Categories
Education Nonfiction Reading

Books I Read in 2018.

I know this post is late (i.e., “These are the things I did in 2018” posts usually appear in December), but perhaps some of the books I read in 2018 will make it onto your reading list for 2019.

Radical Dharma: Talking Race, Love, and Liberation. I didn’t know what to expect when I picked up this book. Because the authors are people of color, they bring a different perspective to Buddhist thought and practice. In some ways, this was a refreshing change from much of published the Buddhist literature (i.e., written by white authors, or written by Asian authors who seem to have a white audience in mind). The authors also share personal anecdotes about their journey in Buddhism that may resonate with readers of color.

The Nonviolence Handbook: A Guide for Practical Action. This was the most compelling book I read in 2018. This slim book offers both concrete suggestions about how to practice nonviolence in daily living and how individuals (often Gandhi) applied nonviolence principles in history. I found this book inspiring, challenging, and meaningful. It also reminded me that I should not take cooperation for granted.

On Tyranny: Twenty Lessons from the Twentieth Century. This book is definitely a “handbook”: It is small and to the point. The table of contents alone provide useful guidance on what we all can do every single day to support our democratic society. I appreciated that the book does not rely on fear alone; it empowers the reader to take action in the face of uncertainty.

Dreams from My Father: A Story of Race and Inheritance. This book pairs well with the next book (Hillbilly Elegy). Obama’s writing reveals a thoughtful and idealistic perspective. He wrote this years before he served as President and I found myself recognizing elements of his character as President in this book. It is a story of a man trying to learn about himself and his beliefs in a world that passes judgment on him because of his heritage and skin color. It also highlights the importance of his relationship with his mother.

Hillbilly Elegy: A Memoir of a Family and Culture in Crisis. I read this after Dreams from My Father and, in many ways, I felt like I was reading the same tale with different details. Vance also tells the story of his efforts to learn about himself and his beliefs in a world that passes judgment on him because of where he was born and raised. Vance, too, highlights the importance of his relationship with his grandmother. Because Vance and Obama have different political ideologies, these two books show how, despite our beliefs, we share more in common than we allow ourselves to believe.

Silence: The Mystery of Wholeness. I picked up this book with hopes of learning more about how to find or create silence in a world that seems full of sonic garbage. This was the most “woo woo” book I read all year. I often wrote question marks in the margins. I intend to re-read this book at some point; I may always find it esoteric. I found the ideas of different silences (e.g., the silence within our hearts versus the “big” silence of the universe; how silence is always with us) useful for my own application.

The Girl on the Train. I rarely read fiction, so this was a treat. I picked this up on a public bookshelf for airplane reading. The story was engrossing, though I couldn’t help but think about the lack of coping skills the characters demonstrated. I also discerned the identity of the villain early on, so the “twist” not surprise me. The book nonetheless makes for fine brain candy.

Falling Leaves: The Memoir of an Unwanted Chinese Daughter. This book was also a selection for airplane reading. The intercultural issues of the memoir are familiar to me and the storytelling is satisfactory. This memoir seemed to lack the depth of self-reflection as seen in the Obama and Vance memoirs. I wanted to learn more about how she grew and understood herself as an individual as a result of her experiences with her stepmother.

Silence: The Power of Quiet in a World Full of Noise. This was yet another effort to apply more silence in my life. This text is similar to other works by Thich Nhat Hanh, though does comment more on cultivating silence within (which, in some ways, paired nicely with the Sardello book above on silence). Did I learn anything new? No. Did it nonetheless bring me comfort? Yes. This book was another reminder to me that we often have to generate our own silence, particularly when there is a lot of noise “outside” that we cannot control.

Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. I read this in anticipation of a talk from the author, Laura van Dernoot Lipsky. Many of the examples in her book come from her previous clinical work in Seattle, so the book felt particularly familiar. The book offers validation to all of us who work in clinical settings. I was hoping for more commentary on how we can adjust or shift systems to better support people who work in human services; the book focuses chiefly on what the individual can do. I also hoped that the book would offer a more evidence-based framework for these individual interventions, though also appreciate that there are spiritual aspects of trauma work that are difficult to measure. Laura is a compelling and energetic speaker. You can watch her TED talk.

Extreme Government Makeover: Increasing Our Capacity to Do More Good. I received this book from a colleague, who received it from the author for free! (My colleague and I both work in local government and when she asked him if he could provide the books at a discount for the staff, he sent a stack of books to us at no charge.) The major premise of the book is the reduction of waste: Reducing the amount of time between tasks (much of which is waiting, with no action happening); eliminating bottlenecks (e.g., where only one person is the “decider”); and minimizing processes that only serve to prevent lawsuits. I suspect that selection bias is at play, though: The people who choose to read this book are probably already aware of how to make things more efficient.

Here are all the books I started in 2018, but did not finish:

A People’s History of the United States. I’m actually over halfway through this book. I found myself getting angry while reading it, though, given the current context of the federal administration in the United States. Some of the events described in the book were similar to the ideas coming out of the current White House. I like reading and don’t need to experience more anger than necessary. I do want to finish this book, just not now.

The Making of Asian America: A History. I found myself getting angry while reading this one, too, so I put this one down. I like that the author discusses the experiences and events of different Asian groups, as, indeed, Asians are not all the same. I will get back to this one, too.

The Art of Memoir. I want to write a book, and that book is a memoir. Writing is already difficult, but the writing for this memoir presents particular challenges. I hope to learn from the mistakes and experiences of others. However, reading about memoir writing takes time away from actual memoir writing. Sometimes we fool ourselves into thinking we need to learn from others when, in fact, we just need to do the work.

The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are. I had never read a book by Brene Brown, though I enjoyed listening to Krista Tippett interview her on the podcast On Being. The book is like a personal cheerleader, which is fine, though that’s not what I needed or wanted.

Good Prose: The Art of Nonfiction. I enjoy reading good sentences. I continue to strive to craft clear, meaningful sentences because I want to write stellar stories. As I noted above, though, sometimes we just need to do the work.

Chinese Culture and Mental Health. While Western psychiatry is getting better at acknowledging the role of culture in the manifestation of thoughts, emotions, and behaviors, it still ain’t great. This book is an academic textbook, so while it is informative, it isn’t the most exciting reading. I will finish this one, too, though it may take a while.

How to Measure Anything: Finding the Value of Intangibles in Business. I picked this up primarily to help me think about my clinical and administrative work in a different way. I have already learned interesting perspectives about measuring seemingly immeasurable things in the first quarter of the book. This book requires a level of concentration that I often did not have by the end of the day. This is a book I want to finish, but it will take time.

If you want to share with me what books have changed your life for the better or made you think about the world in a different way, let me know (e-mail, Twitter, Facebook).

Categories
Nonfiction Observations Seattle Systems

What Seattle Got From Amazon.

Yesterday’s New York Times had an article with the title “Amazon’s HQ2 Will Benefit From New York City. But What Does New York Get?” I don’t know what New York (and Crystal City) will get, but here are my observations (as someone who lived in Seattle from 2004 to 2008, and then from 2011 to now) as to what Seattle got:

Lots of young people. Some of these people look like they’re 12 years old, but that’s because I’m now officially old. And some of these young people, fresh out of college, make six-figure salaries. Sometimes it shows. Sometimes it doesn’t.

Lots of blue badges. Amazon employees wear blue badges. You can tell your proximity from the Amazon campus (which is a campus; it occupies an entire neighborhood) by the density of blue badges hanging from lanyards, dangling off of belts, and swinging off of coats.

Food trucks. The young people apparently like food trucks. Caravans of food trucks rumble towards South Lake Union, the site of the Amazon campus. The rotating food trucks sell Thai bowls, Italian sandwiches, barbecue wings, Turkish kebabs, Hawaiian poke bowls, and other international cuisines from their portable kitchens.

Hip restaurants that sell overpriced food. Here’s an anecdote that I share with some bitterness: One such restaurant has the following item on its dessert menu:

Warm chocolate chunk cookie with whole milk. $8.

Long-time readers know that I am fond of cookies, particularly the chocolate chip variety. Upon seeing this item, my eyes lit up, but the light drained from my eyes when I saw the price.

“No cookie and milk is worth $8,” I said. “Even my favorite cookie (the Levain Chocolate Chip Walnut Cookie) is just $4.”

“But what if it is the best chocolate cookie you will ever eat?” my husband countered.

“I doubt it. This is a restaurant, not a bakery.”

“Let me buy it for you.”

I relented and ordered the warm chocolate chunk cookie with whole milk, my taste buds eager and my mind skeptical.

What actually arrived? Two cookies, each about four inches in diameter, and a glass holding about six ounces of milk. The cookies were barely warm, the chocolate was not chunky, and the overall texture of the cookies was dry. The milk was wholly unremarkable. The dessert was rich only in the flavor of disappointment.

These restaurants can charge $8 for cookies and milk because they know that the young people who work at Amazon have no qualms spending such a ridiculous sum on a treat that is sweet only in memory.

Traffic. The tens of thousands of people who moved to the Seattle metropolitan area have to get around somehow. When I was a resident, I saw few taxis downtown or on Capitol Hill. Taxis of all colors now zip around the city, along with ride sharing vehicles. There are a lot more fancy cars—Teslas, Porsches, and the like—crawling up the hills. The buses, streetcars, and trains are packed with well-heeled young people.

High rents and expensive homes. The city of Seattle is in King County. The average rent in King County is $1,731, which doesn’t seem impressive compared to rents in other major metropolitan areas. The rent in King County, though, has increased 155% in the past twenty years. Furthermore, Seattle, by far, is the most expensive and developed city in the region and pulls the average up, as other areas in the county are sparsely populated and considered rural.

Income inequality. I don’t know if Amazon was/is the cause of the homelessness crisis in this region (remember, correlation does not mean causation). As young people with gobs on money have moved in, more people with little money have moved out onto the streets. Certainly the higher rents have pushed many people out of the city: Some people work in Seattle and live in neighboring counties, as that is the only way they can afford their rent or mortgage. Landlords in Seattle know that they can charge nearly $3000 for a one-bedroom apartment because someone from Amazon can afford to pay that. (Just like restaurants can charge $8 for cookies and milk.)

Anti-Amazon and anti-Jeff Bezos graffiti. It is not uncommon to see graffiti painted on sidewalks and buildings that denounce Amazon and Jeff Bezos. Some of it is frankly disturbing (e.g., death threats), though it illustrates the strong feelings people have about Amazon.

Spherical buildings. They took all the trees / And put ’em in a tree museum / And they charged the people / A dollar and a half to seem ’em

Amazon has done well for itself, though it seems that many people in Seattle have an uneasy relationship with Amazon. They like what Amazon has to offer, but don’t like how the wealth of the company has affected the city. Perhaps the leadership of New York and Crystal City will forge closer working relationships with Amazon from the outset to prevent the congestion, big income disparities, and resentment[1. The resentment that people have for Amazon also comes from its own employees. For a while I worked in a clinic where some of my patients were Amazon employees. They often spoke of the pressures working at Amazon, whether they worked in programming, marketing, supply chain, or warehousing. There’s likely selection bias at play, but their work nonetheless induced anxiety and affected their abilities to cope.] that occurred in Seattle.


Categories
Lessons Nonfiction Reflection

Be Different and Do Better.

I didn’t know that he and I were on the same train. At the Othello stop, I got out of the last car and walked towards the front of the train. The morning chill seeped through my coat and I slid my hands into my pockets.

“Dr. Yang!”

The doors of the train were still open and there he was: A baggy black hoodie was pulled up over his head, but it did not conceal the wide grin on his face. He was leaning forward in his seat and waving his arm and hand at me like a little kid.

The doors were closing when I waved back. I was still smiling when the train whirred back into motion and passed me.

It was the gracious and respectful patient!


There were several men loitering outside the clinic, the red and yellow leaves of autumn scraping the sidewalk around their feet.

He saw me first.

“Hi! Doctor… Yang! It’s so good to see you!”

“Hi!” I greeted. He looked well, though the gaps between his teeth were wider now compared to when I last saw him.

The two men who were standing by him looked at me with curiosity.

“It really is good to see you,” he said, taking a step towards me. “Can I hug you?”

“No,” I said, “but we can bump fists.”

My fist met his in a gentle bump. One of the other men cocked his head to the side, his face perplexed. He slowly extended his arm towards me, his hand in a loose fist. My fist bumped his, too. His head began to bob in a slow nod as he kept his arm extended.

“I’m doing really good,” my former patient said. Over a year had passed since we had last seen each other. During his many months in jail, he had been under my care. “I’m off prbation! I haven’t been in the hospital in over six months! I have a place to live and I see my counselor here every week.”

“That’s fantastic!” I exclaimed. “I’m happy to hear that.”

“How are you doing?” he asked.

“I’m doing well, thank you,” I answered. He didn’t press further when I redirected the focus back onto him. “It is wonderful to see you out here and not in that other place.”

“Jail?” Oh well. I at least tried to keep that out of the conversation. “Oh yeah, I haven’t been in jail in a long time.”

“Which is good news. I’ve got to go inside to meet someone.”

“Oh, okay, Dr. Yang! I need to check in with my counselor, too. It really is nice to see you! Bye!”


Perhaps it is foolish to assume that people are inherently good. How can we believe that people are good when they burst into houses of worship to kill people? Why should we trust that people have good intentions when they send explosives in the mail? When people encourage violence against people who don’t share their beliefs, language, or skin color, isn’t it unwise to have faith in our fellow humans?

The charges filed against the two men described above weren’t trivial:

  • theft
  • criminal trespass
  • resisting arrest
  • assault

I shared a gentle fist bump with one of them. I know what injuries he had inflicted with that fist in the past.

And yet. And yet!

People ask me how often I encounter people who were under my care in jail. They ask me that question with concern; they worry that these chance encounters will lead to danger.

I see former patients from jail about once every one to two months. Most of the time, they see me first, greet me by name, and then go about their business. Sometimes they provide a short update about their lives. Sometimes they make a point of thanking me.

So is it truly foolish to assume that people are inherently good?

Let’s be clear: There are a few individuals who have been, are, or will be under my care who I do not ever want to see on the outside. If I do see them, I cross the street, duck into a building, or otherwise try to disappear. I trust that some of these individuals have probably seen me without my awareness. In those instances, ignorance is bliss and I am thankful that nothing transpired.

Things change, people change, circumstances change. Sometimes we look at the world around us and despair: People suffer, injustices big and small happen to the best of people, individuals we don’t like or respect collect more and more power.

And yet. And yet!

Consider the people in your life who inspire you to do good things. There are people you see and who see you: Friends, family, coworkers. They do things you admire; they say things that spark ideas; who they are makes you want to be different and do better. This happens to you every day.

Then consider the people in your life who you see, but they do not see you: Leaders, artists, and other public figures. Despite the absence of a personal relationship, they also inspire you to be different and do better.

Realize that there are people who you do not see, but they see you. You, too, can inspire others to be different and do better.

We may feel like we don’t have much influence, but we all have influence within the three-foot radii around us. We can choose to amplify the inherent good within us to help ourselves, others, and the world around us—even just the world within our three-foot radius—be different and do better.

Yes, the suffering and injustices continue, but if we do nothing, then we surrender to those who do choose to do something.

Many of these men in jail have and will continue to inspire me to be different and do better. Maybe they will inspire you, too.

Categories
Lessons Medicine Nonfiction Reflection

Centered and Ostensibly Serene.

The nights from that time run together in my memory: The cuffs of my scrub pants getting caught on the heels of my clogs because my pants were sagging; stuffing dry graham crackers I stole from the nursing stations into my mouth at 4am to stay awake while writing notes; what seemed like my pager buzzing against my hip every five minutes; feeling the enormous specter of unending work overtaking me and wondering if I had any remaining skills to gird myself; recognizing the sadness and anger churning within me as I witnessed and listened to tragedies, then shoving the emotions away because there just wasn’t any time I didn’t want to cry I just needed to get through a few more notes I just wanted to sleep of the mistaken belief that if I ignored how I felt, I would be okay.


“Hey, you! You coming to talk to me?” The Big Man shouted.

“No,” I replied. “I’m going to talk with your neighbor.”

“What? But then you’re gonna talk to me, right?”

“I have two other people to talk to first, but, yes, I will talk to you after I talk with them.”

“But you’re gonna talk to me, too, right?”

“Yes.”

I had just finished introducing myself to The Patient and was asking his name when The Big Man, just three feet over and behind a reinforced steel door, started yelling at me: “You lying bitch! You said you’d talk to me!” The Big Man began pounding on the door with his big fist.

The banging reverberated throughout the entire unit. Another inmate on the other side of the unit began banging his door in protest.

I sighed and rolled my invisible eyes.

BANG BANG BANG “I’m sorry,” I said to The Patient. He nodded and came closer to his door. I did the same. “I will try to keep this short, but I do want to hear what you have to say.” BANG BANG BANG

BANG BANG BANG “It’s okay,” The Patient replied. BANG BANG BANG

BANG BANG BANG “Are you in any physical pain right now?” BANG BANG BANG

BANG BANG BANG He tilted his head, telling me without words that he couldn’t hear what I said. BANG BANG BANG

BANG BANG BANG “Are you in any physical pain?” I asked again, nearly shouting. BANG BANG BANG

BANG BANG BANG “FUCKING BITCH! YOU SAID YOU’D TALK TO ME!” The Big Man shouted. BANG BANG BANG

BANG BANG BANG “My feet,” The Patient answered, raising his voice. “I have blisters.” BANG BANG BANG

He pointed down at his feet. The puffy blisters were evidence of ill-fitting shoes. The Patient reached down, grabbed a sandal, and threw it in the direction of The Big Man. BANG BANG BANG “Stop it, man.” BANG BANG BANG I watched it sail past me and bounce in front of The Big Man’s door.

BANG BANG BANG “Do you want me to get that for you?” I asked, recognizing that the pair of sandals were now separated. BANG BANG BANG

BANG BANG BANG The Patient chuckled. “No,” he answered, a small smile on his face. “I only had one, anyway.” BANG BANG BANG

BANG BANG BANG “Do you want another pair?” BANG BANG BANG

BANG BANG BANG “YOU WANT ME TO STOP DOING THIS? THEN YOU NEED TO FUCKING TALK TO ME, BITCH!” BANG BANG BANG

BANG BANG BANG “No, I’d rather have a pair of socks,” The Patient replied. BANG BANG BANG

BANG BANG BANG “I’ll get you a pair.” BANG BANG BANG

Despite the increasing rate and volume of The Big Man’s fist hitting the door, The Patient and I both ignored him. It was clear that we had both mastered this skill at some point earlier in our lives. The Patient made it look effortless; his face was calm and his voice was even. Even though he had thrown his shoe, his limbs did not become tense again.

The Patient told me about his health, asked me to call his counselor, and, when I ended our conversation only a few minutes later due to the noise, he thanked me.

BANG BANG BANG “No, thank you,” I said, smiling. “I appreciate your patience. I will try to talk with you again later. Maybe we will have better luck.” BANG BANG BANG

I didn’t look at The Big Man as I turned away. He stopped banging when I had walked a mere ten feet away from them. I then rolled my actual eyeballs. I knew that was when he would stop.


The stress of internship and residency most certainly contributed to my current abilities to stay centered and ostensibly serene in the midst of chaos. We all had to learn how to manage ourselves in the face of death, disease, and distress. Sometimes our efforts were successful; sometimes we felt embarrassed because we believed our efforts failed.

I learned how to show myself more kindness during residency. This wasn’t a conscious choice. Three things happened:

  1. In learning how to provide psychotherapy to others, I learned how to apply these skills to my own life.
  2. I couldn’t contain the sadness and anger that churned within me as I witnessed and listened to tragedies. Sometimes I cried in the bathroom. Most of the time I wept at home.
  3. People—and more often than not, patients—demonstrated grace and kindness during these moments of heartbreak. They often exhibited a capacity to accept their circumstances and show compassion, despite their physical or psychological pain.

I felt my chest fill with grief as I walked away from The Patient and The Big Man.

What happened to The Big Man? When and how did he learn the only way to get his needs met is to destroy silence?

What happened to The Patient? When and how did he learn to show grace and respect in the midst of hateful noise?

I didn’t cry because, this time, I didn’t shove the emotions away.

Categories
Lessons Nonfiction Reflection Systems

Phone Calls.

I don’t miss making the phone calls in the middle of the night.

“Hi, this is Dr. Yang calling from the Psychiatric Emergency Service. May I speak to Mr. or Mrs. Doe?”

“Yeah, this is Mr. Doe,” he’d reply, his voice thick and slow with sleep.

“I’m sorry to call so late. Your son is here at the hospital.” Take a breath and slow down for the next part. “He’s alive and doing okay at this moment”—I quickly learned that it is important to say these words at the start of the call—“but I hope to get some information from you about him.”

I have marveled at the grace people have extended to me during these conversations. Sometimes family members have grown accustomed to these 2am calls and their voices sound not only physically sleepy, but also psychologically exhausted. Sometimes family members have never received this phone call, but their voices remain calm with only the occasional quaver while they talk.

These days, it’s “Dr. Yang calling from the jail”. Though I’m not making these phone calls in the middle of the night, it is questionable that these are better phone calls.

It is a blessing when family members are still involved, when there’s someone I can call. The person in question is usually a male in his 20s. He often has reached desirable milestones: Maybe he just graduated from high school or is in college. His primary health issue is the mental health condition—often bipolar disorder or schizophrenia—and he’s otherwise healthy. He is often able to tell me about a family member who loves him, even if what he tells me doesn’t make a lot of sense in the moment.

For so many others under my care, there’s no one to call:

  • “They died.”
  • “I don’t want anything to do with them.”
  • “I don’t know where they are.”

Sometimes the person in question is much older. In some ways, these phone calls are more tragic:

  • “I’m in my 70s now and I’m the process of moving my wife into a memory care facility….”
  • “My husband has already died and I worry who will take care of my son when I go. He still needs a lot of help.
  • “Thank you for calling, Doctor, but it doesn’t seem like anything will change. I’ve been doing this for almost thirty years now.”

I marvel at the grace people have extended to me during these conversations, too. For some of these family members, they’ve had dozens of these conversations with many other doctors, nurses, counselors, and social workers. They know what questions I will ask; their answers are succinct because others have interrupted them in the past; they have lists of information already prepared to send.

Almost without fail, after I thank these family members for their help and then comment on the difficulty of the situation, they cry. Sometimes the sobs that escape their throats surprise them.

“I’m sorry,” they mumble. I can hear them wipe the tears from their faces with haste.

I’m sorry that we can’t do better for your son. I’m sorry that the science hasn’t advanced enough that we can prevent this from ever happening to your son ever again. I’m sorry that your son is in jail when he should be in a hospital. I’m sorry that your hopes and dreams for your son haven’t come true. I’m sorry that few people know the depth of the worry you have for your son. I’m sorry that these systems fail you and your son. I’m sorry that your love for your son isn’t enough to save him from these systems.

“Please, don’t apologize,” I say instead.

I wonder why.