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Dr. Darrell White's Personal Blog

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Archive for August, 2016

Wellbeing Is Part of Being Healthy

Some time ago I wrote about creating a way to measure health. Real health. Health that encompasses every aspect of what it means to be alive and well. As a CrossFitter I definitely included Coach Glassman’s Disease -> Health -> Wellness continuum, and I also acknowledged the critical importance of his concept of “Fitness over Time”. As a classically trained physician/scientist there is clearly a place for more traditional metrics like blood pressure, serum lipids and the like, although they may, indeed, be a variable that is ultimately tied to fitness.

Where my thoughts on defining and measuring health seem to depart from most current trends is in the recognition that mental health–emotional wellbeing—is as much a part of being healthy as anything else we might examine.

Think about it for just a moment. Most of what we would classify as mental illness has as many outward signs that we can see as diabetes and hypertension. Which is to say, none. Yet we see nothing but the good in treating diseases like diabetes openly and aggressively. There is no stigma attached to seeking care for your hypertension or your elevated LDL. To the contrary, if someone who loves you discovers that you stopped measuring your glucose before you bolus your insulin, they are for sure gonna get in your grill.

For whatever reason, mental illnesses are looked at quite differently. No one is asking the person with chronic depression whether she is taking her life-saving medication, for example. We might notice an insulin pump on a friend or family member, but then it’s quickly forgotten. Everyone seems to be very uncomfortable around the young man who has very obvious hand tremors from the life-saving medication he takes for his Bipolar disease. We all seem to be so much more understanding when we have to wait for a response from someone suffering from Parkinson’s Disease than from the young women who has those same symptoms as a side-effect from the medicine that quiets the dangerous thoughts in her head from Schizophrenia.

It’s not necessary to look only at these kinds of severe mental illnesses when we are examining the importance of mental or emotional wellbeing as an integral part of being healthy. What good does it do to have a 5:00 mile, a 500 lb. deadlift, and a 1:59 “Fran” if it was self-loathing that drove you in the gym to get there? You may be quite accomplished, the envy of your peers, at the peak of whatever life mountain you wished to climb, and yet you cannot feel joy. How is it possible to be healthy without joy? I look at Usain Bolt and what I see is quite possibly the healthiest man alive. My friend Tim, the writer, tells me that Justin Gatlin has nearly everything that Bolt has—youth, fitness, wealth—but the combination of failure to knock off Bolt, and the public disapproval reigned on him as boos from the Rio stands has left him emotionally broken. It’s subtle, but if you look at his face in the blocks of the 100M Olympic Final it’s there.

Our complex and conflicted attitudes and feelings about mental illness are especially evident when the topic of suicide comes up. Just typing the word makes me uncomfortable. Even how we describe suicide is fraught with hidden meaning that reflects our discomfort: someone has “committed suicide”. Right? Someone committed an act that we simply cannot fathom, one that leaves the survivors completely without any understanding whatsoever. How could someone DO that? It’s as if every suicide is the same as the suicide of the crooked prison warden in The Shawshank Redemption. He looks out the window and sees his fate arrive in the front seat of a State Trooper’s car, and swallows his revolver.

In reality most of the time it’s simply not like that at all. Nothing about it is simple at all.

The outer walls at the periphery of my world have been breeched by suicide twice in the last couple of weeks. One of them, close to my age, actually does feel a bit like that prison warden. Frankly, I am too conflicted, too aware of the external circumstances involved and not enough aware of the internal life of the deceased to offer much right now. The other one, however, stopped me in my tracks when I heard. The loss was profound. It has also introduced to me a new vocabulary that I truly believe provides a starting line from which we can change how we think about not only suicide, but all of mental illness. A friendly acquaintance lost his wife when she was “killed by suicide”.

We don’t need to know all of the details of the story. Suffice it to say that in the face of a child’s illness she suffered quietly. Too quietly to be noticed. Perhaps she didn’t realize how badly she was suffering, or maybe she was like so many of us and couldn’t bring herself to see her illness for the life-threatening entity that it was. No one will ever know. What is clear, though, is that this was not anything about commitment. Kidney failure may be the cause of death in a diabetic, but it is diabetes that kills him. There is no difference here. The cause of her death was suicide. Her disease, her depression is what killed this young woman.

Each of us has a very few moments in our lifetimes that forever change us. On the second Tuesday of July in 2006, unbeknownst to me, one of those moments was transpiring in a lonely, dark corner. Joyfully, the moment was a hopeful beginning, not a tragic ending. Regardless, once learning of the moment I was changed forever. Now I knew. You cannot see any marks from mental illness, no swollen appendage or insulin pump to clue you in. But it is there all the same, and it must be acknowledged and accorded the same degree of care as any other disease that may take our loved ones from us. Mental illnesses are real, and they can be deadly. There ought not be any conflict or discomfort in treating them. There ought not be any conflict or discomfort in seeking treatment.

We may stop losing so many of our loved ones when start to see emotional wellbeing as part of being healthy. When treating mental illness is as much of a non-event as injecting insulin for diabetes.

“Proper English” and First Impressions.

In my day job I work with folks of various backgrounds, both in terms of education and upbringing. In all walks of my public life I come in contact with an even broader swath of humanity in all regards. I routinely travel up and down the social, economic and educational ladders at work and at play. For the most part, with everyone I meet the language we all speak is English. I live in Cleveland, Ohio, USA after all. Our English, however, is hardly the same.

While we cannot truly escape our origins, as we cannot truly escape our genome, we can choose how we interact in the daily mechanics of society regardless of origin. For better or for worse this begins with how we speak. That old saw, you only get one chance to make a first impression, is especially true when you speak, and especially important because for the most part you can choose not only what you say but also how you say it.

There’s nothing new or striking about this concept, either. You can think of it as verbal situational awareness. You would (hopefully) speak differently to a priest than you would the surfer sitting next to you beyond the break. On the phone with the cable company should sound very different I think than on the phone with your BFF. All speech is by definition qualitatively different that a text or an email because speaking implies hearing; speaking and hearing involve the inclusion of inflection, tone, and tempo. Really basic stuff.

Why, then, is it so brutally common to hear such poor English? Poor grammar, improper word usage, a situational tone-deafness. This doesn’t even begin to touch on the concept of working vocabulary (BTW, the person with the largest working vocabulary I’ve ever met is responsible for our little CrossFit thing). Once upon a time one heard much about “Proper English” or “The Queen’s English.” What happened?

In English we do not have the French equivalent of “Tu” vs. “Vous”. No lazy man’s way to “polite-up” our speech. A certain unearned familiarity is too often presumed. We take way too many liberties with grammar, and frankly we too infrequently make the effort at “polished” English when it’s time to do so. That first impression thing is incredibly affected when you open your mouth to speak, on the up and the down sides. It is equally jarring to hear the word “ineluctable” from a guy in faded jeans and a baseball cap turned backwards (up) as it is to hear “me and Joey are gonna go…” from a guy in a suit and starched collar (down).

The stark reality is that there are no barriers to the “up” version of English. There is no genetic, social, or economic barrier blocking the acquisition of the ability to speak well, and by extension to acquire the situational awareness to know when it is vital to do so. All that is required is the effort to learn that version of English that we know as “proper”, and the effort to learn when. It’s not necessary to speak like this all the time. You can choose to “let your hair down” so to speak–my love for the versatility of the “F-bomb” is well known in certain circles–but a lack of virtuosity in the English domain is a choice.

There are many aspects of a “first impression” over which we may have little control. Don’t choose to let your version of English be one of them.

Sunday musings 8/21/16: “Dark Matter” and the Road Taken

The book “Dark Matter” by Blake Crouch continues to provoke. A brilliant physicist and his girlfriend, a supremely talented painter, discover that she is pregnant. They have just begun dating. The pregnancy is a classic crossroad. Which way to go? End the pregnancy, go their separate ways, and pursue the limits of their individual gifts, or follow their emotions and make a go of being a family? In the novel they choose to have the child and marry, settling into a life dedicated to home, in which their respective brilliances are mundanely applied toward supporting the family. They seem to be quite in love, and their little family of three appears to be well to the happy side of the Bell Curve.

Did they make the right decision? A reviewer for the WSJ opines that they “settled for, well, mediocrity.” Had they, though? It turns out that the young physicist is an expert in Quantum Physics, his specialty the study of “quantum superposition” (Google: Schroedinger’s Cat). His area of research is that of creating a portal to the “multiverse” of infinite possibilities, one of which, of course, is the one in which the couple did decide to choose their individual paths. He solves the riddle of Schroedinger’s Cat, gains access to the multiverse, and both versions of the physicist are able to examine the path not taken.

What do you think the physicist who chose his career over marriage and family discovered?  The one who chose family over career and eventual fame? I won’t ruin the story for you by answering those questions, but I will hazard a tiny ‘spoiler’ by taking issue with the WSJ reviewer: the young couple who chose family over devotion to career settled only for mediocrity in their professions. They had simply applied other parts of who they were to their fullest expression in the pursuit of excellence at home, as a more careful reading of the early part of the book makes clear.

The point? Lots of them, actually. Each of us faces more than a few truly epic, life-altering  decisions where we stand at the crossroad. Which way should we turn? The tragedy is not in choosing the wrong path; it is in not choosing at all. Simply drifting through that crossroad without committing to the decision is likely what sows the seeds of regret if things don’t turn out just quite so. In reality, we don’t get to observe what it looks like at the end of the road not taken. Certainly not like the physicist who managed to turn himself into the cat that lived.

“He had his life—it was not worth much—not like a life that, though ended, had truly been something. If I had had courage, he thought, if I had had faith.” –James Salter, “Light Years”.

The antidote to regret lies in the knowledge that one must have the courage to acknowledge the crossroad before you, and the courage to make a choice. What inoculates us as we continue down that path is an unwavering faith that we made the best choice we could at that time, at that crossroad.

Faith that leads us to commit to the best possible destination in our one, singular universe.

 

A Friday Quickie: Genius

We are constantly told of all the wondrous things computerization and automation can do that we humans cannot do, or cannot do as well. What we DO do better, though, is patten recognition. Everything from identifying things visually (a computer can barely recognize a Chihuahua as a dog, let alone differentiate a Chihuahua from a Great Dane) to seeing trends in a data stream, the human mind is particularly wired for pattern recognition.

For this reason some people hold the view that there is no such thing as genius, that each new discovery is simply the next logical extension of what has come before. You know, the intellectual version of “you didn’t build that”, or “there’s nothing new about CrossFit.” I think there’s more to genius than that, though.

Pattern recognition is dependent on the point of view, literally, from which you gaze upon the pattern. An “E” looks entirely different if you look after rotating it 90 degrees away from you or 180 degrees clockwise, for example. Genius might be the ability to see something from a wholly different angle so that the pattern becomes evident; seeing the first “E” from the back side only and knowing it’s an “E”. How many times have you come across the output of someone’s genius and just “gotten” it while simultaneously saying “I coulda/shoulda thought of that”? It really doesn’t matter how prosaic or common (flush toilets–big fan of the inventor), or how poetic and earthshaking (predicting the Higgs Boson).

Genius really does exist, and the product of genius should be acknowledged as such.

Cape Week: In Memorium

The beach was chilly, the water a boiling mass of foam, yet the sand was smooth and calm.  Unaffected. Doubtless, it had seen this before. My eyes began to leak. It must have been the wind. Yes, that’s it. The wind. I stood there in silence, struggling to fix the image in my mind. I knelt down to kiss the sand of my beloved beach. With a shirtsleeve to stem the flow from my eyes I walked away from 25 years of family history and toward the beginning of a new story.

What does it take to bring together an entire family for 7 days under one roof, every year, for 25 consecutive years? Why even start in the first place? Once upon a time families were born, grew, and died in a single town or small group of neighboring towns. Getting together was a given. Holidays presented a challenge born of access: who would host whom for what occasion at what time and for how long? Your Mom or your spouse’s Mom for Thanksgiving or Christmas or whenever. A cousin’s graduation might be a life-or-death obligation, attendance mandatory. Proximity rendered this moot, but we moved away.

First borns both, Beth and I married first and had the first grandchildren. We hit every adulting stage before any of our siblings. This meant encountering in-law issues first as well. Where would we go and when? Sticky wicket, that. The solution, at least for the White family was the creation of a separate holiday totally removed from any established American tradition. We would all go to the beach together, just like we did as kids. Thus began “Cape Week”.

How do you get 4 young couples, all of which had multiple children to return time and again to the same place at the same time to do pretty much the same stuff each year for 25 years? It could be having a parent everyone was afraid of, or another no one wanted to disappoint. For sure having BOTH was a key component. Through every milestone each little family plowed through and found a way to make it to Cape Cod each year to spend every waking moment together in our little compound. Only serious illness kept anyone away.

Over the years change did eventually come in the way of summer jobs for the grandchildren, which led as such things do to real, live adult jobs with little vacation time. That and of course, another generation of in-laws for our children to now contend with. Whispers of change were on the winds these last couple of years, but still, almost everyone was there for almost the whole week each summer.

I know what you’re thinking. Somehow it must have been easy for us. There must have been some sort of massive bribe, or something. Nope. What it took was a ton of commitment and hard work by four (now not so) young couples to make Cape Week happen. One family came from California for several years, another from the Midwest. There were summer camps that were never attended, All-Star teams made but All-Star Games missed. The classic teen rebellions against family were quashed, all 10 cousins showing up many more years than not. Invitations to vacation alternatives were graciously turned down, and every “how come always your family” discussion always ended with some version of “we can do that, too, just some other week.”

Cape week itself took hard work and commitment. Four families, 10 kids, and two grandparents together for meals, beach games, TV at night, and forays en masse to the ice cream shop. It could be a little bit cramped, even with the addition of a second cottage in year 4. Those 10 cousins from homes scattered all over America have grown up to be friends who know an amazing amount about each other despite their age differences and lack of proximity. For instance, 10+ summers of having the “college talk” with their aunts and uncles is uniformly one of their WORST memories. Yet there they were as well, every summer in which there was no unavoidable conflict.

Until this year.

Why now? Why this, our 25th year, are we now closing the book on the last chapter of Cape Week? The easy answer is the loss of one of those grandparents, my Dad. It really doesn’t matter whether he was the one we were afraid of or the one we didn’t want to disappoint, I think it’s more a matter of needing both to make something like Cape Week a forgone conclusion. That one singular loss seems to have opened the door for each family to consider the value of Cape Week to their individual families.  To think the heretofore unthinkable: something is more important to our family unit than the annual assembly of the extended family.

Is that it then? Is it over, 25 years and out? It’s been an extraordinary run. Not a one of us knows a soul who’s even heard of a family that pulled off something like this. What is clearly over is Cape Week written in stone, and while that has always been inevitable if any of us ever really gave it any thought, it is quite sad nonetheless. We will continue to rent the main house, installing Gram for a week in the same chair at dinner, on the same spot on the beach. A calendar will say that it’s number 26, but it will be different. A new Cape Week, year number 1, invitations soon. Who will come?

If I close my eyes I can still see my beach. See it, as it has been these 25 years. With my eyes closed I see my Mom and Dad, young and vibrant, surrounded by babies and toddlers covered in sand and seaweed. There’s my brother and his wife, my sisters and their husbands, my darling Beth. We’re all together. My eyes have begun to leak again and it’s all a blur. There’s a breeze in my house; there must be a window open. Yes, that must be it, an open window has let in the wind.

The winds of change have finally come for Cape Week.

 

Sunday musings 7/31/16

Sunday musings…

1) Clock. Whew! Look at the time. Day kinda go away from me there.

2) Old friends. We are on day 2 of year 25 of our annual pilgrimage to Cape Cod (more in just a bit). One of my oldest friends and his wife came to visit the “compound” today, the first I’ve laid eyes on him in 3 years. It’s amazing how much we once had in common, and even more amazing how much we’ve grown to be alike despite our 3+ decades apart.

Some friendships remain strong, vibrant entities despite the miles or the years. The years can’t be helped of course. The miles, though, can be traveled.

3) Emergency 9. Though I no longer play golf, the game is still a very deep part of my foundation as an adult. What continues to amaze is that such an ancient game can continue to provide new stories, even among old friends. Such is the case with the “Emergency 9″. I first heard the phrase on a trip with my brother when he asked for consideration in the pro shop of a course we’d play the next day. Never heard the phrase before. It’s essentially to golf what “parlay” is to pirates. The request is for 9 holes that are needed after something stressful, in our case a long trip, and is almost always granted. My visiting friend had never heard the term, so the story was that gem of a moment where old friends unearth new treasures from an ancient mine.

We’ll be having experiences like this around our annual extravaganza, the CrossFit Games, in 3-2-1…

4) 25. We begin our 25th family visit to Cape Cod this weekend. I’m sure it will provide fodder for musings next week, as it so often has these last 10 or so years. Today, though, it’s all about noting the change within that which is so much the same. The elephant not in the room, of course, is the absence of my Dad. It’s hard to exaggerate how awkward it was when all present insisted that I, as the oldest male, move into “Dad’s seat” at the dinner table.

No one is ever ready for that change. No one is ever comfortable in that seat.

The White family continues to grow larger, but the participants are actually fewer this year in response to that growth. “The Heir” and his bride stayed behind, the soon to come “Little Princess” too near her arrival date to travel. “Lil’bingo” and his bride encountered their first in-law schedule conflict, so our “Little Prince” will have to wait a year before he digs his toes into our sand for the very first time. Cousins come and go, hoping to overlap with “Lovely Daughter” and her husband for at least a quick hug and hello. Life intervenes in our very special family event in the form of jobs, school, and the like. Families find it easier or harder to make it for all or some of the week as stage of life priorities ebb and flow.

What we hope doesn’t change is the ties that bind, however they may be stretched by those ebbs and flows. What we hope for is that always and forever as we go through time that some part of each of us will grow in parallel with each of the rest of us. That we as individuals will be able to look not only to what we have had, like my visiting friend and I, but also to what we may yet grow together, even though separated by distance and time. That we will ever seek to remain bound.

Families are hard work. There’s no getting around that. Sometimes it’s easy, or at least gets easier. Those times are precious gems, indeed. Most times it’s work, and with growth more work, still. In the end it pretty much always turns out to have been worth it. 25 times we’ve headed to the mine together, most of those times en masse. We are here once again, in person or in spirit, for as much time as each of us can spare. Mining the memories that bind a family takes commitment and effort.

Anything as valuable as a family always does.

I’ll see you next week…

–bingo

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