Random Thoughts from a Restless Mind

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The Slow, Easy Curve at Mile Marker 59

Turning 50 was awful. I stunk at turning 50. From the minute my 49th birthday was over I began turning 50 and I was simply terrible at it. In short I had popped off in my early 40′s about all of the magnificent stuff I was gonna do when I turned 50–climb Kilimanjaro, teach cataract surgery in Nepal–but when push came to shove my life was crammed with stuff happening right here at home. And I was broke. I spent almost the whole year in a tight little angst bubble until one of my patients tipped me off to the problem as we discussed her upcoming 60th. You can read about the details in “The Hard Turn at Mile Marker 49″ if you wish (as it happens it’s actually one of my better pieces. Go figure.).

My birthday is in two days and I will be 60. What’s it been like this past year, turning 60? Funny you should ask. In truth it’s been a tumultuous year of change, challenge, and loss. It should have been a real trial, to be honest. In fact it’s turned out to be kinda easy. Like it was just another year. Just another meaningless romp around the sun. If it wasn’t for all of the folks asking me about it I probably would have had it sneak up on me and all of a sudden appear in the windshield..

How come?

This year should have been the one filled with angst. Seriously, there was so much illness and loss I should have been buried. Every positive milestone, whether it be personal or professional, was paired with some sort of emotional speed bump. When I was turning 50 any one of those speed bumps might have launched me over the edge of the highway, but this year they were strangely tolerable. We lost my mother-in-law Sandy just before my 59th, and Beth and her sisters spent months cleaning up the estate. Both of Sandy’s brothers passed as well, in 13 months wiping out the entire generation of Schaefer’s. My Mom had one medical challenge after another, in and out of ER’s and hospitals and finally out of our family home and into an apartment nearby. Sadly, even though her living situation is much safer, much more appropriate to her life stage, the medical itinerary didn’t change all that much. Maybe it’s just that we’ve all had so much practice at handling the challenges of the generation before us (as opposed to those of the generation that follows us when I was turning 50), but it all passed in a rather matter-of-fact fashion.

More than that, the speed bumps didn’t take away from the joys that found us this year. What would have totally derailed me, and stolen all of the sweetness of whatever lovely stuff was happening, just kinda rolled by in a “handled mode”. Now I will admit that stuff that was happening with my grandchildren still made me anxious, and there was plenty of that. Still, the good things were really good, and I felt that goodness while it was happening. I needed a new hip (not so good), but it went off without a hitch thanks to a great surgeon and the fact that I still control every bit of my schedule. Coming back to the office was a breeze, even though we ended up being crazy busy out of the gate. Instead of pushing back against the extra work my entire team reveled in the fact that we were doing great and stepped up big time. So did I! All of my Dad’s (and Gramp’s) genetics caught up with me this year; my doctor friends all insisted that my CrossFitty lifestyle needed a little boost from modern medicine. Even this passed with little more than a tiny shrug since all three of them, dear friends, softened the blows with heartfelt hugs.

Why so much better at 59 than 49? It all kinda made sense. Middle-aged guy medical stuff? Of course there was. I think it was also about expectations. I don’t think I really had them this time, which left me free to not only see all of the roses blooming along the path to 60, but step off the road to smell them, hang out awhile among them. Seriously, I have no idea why all of the indignities of getting older were little more than a passing cloud in otherwise blue skies.

Actually, yes I do. I am openly grateful for each of the good things in and around me. Those surprises that shocked me at 49 are almost all really nice surprises this time. Seriously, is there anything better than the sound of a grandchild’s excitement when they realize you are home?The warmth of a child’s embrace as if it’s been a month of Sundays since you were last together, and it’s been less than an hour? Without conscious effort I have begun to stop and take a moment each time something is good, someone is nice, things look up, and just enjoy it. Enjoy it and be glad for it. These things are mostly small, almost insignificant (the first time I deadlifted after my hip surgery; my Man Cub writing his name for the first time in my notebook), but some of them were, in retrospect, kinda big (gonna have to trust me on these). But large or small, this time I am openly happy for the happening and grateful for that happiness.

Whereas turning 50 seemed like coming upon a hard turn while speeding along the highway, turning 60 was a nice easy cruise with my darling Beth along a gently winding road with mostly killer views. I was terrible at turning 50 but pretty darned good at actually being 50. Will I be as good at being 60? Who knows, but I have a good feeling about 60, just like I ended up having a good feeling about 50. It’s great to be here, great to have so many of my loved ones still here, so many living so close to me, those not closer wishing they were, so many genuinely happy to be with me. I have what I need and I want what I have; it’s been like that for a really long time and turning 50 seems to have awakened me to that fact.

I’m rounding an easy curve at mile marker 59, arriving at 60 in two days, and I’m very grateful for the ride.


2020? the Kid’s Alright: “New Year’s musings…”

On the surface there seem to be so many similarities. Between 1920 and 2020 that is. A soaring stock market. Companies setting profit records every quarter. Essentially full employment across all industries and economic strata. Technology coming on board that promises to continue to move all of these needles forward. Americans were generally not just positive about the economy and the state of all things American, their bullishness knew few bounds. Of course, there was the little, pebble-in-the-shoe issue of a growing chasm between the “common man” and the ultra-wealthy, a tiny gnawing ache in the soul of the country. Still, there was so much positive stuff, so much momentum.

What’s it gonna be in the 2020′s?

Now the cynical, the naysayers and the glass half-empties would look at our world today and say that there is a fundamental difference between then and now brought on by a single man in power. More contemplative members of this camp are a bit more sanguine about the provenance of this feeling; they would say that it was there for quite some time, perhaps as far back as our last Democratic President, and the latest ass to occupy that particular seat is simply the personification of a movement long present in our midst. No matter. If one were to look back at the 1920′s and peer just barely below the surface one would see a seething caldron of conflict between classes (and races) that would erupt soon enough. After all, the abuse heaped upon the working classes by the ownership class resulted in the great wave of the original labor movements, right? From farm to factory to union hall, and now to Twitter. The times, they don’t feel all that different when looked at through that particular lens, do they?

It could be argued that what made the 1920′s a time of explosive growth is precisely what is happening now. Cheap money available to those who are already moneyed, coupled with an economy based on influence peddling and self-dealing not available below the most rarefied levels of the economic food chain are the common links. Where once we had Big Oil with an outsized finger on our economies we now have internet information platforms without which commerce seems impossible. Banking monopolies, real and virtual, are now represented by the likes of Amazon, without which commerce now seems impossible. And the fortunes! The rich are as idolized and romanticized today as they were in the days of Gatsby.

Where are we in the cycle? Are there 9 years left and then a crash? Or is the apocalypse nigh, right around the corner, ready to take society with it again? Man, who even knows? For sure I don’t. Nor do I have any intention of pretending to know. For whatever it’s worth I do have a couple of thoughts about how to be thinking about it, though. You know those disclaimers in the ads for mutual finds that say stuff like “past performance is not indicative of future gains”? That. There were plenty of the same macroeconomic factors at play just before and after the tech stock meltdown of 2000 and the real estate driven Great Recession of 2008-10. Indeed, we had a leader who was reviled by a majority of not only the national intelligentsia but the non-elected careerists in our government. And yet, no societal collapse.

The second thing is one of attitude. Point of view. What one chooses to look at or emphasize when one analyzes the landscape, so to speak. Last night we listened to a young singer who is best described as nihilistic in her worldview. Everything is so terrible, so riddled with dysfunction and despair, that to make even a perfunctory effort to address the future is a hopeless, worthless gesture. Stephen Pinker, the noted societal observer and philosopher, vigorously disagrees. He has written a book called “Enlightenment Now” in which he makes the case that the world is by far and away better now than it has ever been at any time in history. In almost all ways, every aspect of life is better for pretty much anyone at any level of society today in comparison to any other era we might consider. Because of this every day is, or should be filled with boundless hope. If not for better than at least for more of the same.

So who is right? The 20-something who is not a progressive dreamer committing herself to changing the world but a fatalist who sees nothing worth fighting for? Or the philosopher who sees not a glass full world but one in which the glass continues to be so full that we need to build ever larger glasses to contain society’s bounty? Well, anyone who has read any of my drivel knows right away that, if forced to choose between the extremes I will choose Pinker every time. Our daily existence may or may not be as good as Mr. Pinker describes (although an objective view of the data surely looks like he is on point), but a 20-something living a 2020 version of the bohemian 20-something of the 1960′s barnstorming the Pacific Northwest in pursuit of musical fame and fortune who espouses an existentialism that would make Sartre blush is surely missing not just the point, but a heckuva life to boot.

Only time will tell if we experience yet another come-down from an over-the-top Roaring 20′s peak. In the meantime I, for one, will continue to find comfort as well as encouragement in the oft-expressed sentiment shared by Warren Buffet when the question of how best to prepare for whatever hangover might be on the way: never bet against the United States of America.

I’m betting it’s gonna be a Happy New Year.

We May Disagree. We Are Not Enemies.

I wrote the essay below some 7 years ago. If you substitute “disagree” for “different” or “other” everywhere it turns up this very much applies to our present day world where single issue differences threaten to divide people who should actually be joining together.


“The original “word” for this thought was to be “enemy”, but the more I thought about it the less that seemed to apply. You see, “enemy” is really a very simple concept, one that is just too black-and-white in this world of grey in which we live. An enemy is nothing more or less than someone who has openly declared intent to do you harm. Nothing too very ambiguous about that.

This is very different from a person who dislikes you, or someone you dislike. It’s fundamentally different from someone who is angry at you. These folks can simply be ignored; they can be consigned to the trash heap of indifference. I’ve been known to say that it’s perfectly OK to make an enemy as long as you’ve done it on purpose so that you can assess the ramifications beforehand. Re-thinking this in light of a more accurate definition of “enemy” probably changes my tactical advise to “it’s OK to make someone angry at you.”

This is important today as we traverse our lives with our “situational awareness goggles” on high, important when we identify someone who is better described as “other” as “enemy” or “possible enemy”. By any measure we actually live in a world which is incredibly safe. We are not surrounded by legions of enemies but rather by “others”, people who stand apart for one reason or another as different. Maybe even odd.

If we view our world as one which is inhabited by only friends or enemies we are at risk to categorize these “standouts” as dangerous until proven otherwise, all data to the contrary. We are at risk to extrapolate the actions of one “other” to all, even those who share nothing with those villains besides their “otherness”. Is this really necessary?

Frankly, my worldview as a young man was very narrow, my willingness to even let the “others” be “something” less than zero. No, “others” were to be feared or ridiculed; they were certainly not meant to be ignored, let alone accepted. Now? Most of the “others” are just varying degrees of different, nothing more. Pick a number…99point whatever % are just that and will never be anything more diabolical or dangerous than a friend might be. They will never be an enemy, no matter how much their “otherness” sets us apart.

For most of us the world is filled with friends and others. We just don’t have that many enemies known or yet to be discovered. I do not advocate replacing our “situational awareness goggles” with “pollyanna specs”, but we really don’t need to have the setting on “high alert”. The risk of the false positive, the risk of identifying an “other” as an enemy is very, very high because there really are very, very few real enemies. Very few people who mean you, or anyone, true harm.

Don’t let the cacophony resulting from the rare sighting of an enemy, of evil, blind you to the fact that those who will not be your friends are almost always just “others.”"


We may disagree. In and of itself this does not make us enemies.

“Up By Your Bootstraps”: An American Success Story. Sunday musings 12/22/19

While fooling around on Twitter the other day I stumbled upon the latest beauty from Robert Reich, the Nobel Prize winning economist who has been making a mockery of his earlier achievements as a present day pop-culture economist: 60% of wealth in the U.S. is inherited. Now if that is even true it is at best brutally misleading, verging on dishonest. If even 60% of the dollar value of wealth was inherited the reality is that over the last 30 years whatever the original value was of that inheritance it  has increased many, many times over, falsely elevating its percentage level. What is much more misleading though is the purposeful effort to let readers assume that 60% of the people who would be considered wealthy (pretty low bar to be wealthy but that’s a topic for another post) got that way by inheriting their money. That’s just not true; a super-majority of the global value of wealth in the U.S. is actually concentrated in a very small cohort of super-rich.

What makes Reich’s clickbait headline and lede even more galling is that he uses his little bit of data sleight of hand to dismiss the cherished “up by your bootstraps” (EBYB) story line that underlies the success of literally countless narratives told by American families about their rise from poverty. Indeed, the possibility of EBYB success is a large part of what continues to drive people from all over the world to seek a new beginning by emigrating to America. Reich is calling BS on the entire EBYB path to success and in doing so saying that to seek an EBYB success is a sucker’s game.

Reich is just the latest and most famous non-practicing celebrity economist to let his fascination by, and revulsion at the super-rich blind him to the day-to-day reality of middle class success.

It is the rise from poverty, the elevation from being among the working poor and taking an UBYB approach to leaving both of those states that matters. The creation of super wealth, even the creation of entry-level wealth, is little more than a pipe dream for almost everyone who desires to  rise from whatever financial straights exist at the beginning of their journey. What matters, and what Reich casually nullifies, is not the immigrant who amasses a billion dollar fortune by becoming the owner of the largest yogurt company in America, but the thousands of immigrants who scrimp and save and buy a retail outlet that sells yogurt and at which they will toil for endless hours in order to support their families. It’s not the second generation that takes over the family-owned car dealership but the hundreds of tiny entrepreneurs who buy a NAPA franchise in order to create a little nest egg that can’t be formed as a line worker at Ford. In that 40% of wealth lies a super majority of small “fortunes” consisting of the fruits born from UBYB success stories.

At the risk of being accused of substituting anecdote for analysis (albeit looking at the flip side of Reich’s own story coin) let me tell a couple of stories to illustrate that UBYB is much more than myth. My Dad was born into a family of the working poor during the teeth of the Depression. One of six children his family expanded (to 10? 12?) when his mom died and my grandfather remarried. Dad was a “cardboard in the shoes kid”; when your shoes got a hole in them you neither got new shoes nor a new sole, you stuck a piece of cardboard inside the shoe to cover the hole. Family lore has it that Dad was plucked out of the trade path in high school by a teacher who saw in him the potential to rise. Upon graduation he went to UNH on a football half scholarship, whereupon he promptly starved for lack of money. Like so many young men of the time he joined the Army. During his enlistment and his years fighting in Korea he rose to the rank of Sergeant First Class. After mustering out he went to UVM where a combination of another half-scholarship and the GI Bill got him through school. Dad graduated with a degree in what we would now call industrial engineering, the only member of his family to get a degree.

Our life in the early days of Dad’s career (Mom stayed home after I was born) was one of “enough”. We had risen above the level of working poor, but the most charitable description of our status would be to say that we clinged to the lowest rung of middle class. But my Dad was a true believer in the UBYB dream. He put himself through Business School as he slowly rose among the ranks of middle management at the company where he began his career. When that company was sold and much of the lower and middle managers were let go Dad caught on with a much smaller, older, family owned enterprise. After quadrupling sales at the new company he and two other senior mangers bought out the founding family. For 15 years of so our family was comfortably in what at the time would be the upper middle class. Mom and Dad prepared a wealth starter kit in the hopes that their good fortune would continue on the same upward trajectory.

Did we become wealthy? Did my siblings and I enjoy the fruits of my Dad’s success with a big inheritance or a big infusion of start-up capital at the beginning of our own journeys? Sadly, this was not to be. For all of my father’s brilliance at running a small company he was not equally adept at divining the effects of large macroeconomic trends. The 80′s brought crushing interest rates, inflation, and an artificially inflated dollar, all of which conspired to destroy not only my Dad’s company but the entire domestic industry of which he was a part (there are no manufacturing companies in the U.S. remaining in his industry). There will be no generational transfer of wealth; Mom just sold the family home and hopes that the sale will support her for the rest of her life. Was Dad’s UBYB story a failure? Of course not. My parents sent four kids to college, all four of us debt free on graduation. We are all economically independent and have been since graduation. We would all be counted among that 40% Reich dismisses.

Cynical readers, especially the young, would say that my parents’ story has nothing but historical relevance. Such an UBYB story was little but a historical footnote by the time my Dad bought his company. Nothing could be further from the truth. I have two very close friends, men I’ve know since school days. My oldest close friend grew up in a family that was devastated by mental illness. He and his father shared a one bedroom apartment, taking turns between the single bed and a couch, floating just above the poverty level of the 70′s. Mother and Father were high school grads; there was little familiarity with college as a goal. Like my Dad my friend was raised up by teachers and the parents of a couple of classmates and put on a straight shot to a college degree. He got some scholarship aid and took out a bunch of loans and graduated from a highly selective college. My friend has taken himself UBYB to where he now has generational wealth. None of it was inherited. There was no wealth to disburse when his Dad died a couple of years ago. Indeed, I think he paid for the funeral.

As an aside, as this is the Christmas Holiday season, my friend is the most grateful human being I know. His Birthday is on Christmas Eve. You know how some Christmas babies always resent the fact that they have to “share” their day with Christmas, complaining that they get shorted because of the overlap? Not my friend. There wasn’t anything under the tree or wrapped up in a “Happy Birthday” package; there wasn’t anything at all. To this day I have never heard a single word of resentment from my friend. He is grateful for every tiny blessing that comes his way, even if it has come because he bought himself up by his bootstraps. My Dad was like that. They are both inspirations.

So you see Mr. Reich, even if your data is accurate and tells the story you’d like us to think it does, it still doesn’t render moot the power of UBYB wealth. Wealth, it turns out, is sometimes better measured in smaller ways than those that catch the attention of starry eyed celebrity economists. Sometimes it is something as small as being able to resole a shoe or order a new pair of sneakers without worrying about the rent. UBYB might mean the next generation goes to college. Maybe they even graduate without debt. Where once there may have been inherited wealth for my siblings and me to look forward to perhaps there will be that kind of wealth for our children and/or grandchildren.

“Up by your bootstraps” wealth is about people, and there are many, many more people in that 40% you deride than those fortunate few who have assembled the 60%. The opportunity to raise yourself “up by your bootstraps” within sight of that 40% is still the American Dream. It is still the hope of a nation, the antidote to the pithy observations of economists enthralled by the super rich, the engine that lifts countless families out of poverty. “Up by your bootstraps” is no myth.



A Lesson About Customer Care: Sunday musings…12/15/19

As hard as it may seem to believe this, I learned a valuable lesson about taking care of patients from an airline. Granted, this occurred because I had an unpleasant (for me) interaction on a rather long flight because a flight attendant had an unpleasant interaction (because of me) at the very beginning of that flight. My lesson can be applied any time one finds oneself on either side of the service continuum.

We should give a patient who may be having a hard day the benefit of the doubt.

This weekend I was in Las Vegas for a meeting with my very favorite people, fellow members of the small professional group called CEDARS/ASPENS. It’s a lousy time of year to be traveling, to be away from home. At my best I am a reluctant traveler when I am away from Beth, and at this time of year I’m also a little tired and cranky. Couple all of that with a late night prior to a very early morning flight (and a 3 hour time change to boot) and I was pretty much one big exposed nerve getting on the plane.

Knowing this would be the case Beth had helped me out by booking a bit of extra leg room, purchasing a carry on slot, as well as early boarding. On the outbound leg I had all of this too; I arrived at the gate a bit tardy and ended up with my roller bag 7 or 8 rows behind my seat. My bad, since I was a bit too casual getting to the gate. But on my return flight I was chilling in the gate area for area for an hour; when I got trampled by folks rushing to get on board first in that early boarding group my mood started to darken. Naturally all of the overhead bins around my seat were filled. My attempt to jam my bag in was unsuccessful. Once again I ended up with my bag several rows behind my seat. The flight attendant asked if that was OK and my instant, out loud response was: “nope. Not OK. Not even a little OK.”

I instantly regretted it.

You see, my tiny moment of petulance, during which I was admittedly behaving like an entitled brat, resulted in that flight attendant punishing me for the rest of the flight. For the next 4 hours she effectively ignored me. Not subtly, either. I sat with a credit card out to buy a drink and a snack while my row mate got a coffee. She failed to acknowledge this obvious cue that would otherwise have had her jumping to sell me something (and garner a tip). Newspapers piled up around me as she scooted by with the trash bag, and the beverage cart glided past my row during each trip down the aisle. Thankfully one row mate was sound asleep for the whole trip and the other only had that one coffee request. They did not suffer for my transgression.

Was I badly treated? Yes, of course I was. But I knew in a nanosecond after my micro-tantrum that it was going to happen. The flight attendant was not having any of it, and she was either unaware of the downstream risk she might be creating, or was willing to use her position of power while in flight to deal with any reaction I might have had to being “shunned”. Why didn’t I assert myself and request the same service offered to those around me? After all I was hungry, thirsty, and under-caffeinated. Looking back I am sure that I did not “raise my hand” because it was  obvious that my flippancy had created an enemy. I have spent so many years evaluating the micro details of the customer care experience from both sides that my reaction was to observe and analyze.

Which of course leads us to the question of where does the lesson lie and for whom is it meant? There is certainly a lesson for the young flight attendant but it is not for me to provide. I will tag the airline when I link this on Twitter in the hope that the lesson I learned might be shared with all of their flight attendants. I will not identify my flight; after all, the “original sin” was mine. Rather, I will look at this for an insight into how we as physicians and our staff might be better able to serve our patients when circumstances may not be optimal. Realizing how hard it is to be always “on” for passengers I am almost always solicitous and bring minimal demands to flight attendants. Most of our patients behave like this when they come to see us.

It is where a patient, the “served” individual in the service continuum, behaves less than perfectly that the lesson for me lies. An edgy or unhappy person should be given the benefit of the doubt as long as they do not persist in angry or unhappy behavior.  The young flight attendant whose job it is to provide a service did not give me the benefit of the doubt. My behavior after being seated was impeccable. I neither pouted nor complained. How often do we see a patient who comes into the office and instantly pops off to the reception staff about something trivial like filling out a form? You know, the equivalent of having to place your carry on a few rows behind your seat. Or in the exam room is a little aggressive with the first question? Do we as healthcare providers, doctor and staff, treat them from that point on as if they are the passenger who won’t hang up their phone, put their seat back up, or stay out of the aisle for the entire flight?

Or because we don’t know anything about what else is going on for them do we instead give them the benefit of the doubt? Allow them a few moments to demonstrate that their first little outburst was just that, a trivial anomaly, and not an indication that they are going to be an ongoing problem?

That’s the lesson I learned from the 4 hour punishment for my tiny, brief moment of pique. When presented with a patient who is on edge, who may be less than cuddly on first blush, we should offer them the benefit of the doubt. At least until they demonstrate that they are going to double down on their petulance rather than move beyond it. While I was pretty hungry by the time we landed, in the end I am thankful for the tiny lesson in customer care I received while flying home from Las Vegas.



Memories and Remembering: Sunday musings…12/1/19

Not gonna lie, Thanksgiving this year has been a tough go for me. As you know Thanksgiving is far and away my favorite holiday. The coming together of family and friends for nothing but the joy of coming together as family and friends has always touched my soul. That we would or could continue to do so year after year has been a bit of a touchstone for a kid (and a couple) who moved away. For more than 30 years we have alternated in some way between extended families. Where once we needed only manage two generations there are now four in the mix. 2019 was an “off” year for us, a year when children would prioritize in-laws (if even that was possible). Beth and I neither hosted nor traveled to be hosted by family for Thanksgiving dinner (hugs and infinite thanks to the Taylors for folding us into theirs and to Randy and his little family for joining us for brunch).

I missed everybody.

Seriously, I was a mess. Just a great big blubbering mess. I missed everyone, those both simply away and those who are gone. This longing was occasionally just below the surface, and to my wife’s great amusement bubbled through at pretty much every tiny little emotional prompt. It goes without saying that I sprung a leak watching “Mary Poppins” and “A Beautiful Day in the Neighborhood ” (the Mister Rogers movie), but come on, I cried at the end of “Downton Abbey”. Everybody lived! Everybody was happy! And I still cried. Don’t even get me started about that new “E.T.” commercial. Sheesh.

For whatever reason, well, probably because we wouldn’t have a typical family Thanksgiving, I’ve been thinking quite a bit about family members who are no longer with us. It’s been a tough few years for the White and Hurst families, and for the families of our sibling’s spouses for that matter. I’ve found myself thinking of my Dad and my Father-in-Law, wishing I could chat about any number of things. We stumbled upon a lovely picture of Sandy, my Mother-in-Law, making Christmas cookies. So vibrant, so alive in that picture. My memories of those holiday moments came alive, too, a rush of color and smiles and scents and laughter. Bob’s puns. My Dad’s terrible palate that could nonetheless parse the provenance and price point of Chateauneuf de Pape. They are here with me as if we’d had dinner yesterday.

If I had the guts I would re-watch “Coco”, that lovely little Disney movie about the Mexican day of remembrance Dio de los Muertos. I don’t, and I won’t, at least not now while I seem to be just one raw exposed nerve, but if I did it would probably help a bit. Remembering, that is. Harold Bloom, the Yale professor of literature and societal scold, has given this some thought: “Our beloved dead live only as long as we absorb them into our daily thoughts and feelings. When we die, our own survival will be the extent to which we have changed the lives of those who come after us.” Very Mexican, that. Still, both Bloom and Coco are right; Beth’s folks and my Dad have been here with us this Thanksgiving.

Are they in Heaven? Boy, for as much thinking as I’ve done about that over the years I still don’t know where that is. Heaven, that is. Is it a place like what Disney depicted in “Coco”, where our dead live for as long as they are remembered by the living? Does the Heaven of my upbringing exist as a place of eternal joy for those whose lives were deemed worthy? Or is there some other, more rational explanation like the one that my genius brother-in-law and I have explored through quantum physics? The multiverse of infinite time going both forward and backward?

Or perhaps it is not our beloved dead who are in Heaven but us. Maybe it is we who are in Heaven. Mr. Rogers: “The connections we make here in the course of a life–maybe that’s what Heaven is.” Maybe Heaven is here, now, and those we’ve lost in the flesh are nonetheless here with us in Heaven for as long as they are remembered. Make no mistake it is easier and far more satisfying to be warmed by a hug than a memory. But still, the connections persist. That’s likely the important lesson for me this Thanksgiving. The rituals help us to remember, and the remembering keeps those we love and have loved close by. My beloved Thanksgiving, in every version, may be as close as I will ever come to understanding Heaven.

And that it’s OK for me, for anyone, to want a little more of Heaven.


Holiday Rituals: Sunday musings…11/24/19

“The sign of a healthy ritual is one that can be changed.”

This is my favorite time of year. Thanksgiving, that is. I’m not so much a fan of the whole “Holiday Season” thing, given that it’s all about the commerce of Christmas. What I really love is Thanksgiving. It’s pure, or at least as pure as a holiday can be in our hyper market-driven American lives. For those of you who are now being launched out of your chairs with a knee-jerk response about the heinous effect of the Pilgrims on the indigenous natives here long before the westward move from Europe, save your breath. What I’m talking about is not in any way related to anything historical other than the traditional myth of generosity and comity I first learned about in kindergarten. Thanksgiving for me is simple and pure. We gather and break bread, the only reason to do so being that we are thankful for the opportunity.

We joke in the White family that our traditions, especially those around holidays, are set in stone. Do it twice and it’s as permanent as Stonehenge. While this is certainly true on average, looking back there have been some mileposts where a turn was made. Actually, more than a few. In the earliest of days my maternal grandparents hosted Thanksgiving in New Jersey. This went on until my Dad had enough of traveling with 3 and then 4 little ones. Turkey Day moved to our home for the next 20 years or so. I have to admit that I don’t remember whether or not Gamma and Gramp were there in the tiny house in Southbridge; I cannot remember a Thanksgiving without Gamma once we moved to RI, at least after Gramp died.

Why can’t I remember where she sat?

Take a moment and think about your family meal. What time did you eat as a kid? Do you remember why that was the time? And the meal itself; what did your family eat and how was it prepared? It was always the same, each year, right? We were a football house. In RI every high school has a Thanksgiving Day game. Same for Massachusetts. The annual rivalry with Bartlett (Webster) has been a thing in Southbridge for decades. I got to play in one as a freshman, but I can remember going to the game to see our childhood heroes, the gods who strapped on the pads for the Pioneers, from my grade school years. My first cup of coffee was at at Bartlett/Southbridge Thanksgiving Day game when they ran out of hot chocolate. We ate around 3 if memory serves. The games began at 11 and were done by 1:00. Long after I hung up my cleats in RI we all piled on our warmest outerwear and watched Lincoln High play its annual version of the game.

Stuff starts to change when you get married and the whole in-law thing enters into the Holiday equation. Beth and I are both first-born, first-married, first to have kids (and grandkids) in both of our families. Since our families lived 6 or 7 hours apart there was no way to pull off the double-dinner dance so delicately done by countless friends who married local. It’s funny how you notice the differences in family traditions so much more than that which is the same. The Whites and the Hursts all ended up with magnificent meals, both nutritionally and spiritually satisfying in every way, albeit by vastly different routes. Beth’s family sourced everything locally, each item plucked from the farm within days of Thanksgiving, every course and dessert made from scratch. In our house the turkey was frozen long before dinner, and the only things made from scratch were the mashed potatoes (Dad was very particular about them) and the stuffing.

And yet both meals were the best meals I ate every single year because they were baked in love and enjoyed in the company of those I loved and who loved me.

Change has continued to come to our Thanksgiving rituals as the next generation went to college and began to (yikes!) marry themselves. Two generations of in-laws to manage now. Whoa. Children living out of town with job schedules and travel logistics to contend with. Siblings who live close enough to give at least a passing thought to joining around a single table, and other sets of siblings just far enough apart that to do so would require a quantum computer and a Papal decree. Our little family alternates years as we did for so long when our kids were young. This is an “off” year for us. Beth and I will see one child and his family for a short time at brunch. That will be it for our family gathering, at least on Thanksgiving Day. Another family will fold us into the embrace of their ritual, a change for both of us.

The details change, but do the rituals of Thanksgiving change as well? I don’t think so. At least not enough to change how I feel about Thanksgiving or how I remember our Thanksgivings of yore. We will enjoy the rituals that have surrounded the signature ritual, the Thanksgiving Day meal, and for this year they will be enough. Pizza on Wednesday to usher in the Holiday, and the best steaks we can find on Friday. On Saturday I’ll try to find some way to serve lasagna; we always had Mrs. Cunniff’s ready to defrost after 3 days of leftovers. I’ll bring Cakebread Chardonnay (and think of my sister Tracey) to our friends’ house for dinner, almost 30 years of ritual in that little gesture alone. With those steaks we will drink Chateauneuf de Pape, the only wine my Dad could identify; he had the world’s worst palate and was subsequently the easiest wine drinker to please except on the Friday after Thanksgiving when only Chateauneuf de Pape would do.

The sweet sadness of change will be lightened for me by the strength of the rituals that persist. Each one has grown to fill the space created by inevitable change. By both loss and gain. The rituals that we have now have come from the same place as those they have replaced, a place of love, a place filled with thanks for that love. Yes, this is my favorite time of year. Thanksgiving is my favorite holiday.

Happy Thanksgiving to you and yours.

Mary Poppins and Politics: Sunday musings…11/11/19

Sunday musings…

1) Wit. “Mustard’s Last Stand”. Name of a hot dog stand at Northwestern.

2) Streaming. Lots of churn about streaming fatigue, overload, etc. So many/too many new options layered on top of shows and movies you still need to catch up on. What’s a body to do?

I’m gonna read a book.

3) Burberry. I stumbled upon several articles talking about the new creative director of venerable clothing brand Burberry. All of them talked about their plans to change stuff there. While I am not a regular customer by any means I have had a couple of pieces from Burberry that fit my style and stood the test of time. Which begs the question: why must Burberry, or for that matter any iconic brand known for a particular whatever, change? Evolution seems proper, maybe even inevitable, but the incessant demand for the traditional to change is confusing to me.

Why must change be considered as a mandate rather than an option, especially in a successful endeavor?

I admit that I poke fun at fashion with some regularity, typically timed by the semi-annual release of fashion issues of the big national newspaper magazines. My fascination with the absurdity of what is promoted as good, or even possible knows no bounds. Nobody wears that nonsense, yet lots of somebodies continue to wear garments that are instantly recognizable as Burberry. Does this not denote success? Is this not what a successful venture of any kind in any space would seek to perpetuate? I think of the pillars of healthcare delivery, known for excellence in certain spheres because of their ability to successfully treat the most complex cases imaginable. One of them here in town has a new “creative director” who has decided that change means the equivalent of mass market growth in fashion. Like Givenchy designing and selling volume in Kmart.

How long can a successful brand sustain change before what made it successful has been diluted to the point of nonexistence? How many places can the iconic Burberry plaid be placed before it’s just another color? How far from the classic pieces for which it is known can the new creative director take the Burberry style before it’s no longer Burberry?

These are questions that apply everywhere a traditional product, brand, or name means something.

4) Candidate. Much noise has been generated by Michael Bloomberg’s flirtation with a run for the Democratic nomination for president. He is a political chameleon, running now as a Democrat after a run for mayor of NYC as both a Republican and an Independent. Mostly a down-the-line progressive when it comes to social issues he nonetheless has a couple of positions that would appeal to conservatives; his record for law and order in New York appeals to conservatives while at the same time revolting progressives due to the tactics utilized to achieve the goal. A billionaire many times over he seemed to find a balance in NY between promoting business and the creation of wealth while simultaneously protecting those at the bottom of the economic pile. As much as anyone in New York can, anyway. He likely gets bludgeoned in the primaries even though it is equally likely that he would win the presidential election in a landslide.

As interesting and intriguing as Mr. Bloomberg may be his potential entry into the race makes me think of the most impressive national figure I can think of in my lifetime who should have run for President, Condoleezza Rice. Ms. Rice was Secretary of State under Bush and is now a professor at Stanford among other pursuits. Possessed of a nearly unmatchable intelligence among recent government officials both elected and selected, she checks every conceivable box both as a candidate and as someone prepared to govern. I think I can trace my dissatisfaction with both politics and government in part to her decision to withdraw from public life. Not since Paul Tsongas withdrew from the ’92 race due to illness have I felt like the right person was there to be chosen. Her absence from the national conversation borders on tragic.

I fear that we are thus doomed to at least 5 years of braying from the far Right and Left, or just plain old braying if we have 4 more years of 45. In the absence of someone like Ms. Rice, someone of substance who transcends the pettiness of our politics, I will spend another 4 years waiting. Waiting for someone of substance who will speak to me and the 10′s of millions of us who inhabit the center of American politics. Some a little left and others a bit right of center, but all of us clustered far from what it apparently takes to be nominated to run for either party. I will wait for someone who makes me think of Mr. Tsongas or Ms. Rice. Individuals of arching intelligence and substance who have lived lives that citizens of all political leaning can agree have been honorable. Ethical. Candidates who will take and hold principled positions without denigrating or dismissing those who disagree. Someone who can both campaign and govern.

Watching her leave her post as U.N. Ambassador after a successful run as Governor of South Carolina I felt like Bert, looking skyward as Mary Poppins flies away after saving the Banks children. So long Nikki Haley. Don’t stay away too long.

I’ll see you next week…



Tiny Cultural Collisions

I just returned home from the largest of the annual ophthalmology meetings. At these gatherings I see my professional friends, and some 35,000 or so of us descend upon whatever city we are visiting. We bring all manner of customs and culture along with us, there to collide with those of the locals. Here is what I wrote about this a few years ago, still relevant today.

It takes very little effort to observe the intersection of cultural norms. Indeed, it takes a substantial effort NOT to notice them when they collide, as they must, in the polyglot that is the United States. Physicians, it’s been noted, are little more than paid observers; I see these collisions daily. What are we to do when cultures collide?

Now, I’m not talking about the “old as eternity” cultural divide between teenagers and their parents; in the end the teens will either hew closely to the cultural norms of their heritage or fall more in line with those of their present address. What I am interested in are those cultural norms that remain an integral part of the fully formed adult one might encounter in a rather typical day, and by extension whether and how one should respond to any cultural dissonance. Or for that matter, WHO should be the one to respond.

It’s the tiny ones that catch my attention. Personal space for example. The typical American personal space extends one arm length between individuals. Something shorter than a handshake, more like a handshake distance with bent elbows. The Mediterranean space involves an elbow, too: put your hand on your shoulder and point your elbow to the front and you have measured the personal space of a Sicilian. Asians on the other hand occupy a much larger personal space that can be loosely measured by a fully extended fist-bump. Something which would be anathema in polite Japanese company, but no matter.

My favorite little example of the variety of cultural norms that swirl in the soup of the great Melting Pot is the affectionate greeting. You know, what most fully acclimatized Americans would recognize as the “bro hug” shoulder bump and clasp, something that would be appalling to a Parisian or Persian, or indeed even to a Princess of the Antebellum South. Yet even here there are differences. The Princess, joined by legions of Housewives of Wherever and Junior Leaguers everywhere are ninjas in the practice of the single-cheek air kiss. It should be noted that ~90% of men are NOT ninjas in this particular art, and are expected by its practitioners to bungle the act.

Persians and Parisians, on the other hand, find the one-cheek air kiss to accomplish only half the job. They, and others who share centuries old cultures, warmly greet each other with a two-cheek kiss. I am sure that there are nuances involved here that remain unseen and unknown to both most men and certainly most (all?) who don’t share the heritage. (As an aside let me just say that I am a huge fan of this particular cultural norm because it means that two of my very favorite colleagues, Neda and Carol, always arrive bearing TWO kisses).

So what’s the point here? Two, I think. First, there is a certain boorishness in the failure to observe and recognize the existence of these cultural norms when they are encountered. Some, like those I’ve mentioned, are the relative equivalent of a soft breeze, neither strong enough to fill a sail nor de-leaf a tree. Recognizing them, even in the tiny manner that one tries not to trample on them even if they will be ignored, is a tiny gesture of kindness, respect, and courtesy.

The flip side, number two, is deciding which of these norms is the default setting. Here things get a bit stickier, especially when cultural norms run afoul of SOP on the particular ground they occupy. Think air kiss in Afghanistan, for example. Bowing in the boardroom of Samsung in San Clemente. There are more, and bigger examples, but you get the idea. Here I think geography holds the trump card: “when in Rome” should be your guide, especially with cultural norms where the collision may be substantially more impactful than whether or when you turn the other cheek, a tornado to the above tickling breeze.

Perhaps we could all agree on the two-cheek greeting thing.

In Memoriam: Abby, the Wonder Dog

In Memoriam: Abby the Wonder Dog

This morning I was awakened by a text from Beth: “Call when you can.” That’s almost never good, and today was no exception. My beautiful, brilliant dog Abby had died. A tumor was wrapped around a major artery; there was nothing to do but comfort and love her after the artery burst. She died in her Mamma’s arms as my son Randy gently stroked her head.

May I tell you her story?

My older boy, Dan, shared an apartment with two friends and a very cool Border Collie named Dakota. When Tommy and Megan moved on Dakota went with them, leaving a hole in Dan’s heart that could only be filled by another dog. Did you know that farmers in central Ohio who raise working dogs don’t always spay or neuter their packs? Neither did we. While I don’t know how extensive this next part is, at least some of the pups that are not needed to work the farms are simply turned out onto the land to fend for themselves. It’s enough of a thing that there is an animal rescue in Tiffin, Ohio dedicated solely to these “extras” from the litters.

Abby and her sister were feral for the first 6 months of their lives. After being live-trapped they were brought to the Border Collie/Australian Shepherd rescue where Dan somehow discovered Abby’s picture. There must have been 3 dozen dogs in crates and running in outdoor pens when we arrived to see if they would let us adopt one. It was funny. We had to audition for the staff. They brought out 6 or 7 other dogs to see how we would handle them before finally bringing Abby out of her crate.

Abby, who promptly came right over and climbed simultaneously into Dan’s lap and all of our hearts.

Herding dogs like Abby, part Border Collie and part Aussie, are rightly famous for their intellect and their energy. Having one of these without a farm to run them is a special kind of crazy. As a college junior Dan’s apartment was hardly expansive enough to contain her energy. Was it boredom or anxiety that prompted her to tear the carpet in the apartment and eat down through the subfloor while he was in class? She never said, but shortly after her “redecorating” she came for her first extended stay with Mom and Dad.

We had quite the little pack, Beth and I. Haddie our English Setter was like Nana in “Peter Pan”, mothering dogs, children, and adults alike. Tiny Tim arrived looking more than a bit like a Beanie Baby, so tiny and fragile, velcroed to Beth’s side. And then Abby arrived, all energy and curiosity and mischief. Even with her canine buddies there was still something about being without her people that made her crazy. Nothing on a counter or in a closet was safe from her when we were out.

I’ve told most of these stories before. Like the time she ate about $200 in petty cash from the office. Pretty interesting poops in the backyard after that as you can imagine. The very best one was when she “ate my homework”. We’d gone out to dinner and apparently I didn’t put my surgical sheets for the next day’s cases far enough back on the counter. If that’s all it was I could have run up to the office and simply run off new copies. Nope. As it turned out I was also transporting a couple of special order lens implants from one surgery center to another. Implants for which one of my patients had paid about $1500. Oh yeah, Abby ate those, too. That was a pretty weird phone call, telling my patient why I was cancelling their surgery at 9:00 PM the night before. The OR staff still talks about that one.

Abby never really lost a kind of wariness around new people. It was there with all of us (except Dan) at the rescue and remained after she came to live with Beth and me while Dan was doing lots of traveling as he completed his studies. There’s a lovely fellow who worked for the boys at their gym who Abby never warmed to; he sent us a very nice condolence in which he shared that this had always made him sad. Beth and I had just one worry, that she would be skittish around little ones like grandchildren. No worries there. I will forever see her lying close to her newest littlest people, totally unperturbed as they tumbled on top on her in their travels.

Or the tiny little “drive-by” kisses, soft little licks she gave Landon or Lila or McKenna on her way by. Yes, those…those I will see through my tears forever.

Abby loved us from the minute she chose Dan right up until she died. The last thing she saw on this earth was her people Mom, Beth, and her little brother Randy. I’m still not sure if it was better to be away or not. All I know is that I loved my dog, and that the very last thing I did when I left the house last week before my travels began was to reach down, scratch her ears and tell her. For all of my sorrow I wouldn’t trade our years together for anything.

Fair winds on this last journey Abby, your sails full with the winds of my love. I did so love being your person.

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