Random Thoughts from a Restless Mind

Sunday musings…

1) Feral. Abbie the Wonder Dog was feral for the first 6 or 9 months of her life. I can’t remember exactly. She was live-trapped and rehabilitated by a Border Collie rescue organization in north central Ohio. When she frustrates me it is always helpful to remember this.

Having a formerly feral creature living in our midst is also a very good counter to the frustrations of modern life. I try to remember how far I am from true privation whenever I find myself railing agains the insanity and inherent indifference that the world clearly has toward my existence.

A quick thought of my clever (read: sneaky) pup is usually all it takes to quell my urge to explode when I encounter the tragedy of a poor internet connection…while hurtling through a mountain pass in a car going 80 MPH.

2) Test. Some 10 years ago or so I proposed that a true measurement of health should be possible. Something that combined the most basic of classic medical knowledge (weight, %BW fat, BP, Cholesterol, etc.) and the breakthrough notion that physical fitness could be measured and tracked. My theory included the necessity of including some sort of measurement of “well-being”, a mandate that was initially openly mocked but seems to have been rather meekly accepted as both logical and necessary.

Creation and launch of such a value, call it “Total Health” or something along that line, has fizzled due to the lack of consensus–nay, even interest–in coming up with a way to measure Fitness. Imagine, in a place like CrossFit where the very definition of Fitness was created, no one save me and a tiny group of equal obsessives has so much as let fly a tiny trial balloon. The original owners of CrossFit LA were the first to use a standard entry test. 500M Row/40 Squats/30 Sit-Ups/20 Push-Ups/10 Pull-ups. I suggested pulling from both traditional sources (The President’s Fitness Test) as well as CrossFit and the larger endurance communities: 2:00 each of PU/Push-Up/Sit-Up/Squat, 1RM Deadlift, 1 mile Run. We ran a competition once called the “Fittest Eye Doc” using this.

What is necessary is a test that is a) doable by the general public, and b) capable of creating a single value that can be measured and tracked. Once that is done mathematicians and statisticians can be let loose with the various factors and given the task of coming up with a formula that includes all three categories. Why bring this here, again, when thus far my previous dozen or so postings have been met with crickets? With the pivot to health and the rapid build-up of a cadre of physicians who are at least superficially interested in using high intensity exercise for the purpose of increasing health, I am hopeful of a broader dialogue that comes to an agreement on a test.

Challenge: create a test of fitness that is broadly accessible in all ways (scalable) that can be included in a definition of health. 3-2-1…Go.

3) Volunteerism. Ladies and gentlemen, we are gathered here today to mourn the death of the Age of Volunteerism. While there exist tiny spaces where true volunteers live and thrive in a bilateral exchange of freely given goodwill, by and large volunteerism has been extinguished by its historical recipients. Today marks my last day ever of hospital ER call, the end of 2 years of receiving token payment for making my expertise available following 25 years of doing so for free. My experience is typical, as is this denouement.

Once upon a time all of your doctors were in private practice. We all had tiny little cottage businesses, did our work, and billed you or your insurance company for the work we did. Some of us worked in tiny little groups, but it was the rare doctor who was part of a large group or business whether in a big city or out in the country. Even the slickest Madison Avenue internist was basically a country doc, just with a better, more expensive wardrobe. In addition to having a greater familiarity with our patients we also enjoyed a very clubby relationship with all of the other doctors where we practiced. There was a collegiality, a sense that we were all in the struggle together. Folks who shirked their duties, foisting them off on other docs, were quickly educated about proper protocol or left alone.

Hospitals were different, too. Local or regional, they were hardly the gargantuan mega-businesses they’ve become. The org chart was shallow, and most local doctors were on a first name basis with the few administrators on the hospital payroll. You took call for the ER as a volunteer; the ER respected that you were donating your skill and your time and handled everything it could before calling you. Same thing for consultations. Your colleague only called you if they couldn’t figure out a problem or ran out beyond their scope of practice. There was a faint air of apology with each request, and a definite unspoken appreciation for the help that would be given. You helped because you were appreciated.

This is really no different from all manner of volunteerism in America. Smallish, closely knit organizations depending on the goodwill and generosity of members of their community pitching in to ensure success. Think local memorial 5K races, or CrossFit Games Regionals in the days before ESPN or the Home Depot Center. Countless small private schools that depended on the largesse and time offered by the families who sent their children there. You gladly accepted the opportunity to volunteer because you knew that without you the organization would not be able to function. You also knew that the recipient of your generosity not only appreciated your contribution, they really had no other options. Not only that, but if that organization somehow existed in your professional space you knew that it would never, not ever, abuse the trust necessary for volunteers to continue.

What happened? Money. Money and size and the distance that they create between an organization and its volunteers. Let’s go back to the hospital and the ER for a minute. Where once your efforts as a volunteer were deeply appreciated and those efforts rewarded with respect and care for your time and your expertise, the growth of employment of doctors by hospitals opened a gap between colleagues. No longer was there the esprit de corps, the shared notion that the primary target of our efforts was the patient was replaced by so very many doctors by the reality that they worked first for a business as faceless and uncaring as GM. Work that was once done by your colleague was now pushed to the volunteers whenever possible. Worse, boxes to be checked by the employed (to maximize revenue and minimize risk) meant demands made of volunteers, not requests. Worse, still, were discoveries that some “volunteers” were more equal than others: they were paid.

While this is nothing short of tragic in health care, it was inevitable once medical businesses were incentivized to grow ever larger. It is not confined to health care by any means. How do you think that volunteer at a Spartan Race feels when he learns how much his “team leader” is being paid? Have you ever “discovered” how much the Executive VP of your favorite professional organization is paid? As a people we Americans are generous to a fault. That generosity usually continues right up until we discover that we have been duped, and even worse that we have been purposely duped by the people who run the organizations for which we volunteer.

And so we gather here to mourn the passing of the Age of Volunteerism. Like so many things of wonder and goodness there remain pockets of resistance, little oases where the goodwill, honesty, and appreciation beget the kind of ebb and flow that made things so much better, kinder, more collegial at the apex of Volunteerism. My friend Tom Gardner was just named the president of the Society of Alumni of our Alma Mater. Tom has given tirelessly of his “spaces”, his timespace, brainspace and emotionalspace to help shepherd tiny Williams College as it flows on though time. Is this truly different? A tiny refuge from the Zombie Apocalypse of corporatization of all things to which we once volunteered?

We can only hope. Hope that Tom and those like him who continue to find places and causes where their volunteerism is met with what we in medicine have had to bid farewell. We can only hope that there will be places where being a volunteer means receiving the respect and appreciation and even a kind of love in return for what we have given. We can only hope that there will continue to be places where the incessant drive to grow ever bigger, size measured on a spreadsheet rather than by heart, will be resisted. For if it can happen in medicine, if volunteerism can be killed in what is arguably the most noble of all endeavors, I fear that it is doomed everywhere.

And so we mourn the end of the Age of Volunteerism. We wait with equal parts sadness and fear for arrival of what follows.

I’ll see you next week…

–bingo

Sunday musings…

1) Babies 2. Not gonna lie, still on a huge high from babies on the beach for the first time in 15 years. To top it off our last ‘baby” Ryan visited for a couple of days as he prepares for his senior year in high school.

All 6’5″ of him!

2) Highway. At the moment we are steaming along I-90 headed west to Casa Blanco, Beth at the helm. It never gets old, that feeling of awe that I can be connected to you all while I speed through the countryside of Western NY. I think this cellphone/internet thing is gonna make it, ya know?

This trip is often filled with hours of debriefing the events of extended White family’s week together crammed in our rented house on Cape Cod. Not this year, though. Nothing but a quiet, warm feeling as we work through the math necessary to accommodate what is likely to be a bigger crew next year as word gets out about how much fun we had.

3) Games.  This is the first year that CrossFit, Inc. has included sessions and events targeted specifically toward physicians who do CrossFit. It’s a good idea, albeit one that is rather late to the gate given Coach Glassman’s interest in the intersection of fitness and health. Still, better late than never. One of the best parts of the enterprise is the involvement of Dr. Julie Foucher. Waiting until now means that she is available to participate in the growth of the CrossFit MD movement as she, herself, grows as a physician.

Occasionally I stumble upon a post in the CF MD page on FB. Without meaning to offend, CF is so new to the majority of the MD’s participating that the space looks less like a collection of docs and more like some of the threads we all used to participate in back in the days of CrossFit.com v1.o and 2.0. This is not surprising, nor is it a knock on my medical colleagues. CF is exhilarating in the early stages; the newness of CF is the same for every new adherent. I feel like I am re-reading some of the best threads on the CrossFit Forum ca. 2010 or so.

Which makes me wonder: wouldn’t it be possible to accelerate the indoc (see what I did there?) if either the MDL1 course or the prep work included a review of some of those classic Forum threads? Think Eugene Allen on programming or Larry Lindenman on planned/cycled recovery. Robb Wolfe on Zone/Paleo nutrition. I remember one on scaling the load in a WOD based on your CrossFit Total (back for the first time since the very first Games in Aromas) rather than sex, height, or weight. Pretty sophisticated analyses from some of the OGs we no longer see anywhere around CF, but relevant and on point today as much as they were back in the day. You could accelerate the impact of having doctors engaged in functional fitness by leapfrogging them through the stages of self-discovery.

My take: make healthcare more like fitness rather than making fitness more like healthcare.

4) Reunion. Our return to Ohio is a day or two later than usual because we attended the 40th Reunion of one of my high schools (I moved after freshman year). Not a typo. 40 years. Doesn’t seem like yesterday; more like last week! One funny quirk: we all referred to each other as “kids”, as in “who’s that kid over there in the green shirt?” Every one of us did it. Attending was easy since it was my turn to bring my Mom home from the Cape and she still lives in the house I grew up in.

So? How was it? Was the Reunion a meaningful milepost? An event that will in some way alter the trajectory of any of us who attended? Probably not, but then again, is any Reunion really supposed to do that? No, what happened was a group of really nice people, many of whom still live in or around town, got together and spent a few hours being genuinely nice to one another. Oh sure, Tim (our Valedictorian) made fun of my senior picture outfit (definitely deserved), and some of the goofy stuff we wrote in each other’s yearbooks got a re-reading, but all in all everyone was quite gentle with one another. Heck, we could have spent all night ragging on me after Jane pulled out a pic I signed, but she was too kind to let it go down that way (for which I will be forever grateful!).

Heck, I’ll bet Dianne only got positive responses when she got folks to play the “who has changed the most” game (I wimped out and didn’t play).

No, Reunions are for remembering as many smiles as possible from days gone by, and for enjoying whatever threads there may be that tie us together, still. There were some crazy “it’s a small world” connections that were just a hoot to discover (like the Needham connection, right Lori?!) It was fun, and flattering as hell, to discover that some of my classmates have discovered my ramblings here and elsewhere and liked them. For the record they all seem to agree that Beth is AT LEAST my Better 95%! Tim and Tom came from California to RI and got trumped by Yukio who surprised us from Tokyo. That’s just cool. No revelations, no epiphanies, just a few hours to remember that we were privileged to have known each other in whatever small way, then and now.

I had so much more fun than I expected to, from the first hugs (thanks Kit, Jackie, and Sue) to the last handshake (great party Steve), I’m so very happy to have been a part. Think “yes” the next time you get an invitation.

I’ll see you next week…

–bingo

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.

The CrossFit Games Regionals were on ESPN yesterday afternoon. What? Wait. No? No, I guess you’re right. It wasn’t ESPN, was it. As it turns out the Games have shifted over to CBS Sports. Totally missed that memo. Of course, I only surf to the Games site once or twice a week anymore so I can be forgiven. Thankfully I was marooned at home with nothing left on either my Honey-Do list or my own Wish List, and ESPNU was all kinds of messed up so I couldn’t watch the D1 Lacrosse quarterfinals. Surfboring around cable I stumbled on the Regionals and received my annual reminder about what CrossFit is and who is supposed to do it.

In short the CrossFit Games as exhibited in this year’s Regionals is to CrossFit as the Indy 500 is to your daily commute: almost everyone needs to do the latter, but almost no one can, or should, do the former.

You could certainly say that I am treading on thin ice by proclaiming that you and I have no business doing anything but gawking at Regionals athletes doing full-on Regionals WODs here on .com. Fine. Here is why I feel this way; the incessant urge to emulate Games-level athletes and to turn every CrossFit WOD into a training session for competition risks the undoing of what makes CrossFit (and other high-intensity offshoots) a potential solution (or integral part of an irreducible Rx, to coin a phrase) in solving the population health problem in Western societies. It really could be as easy as eating fewer processed carbohydrates, being stronger, and training at relatively high intensity for periods of time in the 8-20:00 range. Stronger and leaner with greater aerobic capacity is all pretty much any of us needs.

Everyone who has ever owned a Box or coached a CrossFit class has seen the danger of extending the “you vs. you” competition outward into the “Sport of Fitness (TM)”. Clients who leave a gym because the trainer refuses to teach them how to do a CTB butterfly PU when they can barely do a single dead hang PU. Fledgling CrossFitters who insist on rebounding box jumps instead of stepping down because their times suffer when they do. “Linda” or “Diane” done As Rx’d with rounded lower backs, chins held high because, you know, you gotta Rx the Open WODs if you want to go to the Games. It’s really hard to exaggerate how disheartening it is to listen to a client say they are leaving a gym because they don’t feel like you are the best fit for them. Then you look at their data and discover that they are down 15% BW fat, have doubled their 1RM Deadlift, can now do “Fran” Rx’d in half the time they first did it with an empty bar and a green band, all injury-free.

Form, then consistency, then and only then intensity. This is what you need for fitness. The siren song of competition is strong, especially during our Games season. Shout out to those trainers, both within the CrossFit business universe and out, who continue to hue to this orthodoxy. Functional movements, irreducible exercises performed properly at a level of intensity that is high for an individual, coupled with a diet that is designed to fuel performance in the gym and in life is what we 99.9%’ers need. Distilling this prescription into a measurable and repeatable program is the essential genius of CrossFit. That some of us get to do it as part of a community is that much better; friendships formed through shared experiences, especially shared strife (and what is “Fran” if not shared strife), are also an integral part of being healthy.

After my (ca. 2006) WOD I sat down with some left-over steak and a handful of nuts to see how Dani Horan was doing in the East. A little sore and energized, the only thing that was missing was another CrossFitter there to join me in watching the spectacle.

My life is centered around, and centered by, the myriad women with whom I share airspace. There are certainly men there, too, and I am certainly fortunate in that my immediate world does not include anything like what other folks would consider a boss. While most of the women in my daily professional life are either employed by me directly, or employed by someone who has in some way contracted to assist me, the reality of my daily existence is that I have a symbiotic relationship with teammates who happen to be women, and we depend on one another every waking moment.

Because of this I have become alert to all kinds of slights leveled at women in general, and women who work in healthcare in particular. Frankly my worldview is really pretty restricted when it comes to the workplace, especially since the family Box closed a couple of years ago. In healthcare the hierarchy/patriarchy has historical sheltered bad behavior directed at women from both view and recourse. Is it changing in this volatile world that has emerged these last few weeks? That’s not really for me to say, of course; all I can do is whatever is in my means to provide an environment that respects a gender-neutral environment and chain of command whenever I have the privilege of setting the tone.

What is very interesting to me, and what I find to be a very positive (if tardy) side effect of the recent “outing” of men in power who have abused that power, is the celebration of thoughtful women whose thoughtfulness might not have been quite as well-known before. Again, it goes without saying that this should not be something that is remarkable in the least, but for the sake of this particular musing perhaps we can simply acknowledge and agree upon that, and spend our time thinking about what it is that these women are saying.

Reese Witherspoon comes instantly to mind, of course. Ms. Witherspoon has forcefully said that SOP in Hollywood is no longer even a little bit OK when it comes to opportunity to control the spoils of the industry. Not content to simply raise the issue she has literally put her money on the line along with that of like-minded individuals and begun to create those opportunities. Ms. Witherspoon has much to say that is worth hearing. One could do worse than the recent WSJ Magazine cover article as a jumping off point to begin your listen.

It’s highly unlikely that there is any woman in the world about whom more electrons have been circulating of late than the actress Meghan Markle. There’s not a rock big enough for you to have crawled under in the developed world for you to be unaware that she has recently been betrothed to an heir to the British throne. While Ms. Markle and her beau are, indeed, impossibly cute together, it’s more than a bit of a shame that it has taken her very public romance for the non-People reading public to discover her, her story, and her intellect. This is a person of substance.

Hopefully Ms. Markle will forgive me for I will certainly get some of details wrong (as usual I am writing without notes). She is the daughter of a caucasian father and an African-American mother, and she has been on the receiving end of various forms of discrimination from a very young age because of that. She tells a story of being forced to declare in school that she is one or the other, Black or White. To check a box because, well, that’s what is done. She declined. Maybe she was 12. She opted not to opt. I don’t know how long it’s been since you’ve been in school, or had a child in school, but that’s a rather gutsy move.

She went home and asked her Dad why. Why should she have to choose? His response informs her message today: draw your own box. Man or woman, if the choices that are presented to you do not include the right choice, draw your own box to check. Ms. Markle tells the story so much better than I, but I am happy to pass it on with a further encouragement that you should go look for her telling this story, and while you are at it there is a wonderful clip of her accepting an award for her advocacy on behalf of empowering women. She is universally described by anyone who has listened to her as a woman of substance.

My hope, and my goal in writing this today, is that the term “woman of substance” will one day be replaced (as I did above) for both men and women with “person of substance”. Substantive ideas matter, and they ought to matter irrespective of whatever labeling might be applied to the holder of those ideas. While they may not have the name recognition of Ms. Witherspoon or Ms. Markle, I am surrounded by women of substance whose ideas bear our listening. My wife and my daughter, my sisters and my mother, my daughters- and sisters-in-law, as well as the extraordinary women with whom I’ve worked in healthcare and met through CrossFit, give me confidence that this can be.

Not today, not yet, not soon enough but soon, for the benefit and betterment of all.

Sunday musings…

1) Capulet. Juliet’s last name. No reason; just seems like a cool thing to know.

2) Apokalypsis. Ancient Greek for uncovering or unveiling. I’m not exactly sure why, but this particular derivation of “apocalypse” seems all too appropriate for the last couple of months, eh?

3) Lifetime. After a bit of time I recently tried to access an online place to which I’d once been given a lifetime subscription. It’s one that I used to look at very frequently;my user name and password never changed. I discovered a different sign-in format, one that did not even accept the form of sign-in I’d been accustomed to. “Lifetime” in this case had nothing to do with my longevity, but rather the employment lifetime of the gifter, or the lifetime of institutional awareness of my being.

It leaves one to ponder: how many lifetimes do we have, and what is it that brings any particular lifetime to an end?

4) Babar. I have a thing for watching the end of a series. TV, movies, a particular character in an author’s books. I seem drawn to them even if I had little to no engagement with them over the course of their long or short lifetimes. Just the tiniest bit of introspection leads me to M*A*S*H, a beloved television series that I actually did watch quite religiously. I’m pretty sure that the final episode of M*A*S*H was the first finale I consciously watched as such (thanks again for hosting us all Evan Tabor!).

What’s funny is that I have gone out of my way to put the series finale of shows that I pretty much never watched on my calendar with the same amount of “gotta see it” as those few that I never missed. “St. Elsewhere” was just as much of a must-see as “Hill Street Blues”, for example. Even more interesting–maybe sillier is a better word–I find myself with the same type of nostalgic yearning at the loss for both. Weird.

So it is as I discover that the beloved children’s character “Babar” has made his swan song. With the publication of “Babar’s Guide to Paris” author and artist Laurent de Brunhoff signs off and Babar takes a final bow. There is no heir, and the character is not meant to have any further adventures. After finishing the WSJ interview I know that I will read this book despite the fact that I have read (or been read to) only the original story (written by Laurent’s father Jean) and not a single intervening edition. As avid collectors of children’s books and enthusiastic readers to our children and now grandchildren, this is even more striking.

Why this book, and why now? Well, I have to admit that I’m a sucker for sentiment, and this quote makes it a slam dunk: “I never really think of children when I do my books. Babar was my friend and I invented stories with him, but not with kids in the corner of my mind. I write for myself.”

Who wouldn’t want to spend a few pages with a 92 year old and his friend of some 70 years as they explore the City of Lights together one last time.

5) Rigged. “Live life as if everything is rigged in your favor.” –The Persian poet Rumi (as told by Neda Shamie)

Have you ever heard a more lovely description of optimism? What a smashing way to approach life! In the past I’ve written that one should assume that each endeavor will be a success, that this simple assumption does, indeed, increase the odds that it will happen. So often we hear from people that the game is rigged. Heck, I’m gonna go out on a limb and say that every single one of us has felt this at least once in our lifetimes. We all know people who have simply given up on all but sustenance, so completely do they believe that any effort at advancement will be thwarted in a game that is rigged.

But it isn’t.

At least it isn’t if what we aspire to is simply taking that next step up. Sure, if your only definition of “winning the game” is to have Gates/Soros/Koch kind of money, the game is surely not set up for you to succeed. In reality, success (see “Gratitude = Success”) and happiness do not require such an outsized outcome. Therein lies the brilliance of Rumi’s insight. If everything is “rigged in your favor”, if all of your “ducks are in a line” and the deck is stacked for you, why NOT take that opportunity and turn it into your next success? You could certainly accuse me of being a pollyanna here, but heck, doesn’t it feel better to look forward with hope than otherwise?

The game of life is here, today, just waiting for you and me to play a winning hand.

I’ll see you next week…

–bingo

One of my all-time, never fails thrills is a pre-game flyover. I get serious chills and a full coat of goosebumps every single time. Doesn’t matter what event follows, or why I’m watching. Unexpected, surprise fly-overs are an even more special treat, that “oh, you’re kidding…I get to see this even AND I get a fly-over?” It’s like getting dessert first at a Michelin starred restaurant. Never having served in any of the branches of our military I have no special call to feel this way. Yet goosebumps arrive on cue whenever a particularly moving rendition of our National Anthem is played, or if I hear Kate Smith or Ray Charles singing one of our other patriotic anthems.

It should come as no surprise, then, that I am quite completely conflicted about the recent protesting of professional athletes done during these tiny interludes of observing our shared nation. I do get, as should all thinking individuals, that the protests themselves are not directed at either the anthem or the flag, and certainly not toward the men and women who have served in the defense of the historical values that these symbols represent. I truly love these tiny moments of patriotic sentimentality. They are, for me, similar to saying “Grace” before our evening meal: a tiny vestige of a once much larger experience.

Sporting events of all kinds used to be a much bigger presence in my life than they are today. Whether playing or watching, it was weird to not have some sort of game front and center. Once I hung up my various sporting implements, and even when I moved away both literally and figuratively from the teams of my youth, I could usually find some sort of sporting event to have on as background noise on a given day. The fact that I watch fewer games, and almost no football, at a time of unprecedented activism on the field is therefore purely coincidental.

Still, I do think about sports, and major sporting events are still a rallying point (or at least a conversation starter) in most walks of my life. To say that this next statement has me conflicted doesn’t really measure up to the truth: the on the field activism of athletes makes me avoid the discussion of sports entirely. It’s not that I feel the athletes have no place expressing their opinions, nor that I necessarily disagree with the opinions they are expressing. The heartfelt conviction that a particular group has been singled out for mistreatment is a righteous cause to which very public individuals could lend their support. By choosing the venue of a sporting event they have removed my ability to choose whether or when I will engage the topic.

By choosing to do it in the manner that they have chosen prevents me from experiencing a tiny thrill that used to at least feel like it was free.

So what? Isn’t that the point of protest, to make the safe and the secure a little bit uncomfortable? Sure, I get that. I really do. It makes little difference to those protesting to learn that people like me really do set aside time to consider the merits of their grievance; creating discomfort is part of the point. Having twice scrubbed my own workplace of all political activity, making it clear that our team is to avoid the creation of similar discomfort in our clients, I sort of feel like my patronage is being abused I guess. Kind of like that old joke “I went to a fight and a hockey game broke out”, except it’s a political expression upending my expectation. Certain jobs just don’t mesh with political action in the workplace. Who wants to see their local police officers in uniform and protesting anything at all? Can you imagine listening to your surgeon expound on some controversial topic just as you slip under anesthesia?

You could very well read this and say that my bleating is nothing but one more example of “White privilege” (funny, given my name), the smug mutterings of someone safe and secure and as close to immune from the dangers being discussed. I would understand your position. I would disagree, but I would understand, and more than that I would inherently realize that no amount of discussion on our mutual parts would change your mind. All good. I’m uncomfortable, and a little bit unhappy, and maybe that was always the point.

The risk is that my discomfort may make me stop listening. That’s probably not what the protesters are aiming for.

“You want to shine but not so bright that you burn everyone in the room.” –Pharrell Williams

The hubris/humility axis an interesting ride, isn’t it? Like you I am watching Matt Frasier run away with this year’s CrossFit Games men’s competition. How will he respond when he is interviewed after his victory/coronation? Where will he land on that H&H line? It’s fascinating to watch someone who is truly extraordinary at what it is that they do walk the line. Indeed, it’s probably not possible to stand out if you don’t stand way to the ‘hubris’ side at some point, at least while you are at whatever it is you do.

This year marked the 26th annual White Family visit to Cape Cod. Like so many of our recent trips this one was filled with talk of illness and cures. We told stories from my Dad’s past (the world’s most arrogant heart surgeon was a favorite) and sadly from my mother-in-law’s present. The morning of my departure was spent seeing patients for whom I’d done surgery, alternately sharing in their delight at vision re-discovered and fending off what felt like over-enthusiastic praise. Like Matt, I’m really good at what I do, and quite frankly when I am about doing what I do I literally go into each “contest” convinced that there is no one in the world better than I am at that particular time.

Is that hubris, or just the confidence that any “athlete” must take into the arena at game time?

The difference probably rests on a couple of things. One must be ever aware that everyone has limits. True, if you are very, very good at what you do your limits may be so far to the right of the Bell Curve that it can seem like they don’t exist. Succumbing to that sense is precisely when confidence becomes arrogance; someone or something is going to break, eventually. One wonders how that arrogant heart surgeon handled the inevitable defeats in the OR.

Pharrell’s quote likely points us to what it is that separates the arrogant from the humble, the realization that what you do well does not necessarily elevate you above those for whom you do it. One who allows himself to bathe too long or too often in the reflected light of his excellence gets burned just as surely as everyone and everything else.

Frasier, like Froning before him in the CrossFit world, will quite likely acquit himself well in his victory interview. He will allow that he worked very hard at his craft, and that his hard work paid off handsomely. His humility will show in that he will also point out that he was given many gifts, born with certain skills that he could then hone through his work and thus produce this singular achievement.

In the end what humility means is the difference between thankfulness and self-satisfaction. Again, Pharrell Williams: “As long as you’ve got your light, people will see you.”

In an airport, once again, traveling between friends and family, family and friends. Sadly, I’m on my own for these couple of legs. This “sandwich generation” stuff is getting harder by the day. MCO to BOS this morning as I travel from the funeral of my best friend’s Dad to what looks like an abridged version of the annual White Family Cape Cod adventure. We are down one parent, too, and the next generation is in the early stages of careers and families of their own which makes it difficult to get away for a week on the beach. My journey is solo as Mrs. bingo awaits the arrival of the Man Cub’s little sister who begins her own journey any day now.

In the middle of the sandwich, where we welcome babies into the family as we say goodbye to parents who leave, we hopefully share this stage with at least one good friend, and hopefully for our longevity three or more (turns out that’s a magic number). In addition to a brother with whom I cannot be closer and my darling bride with whom I could not be more in love, my journey has been blessed with a best friend who has ridden shotgun or been my driver for 40 years now. We have taken turns carrying each other whenever one of us needed the lift. Mostly we’ve just walked side by side, as friends do..

Friendship is on my mind quite often. I ponder it as I think about friends old and new. My 35th college reunion was a month or so ago, and I am pleasantly surprised at the number of old friends and friendly acquaintances who are emerging from the mists of my past. 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. My parents gave one in 1961; Rob, the friend who just lost his Dad, showed up in 1978.

If we are lucky enough to have such 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 is encircled by farmland that lies, for the moment at least, unexplored. The enterprising gardener is always on alert for new seedlings out there to plant in that garden of friendship.

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. 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. So it has been for my friends and me.

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 am in an airport, leaving my friend and headed toward my brother. It’s raining; we are all missing our Dad. But we have tended these gardens for decades. The sun will come out soon enough.

Sadly, I have had numerous opportunities over the last year or so to note that there is not a single language on earth that has a word or name for a parent who has lost a child. Words exist to describe a surviving spouse, and of course we have a word in most languages for a child without parents: orphan. The word conjures up Dickensonian images of waifs and wastrels in varying degrees of distress and underdress, under-fed and unloved. In reality, despite the ubiquity of this stereotype, there are many, many ways that one becomes an orphan. Indeed, in a proper order of events, each of us will be orphaned by the loss of a second parent.

It is somewhat amazing to me how many people have lost a parent early in life through abandonment. A mother or a father simply ups and leaves. No forwarding address or email, just gone forever. It hurts just to type those words. What must it feel like to live them? Still others lose a parent for years on end before that parent actually dies. Mental illnesses of all sorts, most commonly the various types of dementia, essentially wipe a loved one’s personhood off the planet long before the empty shell passes on. It’s a rather cruel joke, that, to see what looks like your Mom or Dad sitting across from you like some kind of reasonable facsimile, an avatar perhaps, but not really Mom or Dad. Mourning begins years or decades before anyone sits Shiva.

In the end, though, orphanhood comes for us all, in one way or another. My friend Bill, the surgeon, expresses surprise and a sense of something that is a bit more than frustration, though slightly less than anger, at what he calls the “final reckoning” deathbed visit. Why, he so often wonders, do so many people, so many sons and daughters feel the need to achieve some sort of closure, some sort of final peace in the last waning hours of a life? Mind you, this is a man who practices “live and death” medicine; his point, forged so close to the fire, ought not be missed.

Mothers and fathers are no more or less flawed than any other humans. For most of us their flaws lie cloaked behind the curtains of devotion in our childhood. As we ourselves age, certainly if we become parents, those curtains part and we begin to see more of the whole person who makes up Mom or Dad. Blessed are we who find more to like and love behind those curtains. One hopes at worst that what we find does not dim the glow of childhood memory. Bill’s point, or at least what I think he is saying, is that we should know that orphanhood is inevitable. There is nothing that you can say or do on death’s doorstep that cannot be said or done long before you approach the threshold of your own orphan status. Bill would say that closure is important, that he understands and supports the compulsion to make sure that your parents know that you love them. It’s just the timing he’s wondering about.

Why wait until the cusp of orphanhood? Why not discharge regrets and express your love and gratitude when you and Mom and Dad can might have time to enjoy what comes next? Together.