My intention is to post a Thoughtful Thursday column each week and share some of the insights I have learned in the past week. Here are some of the things I’ve learned this week:

115,000 children were adopted in the United States in 2019. The number of adoptions dropped in 2020 to just over 95,000.

391,000 children are currently in foster care in the United States waiting for homes.

Paths to parenthood include:

• traditional parenthood
• surrogacy
• foster care to permanent placement/adoption
• private adoption through an agency or independent adoption

This podcast primarily focused on adoption. Here are some take-aways:

• Adoption through an agency generally costs $40,000 or so, and it is paid in installments (a certain amount to get started, more after the home study is completed, and more after a placement). In addition to the agency costs, you will need to pay legal fees. Attorney fees vary widely from about $4,000-$15,000.
• It takes an average of 2-3 years to complete the adoption process.
• When waiting for a placement, you should be ready with baby stuff, but you should keep it out of sight. Don’t create a baby room. It will remind you of the waiting.
• Be aware and be emotionally prepared for how long the process can take. Many people wait years.

• Insurance companies generally do NOT cover adoption expenses. Many people spend over $40,000 to adopt – the price of a new car! Check your employer’s adoption assistance programs and benefits. The government also offers a federal adoptive tax credit. In 2023, the credit was $15,950. This is a tax refund, not a deduction.
• When considering finances, also have an understanding of your future expenses, such as added costs of groceries, transportation, childcare, and saving for higher education.
• Do your research and make sure you can cover the adoption expenses or have a plan for it. Be sure to include legal fees on top of the agency fees. You will need a lawyer to get the adoption formalized through the state. Evaluate your finances and research additional resources, such as grants, personal loans, and fundraising.

Questions to consider:

• Domestic or international adoption? Adopting a newborn is only possible domestically. You will receive a more comprehensive medical history with domestic adoptions. Many adoptive parents who don’t want contact with the birth parents choose to adopt internationally.
• Foster system – This is the most affordable path to adoption, but does not always guarantee a permanent placement.
• How much do you want to know about the child prior to adoption? Open adoptions grant adoptive parents access to more background information about the child’s family and provide an opportunity to ask questions.
• Private agency vs. independent adoption – you can go through an agency and have someone do most of the work for you, or you can try to find your own “match”

This chart is 10 years old, but gives a better picture of the breakdown of costs.

Studies have shown that, regardless of insurance and income status, racial and ethnic minorities received worse care. When it comes to pain, research shows that bias extends beyond minorities to include women and even children.

• Pain is often dismissed. Many women are told the pain is “all in their heads.” Pain is in everyone’s heads because pain can’t take place without our brain.
• Not all pain is related to tissue damage. You can have real pain with no physical injury or source. Pain can’t be measured by a lab test.
• Pain is subjective and doctors must begin by identifying its source. When there is no source, it becomes open to interpretation, which becomes open to implicit bias.

Women are more likely than men to be prescribed anti-anxiety medicines than painkillers when complaining of the same pain as men do. Clinicians often suggest psychosocial causes or stress for women when they order lab tests for men with the exact same symptoms.

What can be done? We can begin by identifying our stereotypes and rewrite the stories of the people we meet. Are you treating men and women differently? Are you treating different cultures or races differently?

Physicians, make sure you aren’t writing a story that the patient hasn’t told you yet. It is your duty to replace the undiagnosed bias with empathy.

Finding the right doctor may feel a bit like dating. You may need to swipe through a few to find the right one for you.

There are always going to be multiple things vying for your attention, especially in the age of social media and phone notifications. You will always also have your own personal to-do list.

Stop underestimating how long a task is going to take. We consistently underestimate and then get frustrated when we don’t get everything done that we want to get done.

Prioritize what should get done first. Our attention is often drawn to time-sensitive tasks that are less urgent. When you’re busy and overwhelmed, you’re likely to prioritize other tasks that come along with other tight deadlines because you’re already feeling busy. When you feel frenzied, you’d do frenzied things. Introduce rational thinking into the mix with the Eisenhower Matrix. Sort tasks by urgency and importance.

People tend to do the fastest tasks first. People might do urgent things first even though they don’t need to get done. It’s easy to get distracted by the new tasks that come in even though they don’t need to get done.

• Pick up a packaged food at the supermarket and you’ll start to notice the same things: high levels of salt and fat, added sugars, added colorings, added flavors, hydrolyzed protein isolates, high fructose corn syrup, bulking agents like maltodextrin, etc.
• Read the ingredient list! Ignore the health claims and read the ingredient list instead. If it includes ingredients you don’t recognize and wouldn’t have in your kitchen, it’s usually an ultra-processed food.
• Overconsumption of ultra-processed foods results in increased risk of type 2 diabetes, obesity, hypertension, dying from cardiovascular disease, dying prematurely from all causes. These foods tend to have a lot of added salt, sugar, and fat.
• Ultra-processed foods can result in not eating enough fiber. Many ultra-processed foods have added sugars that aren’t needed.

• If you like salty, crunchy snacks, think about nuts (good source of fats, proteins, and fiber). If you love breakfast cereals, look for something with protein and fiber and fewer ingredients. If you like yogurt, look for something with low or no added sugar and add some berries to sweeten it or look for something with added protein.
• Cooking more from scratch is a better option to avoid ultra-processed foods. Focus on things you know you should be eating more of, such as fruits and vegetables. For canned vegetables, you can rinse them and let them drain to reduce sodium.
• Truefood.tech – this is a neat website where you can look up food brands and see how processed your food is. It will also suggest less processed alternatives.
• Aim to fill your diet with fruits, vegetables, lean meats, whole grains, and some dairy (unless you have allergies). 80/20 Rule- 80% of the time, aim to eat clean.

• Stay out of the grocery store. Order your groceries online to prevent impulse purchases. If you shop in store, commit to only going once each week. If you forget an ingredient, go without. This will prevent impulse purchases.
• Check your calendar before you make a budget.
• Track all of your expenses!
• Limit time on social media. People use it to highlight what they don’t have and are more likely to make impulse purchases. You’re only seeing the best of the best, not people’s physical, emotional, mental, or relationship stress when it comes to finances.
• Remember that different people may have different priorities than you do. Their financial situation might look better, but it may not be better for you. Ex: working long hours, having a family, debt, etc.

• Team members may resent one another and be unable to articulate why. In reality, it’s because there are unmet expectations that may have never been spoken. This doesn’t have to be related to work; it can happen in your personal life, too.
• Think about a moment in your life when you’ve experienced conflict. How much of the conflict was sourced in expectations that you had of the other person? Were those expectations ever communicated to the other person? The majority of conflict in the workplace is the result of missed expectations. Someone expects something from a team member, customer, or stakeholder, but the expectation was never clearly communicated and agreed to by the other party.
• We often hold grudges of which the other party is completely oblivious. These corrode our ability to collaborate.
• Have you communicated your expectations in a clear and empathetic way? Don’t carry the pointless burden of the unmet expectations of others. There’s enough on your plate!
• On a personal level, you probably have expectations of yourself that you aren’t even aware of. Learn to make agreements with yourself that you can actually keep. Many of us make agreements not based on what we think we should do, but what others think we should do. Identify agreements that you have made with yourself that you may be unaware of.

• Many creatives live with perpetual guilt because they feel they aren’t doing enough, they’re failing by some arbitrary metric, or feel like they’re falling behind because they’re letting other people establish what getting ahead looks like. They believe they aren’t disciplined because they’re living by someone else’s metric. Who set that metric? Who decided what success or failure looks like for you?
• What do you truly expect yourself to deliver on today? Do you have an accurate assessment of expectations for yourself? Are you living according to someone else’s metrics? Don’t allow others to “ought” and “should” you into feeling guilty about your level of discipline.
• Assess, commit, and achieve. Discipline is making a commitment with yourself and keeping it.

• Leadership is about risk mitigation. Great leaders understand that the goal is to accomplish what they can while mitigating the potential downside – keeping the team in the game.
• Because of the risk involved, many leaders become less than clear about their expectations for the work or for the team. They may speak in vague terms or give opaque direction because they themselves are not certain of the right decision. They want to project themselves into a situation and protect themselves from a mistake, so they lack precision when they communicate. A few team dynamics emerge. Team members wait until you tell them what to do before actually starting their work. Dissonance emerges as each team member interprets what you want, sometimes leading to misalignment and disjointedness among those responsible for executing the work. Dissonance is a gap between the “why” and the “what.” Team members need leaders to be precise about expectations. You need to be clear even when you are uncertain.
• Aim to use precise language and precise expectations – be clear about what you want, when you want it, who will do it, why it matters, and what the outcome will be if you are successful. All effective expectations include assignment of responsibility, articulation of a timeline, and accountability for results. If your expectations don’t include all three, you aren’t being precise enough.
• Aim for precise objectives. Where are you leading the team? How will you know you’ve arrived? Why will any of it matter in the long run? Team members need to know that you have clear objectives in mind, you are aware of the obstacles you are going to encounter, and you have a plan to overcome them. You must be clear about where you are leading the team in spite of your personal insecurities.

I look forward to reading, learning, and sharing more with you soon!