Random Thoughts from a Restless Mind

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The Other Side of the Stethoscope: Sunday musings…3/31/19

A physician is no more or less human than any other person.

It’s comical to watch the reactions when a doctor calls in sick for whatever reason. A lovely minority of patients rally to the side of the physician, offering words of caring and affection. Of course that means that the majority of others who share a particular doctor’s professional orbit exhibit some degree of displeasure, at least on first blush. Annoyance at the inconvenience of one fewer hand on deck from the co-workers all the way to personal affront on the part of some patients. It’s an extension, at least in part, of the well-known (to healthcare workers) phenomenon whereby patients and non-provider workers such as insurance operatives and various managerial types feel permissioned to treat medical staff members of all levels as if they were some sort of lesser version of the species.

The stuff people say to a medical receptionist laboring under the added challenge of being short-staffed due to illness would be considered hate speech if directed at the cashier at a 7-Eleven.

With this in mind I’ve been trying to observe and feel every bit of my experience now that I find myself on the other end of the stethoscope. As I’ve gotten older I’ve had all manner of run-ins with the world of medicine as a patient. Most of them have admittedly been pretty short trips over which I’ve been able to exert quite a bit of control as a physician myself. Even my carpal tunnel surgeries in 2003, potentially career-threatening for a micro-surgeon, didn’t really seem like all that big of a deal. Maybe it was my relative youth (43) at the time. I don’t know.

A couple of years ago I had a triple hernia procedure performed by a hot-shot 30-something general surgeon who could have been my time-traveling surgical soul twin. Literally every step of the way was choreographed by the docs and nurses in such a way that I was barely even inconvenienced. I was escorted to a private area pre-op where I was visited by pretty much everyone I knew as if we’d just happened upon each other at a restaurant. Back at work after a long-weekend off. In all honesty the only time I felt like a patient was when I woke up to some incisional pain.

Perhaps that’s why my upcoming hip replacement seems so different. I’m older, and unlike both my carpal tunnel surgeries and hernia repairs, a hip that’s worn out from a lifetime of use can’t be shrugged off as genetic misfortune like you can do with, say, a family history of weak pelvic floors. Nope, for whatever reason this particular medical adventure is the first time I’ve really felt like a regular patient. This is as close as I’ve ever come to being just another person putting on one of those ridiculous gowns that hang open in back.

My age-worn old man’s flat ass looks just like anyone else’s in one of those stupid gowns.

Because I am the only surgeon in my eye group choosing the date of my surgery was a pretty big deal. I’ll be out of the OR for about a month. The date made the best sense for us as a group and I made sure to vet it with my orthopedic surgeon, a personal friend. Our entire year’s schedule for all 4 doctors was now tied to April 8, 2019. My first clue that I was now more or less a regular patient came a couple of weeks ago when the surgeon’s office called to let me know that he’d changed his schedule and would be out of town during the week of my surgery. My first reaction went something like “NO NO NO! It’s GOTTA be THAT day”, among other (non-profane) strong statements about why.

But I’ve done that a ton of times over the course of my career. Changed an OR day or week that is. My friend would never have done that if he’d remembered that he and I had chosen that particular day, and just like me it never occurred to him to check his records to see who might be on the schedule that morning. I can’t ever remember doing that when I’ve made a change in my schedule; why would anyone else do that just because it’s my date? Is there really any difference between the effect of a schedule change for surgery between a doctor and anyone else? Of course not. Such a change, for whatever reason, is hard on a patient and everyone around him who will be affected by his need for care and his hiatus from whatever it is he will not be doing because of the surgery.

But my doc is human, too. He needs a bit of a break and saw a window of opportunity. Trust me, once I got over the shock of the potential upheaval in my own schedule I totally understood what had happened and what was going on. In my case a little bit of creative manipulation of the calendar will make everything turn out as it should. My surgery will go off as planned and my surgeon will jet off to care for his own well-being as he should. My lesson is two-fold. First, I am a patient and as such I won’t control the process. Second, all of the efforts that my colleagues and I have made to improve how being one of my patients feels are more than worth the time and expense we have dedicated to them.

Little stuff is interesting. Although I’m pretty healthy for a middle-aged guy I still had to go to the hospital for Pre-Admission Testing or PAT. Everything could have been handled by mail or on line, with a quick trip to the lab to have some blood drawn. The likelihood that anything would be uncovered that would derail the surgery is really, really small, but one must always remember the two-pronged priority of hospitals in the U.S.: mitigate any risk possible, and maximize the payday. A hospital gets paid for PAT and makes a profit on it. So there I was on a Thursday morning meeting a series of quite lovely people, all of whom could not have been nicer or more efficient. In and out in an hour, much to my surprise and delight.

So where am I now? A week out from surgery with standard issue instructions on how to clean my buttox before reporting to the OR at 0Dark30 and a promise of meeting the PT wizards who will visit my home and shepherd me back to functionality. There are still some questions floating around, but I’m kinda reluctant to call my buddy, or even his staff, to ask. I have this little nagging feeling that a lot of folks probably have similar questions (for example, can I poop before surgery that occurs so close to my pooper?), and I know that because I’m a doctor all I have to do is pick up the phone. Still, it seems like if I did I’d be invoking a kind of privilege that any other patient might not have.

Then again, maybe not. It’s Sunday and I just got off the phone with a patient of mine who’s had a concern for 4 or 5 days. They “hated to bother me at home on Sunday” but knew that there’d be nothing between me and them but a good story told to the answering service. While this kind of thing doesn’t happen to a lawyer, accountant or stockbroker, it does definitely happen in healthcare. No, I won’t be calling my surgeon to ask him my silly questions, and I won’t be calling anyone at all on a Sunday to ask them, either. But I’ll for sure ask someone sometime this week, because that’s what I’d want one of my patients to do, and I want to be a good patient.

As I spend a week being mostly a doctor in preparation for a few weeks as mostly a patient I’d very much like to thank my surgeon, his staff, and the folks at the hospital for making my journey to the other side of the stethoscope a pleasant ride. A thank you as well to all of my patients who have wished me well, and to my own staff for not telling me any stories about those folks who forgot that their eye surgeon is gonna have to be human, too, for a little bit.

I’ll see you next week…

 

 

Unsought Solitude: Sunday musings…3/17/19

1) Irish. Happy St. Patrick’s Day to all, Irish or otherwise. Legends abound about Patrick of Ireland. Was he a monk as told by the Church? A heathen who did so much good that he was beatified regardless? A scholar who was in the vanguard of scholars who escaped the Dark Ages and “saved civilization” by decamping to Ireland?

Who cares? Slainte.

2) Gueridon. The little table upon which rests a basket, candle, and decanter to be used when decanting older (usually red) wines. Confession: I do not own one, nor do I own a random wine bottle basket or candle holder for decanting.

Who cares? Slainte.

3) Luddite. A young author was quoted in yesterday’s WSJ as preferring to read and write on various electronic utensils. No biggie, really, until she tossed shade at those of us who prefer pen, paper, and the various reading materials that come in the form of ink on stock of some sort. Something about not “offending luddites” by her comments. Does my preference for holding a newspaper or turning the pages of a real, live book when consuming the written word make me a luddite? At the moment I am typing on a ludicrously powerful laptop and bemoaning the fact that the best voice recognition software is not supported on my digital platform of choice. Two days ago I did laser surgery utilizing a couple million $$ worth of ridiculously complex software and hardware. Can you be a luddite if your daily existence is intertwined with tech that is just a tiny bit shy of quantum computing?

Who cares? Slainte.

4) Sears. Yesterday’s WSJ also included a lengthy treatise on the demise of the once dominant Sears company and brand. If you are of a certain age Sears was as important to your family’s commercial life as any bit of the internet is today. The Christmas Catalog was informally known far and wide as the “Wish Book”; as a kid you looked at the catalog and dropped hints (along with turned down pages) as the Holidays approached. Without knowing so, Sears was the Amazon of its day. Every small town had a little storefront Sears on main street long before the advent of the strip mall mega-store. You ordered your merchandise by phone and picked up up at the delivery store. Pretty much anything other than groceries could be bought that way, including your house.

So what happened to Sears? The catalog was shut down in 1994, right when the internet was getting its start. All it would have taken was a single visionary to see that moving the catalog online would have protected the singular power of Sears to define what it meant to be a department store in the internet age. Instead Sears remained mired in the old-school business model of bricks and mortar behemoths, merging and cleaving along various entity lines with a plethora of like-minded companies that will in all likelihood share its fate. Kmart, Ames, and others are but a memory. How long before they are joined by the likes of Khol’s and J.C. Penney?

All for the want of a single visionary in a company that employed hundreds of thousands of people. It makes one wonder about other bricks and mortar businesses. At least it makes me wonder. What of education, specifically college education? Will we have all of these colleges and their campuses in the future? Do we need all of those administrators whose ranks have swelled in response to a government regulating the physical space occupied by 18-22 year olds? Who knows. What of healthcare? Having just had a totally new way of delivering eye care shot down by an organization whose administrators could not see past their new bed towers, could not see past how the bricks and mortar paid their salaries, I wonder how long it will be before an internal visionary makes a move. Health care is the biggest rent seeking economic sector in the U.S. (with education not too far behind), one in which lobbying the government to maintain the status quo appears to be the most important job of senior administrators. Will this save healthcare from a Sears-like fall, or are we just one visionary away?

Slainte, indeed.

5) Solitude. Beth has been away this week tending to her filly on the winter show circuit and fitting in a bonus visit with “Lovely Daughter”. While she is away I have been mostly at work or traveling for work, and thus have been surrounded by other people for the bulk of my mid-week waking hours. Indeed, weekdays are easier on my soul because the alone hours can be shortened by simply going to bed early and sleeping them away. No, it’s the time off, the weekend time that I otherwise so cherish that is hard. Beth knows this, and so these trips are fewer and further between than they should be; she enjoys her barn and horse time immensely. Even typing these words makes me feel a bit guilty.

There is an “uncle” in the Hurst family, one of those people who has been around the family in a lovely and loving way for decades and is such a part of the scene that all of the grandchildren were astonished to discover some years ago that he is not a “real” uncle at all. Jay is an artist, a sculptor, and by necessity his has been a life of mostly solitude when he was working. This always seemed a bit odd to me because Jay was always such a full participant in all of the family dialogue at holidays and the like. How could it be that such a social creature spent so much time alone while creating? As much as I enjoy writing I couldn’t imagine hours upon days sitting alone at a keyboard. Indeed, my favorite writing times are when I am cocooned in a corner surrounded by the activities occurring just outside my sight. I know they are there if I need to jump in for a fix.

Jay has retired with his wife to a thriving community of like-staged folks and is thriving in the bustle of a little micro-society. His is a tale to sow optimism in the face of the lonely later life of another of Beth’s (real) uncles, also an artist, whose illness drove a wedge between him and most everyone else. Much, much later in life the solitude that he sought and which sought him began to ebb. His presence at family gatherings both sad and gay brought enjoyment to all of us, himself included. Both men lived decades in which they spent the majority of their hours alone. There is a significant difference however, and it is the difference that makes my little sojourn in solitude bearable: Jay emerged from solitude at the end of the work day into the embrace of a loving wife with whom he shared his evenings and weekends.

He wasn’t truly alone, he only worked alone.

Beth’s uncle, The King, passed away this week. He suffered a catastrophic stroke a few months after losing his sister, my mother-in-law, and gaining a daughter-in-law. While still more alone than not he was nonetheless close to two grandchildren, and seemed to be moving closer to his children and their varying degrees of happiness. There had been a rapprochement with his brother, words of kindness expressed between the two older men after decades of estrangement. The King had lived a mostly solitary life for years. Unlike Jay (and me) he seemed to be lonely for many of those years. How wonderful that he was able to shrug off at least some of that cloak in his last months, to replace it with the embrace of children, grandchildren, nephews and nieces.

I am lonely this weekend and I confess that it is a selfish loneliness because I know that it will be short lived. Beth will return tonight. My Man Cub and his sister The Nugget might be healthy enough for me to drop by, or their little family might swing by for a sunny dip in the hot tub. There will be corned beef and cabbage tomorrow night at dinner for us all regardless. Solitude for me is partly the side effect of obligation (I have a job) and partly choice (the kids were sick and I stayed home).  Jay and The King teach us the lessons that there is a difference between being alone and being lonely. One can be alone if one has love to look forward to when the solitary hours have passed.

Long live The King. Slainte.

I’ll see you next week…

Goodbyes on Time and Too Soon: Sunday musings…3/10/19

Dinner last night with Beth, her sisters and their husbands was typical of the wonderful times we’ve all spent together over the years. Not unlike our relationships with my siblings and their spouses, Beth and I share a very comfortable friendship with my brothers and sisters-in-law. Laughter, gentle teasing, and a sense of warmth is the typical fare when we dine together. Our bonds have been strengthened through our time spent shepherding Beth’s folks through the last stages of their lives, not unlike the journey we all travelled in the last few years of my Dad’s life.

We were all far from our kids and grandkids, so while we had our phones mostly pocketed we did take brief glances when alerted to emails and texts. So it was that we learned of the dire illness and hospitalization of an elderly uncle and the passing of a dear friend. It’s amazing when you think of it how often we are drawn to this well in mid-life, isn’t it? My close friend lost his wife to a cancer that kills roughly 95% of those afflicted no matter what age they are when they get the diagnosis. There are no known risk factors for her cancer; bad luck afflicts indiscriminately.  Beth’s uncle was felled by a particularly severe stroke; his biggest risk factor was having the good fortune to live long enough. At the moment he lies on the razor’s edge between life and death.

My dear friend and his sons have had many months to prepare for yesterday. Knowing them, and knowing his wife, those months have been jammed with life and living and love. “Goodbye” has been there with each parting, with each night’s retreat to the peace brought by sleep, if that is sleep was to come. Goodbye yesterday was too soon–too soon by decades–the peace that came with “goodbye” notwithstanding. Much too soon and yet they were ready. Or as ready as one can ever be might be a better way to see it. They were not surprised and because they were not surprised they’d left nothing unsaid. “I’m sorry.” “I forgive you.” “Thank you.” “I love You.” The air around them was filled with this and more these last many months.

Nothing was left unsaid. Peace surrounded the family and their closest friends.

I find inspiration in many of the comments of my good friend Bill, the surgeon. Unlike me, the eye surgeon, Bill  deals in disease that causes death on a daily basis. An inherently kind man (his protestations to the contrary notwithstanding), Bill encourages his patients and their families to live in a way that allows them to know that they are at peace with one another long before the end is nigh. He has often professed amazement at the heroic efforts made by family members to be at the side of a dying relative so that they may “make things right”. Why, he wonders, wait? Even in the healthy elderly death is but a moment away. Why wait until the end? Why not be at peace with one another in life before death?

Beth’s uncle lies at the precipice. His children are arriving from near and far. Was his “lifeline” any different from my that of my friend’s wife? As unknowing as we all may have been, as we near the end of our journey we must all be aware that our time becomes short. Sitting in the airport after our brief but wonderful visit I am comforted by another recent visit to celebrate the marriage of Beth’s cousin and our time spent with her uncle around the wedding festivities. There was love. Love and understanding and forgiveness where it may have been necessary, but mostly love. I sit here hoping that it is that, the love, that his children will remember. That they will convene at his bedside simply because of that love, with little else left to say to him or to each other but “I love you”.

It’s always too soon to say goodbye to someone you love, even when goodbye arrives on time.

I’ll see you next week…

Connections: Sunday musings…3/3/19

No man is an island. True? Unlike so many animals who share parts of our space on the rock and only convene when it is time to propagate a species, I do think for humans that the old saw is, indeed, true. We are who we are, but we are expressed in many ways by how and with whom we are connected.

At the moment Beth and I are winding down a visit with my Mom in Rhode Island. She still lives in the house in which my siblings and I grew up, bouncing around like a ping pong ball in a gymnasium. She remains in place because of connections in both the present day and the past. I have no idea if she feels this way, but whenever I visit my primordial bed the house seems oddly full, even though only Mom lives there. It’s as if I’m surrounded by ghosts, connected to the past lives of everyone who ever lived here, myself included.

None of us lives in Rhode Island any longer. My brother and two sisters each live a couple of hours away, and we live a flight way in the Midwest. One could reasonably ask why Mom is still here. Not just in the large home from we which were all spawned, but in Rhode Island at all. Again, it’s the connections. Being near family is the logical choice as one ages, but sometimes the connections are simply strong enough to age in place. Such is what we find each each time we visit, and each time we rediscover this it is that much more lovely.

When my Dad was sick Mom pretty much withdrew into the house to become his primary caretaker. The extensive ties to the community my parents enjoyed did not disappear however, but rather just faded back a bit, remaining there, ready to reappear when Mom emerged after Dad died. Being out and about town this weekend we were impressed again and again by how many people were connected to Mom. Church, club, neighborhood, friendships from the days when she was a part of a couple, our classmates from school, all there and keeping her safely in place.

There’s really nothing new in this observation. Well, maybe the discovery of a few connections that I still have here in town was new, but seeing once again how connected Mom is wasn’t really new. Will it last? Will those connections remain strong enough to continue to stay here, at home? Who knows. For now it’s enough to see and feel the connections that we all have to our hometown, and to see how our hometown continues to connect with our Mom.

Let no Mom be an island.

I’ll see you next week…

On Grief and Grieving: Sunday musings…2/24/19

Sunday musings…

1) Seige. A group of herons. Right up there with a mob of meerkats.

2) Gale. The gales of November may remember, but the 50MPH gusts over Lake Erie this morning are shaping up as unforgettable.

3) Privacy. There is an LA impresario of the highest end social scene who opines that privacy is the new luxury. At best I am a “C” list celebrity with “B” list aspirations, so I have no first hand knowledge to share (if I go to the grocery store in a T shirt I am completely anonymous). I admit a serious respect for Meg Ryan who slipped from public view some years ago; “I lost interest in Hollywood at the same time Hollywood lost interest in me.” Her piquant observation sheds a bit of light on this new “privacy” trend: “I can still get reservations but I only show up in other people’s paparazzi pictures now.”

There’s an awful lot of truth still contained in the near-existential question: would you rather we rich or famous? For those who are both it may very well be that privacy is the most expensive thing they buy.

4) Grief. We find ourselves, Beth and I that is, at a moment in our lives when death and dying is seemingly coming at us from all directions. Parents have departed as have friends, and tragically the children of friends. How to process these losses, how to grieve, is a bit of a challenge for us. What does it mean to grieve? For how long does/can one do it? Is grieving an outward-facing activity or is it necessarily one that is cocooned within? There are no answers to these questions of course, at least not universal ones that can be applied to every person and every death.

While I openly confess that this topic is never far from my mind, grief and grieving find their way here in “Musings” this morning as my sister and her husband bury his brother (gone at approximately my age or close thereto). While thinking about Peter’s death I stumbled upon Scott Van Pelt’s ESPN moment when he acknowledged the “Deathday” anniversary of his Dad’s passing some 31 years ago. Google it. He is wonderful in these two minutes. Van Pelt gets two things very right when he encourages one to address the loss openly, and to then use that opportunity to reach out and just as openly express your love and gratitude for the opportunity to do that with those still here with you.

Grieving looks different on everyone who bears the grief. Beth continues to be a rock, stolid after losing her Dad, her Mom, and her beloved little mutt in 2 years time. I, on the other hand, openly wept at the end of Mr. Van Pelt’s piece when he spoke to his Dad and hoped that he would have been proud of the life his son had created. I know that Beth deeply misses her parents. She still finds herself picking up the phone to call when something that would make one or the other of them smile comes up, only to put the phone down in a quietly wistful moment. My Mom is still here, as are all of my siblings (and Beth’s) and our entire generation of grandchildren. No matter how often one did it before, how hard must it be to reach to call a sibling who is no longer here to answer?

Grieving may be a process with neither a true beginning nor a true end. Our Jewish friends may have it more right than the rest of us when they “sit Shiva” after the death of a family member. One week given to grief. Fully permissioned to grieve in whatever manner best fits you with both a start and a finish. One doesn’t stop missing the dead when Shiva is finished of course, but one has permission to stop grieving. From there one could do worse than choose to follow Scott Van Pelt’s gentle suggestions that remembering is good, missing is healthy, and loving is healing.

5) Mist. Apropos of the above, here is a re-post of the last time I got to visit with my Dad when he was his old self:

My siblings and I only need to remember one weekend each year when it comes to celebrating my Dad. His birthday almost always falls within a day or two of Father’s Day. So it was that I found myself in Rhode Island the past couple of days, in the company of my Mom and a guy masquerading as my Dad, a guy who was very curious about the new fella who’d dropped by for a visit.

Getting old is not for sissies, my friends.

Somewhere inside, deep inside, there’s still some of my Dad in the jumbled up connections of his mind, carried by the body that failed him in such spectacular fashion 2 ½ years ago. Dad is extremely intelligent, the only family member in his generation to have gone to college. Quite the athlete, he used football and the GI Bill to pay for school. Like so many in his generation he then worked, raised a family, and put himself through grad school. He won his club championship in golf twice at the ages of 50 and 60. No typo. Beat the reigning RI State Amateur champ on his home course for the first one.

As we sat on the porch of his house overlooking the par 5  14th hole, I had an ever so brief visit from that guy. From my Dad. Like a citizen of Brigadoon he came slowly through the mist of his mind to join me for a bit. We’d always bonded over golf. My brother and I never turned down an invitation to join him on the course, either as partners or as caddies for him and his buddies. It was quite a privilege to do either; my Dad’s most elemental essence was expressed on the golf course.

A light breeze was blowing through the forest in the back yard just beyond the rough. We chuckled at the golfers who failed to take the wind into consideration, sheepishly trying to sneak into our yard to retrieve their out-of-bounds second shot. Dad talked about caddying as a kid in the Depression. We both noted the absence of caddies as the foursomes passed in and out of view. It was really very nice.

I quite like the Dad of my adulthood. Quick to smile, slow to anger, unfailingly loyal and kind. It’s hard to imagine now how distant he was when I was a boy, his friendship as an adult is so easy. I’m not sure how long we sat there to be honest, nor when I noticed that he was slipping away. As surely as the village of Brigadoon disappears, the mist had returned to claim him. I got up, walked over to his chair, held his hand and gave him a kiss. I wished him a Happy Birthday and a Happy Father’s Day, hoping that I’d made it on time. That he was still there. That he knew it was me, Darrell, his oldest child. I told him I loved him.

He smiled and gave my hand a little pat as he disappeared into the mist.”

I’ll see you next week…

 

Sunday musings… 2/17/19

Sunday musings…

1) Metier. Trade, profession, occupation. More so, something at which you excel.

Not necessarily trade, profession, or occupation.

2) Rigadoon. A lively dance for couples in duple or quadruple time. Pick a headline of the coupled. Any headline.

See also, “Flaneur”. Because: duple.

3) Hope. “Hope is a waking dream.” Aristotle

To have hope is to have a reason to go on. The dream, as it were, is worth following in the hope that one will see it fulfilled. At the same time hope can be a bad dream, one that must be abandoned in order that one can begin anew. After all, reality awaits as we awaken, however fervently we cling to our dreams.

4) Gray. Where did all of this gray hair come from? In 6 months I’ve become…ahem…distinguished. The actor William H. Macy: “Treat getting older as a success. Celebrate it.”

Guess I’m sporting my own “silver medal”.

5) Destiny. Our oldest child, The Heir, is at this moment on his way west, transporting his little family to a new beginning in Denver. Like so many young people before them he and his wife will seek their fortune in the New Territories, hundreds of miles from their families and the land of their youth.
To be sure we did this, Beth and I, and we understand all that goes into the decision. Seeing them off is bittersweet. They, like us at their age, are strikingly independent. A little part of our souls is stashed in their luggage, just in case they need us.

With the rising sun at his back the dawn of our family seeks his destiny just beyond our view as Beth and I contemplate the sunset.

I’ll see you next week…

 

A Very Complex Sunday musings…2/10/19

Complex: consisting of many different and connected parts.

Complicated: difficult to analyze, understand, or explain.

This week’s epiphany: The National Enquirer engages in unsavory behavior. Shocking, I know. Jeff Bezos, the world’s richest man, has publicly accused the
Enquirer of threatening to publish scandalous pictures of him and of his paramour if Mr. Bezos failed to publicly state that the Enquirer was not participating in any type of political skullduggery as it related to stories published in the Washington Post. While discussing his ownership of the Post Mr. Bezos coined what looks like an entirely new word as he tried to explain the effect of owning a national newspaper has had on his life. He called the Washington Post a “complexifyer”.

I think he is trying to say that his ownership makes his life more difficult, though I can’t figure out if he means complicated, complex, or some amalgam of both.

Does he mean that the addition of The Post has increased the number of elements in his life that he is forced to address? That would, indeed, be an increase in the complexity brought on by owning the newspaper. One could easily see that his worldview was expanded well beyond the already enormous one that must exist simply by dint of the massive enterprise he has created and runs. Additionally, publishing a newspaper in Washington, D.C. probably brings him into close contact with a plethora of national and international issues, as well as the real, live people who are involved in them. Many more pieces parts now connected to him through the Washington Post equals more complexity.

On the other hand you might get a sense that he is describing his ownership of The Post as something that is making his life more difficult. Whether or not he has a hand in the general editorial direction of the newspaper, he is certainly being accused of directing at least some of the story lines therein (see: National
Enquirer, blackmail). For a guy who heretofore had been more than a bit reluctant to be seen as a public figure it has to be a shock to find oneself as such an “interesting” person. Of course, there are about 150 Billion reasons why people might be interested in his love life even without the hacking prowess exhibited by the Enquirer. [As an aside, can someone explain to me why so many otherwise really smart people insist on sending photos of their genitalia to anyone, anywhere, ever?] Mr. Bezos life is most assuredly more complicated now that he owns the Washington Post.

So which is it then? Is the Washington Post a complexifyer or a complicator? I love words, and I love the pursuit of the best word for a particular sentence. To be truthful I sat down to write this with the intention of declaring Mr. Bezos a faux sophist who chose to use a rather obscure word simply because it sounded good. You know, reaching for a 50 cent piece when a nickel would do. As I’ve worked through it though I’ve come to the conclusion that he is actually on point. Mr. Bezos is famous for being a jealous guardian of his time. For example, he does not schedule meetings earlier than 10AM so that he can participate in the morning routine of his family (likely to become more complex and complicated). Although it is a tiny part of his financial and business portfolios I think what he was saying is that owning The Post reduces his ability to manage the various and sundry components of his life and their attendant demands on his time. Ownership of the Washington Post is, indeed, a complexifyer.

Complexity Theory is the study of large systems that perform intricate and coordinated functions. Research in this field seeks to uncover the underlying rules on a micro level that govern these systems. Although in many ways larger than life, Mr. Bezos hardly qualifies as a “large system”. Neither do you or I, for that matter. Still, his experience of highly elevated complexity brought on by a single decision might be instructive to even those of us with far, far fewer zeros at the end of our financial statements. Complexity and complications abound for all of us. I wonder if it might be instructive to review our own acquisitions in the same light.

I’ll see you next week…

 

Is It Time to Leave Social Media? Sunday musings…1/27/19

1) Anoesis. A State of mind consisting of pure emotion or sensation, devoid of cognitive content. NOT what occurs while playing with the Man Cub.

Kid is seriously smart.

2) Greeting. “How’s it going?”

“Oh, you know, right between ‘don’t get your hopes up’ and ‘be careful what you wish for’.”

For the next time “OK” isn’t gonna cut it. (HT Frazz).

3) Social*. My Sunday newspapers are filled with articles asking whether one should uncouple from the various social media sites available to us on the internet. You know, Facebook, Twitter, Instagram and their slightly lesser cousins Whats App and Snap. Visuals of index fingers floating over the “delete” button abound. Ever more earnest posts in all of the above ask for help in deciding if it’s the right thing to do, or if it’s the right time to do it. (As an aside, isn’t that kinda like asking the bartender and all of your barfly buddies if you should quit drinking).

Well…is it?

My initial foray into everything social on the internet was a blatant attempt to boost my business while at the same time creating a bit of a personal brand in that space. A funny thing happened on the way to that pretty blatant business play: CrossFit. Yup, my hobby and my fellow hobbyists all discovered each other “off-site” on Facebook. Where I once pretty much lived my CrossFit life only on the main page of CrossFit.com (and existed in a tiny little solo bubble as a CrossFitter in a large commercial gym), now the larger CrossFit community came to dominate my feed. Complicating this was the fact that the lifespan of my sons’ Box occurred in this period, and as any Affiliate member can attest, your gym experience extends outside the gym and into your social media worlds. FB was the same black hole that CrossFit.com once was.

Twitter is an interesting place. Here I’ve been a bit better at sticking with the original plan of using the platform for professional purposes. We post about our business, and my professional writing has found a nice little audience. Here, too, I have discovered a broader community of folks who share some of my other interests (economics, healthcare policy, sports), and these very interesting people make Twitter just as attractive as any other online experience I’ve encountered. There are times when I sit down to spend a moment looking at what’s going on there only to look up an hour later and wonder where the time went. I should note that I pretty much skip by any and all political commentary, and still Twitter devours time as voraciously as a Black Hole does gravity.

So what are all of these folks to do? Or me? Should I stay or should I go? The fallacy is that it has to be all or none for most folks. Only the truly addicted, those who ignore the humans in their presence in favor of the bits and bots on their devices need to seriously take on this question (and for the record, for them the answer is an unequivocal “YES”, you should delete all of that shit. Now.). For the rest of us, why is this any different from TV? Why aren’t we using Social Media in the same manner that we (used to) use the television? People never went to work, set up shop and turned on the tube. You watched it as a diversion AFTER work. Yeah, sure, maybe you gathered with friends to watch a show or a game, but you were interacting with people AND the TV, not the people ON the TV. Tough to keep a job if you spend 1/2 your time watching Wheel of Fortune.

Anyway, that’s my bid. Deal with SM like it’s TV in the 90′s. For what it’s worth it seems that I am the first person to propose that we look at SM this way. At the moment my FB usage is plummeting as I find that there are fewer and fewer people whose activity holds any interest for me. Like 99% of what’s in the old TV Guide. My slow withdrawal feels a lot like my experience with the comments and Message Board on .com. Twitter feels like a cross between business and research, both of which can be treated like “appointment TV”; I go there when it’s convenient. Neither one feels necessary.

There is an obvious benefit to a SM diet, and that is the massive number of minutes you free up for all kinds of other stuff. I experienced the exact same phenomenon when I stopped watching NFL football on Sunday afternoons. More time to read. More time to write. Full on commitment to each moment spent playing with the Man Cub, and for that matter talking with family members who now tend to gather for communal weekend dinners. Admittedly it can be a bit of a challenge to fill the time previously lost to SM, but so much of my sense of needing more time in my day to add something new or different or just fun really seems to have been artificial. How can I not have time to re-learn French when so much time has been spent in the FB rabbit hole? I’d made my minutes artificially scarce.

Today I built something with my hands. You can, too. Re-claim your minutes by putting SM in its place. Like TV.

I’ll see you next week…

 

* I acknowledge the inherent irony in the fact that most of you will read this through SM.

 

 

 

The Stages of Exuberance Sunday musings…1/13/19

1) Toddler. We are hosting the Man Cub for a few days as his parents prepare to move into a new house.

I. Am. Exhausted.

2) Strategy. Trample the wounded and hurdle the dead is neither a growth strategy nor is it a viable marketing tactic.

3) Snowpocalypse When I sit down to write I enjoy looking out over the lake as I wait for inspiration to sit down and chat. At the moment my view is blocked by 1/2″ of ice on all north facing windows at Casa Blanco.

The Ice Man cometh.

4) Irrational. Whenever a new technology or concept surfaces it is often met with irrational exuberance. Early adopters behave more like acolytes than simple adherents. Potential issues with the new idea are swept aside and those who propose that all is not so new or wonderful are labeled as too dense or simple to understand the brilliance of the new new thing. In a similar vein behavior by the creator of the new idea that would otherwise be a possible signal that all is not as it seems is either ignored or explained away without any real investigation. This particular phase is more intense and tends to last longer if it is associated with something that contravenes, and more so actively seeks to disrupt the status quo. A “cool kid” factor also magnifies the exuberance.

Rare is the new idea that does not then enter a phase one could call irrational dissaffectation in which both early adopters who become disillusioned and outsiders who become interested by the buzz created by the exuberance begin to look closely at not only the idea or product itself, but also at the behavior of both the “inventor” and the company that provides the service/product. The vehemence of this response is directly related to the buzz and fervor that exists among those who continue to be excited about the new thing. During this phase it is quite likely that there will continue to be newcomers to the technology who exhibit many, if not all of the characteristics of those people who claimed “first flag” discovery enthusiasm in the earliest days of adoption.

What comes next is either some degree of general acceptance of the new thing with a concomitant adoption into general use, or a slide into irrelevance as it becomes little more than a footnote in whatever historical space it inhabited.

As it happens both my professional life and a very large part of my non-professional activity each have a very significant player/thing that is entering this third phase. You may recall that I am an eye surgeon, in particular one who operates on the front of the eye. My expertise is in surgeries that both improve vision and liberate individuals from the need to wear glasses or contact lenses. In the LASIK world what was largely a PR battle between mechanical “flap makers” and those that created the LASIK flap using a laser was eventually won by the makers (and early users) of the laser. While I still feel that the introduction of the femtosecond laser to make a LASIK flap was a solution to a problem that had already been solved by 4th generation mechanical devices, the allure of an “all-laser LASIK” proved too powerful in the marketplace. Any “bad behavior” in the middle phase was marketing related. Even though it was more expensive, the laser won.

Cataract surgery also has a femtosecond laser entrant in the game. While the technology is actually quite stunning FLACS has never been shown to be more than slightly superior (if even that according to the most recent studies) to what it was developed to replace (the surgeon’s hands). Similar fear-mongering to the LASIK experience in the middle phase was buried in an avalanche of data reiterating the treasure trove of safety statistics and outstanding outcomes achieved with “traditional” surgery. Some really nice people got run over by some not so very nice people as companies were bought and sold. The most likely outcome as FLACS enters the third phase is that it becomes a niche procedure where hopefully the surgeons push back against industry in order to shield patients from predatory pricing; this laser is more expensive, and that has been its downfall.

When thinking about my non-professional activities over the last 12 or 13 years CrossFit is the obvious topic. In my entire life I have never been a part of anything quite so exciting as the first several years I spent in the CrossFit world. When I first found CF in 2005 there were about 100 gyms and maybe 5000 of us doing it on a regular basis. We were self-proclaimed fitness infidels, rising up against a cynical entrenched fitness orthodoxy and industry. Man, it was cool, and we were cool because of that. Not only did (does) it work if done properly, but we all had that same kind of first flag planted buzz you get when you discover something that becomes a phenomenon. Think being in your local in the 80′s and Nirvana is the house band kind of cool. It was like that.

CrossFit, too, is now in the earliest days of its own third phase. Having turned away from the strong (at least outward appearing) emphasis on CrossFit as sport, the company has pivoted back to something that sounds and feels more like what we all were doing prior to 2010 or so. Quite frankly I was personally too close to many of the primary personalities in phases 1 and 2 to objectively assess the players and how they played. Where CrossFit places its emphasis now is where I always felt it belonged, high intensity functional fitness as health rather than as sport. Which “laser” will CrossFit emulate as it leaves the stages of exuberance? What kind of laser company will CrossFit, Inc. be like if it, like the femtosecond laser, is proven to be only one among several ways to achieve the desired outcome in fitness and health?

In my day job phase three means a femtosecond laser for LASIK but not for cataract surgery. I am largely indifferent to the companies involved.

 

Sunday musings 1/6/19 An Older Me

Sunday musings…

Do you play the New Year’s Resolution Game? I do. Sorta. Kinda. I have a January birthday so it’s pretty convenient to work on being a bit better, or at least trying to be a little less aged (while rejoicing that I am still getting older) around this time of year. At the moment I am climbing out of the rat hole that is MyFitnessPal and trying to fit my numbers in so that I can track my actual nutrition consumption in my quest. To be honest I’m not sure if that was so much the beginning of a deep dive or a close encounter with drowning (in information).

Anyway…

Tomorrow I turn 59. Yup, that’s right…once again I stand on the cups of a “number” birthday. You probably don’t recall my angsty year as I was turning 50 (See: The Hard Turn at Mile Marker 49), but trust me, Beth sure does. “Are we gonna have another shitty year listening to you whine like when you were 49?” Or something to that effect LOL. For whatever it’s worth I really don’t see that coming this year. While I admit to a bit of frustration and a touch of sadness as my body takes on its new, decidedly more fragile mid-life form (bonus: soft = cuddly!), it all just seems to be OK. Just where I am at the moment.

Our lives are getting longer. At least for those of us who are not unlucky, that is. One need not be nearly as consumed with the fitness thing as I’ve been these last 10+ years to remain reasonably healthy and able. Really, all you have to be for the stage I’m entering is fit enough to walk after a tyke learning to ride a bike. Once your cubs have progressed past that stage you’re not keeping up, even if you fancy yourself a Masters athlete of some kind or another.

It’s easy to think of longer lives as being all about the years added on to the end and what they constitute. Natural enough, especially if you, like Beth and me, have aging or recently deceased parents and the endgame is forefront in your mind. In truth it’s probably more reasonable, and accurate, to think rather of those extra years being added to the middle of our lives, extending what may be the best part of the modern human existence (credit: Marc Freedman). Sure, we will all likely end up a shell of our former selves in most ways at the very end, just like our parents and grandparents, and probably for just as long. It’s that we are likely to enter that particular phase at a much older age, hence the “enhanced middle” years.

Turning 40 was pretty much a non-event for me for a couple of reasons. First, my darling Beth got terribly sick right around the time of my birthday. I mean ICU level care, are you gonna make it sick. That kind of thing really grabs your attention, especially if it is happening to the single most important person/thing in your entire life. That birthday pretty much never happened. But even before then a chance encounter on a chairlift in Utah had already smoothed out all of the speed bumps on the journey. A former NHL hockey player who’d found another success as a businessman shared his philosophy about being in his 40′s. He described this stage of life as the optimal intersection of experience and physicality. In your 40′s you are likely still rather fit and able, and you are therefore able to put into play all of the knowledge gained in the “learning decades”.

I liked that very much indeed, and it turned out to be pretty accurate as well.

So what about now, sitting on the cusp of 60? Good, bad, or indifferent it’s been quite a while since I’ve been on a chairlift, but if I were to close my eyes and imagine myself once again sitting next to this sage what might he offer about what comes next? Not gonna lie, I’ve given this quite a bit of thought. If your 40′s and maybe your 50′s are the stage where experience meets your physical self then I think your 60′s (and hopefully 70′s) are that part of life where you are blessed with wisdom and time. Wisdom in its simplest form is the result of experience and reflection. Freed (again, hopefully) from the pressures that earlier life stages present one has time now to employ that wisdom in any number of ways.

Most of us have spent at least a little bit of time looking for some sort of meaning, or meaningfulness in the daily living of our lives. With any luck as you approach 60 this is somewhat clearer for you. I know it is for me. Those first four decades were about gathering and growing, and the last two for consolidation and contemplation on what I’d accumulated. Knowing, or coming to know what seems to be important among that “collection” should allow me to shed that which lacks meaningfulness. For example, things like grudges and the fantasy that they might somehow be avenged certainly find their way quite easily to life’s trash heap at this stage.

Where am I now as I sit on the cusp of wisdom and contemplate how I will spend the (hoped for) riches of time? Older, no doubt, but perhaps only that.

I’ll see you next week…

 

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