn. How can any of us be totally fine? It depends on how wide of a circle I’m responding from. 

A compassionate workplace would allow space for all of those, not because we need to pull a fire alarm, but in order to recognize that whole and amazing human beings can also be hurting, harmed, and living with things we are unaware of. Imagine a world where we can all be whole human beings and no one is trying to tell me a story with only one arc to it. It’s a lot of work, takes some trust and vulnerability, and it is totally possible.

In mid-February, former President Jimmy Carter opted for hospice care, and the media immediately began writing eulogies and obituaries, as if entering hospice means that death is imminent. In the statement from the family, “the decision was made after a series of short hospital stays.” It reminded me of my dad, who also chose hospice after a hospital stay where he realized that for him at 96, there was no cure for what was happening with his body. He wanted to be seen as a whole human being, and not as a patient who was dying. He wanted to live the rest of his life in peace, with family, in comfort, surrounded by caring individuals. He enrolled in hospice and lived for another 16 months. Eight years earlier my mom also chose hospice, but she had to advocate for it within her health system, and was so relieved after doing so. The reason she had to fight for it: her clinical team was afraid that she would give up her will to live if hospice was presented to her as an option.

I think sometimes we forget that being inside of a medical-treatment and cure-focused system is exhausting and takes its own toll on those who want a more peaceful arc to their lives. I’ve been thinking of the Carter family a lot this week, especially with the more recent news that the former president is ‘doing well’ in hospice, and I applaud their bravery in sending these messages out publicly.

How does this relate to North Sound ACH and its themes of belonging, targeted universalism, and equity? It is about how we belong to and with another, how we provide care and nourishment to each other, and how we make each person be seen in their total humanity, leaving space for our uniqueness and our commonality.

Imagine if we could do that in all facets of our lives, not just the final days, but every day? If those themes of caring, without thinking of cures, could extend to our policies around housing, employment, food security, immigration, transportation, health, and yes – even health care. If we can bridge themes of leading with belonging, humanity and love, we can accomplish so much more than by crafting more boxes, eligibility criteria, and rules that allow some people access while denying access to others.

Our histories differ, our current situations differ, and our access to meeting our vital needs differ. What we hold in common is our humanity, the fact that we are here and part of the fabric of our communities, and we will not heal if we allow portions of that fabric to continue to fray. For us to create a space where all belong, we must truly see and welcome everyone in the common space.

Be well,

The past twenty-four hours have brought snow, hail, rain, bright blue sky and tremendous winds. It must be getting close to spring, right?  

We held the first in-person partner convening in three years in January, and it was a mix of emotions – joy, passion, camaraderie, frustration, and challenge to do better and take more actions. New relationships were made, and I’ve already heard of small groups that are continuing to meet since their ‘open space’ discussions. We have almost twenty project submissions that have been submitted so far, and the Regional Projects Investments Support Committee (formerly called the Review Committee) is eager to start reviewing and approving them to move forward. 

For the past six years, one of the largest responsibilities that North Sound ACH has undertaken is a partnership with the Washington Health Care Authority (HCA) to carry out its Medicaid Transformation Project – a federal waiver that allowed initiatives to flourish and grow to advance the health and well-being of people on Medicaid. It was an incentive-based agreement, and there were things that each region had to demonstrate in order to earn dollars for the region. And oddly, while the work is completed and there are no more deliverables, we will not receive the last of North Sound’s earnings until mid/late 2024.

That leaves us with unprecedented opportunities to imagine how we can invest dollars to advance equitable well-being across the region. That’s what we have been seeking from you in reporting, surveys, zoom discussions, and the partner convenings. Who could have envisioned that we’d be hearing demands to acknowledge historic and current oppression and harm, and learning a salsa dance in the hallway? Laughing at the joy of seeing people in real life, and feeling the discomfort of painful truths that must be learned and recognized. I have lived my life ‘in-between’ – visible and invisible, marginalized and in seats of privilege, access to leaders with power and had my voice muted. What we are asking members of the network to take part in will not happen in any single meeting. Movements rarely do. But I believe it will continue to grow, as we find space for those who are impatient and those who are so new they don’t know what the impatience is about. We can have joy and lean into discomfort in the same day, the same hour, the same meetings. We must. And, as we build trust and relationship it will become more clear just how far we can move this work forward. 

Another thing that the end of the (first) Medicaid waiver does for us, is provide a period of transition. Internally things are changing at North Sound ACH, and we will announce some of those changes in the upcoming newsletter. New and emerging leaders are stepping into roles that have been crafted because of your input. In the second quarter, we will be hosting a convening of DEI leads from across the Network (if interested, please fill out this survey), and planning for a region-wide Community Health Worker convening. 

I appreciate each and every person who shares their ideas with me and our team, even when you think we don’t want to hear what you’re saying – we do; and we incorporate what we learn into our upcoming planning. Throughout my career I’ve often said “I don’t need another someone just like me; I need someone who brings other perspectives, other experiences, other purviews – how else can I learn what I haven’t seen?” That’s what our team does, what you add to us and to each other, and I hope you will continue on this journey as we continue to make this region one where all feel they belong. 

Be well,