Random Thoughts from a Restless Mind

“Achieving a risk level of 0.00000% is costlier than 0.0%.” –Saurabh Jha (on Twitter)

Think about that for a minute. It was written in the context of medicine and medical care, but we should think about risk in the context of our CrossFit or fitness practice, too. Beth and I had a really nice conversation with my sister-in-law Amy (of Champlain Valley CrossFit, home of Games champion Matt Fraser) about CrossFit for the masses. The specific topic was how many CrossFit WODs should regular folks, especially–ahem–more mature regular folks be doing each week and what sort. In a way it was a discussion about managing risk.

As I’ve gotten older my ability to challenge my body without incurring minor injuries has declined. At the same time, my ability to recover from those injuries has declined apace. A far more mundane, but equally actionable observation is that I do not recover from the intensity of the WOD as quickly as I did 5 or 8 or 10 years ago. In other words, there is some risk in continuing to do CrossFit in the same way that I did in years past.

There is a flip side to this, of course. Prior to embarking on my Crossfit odyssey I would be incapacitated with back pain 2 or 3 times each year. Since January 2006 that has occurred precisely once, and that was because I deviated from standard-issue CrossFit to join a friend in his Oly workout while visiting. I am struggling to create a regular workout schedule since CrossFit Bingo/Comet CrossFit closed. Without question I am not as healthy as I was at this time last year.

Each of us is a study group of one, each with a personal risk/benefit ratio that can only be discovered by at the very least coming right up to the edge of “too much”. The more experience you have the more confidence you probably have in your own ability to determine where that is. Others can, and should, put the responsibility for charting that course in the hands of their CrossFit or other trainer. Once identified, though, it makes little sense to flirt with the flame of “too much” when there is so much to be gained from “enough”.

For me what that means is continuing to pursue at least the maintenance of my functional strength by continuing to follow the latest version of CFSB from The Brand X Method(R). I find that 2 high intensity WODs, 3 at the most, is what I can handle each week. As much as I hate to admit it, long brisk walks are becoming a staple of my fitness and health plan. I should probably ask Abbie the Wonder Dog to join me on those.

Nothing is completely safe; seeking yet another zero after zero after the decimal point before starting treatment means never starting. Once effective dosing is established, in medicine or in CrossFit, one must judiciously minimize risk, but not to the extent that the benefit cannot be achieved.

So much strum und drang in the air. So many panties in a bunch. The offensitive are on the warpath about, well, everything. We seem to have a surfeit of ethicists among us, proclaiming in nearly real time where anything and everything fits on some mythical ethics grid. To them I offer my own filter, the question I ask before I expend an iota of energy of any kind on the type of “news” that has them all so agitated:

Is what I am viewing unethical, or simply unseemly?

Ethics is a synonym for morals. As such it should be universal and timeless. Ethics should bear nothing in common with fashion.

Speaking of which, it is fashionable in pretty much any field in which expertise can be obtained and the label “expert” attained to lay waste to those so acclaimed by accusing them of having a “conflict of interest”. Traditionally this meant that one might enjoy some sort of tangible gain by trafficking in one’s area of expertise, thereby rendering the expert’s stated opinions somehow tainted. Of late it means that being employed by someone with whom your critic has a beef means your standing to hold an opinion at all is nullified.

Nonsense.

We would be a wiser society if we instead made an effort to sort through the biases held by experts in any field. To demand that one not express any opinion that would support your employ should disqualify the individual who holds such a position, not the expert. To look at the bias that may be present in any expert opinion allows the audience to better evaluate both the veracity of the opinion, as well as its relevance to their own situation. For example, in my day job I have a strong bias to treat any condition that produces meaningful symptoms in my patients.

In truth, in many of the general categories that I cover my remuneration is identical whether or not I treat. Those who bleat on about conflict of interest would seek to nullify all of my thoughts simply because I make my living in the arena on which I opine. Again, this is silly. It is far more useful to read my professional writing through the prism of my pro-treatment bias. In so doing it is far easier to compare and contrast my public opinions with others in my space who may differ. Do they differ on substance, or do they differ because of a countervailing bias?

This is not to say that conflicts of interest do not exist, or that if they do exist that they are never a problem. If you have invented a medical device and choose to use your own device rather than a competitor’s you have a COI. Disclosure of your COI should be mandatory (I disclose all consulting contracts around prescription drugs, for example). If they are of equal quality (equal safety, equivalent outcomes), the COI is mooted. If your device is much more expensive (thereby generating much more income to you), your conflict of interest is unseemly but not necessarily unethical. It should be obvious on its face that using your invention if it is less effective (or Heaven forbid, unsafe) is unethical.

Expertise exists everywhere. Here, on CrossFit.com in the fitness world. Would you disqualify Greg Glassman because CrossFit has been a successful business? How about Jeff and Mikki Martin who have launched a business in the same space? Is their competition a conflict that nullifies their contributions to youth fitness? Among the bureaucrats at the EPA in the care of the environment. Do they not have a contribution to make despite their tax-supported position? Is their (presumed) anti-business bias a reason to dismiss all federal policy? How about the various and sundry talking heads on all of the financial offerings on cable news channels. Don’t you really want them to be rich and successful, especially if you are going to follow their advice?

If we seek to understand the biases that exist underneath the opinions of experts we can better evaluate the conflicts of interest that they inevitably carry along with those opinions. From there it is an easier task to evaluate the character of those conflicts, and better decide whether or not we accept their guidance.

Getting paid to be an expert and to share your expertise is definitely a meaningful conflict of interest if it is unethical, but is most assuredly not if it is just unfashionable.

The author of an article in last week’s Sunday Times asserted that Google and Facebook are “essential tools.” Jonathan Taplin states that everyone has “no choice but to use them.”

Facebook as an essential tool. He really said that, presumably with a straight face and no irony intended.

The reality of the developed world is that search is indeed essential at some point in most lives. Google owns 90% of search traffic, but there are at least 3 other search engines that are adequate at worst, and likely comparable in terms of information acquisition (if not ad awareness) with Google. Facebook, on the other hand, is little more than a toy in the hands of its users, and likely a dangerous one at that. The nameless, faceless scientists behind the curtain in Oz…er, Facebook…want to get you there, keep you there, and control what you do there. Facebook (and its kissing cousin Instagram) is purposely addictive, and face it, the super-majority of what you may do there is far, far from essential.

It’s very helpful to be able to call up information at the touch of the finger (a sales guy answered a complex, archaic golf question for me yesterday in about 27 seconds). Quite frankly I’m at a loss to think of a single essential aspect of FB in daily life.

My dentist still puts out magazines to help me kill time in the office.

When did a difference of opinion become a de facto conflict? When did the evaluation of another come down to whether or not they hue to a fine line of agreement on a single, or a few, or G0d forbid every issue? When did this phenomenon then morph into one in which a difference of opinion then becomes the basis for labeling another ‘good’ or bad’?

Am I the only one who’s noticed this?

I’m not talking about a difference of opinion which is then followed by a concerted attack, one that forces you to identify the holder of the other opinion as ‘bad’, and enemy. There’s nothing new to see there. One only has so many cheeks to turn. Eventually you need to fight or flee an attack, but that’s not what I’m talking about.

On a personal, local, and national level we could once identify broad stroke issues on which we could generally base a level of agreement or disagreement, very few of which would be a ‘deal-breaker’ when it came to civil discourse. The first part of this, the existence of broad stroke issues, remains true. What is fundamentally different in my mind is how un-moveable many of us have become on ever more minute details as we drill down from the 30,000 foot view. All well and good, I suppose, to seek fidelity to an ever more granular level of agreement on whatever issue is at hand, especially in this age when we have ever greater ways in which to find and connect with people of a like mind.

What I don’t get is the subsequent labeling of any and all others as “bad”. Unworthy. Lesser in some way because they do not agree at every level with a particular–very particular–point of view. As I remember it the “80-20” Rule pretty much applied to belief systems as well as business: if you shared 80% of your beliefs with another that was plenty good enough to allow a friendship, and certainly enough to inoculate against a conflict. Now? Seems like something more like the “980-20” rule: only the smallest amount of the most trivial difference of opinion is permissible. Anything more than nuance between people and they’re going to the mattresses. Anything more than nuance and we’ve identified something other, something lesser, something to destroy.

What’s up with that?

You could say that anything other than full devotion to a cause or a concept or a worldview is not pragmatism but something more akin to weakness. An inferiority of spirit, perhaps. You could say that nothing other than full devotion to some grand theme or concept is acceptable and brook no deviation from a one, true path. I would say that the world is infinitely too complex to approach life in this manner. I would further say that to do so needlessly isolates you from people who might very well bring infinite joy to your life despite differential nuance or even a fundamental disagreement on one issue. Living and letting live rather than identifying a different opinion as identifying the other as an enemy might just mean a more pleasant life filled with more people who might be better described as friends, or at least friendly.

At the very least perhaps we could just agree to disagree and be on our way.

*Lest one think this is a reaction to the news of the day, originally written in April 2014.

Sunday musings…

Chaos and calm. As far as I can see, and for as long as I’ve known, these are the only two states of being for a father.

To be sure, not all states of chaos are unpleasant, and there are innumerable degrees of calm. At the moment I am luxuriating in the calm of quiet, accompanied by only Tiny Tim and Abbie the Wonder Dog (both of whom have re-racked). A social creature, these moments of calm were once painfully lonely for me. Having rediscovered my “pen” they are now cherished little gifts, times during which I alternately “sits and thinks” and even “just sits”.

Father’s Day brings soft and warm memories of the other type of calm. Those times when I was with one or several of my children or my “extras” (thanks for the new vocabulary Dillie!). Memories of late summer 1988, coming home to “The Heir” in his infancy just in time to fall asleep with him swaddled and resting on my chest. Or tiny Barbie tea parties with “Lovely Daughter” in her “Megan-Loo Who” stage (from which she eventually acquired the nickname “Goobs”). There’s no yelling at a tea party, right? Lil’bingo and I would work on “construction projects” with his Tonka trucks that could last for hours. The best type of calm for a Dad isn’t lonely at all.

Chaos is just as much a double-edged sword. Man, why couldn’t there be a family frequent flyer program at the ER or the orthopedic surgeons’ office? Even chaos, though, is a net positive as a Dad. I find myself smiling as I remember all of the events we just barely got to on time, the “fire drill” leading up to our arrivals notwithstanding. The chaos of a house filled with toddlers, pre-teens, teens or young adults is filled with enough energy to light up a small city for a weekend. My sides are aching from the memories of the laughter.

Chaos and calm.

Father’s Day for me this year will be like every other Father’s Day since we welcomed “The Heir” so long ago. Unlike so many who use the day to do something like play golf or climb a mountain or some such, I will try to spend as many of my waking moments in the active pursuit of doing Dad stuff. Firing up the griddle this morning and making the bacon is so much more fun than breakfast in bed, the chaos of the Man Cub and the dogs and the timing of the delivery of our new grill (presents!) notwithstanding. I have always spent so, so much time away from my kids (and still so much away from my grandchildren) just doing the things that a breadwinner must do; on Father’s Day what I want more than anything is to be allowed to do Dad stuff as much I can. To be able to just be a Dad today is always my goal, always the best gift possible.

Chaos and calm. Happy Father’s Day to each of you lucky enough to enjoy both.

I’ll see you next week…

–bingo

Sleep was late in coming. I stayed up texting with a West Coast friend and professional colleague, thinking and reminiscing about the 3 core guiding principles that helped me (and in many ways him) make it through our training and early professional careers. All 3 have stood the test of time, have continued to inform my best decisions both professional and personal, and over the 30 years now since I first said the out loud I’ve only needed to add one additional guideline.

“Knowledge is power.” One is at such a profound disadvantage if there is asymmetry in the amount of information they possess relative to those with whom they interact that at a certain point those not “in the know” cease to be independent entities. Without knowledge, awareness of the ground as Sun Tzu would say, you are at the mercy of another. You must depend upon their kindness for, well, almost everything.

“Perception is more important than reality.” The explanation of this, of course, is that perception is the reality of perceiver. While you could say that this is simply an extension of the first guideline–creating the perception is in some way controlling the knowledge–I would simply say that one need only look at the deeply held worldview of some of the U.S. voting public, their perception of what is real and what is important, to illustrate that perception comes from within. This is all the more so when dealing with “one issue” voters. Understanding this should inform your approach to any situation whatsoever. What does this individual perceive at this moment? That becomes the reality with which you will be dealing, your version notwithstanding.

“Evolution is better than revolution.” Funny to have initially stated something like that  on CrossFit.com, the home of a truly disruptive revolution in fitness, eh? Again, this CrossFit that I have so wholly embraced must be the example that renders this guideline moot. Here is where my conversation with Dave that night was so helpful, for Dave was (and still is) a man in a hurry to effect change for the better: evolution involves a conscious attempt to minimize unnecessary collateral damage. Sometimes that damage is directed at oneself, and thinking more along the lines of the “long game” is also sometimes a very reasonable approach to self-preservation. After all, the fire of revolution burns brighter the nearer it gets to the revolutionary. My friend Dave now seeks change in the cool contemplative glow somewhat removed from the fire, conscious always of the need to care for, and be careful for, the growing flock that surrounds him.

To these 3 I have added a line from the Tao te Ching: “The man who knows when enough is enough, will always have enough.” While this particular guideline has not been particularly helpful in my outward looking life, it has done more to aid in my inward looking experience than anything otherwise has (the exception being my 35 year quest to be a better husband). Those of us who live in the West are under a constant sensory barrage that demands that we submit to the need to acquire. More. More and more of everything. More because it’s, you know, more. To be honest, I gave this little more than lip service until I actually lost quite a bit of  stuff. Being reminded that almost all of it was something I wanted, rather than needed, allowed this guideline to bring an internal peace that was missing.

These 3 original guidelines have served me well lo these 30 years or so. Adding and committing to the fourth has brought me peace in the bargain. They may or not work for you; they may be nothing more than tinder to light the fire of your own guiding principles. Some day perhaps I’ll share the epiphanies of 9/11 and Heinlein that underly the tactical application of these 3 strategies, but there’s plenty to think about in these simple suggestions. “Knowledge is power.” “Perception is more important than reality.” “Evolution is better than revolution.” “Enough is enough.”

There are, I think, 5 groups of people around each one of us. True friends occupy the closest orbit, the small and intimate center of the bullseye. The next ring holds our Friendly Acquaintances, folks with whom we share happiness but not necessarily the intimacy, ease, and confidences of true friendship. Surrounding this ring is the one holding our Acquaintances, folks we simply know. Orbiting these concentric rings is a (hopefully tiny) globe of enemies; sadly we all have some. All of this floats in the vast sea of those unmet.

Do you know the difference between a “friendly acquaintance” and a friend? What draws the line for you? How many true friends do you have? What does it take for you to be someone’s friend? Is your bullseye static or dynamic? What moves people into and out of the rings in your friendship bullseye? Is there room in your bullseye for a new true friend? How do you feel when it becomes clear that someone is just a friendly acquaintance and not the friend you thought? How does it feel to make a new friend?

Beth and I have had a very dynamic bullseye of late, prompting me to return to this yet again as I try to make sense of recent events. Old friends lost and found. Discovering friendly acquaintances in our group of friends, acquaintances among our friendly acquaintances. New friends who have arrived through an open side door, unbidden and unannounced, to fill the empty spaces abandoned by others.

One can never have enough friends.

Savannah is populated by hundreds, maybe thousands, of ghosts. In truth if we met any  when we visited I either didn’t notice or don’t remember. They, the ghosts that is, are all said to be sad or angry. If Savannah does indeed have ghosts it stands to reason that they ALL aren’t angry or sad, and that got me to thinking about ancestors.

Have you ever examined your heritage? You know, looked at what’s swimming in your gene pool, and where it’s been through history? There’s probably a ton in there, probably a ton of information that is worth knowing. History is awfully cool, a rich and vibrant panorama that can be viewed from any spot and examined in either direction. Your OWN history is like this. You should know your own story.

The entry of grandchildren has focused my attention on our family’s stories. Beth went through hers while she filled in a “My Family” book for the Man Cub. I have my version of that book lying on my nightstand, and I’d better hop to it and fill it in with my Mom’s help the next time we get together. There’s no indication that Mom is planning on joining the brigade of ghosts any time soon, but just the same, she and I should make time to do this.

Some of your own heritage may still be around, their panorama moving ever slower as they spool toward the end of their part of the story. Are they happy? Are they fulfilled? Have they imparted all they, and you, need? If they were to leave this life, if there be ghosts, would they be those quiet, happy types, or the sad angry ones that provide fodder for tour guides “crawling” the haunts of Bogart and his ilk? Time grows short for your living heritage, for them and for you.

If there be ghosts, might you be wise to learn their stories before they cross over?

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 sounds a lot like 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.

My gentle, sweet, and much beloved father-in-law is now on his final glide path. As sad as we all are to be witness to this last landing we are equally joyous at this bonus year we’ve all enjoyed. What a gift it has been. You see, Bob was told he had a scant few months to live almost 1 1/2 years ago. Through a combination of good fortune, excellent modern medical care, a strong foundation of fitness (Bob’s trainer used CrossFit principles in his training!), and his drive to thrive, he has graced us with innumerable moments of love and joy we had no expectation of sharing.

Nothing focuses your attention on what matters in life so completely as imminent death. It’s quite a shame, actually. What we as an extended family have done over these last 15 months or so has come to seem quite natural and, while not easy, not terribly difficult to pull off either. Our efforts have centered on love and kindness. Full stop. We have all made an effort to connect so that we might express and share our love. That we might give ourselves extra opportunities to be kind to one another. It has certainly taken a bit of work, and for some of us it has tasked us with looking carefully at how we prioritize our lives. In the end, though, we all discovered that the effort/outcome equation has fallen squarely on the good side: we got more out of the effort than we ever thought we could.

Listen, it’s never the same before you see the glide path beginning. To conclude this little snippet by imploring you to totally re-order your life as if you, or someone special to you, is soon to land their flight forever is so trite it’s little more than drivel. It’s not natural, and none of us can do it. What is possible, though, is to inject just a bit more of that love and kindness into your everyday thoughts and actions with your loved ones now. If you get the same kind of optimization of your effort as we all in Beth’s family have received (and as an aside, what my family achieved during my Dad’s illness) perhaps you can try to add just a little more of each over time. It’s very CrossFitty, that. A little more love and a little more kindness offered today in the hope that tomorrow you and your loved ones will be a little bit closer, a little bit happier together than you were yesterday.

As for us, all that is left is to fasten our seatbelts as we hope for fair winds and the gentlest of landings.