Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Jim Brown Lived A Long Life: Sunday musings…5/21/2023

1 Arhoolie. Field hollers. Now, I have no idea what a field holler is (Google is kinda cheating if I’m pulling these musings out of my own Restless Mind, eh?), but that’s just a very cool word.

2 Phonics. “Fa-aw-nah-icks been good to meh. Meh.” –Brian Reagan

NYC schools will return to the use of phonics to teach school children how to read. After some 30 years of using something called “balanced literacy”–what does that even mean?–the country’s largest public school system will return to the program that turbocharged the increase in American literacy in the 50’s through the late 80’s. Heck, we were taught how to read French in middle school using phonics.

‘Bout damn time.

3 Reunion #1. I had a chance to chat with the third leg of my friendship triumvirate in college yesterday. Ricky V was in CT visiting his MIL, who is sadly preparing to shrug off the chains of our earthly lives. While there he dropped in on my closest friend from college, Rob, and the two reached out on Facetime.

It was a wonderful visit.

Tiny lesson here: never let go of the memories of a wonderful friendship, no matter how long it’s been since you were able to actually, you know, be IN the friendship. Always take the opportunity to reach out if you happen to be randomly in the vicinity of an old friend, and always say “yes” if an old friend calls up and asks you to get together.

I’m really looking forward to seeing Ricky (and Rob) in real life, soon.

4 Reunion #2. My closest friend from high school, Tom, called me out of the blue yesterday morning. I’m home, minding the dogs while Beth celebrates her middle sister’s 60th birthday in VT (Happy Birthday Lisa!!). Tom and I had spent a few seconds texting about a possible trip to his summer home and he grew frustrated by the act of the text, picked up the phone and called.

Lesson: calling trumps texting. Not even a close contest.

We caught up on our kids, my grandkids, and his now three year old relationship, the first real one since losing his wife to pancreatic cancer some years ago. You may recall my pieces here about my friend Ken, lost to the same cancer in his 40’s. My FIL and his best friend both died from variations of pancreatic cancer, and in a very strange coincidence the woman Tom is dating lost her husband to, yup, pancreatic cancer.

Even though this was a very tiny part of our delightful 45 minutes or so together, it does give me an excuse to tell you about a new genetic test that can detect markers for some 50 of the most deadly cancers, including pancreatic cancer. Tom and I had both read the same letters to the editor in the WSJ that describe both the test, Grail by Illumina, and the idiocy transpiring at the FTC surrounding a merger that would make the test more widely available. The test is not covered by insurance, and since it’s pretty expensive I’m not sure how I feel about that. But if you have pancreatic cancer in your family, you should know about Grail.

5 Encore. “What ya gonna do when the music stops?” Encore, Graham Nash.

I’ve reached the point in my life and career where seemingly everyone wants to know when I will retire. Patients concerned that I’ll lay down my diamond blades and sit back from the laser before I can operate on them (a sentiment I’m personally familiar with since my hip surgeon retired before my second hip was ready to go). Industry partners who feel I’ve made a contribution to new products and would like me to remain relevant by staying in the game. Friends and family who very kindly and sweetly have made it known that my day job is interfering with their plans for us to have fun together. It’s all very nice, and it makes me feel good to by honest, to be asked in this way.

I just don’t know what’s next after the music stops.

John H., a very famous cataract surgeon some 15 or 20 years older than I, started to experience the same phenomenon in his mid-60’s. When an industry friend asked his response was, at least to me, rather sad. “I don’t know how I can ever give this up, Tom. I’m only special in the operating room.” Like the musician in Graham Nash’s song, Dr. H. only felt truly alive, only felt that he was seen and that he mattered when he was sitting at the microscope doing surgery.

Jim Brown died this weekend. Arguably the best running back in the history of football (with a nod to the greats Gayle Sayers, Walter Payton, and Barry Sanders), and with at least a seat at the table of the greatest football players irrespective of position, Brown was a man who was much more than just a football player. Athletically there are still those who argue that he was the best college lacrosse player ever, though it’s very hard to compare players across literally centuries in which the game underwent substantial, fundamental change. Brown played professional football because it gave him the means to live the rest of his life.

This was a man who walked away from the endeavor that brought him fame and fortune, literally while he was at the peak of his skills. Unlike Sanders, who also retired when he was the undisputed best pur running back in the game, Jim Brown did not just fade away. On the set of The Dirty Dozen, his first major acting job, he was given an ultimatum by Cleveland Brown’s owner Art Modell: abandon the movie (it was running way behind schedule) or face daily fines until you show up. Aware that he could very well have a long life ahead of him, and that he could act for much longer than he could play football, Jim Brown called Model’s bluff and retired. He would go on to make some 50 films and make 30 or so television appearances before leaving his SAG card in a sock drawer.

Jim Brown always had another encore in him.

While still acting Brown became deeply involved in the Black power movement of the 60’s and 70’s. he is famous for organizing and participating in the so-called “Cleveland Summit” of Black athletes supporting Muhammed Ali, ne: Cassius Clay, when he declined to report for service after being drafted. Standing alongside the likes of Ali, Kareem Abdul Jabbar ne: Lew Alcinder, and Bill Russell, Brown launched himself into both the “big ideas” arena of race relations, as well as the tiny gritty details of the daily struggle (he is famous for directly, personally engaging gang members in an effort to reduce gang violence).

Jim Brown was hardly a saint. His legacy is marred by allegations of physical abuses, and he admitted his problems with anger, and expressions of anger. This part of his life is beyond the scope of my Sunday Ramblings. If interested in a deeper look into more things Jim Brown you would do well to Google “Tim Layden Jim Brown” and read the 2015 Sports Illustrated interview.

What interests me about Brown and his life is that he seemed to sense something that I’ve been thinking about, and writing about, as I start to think about what my next act might be, whenever the encore may be called for. Jim Brown somehow knew that life is long. That he, we, might live a very long time after he retired. After each time he retired. Like Dr. H. above but on a much grander scale, Brown felt the adulation of an admiring crowd, a crowd that, for him, never dispersed. What of the rest of us, though? What will be next? Will we also be called back to the stage for an encore, or two, or three?

“How you gonna feel if the music dies? How you gonna live with the soul sadly sighing, into the wind that is our life? Encore. Encore. The last song is over.”

I don’t yet know what my next act will be. What song I will play if I am called to do an encore.

I’ll see you next week…

The Orphans: Mother’s Day musings…5/14/2023

It’s Mother’s Day here on the North Coast and elsewhere across the land. A day widely acknowledged as the invention of a greetings card company in pursuit of a card-giving occasion, and despite this a day equally accepted as one worthy of the observance. In years past I have encouraged the tiny, but meaningful option of re-naming it “Mommy’s Day”; those who actively pursue the state of active mothering, Moms, in my opinion more deserving of the adoration of the day.

Do you still have a Mom? If so you’ve already called her, right? Come on, it’s way late in the day for me to be typing this, and if you haven’t called what the heck are you waiting for? I just took a quick look at Facebook and the first thing that came up was an acquaintance, Geoff, whose Mom made it to today before she shrugged off the chains of this life. All of her kids were there to wish her a happy Mother’s Day as she went on her way. Crazy, huh? They got to say a final Happy Mother’s Day just before they all became orphans.

And you’ve not called your Mom because, why?

If you think about it at all, it doesn’t matter when it happens, but the death of your only remaining parent makes you an orphan in the most traditional sense. Even if you are 40, 50, or 60+, losing your last parent means that you are now an orphan. When Beth’s Mom passed away some five years ago, not too very long after her Dad, Beth became an orphan. However trite, however commercial it might be, we all feel the tug of our Moms on Mother’s Day.

From what I’ve observed over my lifetime, there are sadder ways to be orphaned. We have more than several friends who were abandoned by a parent early in life, leaving them with only one left to lose in the more “traditional” way. A couple of special people in our lives were “left” by parents who may as well have died, so dead did they become by leaving behind their child or children. One wonders if it is the same as losing that last parent to death. I confess that I’ve not been brave enough to ask.

It’s been a couple of weeks since I wrote about my visit to see my Mom. About how small everything seems now. It’s as if my siblings and I have to pay ever closer attention lest she shrinks until she just disappears. What a joy it was to hear her voice today. Hear how strong, how BIG it sounded. Having lost my Dad some 7 years ago I know that one day I, too, will become an orphan. But not today, you know?

Not today.

There’s no lesson here. Well, at least not much of a grand lesson anyway. It’s almost dinner time on the East Coast, and it’s still Mother’s Day. I hope that you, like me, like Beth, were blessed to grow up with someone who was Mom, or Mommy. No matter how old you are today, I hope that you still have her, and that she is not only alive but not yet small. Still big in your life. Today is not a day for the conveniences of our modern world. No texting, no snapping, no WhatsApping. Pick up the phone and call your Mom.

No one is there to answer the phone once you’ve become an orphan.

I’ll see you next week…

Lives Lived are Never Small Lives: A “Sunday musings…” Repost

“But players don’t feel like bit players in their own lives.” –Richard Russo

Oh man…how good is that? Every life is just huge if it’s you who is living it. Every story suffers or soars depending on the frame of reference of the author. The eyes and ears of the storyteller only catch so much, and some of what is seen or heard never makes it past the “bit player” level in the story that is eventually told. This is what Russo refers to. There are short stories, but there are no small stories. There are quiet lives lived with little or no acclaim, but there are no small lives. There are people who move as if shadows among giants, but there are no small people.

Misplaced, lost, or cast aside, the skeletons of friendships past walk with me, still.

We are blessed, fortunate beyond measure, if we can count among the masses a single friend. One to whom we can always turn, from whom we withhold nothing, who will give to us everything. To have more than one friend such as this is to have a kind of wealth that beggars description.

If we are lucky enough to have friends they are joined in the garden of our lives by that next best thing, friendly acquaintances, and these in turn are surrounded by acquaintances, the entire garden encircled by farmland that lies, for the moment at least, unexplored.

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

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

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

“I have given up all hope of a happier past.” A better, more poetic version of the lesson Simba “absorbed” from Rafiki about longing for the past or hoping that it will change if one wishes just a little harder. Alas, the ball STILL goes through Buckner’s legs each time I watch the replay.

The moment is NOW. Now is what we have. We have learned from the past, and we plan to apply what we have learned to the future, but what we have is “now”. Now is all there is. Pay attention. Now is important. The people you are with, the task at hand, the place you occupy NOW are what you have. Pay attention; don’t miss the moments now.

In the end “[all] those moments will be lost in time. Like tears in rain.”

I’ll see you, from home, with new “musings…” next week…

Smaller and Smaller. A “Sunday musings…” Trip to Visit Mom

Smaller and smaller. That’s all I could think about as we drove from Lincoln to Boston after a weekend visit with my Mom in her new home. So small.

Everything about Mom has become ever smaller. Someone snuck up and zapped her with some kind of shrinking ray. Never a big woman despite my brother’s teasing about her caboose, Mom looks incredibly tiny now. Lighter, thinner, shorter; even the good things about her are about small (a bit healthier, you can now see her ankles). Her apartment is less than half the size of the one she left a few months ago, which was itself about 20% of the size of the family home she left behind. Her very large circle of friends and acquaintances, once at least a couple of dozen strong with whom she had weekly contact, is now precisely zero. Outside of family (my siblings and our spouses), Mom’s world is encompassed within the four walls of her senior living facility.

There’s nothing really surprising about this. Not intellectually at least. We all certainly saw this happen to my Dad, both of Beth’s folks, and our brothers and sisters in-laws’ parents. It’s really just seeing it, and in my case seeing it episodically over intervals of months rather than weeks or days. Heck, Beth and I were lucky this weekend. Mom was feeling pretty well in comparison to recent weeks, and she was fairly easy to motivate toward movement. This is hardly a given as my poor sisters and brother have experienced over the last couple of months. But it was still striking to see it up close.

Everything has gotten so very, very small.

Once upon a time I wrote about this after visiting my Dad. He wasn’t a very big guy physically, but looking at him through the eyes of a son…boy…did he seem huge. He was a quiet man, at least around the house and certainly when we were all young. My son Randy was telling his fiancé about Dad sitting in his rocking chair and tipping the corner of his newspaper over just before he laid down the wood. I’m chuckling as I write as I think about the look on the faces of my sister Tracey’s dates when Dad looked over his reading glasses: “11:00 Tracey Jane.” A super-sized eye roll from Tracey and abject terror on the boy’s face. Seeing him diminished, so very small in so many ways toward the end, was simply gut-wrenching.

It’s sad. I’m sad. Despite the fact that I knew that it would be like this (again, my siblings have been terrific in both visiting and sharing updates), I’m just very sad about how very small both my Mom and her life have become. There are certainly lessons to be learned from what Beth and I saw in my Mom and the small group of women who have befriended her. For me, that is. In the process of finding places to live for both of our mothers Beth has visited quite a few senior living facilities, so what we are seeing now is what she discovered in her research. What I’m learning by seeing in real life actually reinforces and brings to life some of the things I have been researching at arms length.

Sorry, it’s a teachable moment and I’m gonna lay some, um, teachables on you.

All of the stuff that I’ve been reading about and observing about the importance of close relationships is true. Brutally true. In the book “The Good Life” by the researchers heading up the Harvard study on lifelong happiness there was an anecdote about a couple who had a lovely life. Really, quite lovely was the only way to describe it. The cornerstone of that life was their marriage, and from that the friendships that they’d forged both as a couple and as individuals. The husband had but one wish: “Please, don’t let me die second.” Man, it was just devastating to read that he did, indeed, die second, albeit only a couple of months after his beloved wife. I saw precisely two couples at my Mom’s place. Two. There were a handful of single men, but by and large the place was occupied by widows.

Maybe modern medicine will change this dynamic. Maybe there will be more men who survive long enough to be in senior living circumstances. Let’s hope so. Maybe that will make it easier for the single women who arrive without a tribe. Like my daughter Megan said so many years ago, the mean girls of high school don’t really graduate, they just move. Eventually they move to the last high school they will attend: senior living centers. Please let me live long enough to spare my darling Beth the pain of being single in “high school” again. Sorry for the rant; there is really no teachable moment to this part.

All of the teachable stuff comes straight out of the traditional CrossFit playbook, at least the physical stuff we saw. On the plane flying home I was reading Outside Magazine. The outdoors stuff really does speak to me, but for the life of me I can’t figure out why I insist on reading the fitness stuff. This is the magazine that persists on calling some skinny-fat ultra-whatever athlete the fittest person on the planet. A magazine published on a planet on which the likes of Lebron James lives, mind you, never mind Jason Kalipa and all 27 of the Thorisdottir’s. “Use It or Lose It” was the title of an article that cites researcher/trainer Alan Crouzen’s “Immortality Quotient”: the amount of aerobic fitness lost by endurance athletes due to age can be reversed by adding one hour of training time per month. I saw precisely no one at my Mom’s facility suffering from a lack of aerobic fitness.

Say what you will about Greg Glassman and the CrossFit Rx, ca. 2005-2015. Glassman and those who developed offshoot programs (e.g. Jeff Martin/Darrell White and CF Strength Bias) correctly identified the key, critical issue for aging humans: decrepitude. A broad, inclusive fitness that is NOT obsessively devoted to aerobic performance but is rather balanced in such a way that includes both strength and strength endurance is what is necessary in the real world of the aged. What Beth and I witnessed was countless individuals who were simply too weak to perform the blocking and tackling of their daily activities. We observed a cohort of men and women who struggled to stand up.

No matter how many friends you may retain as you enter the last couple of innings of your life, your world contracts if you can’t get your ass off the toilet.

This “musings…” began at Gate A2 in Boston. At the moment I am sitting at our only table at Casa Blanco, 40 minutes away from what promises to be an epic sunset and watching Beth mow the lawn while Bohdi assaults her lawn mower. At dinner I admitted that I was still sad. Sad about how small my Mom and her life had become. Sad because I was missing both of our parents when they were our age now. When their grand children were just getting started. Missing all that they were then, so unaware of the consequences to come from not planning for how they might find themselves in the decades to come. The glow of the sunset to come reflected off my darling wife as she maneuvers her lawnmower across our tiny backyard is a tiny beacon that might guide us both. Might signal that we both saw what might be before us if we don’t pay attention to what it was we were witness to this weekend.

Everything about my Mom had become so small. So very small. Some of that diminution is inevitable, of course, but the WHEN of that diminution is not. There are choices to be made, decisions over which we have control at the moment. Gravity will be victorious, but the timing of that victory may be partly in our hands. We will become smaller, too, but the speed at which we suffer that decline and the time at which that decline begins may be partly in our hands. There are many aspects of who our parents were when they were our age that Beth and I would be proud, thrilled, to possess, and we both are determined to do just that. The sun will set on us as surely as it did for our parents. No one escapes the sunset.

Unlike our parents, we need not face the sunset seated until help is at hand to help us stand.

Some very important things were learned about how we might be able to choose how we head to our own sunset. The lessons are there for the learning. Find your tribe and gather them close. Aerobic fitness may very well lead to a longer life, but it is strength that will lead to a better life. Run, walk, or bike as you will, but be sure to do what it takes to be able to get up and out of the loo on your own. We, too, shall be diminished in the end. Small is what waits for us all. It made me sad to see how small life has become for my Mom.

The lessons Beth and I are learning is that the when and the how fast our lives become small may very well depend on choices we make today while the sun is still high in our sky.

Burnout and Microstress: The Drips That Flood the Buckets. Sunday musings…4/23/2023

1 Time. For a guy who has been told, and who really does believe that he needs to find some hobbies so that he isn’t bothering the people around him who already have, I certainly seem to run out of time awfully frequently. Like, every day frequently.

Clue? It’s been three weeks since I’ve “mused”.

2 Spam. Not gonna lie, the bots are winning. Big time. It’s tough to filter out an email address when the bot has 50, or 100,000 or a million different versions of an address from which to bludgeon your email. My spam filters on email are nearly worthless.

It’s almost bad enough that you wanna find out just what it is that all of those “sexy Russian girls” find so fascinating about a slightly chubby, easily winded middle-aged man.

3 Fat. Man, I’m tired of being soft. Sure, there are a couple of very good reasons for these extra 8 or 10 pounds of marshmallow. 5 or so months of pre-surgical pain that prevented me from doing even the most minimal of physical activity, including walking. 4 months of post-op pain after I got my hip fixed. Not gonna lie, the miss-met expectations after surgery put me in a pretty dark and foul place.

Now? I am weak as a kitten and starting back at the whole fitness thing with less strength in my anything than at any time in my life with the exception of my teenage recovery from a broken back. While I am no longer in a dark place, let’s just say that this lack of fitness (and associated hurt caused by the pursuit to regain some modicum of the same) occasionally leaves me in a black mood. All exposed nerves and impatience. The sight of my well-cushioned navel unintentionally exposed when I reached up and my tee shirt ran out of cover almost cost me a full-length mirror.

Good thing I couldn’t bend down to grab a shoe.

4 Safety. “Keep children ‘safe enough’ rather than ‘as safe as possible’.” –Mikki Martin. Supportive reading: Outside Magazine article on raising children outdoors in Norway.

Mikki and her husband Jeff are the founders of the original CrossFit Kids program. There are many things tragic about the demise of the original company we knew as CrossFit, Inc., but for my mind none greater than the dissolution of the bond between the Martins and their creation, CFK. Fitness and the training of children in effective functional movement is fundamentally different than doing so in adults. Literally everything about it is different; the Martins cracked the code and brought what you could think of as Physical Fitness v2.0 to the masses. You can find them and v3.0 of their creation by looking for The Brand X Method.

Many parents would read Mikki’s quote and be appalled. Who in their right mind wouldn’t do literally everything possible to keep their children safe, right? But that creates more than a little bit of a problem if your ultimate goal is to raise a healthy, fit, creative and resilient kid. I mean, come on, the whole “as safe as possible” thing has brought us a couple of generations of kids who have no idea what “monkey bars” are. Climb a tree? No need to worry about some cranky old guy yelling “get off my lawn” when a panicked parent has hauled their budding climber off the maple tree before they were high enough to do a pull-up.

There is an extraordinary young woman, mother of 5 or 6 if memory serves, who was once one of my older son’s close friends. She would come over to our house, partly because she and Dan were buds but really, if she was being honest, because Beth let them play in the dirt. Or the mud, maybe with a little mudpie consumption. Or in a gently flowing stream, perhaps washing down that mudpie with a sip. All of which would be anathema to the “as safe as possible” crowd of course, notwithstanding the research showing that all of the above leads to healthier, happier kids.

Likewise, organized sports and other athletic activities. Here I will admit that I am conflicted, almost paralyzed in fact by my aversion to the wanton head trauma that seems so prevalent in all of the so-called “helmet” sports, including the beloved football of my youth. But even if we exclude them there are still risks involved in literally every physical activity in which our kids will participate. Do you know what the most dangerous sport is in terms of injuries? Hint: it isn’t a helmet sport. It’s actually baseball. More injuries, indeed, more deaths than any other junior sport. Care to guess what the safest is? Yup…a tie between strength training and functional fitness programs like TBXM in children as young as 8.

We should let our kids be kids. Explore. Try some stuff that may not turn out like riding a horse or trying to “ollie” a skateboard. Climb a set of monkey bars or see if you can traverse that horizontal ladder when your feet are hanging a yard or so above the ground. Ride your bike to school. Jump in that big pile of leaves that Mom or Dad dumped just on this side of the street. Grab that sunfish and try to get the hook out. Play in the dirt and dig up some worms.

Nobody ever died from tasting a worm to see why the fish seem to like them so much.

5 Microstress. Four clicks. That’s all it took. Four additional clicks added to the process of putting in a post-op order after surgery without any warning or explanation. 11 seconds of additional work on top of the tripling of the time taken to paperwork my way out of the OR necessitated by the advent of EMR. That’s all it took. Why? Why did we have to add this duplication of stuff that was already accounted for? Four clicks and I was literally enraged.

Four additional clicks pretty much defines the “micro” in “microstress”.

All of my reserves were depleted. There was no room for, well, anything else. I like to think of myself as possessing three distinct, finite “spaces” that encompass my daily lived experience. Timespace is easy: how many minutes I have over the course of my waking day to accomplish whatever it is that I need or want to accomplish. Brainspace is a little more complex: the amount of “carrying capacity” I have in my brain for the combination of accessible information storage and “computational” power to apply to the memory I am carrying in my RAM, so to speak. Lastly is Emotionalspace, the most complex of them all. This describes where I am on the proverbial “happy <-> sad” scale, my emotional resilience (how likely I am to be able to withstand negative events or vibes), and my emotional carrying capacity or empathy.

In my mind I see these three spaces as buckets, each a particular size at any given moment, and each filled to a level that corresponds to whatever state in which I find myself and the world around me. Timespace is mostly fixed of course; my bucket can never hold more than 24 hours worth of minutes. I only get to determine how many of them I’ll be awake to use. Both BrainSpace and EmotionalSpace are more elastic. There are some days when it seems like I can bring up any fact or notion I’ve ever acquired, and then work it effectively to carry out whatever task I’ve been presented. The BrainSpace bucket just seems a bit bigger sometimes. So, too, the EmotionalSpace bucket. There are days when I am just feeling on top of the world. I’m happy, and happy to spread some of my joy. I can withstand the emotional currents, both internal and external, that buffet each of us as we sail along. On days like this my EmotionalSpace bucket is as big as a swimming pool. On others it is quite the opposite; each tiny bit of negativity goes into bucket that shrinks with every passing minute.

Until four additional clicks, four tiny drops cause one or two or all three of my buckets to overflow.

That’s when stuff gets dicey, when the buckets overflow. It’s rather rare that you wake up with huge buckets, with all of your spaces sitting there and all kinds of volume available like so much space on a hard drive, and something comes along that floods one or more, producing what we might call “acute stress”. Chronic stress is what brings most of us down. The accumulation of tiny microtraumas, little moments of tension, discord or anxiety over time. A continuous flow of tiny drops filling up your buckets.

My Mom isn’t doing all that well in her retirement facility, a situation that produces a chronic drip that fills all three of my buckets. A kind of background stress. I barely know it’s there most of the time, but that’s a part of why stuff like that is so insidious and therefore dangerous. Unlike the tsunami that will ensue when Mom eventually passes away, the daily drip, the microstress of having her be less than well slowly fills my buckets and leaves less room for, well, everything else.

We each live our lives in a constant state of filling and emptying our buckets. “Burnout”, the inability to roll with the mundane in our lives, occurs when one or all of our buckets is so full that a single additional drop affects us as if it was that tsunami above. My buckets were so full from microstraumas like my Mom’s situation that the surprise addition of four clicks after surgery brought me to a place of injury no less hurtful than if I’d gotten there all at once; once there it doesn’t matter if it was four drops or from a veritable shower of challenge or trauma. Either way, you’ve entered the burn-out zone. I knew I was close; the “empty space” above the water in my buckets is where patience and empathy live and I’d been getting short of both. As it turned out, the surprise addition of four clicks on top of all of the other clicks it took to paperwork my way out of the OR was at least one drop too many.

Understanding burnout, understanding stress and stressors both micro and macro and how it all affects each of us, means understanding that the breaking point is more often a tiny drop into a bucket filled to the brim, with no space left above to breath.

Easter musings…

1 Vacation. Slept in yesterday. Took a walk. Had a drink. Declined to open up my laptop and type. The dogs napped.

We let them lie.

Here is a vacation edition of “Sunday musings…” with a couple of lightly edited entries from Easter weekends past.

2 Role model. It’s Easter Sunday, the holiest day in the Christian year, falling this year during both Passover and Ramadan. As Christians we “celebrate” the ultimate sacrifice, the ultimate expression of altruism in the “history” of mankind. Men and women are tasked with following Him as the ultimate role model for how we are to live our lives.

If one does, indeed, believe, and if one does follow Him as the role model in one’s life, then all other talk of role models is irrelevant. Like so many other goals and targets, though, the Lamb as role model is ultimately unachievable by any and all, and thus we have the all too human phenomenon of other, human role models.

What then constitutes a role model? Who is qualified to fill this role? Who would be willing to do so? How do we find these people, these role models?

In a world that was much less heterogenous, where people of all stripes had more in common than not and acknowledged that fact, role models seemed to be a little easier to come by. Audie Murphy. Stan Musial. Jackie Robinson. Heck, even a politician or two filled the bill. Every town had a teacher or a coach or a cop who everyone looked up to. Why then and not now? Partly because of that sense that we were all more the same than less, but partly because we only knew the good stuff about our role models, and on top of that we only really wanted to know the good stuff, ya know?

Once upon a time to be a role model meant to be always trying to do the right thing for the right person at the right time. We forgave the occasional slip because we saw the effort and appreciated the ongoing effort. It inspired us to do better ourselves. We forgave the occasional failure because we knew how hard it is to always look to do that favor, to offer the helping hand, to put forth the best effort. Our sense of our own humanity was extended to our role models as a gift to them such that they would continue to lead us.

The perceived lack of role models in society today says more about us than it does about any role models that we may have and ignore, or have and have discarded. We accentuate our differences rather than our commonalities, no matter how far on either end of the curve lie those differences. We not only accept too much information about our all too human potential role models, we actively seek the “smoking gun” that will bury them. We are all the lesser for all of that, for we deny ourselves the potential that could come from having a role model just a little bit better than ourselves. Someone to look up to, perhaps to guide us, or at the least provide us a living example of how we might be even just a bit better at the task of being human.

In our world of imperfect humans we will ultimately fail in any search for a role role model living unblemished among us, for the only perfect role model, at least in the Christian world, continues to set an unachievable goal, however noble might be our efforts today.

And He has been dead for some 2000 years now.

3 Death. Death continues to stalk our Clan. This makes us no different from Clan You; death comes for us all. Rare among us is the one who knows when the knock will come. Yet come it will. Beth’s Uncle, the last remaining of either side of the previous generation of her bloodline, resides at the moment in an ICU. It comes for those of every age. A year ago it came for a work world friend’s son. Seven years ago yesterday it came for a little girl who was a part of our horse world, taken at 12, alone in the gloaming, an unseen calamity leaving behind, well, everything and everyone. In this there is nothing special about our family. It is simply our time, our turn for Death to stalk our circle. Death takes us all, and we have very little choice about when it will inevitably come for us.

Life, though, is a very different thing entirely. Life, you see, can be taken by the reins and ridden for all its worth. We need not sit back and let life come to us like a horse at the far end of the field. It may, come for us that is, but it just as well may not. Like that horse, though, we can go right over and get it, hop on, and ride like hell. That’s the beauty of life. Of living. Being alive is a full-contact participatory sport. Every day you get to wake up is just chockablock filled with literally herds of horses just there for the riding. Some days you’re ready for literally anything and it’s off after that fire-breathing stallion and a gallop for the ages. Others, it’s all you can do to pull yourself into the creaky old saddle of an ancient herdy-gerdy pony barely able to put one foot ahead of the other. No matter. You’re alive. You woke up again and you looked into that pasture at all of those horses, chose one, and started to ride.

Death may indeed be stalking us, stalking you and me, but today is not our day. Uh uh, not today. Today we are alive. We are surrounded by our people, here and everywhere. Our circle is full. Today you have your people, and your people have you. This is not a day to be “not dying”, this is a day to be living. Choose a horse. Take the reins.

For today, we ride.

I hope you enjoyed my little vacation “look back”. I’ll see you next week…

Optimization; The Minimal Effective Dose: Sunday musings…4/2/2023

1 Fools. April Fools Day brought a very funny gag from my past. Supposedly Williams College and our arch rivals Amherst were merging, becoming Wamherst.

Easiest AFD joke to suss out in history.

2 Plural. Sometimes I struggle with spelling. English is an odd language, eh? Today it was the plural of “journey”. I kept trying to put an “ies” in place of the “y”.

Actually had to look it up to realize is was a simple “s”. Doh.

3 Offended. “Second hand offended”: to be offended on someone else’s behalf, whether or not they, themselves, are offended at all. Seems to be a major source of fuel for the interactive social media market. HT “Lovely Daughter” Megan.

There just isn’t enough time or energy to partake in this, at least for me. In my effort to optimize my various reasons to be offended (see below) I just can’t fit in any dose of offense on behalf of someone else at all.

4 Message. “Turn your mess into your message”. –Julie Walker, founder of the Peyton Walker Foundation.

My friend Julie lost her daughter to a cardiac condition almost 10 years ago. To honor Peyton’s brief but extraordinarily wonderful life Julie and the rest of the Walker family founded a charitable foundation dedicated to the twin goals of screening to diagnose cardiac conditions that pre-dispose to sudden cardiac death, and to donate AED’s to schools and other organizations so that they might have the means to save a life in one so afflicted. Very cool, very strong stuff, that.

A tip of the hat to Julie and her family. I’m gonna steal that quote but you can bet I’ll be giving attribution, Julie.

5 Optimization. Some time ago I wrote about the Minimum Effective Dose (MED), the concept in which we seek to optimize our results with the smallest amount of whatever it is that we are using to achieve that outcome. The quest to find the MED is one that crosses quite easily between my day job (medical) and my own quest for health. A quick mention of Eva T in Outside magazine and the program she uses with her clients made me think a bit more on the MED. Robb Wolf, one of the most knowledgeable nutrition experts on the face of the Earth, linked a Tweet today to another trainer who proposes that low-intensity aerobic exercise is the only thing that has ever been shown to postpone mortality. Big shift for Robb given his legacy involvement with CrossFit, the ultimate high-intensity program, and given the “slow” part of aerobic fitness programs, one that puts pressure on the quest for MED. The Everyday Math column in the WSJ provided an enhanced vocabulary for the journey.

Sometimes the MED really is a “something” you take. Here one thinks of medicine or food, for example. It is astonishing how many viewpoints there are on the topic of daily protein intake, for example. More often is the case that we are looking at a dose of time or effort. Or perhaps both. In this case we are seeking to optimize the effort as it relates to the outcome, to make the value of outcome divided by effort as large as possible. In healthcare “Effort” includes not only the number or test you get or pills you take, but also such things as time devoted to stuff like insurance forms and the figurative effort of reaching into your wallet to pay for medicine. The rate limiting factor is the Law of Diminishing Returns, of course: at some point additional effort produces such a small incremental increase in the outcome that it becomes not worth making. This applies to everything from workouts/week (or day) to decorating a birthday cake. At a certain point you just have to feel you’ve succeeded.

How, then, to know when you have reached this optimal level? Eugenia Cheng, the mathematician who wrote the WSJ piece, offers the concept of the “minimal acceptable standard”. Once she has reached this outcome the additional effects garnered from more effort have moved beyond the point where Diminishing Returns kicks in and she simply accepts the outcome. We would call these “minimal standards” goals, but the concept is essentially the same. We want an outcome; setting a target or a goal is step one in optimization.

Cheng then goes on to refine optimization with a discussion about boundaries. One is your goal, of course. In real life others also exist, things like a 24 hour day and a 7 day week and the need to make a living. The dose you choose, both qualitatively (what it is) and quantitatively (how much you get) is unavoidably affected by boundary conditions over which you have less control. In the end no outcome worth achieving happens without effort. Health, friendship, or the unraveling of a gnarly math problem–you’re going to put effort in to get your results out.

Maximizing your outcome-to-effort ratio is just another way to say you are seeking your Minimum Effective Dose, in fitness, health and elsewhere. Doing so in any one domain necessarily leaves you the resources/time to do the same in many more or the other domains in your life.

I’ll see you next week…

Sunday musings…3/12/2023

1 Spring. As in “spring ahead” and change all of your clocks to Daylight Savings Time, one hour LATER than this time yesterday.

Did I read somewhere that this is the last time that we will ever do this in the U.S.? That EST is now EDT? Forever?

2 Umbraphile. Lover of shadows. A belated RIP to Jay Pasachoff, beloved professor of Astronomy at my Alma Mater Williams College and perhaps the world’s expert on solar eclipses. Jay was a particular favorite of athletes at Williams (“Stars for A bars), and the feeling was mutual. The holder of the world record for most solar eclipses witnessed, he was famous for taking students and alums along for the ride as he chased the sun around the globe.

Sadly he will miss the next big eclipse which is set to take place in 2024. Let’s hope that the good folks in Sinaloa, Mexico are able to safely welcome Jay’s fellow umbraphiles as they congregate in his memory.

3 Monk. Malachy McCourt is 91 years old. Younger brother of Frank, he of “Angela’s Ashes” fame, Malachy was most famous for being a raconteur/n’ere-do-well who ran in the original Rat Pack circles. His memoir, “A Monk Swimming”, remains one of the funniest reads of my life. I vividly remember reading it on a plane, every five minutes bursting out laughing and wiping tears out of my eyes so that I could continue. My seat mates thought I was nuts.

Having outlived his siblings and pretty much all of the running mates of his younger years, McCourt will hold a lonely court this Friday in NYC at the annual St. Patrick’s Day parade. HT to the NYT for reminding me how much I liked his book; I think I’ll pick it up again, if for nothing else than to read once again where he got the title for his book.

Think “Hail Mary”.

4 Cool Adjacent. My “Lovely Daughter” Megan once described the three versions of her Dad. “Work Dad” was pretty intense. Not a whole lot of fun most of the time. “CrossFit Dad” was cool. I always got a kick out of it when she added “who thought a Dad could be cool?!” I am now “Lake Dad”. All chill. A different kind of cool.

I love this phrase, “cool adjacent”. For the most part that probably describes any phases in my life when someone might have used “cool” to describe me. Yes, I was deeply involved in CrossFit for some 13 or 14 years, and I certainly circulated in the same air as the truly cool among the CrossFit crowd both locally and nationally. Not unlike where I fit in with my professional colleagues on a national level now, what I really was, and likely am, is cool-adjacent. I fit comfortably near the cool kids or the cool stuff, and by and large they are comfortable with me in the vicinity. If I am being honest, despite my darling daughter’s lovely description, I’ve always been just a bit too old, or young, or whatever, to really, truly be cool.

But that’s OK. I’m happy to be in the neighborhood.

5 Level. As in level setting. As in I am so sore from three workouts over the last four days that it’s embarrassing. Mind you, these workouts were nothing like my prior CrossFit WODs, the things I wrote so much about when “Sunday musings…” was a part of my CrossFit experience. It’s the CrossFit Open season right now and even though my Coach is a very experienced CrossFit trainer and Box owner (hi Bill!) trust me, I am doing nothing of the sort.

What I am doing now is struggling to find my level.

I came across a quote a bit ago–I wish I could remember whose it is so I could give credit–that applies here. At least as far as my hobbies and other avocations are concerned. “It’s OK to not be too good at something that you like to do.” This does not apply to your job, of course. Especially if you have a job like my day job. There’s no way around it there; if you do the kind of thing that I do for a living you gotta be more than good, and you have to be more than good all of the time. This isn’t about what you have to do, though. This is about something that you simply choose to do because you like doing it.

Think golf. Or dressage like Beth. We watched a really cool documentary series on Disney+ last week called “Chasing Waves” about a group of young surfers shooting for Olympic medals or trying to make a living as “Free Surfers”. What interested me the most was the older surfers, the pioneers long past any aspirations for their surfing, who nonetheless headed to the beach at every opportunity. Each one admitted at some point that they weren’t really all that good anymore, at least in comparison to what they recalled as their competitive peak.

No matter. They were good enough.

I’ve spent quite a bit of time and wasted a bazillion electrons trying to figure out what will occupy my time as I eventually move on from that day job of mine. To be honest, I’ve struggled with the whole “not as good as I once was” thing with stuff like golf. It used to be a kick aiming for PR’s during my peak CF days. Even though it wasn’t really anywhere near any kind of elite level, deadlifting more than 2X my bodyweight at age 55 was a kick. Raising my lifting PR’s and lowering the times on benchmark WOD’s like “Fran” was for awhile my version of Beth’s progress up the dressage ladder of levels. Even though I was really and truly doing CF as a means to an end, elevated fitness as a way to be better at life in general, it just felt good to keep getting better.

But that’s all over now, and that’s OK. Exercise is just that, a means to an end with no aspect of “getting good”. I am working out, and putting up with the above-mentioned soreness, so that I can pursue a couple of things that I like to do. Now that I am past both of my hip replacements (and the ambush carried out by my TFL and IT Band after the last one), it’s time to get back to things I do just for fun. Because of the pain I never got up on a paddleboard last summer. Not once. I’m not all that good at the SUP thing, but I sure like being on a board. My functional workouts will hopefully get me back on a board, or back in a kayak.

Probably not getting up on a surfboard, but that’s OK.

The concept of not being all that good will be a bit more challenging, and the process of level setting much more complex with the activity that is most likely to be the most fun: golf. Not because I will be able to regain some semblance of the level I once enjoyed. That particular golf cart has sailed. Nope, what I need to do is to get to a level of “good enough” to be able to enjoy the best part of golf at my stage of life: playing golf with other golfers who really like being on a golf course. The reality is, you have to be at least a little bit good at those things you like to do, and on the golf course there is a certain level I’ll have to work to get to in order to be able to achieve my goal of being in those foursomes of guys who are doing what they like to do, however “not too good” we all may be at doing it.

So it’s off to the indoor range after my sessions on the C2 bike and rower, my muscles still trembling a bit from the sneaky-hard work my buddy Bill is getting me to do. The Orange Whip and Speed Sticks my brother insisted I buy last year are waiting their turn in the leveling process (gotta clear out some space in the garage), all part of the price I am willing to pay for the privilege of not being very good at something I know I like to do. And who knows, perhaps allowing myself to just like what it is I’m doing, however good I am or how good I’m not, will make it easier for me to find a couple of other things I can like to do. I mean, it may not be all that good to become very good at my latest discovery.

Have I told you yet about how much I’ve been learning about the world of rum?

I do like doing these “musings”, no matter how good or not good I am at it, so I’ll see you next week…

Talking To Strangers: Sunday musings…5/5/23

“You want to escape winter and you are looking at a map Quebec City? The weather app says it’s zero degrees there!” “Now you know why I prefer looking at paper maps.” –Frazz

“The map is not the same as the territory.” Ray Nayla, The Mountain in the Sea

Beth and I have just returned from an adventure in south Florida experienced in two parts. We followed Hero, Beth’s epic dressage horse, as he spent a part of “Season”, as the Floridians call it, in the equestrian mecca that is Wellington. When folks asked me where I was headed I told them that Beth was following her horse, and I was following my Beth! In truth, absent Hero and our friends who train both him and Beth, Wellington holds very little of interest for me.

Which is why I make it a point to talk to strangers there whenever I can.

Do you do this? Talk to strangers? I make a special point to do this all the time, but I make a particular effort when I am far afield from my home coordinates. Whether playing at home or away, talking to strangers puts me in “the territory” rather than simply placing me on a map. I’m pretty good at it, actually. Likely due to the potent combination of both nature and nurture at home (my mother is famous for chatting up literally any poor soul who is even momentarily motionless in her vicinity) and the necessity of doing so on the daily at work (I am a physician who sees dozens of patients each day). Breaking the ice and starting a conversation is second nature, and thankfully I have a keen sense that alerts me when a stranger (or I) might wish to remain strangers.

We chatted up any number of strangers over our 2+ weeks in Florida. Have you ever flown Allegiant? They don’t have a bulkhead on the port side in the front of the bus. This left us sitting knee to knee with the flight attendants on the way up and down. One of them literally couldn’t make eye contact, either with us or their teammates; no chatting there. On the other hand we did get some giggles out of the other flight attendant. She sent us off with a huge smile and best wishes for the trip ahead. Friendly banter with the rental car garage attendants resulted in two super-sized upgrades.

We spent just a little bit of extra time with every single person who responded to tiny bits of outreach. I thought I was educating the seemingly pushy owner of a surf shop who was trying to sell me a pair of Maui Jim sunglasses (we sell more of these than anyone else in Cleveland). While discussing the fact that thus far it is a physical impossibility to make a clear, un-tinted polarized lens we discovered that he is actually a particle physicist on break from Berkeley filling in for family. We looked him up on Google Scholar; he’s the real deal! Maybe my poking at his sales pitch will turn into an idea that benefits anyone who ever struggled with glare while driving at night.

A waitress in Stuart was so excited to tell us about the hidden gems in her town that she wrote down her “must see” list on the back of the proverbial napkin. Her highlight was “Blowing Rocks”, a natural phenomenon at the local beach where the incoming tide, aided by a favorable wind, sends water through porous beach rocks and creates a kind of surging geyser. Very cool. The owner of a tack shop we visited for an “emergency” equipment fix spent 33 years in Oklahoma trying to move back to NY. Banter with her about “fraidy pits” led to a side trip to the local Italian deli for lunch on a day when we were at risk of defaulting to Subway. I literally bumped into a woman pouring coffee in the French bistro where we got breakfast each morning. Her accent said Massachusetts; sure enough, she was from Worcester. When I told her I was from Southbridge she asked if I was French. I sent her off giggling with my Mass/Rhody/Canuck patois ringing in her ears.

But it was two more significant instances of “talking with strangers” that really made the second leg of our Florida adventures memorable. Our outbound departure was kind of a disaster. I knew that my back tires needed to be replaced. It was my plan to do it in the beginning of the week when we returned. Honest! Really, I was. So of course we had a blow-out on the way to the airport. Thankfully it happened about 200 yards from an exit on the highway, and we limped into a gas station/convenience store right across the street from the off ramp. Out comes a stranger, a young man in a pulled-up hoody, who looked over and asked if we were OK.

Turns out he was a tire mechanic! More than that, he is a tire mechanic who talks to strangers. Here we were with a totally flat tire, 35 or so miles from home and still 15 miles from the airport. Now, anyone who knows Beth is assuming that she was just gonna change that tire, impressing the crap out of that tire mechanic along the way. Of course she was. She can do pretty much anything. Except that our car doesn’t have a spare since it is shod with “run-flat” tires. Even Beth had no idea what that really meant. Our new friend the tire mechanic pulled an air compressor that you plug into your car and tried to pump nus up. No love. An inspection of the tire revealed a tear the the sidewall/tread junction. So it was 15 miles of back roads at 35 miles and hour (the run-flats supposedly will go for 50 at 50mph) with the blessing of the stranger/expert who was willing to talk with us.

And if we hadn’t gotten on that plane we never would have struck up a conversation with Max!

Meeting Max was a classic in the “talking with strangers” canon. Anyone who reads my drivel (or who followed my adventures “Drinking with John Starr” on Facebook) knows that I have a ton of fun with wine and spirits. I also have this little quirk, always on the lookout for something new, and preferably different from what everyone else might be drinking. Anyway, there we were at the festival that is Total Wine and More in Wellington, a store so fabulously stocked with spirits unobtainable in Ohio that we make an annual pilgrimage. We were there to pick up the ingredients for a cocktail to accompany that evening’s crab fest, and I planned to seek out a couple of prized, “can’t get ’em” aged rums.

Which is where Max came into the picture. One of the store managers suggested a couple of his favorite rums and offered us a taste. Max tagged along and proceeded to give a 3 minute master class in tasting rum. The fact that I agreed with his off-the-cuff tasting notes as he eviscerated the poor manager’s suggestions prompted me to invite him back to the rum aisle to review my purchases and make suggestions. It turns out that his entire career has been in the spirits industry specializing in rum. It’s a rather longish story from here, but the Reader’s Digest version is that he changed half of my selections at Total, and then hunted down 3 gems for us while he was shopping for himself in Miami the next day. Oh yeah, and when he delivered them to our VRBO he brought along all of the fixin’s and made us one of the best Mai Tai’s Beth and I have ever had!

The moral of this story is easy and it is obvious: a map is nothing more than the “where” of where you are going. What makes being there worth the trip is the “who” that you encounter once you’ve arrived. The adventure of actually being in the places you see on the map more often than not begins with, or is certainly much more interesting, when you talk to strangers. It’s easy, and it’s fun. Tonight we will make a Mai Tai, raise our glass, and offer a hearty toast to Max and the other strangers to whom we talked, and who helped make our trip an adventure.

I’ll see you next week…

Sunday musings…2/26/2023

1 Flies. “Like flies on shit.” At the moment I am at a horse barn, my GPS coordinates for at least the morning for a week.

Do the math.

2 Trace. A beaten path or small road; a track. More in a moment.

3 Mews. A row or street of houses or apartments that have been converted from stables or built to look like former stables.”An eighteenth-century mews”. Wait for it…

4 Road. Or street. What everyone in North America calls a thoroughfare. Everyone, that is, except the supremely affected class in Wellington Florida, winter home to fancy horses and the people who fancy that owning said horseflesh makes them, you know, fancy. Don’t they remember that a classic eighteenth century mews in the Uk was literally awash in shite?

No matter how fancy those horses are, or how fanciful you may believe naming your streets with names that conjure up images of a bucolic countryside and yourself landed gentry, cruising the various traces and mews in town, the lineage of these words includes bountiful amounts of horse shit.

5 AI. There is a new player, a new candidate for the force behind the next major disruption along the timeline of human intellectual evolution. Artificial Intelligence (AI) in the guise of pseudo-autonomous bots is being heralded as the vanguard of this next major step. As an aside, I hesitate to call it a “leap” given that the “intelligence” involved isn’t really human. As a matter of fact, the computer scientists and engineers who have developed the “machine learning” that has spawned this phenomenon admit that they really have no idea how it is that these AI programs work.

Imagine that. You’ve created something which is very likely the next step along the timeline that began with the drawings of cavemen, on to papyrus and the written word, through the invention of the printing press, radio, and television, and most recently the internet (and specifically internet search which makes almost all knowledge findable), and you don’t know how it works. All of these steps brought about the liberation of information, each subsequent one increasing the access to information to a greater and larger slice of humanity. Indeed, the printing press likely did more to topple the prevailing hierarchies of the day than anything before or since. Anyone living along a trace who could read now had the same access as all of the lords and ladies living above those mews.

Here is what I wrote about the internet’s effect, further driving down the barriers to information, and what this has done to the intellectual processes of a typical human, as I mused about why I muse:

“Why do I write? Why do I sit down and use time that could otherwise be put to use in the gym, or in the office, or even just hanging with the Man Cub? As a long-standing lover of language I am always on the lookout for the best vocabulary to explain concepts I sometimes struggle with. “Offloading” is a term that is used in this case to describe what it is that humans do with information that they do not need to keep on hand in “useful memory” space.

This is what I do with ideas when my “wetware” memory is full. This is hardly new. Indeed, the sturm und drang associated with the mega-trends in education, etc. associated with our massive information/recall apparatus that is the internet actually has its origin in the Greek era of Socrates and the transition from an oral tradition to one in which teachings were written. (HT to Frank Wilczek). Prominent adherents to the oral tradition such as Socrates and Simonides argued forcefully that the advent of the written transfer of information would weaken the mind and produce an inferior type of intelligence. In a fascinating and delicious ironic twist, all we know of either of these men we know because someone else wrote down what they recalled hearing.

In my day job we are still encased in a paradigm in which information is transferred from teacher to student and then tested to see if that information has been committed to memory. Imagine, with the explosion of data now available in the world of medicine we test (and test, and test…) both new doctors and established ones to see if they remember a certain percentage of facts, regardless of how often those facts come into play in the act of practicing medicine. A CrossFit analogy is to test a trainer on the precise moment that the obturator engages in the deadlift. One neither needs to know this to teach the deadlift, nor does one need to have memorized this in order to have it on hand in the gym. So, too, in medicine.

Please don’t get me wrong, I still enjoy knowing a bunch of stuff and being able to call up that stuff without needing to use my Google-Fu. The reality is that we have made a move from memory in written form to memory in digital form that is just as profound and disruptive as that from oral to written. We have only to remember where it is we have stored our memories, our books and our music and our musings.

And our passwords. We still need to remember our passwords.”

What, then, of AI? It surely seems as if it’s more than a simple repository of information or a new way to share that information. Or maybe, not.

As I understand it, the AI that we are seeing in ChatGPT does little more than mine our existing cache of knowledge and then regurgitate it in a way that mimics what we humans do when we are in possession of a tiny slice of that knowledge. More that that, ChatGPT is capable of discerning the patterns of an INDIVIDUAL human, then to respond to a prompt in a manner which is consistent with how that human, or “kind of” human might respond. Want a picture in the manner that one would expect from Salvador Dahli? Sure. Piece of cake. Here you go. How about a Shakespearean sonnet, pegged to any time in recorded history? What the heck…make it in the style of Ben Affleck and give ChatGPT a chance to woo JLo. Again, piece of cake.

But is that a form of intelligence? A kind of “mind” capable of something truly original? Or even an original thought or concept which is derivational from something prior, as is much of what we consider conceptual development? I’m saying “no”.

The potential for this particular form of faux AI is that is has provides the possibility of relieving the role of humans from a very large percentage of tasks presently requiring “wetware”. Customer service. The process of registering for pretty much any service imaginable (e.g. medical). It can provide a probabilistic answer to an almost immeasurable number of tasks. For example, in my world of medicine this type of AI could be used to force the use of algorithmic protocols, albeit using the best of knowledge available as well as probabilistic (Baye’s Theorem) methods in coming to suggested diagnoses and treatments. After all, it’s just math, and in reality all AI in its present form does is a kind of math.

Shakespeare’s genius has been reduced to the mendacity of the binary.

Is this a bad thing? Ah, here lies the rub. In a world where more and more of the decisions that are being made for us have been reduced to math, the technology behind ChatGPT and the like gives ever more power to those who would profit most through the mathification of the individual. Would this work for the majority of humans a majority of the time? Of course. Common things are common, and this type of “intelligence” is designed to parse the common.

It is in the soft surroundings that we see the danger in this next, latest great “advance” in the liberation of information, precisely because this is the first iteration in this inexorable progression in which the information is not actually liberated at all. It is, in essence, captured through the process. It is a regression to the mean, albeit many precisely defined means (Dahli, Shakespeare, Affleck, et al). After all, what each prior advance in our liberation of knowledge, each leap in the ease with which a greater percentage of humans could acquire that knowledge has done is make the next truly human genius leap accessible to more humans.

This is NOT what the faux AI of ChatGPT is doing.

A true intellect, one that is alive, intelligent, creates something new. Truly new. Something that has heretofore not existed. Cell theory. Quantum physics. Gravity. Relativity. Heck, Baye’s Theorem. Nothing that we know about AI as it now stands leads us to believe that it will solve the essential problems that lie in the pursuit of energy from fusion rather than fission. The work being done to decode the unbuilding blocks of aging is being done between the ears of living humans, not AI. The best, and worst, that we can say about the “AI” implied by the likes of ChatGPT and Bing is that it has the possibility of relieving humans from the menial, the mundane, and most damningly, the meaningful.

What will we become if we cannot, or do not interact with one another when it is meaningful? See “Ex Machina” for a particularly apt example.

In the end, or at least this beginning of the end, AI as we presently experience it is nothing more than the wrote recital of an admittedly more complex rendition of the present knowledge base of humankind. In a sense it curates the massive volume of knowledge sitting behind a query and presents it us in a manner that makes it digestible. The written word allowed us to preserve the thoughts of men such as Aristotle. The printing press made it possible for any human to read to have access to Socrates, et al. A combination of the world-wide web and the marvel that is the search engine essentially removed the need to memorize Socrates’ words, while at the same time expanded access to him, and all of his ilk, to a nearly every demographic on the planet. ChatGPT and others of its ilk can tap into the vast amount of information from, and about Socrates, curate and cull it, and then present us with a cohesive, one-bite whole.

But is that intelligence? iI is a singularly human trait to be able to conjure the truly original. As fascinating, and admittedly entertaining as it is, the AI we see demonstrated by ChatGPT, Bing, and the like is not intelligence if we define intelligence as having the capacity to create something truly original. Might it be convenient? For sure. Why not? Is it, as it is now, an unabashed and total positive? Of course not. The internet/WWW/browser universe has diminished our human intellect insofar as we as a species tend not to commit too very much to our “wetware” memory any longer. I can’t help but think that will somehow come back to haunt us, in much the same way that allowing the juvenile, barely above trivial abilities of ChatGPT and the like to take over our mundane tasks. What if we conflate the mundane (fixing a plane reservation) with something as meaningful as falling in love (vs. the mathematics of having all of our desires and expectations anticipated and fulfilled a la Ex Machina)?

In the end this is no more than another evolutionary step, and in my opinion a rather small one from a technical standpoint. It is real, for sure, and it is meaningful. But printing press meaningful? Internet meaningful? Not yet, I don’t think. Not at the level of the individual, the almost sacred level of the enlightened world. We risk demeaning our very humanity if we delegate too very much to an “intellect” which is still nothing but 0’s and 1’s. It’s nothing more than math, after all. We have used math in ever more ways over the millennia to improve the life of humans while holding tight to the non-math that defines what it is to be, you know, human.

Like feeling empathy for a patient. Or falling in love.

What passes as AI at the moment is nothing more than a tool, albeit one that will need tight leash of unbreakable rules (see Asimov: The Three Rules of Robotics). In the end intelligence, real intelligence, intelligence that moves us ahead as a species in a meaningful was as did the written word, the printing press, and the access to both afforded by the internet, comes from a place not yet visited by the artifice of ChatGPT and the like. We will need to guard against allowing such an immature intellect to provide much of anything at all in our lives, in my opinion, other than the curation of content. After all, we know not who it was to whom Shakespeare wrote his most loving sonnets, but we know that he did, indeed, love whoever it was. A new, truly real intellect will need to do more than simply create a sonnet a la Affleck as Shakespeare, professing love for Jennifer Lopez. Humans are capable of love. Whatever comes next must not only be able to speak lovingly of JLo.

To be real, to be intelligent, whatever comes next must truly be able to love Jennifer Lopez.

It’ll be me, in person, and I’ll see you next week…