On revisiting a placeholder

Spring is in the air in Coopersburg, PA. I see bulbs pushing out new growth. The sun has been warm. Next week is the Equinox. We have shut down the fireplace (partially because the chimney is clogged, partially because the weather no longer calls for a large, constant fire).

This week, I’ll revisit the placeholder bullet-points from the previous reflection. I’m going to rejigger the order, because some are more personal and I think should take priority, and others are more for my own documentation of events and a ‘recipe’ for future gatherings.

  • Time away from Joonsu and Mackenzi challenged me greatly.

Four days and three nights away from the family.

I was far too stressed leading up to the bachelor party. I wasn’t very present. I knew that Mackenzi’s time over the weekend would stress her greatly, the peek into single mother life.

I noticed that I have this pattern from my father. I spend so much energy attempting to prepare for a departure, such as cleaning or arranging support or random chores, that I am not actually present for the departure. Think of the parent that works so hard to secure the financial stability of their family that they do not actually enjoy that stability. It was a shock and a reminder that being here for Mackenzi is so much more important than preparing for my absence. There’s a balance, for sure. But I know I swung too far in one direction.

Coming home to Joonsu and Mackenzi felt so good, after a 9hr drive and a weekend of activities with friends. I melted when I held him.

And this past week of stay-at-home dadness felt so much better than the previous week. I felt like I could read Joonsu’s rhythms. That he needs help to poop. That he is ready for a nap. That he is waking from a nap and will be hungry soon. I could work when he rested and play with him when he awoke.

Now, when I walk in a room and he hears my voice, he turns his head in my direction. Such a wonderful recognition of me in his life. Few efforts have ever rewarded me so much.

The first four months of his life were a great challenge to me. There were many days when I resented the idea of him: how much he changed my ability to do the things I wanted to do and how he altered the fabric of Mackenzi and I’s relationship. That was a period of growth, and as he is teething now I am reminded that all growth is inherently painful.

We are doing things that we have never done before, so we feel the hurt. Now that the growth is slowing, I can find myself enjoying the process rather than running around in a constant state of panic. And of course, right when I hit this stride, he begins to teethe. A lovely reminder that the growing won’t stop and that the pains associated will continue and change on a daily and weekly basis.

I am, however, accustomed to the process now. I feel excited to grow and to learn with my son and my family. I’m finally enjoying this.

  • We just found out this morning that we both matched. I matched into the inaugural residency class here at LVHN. We find out where Mackenzi will reside on Friday, the official Match Day.

Official Match Day, this Friday. It was a blur of emotions. We arrived late, as per usual. A small group of us up here in the Lehigh Valley, most of our class traveled down to Tampa to Match with the greater Morsani College of Medicine. Lots of drinking and debauchery down there, we had a much more reserved tone here in PA. And we had a much shorter time to wait for our results, which was a major plus.

Mackenzi matched here with LVHN, and I formally acknowledged that I will serve as a resident at LVHN. Felt great. My peers received good news as well, and it was lovely to share the day with them.

The Psychiatry Department Chair came by and congratulated us; however, I didn’t recognize him at first. He is such a no-nonsense fellow and he was so happy at Match Day that I didn’t realize who I was speaking with until we were already saying goodbye!

For my peers, I know of so many stories that are just beginning or unfortunately ending with Match Day. Relationships which cannot endure the physical distance and the challenges of residency. Humans that have worked so hard to get the results of their #1 choice. Couples that finally have the opportunity to be within the same timezone, or maybe even the same city or hospital!

Thinking about Match Day as a first year seemed like a distant prospect. I couldn’t imagine the end of my first finals week, much less matching into residency! Our two Schrodinger’s Boxes are finally open (Joonsu’s birth and Match Day) and I have a sense of clarity regarding the future that I have lacked for this entire fourth year of medical school. Things can be good. Things aren’t good for everyone else in the world, so I should be thankful for what I, what we, have.

  • Bachelor Party went incredibly well. So much growth and positive change.

This weekend had been a year in the making. There’s a lot here. I’ll provide the recipe first, then a chronological account of the experience.


Essential Preparation

  • A group of individuals that yearn for deeper, more emotionally open friendships. Closed group when preparing for a gathering (no sudden addition of members once the preparation has begun or in the immediate afterglow of a gathering). Open group between gatherings (adding members should be intentional and careful)
  • Commitment of the individuals to the group. A group member can miss the occasional preparatory call, but members must be willing to commit the time, emotional energy, and financial resources for the gathering. Membership is ‘opt-in’ – Individual members make the decision to be apart of the group and the gatherings. Removal of members from the group by the group or on behalf of individual members has not yet been required. Consideration of how this would proceed is pending requirement.
  • Regular gatherings of the group. A commitment to the gatherings is essential, however, having attended one gathering does not require or demand commitment to future gatherings. Attendance at a gathering must be made individually: a conscious decision that is respected by all. While life may demand absence from one or more gatherings by attendees, the effort to “make the fucking time” is presumed. Regarding length of gathering, we recommend a long weekend (3+ days) at a minimum. This allows group dynamics to settle in-person and at least a full day together, considering an arrival day and a departure day, and the work to emerge and be processed appropriately.
  • An organizer, or de-facto ‘leader’, to facilitate the structured conversations including group video calls and in-person circle gatherings. This organizer can rotate throughout the course of the group’s lifecycle. The organizer does not hold veto power or any other decisional advantage over any other group members, only the ability to organize the group at the group’s consent. The organizer contacts group members individually prior to and following a gathering to ensure everyone is on the same page page regarding intention and follow-up. The organizer is not solely responsible for logistical planning or execution of the weekend: this is a group effort.
  • Regular video calls leading up to the gathering Ideally all group members participant in the calls, however it is understood that this is not possible for every video call. An effort to ‘make the fucking time’ is assumed. Holding a call with 4/10 members is far superior to not holding the call at all. For members unable to make the live call, we recommend that they record either a video or audio check-in and submit this to the group to allow for a passive update on their life and happenings. For the structure of the call, we recommend allotting 10min/member: 5min to check-in and update the group on their lives, 5min for Q&A and cross-talk regarding the updates. Regarding frequency of the calls, we recommend monthly to quarterly, depending on the schedules and other obligations of the participants. An increase in frequency from quarterly to monthly is recommended when leading up to a physical gathering.
  • Number of participants We imagine an upper limit to the number of participants to be 12-15. Considering 10min/participant on the call, with 10 members that would easily stretch to 2hrs. Keep this in mind when composing the group. We believe a minimum number of participants to be around 5-6, which would allow for meaningful group interaction and dynamics to emerge.
  • Timing and frequency of gatherings Annual gatherings of a specific group allows for appropriate preparation and decompression. An individual may participate in multiple groups, which have different gathering timings: one group in the spring, one group in the summer, another in the winter, for example. We hesitate to recommend gatherings for a specific group to occur more frequently than once a year, to ensure quality over quantity.

Essential Gathering

  • A private, natural setting to comfortably host all group members for gatherings
  • Formal gatherings of the group within the larger gathering This includes an initial meeting once the group gathers, meetings each morning and evening, and a final meeting prior to departure from the gathering. We recommend gathering in a rough approximation of a circle and passing a physical token (a ring, antlers, a flower, or a game piece for examples) around the circle. The token serves to denote to the group who has the floor and who will be speaking. Cross-talk during this formal gathering is discouraged. We recommend an identified phrase for the group to communicate agreement or acknowledgement of what was said by the speaker (aho, amen, yasss, *snaps fingers*, etc) instead of cross-talk. Once the token makes a complete rotation through the group, then the formal gathering is over and unstructured interactions and conversations may resume. A period of Q&A may be appropriate to lay down ground rules regarding conduct on the first day, or to keep the group abreast of scheduled activities (‘we all need to be in the cars at 2p to go for Y activity’, ‘yoga session over there at 4p!’) as the gathering progresses. This may be conducted formally with the passing of the token to the person requesting to make an announcement, or informally without the token. The formality of these gatherings may cause discomfort for individuals at first, however as the group learns the value of these formal gatherings, the discomfort will fade and work will emerge.
  • Activities which foster connection and teamwork among the group
  • Body movement involving physical contact. Formal group time may be devoted to these practices or they may occur spontaneously. As a society, we often lack physical contact. This is why we highly recommend these types of activities for increasing group member intimacy and vulnerability

Essential Afterglow

  • Commitment of the group to the individuals. Follow-up must not flow solely through the organizer. Individuals need to reach out and maintain connections with others beyond the formal structure of the calls/gatherings. This may take the shape of simply calling to follow-up on topics discussed during the gathering or forging new in-person friendships when geographic proximity allows.
  • Resuming regular group calls. We recommend resuming group calls shortly after the gathering. Of course, some solo decompression time is essential to recognize individual processing strategies. However, organizing the group back onto regular check-ins is essential for long-term health of the group and to maintain momentum toward the next gathering.

Optional Preparation

  • Gendered membership Men’s/Women’s group versus Mixed Gender groups. Single Gender groups may remove sexual tension and may increase levels of vulnerability versus Mixed Gender groups, however it is recognized that this is a simplification and generalization. Each group will have its own unique characteristics and make-up, which is to be respected. Recommend great care and consideration when changing the gendered make-up of an established group.

Optional Gathering

  • Intentional altered states of consciousness, possibly mediated by substance usage
    • Alcohol to increase conversation
    • Yin yoga to physically open up the body
    • Deep meditation to increase individual awareness
    • Holotropic breathwork to induce psychedelic states without substance utilization
    • Cannabis to increase critical thinking
    • Psychedelics to increase perspective or induce ego death
  • Giving back to the community surrounding the gathering
    • Cleaning up the environment around you – Formal group clean-up time versus spontaneous individual efforts
    • Volunteering with a local homeless shelter or school
    • Physical creation of useful projects – Consider Eagle Scout Service Projects as a rough example
  • Outdoor exploration to appreciate the world around us

Optional Afterglow

  • Separate, smaller get togethers between group members in between the formal gatherings This ensures group cohesion out of physical gatherings and the video calls.

Five months ago, in late October 2018, I listened to a podcast describing a men’s retreat. One filled with vulnerability and open, honest communication. Hearing their experience, I felt a deep envy. Why?

Earlier that year, in June 2018, I traveled to Cape Cod to spend time with my core group of friends. I have known them since college and we have stayed in touch as a unit since graduating almost a decade ago.

However, I did not formally write a reflection on that experience. I had such mixed feelings on the trip. One of us found out that his father received a diagnosis of Multiple Myeloma. He would later die a few months later. During this trip, my friend did not feel comfortable enough sharing that difficult news with the group.

This left me shaken to my very center: we are all adult men, carving out time and resources to spend precious days together. Yet, we do not have a structure or the safety to share challenging life events together. I had never felt so alone when surrounded by such old friends.

I left that weekend unsure if I would attend another gathering with this group of friends. Why would I take precious time away from the rigors of medical training to physically be with my friends but not emotionally?

And so, I left that thought lingering in my mind until I heard that podcast in October.

A bout of inspiration struck.

I can change the tenor of our group interactions. The next scheduled one was March 2019, five months from that decision. A bachelor party. Not the most intentional of events.

So I contacted the bachelor. I asked for permission to try something new. He could tell that I felt great passion. He gave me his approval to continue.

Then, I called each participant individually: ten in total, including myself and the bachelor. I explained to them my reasoning for a change in our group dynamics and how I would do so. I needed their individual buy-in, otherwise my efforts would be for naught. We either do this as a group or not at all.

Leading up to the bachelor party, we would conduct monthly video conference calls. At this event, there would be two new faces to the group. The monthly calls would allow the newbies to acclimate to the personalities and dynamics of the established group, and allow the established group to get a sense of the newbies. This way, when we hit the ground in March together, we are already going at 40mph toward merging into the highway, rather than deadstop before the on-ramp.

The calls started off a bit rocky. We needed to understand as a group how would we conduct the calls. After two or three, we settled on this rhythm: folks call in and we rotate through the group in that order. As we rotate, we give a five or so minute update on the happenings in our lives: professional, personal, emotional. Then, the floor opens for a round of peppering questions from the group, to clarify and to poke the person on the floor. Rotate until done.

The calls took anywhere from 90min-2.5hrs, to get through all ten participants. Sometimes we had all ten, sometimes we had four. Each call was recorded in its entirety and uploaded for the benefit of the group to reflect upon or for anyone that couldn’t make the call.

The longitudinal nature of the calls allowed us to track the changes in each participant over the five months leading up to the bachelor party. One had an unstable work situation and ended up leaving his job. Another was considering castrating his puppy and he had greatly mixed emotions about the prospect. I went from a pregnant partner to a newborn during this period.

One of the above also experienced the death of his father. We had a call in November, and his father died unexpectedly shortly afterward. Supporting him through the grieving process at a distance was difficult, but others in close proximity were able to take up the slack on the group’s behalf. Hearing how he healed in the wake of such a loss as the months and calls progressed allowed us all to acknowledge his process in a way that I don’t think we could or would have without this structure.

Life marches forward and it is nice to have a formal schedule of updating my close friends on the various happenings.

Then, this past weekend, we finally arrived on bachelor party weekend.

My goal was to provide a structure to the experience. Something to start the weekend. Something to end the weekend. Something to mark the beginning of each day. Something to mark the end of each day. Together.

This is what that looked like, for this group, for this weekend.

We gathered together in a room that was separate from the normal hangout space. I arrived late on the first day, when many were already beginning the revelry. It was a challenge to herd the cats, but I got it done.

I lit a small beeswax candle and placed it upon a mandala tapestry, in the center. Then, I gathered everyone together in a loose approximation of a circle.

Many giggles and lots of side talk, initially. I had to scold a bit to achieve some level of order, or respect for the process. This group and these individuals were not used to this kind of work, so it makes sense that there would be growing pains.

We passed a set of deer antlers from a roadkilled buck that I gathered. The ‘talking antlers’, if you will. The antlers made their way around the circle and we each spoke. For this first circle, I encouraged us to think about what baggage we may bring into the group that others should know about and what we each expected to get out of the weekend. That way, we could all respect if someone was quiet or if someone needed to particularly enjoy the revelry.

After each person spoke, we allowed for some Q&A and some light cross-talk, before the antlers were passed and the quiet descended once again. Tears were shed. Hype for the weekend was had. This marked the beginning of our time together.

Then, when the antlers had made their way back into my hands, I asked if there were any questions for the good of the realm. Any logistical concerns that we should air out now, when we have everyone’s attention. A few back and forths and we covered the ground necessary to enjoy the bachelor party.

To close the opening, I blew out the candle at the center.

Then we began our weekend of healthy debauchery.

Only nine of the ten were present for that first night, Thursday.

One of us would arrive in the early afternoon on Friday. Part of my statements for the good of the realm included a request that we gather together again once our tenth arrived and settled, so that he can feel included in the group as quickly as possible.

In much the same manner as above, we conducted the circle and truly began our group’s time together.

Leading up to the weekend, I had imagined two circles. One in the morning and one in the evening. The morning circle would mark the start of the day. Perhaps before or after breakfast, when some folks were still bleary-eyed and others already beginning the day’s routines. The evening circle would mark the end of the day and the beginning of the night. The night being an important time for the group, especially during a bachelor party.

However, for the first two nights I didn’t organize that evening circle. I either didn’t want to, feel like it, or deem it necessary. After one of our members called an early night on Friday, I knew that I needed to do things differently for the final full day together

So we gathered together in the morning on Saturday.

Saturday marked the only full solar cycle of the ten of us together. We would leave on Sunday morning, I head out for a 9hr drive home from NC to PA and the rest would leave in rental cars for the airport, to disperse to the wind.

My remarks centered around the fact that I would need to gather us together early (9a) the following morning in order to fulfill my responsibility to my family, to get home at a reasonable hour and to support my partner.

I could feel the wind leave the sails of the group for a moment, as we all contemplated the responsibilities to which we would return at the close of this trip.

I also highlighted the fact that we have until 9a tomorrow to be together. To truly be present. That we have 24hrs of revelry to enjoy.

And thus the day began.

And we gathered together in the evening on Saturday. This time, we sat around the dinner table, cleared off of everything except for a candle. Instead of the antlers, we passed around a cute marker from a board game we all enjoyed the previous evening.

Different setting, same idea. I thought being flexible about the methods was important, so that we all knew we could gather together into a circle without the formality of a deer’s antlers and a tapestry.

This circle was much smaller, more intimate. We had 12hrs left together. How would we spend that time?

Going around, tears were shed. We resolved to enjoy this finite amount of time. Rage, rage, against the dying of the light.

And thus the day ended.

And thus the night began.

I awoke early on Sunday. Sleep didn’t come to any of us particularly easy after the previous late night. I greeted the rising sun with some stretches outdoors, in the warm air.

Then, I started a pot of coffee and began packing my things, so that I could leave shortly after the final gathering. Folks awoke in a trickle. Some, I could tell, enjoyed being assigned a task, so I asked that they go around and gentle wake the others, so that we could gather at the appointed time of 9a.

The circle gathered slowly, but inevitably. We all knew it had to be done, the weekend together had to end.

More tears were shed. Gratitude over all shone from us. We did something different and we did something special this weekend.

Once the antlers made its way back to me, we sat in contemplative silence. I said a quiet prayer. Then I stood up and went around the circle, opposite direction that we had passed the antlers, and gave each member of the group a good, long hug.

To me, the weekend had ended.

And now, on the other side of the gathering, I find myself in a beautiful symmetry.

I am calling and catching up with each member of the group, individually. How were they integrating back into wider society? How could we, as a group and as individuals, support them in the coming months?

We have planned another gathering, in a year’s time. March 2020. We will separate our gatherings from bachelor parties, so that we can devote even more intention to the work. Bachelor parties should be about the bachelor. These gatherings are about something different.

We will continue the monthly calls.

I consider the first three calls following this weekend to be afterglow. Integrating change into our lives and supporting each other through that process. Keeping us accountable to be the men we want to be.

Then, we will begin to transition into a preparatory phase for the coming gathering.

I wonder how different the next one will be. I wonder how much more work we can do. I wonder how deep we can go.

Now, why did I do this?

I did this because I felt that it was necessary. I also felt that I was the only one that could or would change the group, so I had to step up.

On a broader scope, I feel that we lack culture. We have a society with norms and mores. However, I do not feel like I have culture.

I want and crave structure. I can wait for others to do this, or I can do it myself.

I want Joonsu to grow into a world that respects the trauma of simply being a human. A world that provides outlets for the pain and space for true healing.

I know that this structure will not serve everyone. I do know that it served this group, this time. Future gatherings of this group will be different and I will need to adjust the methods to best serve the humans present, not just my idea of what should be done.

Remain firm about your goals, but flexible about your methods.

I also imagine that this is an early example of what my future psychiatric practice will look and feel like. I want to gather folks together for intentional change. I can wait until I am out of residency to start practicing. Or I can begin now so that I am ready for the awesome power of the prescription pad and Dr. preceding my name.

I don’t know where this is going. I want to spread this idea to the world and let it smolder and catch flame where it can. I know it is not for everyone. But for those that can sit in circle, there are many benefits.

I don’t know where this is going.

But I do know that this is only the beginning.

Long Form Sundays

On Death Podcast

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