Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

Cape Cod

Of Tradewinds and Science

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die.” –Max Planck

So very much of what we encounter as we seek any kind of guiding truth is not science at all, but strongly held opinion forcefully presented. Think about it for a moment. Think about a few of the really big issues orbiting the intellectuosphere. Climate change. Health. Fitness. The search for the cure for cancer. Heck, the decision on what to have for lunch. So many opinions…so much money…so little true science.

Even more than that, scientific truth is continually bludgeoned by the one-two punch of politics and commerce. True science has always been held hostage by those who have vested interests in what constitutes the prevailing truth at any given time. How many promising avenues of inquiry have been blocked, and how much time has been lost because of the failure to pursue additional lines of inquiry that ran counter to “consensus”? One need only think of inflammation in vascular disease or alternatives to “fat in the diet is unhealthy”, both squelched along with the careers and reputations of their proponents while the single consensus theory was pursued. Why? Alternate theories or parallel theories would siphon the spoils from those who fed at the consensus trough.

It’s quite tempting to hold that this is all relatively new, that it is a function of our highly developed Western societies. Tempting, but ultimately false. Has there ever been a time in recorded history when a new scientific truth has upended orthodoxy and there has NOT been an attempt by the entrenched to not only stop an new line of inquiry but also destroy those inquiring? Think Galileo. From where I sit it seems as if a substantial majority of truly disruptive new scientific truth has arisen from the ranks of those who stood aside the prevailing winds and charted their own course.

What does this mean for each of us as we sit in our own little boats and sail along? The trade winds of consensus are strong, and it seems the weaker the science behind them the stronger they blow. It’s fine to allow these to fill your sails, of course, for the majority of them do in fact propel us along a true course. The best course, however, may lie in the breezes that cross the trade winds. Those tiny little gusts that represent the true essence of real science–skepticism accompanied by inquiry, followed by proof–will ultimately propel us to the proper destination despite the power of the commerce attached to the trade winds.

Every now and again the Newport to Bermuda race is won by a rebel who went off alone and discovered a new truth about sailing. We should be open to the possibility of a new scientific truth in all parts of our lives, lest we find ourselves far behind, capsized in its wake.

Or worse yet gone, as Planck suggests, long before we ever had a chance to benefit.

Evaluating Risk in the Mature Athlete

“Achieving a risk level of 0.00000% is costlier than 0.0%.” –Saurabh Jha (on Twitter)

Think about that for a minute. It was written in the context of medicine and medical care, but we should think about risk in the context of our CrossFit or fitness practice, too. Beth and I had a really nice conversation with my sister-in-law Amy (of Champlain Valley CrossFit, home of Games champion Matt Fraser) about CrossFit for the masses. The specific topic was how many CrossFit WODs should regular folks, especially–ahem–more mature regular folks be doing each week and what sort. In a way it was a discussion about managing risk.

As I’ve gotten older my ability to challenge my body without incurring minor injuries has declined. At the same time, my ability to recover from those injuries has declined apace. A far more mundane, but equally actionable observation is that I do not recover from the intensity of the WOD as quickly as I did 5 or 8 or 10 years ago. In other words, there is some risk in continuing to do CrossFit in the same way that I did in years past.

There is a flip side to this, of course. Prior to embarking on my Crossfit odyssey I would be incapacitated with back pain 2 or 3 times each year. Since January 2006 that has occurred precisely once, and that was because I deviated from standard-issue CrossFit to join a friend in his Oly workout while visiting. I am struggling to create a regular workout schedule since CrossFit Bingo/Comet CrossFit closed. Without question I am not as healthy as I was at this time last year.

Each of us is a study group of one, each with a personal risk/benefit ratio that can only be discovered by at the very least coming right up to the edge of “too much”. The more experience you have the more confidence you probably have in your own ability to determine where that is. Others can, and should, put the responsibility for charting that course in the hands of their CrossFit or other trainer. Once identified, though, it makes little sense to flirt with the flame of “too much” when there is so much to be gained from “enough”.

For me what that means is continuing to pursue at least the maintenance of my functional strength by continuing to follow the latest version of CFSB from The Brand X Method(R). I find that 2 high intensity WODs, 3 at the most, is what I can handle each week. As much as I hate to admit it, long brisk walks are becoming a staple of my fitness and health plan. I should probably ask Abbie the Wonder Dog to join me on those.

Nothing is completely safe; seeking yet another zero after zero after the decimal point before starting treatment means never starting. Once effective dosing is established, in medicine or in CrossFit, one must judiciously minimize risk, but not to the extent that the benefit cannot be achieved.

Better Understanding Conflict of Interest By Studying Bias

So much strum und drang in the air. So many panties in a bunch. The offensitive are on the warpath about, well, everything. We seem to have a surfeit of ethicists among us, proclaiming in nearly real time where anything and everything fits on some mythical ethics grid. To them I offer my own filter, the question I ask before I expend an iota of energy of any kind on the type of “news” that has them all so agitated:

Is what I am viewing unethical, or simply unseemly?

Ethics is a synonym for morals. As such it should be universal and timeless. Ethics should bear nothing in common with fashion.

Speaking of which, it is fashionable in pretty much any field in which expertise can be obtained and the label “expert” attained to lay waste to those so acclaimed by accusing them of having a “conflict of interest”. Traditionally this meant that one might enjoy some sort of tangible gain by trafficking in one’s area of expertise, thereby rendering the expert’s stated opinions somehow tainted. Of late it means that being employed by someone with whom your critic has a beef means your standing to hold an opinion at all is nullified.

Nonsense.

We would be a wiser society if we instead made an effort to sort through the biases held by experts in any field. To demand that one not express any opinion that would support your employ should disqualify the individual who holds such a position, not the expert. To look at the bias that may be present in any expert opinion allows the audience to better evaluate both the veracity of the opinion, as well as its relevance to their own situation. For example, in my day job I have a strong bias to treat any condition that produces meaningful symptoms in my patients.

In truth, in many of the general categories that I cover my remuneration is identical whether or not I treat. Those who bleat on about conflict of interest would seek to nullify all of my thoughts simply because I make my living in the arena on which I opine. Again, this is silly. It is far more useful to read my professional writing through the prism of my pro-treatment bias. In so doing it is far easier to compare and contrast my public opinions with others in my space who may differ. Do they differ on substance, or do they differ because or a countervailing bias?

This is not to say that conflicts of interest do not exist, or that if they do exist that they are never a problem. If you have invented a medical device and choose to use your own device rather than a competitor’s you have a COI. Disclosure of your COI should be mandatory (I disclose all consulting contracts around prescription drugs, for example). If they are of equal quality (equal safety, equivalent outcomes), the COI is mooted. If your device is much more expensive (thereby generating much more income to you), your conflict of interest is unseemly but not necessarily unethical. It should be obvious on its face that using your invention if it is less effective (or Heaven forbid, unsafe) is unethical.

Expertise exists everywhere. Here, on CrossFit.com in the fitness world. Would you disqualify Greg Glassman because CrossFit has been a successful business? How about Jeff and Mikki Martin who have launched a business in the same space? Is their competition a conflict that nullifies their contributions to youth fitness? Among the bureaucrats at the EPA in the care of the environment. Do they not have a contribution to make despite their tax-supported position? Is their (presumed) anti-business bias a reason to dismiss all federal policy? Among the various and sundry talking heads on all of the financial offerings on cable news channels. Don’t you really want them to be rich and successful, especially if you are going to follow their advice?

If we seek to understand the biases that exist underneath the opinions of experts we can better evaluate the conflicts of interest that they inevitably carry along with those opinions. From there is is an easier task to evaluate the character of those conflicts, and better decide whether or not we accept their guidance.

Getting paid to be an expert and to share your expertise is only a meaningful conflict of interest if it is unseemly or unethical, not just unfashionable.

 

Ghosts in the Attic: Lives Remembered

An attic is in many ways similar to the vast storage facilities that lie hidden beneath and above every museum you’ve ever visited. The exhibits you walk through are like the life you see being lived right in front of you. If you are an experienced museum goer the existence of that treasure trove of unseen artwork is something you know is there somewhere. For the archivist, all of that art is there for the asking.

A life remembered lives in the attic or the basement or the back of a closet in the remotest room in the house. Beth spent 3 long days and nights pulling together the totems of her parents lives from the nooks, crannies and crevasses of what is literally the Hurst family ancestral home. No fewer than 4 generations lived significant parts of their lives in what was once a tiny one-room schoolhouse surrounded by Amish and Mennonite farms. What an incredibly daunting task, that.

Hearing her tell of her task (we were “together” on speakerphone) was what it must have been like if you could have been an open ear at the excavation of St. Paul’s Cathedral in Rome. The attic had an attic; each closet had a closet. Every step further into each space unearthed another layer of the family’s history. Here a deed to the original schoolhouse, there the wedding certificate for her great great grandparents. Was her Dad a good student? Well, he had a pretty solid 3rd grade judging by his report card.

And the pictures! Oh my, yes, there were pictures. Beth and her sisters fell straight down the Schaeffer family tree. Who knew how much they looked like their Mom when they were all younger women? I got to see pictures of the stunning beauty I fell in love with some 35 years ago, a literal restoration of the portrait in my mind’s eye of our days of courtship. Treasures unearthed in the attic.

Stories, journals, histories, legends…they all came out of the attic’s attic and emerged from the closet’s closets. Beth’s “legs” fairly buckled under the responsibility of curation. What to keep? What should go? They are the last of their line, these Hurst sisters. Whatever was consigned to go would be forever gone. There are no more attics; there will be nothing to curate. She felt the presence of not only her parents but of their parents, and theirs, and theirs as well.

Is this nothing more than a melancholy musing on memory and loss? Maybe. There was a lesson in there, though, one that Mrs. bingo and I stumbled upon as we “walked” through those archives together. It didn’t have to happen like that. As it turns out each attic corner, each tiny closet contained notes and stories that lead, like so many tiny treasure maps, to the next discovery. Why had my in-laws not taken us all in hand and walked us together along those pathways? For sure there were stories that should have been buried elsewhere, art not meant to be seen by generations hence (note to self: remember this lesson when it is time), but still, we thought of the joy we could have shared had we just known these treasures were there to share. That’s the lesson my friends, one that Beth would agree afterward was worth the lonely emotional lifting she did as she curated a life remembered, archived like so many art treasures in the attics and closets filled over generations and hidden from view.

Someone may be alive today who’s been filling those attics. Find them. There is joy in the attic. Like so much that is joyful, to share your discoveries with those who created them is just too wonderful to let it pass now that you know that you don’t have to. Ask your parents or grandparents to take a walk with you in the attic. Together.

 

In Which Pooh and Christopher Robin Reunite

Christopher Robin: “I’m not going to do Nothing anymore.”

Winnie the Pooh: “Never again?”

CR: “Well, not too much. They don’t let you.”

Toddlers rule the world. Seriously. Beth and I are watching the Man Cub and his tiny baby sister (“Pippy”, at least for now) as their parents take an afternoon to be the young couple that they are. A two year old is nothing but non-stop movement, all curiosity and instant gratification in a tiny bundle of Brownian Motion. There’s no sorta minding the toddler while you “get stuff done”, either. When it’s your turn on watch you are either on them like a hawk or you beg to be relieved of duty.

We are (mostly) blessed that our little guy is also quite bright and very verbal. It makes the time quite a bit more enjoyable while simultaneously taxing. “What is it?” pops out every 2 or 3 minutes, and every activity is preceded by an announcement–”I gotta do whatever”–and then accompanied by “play by play”. The announcements are quite handy in that they let you know where the next disaster is headed so that you can be ready to avert.

Having said all of this I am nothing short of astonished by how much more I am enjoying this stage than I did with my own kids. Don’t get me wrong, the sense of discovery and the unconditional love were there when my kids were toddlers for sure. The difference in the experience has everything to do with me: I have given myself permission to enjoy it this time. On Sundays now I muse whenever, whereas if I were a muser back then I would have tried to muse while on duty, an impossible task guaranteed to increase frustration and diminish the joy in both activities.

Therein lies the key, the gift of grandparenthood: you realize that you really do have a choice. If you are wise (or live with a wise spouse like I do) you give yourself permission to do what once upon a time felt like doing Nothing. It’s not, of course. Not for you and not for your little one. For you the gift is to re-live the wonder of discovery in a child while you witness the purity of the experience your grandchild is having. What your grandchild receives is you. All of you, all to themselves, for what feels like to them at the time like all the time in the world.

In the end the most fortunate among us are those who get to live in the chapter that A.A. Milne never wrote. The one in which Christopher Robin realizes that “he” has become “they”, and that it is only for him to decide that it is time for him to return to the Thousand Acre Wood. In the guise of his grandchild he will find that Pooh is still there, that he still loves Pooh and Pooh loves him. There to sit doing what “they” would call Nothing.

With his grandchild at his side, to sit together doing Everything.

 

Life is Longer Than You Think

Life is long. I’ve been saying this for a while now. Life is only short if you are unlucky. More often’s the case that your life is very hard and it’s STILL long.

How often have you heard the term “long and slow wins the race”? I’m becoming skeptical about this one as well. It seems to me that the average speed of the winning racer is, indeed, rather slow. But if you watch the race itself you notice that the most successful “racers” are actually doing serial sprints. Picking their spots and turning it on. Knowing when it’s “Go Time” and being able to floor it seems to be the best strategy in the long-life race.

If life is long we need to re-interpret some of our other strategies as well. “Carpe Diem”, live for the day, becomes somewhat more complex if we anticipate that we will live another, and another, and on and on. We typically view “Carpe Diem” through the prism of the classic thought experiment, the “get hit by a bus” scenario. As in: “If I get hit by a bus tomorrow would I be pleased with all I’ve done thus far, with what I did today?” In any life, long or short, this line of thought has merit; one should strive to max out each day, wring the most life out of every single one.

A long life prompts one to rise up and view a life not from 3 feet but from 3,000 or 30,000 feet as well. What happens if I DON’T get hit by a bus? If I look at the path I am now on, the trends I have established with the decisions and actions I have taken thus far, is what I am doing and where I seem to be going likely to create a life I will look back upon with pride and with a smile if I DON’T get hit by that bus?

The reality is that you are driving the bus, pedal to the medal at times and just cruising at others, carrying as your passengers the friends who get on and off over the long life. It may be more important to avoid hitting someone else with bus you are driving than it is to worry about being hit by a bus yourself.

For the duration of the trip, however long.

Essential Tech? Really?

The author of an article in last week’s Sunday Times asserted that Google and Facebook are “essential tools.” Jonathan Taplin states that everyone has “no choice but to use them.”

Facebook as an essential tool. He really said that, presumably with a straight face and no irony intended.

The reality of the developed world is that search is indeed essential at some point in most lives. Google owns 90% of search traffic, but there are at least 3 other search engines that are adequate at worst, and likely comparable in terms of information acquisition (if not ad awareness) with Google. Facebook, on the other hand, is little more than a toy in the hands of its users, and likely a dangerous one at that. The nameless, faceless scientists behind the curtain in Oz…er, Facebook…want to get you there, keep you there, and control what you do there. Facebook (and its kissing cousin Instagram) is purposely addictive, and face it, the super-majority of what you may do there is far, far from essential.

It’s very helpful to be able to call up information at the touch of the finger (a sales guy answered a complex, archaic golf question for me yesterday in about 27 seconds). Quite frankly I’m at a loss to think of a single essential aspect of FB in daily life.

My dentist still puts out magazines to help me kill time in the office.

 

Hubris and Humility

“You want to shine but not so bright that you burn everyone in the room.” –Pharrell Williams

The hubris/humility axis an interesting ride, isn’t it? Like you I am watching Matt Frasier run away with this year’s CrossFit Games men’s competition. How will he respond when he is interviewed after his victory/coronation? Where will he land on that H&H line? It’s fascinating to watch someone who is truly extraordinary at what it is that they do walk the line. Indeed, it’s probably not possible to stand out if you don’t stand way to the ‘hubris’ side at some point, at least while you are at whatever it is you do.

This year marked the 26th annual White Family visit to Cape Cod. Like so many of our recent trips this one was filled with talk of illness and cures. We told stories from my Dad’s past (the world’s most arrogant heart surgeon was a favorite) and sadly from my mother-in-law’s present. The morning of my departure was spent seeing patients for whom I’d done surgery, alternately sharing in their delight at vision re-discovered and fending off what felt like over-enthusiastic praise. Like Matt, I’m really good at what I do, and quite frankly when I am about doing what I do I literally go into each “contest” convinced that there is no one in the world better than I am at that particular time.

Is that hubris, or just the confidence that any “athlete” must take into the arena at game time?

The difference probably rests on a couple of things. One must be ever aware that everyone has limits. True, if you are very, very good at what you do your limits may be so far to the right of the Bell Curve that it can seem like they don’t exist. Succumbing to that sense is precisely when confidence becomes arrogance; someone or something is going to break, eventually. One wonders how that arrogant heart surgeon handled the inevitable defeats in the OR.

Pharrell’s quote likely points us to what it is that separates the arrogant from the humble, the realization that what you do well does not necessarily elevate you above those for whom you do it. One who allows himself to bathe too long or too often in the reflected light of his excellence gets burned just as surely as everyone and everything else.

Frasier, like Froning before him in the CrossFit world, will quite likely acquit himself well in his victory interview. He will allow that he worked very hard at his craft, and that his hard work paid off handsomely. His humility will show in that he will also point out that he was given many gifts, born with certain skills that he could then hone through his work and thus produce this singular achievement.

In the end what humility means is the difference between thankfulness and self-satisfaction. Again, Pharrell Williams: “As long as you’ve got your light, people will see you.”

Gardening and Friendship

In an airport, once again, traveling between friends and family, family and friends. Sadly, I’m on my own for these couple of legs. This “sandwich generation” stuff is getting harder by the day. MCO to BOS this morning as I travel from the funeral of my best friend’s Dad to what looks like an abridged version of the annual White Family Cape Cod adventure. We are down one parent, too, and the next generation is in the early stages of careers and families of their own which makes it difficult to get away for a week on the beach. My journey is solo as Mrs. bingo awaits the arrival of the Man Cub’s little sister who begins her own journey any day now.

In the middle of the sandwich, where we welcome babies into the family as we say goodbye to parents who leave, we hopefully share this stage with at least one good friend, and hopefully for our longevity three or more (turns out that’s a magic number). In addition to a brother with whom I cannot be closer and my darling bride with whom I could not be more in love, my journey has been blessed with a best friend who has ridden shotgun or been my driver for 40 years now. We have taken turns carrying each other whenever one of us needed the lift. Mostly we’ve just walked side by side, as friends do..

Friendship is on my mind quite often. I ponder it as I think about friends old and new. My 35th college reunion was a month or so ago, and I am pleasantly surprised at the number of old friends and friendly acquaintances who are emerging from the mists of my past. Misplaced, lost, or cast aside, the skeletons of friendships past walk with me, still.

We are blessed, fortunate beyond measure, if we can count among the masses a single friend. One to whom we can always turn, from whom we withhold nothing, who will give to us everything. To have more than one friend such as this is to have a kind of wealth that beggars description. My parents gave one in 1961; Rob, the friend who just lost his Dad, showed up in 1978.

If we are lucky enough to have such friends they are joined in the garden of our lives by that next best thing, friendly acquaintances, and these in turn are surrounded by acquaintances. The entire garden is encircled by farmland that lies, for the moment at least, unexplored. The enterprising gardener is always on alert for new seedlings out there to plant in that garden of friendship.

The garden analogy is an apt one for friendship. A garden requires tending and so, too, does a friendship. Left untended, left to chance, it is certainly possible for a garden to flourish. All too often both gardens and friendships ignored too long have a beauty that is but a cherished memory, seen only with the mind’s eye.

Friendship, like a garden, grows best when exposed to both sun AND rain, albeit for different reasons. A friendship that has known only sunny days may weather that first storm; a friendship that has known both sun and rain is steeled against any and all weather, especially if we gardeners were active in the tending despite the elements. So it has been for my friends and me.

Who is your friend? Who is there for you in both sunshine and rain? From whom do you wish only friendship, and who asks only the same from you? Have you done your part? Have you tended your garden in both sunshine AND rain?

I am in an airport, leaving my friend and headed toward my brother. It’s raining; we are all missing our Dad. But we have tended these gardens for decades. The sun will come out soon enough.

The Expense of Early Sport Specialization

My role in the horse world to date has been little more than loyal supporter. This includes my posts as head cheerleader, financier, and klutzy outsider comic relief (for example, I always seem to be over- or under-dressed). My ROI is measured in the smiles on my girls’ faces over the years. They have seemed to truly enjoy the process, the journey, sometimes with little regard to the outcome or the score.

Everything about the horse world is expensive. Really expensive, actually. There are lots of expensive sports out there to be sure. Golf, tennis, and hockey come quickly to mind. All have in common expensive equipment, coaching, and venues, even at the lowest levels of participation. Most other sports only become expensive when you add in the effects of higher level competition with the new burdens of professional coaching and travel. Think AAU anything, gymnastics or swimming.

One thing that sets the horse world apart is the Sugar Daddy or Sugar Momma, a usually over-monied individual whose sole role is to write checks. Big checks. Lots and lots of checks. Most whom I’ve met don’t really seem to enjoy hanging around horses, actually. Kinda like someone who owns a big boat but gets seasick in the bathtub. The other essential difference between a Sugar Daddy/Momma and a “Little League Parent” is that the Sugar Daddy/Momma doesn’t care a lick about the outcome of the event.

In a funny, very roundabout way this makes me think about youth sports, high school sports, and the behavior of parents in that world. Unlike the Sugar Daddy/Momma the youth sports parent is highly invested in outcomes, not only game by game but also in terms of reaching the next level. As in that level to which the ridiculously large percentage of participants never get. You probably think this is about going pro, about making a living at your sport. Nope. That number is so tiny and has been parsed so many times and so many ways that it’s not worth spending the electrons thinking about how few college athletes or minor leaguers make it to The Show. I’m not even talking about getting a scholarship to play a D1 sport.

What I’m thinking about is some fascinating facts about how few high school athletes go on to play a sport at any level in college.

Seriously, the numbers are comically low. Cut and past this for a look: http://www.ncaa.org/about/resources/research/estimated-probability-competing-college-athletics. For boys, only lacrosse and hockey are above 10%. More boys go on to swim in college (7.1%) than play football (6.8%). The statistics are similar for girls led by Ice hockey (24%), lacrosse (12.9%), and field hockey (10.1%); all other sports are in the low to mid-single digits. I don’t know about you, but with all of the teams sponsored by Division 3 colleges out there, along with the dearth of multi-sport athletes taking up more than one slot, these figures are really shockingly low.

How, then, can we justify the expense of early sport specialization, both in real financial terms, and in terms of the epidemic of injuries suffered through over-use and under-preparation?

On my most recent foray into the horse world I met a  youngster who plays on a volleyball team that uses CrossFit to enhance their fitness.  She no longer does her first-love sport, tumbling, because of a repetitive use stress fracture in her back suffered before she started to play other sports. All tumbling all the time wrecked her. How many young arms must we scar with a Tommy John “autograph” prior to obtaining a driver’s license before we suggest adding in a little winter reprieve from pitching? Isn’t it just a bit disheartening to think that the ACL tear rate in young female soccer players is higher than the overall NCAA participation rate for girls who played that sport in high school? Mind you, these are TOTAL participation rates, not the percentages of kids who got a scholarship to play D1. The list goes on and on.

Says here that the kids would be far better off playing more sports with their buddies in their hometown schools, both physically and mentally, than they are now joining elite travel programs and chasing after such a small number of slots at the next level. Probably have a better relationship with Mom and Dad, too. For sure Mom and Dad are likely to be better behaved. Throw in a little bit of fitness training that emphasizes proper mechanics in functional movements and maybe we can start a trend.

No Sugar Daddies or Mommas necessary, either.