Happy National Women Physicians Day!

Today, February 3rd, is the 205th birthday of Dr. Elizabeth Blackwell, the very first woman in the United States to earn a medical degree.  Dr. Blackwell was famously allowed to attend medical school as a prank by her fellow students.  She had applied to a number of medical schools, only to be told that medicine was a profession not meant for women.  She applied to Geneva Medical College (now known as Norton College of Medicine at SUNY Upstate Medical University).  Apparently the faculty asked the other (both current and incoming) medical students to vote on whether to accept her or not (the stipulation was that the vote had to be unanimous).  The students voted unanimously for her acceptance as a practical joke to get back at the faculty.  Dr. Blackwell entered medical school with the 1847 class and graduated in 1849.  During those days, medical school consisted of a one year course of study that was repeated in the second year.  The faculty and students eventually came around, and when the dean of the medical school awarded Dr. Blackwell her diploma, he stood up and bowed to her.

Dr. Blackwell continued to encounter prejudice throughout her career, and later left the United States to continue her training in Europe.  There, while caring for an infant with ophthalmia neonatorum, she accidentally contaminated her own eye and contracted the infection.  Unfortunately, she became blind in that eye, which forced her to abandon her dream of becoming a surgeon.  She would later return to the United States, where she founded the New York Infirmary for Women and Children with her younger sister, Emily Blackwell (who incidentally was the third woman to graduate from a U.S. medical school).  Both Drs. Blackwell focused on women’s health, pediatrics, and social justice.  

The Doctors Blackwell were pioneers in medicine and early advocates for a woman’s right to practice our profession.  Their story was superbly told in an excellent book by the author Janice Nimura (The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine).  National Women Physicians Day was established to honor Dr. Elizabeth Blackwell and recognizes the contributions of all women in medicine.  While we have come a long way since Dr. Elizabeth Blackwell graduated from Geneva Medical College, the struggles for women’s equity in our profession remain real today (see my post from 2018, "Do we need a National Women Physicians Day?", as well as a follow-up post from 2021).  There is work ahead, and we all must play a role.  However, for now, congratulations to all of my women colleagues and friends in medicine, and Happy National Women Physicians Day!

"We all need the human touch..."

The pop song "Human Touch" by Rick Springfield, released in 1983, was the second single from Springfield's seventh album Living in Oz.  The song would eventually reach number 18 on the Billboard Hot 100 in the United States.  The song's lyrics talk about the isolation of modern life (kids in the 1980's were spending more time in front of video games, personal computers, and televisions) and the need for real connection.  Google's Gemini artificial intelligence app says that the song "...contrasts technological detachment with the essential, vulnerable act of genuine human interaction and love...the song highlights how we build "prison cells" but need someone to break through, emphasizing that despite feeling "cool and calculated," we crave that physical and emotional closeness."  The American music magazine Cashbox emphasized the irony of using synthesizers and drum machines in a song that rails "against the impersonal coldness of computerized society."  

Ironically, I used AI to write about the meaning of the song's lyrics!  Did you catch that?  I've written a number of posts in the past year highlighting some of the drawbacks of technology (television, social media, mobile phones, and even artificial intelligence) and the role that technology has played in what former U.S. Surgeon General Vivek Murthy calls "an epidemic of loneliness" in today's society (for more on the "loneliness epidemic", please see my posts "The Loneliness Epidemic" and "Ubuntu").  For example, I've posted a lot about the role that television (see "Amusing Ourselves to Death"), technology (see "The Walkman Effect", "The Quiet Commute", and "Take a Break...") and social media (see "Familiarity breeds contempt...",  "Liberation", and "The truth about connection") have played in this epidemic of loneliness.  I have referenced the author and journalist Nicholas Carr a number of times in the past (see his most recent book, Superbloom: How Technologies of Connection Tear Us Apart).  I've mentioned Jonathan Haidt's book The Anxious Generation, which has received a lot of attention in the past year as well.  Haidt argues that a dramatic shift in childhood, largely driven by smartphones, social media, and changes in parenting styles, has led to a surge in anxiety, depression, and other mental health problems among young people.  

In my post, "Connections", I talked about Aaron Hurst and "The Six Points of Connection" that can help foster a sense of community and restore our trust in society today.  We need to get back as a society to emphasizing personal connections and the "human touch".  It's no mere coincidence that nonhuman primates (gorillas, chimpanzees, etc) spend close to 20% of their day on grooming behaviors, where one ape will groom another.  Grooming behaviors are an important aspect of the social behavior of nonhuman primates.  Touch builds the kinds of bonds that are important to surviving (and thriving) in the wild.

We humans too can benefit from fostering personal connection via touch.  Importantly, this was tested in an incredible study published in the journal Emotion in 2010 by researchers at the University of California, Berkeley (see "Tactile communication, cooperation, and performance: An ethological study of the NBA").  Researchers analyzed game film and collected key statistics from the 2008-2009 National Basketball Association (NBA) season.  They specifically looked at the tactile communication in one game played within the first 2 months of the season for all 30 teams, yielding data from 294 different players from all 30 NBA teams.  They specifically focused on 12 distinct types of touch that occurred when two or more players were in the midst of celebrating a positive play (scoring a basket, blocking a shot, etc) and included everything from fist bumps, high fives, chest bumps, and leaping shoulder bumps to half hugs and full hugs.  Early season touch positively predicted the team's performance during the full NBA regular season.  Players on winning teams fist bumped, high fived, chest bumped, and hugged more than players on losing teams.  These seemingly small forms of tactile communication significantly increased the cooperative workings of the team, which in turn translated to better performance.

Personal touch goes a long way towards establishing the bonds of human connection, and that's hard to do via a computer screen.  Bottom line, I do think that emphasizing the personal connection will help address some of the problems around trust, collaboration, and engagement that appear to be so widespread with today's workforce.  There's no question that technology is here to stay, but we can't let technology replace the need for personal connection.  Rick Springfield perhaps said it best, "We all need the human touch..."

Red light, yellow light, green light, GO!

A few years ago, the Neonatal Intensive Care Unit (NICU) at my former hospital came up with what I thought was a brilliant initiative focused on nursing staff wellbeing.  Basically, at the end of every shift, each nurse would place a colored ball (red, yellow, or green) into a jar by the main desk.  The red-colored ball indicated that the shift was very stressful, while the green-colored ball indicated that the shift was not stressful at all (the yellow-colored ball signaled that the shift was somewhere in the middle of those two extremes).  The unit leadership collected and counted all of the colored balls to get an idea of how stressful the shift had been for the unit as a whole, which they then used to retrospectively look at other key factors, such as the unit census (total number of patients), acuity (how critically ill all of the patients were during that shift), and staffing levels (how many nurses were working that shift, how many patients each nurse had been assigned, etc).  

Admittedly, the system that the NICU leadership had created provided a good retrospective view of the shift, but it could not have been used to adjust staffing levels or increase the number of manager check-ins and leadership rounds during that actual shift.  I filed away the NICU's initiative as something to consider for the future, but to be honest, the retrospective nature of the system of colored balls limited its widespread application to other inpatient units.  

I was reminded of this same NICU initiative after recently coming across a blog post about using a similar system during leadership check-ins (see Chad Dickerson's blog post, "The magic of the personal check-in: Red, yellow, green").  Here, meeting participants kick off every meeting (whether a 1:1 meeting or group meeting) by stating at the outset how they are feeling at that particular moment.  As Dickerson writes, "Red means you are having trouble focusing, you're extremely distracted, and/or you're feeling distressed.  Green means you are feeling good, focused, relaxed, and ready for any discussion.  Yellow is somewhere in between."

Dickerson explains why this simple "trick" works so well, stating, "The reason that the red/yellow/green exercise is so powerful is that it can quickly create a space of psychological safety that helps teams do better work.  It's also quick and simple.  You don't need to hire expensive consultants or take personality tests or get a special certification."

Participants don't have to explain why they are feeling Red, Yellow, or Green.  Rather, just by stating how they are doing at a particular moment in time creates a sense of authenticity, vulnerability, and humility, which in turn helps build psychological safety and engenders mutual trust.  There is perhaps no better way to build trust within a group or team than by individual members being vulnerable and honest.  

Incidentally, Dickerson references a Harvard Business Review article ("How One Hospital Improved Patient Safety in 10 Minutes a Day").  The article was written by Roel van der Heijde and Dirk Deichmann and presents a very similar initiative developed by leaders at Rotterdam Eye Hospital.  Prior to the start of every shift, team members would "huddle" together and rate his or her own mood as red, orange, or green.  The team leader then asks if there is anything that the team needs to know to work more effectively together that shift.  Lastly, the team leader assigns two staff members to each draw a card.  One card has a safety-related quiz (e.g. "What are the five steps in hand hygiene?"), while the other card asks the person to observe something during the shift and share his or her findings during the next day's team huddle.  Of particular interest, Rotterdam Eye Hospital claims that this routine has resulted in an improved safety culture, improved patient safety performance, and increased staff engagement and wellbeing!

What I particularly like about all of these similar initiatives is that they are so simple and easy to use.  As Dickerson suggests, they do not require specialized certification or training and can be easily implemented.  Incidentally, I am feeling particularly "green" today!  Now it's time to go!

For nearly a quarter of a century, nursing is the most trusted profession!

Gallup released the results of their annual Honesty and Ethics of Professions survey earlier this month, and once again nursing ranked as the most trusted profession in America.  The nursing profession has now held the top spot for the last quarter century!  Nurses have ranked number one every year since being added to the survey in 1999, with the sole exception of 2001, when firefighters ranked first (and nurses ranked second) following the 9/11 terrorist attacks.  Military veterans, who were added for the first time in this year's survey, ranked second, while medical doctors and pharmacists also received high marks.  In contrast, telemarketers (5%), members of Congress (7%) and car salespeople (7%) remain the lowest-rated professions for honesty and ethics.

Notably, while the nursing profession continues to be the most trusted profession in America, their latest rating is near the 73% low for the profession and 14 percentage points shy of their record high in 2020 during the COVID-19 pandemic.  Similarly, the rankings of the other two professions that rank just behind nursing (medical doctors and pharmacists) have also fallen by 20 and 18 points, respectively, since peaking during the pandemic and remain below pre-pandemic ratings.  

Seven of the 21 occupations surveyed in the annual poll, conducted December 1-15, 2025, reached new low points or tied their previous lows (these include, most notably, nursing, accountants, advertising practitioners, bankers, members of Congress, building contractors, and car salespeople).  A core group of professions has been tracked consistently over the past four decades, including 11 that have been measured annually since 1999. The average positive rating across these 11 professions is now 29%, the lowest historically by one percentage point.

Gallup concluded with the comment, "Although nurses and other healthcare professionals remain among the most trusted, their ratings, along with those of many other professions, have declined from pandemic-era highs, leaving overall ethics ratings across many occupations at or near historic lows."

Pure Magic and the Hardest Song in the World to Sing

If you've ever been to a Chicago Blackhawks game, you would not have been so surprised to hear Jim Cornelison's singing of our national anthem at the Chicago Bears - Los Angeles Rams Division Play-off game this past Sunday night.  I've seen headlines such as, "Bears' national anthem singer sends NFL fans into frenzy with performance before playoff game" and "NFL fans go wild for 'best national anthem of all time' before Rams-Bears playoff game".  It was an amazing performance.  It's not often that you see so many NFL players singing the national anthem before a game, but Cornelison's rendition was so inspiring that fans and players both joined in to sing.

Cornelison is a regular at Chicago sporting events. He’s been the Bears’ national anthem singer since 2010. He has been singing the national anthem before every Chicago Blackhawks home game since 2008.  Cornelison has even sung "Back Home Again in Indiana" (one of my favorites) before the Indianapolis 500 since 2017.

It was a great moment for Chicago, even though the Bears' magical season finally came to an end with a disappointing loss to the Rams.  I was truly reminded of another magical moment - when legendary recording artist Whitney Houston sang the national anthem before Super Bowl XXV on January 27, 1991, just 10 days after the start of the Persian Gulf War (codenamed Operation Desert Storm).  Houston's performance is considered one of the greatest renditions of the U.S. national anthem of all time.

As I shared in a post from December, 2019 (which I will repeat, in part, here today), the "Star Spangled Banner" is notoriously difficult to sing.  The humorist Richard Armour once quipped:

In an attempt to take Baltimore, the British attacked Fort McHenry, which protected the harbor. Bombs were soon bursting in air, rockets were glaring, and all in all it was a moment of great historical interest. During the bombardment, a young lawyer named Francis Off Key [sic] wrote "The Star-Spangled Banner", and when, by the dawn's early light, the British heard it sung, they fled in terror.

Not everyone has Cornelison's operatic voice or Whitney Houston's five octave vocal range - not even close!  As a matter of record, there are several well-known disastrous performances of the national anthem (for example, see Billboard's top 10 worst performances of all time, as of 2024, here).  Both professional and amateur singers struggle with the song's vocal range and have been known to forget the lyrics.     

Take a look at this video of a woman who starts to sing the national anthem before an NHL hockey game.  She appears to forget the words, abruptly stops and turns around to go back and grab a lyric sheet, and returns a few seconds later.  While walking back onto the ice, she slips and falls, as the audience cheers and jeers in the background.  Now ask yourself, what would you have done if you had been there?  Would you have jeered or even booed at the woman?  Admittedly, I can totally see myself reacting in that fashion in a similar circumstance.  And I am not proud to admit that.

Now, check out this video of a similar circumstance.  In this case, a young singer was invited to sing the national anthem before an NBA basketball game between the Portland Trailblazers and Oklahoma City Thunder on April 25, 2003.  The singer was a 13 year-old 8th grade student who had been selected by the fans in a promotional contest.  As luck would have it, she woke up that morning with a case of the flu and felt awful as she walked out in front of 20,000 plus fans. 

The young girl started singing, but when she got to the phrase, "What so proudly we hailed," she stumbled over the words.  She stopped - complete mind block.  She started looking around for her father for help.  At first, the audience tried to encourage her to continue, but the longer her uncomfortable pause lasted, some of the cheers turn to jeers.  Suddenly, one of the Oklahoma City assistant coaches, Hall of Fame basketball player Maurice "Mo" Cheeks, walks up behind the girl, put his arm around her, and started singing with her.  He coached her through the next few words of the song (and if you pay close attention to the video, he actually gets some of the words wrong too!).  The audience's jeers and boos turn to cheers, as they collectively finish the song together.  The girl would go on to say, “It was like a guardian angel had come and put his arm around my shoulder and helped me get through one of the most difficult experiences I've ever had."

Which situation would you rather be in when you make a mistake - having people make fun of you or celebrate your failure, like the first video, or have someone support you and coach you through the difficult times, like in the second?  Now, ask yourself my earlier question again.  The next time you see someone struggle, will you be like the hockey fans in the first video or like Coach Cheeks in the second?

You don't have to be an NBA Hall of Famer to be a leader.  At times, leadership is defined as being directive but calm under pressure.  At other times, leadership requires patience and humility.  There are going to be times in your leadership career when everything seems to click - those times will seem like pure magic.  There are also going to be times when things don't go very well.  How you react to both instances will define you as a leader.  How you react will make all the difference in the world.

"But if you keep your nose down in life and keep working, anything is possible..."

Congratulations to the Indiana University Hoosiers for winning their first EVER National Championship in college football last night!  They finished a perfect 16-0 season by beating a very tough Miami Hurricanes football team.  The Hoosiers won by beating traditional football powerhouses Ohio State (in the Big Ten championship game), Alabama, Oregon, and Miami.  

What is so unbelievable is that Indiana University has been for many years known as a basketball school (as Wall Street Journal reporter Jason Gay wrote today, "This was a basketball school that played football as a way to get to the basketball season"), winning the NCAA National Championship in 1940, 1953, 1976, 1981, and 1987.  The football program has been the proverbial doormat, losing 715 games in their history, the second most in FBS history and just one game less than Northwestern University.  IU Head Coach Curt Cignetti came to IU just two years ago, following the firing of then Head Coach Tom Allen.  Coach Cignetti inherited a team that had finished 3-9 in Coach Allen's final year.  Shortly after his hiring, he was asked how he was selling his vision for the program to potential recruits and transfers.  He replied, "I win. Google me." 

The Hoosiers finished Cignetti's first season in 2024 ranked number 10 overall with an 11–2 record, but their season ended with a loss to Notre Dame in the first round of the 2024–25 College Football Playoff (CFP).  They would not be denied in Cignetti's second season, finishing the Big Ten season with an undefeated record before defeating the defending national champions Ohio State Buckeyes to enter the CFP as the number one ranked team in the country (their first ever number one ranking).  Along the way, quarterback Fernando Mendoza would win the Heisman Trophy, the first in Indiana University's history.

Coach Cignetti is famously stoic on the sidelines and during post-game interviews.  Not this time.  During post-game interviews with ESPN sideline report Molly McGrath, Cignetti said, "Let me tell you, we won the national championship at Indiana University, it can be done.  I’m so happy for our fans. Words can’t describe it."

McGrath asked what he was feeling at that moment.  Cignetti replied, "What’s this moment like for me?  Back when I was waxing the staff table at IUP, Thanksgiving weekend and school was shut down for the playoffs, did I ever think something like this was possible? Probably not. But if you keep your nose down in life and keep working, anything is possible."

Amazing performance by an amazing football team.  Just to put it all in perspective, the last time a college football team won the national championship and finished an undefeated 16-0 was 1894, when Yale's football team did it.  Cignetti called his team's season "probably one of the greatest sports stories of all time," before ending, "but it's all because of these guys and the staff."  Congratulations to the Indiana University Hoosiers, National Champions!

In Honor of Dr. Martin Luther King, Jr

Today we celebrate Dr. Martin Luther King, Jr Day.  President Ronald Reagan signed a bill in 1983 marking the third Monday of every January as Martin Luther King, Jr. Day, the first national holiday honoring an African American.  I was looking back on some of my past posts celebrating Dr. King (for example, one of my first posts in 2017, "Remembering Dr. King" or "Silence is Betrayal" the next year).  I've posted about some of his well-known speeches (see "I have a dream" or "Tell them about the dream, Martin").  I've posted about a trip my wife and I made to the National Underground Railroad Freedom Center in Cincinnati, Ohio (see "The Three Dimensions of a Complete Life").  One of my favorite posts, however, was "What would Dr. King say today?" in 2021, which I wish to re-post today.  Here is the post from 2021:

Dr. Martin Luther King, Jr was born on January 15, 1929.  Today, we officially celebrate his birthday and honor his legacy.  Given all of the events and changes of the past year, I can only wonder what Dr. King would say about the state of our world today.  

I believe he would say something about how polarized our country has become and tie that fact back to the state of race relations that existed during his lifetime (and which unfortunately haven't changed all that much), using "The Other America" speech that he gave at Stanford University on April 14, 1967 (see also one of my old posts, "The Other America" from last Spring).  His words then are eerily poignant in light of recent events in the past couple of weeks, "What I'm trying to get across is that our nation has constantly taken a positive step forward on the question of racial justice and racial equality. But over and over again at the same time, it made certain backward steps. And this has been the persistence of the so called white backlash."  

In this same speech, Dr. King goes on further to talk about civil unrest and civil disobedience:

Let me say as I've always said, and I will always continue to say, that riots are socially destructive and self-defeating. I'm still convinced that nonviolence is the most potent weapon available to oppressed people in their struggle for freedom and justice. I feel that violence will only create more social problems than they will solve. That in a real sense it is impracticable for the Negro to even think of mounting a violent revolution in the United States. So I will continue to condemn riots, and continue to say to my brothers and sisters that this is not the way. And continue to affirm that there is another way.

But at the same time, it is as necessary for me to be as vigorous in condemning the conditions which cause persons to feel that they must engage in riotous activities as it is for me to condemn riots. I think America must see that riots do not develop out of thin air. Certain conditions continue to exist in our society which must be condemned as vigorously as we condemn riots. But in the final analysis, a riot is the language of the unheard. And what is it that America has failed to hear? It has failed to hear that the plight of the Negro poor has worsened over the last few years. It has failed to hear that the promises of freedom and justice have not been met. And it has failed to hear that large segments of white society are more concerned about tranquility and the status quo than about justice, equality, and humanity. And so in a real sense our nation's summers of riots are caused by our nation's winters of delay. And as long as America postpones justice, we stand in the position of having these recurrences of violence and riots over and over again. Social justice and progress are the absolute guarantors of riot prevention.

I would imagine that Dr. King would have a comment or two on the state of our health care system, especially in light of the racial and ethnic disparities that have persisted since his lifetime and are perhaps even worse now with the COVID-19 pandemic.  Back on March 25, 1966 in a Chicago press conference following the annual meeting of the Medical Committee for Human Rights, he said "Of all forms of discrimination and inequalities, injustice in health is the most shocking and inhuman.”  

And, rather than just talking about the problems we are experiencing today, Dr. King would offer a message of hope for the future, giving us a roadmap on how to move forward, just as he did in his famous, "Letter from Birmingham Jail".  He would likely tell us that we needed to do more, each and every one of us, both individually and collectively, to fight for social justice: "...all too many others have been more cautious than courageous and have remained silent behind the anesthetizing security of stained-glass windows."  

I think Dr. King would also tell us that in order to bend the long arc of the moral universe towards justice, we would need to go deeper to understand these issues, perhaps deeper than we are comfortable with: "Shallow understanding from people of good will is more frustrating than absolute misunderstanding from people of ill will. Lukewarm acceptance is much more bewildering than outright rejection."

I would love to have that conversation with Dr. King.  I think he would have a lot to teach me.  Today, I think that the best way that we can honor his legacy and his memory is to go back and read some of his speeches and truly begin to live by his words.  We have a long way to go still, but “Let us not seek to satisfy our thirst for freedom by drinking from the cup of bitterness and hatred.”  Let us move forward.  “Now is the time to rise from the dark and desolate valley of segregation to the sunlit path of racial justice.”  “Now is the time to make justice a reality for all of God’s children.”  “Now is the time to lift our nation from the quicksands of racial injustice to the solid rock of brotherhood.”