When an American acquaintance of mine, out of her kind heart, offered to be my teacher of American popular culture, I started questioning myself. Do I appear this dumb, after 1/4 century stay mostly in higher education section?

This reminds me of the talks people so much enjoy engaging daily on how this or that dresses, in or out of fashion, and how much importance people attach to being right in one’s dress. Last week, I noticed how a CRC looked up and down at a monitor, as if making judgment on how people dressed.

All this reminded me of the time when I first reached this land in 1984 in Waco, TX. A nice highly religious lady, in an attempt to civilize me, blessed her heart, taught me how to eat apples. I was very much tempted to crack a joke telling her I used to live in cave or just got used to life off the tree. A salesgirl at a camera store ignored me at first but took a 360 degree change of attitude when I insisted on seeing her manager. All because I looked like a refuge fresh off the boat instead of a Ph.D. candidate.

Looking right has been important from very beginning. Yet I have all these years conveniently ignored it, lazily gone by my own rule, refused to yield to the shallow and superficial part of American culture, well, except during job interviews when I cared to look not-like-me. Meanwhile, I have observed the spectatular ignorance demonstrated by the nicely dressed and thickly-powered folks. A constant source of amusement at work.

It is so funny that both of these should occur on the same day. Yesterday morning, we had a meeting introducing another must-take-annual-training-course “Just Culture.” I had a great expectation before meeting, but was disappointed after that.

I thought it was going to be focused on being positive and respectful, no gossip and dirty language at work place. Got really excited over the change of office culture. Instead, it emphasized on being legal and lawful, doing nothing against rules, regulation, laws and orders. Do not do anything to get us into legal trouble. The purpose is to create a culture in which everybody automatically follows laws and rules. This is actually another version of compliance training.

In the morning, something rather unpleasant happened because of lack of a good work place culture. A colleague asked me about a patient. I wrote back saying it was not my patient. She wrote back saying I should do this or that, even if it were not yours. When I went to her office to explain, both the office dwellers said the same thing to me, and even worse.

I was extremely upset over their undisguised arrogance and immediately wrote an email but did not send. Why don’t people use “Can you …” instead of “you should …” as if they were some kind of boss barking out commands when they are nothing of this sort and are in no position to tell me what I should or should not? I resent greatly this kind of bossy attitude.

One step forward, even if they were boss, respect is still in high demand. Why is respect so much obviously absent among people who dress like going to Sunday church? The discrepancy between the appearance and the behavior defies explanation.

What a just culture or lack of it or whatever you name it! I shared this office experience with my daughter in the evening. She told me not to let it bother me, “Not worthwhile to think more of it.” I wrote to a friend of mine who wrote to me with this …

“I wish so badly you weren’t treated with such disrespect there… I will keep you in my thoughts and hope that the situation improves and that things will blow over!”

Now dust has settled and peace finally returns.

P.S. I am currently reading a book on American work place culture, Then We Came to the End: A Novel by Joshua Ferris. A depressingly true presentation.

The doctor next door to my office was Women Who Mean Business honoree for the year 2008, chosen by Kansas City Business Journal. She is the only doctor in the list. She is one of the few doctors here who is easy to get along and has the least air of importance around her. Sometimes, I was wondering why other doctors couldn’t be like her. Now I know why.

On 10/15, one of my colleagues sent out an email, asking us if we would do something for our boss on the Boss’s day, like what they did last year, inviting the boss for lunch. I turned it down flatly as I am straightly against any activities that aim at bootlicking your superior and sacrifice my integrity, even though everybody does it and makes it a tradition here.

Last week, a big mistake committed by a colleague came to my attention. But as it was not up to me to point it out, I chose not to say anything to that person. I confirmed my view with another colleague of mine, who properly revealed the issue to some related person who wrote the doctor, without getting me involved. Alas, it takes so much to bring it into the broad light.

Yesterday I copied and gave my posting on work hard and spend harder to one of my colleagues, who asked for my blog site and was turned down. “You must have written about me on your blog,” said she. Well, on hindsight, I should not have shared so much in the first place, though I have nothing to hide from her.

The World Health Organization has called chronic job stress a “worldwide epidemic.” Work-related stress seems a part of modern life and culture, especially if one has to work in a company. Facing constant threat of layoff and deadlines, encountering and dodging unagreeable people everyday, modern stressful life causes stomach-irritation, appetite-ruining, sleep-deprivation, fatigue syndrome, general decline of health, and even cancer.

If you have choice, you can leave the stressful position and go with some less stressful one. Yet, for most of us, stress-free job is simply not an option. Still, no need to be pessimistic. There is forever one thing that is within your control, your attitude, regardless of your environment. Yes, you can always choose an attitude and a mentality, that gravitates to stress-free and to your health and benefit.

This is from a monitor who used to work for US government, that is, for CDC. Now he is working for a private company. This is what he told me. “It never pays well if you work for government or for university. Only private practice pays well. The tradeoff is you have more security working for government or university but not enough to live well. You got paid well working for private practice but never have the same level of job security.”

This is true in the past, but I am not sure how things are now and how it will be in the future. Also, I realize he has to travel for 80% of his working time, away from home, from his responsibility as a father. Because of this I would say he has to pay dearly for his well-paid job. Yes, the cost of his well-paid job is the joy of his family and the hardship of constant travel.

Life consists of so many tradeoffs, though not always of equal value. We always compromise, sacrifice or give up something in order to gain something else. I hope my children will follow a rather different path from that of this monitor and will take whatever job, government or private, as long as they don’t have to compromise the joy of their families.

A company that I know of has an internal newsletter, which is supposed to be something relevant and interesting to the rank-and-file employees. Instead, it has become the showcase of the company and the upper management. It is getting more and more irrelevant to the employees, not even providing short fillers to entertain, so much so that some people trash it without opening. Now, the MyNewsLetter is better known as myBossNewsletter, as the newsletter writer, being hired by the upper management, seems to succumb herself to be a mere mouthpiece of those who pay for her.

This MyNewsletter, being severely lack of job integrity, reminds me so much of the newspaper in China a quarter of a century ago. At that time publications served wholly for party’s propagation, with newspaper being the direct mouthpiece of the controlling party. Things are a whole lot better now in China.

It is a great pity that the newsletter writer abandons a more interesting route, that is, go to each work sites, meet people, talk with those working down grass-root level, read what the customers write about the employees, seek out stories, and scoop something news-worthy enough for people to read. Indeed, life is as interesting as we represent it.

In applying for CCRP exam, I had to write a description of my job. Hence I scribbled the following incomplete and much simplifiied list, which excluded any unpleasant details that is also part of the job. Such as dealing untoward persons everywhere. I am amazed at how much I have to handle or how much fun that I should enjoy.

(1) Review extensively physician and clinical documentations, lab results, CT reports, pathology reports, and treatment plans in patient’s medical record to verify and process data.
(2) Ensure accuracy, integrity, compatibility, and compliance of data in accordance with related federal rules and regulations and industry’s standard practice.
(3) Capture all related identified or de-identified clinical research data
(4) Prepare for and assist federal, sponsor and network company audits and monitoring activities.
(5) Function as the contact at the clinic for auditing and data monitoring activities.
(6) Participates in education, training and activities regarding clinic research.
(7) Resolve and handle data discrepancies with sponsors
(8) Process sponsor regulatory documents at the clinic level
(9) Obtain medical records from outside facilities when needed
(10) Update company’s internal clinical trial management system
(11) Response to sponsors’ request for medical data
(12) Maintain open communications with physicians, project managers, nurses, clinicians and sponsors to clarify, verify, confirm data and ensure the proper documentation, data integrity, and accurate and complete collection of subject data.
(13) Maintain open communications with monitors to clarify data and resolve data discrepancies.
(14) Develop and enhance internal data verification and collection system
(15) Explain protocol to the patient when needed
(16) Involve the screening patients for clinical studies
(17) Help making schedule according to protocol when needed
(18) Write protocol deviation when needed
…
I surely do not suffer from lack of diversities.

Here’s something interesting which I daily observe in our healthcare field. The doctors almost never talk to non-doctor others unless being talked to. Their faces are poker-like, lifeless. When they are talked to, they are very curt and laconic, absolutely no nonsense, as if they were totally above any trivialities or small talks like the rest of humanity. But they transform into different persons when they are among doctors, taking off their masks, sitting around, chatting and joking.

I asked a colleague of mine, “How do you explain this?” She agreed with my observation but was totally clueless. If I say I am as clueless as she is, I am telling a lie. I have seen too many birds in the forest and can easily see through the mask of authority on the expressionless face of some of the doctors. One might be wondering constantly what it is beneath the mask. Well, nothing deep. Actually they are not as complicated as one might think. I feel sorry for them when they have to carry the air of importance and behave so unnaturally outside their doctor circle. Life is so beautiful when the sun is out and everybody is randomly kind to each other. If not, you have to picture it in your head.

Call me hopelessly optimistic. I shall not think myself otherwise.

A small incident of miscommunication happened in my office on 8/18/09. A project manager asked about the status of some task. Instead of saying something like this, “I have been busy lately and will get it done this week,” the responsible person P1 emailed back listing what had kept her busy lately, which implied that she had done the work that should be done by another person P2, as if P2 had been negligent over her duty. She even cc’ed P2 this email.

Nothing is more thoughtless and imprudent than this email! P2 was furious over this email, writing back with a vengeance. Upon receiving P2′s email, P1 sensed the furor in the writing and wrote back about 10 paragraphs in length, full of explanations, trying to put out the fire. However, the damage cannot be undone regarding their working relationship.

Thanks for providing an example of the consequence of thoughtless writing! To me the incident emphasizes this — a good communication requires due respect and consideration, no matter where you are, at home or in your office.

During our second workshop, we learned theories on motivation — what motivates people to carry on their daily activities. We first learned Maslow’s hierarchy of needs, from the lowest level of need for self-preservation — food, clothes, and shelter to the highest need for self-fulfillment.

I still like what Psychologist Carl Rogers said about ideal self, that is, there exists in most of us a self-perceived self, a real self, and an ideal self. The ideal self is the one we aspire to be. I am motivated by the belief that there is always a better me, an ideal to pursue, always a goal or a new benchmark for me to reach. Tomorrow or next year will find me better than I am now.

Here’s what I learned from the workshop — most people live each day without any stuff like this at all. They express their really basic need for mere existence. Imagine the frustration one might feel sitting through the whole two hours observing these people with least entertainment!

This morning, bright and early at 7 AM, we had a clinic meeting on Dr. Geffen’s Seven Levels of Healing program. To be sure, this was created for cancer patients, but I think it useful for anyone who has to go through any devastating experience brought upon either by disease or any unexpected and unfortunate events in our lives. Here they are, thanks to Dr. Geffen.

Rebuilding the Bridge Between Body, Mind, Heart and Spirit
Level 1: Education & Information
Level 2: Connection with Others
Level 3: The Body as Garden
Level 4: Emotional Healing
Level 5: The Nature of Mind
Level 6: Life Assessment
Level 7: The Nature of Spirit

Detail information can be obtained from Dr. Geffen’s site,

http://www.geffenvisions.com/seven_levels_of_healing/index.htm

On level 6, Life Assessment, we are asked essential questions like this,
“what is the purpose of your life?”
“What do you want to achieve in your remaining time?” [may be days, months, years, yes, life is so freakingly uncertain]
“What do you want your loved ones to remember you?”
etc.

It is interesting that we tend to put off these ultimate questions in our lives until we are ravaged by life-threatening event. But questions like these knock us like a waking-up alarm — wake up from your humdrum, unexciting and uninspiring existence, value what you have, fling yourself into the excitement of living. Yes, get more than the maximum out of it, while we can, because we got only one life to live.

The company issued to us “10 Commandments for Your Workplace” created by Harvey Mackay. Like the Ten Commandments in the Bible, the emphasis on these points only projects the reason behind this emphasis, that is, the sorrowful lack of them among the employees. To be sure, these are very good points, rich and sweet. That’s why I post them here to share with my readers and hopefully with my children someday. Comments are mostly my words.

(1) Be respectful, including people’s ideas, views, time, manners, etc.
(2) Follow through — if you promise it, do it no matter what.
(3) Think before you speak. Don’t exercise your freedom of speech at work
(4) Help out — go out of your way to help whenever you can, always
(5) Learn something new everyday — grow and develop for your own good
(6) Pay attention — don’t bury yourself in your own desk, keep your ears open to going-ons around you.
(7) Ignore pettiness — think BIG, rise above, always in life
(8) Be patient — you will lose everything if you lose your cool
(9) A good attitude is up to you — be a positive factor wherever you move your graceful self
(10) Do your best, in all situation and under all condition. You are the one who need to answer for judgement of your conscience.

Yesterday I met a neighbor of mine at the local grocery store. Most of the time we see each other and say hi and are too busy to chat, but not today.

She asked about my children, then the topic moved to her plan. I learned that the only bread-earner in her family lost his job recently. Though he found one later, the pay was far less than before. “We will probably work till [age] 70.”

After that, I kept thinking of her and feel sorry for my neighbor. What makes some people keep on working at age 70 and some others can retire before they turn 40? The only factor that determines when we can retire is money.

My daughter said, “How boring it is if you don’t work.” Unless you day job is exactly what you are interested in, you are better off turning to your real passion if you have this money.

Yesterday was a busy day — meeting early in the morning, monitor visit after that, fetching my daughter from school at noon, and leadership workshop at 3 PM.

On homework for yesterday’s workshop, we were supposed to ask 6 people of this question, “How would you describe the workplace culture here …?”

My partner and I each got 6 responses from 12 sources. While the responses I have received are almost all positive, those of my partner’s are just the opposite, partially because she assured people they were anonymous.

My attitude toward all positive input is, somewhere some people have not told the truth. It seems we need to cover our face to reveal the truth. Or some express what the workplace culture should be instead of what it in reality is.

I view negative input (criticism) as being more helpful than praise. First of all, people care to provide lengthy input. I would not spend that much time. Secondly, criticism opens our eyes to places where improvement is needed. Criticism has the potential to bring about changes, advances, and progress. If we are all content with our status quo, we feel no need to change, innovate and advance, and just wait for a sad ending.

I was shocked over some people’s attitudes toward negative input. They got defensive, trying to invalidate any negative inputs. In fact, other than the organizer, all present got defensive. In fact, their attitude toward criticism is nothing but negative. No wonder people want to remain anonymous — the only way to tell the truth. It is all because of this hopelessly non-confrontational lie-telling American culture. Happy Friday.

Don’t give up your paycheck to chase rainbow or go birdwatching or whatever catches your fancy.

I am not a big fan of the 2007 Consequence debut album — Don’t Quit Your Day Job! Yet, don’t-quit-your-day-job reveals so much of the conflicts between what we have to do and what we would rather do during the day.

“It would be so nice if your day job is what you are talented at and also what you are interested in,” I told my daughter dreamily. “That doesn’t happen often,” she soberly reminded me.

You may be talented in singing, dancing, drawing, even blogging. But if you cannot make a living in the field of your talent, you are better off flipping burgers and at least get paid for it during the day.

It brings to my mind my favorite Russian writer Anton Chekhov. His day job was a medical doctor, moonlighting as a writer. In his own words, “Medicine is my lawful wife and literature is my mistress.” It must be exhausting to support a wife and a mistress. No wonder he lived only 44 years.

Isn’t that tragic? I wish we all could reconcile the two. So nicely goes the day job.

How are these values important to you — least, somewhat, or very important? That’s what our company asked us to answer in a monkey survery last Friday. I am sure these values are industry standards, not invented by us, though I don’t know where they copy them. To be sure, most of them are sadly and painfully absent here. Here they are.

1. Customer Service
Committed to service and quality; deliver strong customer service; believe everyone is a customer; strive to exceed our customers’ expectations; put our customers’ needs and desires above our own; measure our success by our customers’ satisfaction

2. Accountability
Take responsibility for our work and actions; act like owners; deliver on promises made; have a strong work ethic; pride ourselves on operational excellence; take pride in the work we do

3. New Ideas
Welcome new and different ways of thinking and working; are constantly thinking, “How can I make this better?”; value a spirit of continuous improvement; embrace technology and the efficiencies it enables; are innovative

4. Communication
Demonstrate candor, honesty, and forthrightness; express opinions willingly; value and respect the thoughts and opinions of others; are active listeners

5. Energy
Demonstrate sense of urgency; are fast-paced and active in our work; have a positive, can-do attitude; are self-motivated, self-starters; approach work with excitement; are energized by a desire to help others

6. Results
Meet commitments and deadlines; are metrics-focused; approach projects with stated goals and objectives; are decisive, assertive, and persistent in our convictions; meet customer and financial objectives

7. Collaboration
Value a team approach; seek feedback; build consensus; value trust rather than control; give credit to others vs. take; are flexible; support organizational goals

8. Analytical Thinking
Understand complexity; are analytical; show intellectual curiosity; are students of healthcare; are problem-solvers; are experts in our fields; learn from our mistakes; make informed decisions

9. Respect for Others
Respect others at all levels; develop and value relationships; engage with others; exhibit humility; are sensitive to the values inherent in community-based cancer care; treat each other fairly with courtesy and respect

10. Ethical Standards
Seek to do and say the right thing; are trustworthy and honest; respect confidentiality; adhere to a clear system of ethics, standards and values; comply with US Oncology’s Code of Conduct; pride ourselves on operational excellence

11. Self Care
We honor and care for ourselves as multidimensional beings – body , mind, heart and spirit. We take responsibility to care for ourselves on these various levels in order to live fully with focused intention. We seek to cultivate peace, love and joy within ourselves and to share this with those who enter our circle of care. We value a balance between work responsibilities and our personal private life.

I vote “very important” to all of them.
P.S. I asked HR person who invented the above. The answer confirmed my initial thought. They copied them from the Internet somewhere, but forgot where. LOL.

Yesterday morning my son left home with his high school friend, driving their big vehicle. My worrying mind has followed them all the way to Atlanta, Georgia. Thank God they reached there in the evening, safe and sound.

During evening walk with my daughter, she said she missed her brother but she chose not to think about it. I told her the only thing she could do was to do something that could make her brother smile, like getting good grades and some other achievements. For some reason, she plans to take private violin lessons. Fine as long as she practises it.

While my son was home, short as it was, we had no time going out for a walk as we did before but we did talk about many things. I am always amazed by how young people think these days and how they are different from the way people of our generation do.

When we talked about college majors, I thought it very good to go into healthcare, as there was a perceived demand for such job and it promises high job security. But my son said it had very limited pay potential, even if you were a doctor. Indeed, it is true a MD has little chance of ever breaking its ceiling to reach even half a million. He would not get into any profession with a limited income. I never thought it this way.

Every time I talk to him about his occupation, he always gives me the feeling that life is so exciting and full of opportunities, with the sky being the limit. There is always something new and fresh, out-of-box thinking, vastly different from the way I think. He must be characteristic of his generation and I of my generation. We are intriguely different from each other. Because of educational background or cultural difference or different parenting? It is too interesting to be dwelled upon in detail now, something for me to think about later when I have more time.

I am not sure if I have written anything regarding this experience, but something happened last Thursday reminded me of this experience again and I felt a strong urge to possibly re-write it, even if I might have written on this before.

The monitor wanted to see a document which was requested over two years ago, even before I came into the team and I had no idea if that document was ready for monitoring. Plus patient’s record was not immediately available since patient expired two years ago and her records was sent to storage.

So I went to ask the person who should be responsible for this patient. That person, immediately sensing something went wrong, yelled at me for not having patient’s record ready for the monitor, her eyes like a pair of daggers out of a honey jar. I did not utter a sound. I just shut my eyes for I saw what I had witnessed during Halloween night when I suddenly opened the door and in rushed a vampire with bloody distorted vampire fangs, sweet and threatening, ready for action. I felt strongly about knocking out that fang pair. To be sure, she did much more than what I describe here. She also called the project manager spitting out more words unsuitable for any gentle ears. How I wish I could erase this miserable experience from my memory!

Number one, the monitor did not request this patient’s record in her pre-visit letter. I normally do not request chart to be retrieved from storage if monitors do not request it as it cost something extra for the retrieval.

Number two, this is not my patient and I have no idea what have been done in this regard. Remember I was not even there during her last visit 2 years ago.

Number three, I dislike strongly to be yelled at, just as an innocent baby hates to be inhumanely treated or being unreasonably kicked. One thing I find it extremely hard to stand is hearing f word throwing in the air all the time. I just take for granted that I work with an extremely mentally and psychologically perverted patient everyday. No other explanations. Honestly, I avoid this person as much as I can. Not that I am afraid of anyone, but that I value myself too much to allow my mind and spirit to be polluted by such a unworthy patient.

I used to think there is inconsistency in some people’s behavior — nice some day and nasty some other days, probably influenced by the hormone fluctuation, beyond personal control. Now, I announce that consistency does exist, that is, consistently mean and nasty, obnoxious and hostile, as if a lethal fluid running non-stop in that person’s blood. Yes, have you heard of non-stop infusion? Here it is.

Shut your eyes and imagine how it is felt to be biten by a mad dog. It is okay to be thus biten, considering it is of a different species, but the sad part is we humans never bite back in the same manner, do we? One has to remain funny in a mean way, if necessary, just to stay sane and sound, and not away from one’s principles. Honest, it is hard to be around such species everyday! Had I have a choice, I would stay away from mad dogs. I simply want to avoid being bitten by a dog. Blame me for being too civilized.

Yes, you can see I am not in a good mood when I think of this event. Hopefully I can forget it after this posting and start enjoy this sunny day.

PS. 5/19, I couldn’t believe I was in such a mean spirit. Well, if it is how I felt at that moment, as always, let truth stands as it is.

We had a very interesting workshop on leadership yesterday afternoon. During our last meeting, we were given 5 leadership ability pre-assessment forms. I gave one to my manager and three to co-workers, keeping one for my self-assessment. It is supposed to be anonymous. They sent the completed forms directly to XYZ, the person in charge of the workshop.

To my surprise, XYZ gave back to us the results together with the complete forms. I could tell who did what even if their names were absent, their handwritings easily betrayed them. Some people stared at the results, utterly speechless. The discrepancy between their own and those of others must be shockingly and disturbingly huge.

The assessment rating goes from 1 to 4, with 1 being very weak and 4 the other extreme. I ranked my leadership ability mostly 4 and 3, very few 2s, and never weak on anything. Big ego, right?

But the one with whom I work closely everyday gave me either 1 or 2, mostly 1, absolutely no 3 and 4, which means, I am weak on almost everything and strong on nothing. I feel like out and out happy-go-around good-for-nothing. A blissfully happy idiot.

I shared it with my daughter, who said it was insulting to give this rating. To be sure, none of these assessments are free from bias, including that of my own. They are all rather subjective . There is no point to argue about the truth or authenticity. The amusing part is seeing the vast difference between perception of mine and that of this co-worker, though I don’t care even to know why they are so different in their perception of me.

If anything, it is a very good exercise. I hope my children could take this type of attitude if, in the future, they faced similar situation. Remain undisturbed no matter what is said of you. What others think of you is not as important as what you actually do. Do the right thing, always.

For me, I am more amused than anything else, least disturbed. I wonder if they would give the same assessment if they knew the results would come back to me with their true identity fully revealed. LOL. Another exercise for your imagination.

Happy Friday!
By the way, we have a lucky day today — month 5 times 3 = day 15 and weekday is also 5. What a fun!

To be sure, we do need some help occasionally at work, but whom to go for help is an art in itself and that gives me some thought about parenting and about how we give help. You got to know the person really well before venturing out. Not fun to figure that out, but a necessary evil.

There are two co-workers that I have heard of. People normally go to one and only one if people have any questions and avoid the other one as best as they can. The other one will surely chew you thoroughly out as soon as you approach her with some questions. Very touchy, irritating, cantankerous, any unpleasant term that you can dig out. You can feel she jumps over you simply at the thought of going to her. The worst part is you never know what she will do next, just to make sure you are having a hell of time.

The puzzle is she is totally unaware of how much she tortures others this way. Her attitude serves as a never-failed mirror, showing people how not to behave like this when we give out help as parents or co-workers. Sometimes, I feel a strong urge to reveal this baby-simple truth to this co-worker — each of us is extremely limited in our ability to help and to make difference in brief span of time on this hugely polluted planet. But I prefer to keep it to myself.

For my children, embrace each opportunity to reach out and help. Well, make sure not to over-reach any boundary that you might bump into.

We are having a workshop on leadership lately. Not sure if it is ever useful to me. Still, as I am exposed to some ideas on leadership, I have discovered that these are actually nice ideas, so wonderful that I am going to share with the readers here. It might be of some help to us as parents. You might be surprised to learn that leaders are humans first, leaders second.

Traits of Outstanding Leaders and Parents.
To be sure, the workshop was never on parents, but I keep thinking it for parents. Call it professional bias. Here are the four major traits.
1) Nurturing ongoing and interactive relationships
~~~~Allow for an equal exchange of ideas (so that they feel comfortable speaking up what they have in mind)
~~~~Consider the needs of employees (show you care about them)
~~~~Meet the needs of employees (so that they are willing to go extra miles for you)
~~~~Validate employees’ concerns (you actually listen to them)

2) Being in touch with innermost thoughts, feelings, and values.
~~~~Cultivating alone time
~~~~Connecting with nature
~~~~Assuming distance from the mission
~~~~Mediating and thinking deeply
~~~~Enjoying silence and solitude
~~~~Reflecting and writing
~~~~Visualizing and relaxing
~~~~Exercise regularly
~~~~Reading continually
~~~~Engaging in creative activities
~~~~Knowing yourself
Have some time at the end of the day for yourself, stick to your exercise schedule, take time to relax. Some people say exercise is an outlet, letting out the steam built up inside.

3) Walking the talk– act in a manner that is consistent with your words, practice what you preach. It is the epitome of leading when talk and actions fuse. Good leaders must truly believe in what they are doing. Sounds so familiar to me. Of course, the leaders learn it from Parents magazine.

4) Leading by influence — use influence instead of force. No spanking, that is.

It gives me such a warm fuzzy feeling to imagine having leaders fully equipped with these traits. Well, don’t be silly.

Some of my friends have asked me about jobs at healthcare industry. Are they secure? They were wondering. Not exactly. Nothing is guaranteed and nothing is secure. Face this reality — anything that can be digitalized can be offshored. e.g. medical transcription, radiology images, medical coding and billing. You can always scan the paper, the bill and transfer it anywhere you can find cheap labor to analyze it and file it to the insurance company.

At least two key trends have been made possible by IT and Internet. The first trend is going electronic in as many fields as possible, eGovernment, eHealth, etc. The general rule is any jobs that need in person service in health care, like doctors and nurses, cannot be outsourced.

The second trend, also made possible by the Internet, is more and more companies are seeking for global solution, which means seeking globally for cheaper solutions and high profit. The fast development of IT and Internet opens unlimited possibilities for the way a company organize and runs its business.

Face this fact, if you think you can put on a white uniform working securely in a lab, chances are someone in other countries can do a similar job or even better job than you, all at a fraction of your paycheck. There is nothing to stop the off shoring of this whole lab. This is only one possible scenario. Not that far-fetched when you are in dire need for cheaper solution. That is, until everybody’s labor gets cheaper not by dozen.

As I promised the day before yesterday that I will get back on stress at work and the way to stay away from it. I realize this list is getting longer and some people might not need to be told of them. Such as, a compulsively neat and well-organized person needs to build up tolerance for the not-so-neat.

(5) Be Organized, especially when we need user name and password wherever we go. Nothing can get you more panic-stricken than forgetting your password and losing that piece of paper on which all your important stuffs are stored.

(6) Always work from a list. That is, make a to-do list the first thing in the morning and work from there. On the one hand, you got a clear picture of what is needed to get done for the day; on the other hand, it always gives you a good feeling to see them done by the end of the day. It is a good practice for anyone either at work or at home.

(7) Be prepared and proactive. From my own experience, nothing causes me to sweat more than being caught unprepared when a monitor showed up at the door. You feel a sense of control and less stressful when you are well-prepared.

(8) Good communication with your supervisor . Someone suggests making your needs known to others in your work place, that is, at discretion and right judgement. Sometimes, especially for very private persons, you feel less burdened if it is shared and understood by your supervisor. Again, you determine what is needed to shared with others.

I am sure there are more ways to make your work experience enjoyable. Once again, a positive attitude always all the time heads the list, be hopelessly optimistic, which reminds me of a book that caught my attention lately, Always Looking Up: The Adventures of an Incurable Optimist , by Michael J. Fox, an actor and a patient of Parkinson’s disease. I love his book along with his shows. Program your mind to be this incurable optimist. Incredible? Yes, your mind is programmable.

Last weekend I read an online article on job stress, which, I thought, is related to both our health and work experience. Nowadays, people who are not sacked out of labor force have to work under unprecedented and unhealthy stress, if nothing else, just to hang on there.

When we do what we have to do, the need to “enjoy” doing it against our will is extremely important. It’s like you trying to enjoy beating your brain out with a heavy-duty hammer. Well, a horrible scene indeed. Therefore, here are some of the tips that I garner from my reading and my own experience.

(1) Yes, your attitude is the number one factor. It determines your life’s experience, no matter where and when. Negativity in your outlook and total attitude toward people and your work poison your day more than anything else. Be nice, always, randomly and purposelessly, like an idot.

(2) Keep a record of your achievements. Take time to celebrate yourself when you feel you deserve it. Pat your own shoulder if nobody else does it. You must be the first to recognize your own effort, progress, and accomplishments. Call it big ego or whatever. I do it all the time just to make myself feel good and I need to feel good to move on in life. The ugly fact is –if you don’t see value in yourself, nobody ever does. How not pleasant!

(3) Keep fit physically. An old Chinese saying which I often quote to my children goes, “Sharpening your ax won’t take time away from your woodcutting.” In other word, when you take time off to sharpen your tool, it won’t leave you with less time for your work, because a sharpened tool will enable you to work more efficiently. The plain message is take time for exercise daily so that you will be happy and energetic, stress-free. Beside, a thorough workout can serve as an outlet for your pent-up, suppressed energy, especially when you work at customer service section.

(4) Create and maintain your own birds-of-a-feather network — your support group, which is the channel through which you can occasionally exchange complaints or any “politically-incorrect” expressions, without any fear, when you feel the need to.

So much for today. Not done yet. See part 2 tomorrow. The sun finally comes out today. Enjoy Mother Nature.

Referring to my 3/26/2009 posting, “Pluck Up Your Courage and Rise Above Any Adversities” It would not be that hard to jump back after layoff in normal economic times. As it is now, we are so far below normal times when massive layoff takes place everywhere. A few weeks ago a friend of mine told me nowadays even a janitor position in KU attracted over a hundred applicants.

For those who opt for taking classes to further enhance their skills, time management is often not a big issue. When you choose to read and prepare for job market by yourself, your time will not be well-structured and this will call for well time-management by yourself.

Here are something to share from my own experience.
(1) Set a timer when you start certain housework so that you don’t get adicted to it and be carried away with over-enthusiasm. e.g. if you allow yourself 15 minutes cleaning off after a meal, set 15 minutes timer and stop yourself when time’s up, even if you are half-done. Do this for all kinds of housework. Trust me time runs away faster than you prepare.

(2) Turn off TV while working. Back at graduate school years, a friend of mine got to watch some soap shows everyday. It all started as an excuse, “I don’t just watch it, I am doing housework while watching.” Pretty soon, addiction was formed and watching became as much a must as household work. Imagine that. It is another story if you want to hear news.

(3) Try not to fall victim to the expectations of other working adult at home. To be sure, expectations of you are naturally built up when you are home, as if you had nothing to do at home, while the other adult is busy working outside. If you try to live to these expectations — cooking, cleaning, child-care, and tons of other drudgeries — you will find no time for job preparations and will feel frustrated by the end of the day for not having done much. Not a good feeling.

(4) I have nothing against being homemaker, if that’s your goal. But if you don’t want to end up being a homemaker, watch out for homemaker habits and pitfalls. There are too many of them to be listed here. You know behavior leads to habit and habit leads to your life course.

(5) Stay away from home if you find yourself wondering around doing nothing but endless non-urgent housework, answering calls and cleaning here and there. You can either go to a local library or a bookstore, where you can be more focused. Both of my children move themselves away from computer when they need to concentrate on their homeworks. Adults can do the same. Note, thanks to a friend of mine for mentioning this.

(6) Go on the Internet with a specific purpose and stick to your original purpose. Get off the line once you get what you look for. It is so easy to get sidetracked once being online. Before we realize it, the whole day is sadly gone.

(7) Avoid being the slave of your own creation. It means the amount of cleanup depends on how much you mess up during your cooking. You want to create as less mess as possible so that you have less to clean up afterward. A lot of time can be thus saved by forming this habit — less messup, less cleanup, small house, less cleaning. Alas, life would be much simple and beautiful if we were not buried to the neck with useless junks that we once willingly exchanged with our hard-earned money.

(8) Goal-setting using the SMART rule. We know the restrictive function of any rule. We need it especially when self-control and self-discipline are in short supply.

One last but not the least, perseverance, and mobilize all the fine qualities that you can summon in you. Make it a job to find a job.

Good luck, my dear friends!

If I could sing a beautiful song, I would dedicate it to those unremitting souls. This is how I felt after chatting with a friend of mine over the phone early this week. She is a single mom with two youngsters, approaching mid-age, just being laid off by Sprint. I was worried about her before. But now I felt greatly buoyed up by her high spirits and determination to bounce back. And I am so proud of her! Too bad I cannot sing and find myself badly handicapped when it comes to writing.

She told me of her plan to get a degree in health care. In fact, she has already started taking courses. When I told her story to one of my relatives in China, that relative said, “Why doesn’t she just stay home and take care of the kids?” For some people, the task may seem unsurmountable and they will simply chicken out. After all, they seem to have ample excuses not to try anything new. The inertia in each of us is simply too strong to make a slightest change, not to speak of a career change.

To be sure, it takes an extraordinarily strong will for people under her situation to go back to school, get re-education, and make a successful career change. Where there is a will, there is a way. I have nothing less than the highest prediction of her success. I just know many of my friends are like her and they will come back fresh and strong. To people like her, here’s my unreserved cheer!

This is how people with strong wills can pluck up their courage and rise above any adversities. This posting is dedicated to those who refuse to be crushed under the burden of misfortunes.

Recently, my daughter and I have been talking a lot about her job, her eagerness to make money. When she was 12 year old, I told her to start working as a volunteer in the field she was interested in and continued into the end of her college years. By then she would have 10 years work experience and would place her far above her peer in job market. Time is on your side when you are so young. Nothing has been done so far.

Now she is eager to find a paid job in an attempt to fund her own summer school and other high expenses. While it is a good thing that children want to earn their own spending, I still find it hard to see kids taking any kind of job just to get paid. I told her that she should expect at least three gains from her job, money being the least important of all.
(1) Accumulate work experience
(2) Learn the skills so that you can get job done.
(3) Money.

Work experience is like investments — start as early as you can. Also like investment, it takes a long time to mature and to be experienced. My son started his internet adventure at age 14 during the first year of high school. You can never under-estimate its long-term benefit. I know my daughter will soon find something of her interest. To be continued…

Yesterday morning, a department meeting was called within less than one hour of notice and everybody must attend it. We all sensed something bad was going to happen, but I thought normally bad news was passed in a private setting, not in a meeting. The thought calmed me down a little bit. Indeed, it turned out the meeting was to inform us that a reduction in force had been implemented, reducing 21% of our department employees.

Although we had guessed something of this nature would happen and had prepared for it to some extent, we still felt very uneasy and could not go back to our work after that. Those impacted left the company immediately. It could be any one of us. It could be just the beginning. People started talking about next round of headcount reduction.

This is actually expected. With people being laid off everywhere, patients without money and insurance cannot pay their medical bills and thus medical practice cannot carry on as usual.

A few weeks ago, I bumped into a book entitled Bulletproof Your Job: 4 Simple Strategies to Ride Out the Rough Times and Come Out On Top at Work by Stephen Viscusi. Flipping through the pages, I didn’t give it much attention.

I think the book does not offer anything new. It only reinforces the obvious unpleasant fact that we must keep in mind everyday, that is, no job is secure and no job is bulletproofed, especially during this all-time downturn. The simple solutions or rather the author’s advice are four words: visible, easy, useful and ready. I wrote down mostly for my children in case they are fortunate enough to find themselves in need of them.
(1) Be visible. Not just do your work but show your work. A toughest one.
(2) Be easy to work with. That’s easy.
(3) Be useful.
(4) Be ready to do whatever is needed.

Here’s the most challenging task –”keep friends close and enemies closer.” The thought behind it must be: the greatest harm comes from our enemies. But what if we cannot tell who’s who? Beat me. Back to work.

Robert Sutton suggests in his book that that sometimes you just have to go with the flow and practice “indifference and emotional detachment.” “Just rely on your life vest and float with your feet out in front of you.”

It is so easy to say this when we are a bit distance away from the event. Now I can laugh at many unpleasant things that happened to me in the past, yet the hard part is to be able to put things in perspective when you are directly facing the event.
 
I feel sorry for those who have to work with either bitchy, aggressive or downright unreasonable people. There is no universal cure to this problem. It all depends on the kind of people you are dealing with and the kind of person you are and the amount of tolerance you can put up, and the amount of psychological and emotional damages you can stand by bitching back, and how much you are willing to give up.

The real sad part is you don’t have many legitimate choices in dealing with bitches at work. See if you can do better than this.
(1) Confront the bitch or the aggressor.
(2) suck it up
(3) inform the management
(4) pack up and go
 
At any rate, I have found none of the above works for me.  Well, I did confront but not aggressive enough.  I think it extremely important not to let the bitch turn you into one of them, that is, if you are not already one.  This is what I have to say to my children – always comport yourself with the full dignity and integrity befitting the standards and principles that you have been adhering to.  So much for the Friday.

This was sent out around the end of year 2007. I dug it out when I cleaned my crowded email box, getting ready for a 2-week trip to China. I thought to share part of the email here. She said she was fully aware of the fact that it took “a team to provide the incredibly complex management our patients receive. And that we all have an important part in providing the dignity, respect, and compassionate caring that our patients deserve during such a challenging passage in their lives. I feel so very fortunate to have been part of the best team I could imagine.”

She ended her email with this — “I appreciate all of your help and support. With gratitude and thanks.”

I was touched by these words — “providing the dignity, respect, and compassionate caring,” when I used to think of doctors as simply curing disease and making huge money. Idealism still exists somewhere even among doctors.

Every time I met a good person I think of Flannery O’Connor’s short story, “A Good Man is Hard to Find.” She was wrong again. I know I am so bad at seeking out the good folks as if they do exist.  Laugh out loud.

If you think you can ask your smiling colleagues any work related questions at work, think again. If you assume everybody is willing to help because our ultimate goal is to get the job done, grow up or wake up, my dear friends. If you truly believe in the slogan of “teamwork,” try that in kindergarten.

The downright truth that has been repeatedly revealed itself to me is this — you are asking for trouble way more than for help.

First of all, you give people the opportunity to interpret your question as your being incapable of handling your own job independently,or as being incompetent on the job, or as lacking of the necessary skill to complete your task alone. Such a nightmare! You want to avoid this booby trap as best as you can.

Secondly, not everybody is as helpful as you naively assumed when helping others does not pay. Very often, people try to prove how competent they are on the job. Helping others only takes away their time to prove how good they are. Even worse, helping you accomplish your task might dwarf the accomplishment of the helper. After all, who wants to be the ladder for others to climb?

Thirdly, you expose yourself to all kinds of criticism, innuendos, and unfriendly gossips when your question reveal your weakness to some people with ulterior motives. Don’t be this silly. Don’t throw yourself into the mouth of a lion.

Benefit, you can get answer quickly, not without cost, though.

What is wrong with me? Nothing but the reflection of my two decades of work experience in the States.

Recently I have met more than my share of frustrations lately – teaching a 10-year-old how to play chess when he simply cannot remember the rule of the game, not to speak of the tacts and strategies of this mind game.  At office frustration level went up when I encounter a different level of stupidity.

I often see people reporting adverse event like this — “cold/headache” or “CHF/pulmonary edema” or “CHF/kidney failure”  Are they two separate events or one causing the other?  In either case, we cannot report adverse event like this. Medical records are legal documents which is no place for any ambiguity like this.  Incidents like this often make me wonder what these people were thinking when they did it.  I had to spend a lot of time digging through thick records determining which is which.

Even more stupid than this is — the patient that I have spent so much time on was not my patient.   Frustration goes up to sky high when I think of so much of my precious time being wasted on someone else’s responsibility. My anger level never fails to shoot up every time I waste my precious time on stupid thing like this.

When reflecting upon this piece of my work experience, what can I say to my children?  Well, avoid getting yourself down to this level in the first place.

A friend of mine asked me about the quality of those people at the clinical level, where I meet everyday. Let me put it this way — people here are sandwiched between grocery store salesperson and those who work at big company like Sprint. This is the worst part, because very often they have a little bit education, like two-year technical training, better than nothing, yet not high enough to move up. The dangerous part is with a few drops of water in their buckets, people are more likely to boast about their meager education and show undisguised contempt toward those they perceive as below them.

This is what I experienced not long ago. This is not a true revelation to me, but shocking enough for some people at my office.  Last Friday a question was posed to me as if I had not graduated from high school. I must look really dumb to many of them as I am friendly and good-natured, which could be ill-interpreted as being a dim-wit. This time I was fed up with the assumption that I had not even finished high school here, so I inadvertently told one of my colleagues to type in my name in full and do a yahoo search. That colleague was totally dumbfounded to learn of my level of education — unbelievable for a high school dropout to be a Ph.D holder.

I have been utterly amused observing the way some people talk to me at the office, imagining what is going on in their minds when they talk to me in a babyfeeding manner.  An interesting interval to an otherwise boring daily routine.  The contempt has never been concealed because some of them think it unnecessary since I have been considered too dumb to even comprehend any contempt shown on their faces.  

Normally I don’t bother to explain anything. I would rather have some peace of mind. I engage in intelligent conversations only to those who can appreciate it.  Otherwise, I avoid any chance of depreciating myself. It is so funny that an explanation is even necessary. I must be genuinely bored to death.

Will continue on the book Time Paradox tomorrow.
P.S. 7/12/2009 since that time, that colleague has been trying to avoid my eyes, as if she was a bit intimidated by something. Strange things do happen.

I had another busy week at office with monitor on Tuesday and Friday and preparation for auditing next week.  Weekend comes when I am so much ready for it.  Yet, weekend always means a different busy schedule, starting art class in the morning and tennis lession in the afternoon.

Someone, I-can’t-tell-who, read some of my postings today, requesting to remove those postings that mention that someone.  I said there was nothing untrue and that person also writes about me in cyberspace. Still, I have to take them off.

It is a rather rough week so far with one monitor on Tuesday and two on Wed and Thurs and three on Friday. One of my colleagues left last Friday, her replacement from another site came on Wednesday, busy getting herself familiar with the cases. The worst part of the week so far was yesterday morning when a colleague told me what the monitor said of me — “She could have got this or that done but she did not, etc.” If the monitor did not know better, the colleague should know how under-staffed our team is lately and how much I have been working on. The department manager came over to the site and wrote to me about this since I had left at 3:45 PM. There were so much not-so-nice gossips behind my back. All because I have been nice to them and they think I am an easy ball to kick around.

The funny part is they were talking about the patient that I should have worked on and this patient turned out to be the patient under the care of the one who just left (for KUMC). Outside my realm of responsibilities.  Get it? They blame me for something that has nothing to do with me! Good job but wrong target. What would be their next accusation against me? I am badly intrigued.

For my children, I would be a liar if I said I was not disturbed by all this unfairness and unpleasantness going on around me. Yet, I have been able to focus on the important things in my life and move on as happily as I can. It is extremely important not to succumb yourself to the toxic environment that you find yourself in. When you know backstabbing is indecent, you will not do it even if everybody around is doing it all the time. Hang on there nicely and decently. Time will cure it all.

You need expertise to do your job well, but you need a lot more in your character to be decently happy and productive at work.  There are two terms in Chinese, zuo shi, zue ren.  You need to do good things and be good person at the same time.

By today, 10/10/2008,  I have witnessed four people left the team, since I came on board in July 2007.  This represents over 66% turnover rate in one year.  Two of them were with research for less than one year, the other for two years, the last the longest one.  To be sure, it is the company’s loss seeing such a high turnover rate.

The other 50% of time is spent happily on extrapolating medical data from source documents.  For me this is the easy and fun part of the job, not as tasking and stressful as dealing with people.  The medical documents include:
CBC lab report
Biochemistry lab report
echocardiogram
immunohistology report
hospital discharge summary
surgical pathologist report
biopsy report
surgery report
MRI report
CT/PET report
X-ray report
body bone scan report
radiation report
physician order
physician progress note
physician consultation summary
New patient medical history questionnaire
Cancer drug pathway report
nursing note
medication pink sheet
drug administration blue sheet
Reference used daily:
AJCC: Cancer Staging Handbook
Mosby’s Drug Guide
Elsevier’s Oncology Drugs & Regimens
Tortora’s Principles of Human Anatomy
An English-Chinese Dictionary of Medicine
Clinical Trial protocols, etc…

Online references that I use daily include:
http://www.fda.gov/cder/cancer/oncrefto.htm — oncology tools
http://www.labtestsonline.org  — understanding lab results
http://www.medscape.com/medscapetoday  — medscape
http://www.druglib.com  — for drug information
http://www.clinicalpharmacology-ip.com/Default.aspx  — clinical pharmacy
http://seer.cancer.gov/resources   — SEER
http://medical.merriam-webster.com/medical  — online medical dictionary
http://www.cap.org/apps/cap.portal  — American Pathology
http://www.globalrph.com/calculators.htm   — clinical calculation
http://doctor.webmd.com  — web MD
http://www.oncologystat.com/index.html   — oncology statistics
http://www.wikipedia.org    — ultimate reference

One thing I can surely say of my job is I always find something new to learn, which gives me a sense of accomplishment and keeps me going, not a big one though.

       Last week I have more than once written about my experience at work. It doesn’t seem to be related to parenting, does it?  No, it doesn’t. Also, I don’t think my children will read much out of them now, but it is better to have a record of them now so that years later they will have something to go back to if they want.  My parents did not leave much writing for me to read about them, much as I wanted.  It seems a forever regret every time I think about it, especially my father who passed away in 1987 at age 57. 

       When I talked to some of my friends about writing their parenting experience, I was sure the value of these writings would be appreciated in the future. This reminds me of a weblog that a friend of mine set up for his daughter. I have been so much touched by these devoting parents and feel so much dwarfed by comparison, yet, here I am, trying to be a good parent, with every good intention.  Good enough, isn’t it?

This is the fun part of my daily work. I think my children can always get something out of this observation.
I work in an oncology clinic, having tremendous fun dealing with all kinds of people, like going into a large forest hearing the singing of all kinds of birds. To be sure, none of them are as light as birds (shen qing ru yan). Some doctors make efforts to be nice and accessible to others. They are as precious as sweet babies. Some keep a recognizable distance from others, sending a message of “Leave me alone” “Don’t bother me.” Some will respond if you say thankyou while others will take it as if you were talking to an inorganic matter.

The funny thing is none of them are aware of how we interpret their behavior. I should put it this way, none of them care how we perceive them. I talk as if they cared or I cared and have always been amused by my observations. Maybe it is what life should be. I have heard of this but have firmly confirmed after I actually observe this, “Healthcare field is the most hierarchical of all.,” though not all of the doctors behave hierarchically.

I’d better stop here before it is getting too funny for some people. So much for freedom of speech as long as you are not in the circle.