Random Thoughts from a Restless Mind

Time is the most valuable commodity. For each individual it is a finite item. Precisely 24 hours in each day, thank you very much, at least a couple of which you must spend sleeping. It has been called the ultimate luxury, spawning a new class of individuals for people to be jealous of: the time affluent.

It seems that there are two diametrically opposed camps when it comes to time. There are those who feel that the proper approach to the finite nature of time is efficiency; one must develop the ability to utilize each waking moment to its fullest, most productive limits. This group includes both multi-tasckers who try to do lots of things simultaneously, and power workers who have preternatural powers of concentration and just motor through one task after another. For the record, bosses love this kind of producer, right up until they crash that is.

On the other side of the coin is a group that cherishes the freedom that unassigned time provides. Time, that is, in which one can choose to be “productive” in a way that can be measured (e.g. practice bending notes on a harmonica) or not (play along to Wammer Jammer). Knowing the difference between the two is the first step toward this type of freedom. I have professional friends who simply can’t get enough of our particular medical specialty. They work all week, every week, and in their “free time” they attend conferences at which our specialties nuances and science are discussed and debated. Some of them are very serious about all of it. They have each day mapped out to the minute and race from one session to another. They are productive. Others approach it differently; they are exploring.

Each of us has that same 24 hours each day, and we all have some version of the same things that must be accomplished over the course of those hours. The aforementioned sleep, eat, earn a living…almost all of us have this going on. One can choose to “invest” in time, though. If someone else mows your lawn that frees you up to go to the gym, for example. Cooking, cleaning, shopping, stuff like that can be offloaded or batched so that extra aliquots of time are available for other stuff. This is what it means to be “time affluent”. There are choices that can be made, sacrifices in one area that gives you more time in another.

As is my wont I will offer an example from life Chez bingo. Many of my close professional friends spent last weekend in the mountains of Utah at a conference. All of the stuff that I like to do and all of the colleagues I like to hang out with were there. Me? Stayed home. The lake was flat and the Man Cub was available to hang out. Going to the conference would undoubtedly have brought me consulting and writing gigs, but I have more of those than I have minutes to spend with a water-loving 2yo. A really interesting business opportunity is circling my day job, looking for a place to land in my schedule. Frankly, it’s great business. But it will take time. Time that I have gotten accustomed to using in other ways.

While I have more freedom than most I am not “time affluent” enough to walk away from that joint venture; Monday morning will find me in meetings about how to make it fly. It’s actually interesting and intellectually engaging enough that I might have done the same thing even if I didn’t have such a compelling business prerogative involved. Still, the thought did cross my mind that maybe, in the end, I was actually better off letting it pass me by in favor of owning those minutes that will now be jointly owned by our venture.

Like money, no matter who much you have, someone always has more free time than you do.

DNA always wins.

In the fitness world, and sometimes even at that tiny intersection where fitness and health or healthcare cross paths, there is a recurring theme: you can’t out-train a bad diet. For whatever it’s worth, I think that’s true. Having said so there is a dangling little assumption that hangs off the back end of our axiom, that if you are fit and follow an evidence-based nutrition program that you will inevitably be healthy. Indeed, every worthwhile fitness program I’ve ever encountered pretty much says just that. “Fitness in 100 Words” on CrossFit.com was my first exposure to this as a mission statement. Loads of folks from the substantive (The Brand X Method) to the frivolous (The Biggest Loser) support this logic as the foundation of health-based fitness. For the most part it is true, and for most people the combination of general physical fitness and solid nutritional strategy results in health.

Except, you know, the whole Jim Fixx thing.

For all of you puppies and kittens out there Jim Fixx was the original running guru in the United States, the author of The Joy Of Running. You could make a case that only the late, great Jack Lalanne was a more influential historical figure when it comes to promoting health through exercise in the U.S. Jim Fixx was responsible for the surge in interest in running as both exercise and as sport, and his writing launched an era in which U.S. runners were competitive on the international stage in ALL distances from the mile all the way to the marathon.

As it turns out Jim Fixx may also be the single most influential non-medical individual in the history of the cholesterol theory of heart disease. You see, Fixx had hereditary hyperlipidemia. Despite his epic running history he was found one day in his running shorts at the side of the road, dead from a massive heart attack. Blood work at the time of his autopsy revealed a cholesterol of 750 or something like that, as well as other elevated serum lipids. His healthy diet, his outsized VO2 Max, and his prodigious training schedule were no match for his DNA. He died with epic fitness numbers, a single-digit bodyweight fat %, and coronary arteries that were so clogged red blood cells had to pass single-file. You can trace many of the USDA dietary guidelines and literally billions of dollars in research to the death of Jim Fixx.

Why bring up Jim Fixx now, in 2018, when we know that hyperlipidemia is a significant part of the cardiac risk story, albeit not the whole story? Well, we should harken back to the beginning of my thoughts: DNA always wins. While you can reduce your health risks by adopting a healthy, evidence-based diet and couple that with an exercise program that produces a comprehensive degree of fitness, you cannot escape genetics. Why at this particular moment? Yours truly just got all of his lab work back and despite 13+ years of a clean Zone diet and varying degrees of devotion to functional fitness, most of my serum lipid numbers have continued on their ever-upward march and have now reached a level where they simply must be addressed by modern medicine.

To do else wise would be madness.

I must confess that this is deeply disappointing. Quite frankly it feels like failure. At 58 I am relatively lean and strong, albeit a bit under-trained in the aerobic domain. Why didn’t this inoculate me from the need to take medication to lower my LDL? In the last couple of days I have chatted with my docs locally (both of whom are close friends who care about me) as well as really significant, nationally recognized experts in the science of health and cardiac risk mitigation. There is a consensus; nay, the voting was unanimous across the board. Don’t be stupid. Continue my program of fitness and nutrition and take the meds. We’ve now moved on the the minutia of choosing which one, a not-trivial discussion to be sure, but one that is less than earth-moving, you know?

Some years ago while proposing a unified theory of health on my personal blog I received an advance copy of Coach Greg Glassman’s definition: if fitness is WCABTMD then health is Fitness Over Time. As a physician and scientist I readily saw the value of this concept. However, I also saw and pointed out the deficiencies inherent in such a narrow definition. For example, any definition of health must explicitly address mental health. Over the years I have championed the term “well-being” and have suggested several metrics that can be used to measure this state of mental and emotional health. Mind you, I was openly mocked at the time for this, here and elsewhere. If you have followed the conversation in the CrossFit world since you will see an evolution of thought along this line, though. “Well-being” has been openly discussed in various ways as an integral part of health in most medical, health, and fitness communities. I like to think I played a small role in that.

I wrote before, then, and subsequently over the years that any definition of health must be more than a snapshot of how “healthy” you may be at any given moment. You may have a 2.5X body weight deadlift and squat, run a sub 5:00 mile and do “Fran” in under 3:00, but can you truly be declared “healthy” if you also harbor a malignant tumor in your gut or are running around with an LDL of 175? Like it or not, any comprehensive definition of health must be able to provide some degree of probability that you will remain healthy in the future. It must have some predictive value. Traditional health metrics–blood pressure, lipid levels, family history, etc.–added to a measurement of fitness and well-being do just that.

In practice such a value has proven elusive for a number of reasons, none the leasts of which is the difficulty in designing a truly measurable variable for fitness that would be accessible to the masses. Once such a measure exists the rest is just math, right? It will be necessary to determine the relative value of our three variables–fitness, well-being, and risk predictors–and then plug them into a formula to kick out something that we might call “True Health”. While this is still “pie-in-the-sky” stuff I am convinced that it is only a matter of time before it is a reality. To do my part I have tried to enlist new “partners” like my brother-in-law Pete, the cardiology savant, and others.

But for now there are lessons to be learned from Jim Fixx, and yes, once again there is a teachable moment in my little epiphany and “Sunday musings” this week. You can’t out-train a poor diet. A healthy diet of any type combined with a program of functional fitness meant to produce general physical preparedness that includes both strength and metabolic conditioning is the optimal strategy. Even here, though, you cannot escape genetics. DNA always wins. Good, bad, or in between, your DNA talks to you in the language of traditional health risk metrics.

Your DNA doesn’t care how fast you can run a mile or how much you can bench. I start my new meds tomorrow.

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 (CrossFit). 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. 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. 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. The rate limiting factor here 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 WODs/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 getting 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 CrossFit and elsewhere.

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. The 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.

(Surely you knew this was coming) This weekend begins the Royal Hawaiian Eye Meeting, an annual gathering of eye surgeons that I have thus far managed to avoid attending every year of my career. Why, you ask? Meh. 6 time zones for 3 days of work is the best answer. If that doesn’t do it I’ll add that Mrs. bingo won’t join me for the trip, and I really dislike most travel without the company of Mrs. bingo.

As you may have heard there was a bit of excitement in Hawaii yesterday. Seems a rather fumble-fingered employee jabbed the “alert all” button when taking his turn at the helm of the Emergency Response Center and sent off a 1960’s style, death from the air is coming, curl up under your desk kids and kiss your ass goodbye nuclear attack warning. Funny (funnier?), the doof figured out what happened when he got a text on his own cellphone.

Note to Expedia: this guy needs his own “Wanna get away” commercial.

What was your reaction? Mrs. bingo is away visiting her ailing Mom so I was alone chez bingo to contemplate what I would have done (interestingly, I would have been alone in Hawaii as noted above for real). The good folks of Hawaii and their 10’s of thousands of weekend guests were handed the dubious privilege of contemplating, if for just 30 minutes or so, how they would spend the last couple of hours of their lives knowing that they were about to spend the last couple hours of their lives. Did this occur to you, too?

Yesterday also brought me a couple of articles in a similar vein. One, from the WSJ, was not quite so stark. It asked when you would take a pill that arrested the aging process. At what age would you decide that the balance of physical prowess and age-begotten wisdom was optimized? (N.B. this was going to be the main topic of “musings”…) I also stumbled across a review of a book or a movie or something in which 3 siblings are told as young children the precise date of their deaths. What followed was the decisions these young children made based on that knowledge. Gotta admit, I went right to that place when I heard about the Hawaiian modern air-raid siren.

T’was a time when this type of inquiry was a rather commonplace occurrence. You could do worse than reading Neville Shute’s novel or the Stanley Kramer movie “On the Beach” based on it to get a sense of what a nuclear fraught world felt like. Both the novel and the movie depict a world destroyed by nuclear war, and life in Australia as the end-of-life nuclear cloud approaches the continent. How and what normal people decide to do in the face of an unavoidable expiration date some weeks ahead is central to the story. Yesterday’s equivalent would have been some hours ahead it seems.

What would you have done? Would you have sought shelter, as suggested, and hoped to somehow miraculously escape incineration if you were at ground zero? (As an aside, can you even imagine the horror of taking part in the effort to get off the islands to escape the radiation? We’d learn what savages we actually are, I fear) Would you go all Sartre or Beckett and choose an earlier “departure” of your own making as did so many in “On the Beach”? If it were real, what do you think you would have done?

As it turns out this kind of hypothetical is not solely the enterprise of the nuclear age. In fact a Parisian newspaper asked essentially the same question of its readers in 1922, long before the dawn of the nuclear age. Marcel Proust, the famous philosopher, offered perhaps the most lovely response I’ve heard before or since. “I think life would suddenly seem wonderful to us if www were threatened to die as you say. Just think of how many projects, travels, love affairs, studies, it–our life–hides from us, made invisible by our laziness which, certain of a future, delays them incessantly. But let all this threaten to become impossible forever, how beautiful it would become again!”

I surely know not what came before, as surely as none of us truly knows what, if anything, comes in the end. Questions that arise from the (usually) hypothetical “what if you knew when” scenarios lack the urgency to force an honest appraisal. Again, Proust: without the cataclysm “we find ourselves back in the heart of normal life, where negligence deadens desire. And yet we shouldn’t have needed the cataclysm to love life today.” It will be interesting for me to have a chance to chat with folks I know who are in Hawaii right now (a couple are close friends), but for now it was enough for me to have undergone this thought experiment for the umpteenth time and come to the same conclusion: I would have sought my people. Some how, in some way, with my last dwindling moments I would do whatever it took to be with my people.

Greater personal meaning will come from Proust: I will seek my people every day, for it is with them where lies joy. It is for others to seek the greater societal and geopolitical meaning and impact of yesterday’s blunder.

Chief Justice John Roberts gave a commencement speech to a group of 9th graders this year in which he wished them “bad luck”. Now, lest you think ill of the Chief Justice, that he was being churlish and mean-spirited, what he meant was that he wished that these young people would experience some degree of hardship in their youth so that they would develop tactics to persevere as adults when those same hardships inevitably arose.

“I hope you will be treated unfairly, to that you will come to know the value of justice. I hope that you will suffer betrayal, because that will teach you the importance of loyalty. I hope that you will be lonely from time to time so that you don’t take friends for granted. I wish you bad luck from time to time so that you will be conscious of the role of chance in life, and understand that your success is not completely deserved and that the failure of others is not completely deserved either.

And when you lose, as you will from time to time, I hope every now and then your opponent will gloat over your failure. It is a way for you to understand the importance of sportsmanship. I hope you’ll be ignored so that you know the importance of listening to others, and I hope you have just enough pain to learn compassion.”

My hope for each of you is encapsulated in Justice Roberts’ conclusion: I hope that you will have the ability to see the message in any of your misfortunes, and that you will express appreciation for the people who help you overcome them.

Let me leave 2017 with a final thought, inspired by Ben Reiter’s review of the movie “I, Tonya”.

“Each of us, “I, Tonya” suggests, is more than the worst thing we’ve ever done–or, in Tonya’s case, the worst thing she might have done.” In our present days of instantly available and infinitely scalable opinion, we should add that we are more than the worst thing that someone says we did.

Let us, each of us, resolve that in 2018 we will look first to that which is good about each other, and endeavor to see that each of us is more like the best thing we’ve ever done than not.

‘Tis the season, eh? Indulgence at this time of year, at least in the Judeo-Christian world, is rather obvious. I WAM my nutrition all year so that I can eat pie at Thanksgiving and cookies at Christmas. Neither of which I weigh or measure, by the way.

There’s an aspect of guilt when it comes to indulgence. It’s more than just the occasional treat. An inch of dark chocolate on your Paleo Diet doesn’t really cut it, and if you consider that an indulgence it’s probably time to loosen up a bit. I was thinking that the ultimate First World indulgence is the un-timed hot shower, but anything that occurs on a daily basis probably doesn’t count either.

Uh uh…indulgence involves a certain sense of not only excess but also a bit of “I really shouldn’t”. Jay McInerney: “I find the shadow of guilt always adds piquancy to any indulgence. It’s almost more pleasurable, feeling slightly guilty.” As a boy raised Catholic by a mother who openly admired the way her Jewish friends raised their kids (producing what I’ve come to call “double guilt”), I definitely get the “shadow of guilt” angle to indulgence, especially with ones that only occur on rare occasions.

Others, though, indulge in ways both frequent and grand. Indulgence writ large, if you will. Take, for example, Lilly Bollinger and her approach to Champagne: “I drink it when I’m happy and when I’m sad. Sometimes I drink it when I’m alone. When I have company, I consider it obligatory. I trifle with it if I’m not hungry and drink it when I am. Otherwise, I never touch it–unless I’m thirsty.” Man, THAT woman knows how to indulge. Not much guilt evident, either. I’m sure my Mom wouldn’t approve, and I’m equally sure that Lilly wouldn’t care.

In a perfect world we would all be more like Lilly Bollinger, indulging on a daily basis in something that brings us pleasure with or without a side of guilt. The world, as I’ve oft said, is messy, no matter where it is you might live. Indulgence is what you make of it, and it’s probably a good thing that we have this Holiday Season during which we give ourselves permission to indulge a bit. Life is messy and exercise is hard–you’ve earned it.

[Raises flute]

Let’s talk about stress, shall we? It’s the Holiday Season in North America after all. Frankly, it’s been on my mind pretty much all day, every day, for a couple of years now. Probably because it appears to have taken up permanent residence in my body and soul for that same couple of years. Lots and lots of talk about stress around me, too. Everybody is talking about “having stress” in their lives, especially as the holidays roll around, so let’s talk.

First of all, as in all things it’s important that we lay some ground rules, establish some definitions so that we are sure to be talking about the same thing. Stress is what appears in your body in response to stressors; stressors are what you have in your life that produce stress, like serving dinner to family on Christmas Eve. I know, I know, it’s a pretty fine point, but bear with me because I think it will make a bit more sense in a moment.

In my day job I am constantly asked if various and sundry ailments are caused by stress. The most accurate and honest answer, from a strictly medical/scientific standpoint, is “yes”. What people are actually asking me, though, is: are the ailments that they have a direct result of the stressors in their lives? Again, perhaps a bit of a fine point, but it will matter. Everyone routinely conflates “stress” with “stressors”.

You can reduce the stress in your body; you may or may not be able to effectively reduce the stressors that cause it.

Think about that for a moment. You can do quite a few things that will reduce the ailments you may have because stress has been induced in your body. The simple science is that chronic stress throws your neuro-endocrine “fight or flight” response out of whack. Our bodies secrete cortisol when faced with acute stress. This is in turn associated with a release of adrenaline. Your pupils dilate, your BP and heart rate go up, and you shunt blood to skeletal muscle in preparation to do battle or to flee.

Chronic stress, on the other hand, causes an increase in both the basal cortisol secretion and a blunting of the normal daily secretion pattern of more in the AM and less in the PM. You have a flatter curve over the day, and the whole curve is elevated. In time you have a chronically elevated BP, and your state of chronic “readiness” begins to affect all manner of the rest of your systems. Stress then becomes a stressor itself, a repeating negative feedback loop. For example, your sleep pattern gets fried. Heck you may not sleep very much at all. That makes stress worse. That “lump in your throat” feeling when you are just pre-panic”? Yeah, that can be there all the time. It even has a name: globus.

Rather ominous word, that. Globus. Stresses me out just typing it.

Here’s the rub: if you could avoid stress—the adverse affect on your body—who wouldn’t do so? When people talk about trying to have less stress in their lives what they are actually saying is that they wish they had fewer and less powerful stressors causing that stress. Work issues, illness, family strife, money issues…life would just be better if we didn’t have them. Pretty simple. Get rid of stressors, get rid of stress. Sadly, our ability to excise stressors from our lives, or even insulate ourselves from them, is somewhere beyond inadequate and approaches impossible.

What to do then? If we cannot avoid the root causes of our stress, how can we relieve it? It turns out that both the magnitude and particular variety of stress can often be measured. Specific symptoms (sleep abnormalities, globus) will point toward equally specific interventions. There are laboratory tests that can be ordered given your particular stress (e.g. midline fat deposition); nutrition adjustments can be made in response (elevated cortisol reduces insulin sensitivity->consume carbohydrates during periods of lower daily cortisol levels).

For me the bottom line is this: we likely have little to no ability to control stressors, those exogenous factors that incite stress. Further, left to its own devices, our body will respond with stress. We can manage that stress by acknowledging it, evaluating it, and then proactively going about counteracting it. You are a Black Box experiment with an n=1.

Attack stress in exactly the way you attack fitness or nutrition. Weigh it, measure it, analyze it, and then attack it.

Sunday mornings are quiet mornings at Casa Blanco. Re-rack after feeding the dogs, catch up with newspapers that have piled up in addition to the Sunday papers, a third cup of coffee just for the linger. Over the course of a week I collect thoughts and ideas for either musings or an eventual longer piece here, but as often as not it’s something that I read over coffee that turns up in my little Sunday piece. One fertile hunting ground is The Ethicist in the Sunday NYT Magazine, and it is here that I found my muse this week.

I have offered, here and elsewhere, that it is perfectly proper to make an enemy as long as you do it with forethought, and do it on purpose. In my long-held opinion to make an enemy by accident is the second greatest insult one can extend to another human being; it suggests that the newly formed enemy was not even significant enough to consider that they existed prior to your actions (or inactions). This leads, of course, to the single greatest insult that you could ever foment: to actively and purposely choose indifference to the existence of another.

This is a part of a topic addressed by The Ethicist on Sunday. He defines a “decent person” in part by whether or not they have what philosophers call appropriate “reactive attitudes”. In short how we react to others, and by extension how we react to what others in turn display toward us. The philosopher Peter F. Strawson mentions resentment, gratitude, and anger that we may have in response to how we perceive that others have treated us, or treated someone who we care about. Simply feeling these emotional reactions acknowledges that we feel the others are a part of our lives. They exist. They matter.

This time of year is fraught with the entire spectrum of emotions as we come into close contact with family and others with whom we have history. The simple fact that we come together means that we are not, cannot be, indifferent to either them or their feelings about us. Now to be sure there are some among us who have family members who are truly disturbed and either cannot or will not extend any type of goodwill or positive emotion whatsoever. Those, I believe, are rare exceptions, and to you who may be in this position you have my deepest, heartfelt sympathy. For the rest of us, though, in North America the Holiday season presents us an opportunity to re-boot our “reactive attitudes” toward family and friends.

Do you remember what it felt like to go home those first couple of years after you got out of high school? Remember how excited you were to see your folks, your grandparents, and your siblings? There was a buzz in your circle of friends as you conspired to sneak away and re-convene right where you left off the last time you were together. Remember? Trust me, the feeling was at least mutual (if not even stronger) on the part of your parents (and grandparents).

Families are complex and messy, but for all of that no matter what your particular story may be families are never indifferent. You could certainly take the position that we should always be connecting with family, and that the pressure of the Holidays would be lessened if we made more of an effort to be with those who trigger our “reactive attitudes” throughout the year. I’m OK with that. Actually, as a son, brother, in-law, father and grandfather I’d be thrilled with that. But here we are during Hanukkah, with Christmas a week away, so how much we see folks over the year is a topic for another Sunday.

Today, it’s time to go home.

There are some really big decisions in a life. I mean huge, consequential decisions that simply must be made. To do so is very, very hard. There is simply no escaping that fact. You reach a point where you have to make a call on something that matters. Really matters. Like, rest of your life hinges on your decision matters. As part of this monumental process you must make peace with the concept of “certainty”.

You can–you really must, actually– be certain that this is a really big decision, but you must at the same time be cognizant that you cannot be certain that you are making the best decision possible.

I am forever in search of a better vocabulary to describe things I know or things I feel very deeply. In that never-ending search I came across an article about the former GM of the Philadelphia 76’ers, Sam Hinkie. Mr. Hinkie is a polymath who is at any particular time either wildly sentimental or icily objective. Fascinating guy, actually (you can read the article in SI 12/5/16). Throughout the article it was somewhat difficult for me to establish common ground with him (except for our shared devotion to precise language) until I came upon a brief discussion of “certainty” in decision making. Both Hinkie and I had the same decision to make–to prioritize our courtship and subsequent marriage over other pursuits like education and vocation–and we both not only made the same call but continue to describe it as the best call we ever made.

We were certain of its importance, and in response at some point we went “all in” on the decision. Here is Hinkie on the process:

“You have to be careful that you are thinking reasonably. People are too willing to scratch the itch of the near thing. Discipline is the difference between what you want and what you really, really want…I think people often don’t bring that kind of rigor to whatever it is, if it’s important. Because they’d rather make lots of little tiny decisions that a few big ones.”

Certainty is a sword that cuts both ways. One cut you control is the one of knowing that something is really big. Something you really, really want. Something that matters. The quality of the next cut depends on your decision making process: are your motives proper? Are you making the decision in such a way that you not only maximize your chances of success, but at the same time minimize the likelihood that you will suffer remorse at the outcome? You cannot be certain that you will make the right decision, but the only way forward once you are certain about something is to pour everything you have into whatever that thing is.

Hinkie: “What wouldn’t you pay to make it so, if it’s right?”