Each year, the Macy Faculty Scholars family—including current Scholars, alumni Scholars, National Advisory Committee members, and Macy staff—gather for the Macy Faculty Scholars Annual Meeting. This yearly convening offers a wonderful opportunity to share ideas and fellowship; to offer to support and feedback to one another, especially to those who are in the midst of their award period; and to celebrate each other’s successes. We have also invited guest speakers to join us at some of our more recent Annual Meetings to provide new perspectives and voices. This year, one such guest speaker was Dr. Kimberly Manning, Professor of Medicine at Emory University School of Medicine and Vice Chair of DEI Initiatives in Emory University’s Department of Medicine. Following her moving plenary talk, Dr. Manning joined me for a “fireside chat,” during which time she and I discussed some of her reflections on humanism and she took questions from the audience. The following is an excerpt of the transcript of the thoughts she shared with the group.
Holly Humphrey (HH): What guidance do you have for supporting humanism in our learning environments when we care for patients through the practice of nursing or medicine?
Kimberly Manning (KM): The lowest-hanging fruit we have is through role modeling, but you cannot role model humanism unless you’re well. Therefore, you have to be pretty maniacal about self-care. My self-care begins with a favorite scripture: “let your yes be yes and your no, your no.” If I say yes to something, it’s a full yes. If I say no, it’s a full no. If I follow these words, when I walk into work, I’m not feeling crushed, and then I’m in a space where I can operate in an awareness of the fact that there will be people watching what I do and probably mimicking what I do.
This leads me to the second point, which is that I think leaders need to be intentional about what their interactions look like with everyone, not just the way we talk to the patient at the bedside when taking the history. I like to make it explicit and talk to my team about my intentions, things like: “We have eight people to see on this same floor; why do we need to come bust in here and move the phlebotomist out of the way of this one patient?” or, “Why do we need to hover outside the patient’s bathroom and force them to come out quickly? We’ve got eight other people to see. We can go see somebody else.” Being intentional with each of our interactions honors the patient.
And finally, we need to appreciate humanism ourselves and share what that looks like. I work in a safety-net hospital. I see a lot of things that are sad, but I see a lot of things that are joyful, too. I see some mighty, mighty resilience in people. I honor those patients by telling their stories. Our patients save our lives and we have to let them; we have to open ourselves up to them and then tell people that they did so. We as leaders need to model the humanism that we want to impart to our learners.
HH: I think it’s fair to say that many people across the country are losing hope that we will continue to make forward progress with diversity, equity, and inclusion goals. In fact, some people say that we are eroding the basic civil rights legislation of the 1960s by what’s happening in America right now. Where do you find hope as it relates to what we see happening across the country, specifically related to DEI?
KM: While I am annoyingly optimistic, I’m also a realist. I don’t want to gaslight anybody and say it’s all good. It’s not all good. It’s not. But joy and pain are like sunshine and rain. There will always be pockets of sunshine in places, but you need rain for the flowers to grow. I try to ask myself, is this rain for the flowers to grow? What will be born out of this inflection point that we have right now?
When I speak to leaders and people that I know are not necessarily in agreement with me, I start with what we can agree upon and is our true north, which is that we care about patients. If you went through all the hassle of becoming a medical doctor or a nurse or a therapist or a health professional, you want people to thrive. We can agree upon that.
I talk about it from that framework, not from the urgency I feel as a Black American. In fact, I actually think it’s a calling for me. It’s making me, as a leader in DEI, go and find more facts. Let me be a subject matter expert by knowing my stuff and showing up. As it relates to the SCOTUS decision, I’ve been asking people, what do you know about it? There are a lot of people who don’t even know what that means to their institutions.
We need to educate those around us, but then just go back to what’s our true north. We care about human beings; we care about patients. Find language that allows us to do that without creating so much noise that people can’t realize that we actually want the same thing. That’s what I’m thinking about a lot: trying to find ways for us to speak the same language.
Scholar Question: Your presentation today demonstrated so powerfully the power of stories and the power of reflecting on your lived experience. I’m wondering what practices we can use as academic leaders, as clinicians, to practice that kind of reflection ourselves. We ask our students to do it, but what about us? What are the practices that we can use to imbue our lives, our professions, with the kind of meaning that you demonstrated?
KM: I love that. Thank you so much for your kind words. I think the best reflection is just recognizing what is extraordinary about something ordinary. Even when I write something, people don’t respond to those “pivotal moments” the same way they respond to something that was super ordinary, which means we can all relate.
To be concrete, I’ll suggest a few things that people can try. One is that not everyone likes to write. Sometimes—with my ward teams and with my clinic teams and my small groups of medical students at Emory—I’ll have everybody take a picture that does not include a human and is somewhere in our healthcare environment. Then everyone will bring the picture in and we will talk about what made you take that picture. As an example, I remember one day an intern took a picture of the bus stop across the street from Grady. The context that she gave is that a patient was 20 minutes late for clinic, and she asked how he got there, and he said he took public transportation; the patient lived in Lithonia, Georgia. She looked at what it took to get to Grady Hospital from Lithonia—how much time it would take. That picture made us all begin to think about social determinants and all the things that patients face when they’re coming to see us.
Another one is the 55-word story. This is where you tell a story in exactly 55 words, and I have the learners use their smartphones to do it. Then, after you read your 55-word story (because 55 words, even if you hate narrative, is so quick), I ask you to distill it into six words, which is really powerful.
The last one, which is probably the easiest of all, is whenever I walk into my small group, I always have a culture question that we start off with. The question I asked recently was, “what was something that delighted you that was small that you saw or heard this week?” I’ll usually start with an example to prime everybody to know what I mean. This just happened three days ago with my small group: I said I was driving down Piedmont Boulevard here in Atlanta, and as I was coming up to the light, there was a man jaywalking across the street and he was holding a bunch of balloons and some flowers and a Kroger bag, and he was wearing a Dunking Donuts uniform. You could tell he was about to take those balloons and those flowers to somebody. The look on his face—he was so happy in anticipation of taking this to someone. That was so delightful to me. No matter how busy we are and how much I have to teach, I always have a culture question that we start with that prompts people to reflect.
Scholar Question: How do you engage with negativity so that it does not get you down and you can continue to bring positivity to the work that you’re doing?
KM: Extremes of emotion are never about me. If you don’t know me, that’s what I tell myself. The most venom I probably saw directly to my face, outside of DEI stuff, was during the time of COVID, because I had decided that I would tell stories over social media to get people to think differently about the vaccines. People would say crazy stuff to me. But then I realized, you don’t know me. Let me think about what it’s like to be you. Let me think about what would get you so riled up. When I think about it that way, I take it less personally. I respond with openness and curiosity. I’ll ask questions; I find that people are often disarmed by that. For me, the meanest people are disarmed when I actually show curiosity and not anger. I cannot control you. I can control me, though. I can control me, which is probably why I really like angry patients because most just wish to be heard. Most of the time it’s just because you’re hurting and you’re looking for some place to put it. But what if I met you with empathy and I asked you a question?
If you’re just trying to be ugly, I’m going to leave you by yourself to do that. I’m human; those ugly things can hurt my feelings. In those times, I go to people that I find who are safe and who can remind me of who I am. A lot of those people are people that I work with. I do highly encourage people to build meaningful connections that are beyond transactional at work.
Scholar Question: One thing that has been weighing heavily on my mind is thinking about the next generation and burnout and moral distress. Just as we are encouraging meaningful connection, I hear about students or residents around the country not showing up for a shift or call-outs increasing dramatically over the last couple of years—more mental health call-outs, which we want to encourage. People need to take care of themselves in all aspects. I’m wondering how you suggest that we navigate that need for time off to rest in light of the need for meaningful connections and conversations.
KM: I think we have this idea that connections take way, way, way longer than they take. Something really meaningful and wonderful can happen in the course of just one minute. We can model those interactions. We can show what it looks like to know the names of all the nurses on the ward that you see every day or even share a little anecdote and say, “oh my gosh, Ms. X, she knew me when I was pregnant.” Those little interactions are quick and they build connection.
Our culture question when you’ve had a day off is to tell me about your day off. What did you do? That way we build intention into time away because sometimes people get time off, but they don’t fill their cup back up. Building meaning into what off time looks like and also building meaning into what building connection looks like. It does not take long.