Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Archive for April, 2009

Grace Under Pressure

Adapted from Sunday Musings…

Grace under pressure. The theme running through Hemingway’s collected works is that of men exhibiting grace under pressure. His writings were informed by, in part, his close observations of the Spanish Civil War (A Farewell to Arms) and his time among other hard men outdoors (The Old Man and the Sea).

In suburbia, the home of most Americans, we witness not so much grace as desperation. Men and women separated from the frontier by three or more generations, separated from systemic hunger and deprivation by as much as well, now have fewer models to follow when faced with pressure or failure or tragedy. More Tom Joad than Job, and more rare still the selfless grace of Joad’s savior.

And so it is all the more striking, alarming even in such stark contrast ,when we see not quiet desperation but quiet grace under the pressure of tragedy or deprivation or loss. There aren’t many, but there are still families where illness or job loss means someone doesn’t eat. Usually a parent so that a child does not go to school with an empty belly but occasionally a child as well. These gentle souls quietly struggle on with grace and dignity, and accept what help there is with equally quiet gratitude.

Men and women lose sons and daughters, husbands and wives who die in the service of their country, either defending Her abroad or on the streets here at home. It’s amazing, don’t you think, how infrequently we hear those left behind rail at the injustice of this particular loss. Striking how rare it is to hear them flail at those who march on through life unaware of this loss, unaware of the sacrifice that had been made so that they might walk still unaware. Grace.

What may be the cruelest example one can think of is knowing you will die,while knowing pretty much WHEN you will die, and knowing that you are essentially powerless to alter your fate. It happens every day around us, you know. The lump returns in the breast that was “clear.” The bone marrow transplant fails. No heart arrives in time and the transplant never occurs. The cancer is inoperable at the outset, a death sentence meted out on diagnosis. The clock spins, the pages of the calendar flip, and you know exactly when they will stop.

I have a friend who has encountered this last scerario. Younger than I, he will never see a child graduate from high school. Never give a daughter’s hand in marriage. Never hold a grandchild. And yet…not a word of protest. Sadness to be sure, but no anger. Pleased and purposed to fill the few months remaining with whatever may come. Not terribly religious but graceful and filled with grace nonetheless. Would I demonstrate as much were I so afflicted? I confess that I just don’t know. I fear that I am a coward, and that my cowardice might overwhelm the courage necessary to live with such grace.

I share the small glimmer of hope, that tiny burning ember that my friend, his family, and all of us who love him husband and fan as we try to turn that ember into a flame. I will remember, always, my friend’s grace under pressure, and hope that this memory will give me the strength to do as much and as well should the need arise.

I’ll see you next week…

Comment #54 – Posted by: bingo at April 26, 2009 6:03 AM

Saving Cleveland

Maybe I should move.


I’ve lived in or near three major cities in my adult life and each one of them tried to commit economic and/or social suicide while I was there. I grew up just outside of Providence, Rhode Island in the 70’s and 80’s, and I lived and trained in New York in the 80’s and early 90’s. Each one of those cities was in a death spiral, largely from self-inflicted wounds, while I was there, and each of those cities enjoyed a phenomenal resurrection after I left.

Now I live in Cleveland.

Cleveland, Ohio and its surrounding counties is in the midst of a 4 decade long plunge from prominence and prosperity. Did you know that Cleveland was once headquarters to more Fortune 500 companies than any other city in the U.S.? That Cleveland Hopkins Airport was once the largest busiest airport in America? Didn’t think so. How did this happen? How did Cleveland go from being a major player in all regards to being the sad relative who fell from grace, kicked away her fortune and is now spoken of in hushed tones if she is spoken about at all? How did we arrive at a point where everything seems to hinge on the success of something called the “Medical Mart”, the equivalent of sending a slap-singles hitter to the plate with two outs in the bottom of the ninth to hit a walk-off grand slam?

The macro answer of course is the loss of our core manufacturing businesses, the long, slow cruel death of the domestic steel and auto industries that employed so many of our men and women. The corollary to that is the failure of Cleveland to replace its lost industries with newer ones, industries that provide the jobs and financial bounty that keep a city and a region afloat. Boston is a very good example of a city that lost an enormous economic engine (textiles) and actively replaced it with a newer industry (bio-tech and computer tech). What Boston had and never lost, however, was a willingness to do whatever it took to give businesses and the people who work for them a reason to live in and around Boston.

Which brings me to Providence, a slightly smaller city than Cleveland that had the same micro and macro issues in the recessionary 70’s and 80’s facing us now. The textile and jewelery industries were dying or dead, victims of age, inattention, and a strong U.S. dollar that prompted a wholesale flight overseas. Unemployment was high, taxes were high, and there was a steady exodus of people young and old out of the City to the suburbs. When I was growing up Providence was a rat hole with only one street worth visiting; at that you took your life in your hands to get to Thayer Street.

A beautiful waterfront was undeveloped and left to waste. Providence did have an excuse on that last point, though. The Providence River was PAVED when I was growing up, covered in streets upon which were built uninspired and eventually empty buildings. I didn’t even know there WAS a Providence River then! I look at Lake Erie every day.

And now? Well, now my son and his friends in Denver think they might like to move to Providence! A group of twenty-somethings living in Denver think Providence is a likely place to find fun and financial success! It’s really unbelievable. MY Providence is cool! How did THAT happen?

Let’s use a sports analogy. We brain-damaged, washed-up ex-jocks love sports analogies, either due to inadequate imagination or the afore mentioned brain damage.

I last visited Providence in October on the occasion of my parents’ 50th Wedding Anniversary. Downtown Providence was teeming with people, thousands of people, on a Saturday night. The Providence river was ablaze in a bi-weekly summer event, the River Fire, in which mid-river cauldrons held wood fires along the length of the River. This was similar to what I had witnessed on a previous trip in the mid-90’s except that now the river was chock-a-block filled with new residential buildings, restaurants, and clubs, all new since my last foray downtown and all filled to the gills.

More than somewhat amazed I asked my Dad how this had all happened. He laughed and answered something like “little ball”! Like a manager facing a 9th inning deficit someone in Providence, someone with true vision, realized that a grand slam was going to be necessary. But that particular someone also realized that in order to hit a grand slam (in this case “un-pave” and develop the Providence River) you first had to load the bases. A single here; a walk there; a steal; bunt the man over. You can’t hit a grand slam if the bases are empty.

The City of Providence, the mayor and City Council, played “little ball” and did the little things first before trying to do the big thing. The City was unsafe, and more importantly it was perceived to be unsafe by everyone in and around it. Policing was dramatically stepped up in both volume (number of officers on the street) and intensity. Neighborhoods were re-claimed one at a time from the hoodlums who struck fear in residents and visitors alike, and this was the stated priority of both the mayor and police chief. Every success in this venture was trumpeted from on high. No success was too small to crow about.

One tiny, high profile neighborhood was chosen for a city “investment”. They paved the sidewalks in Federal Hill, “Little Italy” in Providence, and erected an arch at the entrance to the neighborhood. The whole project may have cost $500,000, a rounding error in the city’s budget but a very visible investment in making the city livable. Most importantly, the city and its elected officials received a “Love Bomb” from the local media. Every radio station, TV station, and newspaper (including the 800 pound gorilla the Providence Journal) made every little success a BIG STORY.

Then a funny thing happened. Businesses started investing in the city that had invested in itself. There’s a little luck here, for sure. Kinda like hoping that slap-singles hitter will clear the bases, but the business community bought in. Then came the River and more good press. Then came the young people. Then, and only then, came the Convention Center.

So, back to Cleveland. Where are we in this process here in Cleveland? Well, in the early innings of the game there was some promising stuff. Gateway and the building of the ballpark and arena. Oops, no support and dwindling good stories. Three men left on base. The Flats grows into a vibrant entertainment area. Rats, the perception that the Flats had grown unsafe due to insufficient safety assets and continual harping on the bad stories by the local press. Inning over. The Euclid Corridor receives interest and an offer from one of the most famous consumer tech companies to set up shop right in the middle of the new district but the Mayor declines to meet with the senior executives when they come to town. Wasted batter.

Maybe the only thing left for me to do is to move. Maybe that’s what’s holding Cleveland back. Heck, just the other day I turned the Tribe game off and Pronk jacked one out!

But I don’t want to move. I truly want Cleveland and its leaders to do the little things, play some “little ball” to load the bases. Make the city safe in both reality and perception. Choose a couple of small projects, succeed, and then tell the world that you succeeded. I want the Plain Dealer, all the “W-somethings” of Cleveland radio and TV to send a “Love Bomb” to Cleveland.

As it stands now it feels like Cleveland is down by 5 and trying to hit a grand slam to win the game in the bottom of the 9th.

And the bases are empty…

Sunday Musings 4/19/09

I have said over the years that if this Ophthalmology thing doesn’t work out that I would move as far out on Cape Cod as I could and try to write for Sports Illustrated. Fortunately for everyone in the White house I’m still working with my hands but not necessarily using them to type!

My writing career, such as it is, began with some Random Thoughts from my alter ego “bingo” shared with the Crossfit community each Sunday. My very good friends Greg and Lauren Glassman are the founders of the Crossfit movement ,and they have indulged this little exercise that I called “Sunday Musings” for a little over two years, basically by ignoring both me and everyone who complained about my musings! It is through their generosity, giving me a place to exercise my “brain muscle” along with all of my skeletal muscles, that I re-discovered my comfort with the written word. I’ll have lots to share about Crossfit as time goes on, but as long as you are here I thought I’d share this little part of my Crossfit world with you each week.

So here, with gratitude and love to Greg and Lauren, is bingo’s “Sunday musings”…

1) Opera singers give and get more out of one syllable than any American Idol does in an entire album.

2) The Never List. I used to have one of these. You know, things I never have to try unless forced to. Mrs. Bingo was teasing me the other day while I was slicing some tofu into soup. “Wasn’t tofu on your ‘Never List’ when we met? You wouldn’t even say the word–you called it ‘oofaught’!” Back then my list had things like war, cocaine, cowboy boots, and other sillier stuff I can’t remember.

Mrs. Bingo was teasing me and gently reminding me of how narrow-minded and certain I was as a younger man, while reminding me of how well she has “raised” me. I have to admit, AGAIN, that she is right, that I have had more fun by shrinking my “Never List” than I would have by expanding it. Of course the real “Nevers” will stay that way, but maybe think about re-visiting your own “Never List” with fresh eyes.

FWIW, I would still look silly in a bow tie and cowboy boots…

3) Progeny. We’ve had quite a few births chez Crossfit recently, and we have some twins on the way soon. For most of us, and for most of our lives, we all share something quite special with “S’morelle” and the JroCk “Pebble”–we are all sons or daughters for as long as we have a Mom or a Dad.

I am at that stage of life where my friends are starting to lose their parents; I have a wake to attend this afternoon. Whether or not we choose to acknowledge it, being a son or a daughter is a significant part of who each one of us is as an individual. For some it’s good and for others it is certainly less so, but we can’t escape the reality of our “son-ness” or “daughter-ness”.

Until we are no longer a son or a daughter. Until we are set adrift by the loss of our last remaining parent, awash in the memory of being someone’s child yet no longer engaged in the daily acts of being a son or being a daughter. Some have spoken about a sense of “orphanhood”, an unexpected emptiness in the time-space both ahead and behind.

Blessedly I am still a son, still in possession of both parents (or possessed by both parents; Grambingo still considers her son a work in progress). We never know when that day will come when we, too, will become “orphans”. I have enjoyed being someone’s son, and I think today is a great day to remember that.

A great day to let my Mom and Dad know that.

I’ll see you next week…

Comment #65 – Posted at April 19, 2009 6:22 AM

Why Ophthalmology?

“What made you want to be an ophthalmologist, Dr. White?”

Not a day goes by that at least one of my patients doesn’t ask me this question. Today it was a new patient, 75 years old or so, and a young man in for his first glasses at age 12. Sometimes it’s “why did you want to become an eye doctor?” I have a quick answer for the office of course, but I thought I’d use this as an opportunity to go back in time and “watch” myself make the decision all over again. It was a good decision then, and it’s been a good decision ever since.

I originally thought I would be an orthopedic surgeon. After all, I’m a washed up, blockhead, brain-damaged ex-football player. Orthopedic surgery just seemed to be a really good fit. I loved my Ortho rotation during my 3rd year rotations at UVM. Loved everything about it. The work, the patients, the clinical problems we encountered. I loved the surgeons–heck, they were all basically ME 10 or 15 years older. Loved it all.

Then I met Peter Linton, Chairman of the Division of Plastic Surgery at UVM, and Peter very quickly became my mentor. He and his wife Pam “adopted” my wife-to-be and me, feeding us and giving us a safe place to bring the problems that arise in a young physician and in a young marriage. And what cool surgery! Putting broken pieces/parts back together. Rebuilding a self-image through a combination of technical skill, vision, and artistry. I was smitten, and Peter lobbied day and night, enthusiastically pushing me to follow his career path.

There were a couple of problems, though, with each of these specialties. In the first place people die, and the broken patients in these two surgical specialties are no exceptions. I struggle with death; always have. How would I handle this? Also, I was deeply in love with Beth and committed to doing whatever it might take to be the very best husband and eventually father I could be. We talked for hours about the impact of residency on our new family, about the killer hours in Ortho and about the 7-9 YEARS of training that most Plastic Surgeons undergo. I can still remember, as if it was last night: “I love you dearly, but I’m not sure if I can love you 9 years of residency.”

My Dad spent his entire working career in ophthalmic manufacturing, running companies that made all kinds of things associated with eye care and vision. I grew up around optometrists, opticians, and optical fashion designers. To see what the medical side of my Dad’s world looked like I took a “flier” on an elective in Ophthalmology to see what the medical part of Dad’s world was like. Two weeks of cataract surgery, glaucoma checks and new glasses for nearsighted kids. I followed this up with rotations visiting the academic programs at Georgetown, Wills in Philadephia, and Pacific in San Francisco. A local surgeon in Burlington took me in for a month and showed me what the real life of an Ophthalmologist felt like. What a cool world! What cool gadgets! High frequency ultrasound to dissolve cataracts. Lasers–all kinds of lasers that did all kinds of cool stuff. This was it.

To top it off the residency programs were a total of 4 years long, and most of the Ophthalmologists I met were home for dinner with their families. Score! Although my choice DID come as somewhat of a surprise to the rest of the faculty. When the residency Match results were published the Chair of the Department of Family Medicine cornered me, a concerned and sympathetic look on her face. “What happened, Darrell? You matched in Ophthalmology?” To which I replied “I know, Marga, isn’t it great?” “Hmm…we were all sure that you would be an Orthopedic Surgeon; you were just the right amount of malignant.”

Well, Marga, this Ophthalmology thing has turned out pretty well for me so far. I married that girl, My Beautiful Bride and Better 95% Beth, and we are married to this day. I’ve been home for dinner most nights with her and the kids since then. For the most part my patients don’t die, at least not from anything that I’M treating. Ophthalmology patients get better, and because vision is such an integral part of the human experience, both physically and emotionally, the gratification that one gets from returning someone to the sighted world is simply immeasurable. Oh yeah, we still have the coolest gadgets in all of medicine, and we get new ones to play with every year. And for whatever it’s worth, most of my best friends in medicine are also washed up blockhead ex-jocks, most of whom are slightly less brain-damaged than I.

Except, that is, my Orthopedic Surgery buddies…

Welcome to a Restless Mind!

Welcome to Random Thoughts from a Restless Mind!

Why a blog? Well, it’s rather simple and rather complex, just like most of this stuff I guess. I enjoy the act of writing, exercising my “writing muscle” as it were. It’s fun to work at words. To put them together in a way that makes sense, but also in a way that pleases a reader. I am a victim of my upbringing (and you can expect to hear more about that as time goes on!), and I can’t escape my Liberal Arts education. My career as an eye surgeon does not afford me many opportunities for continued exploration of the Humanities, and I’m hoping that RTRM will allow me to travel those paths once again.

Why now? This is the complex part. Do you ever get an idea, something in your mind that has no place to go, and you can’t let it be until you find its place? Happens to me all the time. As a matter of fact it’s getting kinda crowded in the Restless Mind with a lifetime of thoughts, ideas, inklings and epiphanies all circling with no place to land. Perhaps if they find a home here they will take flight in a new, different way, clearing some airspace behind.

So, what’ll I write about? Likely stuff I know a little something about, at least in the beginning. Things like Eyes, Eyecare, and Eye Surgery. Vision and “the Vision Thing”. Parenting, marriage, and family. Sports, competition, coaching, and my beloved Crossfit. Soul Patches. I’ve spent a lot of time teaching myself about economics and learning about things like medical economics and Healthcare policy–I imagine I’ll have stuff to say about all of those things. And don’t forget, I’m a surgeon after all. We surgeons are pretty sure we know something about pretty much EVERYTHING!

Who’s going to read all of this? Frankly, I have no idea. I think I’m going to enjoy the process of writing this even if my only readers share my genome. But I hope a few other folks might stumble across this space as they amble through cyberspace, a random stop in their restless meanderings. If so, I hope they enjoy the visit. Perhaps something here will spark a new thought in a visitor, and perhaps he or she will share that thought with me and anyone else who happens to be here. I hope so.

Welcome the the Random Thoughts from a Restless Mind! Don’t be a stranger…

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