Black and White is anything but.

*Disclosure: I’m a rich, white man.  

This week, race-related issues have made headlines. From the BLM protest at Pride, to the seemingly senseless shootings of black men by police, to the horrific killings of officers in Dallas, we are reminded that racial conflict is pervasive in North America. I have read many posts by very intelligent people who are on seeming “sides” of whats going on. But the matter of black vs white is anything but black and white.  When stressed by emotions, it is our nature to dichotomize.  But while a coin has two sides, society and it’s challenges does not.

For all the criticisms of BLM staging a sit-in at the Toronto Pride Parade and demanding that police floats be banned in 2017, I would remind us all that the very birth of Pride was political and necessitated by injustice of a marginalized population. The message of BLM must be separated from its tactics; to combine the two is to lose the forrest but for a tree.  Speaking of losing perspective, it appears that BLM leaders are not favouring the historically-proven benefits of reconciliation.  Groups of people that have murdered each other now live in relative harmony after undergoing heartbreaking reconciliation processes, letting go of historical injustices in favour of connecting through shared humanness.  Their message, that black LGBTQ people continue to face discrimination, is valid and real and political and deserved attention through peaceful protest.  Their demand to exclude police members from a parade that at its core represents human value is, in my mind, clouded by the very hate they hope to dissipate.

Viral videos are telling.  They shed light in places once left dark, where officer testimony offered a deceptively bright moonshine on events where memory can hardly be considered reliable.  Yet, they are only telling part of a story.  I have worked in the field alongside police officers.  They have, on at least one occasion, saved my life while risking their own.  I thank police officers for their service; they have a tremendously shitty job more often than most people would care to know.  With that shitty job comes shitty, but often reasonable, tactics.  But it would seem police are still often too quick to pull the trigger.  Stressful circumstances demand resiliency and bravery, and at times constables suffer from human failings that lead to bad decisions.  Being caught in the fog of crisis is not an acceptable excuse.  This problem, it appears, is systemic.  It amounts to two things, training and culture, and both of those can be addressed.  Shaky videos demand answers – even if those answers are more nuanced and granular than those who don’t make shoot-to-kill decisions can process.  The symbol of justice is a scale that is meant to be level.  Both police and civilians should be treated with due process, and penalties brought against those who break the law.

Line of duty deaths are horrifying for those who serve in dangerous roles.  Our families and friends fret for our safety.  An underlying stress digs into our dispositions, modifying our personalities and narrowing our viewpoints.  No one should go to work in the service of others and be killed.  What happened in Dallas is unspeakable.  It is separate, so separate, from what happened in Louisiana and Minnesota (and on a Toronto streetcar).  Motivated by these events, probably.  But oh so separate.  We can be outraged about a white officer killing a black motorist in Minnesota, and we can also be outraged about a black man killing a white officer in Dallas.  We don’t need to choose because there is no choice unless we subscribe to a construct that is as outdated as it is insane.

I choose to be outraged by human lives cut short. The test for outrage is simple when you apply equality to all human life, an application easier to write than to truly believe.  I struggle with this daily, and check my privilege at the door when trying to understand how it must feel to be a cop or a black person or a black cop in times like these.  But, if I try, and I do try, to understand, I think back to the morning of June 12 when I read about 49 gay people being gunned down.  I can’t list the myriad emotions that are rising to the surface even now as I write this post.  I can’t understand but I can try to understand.

These issues are not black and white.  They are more complex than a tweet or a sound byte or a blog post could capture.  By coming together as human beings, we can try to understand better, and when we can’t, to know that it’s ok not to know, not to be understood, but just to hold value, and be valued, for being.

Thanks for reading.  If you agree, or disagree, let’s have a discussion in the comment section.  I”m eager to hear more views about these difficult topics.


A Prescription for Writers Block


“If I waited till I felt like writing, I would never write anything at all” – Anne Tyler

A dear friend called me today lamenting about a particularly bad case of writers block. If my factitious epidemiological data is to be believed, 10/10 writers will experience writers block in their lifetime. While writers block is usually self-limiting, resolving in hours-to-days, severe cases can persist for weeks and require the intervention of a specialist.

Signs of Writers Block are sometimes hard to talk about and include:

-avoidance of writing tasks

-frustration when staring at blank pieces of paper or computer screens

-demoralisation and loss of sense of self-worth

-sudden desire to quit

-googling new careers

The Prescription:

Stage 1 Writers Block

  • bomb2.JPG
    You’re a writer, not a bomb tech.  Don’t feel pressured.

    Plan your writing day. Schedule it. Sleep well the night before. Eat breakfast.

  • Have a reward in mind for after the task. Pizza? Yoga? You name it.
  • Make a list of things you want to write.
  • Change locations. A different room, a coffee shop, a library… find a spot where you can be alone without distractions.
  • Walk away. You have to be in a mood to write. If now isn’t the time, go do something else and come back later.


Stage 2 Writers Block

  • Draw out a skeleton of what you need to write. See if a particular component speaks to you, and start writing about that. If none of the components seem interesting, try writing just one sentence for each one. Sometimes one sentence will turn into two, or three, or a book.
  • Post-it notes with paragraph or section titles stuck on a wall allow you to move things around and use visualization to frame what you are trying to write.
  • Write the end. The end is always the best part, and by writing it, you may feel inspired to tell the whole story. Of course, you’ll edit the end later… maybe.
  • Write something else. Rather than write what you are trying to write, write about something you want to write about. Maybe a poem about cats, or a rant about your toaster. Be silly, be tangential, and write like a lunatic. Once you start to have fun writing, you may start to gravitate back to the work at hand.  The saying is “the worst thing you write is better than the best thing you did not write.”

Stage 3 Writers Block

  • Stop writing; read.  Go read a book.  A book you want to read.  Reading will sometimes encourage creativity and you just might get inspired to run back to that writing task.
  • Consult a friend. Gain perspective. Get inspired. Be told you need to forgive yourself for your writers block, which isn’t your fault at all.
  • Ask for deadlines. Speak to your editor, supervisor, or mentor. Ask them for a due date. Commit to it.
  • Go back in time. What originally inspired you to end up having to write? Remember those emotions. Allow them to carry you through the difficult task of putting pen to paper.

If none of these ideas work, it’s ok. Consult this:

Emergency Writers Block Algorithm

Do you have tips and tricks to write well?  Share them in the comments!

Thoughts: Make Your Patient Feel Super(Elite)

(This relates directly to medicine; give me a minute to get there…)

I’ve come to learn a thing or two about how to make the flying experience a little less painful. The year before I quit my job to attend medical school, I spent 91 nights in a hotel, 11 nights on an airplane, visited 32 countries, and flew 304,542 miles. That’s nearly 1 in 3 nights away from home and just a few miles short of flying to the moon. I’m not bragging – trust me, flying that often isn’t all giggles.  But when airplanes, airports and hotels become your home away from home, you start to notice the little things.


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I wonder if patients feel like passengers sometimes.

Most people fly once or twice a year, and they often find their skyward travels infuriating. Can you imagine waiting in check-in queues every day? Sitting cramped in the back of a jet for 72 hours a week? Eating chicken (or was it beef…) that tastes oddly like paper mache? You would feel unloved.


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Ahhhh that’s better.

But the airlines love people like me and they have us in their sights; see, my company spent over $100 000 to fly me almost-to-the-moon that year. That’s money they airlines want, and they want it badly. Badly enough to go the extra airmile and improve my flying experience so I choose Airline A over Airline B. And you know what? It works. Over the years I have developed my loyalty, sometimes based on rationale and other times based on irrational emotions.

These perks I get – from hotels, airlines and travel companies – make for exceptional travel experiences. Flying to Australia for a week makes sense when your trip over is in Lufthansa First Class and your ticket cost nothing more than points in some bank you’ve accumulated over time, and you bypass every line an airport can throw in your face.

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Suite upgrade? If you insist.

One of the smartest tools the airlines and hotels use is to give me an honorary title. I’ll never forget the day
Air Canada declared me “Super Elite”, or the day Hilton upped my status from Gold to Platinum. With those titles come perks that start with customer service and end at every possible detail the discerning traveller could care about. These perks have one massive effect: they make me happy.

I’m often told I have great bedside manner. My patients seem to like me, and I think that means they listen to what I tell them about improving their health. By providing a great experience in what are universally shitty circumstances, I am able to build credibility and exert influence that, I hope, leads to behaviours that are conducive to good health.

This bedside manner isn’t innate; it’s learned. My experiences travelling in gifted luxury have rubbed off on me in a good way (and also bad ways, as my close friends remind me every time I get pretentious).

Here are my Top 6 Tips to make your patient feel SuperElite.

  • Make people feel welcome by connecting with them. Know your patient’s name, and use it while making eye contact. Do this at least twice; once at the start of the interaction, and once at the end. I repeat: and once at the end. We are great at starting off strong, but often we end by dashing off in mid-sentence. Close the conversation in a genuine fashion.  Did you know that hotel maids are taught to say “Hi” to guests that they pass in the elevator or meet in the hallway and hotel check-in clerks are trained to discuss the city you’re from? These are ways of making you feel like you belong.
  • Acknowledge screw-ups. The wait, the delay, the miscommunication, the odd paucity of pillows in hospitals, the terrible food. Acknowledge that we could, we should, do better. It’s not offering excuses, but it’s not hiding our limitations under the rug either.  Have you noticed how irritated people get when their plane is late but they don’t know why? A good airline will announce the reason for the delay and update passengers on when the flight might board.
  • Patients are my guests. The hospital is my home, and I am a host. Patients are not a pain in the ass, they are not intruding, and they are not a bother. Use phrases like “I’m really glad you came to see us for this” to validate their presence. Use phrases that demonstrate that you are there to help them. Small word swaps can make huge differences. When a patient asks for a glass of water, “sure” or “yep” can be swapped for my favourite phrase, “My pleasure.” Make eye contact to add non-verbal language that you actually want to get them a glass of water, because you don’t want your guests to be thirsty. I’m not suggesting we do anything unreasonable or burdensome, but small tokens go a long way.  Hilton Hotels has noted my preference for a high floor (I love skylines).  Each time I check in, the clerk says something along the lines of “And Mr. Bigham, I’ve found a room right at the top floor.  You’ll have an incredible view.”
  • Offer “perks.” It really doesn’t take much time, and it makes all the difference. A glass of water, a warm blanket, an adjustment in the recline of the bed… it’s a small signal to say “I want you to be comfortable here.” Many hotels will give frequent travellers suite upgrades, while airlines will upgrade SuperElite fliers to First Class or provide complimentary lounge access.  Lufthansa goes the extra mile: on my recent flight to Singapore, they picked me up at the lounge in a Mercedes and drove me down the tarmac directly to my A380! 
  • Watch your non-verbal language. Nothing is worse than words that don’t match their delivery. This makes people feel abused and disrespected.  Many companies will have specially-trained staff take care of their elite guests; these staff are trained in the fine points of communication.
  • Set expectations. Let people know why they are waiting and what is going to happen next. Evidence strongly shows that people who are dissatisfied simply wanted to know what was going on. “I’m going to do some bloodwork, and it should take about 2 hours to get the results. In the meantime, please don’t eat or drink anything in case you need surgery. If your bloodwork is normal, we’ll get you a sandwich.”   Part of this is to promise a little and deliver a lot. If you say 2 hours for blood work and it only takes 90 minutes, you’ll exceed expectations.

Does this resonate?

Think about your last trip on a plane, or stay in a hotel. What made your experience particularly special? Can you be specific? Was it the tone of the gate agent, the upgrade to more leg room, the art in the foyer? It was probably a small detail… a “nice little touch” that made you feel particularly well-served. It only takes an inch to go the extra mile and make your patient feel SuperElite.

If only every hospital bed came with a rose and mimosa… 

If I still haven’t convinced you, there is strong evidence that nice doctors don’t get sued as often as mean doctors, so re-read this post with that in mind. 🙂

A summary of tips to make your patient feel SuperElite:

Welcome people. Connect with them.

Apologize for screw-ups.

Patients are our guests. It’s “our pleasure” to care for them.

Offer “perks”.

Be aware of non-verbal communication.

Promise a little, deliver a lot. Set expectations.

“Hi Elaine, I’m Blair, one of the resident doctors working tonight. I love the author you’re reading! I’m so sorry for the wait. I heard about your chest pain from Julie, and I’m so glad you’ve come to get it checked out. I’d like to do some bloodwork, which will take about 2 hours to run. Can I grab you a warm blanket while you wait?”


How do you go the extra mile to make patient’s feel welcome?  Comment below!