Mind Body Spirit. Empathy and Social Justice.

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In Ecuador, I found there were the traditional indigenous views of health melding with Western medicine. So, your physical and melding with Christianity as well. Your physical, spiritual, and mental health felt much more interwoven. You might see a shaman and pick up some medications from your doctor on your way to the church to say a prayer.

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Credits

Music by permission from Joey van Leeuwen, Boston Drummer, Composer, Arranger

Sponsored by Abridge

Thanks to these fine people who inspired me for this episode: Rebecca Archer, Ann Boland, Amy Faeskorn, Patti Harris, Jenni Keeney, Karl Madeo, Jim McEvoy, Eric Pinaud, Simon van Leeuwen, Maria Xenidou

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About the Show

Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all this.

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The Show

Introducing Anica Madeo

My Opa Henri van Leeuwen, born on Leap Year in 1888 and a survivor of the Bergen Belsen Concentration Camp, told me that he survived the camp because of his spiritual strength. He weighed less than 90 pounds when he landed in Algeria after being traded as a prisoner of war. We had this conversation when I was 16 and worried about the draft and what I was going to do if my lottery number was low. My Uncle Leon introduced me to metaphysical health, the notion of mind-body-spirit healing. He told me that spiritual, mental, and physical health were intertwined and spiritual health comes first, bolstering the others. My son, Mike’s spiritual health awed me as he grappled with his pending physical demise from metastatic cancer. Today, we hear my ‘sort of daughter’ Anica describe her travels to Latin America and her experience, as she says, with people who might see a shaman, go pick up some medications from their doctor, while heading to the church to say a prayer.

Health Hats: Hi, Anica.

Anica Madeo: How are you, Danny?

Health Hats: I’m good.  Nice to be here with you. Unusual for me to interview in person, so this is nice. Anica, how do you introduce yourself in a social situation?

Anica Madeo: I introduced myself often as a mother if I’m local, I talk about my two kids who are 12 and nine. Sometimes I talk about where I’m from, about being raised by a group of hippies in rural West Virginia.  I have a background in public health and social work, so I identify with those two aspects of who I am. I currently work as an organizational consultant, and people always want to know what you do for a living. So, I often talk about that work as well.

Health is fragile

Health Hats: Where were you when you first realized that health was fragile?

Anica Madeo: That’s a good question. I could probably tie that back to growing up in West Virginia where many of us were quite low income. Although in many ways we also had healthy lives running around out in the country and eating fresh vegetables from our gardens. I didn’t identify it so much until college and after. Probably when I traveled throughout Latin America, saw quite extreme poverty and began to think about the health of these different communities. That led me toward a public health career thinking about the health of populations, thinking about the social determinants of health. So, that’s an interesting question when I first realized that health is fragile? My grandma Mary died when I was still a youth.  She was not yet the ripe old age that you expect to lose a grandparent.

West Virginia to Latin America

Health Hats: I have this memory of you from a photo I have. You’re a young adult in Guatemala, surrounded by a bunch of kids. What did that experience teach you about the health and wellness of children?

Anica Madeo: Guatemala was one of my first experiences in Latin America. One of the first, because my mom took me to Mexico during our homeschooling years when I was a fourth-grader.  One of the things that stood out to me was this grandmother, who had a child with her. They were sitting in this box on the street and the young one was begging for money. You didn’t see that in West Virginia. So that stood out to me.  I continued going back to Latin America for several years. I know the picture you mentioned. I’ve always loved kids. It taught me is that humans are similar. Wherever you are, there’s so much about the human condition that’s the same regardless of the culture. We often think about the differences, but kids love to have fun and enjoy each other. They love when a young adult comes through town. I’m the very pale pink minority in the picture. I’m tall and stand out. It’s interesting for a white woman to be in the minority and experience what that feels like.  I can’t remember if it was Guatemala or later, perhaps in Nicaragua, that I ran a kids’ camp. The parents could send them down and we would organize sports for them, and they would all have fun. After two hours, they’d go back home. We were playing pelota, baseball style, and somebody was being excluded. One of the kids said, ‘everybody has a right to play.’ Those kids were wise and in touch already with how we organize ourselves socially and already sticking up for one another—sticking up for the kid who was slower or somehow wasn’t fitting that other kids wanted to exclude. ‘No, everybody has the right to play.

Health Hats: How did you end up having the opportunity to be in these different places.

Anica Madeo: I went to Guatemala for a language school. How did I get the crazy idea from rural West Virginia that I’m going to school in Guatemala? I spent some years after college traveling – five years between undergraduate and graduate school. I did a lot of traveling and finding opportunities. That was a language school. You could live with a family to be more immersed in the culture and language. Later, when I came back, I still wanted to see the world. Your son, Simon, had gone to do some work in Africa through an organization that also did work in Latin America. So, I had the opportunity to go back to Nicaragua for about six months. Then I went to graduate school.

Health Hats: That was through DAPP, Development Aid People to People?

Anica Madeo: No, the Institute for International Cooperation and Development, IICD. We spent six months with our group training and fundraising in the United States, then six months in the country that we were visiting, then back for a couple of months to debrief. Before I left, we were fundraising in Boston when September 11th happened. So, it’s one of my memories that suddenly I became much more aware of the relationship between the United States and our global position.  When I was in graduate school, I had the opportunity to go to Ecuador to work on a documentary film. That time I was wearing the hat of a public health consultant on this team of budding filmmakers who had just finished their degrees at the university, creating some of their early films – talented cinematographers. We interviewed people about their beliefs about health and how they saw their own condition. It struck me that in our country, we’re very attuned to Western medicine, separating our physical health and mental health. Then spiritual is not even thought of as health. That’s usually another domain.

Shaman, Doctor, Priest

In Ecuador, I found there were the traditional indigenous views of health melding with Western medicine. So, your physical and melding with Christianity as well. Your physical, spiritual, and mental health felt much more interwoven. You might see a shaman and pick up some medications from your doctor on your way to the church to say a prayer.

Health Hats: It is so weird, in our culture, how separate it is. It makes no sense.

Anica Madeo: It’s something we must get past. In my, that’s been a problem.  I saw my physical health as separate from my mental health. I’ve had more challenges in the depression and anxiety realm, but my physical health is good. There’s a missed opportunity to address the whole person. There has to be something also about my spirit and how I’m finding purpose in my life.

Health Hats: What else did you learn supporting that filming effort?

Anica Madeo: That’s a good question. The film was called La Curacion, The Healing. For me, it was the degree to which the spirit was integrated into physical health. From what I could tell as an outsider – Spanish is a second language for me. We may have lost something in translation. It didn’t feel like there was language to separate your body and spirit. It felt like the two words were connected; they were one.

Best people

Hats: Maybe we should take a moment to share a bit about how we know each other. When I talk about you with people, I talk about my ‘sort of daughter’. I’ve known you almost all your life, maybe not the first few months, but other than that, I’ve known you all your life. For my kids, you’re their sister, and for my grandkids, you’re their aunt. There’s no question. Your kids are their cousins. We were in a community in West Virginia together, and we homeschool together.

Anica Madeo: I say that you and Ann are my extra set of parents.  If something happened to my parents, then I would come to you, the next in line for the role that parents play in your life. Also, I’ve told you that you and Ann have this long-lasting relationship. My parents separated when I was young. I only know them as separated. They’re good friends. You’ve been the role model for me for a love that lasts throughout your life and the work that it takes to commit and maintain.  I talk about your sons as being my brothers from another mother. Certainly, when you moved away from West Virginia, it felt like half of my family was moving far away. Your sons have been my brothers. I think of you with my extra dad.

Health Hats: I always appreciated that when Simon, who’s my oldest son, got married, he had best people and not best men. You were there.

Anica Madeo: And I got married, and you officiated the wedding. I had only best men, Simon and Ruben.

Putting down roots

Health Hats: When you came to Ann Arbor early on, you were working with students who are studying at the University of Michigan, residing in the States on student visas. You had a role. Tell me about that role and your experience with all these different cultures and people and dealing with regulation.

Anica Madeo: First, I was thinking about why did I come to Ann Arbor? At the time, I had been traveling around the world and wanted to put down roots. Your son was here with his wife and other long-time friends who we’d known since West Virginia. So, it felt like a place I could move, put down roots, and have that connection I hadn’t had for several years traveling. All that traveling drew me to international work. I worked at a center at the university applying for visas for folks who wanted to come either as students, researchers, or faculty members. Interesting work because you got to meet people from all over the place and frustrating work because you’re working with government regulations, which are changing all the time – regulations that seem designed to make it challenging for people to get here to work and study. I found it to be the kind of work that drains your soul. Ultimately, it pushed me to go back to school.

Empathy, social justice, fairness, children

Health Hats: When we first talked about having this conversation for the podcast, my frame was thinking about you as an advocate.  I never heard you call yourself that.  You think about what’s going on with people and what they need. You advocate for people, but it’s not a label that you put on yourself. Can you talk about that a little bit?

Anica Madeo: Simon posted something on Facebook not so long ago acknowledging the strengths and tendencies among some of his old friends from West Virginia. He pegged me with an unusual amount of empathy – holding a mirror up to me. Yes, that is something about me. Throughout my life, I’ve had the ability/tendency to put myself in other people’s shoes – to feel how they feel. I am a natural advocate because I understand where someone’s coming from. I imagine and even viscerally feel what that person might be feeling. Couple that with my father’s side having a strong social justice orientation, awareness of the role of power in society with the haves and the have nots and all different domains. Certainly, growing up in West Virginia, many of us were low socioeconomic status. When I went to college, I was different than many other folks.  I went to my work-study job while they would go to spend money on dad’s credit card. I thought that was crazy. I’d never heard of credit cards being available for such things. Growing up as a woman, I have seen how we are treated differently than men in those small microaggression ways. I’m a white woman. I don’t know what it’s like to be a person of color in this country. Yet I can imagine, empathize with a lifetime of being different from the majority. You could extend this to physical abilities. I do have a sense that it’s not right that people can wield power over others, whether it comes from people who are stronger or have more money. I see it in my children now. If only one of them is getting something, give it up because the other one’s not getting it. I punished one kid for doing something bad and said, ‘well, now you don’t get to have this thing, this treat or whatever.’ The other kids have that; I’m not going to have mine either. So, I can see our children are mirrors for us. Now I can see through a social justice lens. This is not fair. Even though it’s tiring as a parent to get challenged on the fairness of everything, I hope they take that into their lives, look around. It’s not so much about what’s fair for them because they have privileged lives, but to look around and say, ‘who’s not getting a fair chance at the life that I have the opportunity to lead?’

More similarities than differences

Health Hats: Wow. With these experiences that you’ve had, how do you impact that? It’s one thing that your kids are the mirror of you. I remember having conversations with you, Simon, and Ruben of the importance of example. Example is a big deal. On the other hand, that circle is small. That’s a personal level. How do you think about the personal as well as the societal? What have you experienced in terms of trying to impact something on a larger scale than your immediate circle?

Anica Madeo: When I was in college, I studied for my master’s degrees in public health and social work to bridge that public health macro with social work interpersonal or macro. I was drawn to the macro because I thought you could have an impact at scale when you’re working on the organizational or policy levels. Yet, I’ve always been drawn to the interpersonal – sitting down with one person and finding out what drives them. I’ve come to believe that we have a false sort of sense of individualism and uniqueness in this country – we are individuals who are very different and have a lot of control over our destiny. There are so many patterns and ways in which the societal structures influence us. There are many, many similarities. Even the voices we have in our heads telling us the little self-talk stuff turns out to be common across people. The individual is like the larger community or culture. Now, in my work, I’ve settled into organizational consulting. Here I am meeting with organizations and finding out where they’re struggling or doing strategic planning. Again, seeing that sometimes it’s a very personal, individual challenge. Yet, you see the same challenges across multiple organizations. You see group dynamics across organizations.,

Generalist  – bridge for specialists, connector, seed planter

Going back to your question about how can you have influence?   I’m a generalist. I’m now a proud generalist. Used to be a questioning generalist.

Health Hats: Generalists, meaning as opposed to a

Anica Madeo: Specialist. I went to a university where there were so many specialists and so many people who spent their careers getting incredible depth on a certain topic. What did I want to be when I grow up? I kept thinking that I had to find an answer, a definitive answer. Instead, I had that winding path. I’ve collected all these different experiences and different tools along the way. And now, I finally come to see that as a strength that I can have a breadth I can draw from in addition to depth in certain areas.

Health Hats: That’s like health for me: Health Hats. I know a little bit about a lot and not a lot about much. I resonate with that because I work with a lot of specialists. It’s just amazing how challenging it is for them to talk to each other or understand each other. I think having the spice of generalists is important.

Anica Madeo: We’re the connectors.  I often serve as an interpreter. I can sit in a meeting and hear people talking, and I think. ‘Ah, you’re trying to say this, and you’re trying to say that. You’re missing each other in some way.’ You see that throughout organizations and teams. Being able to listen very deeply and mirror back, convey back things that maybe people already know but haven’t been willing to see, or they haven’t quite heard between the lines when they’re talking with each other. So, I think that maybe that goes back to some of the international work. There’s an intercultural interplay there when people don’t understand each other’s languages. Maybe they’re saying the same thing or have the same human desires and instincts. But they’re hidden in their own ways of talking about the world. That’s something I find very interesting.

Health Hats: I’m thinking about impact, the micro and the macro. When I think about the impact that I have had in my work, often, I can see that I worked with one person who had an aha, and that was a person of influence. Although the impact was for one, they’re a person who touches a lot. Then I feel like, okay, he or she is going to carry that.

Anica Madeo: I had that same reflection recently. Macro-level work drew me in. Originally, I studied speech pathology, a very interpersonal practice. Then I was drawn to the macro-level work. Now in some ways, I’ve come full circle to that same realization that you can impact one person and what they go on to do with their lives. Maybe there’s a seed in there that you planted, and then it grows in some way. They’re responsible for what happens with it.  You’ve planted that seed that has changed something that grows into something much larger.  You may never know.

Now a word about our sponsor, ABRIDGE.

Use Abridge when you see your doctor or shaman. Push the big pink button and record the conversation. Read the transcript or listen to clips when you get home. Check out the app at abridge.com or download it on the Apple App Store or Google Play Store. Record your health care conversations.

Self-care: a lesson for advocates

Health Hats: A proportion of my listeners are people who found some equilibrium in challenges with their health. Since they’re finding some space, they want to impact other people who are coming along on a similar journey. In your experience, what might be helpful for those people who are young in their advocacy, what lessons have you learned that may be helpful?

Anica Madeo: The first thing that comes to mind was my struggle to find some sense of equilibrium because I went through a full professional burnout moment in my career. I’m someone who needs the balance and the time to reset. If I’m out at a party, I’m going to need some downtime the next day. I can’t be on all the time. I don’t know that you would call me an introvert. Maybe I’m an introverted extrovert. I need that balance. Also, raising kids teaches many of that we reach a point at which we don’t have anything more to give unless we’re filling up our own cups. Putting on your own mask before assisting others is real. As advocates, parents, or caregivers, we can’t just give everything we have to someone else. We must fill our own cup and put our own mask on first. That’s a lesson I wish people could learn without having to do it the hard way. We’re in a society that wants to do more and more and more. For my clients I can sometimes help them recognize that they’re trying to give more than they have. Then you lose your effectiveness. There will always be more to do.

Health Hats: In the various teams that I’ve led as a leader in quality management, the people that I hired and worked with were very go, go, go, and I’m go, go, go. It was nice when I got to the point of maturity of realizing that our expectations were way more than everybody else’s. We could afford to back off a little and take care of ourselves. That was an important moment. You can do it slower. You can afford to rest. You have to rest.

Anica Madeo: Sometimes we don’t fully embrace that until there is a health crisis that forces us to slow down and take care of ourselves. I have a friend who had cancer at a young age. She’s been reflecting on how it’s just forced her to slow way down and take a breath. She’s someone who kept really busy. If you don’t do it on your own, someday you’re forced to slow it.

Bring different impactful voices forward

Health Hats: When I first started blogging, I used to talk about the magic leavers of best health and looking for those small things that have a big impact. We’ve talked about one lever, taking care of yourself, supporting the individual. What are other big impacts?

Anica Madeo: Societal structures reinforce overemphasizing the individual in our society. The belief that if we pulled ourselves up by our bootstraps, we could all be successful.  We look at individual choices and responsibility. When working with organizations, I see where the structure of the organization makes it easier for some and harder for others. Who are the voices that you’re hearing and who are the voices that you’re not hearing? What are the questions asked? Who’s at the table, who’s in the room? We know that some of us are more dominant in group conversations than others. In my facilitation work and my strategic planning support for organizations, I try  to examine the ways in which the structures might be illuminating some voices over others and then actively look for ways to bring forward that marginalized voice or perspective, or just a different voice. It’s okay to disagree. We don’t all have to nod our heads and agree.  I know you’ve done this work throughout your career of helping leaders of organizations be open and feel comfortable with the vulnerability of being criticized.  Their ideas could be criticized in a constructive way by folks who are seeing the impact. They might say, ‘that’s right, you have a great point. Let’s make a change.’ Supporting leaders who have impact within their organizations, have hundreds or thousands of people, who’s lives might change. Our voices might be heard, depending on how comfortable that leader is in their own skin and being able to hear the radical candor of their constituencies. That’s where you get into the macro opportunity.

Homeschooling – time for impact learning

Health Hats: We homeschooled together for several years. How do you think that homeschooling impacted your view about the larger world or social justice or advocacy?

Anica Madeo: It allowed us to think more creatively. We had schoolwork that was mandated by the local school system. We had workbooks to work through and standardized tests we needed to complete. But by and large, my recollection is that we did those in the first couple of hours of the morning. So, we were able to get through the stuff that may be in a classroom will take all day to get all the students to move through. After that we could build things we could test. We had a concept and we could test and have proof of concept right there, whether it was building something with our hands and cardboard boxes or traveling. My mom took me to Mexico for four to six weeks when I was homeschooled. I had that direct exposure to all these different cultures and languages. We had the time and space for the type of learning that is impactful for students. It’s not just doing homework or the worksheets or the rote memorization. It’s being able to connect disparate ideas or being able to create something, being able to try and fail at something. Now people realize if we want to be innovative, students need to be able to fail. There’s so much focused on grades and achievement and what do I need to do to get the A, to get to the next thing. We’re not saying, ‘what do I need to do to learn or to become a better learner?’ Learning to ask questions with questions that matter. I think homeschooling created the time and space. Because we were a few students, we all could interact with each other in a close-knit, deep way. Then we had the opportunity to, to think about things differently, ask different questions, try different things that sometimes just get squeezed out of an academic day especially now that we want more and more students in a classroom with one teacher and students come with all these outside challenges and it’s just a lot to expect.

Health Hats: Anything you want to ask me?

Anica Madeo: What did you learn from bringing up this small herd of kids. We all ran as a tribe. Every day you could look outside and find kids from multiple families. We might be riding our big wheels down the road or sledding through the trees. Now I’m raising my kids. So, looking back on your time as a parent, what did that teach you.

Health Hats: It taught me about how many ways there are to learn. I tried to sense what interested you, what interested Simon, what interested in Ruben? Did it interest me, too? Basically, I’m a selfish person. If it interested me as well, then let’s explore it. If not, make a connection to an expert. We put our careers on hold to do homeschooling. That was a total blessing that informed and enriched my nursing, my advocacy. That time I spent with you guys was the right value.

Anica Madeo: So many lessons go back to how we raise our children, how we parent. Often in professional settings. I find myself going back to what kind of parent you are. It could be literally parenting to your own children, or it could be how you care for others who are in your care?

Health Hats: One of the ahas that I had hanging out one day when you all were older, I thought that in in homeschooling, my wife took much more lead and much more direction in what we were doing, and I was more, okay, well, we’re living in West Virginia is a lot about the civil war. Let’s study the civil war, or it’s a homeschooling law that,  we wanted to get past. Let’s go to Charleston and advocate. So I was more of the, opportunist. One of the proudest things I have is you saying that Ann and I are an example.

Anica Madeo: It’s rare staying married for all these years and staying in love. It’s the work of human connections and human relationships, and those are hard. You should be proud of that and you’re reaping the benefits of it, as you know.

Health Hats: Well, thank you. It’s been great. Thanks for taking the time.

Anica Madeo: My pleasure.

Reflections

I love the expanded notion of family. Anica is part of our family. We are part of hers. We are her extra parents. She has brothers from another mother. I had extra parents, too. We are fortunate and privileged. We feel safe opening our heart while parenting, advocating, teaching, and learning. We can pay it forward. She’s paying it forward. Powerful stuff, spiritual strength. Happy 33^rd birthday, Opa.