Random Thoughts from a Restless Mind

1) Heat. Spending a week in our southern outpost. Almost 3 months later in the year than we said we ever would. 97 degrees today.

Wet or dry, that’s just hot.

2) Bugs. The no seeums are out in full force. You can hear them and you can for sure feel them.

They seem to like the heat.

3) Election. Seems they’re having one down here, too. It’s hard to tell who has more money backing them since everyone has 3 ads in running in every break.

On the upside, that’s 3 times I don’t have to watch one of the ambulance-chasing lawyer ads that normally pollute my TV.

4) AI. Man, AI giveth and AI taketh away, doesn’t it? We added so-called ambient scribing via AI-guided recording. Should save us a bunch of typing time while also allowing us to more accurately divine the issues our patients want us to address and how we plan to do so. Learning new stuff always slows the roll for a bit, and we are certainly seeing our collective roll slowed.

But our biggest problem is using a product that isn’t really ready for prime time.

All AI stuff kinda works like this if you think about it. You get whatever version is the latest iteration of your chosen model, and in general it is a time saver because of your understanding of just what it can do for you right now. For example, I have an 11 mile commute to the office; v1.0 of Chat could tell me every detail about every landmark on the way in seconds. What does it matter that it took until v3.0 to chart a course for a shuttle through the asteroid belt, a trip I won’t ever take?

In task-specific software targeted at an industry that is suffering from inefficiency that affects outcomes there are unaligned priorities between players, in this case practicing physicians and the companies that develop and sell the tech we use. You can absolutely sell software or an AI program that has a finite list of areas where they can be applied, and you can even sell it before it’s really ready but admitting that it is a beta-version: not really ready for use by the masses. What you really shouldn’t do is sell any kind of product that can only be used in a small fraction of the daily circumstances encountered by your customer, in this case me, without disclosing that fact up front, out loud, and often.

I bought the beta version of a product that was marketed and sold to me as a finished, out of the box and ready to use. In the tiny slice of my daily life in which I can use it I am impressed and hopeful. For the 80% of my day in which it either doesn’t work or even worse increases the work that must be done, it’s hard to escape the fact that I am paying for a beta version.

And what this AI taketh is my time.

5) Happiness. “Happiness is quality of life minus envy”. Most recently the comedian and writer Jimmy Carr.

Once again, to the well of “enough”. Quality of life begins with having our needs met. Food, shelter, clothing. Community; we are social creatures and very much need the company of others. Safety from as much preventable harm as possible; I’m reminded of the need for air conditioning in a southern summer as much as this last northern winter reminded me of the dangers of the cold. In our American society the able need a means to provide this for themselves and any others whose needs they must cover. Think job for the head(s) of a family household. Second order needs, those things without which one would struggle to cover the most basic needs. Think transportation and communication. In a developed world these second order things should also be considered needs.

What, then, is Quality of Life (QOL)? Once you have both first and second order needs met, what defines QOL? It’s a tidy little phrase, but as I sit here thinking about it, QOL is not as intuitively definable, at least not in the same way that I find “needs” to be definable. You may certainly disagree with my definition of needs, but you are unlikely to struggle to find your own version. QOL on the other hand is a pretty personal, subjective kind of thing. Every human requires protein to survive, a clear example drilling down into the need for food.

You may feel that your quality of life will suffer if your protein does not come in the form of beef tenderloin served medium rare and surrounded by puff pastry.

But if I take a stab at what QOL might be I would start with the effort required to obtain those needs. How arduous are the mechanics around meeting your needs? How much of your time is consumed in the process and in recovering after you’ve done so? There has to be time left over in order to have the rest of a life.

How collegial is your slice of society? I’ve written here and elsewhere that ultimately happiness is driven in large part by the size and quality of your closest personal connections (see: The Happiness Project, a compilation of the most recent data from the study of happiness that began with the Harvard Class of 1955). In order to acquire and tend to your close personal relationships, friendships and family, you can’t spend all of your time meeting your needs or recovering from your efforts. Loneliness is a major drag on QOL; close friends is likely THE major building block.

Is there fun to be had in your life? Stuff that makes you smile or laugh almost always increases QOL. There are likely a million or so Knicks fans whose QOL is markedly elevated today after the Knicks clinched their first NBA championship in 53 years. They had an awful lot of fun last night! Beyond breaking the law or only finding the fun in someone else’s unhappiness I don’t think there are a lot of rules and regulations on what you might find makes you happy.

There’s a pattern here. All of this is about you. What you need. What is fulfilling and what makes you happy. There really isn’t anyone else in the picture. What someone else has isn’t in the equation unless it is something that brings happiness to someone who is in your close circle of friends. I mean, you’re happy when your BFF is happy, aren’t you? Your QOL necessarily goes up when the people you care about are happy. Honestly, while there is a bunch of things that make me happy, nothing makes me happier than just being around Beth when she is happy. Happy by proxy is still happy.

If your QOL as I’ve just defined it is high, if all of your needs are covered and you have the time to enjoy your closest people, then by definition you must have enough. That makes sense, right? The car you drive gets you where you need to go whether or not your neighbor drives something bigger or newer or fancier. Your clothes might not have a chic logo and the soles of your best dress shoes may not be bright red, but I’m betting you look really good in the stuff you wear. And come on, you and I both know that Gucci logo adorns 10 times as many fakes as it does the real McCoy anyway.

It’s all just stuff.

Envy is wanting something simply because someone else has it. The bigger house or the faster car or maybe the more prestigious club membership. It’s OK to want something. Heck, sometimes having something you want badly enough sets you up for the happiness that comes with having a goal and making it happen. Envy comes along with something that feels an awful lot like jealousy. Envy seeks to turn happiness into a zero sum game in which someone else’s happiness somehow comes at the expense of yours. Someone else’s win somehow becomes your loss. Somehow your QOL gets downgraded in the face of someone else’s, or what you observe is someone else’s QOL.

My buddy Mel is a pastor in a Baptist church. I still think about the sermon he gave the first time I visited for Sunday service. He was talking about how different folks receive different blessings at different times, and how that sometimes generated what sure sounds like envy in those who felt they were less blessed. Mel’s take? “I am happy about your blessings. Your blessings bring me joy. I do not need to worry about your blessings. Your blessings will not keep my blessings from coming. I think of my blessings up above, floating in a circle far above me, just waiting for the right time to come down. I don’t need to worry about your blessings. My blessings are on the way.”

Blessings, like QOL, are not a zero sum game. One person’s blessings does not mean that another’s blessings will not be on the way.

We are all exposed to the QOL of a much wider swath of humanity than we were in times past. Where once we had classic “appointment TV” in which we “saw” a slice of life that may have looked like it was in some way “better” than what we had at the time, now we are literally bombarded with stories and images of a strata that we once didn’t even know existed. Somehow this is what we need in order to be satisfied with our own QOL? I’m not sure I understand why.

Maybe it’s because my own QOL has had some pretty significant ups and downs over the course of my lifetime, but for the life of me I can’t really remember much unhappiness. Sure, there have been harder times. The three years of my residency in New York? Yah, those were hard times. That big pay cut that we took to start my own practice, the one that was only supposed to last a year or so? Boy, those 6 or 7 years it actually lasted were hard, for sure. Stuff that factors into my QOL if I ever think about it, things like going out to dinner, something that has made me happy since I was a three year old tagging along with my beloved grandparents, they just all dried up for long periods of time during my life. There was no joining my college mates at the fancy NYC steak joints or going dutch at the French bistro on the lake with our Cleveland friends during those times.

But I don’t really remember being less happy. I have mostly memories of happiness, even during the hard times. I had pretty much everything I needed. I definitely wished for the times to be easier, but I don’t know that I wished for anything that I was missing. For sure I didn’t begrudge those around me who had more, or who seemed to have it easier. It never occurred to me how that might have eased my passage.

H = QOL – E. Our Quality of Life begins with covering our first and second order needs while we assemble our closest circles of friends and family. The more time we get with those closest to us, especially when they are happy, the higher our QOL rises. Envy may be the variable over which we have the greatest degree of control. Imagine if we simply turn that “E” on its head, finding happiness in the blessings of others rather than lamenting that those blessings had arrived for them and not yet for us. A kind of anti-envy, if you will.

After all, at least for most of us, my friend Mel continues to be more right than not. We need not covet or resent the blessings of those around us who may appear to have more. At what level of QOL measured against the moving targets set by envy would we ever find that elusive entity, “enough”? Because “enough” is the feast. “Enough” means there’s nothing on the right side of that equation in the minus column. Once you make the “E” in Envy precisely zero it becomes the “E” in Enough.

And that “E” is what eventually brings those blessings home to us. Like a new variable that multiplies your Quality of Life and along with it, your Happiness.

I’ll see you next week, and that, too, makes me happy…

1) June 7th.

Mancub: Papi, am I going to see you on Sunday?

Me: I dunno Bubby. Why, what’s up?

Mancub: It’s June 7th!

Me: And?

Mancub: Six Seeeeven!

Love my Mancub!

2) Rosenblatt. #2 in the latest list of ways to “stay old” from Roger Rosenblatt: marry above your station. His thesis on this is that your station is most likely low enough that you can’t help but “marry up”. I get the sense that he is mostly directing this toward his fellow fellows. Can’t really muster up much in the way of defense on this one of course.

I’m the guy married to his “Better 95%” after all.

3) Newport. I really love the monthly magazine supplements to the weekend edition of the WSJ and the Sunday Times. Occasionally there is a cool article, albeit one mostly there as a part of a marketing campaign for a movie or a book or the latest super hot fashion designer. You know the type of spread that is…clothes that no sane person would ever be caught dead in out in public, even the impossibly skinny boys and girls modeling them.

This Saturday brought tidings from Newport, R.I., stomping grounds of my youth. Supposedly Newport has been overtaken by a swarm of Millennials. Perhaps a re-boot of the original upper crust colonizers of Newport society, the less ambitious, less bright, better looking second children of New York wealth according to my pal Julie Bowen. I find myself a bit puzzled by this invasion though; all of the rich folks who populated Newport when I was a knuckle-dragging college kid always seemed awfully happy. All those pretty boys and girls in my WSJ Magazine are scowling or pouting.

Come on. You’re in Newport for free wearing a pair of shoes that cost enough money to rent a house on the beach in Narragansett for a month. Whaddaya say…give us a smile, eh?

4) Ali. “It isn’t the mountain that wears you down, it’s the pebble in your shoe.” –Muhammad Ali

Ali died 10 years ago this weekend. Here we see the deep understanding that this giant among mere mortals had for the trials and tribulations of everyone else. Who among us must actually give consideration to the mountain at all? Every day, though, each of us must plod on in the face of chronic constant discomfort. Just getting to the next challenge can sometimes seem to be insurmountable. Ali understood. Perhaps this, more than anything, explains why it was that every single person who was ever blessed to speak with him felt that Ali spoke for them, believed in them, cheered for them.

Knew them.

Ali had a kind of courage that I still find awe-inspiring all these years later. It’s humbling to think about the simply monumental societal issues that landed in his path, uninvited and unprovoked. At age 24 Ali received his draft induction card. Having recently converted to Islam, Ali declined to serve and was stripped of his titles. Thus began 3 years of exile during which he struggled to support himself and his family. Three years of being hated by a majority of Americans. The likelihood that he would have actually been asked to carry a rifle and plod through the rice paddies along with the rest of the American servicemen was precisely zero. Think Elvis Presley. He must have known this, and yet he drew his line in the sand and refused.

I’m pretty sure it does’t really matter when we consider this whether or not you (or your parents, or your grandparents) agree or disagree with the particulars of his stance. Like almost every male in my age group I registered for the draft, and like so very many white suburban kids I would have spent almost all of my draftable years as a student, high and dry and thousands of miles away from the war. We didn’t discuss this at home; I have no idea what my Korean War vet Dad thought. I do remember thinking then, as I still regrettably think today, that what he did took a simply unimaginable amount of courage, a courage that I wasn’t ( and aren’t) sure I had (have).

Who among us hasn’t been faced with something that is hugely important, where right and wrong is a stark black or white, 0 or 1 binary question, where we just know with our heart and soul what we should do? There’s always a catch, though. A price to pay. Doing the right thing, even speaking out on behalf of the right thing, will have severe consequences for you or your loved ones or both. Your boss is a racist or a misogynist, perpetually abusing the weaker in your midst. Do you speak up, knowing it likely will cost you your job? A powerful interest group has descended upon your community and is singling out a group of which you are not a part, institutionalizing a prejudice that causes harm to innocents. Do you speak out, knowing that you will now be a target for a vengeful, wrathful power? The government has trained its regulatory aim squarely at your business, singling your world out for unfair attention just because it can. Do you speak out, knowing you will come under such withering scrutiny that you will likely be destroyed?

It’s not just being aware of the injustice, not just acknowledging the injustice, it’s doing so in the face of certain danger to you, or to you and your loved ones. Could you do it? Granted, Ali was 24 at the time of his stand, had come from little and had relatively little to worry about in terms of collateral damage, but still, there he was, walking away from the peak and willingly walking into the valley. Could you do that? Could you have done it at 24, even if you were just one more pebble in the shoe guy, with little to lose and little risk to those you loved? Could you do it during 40’s when you were a shoe-in success, your 50’s or your 60’s when you’ve crested the peak and it would be too late to go back to the bottom and start the climb again?

That question has led to more than a few sleepless nights for me over the years, including the night after I heard that Muhammad Ali, the man who introduced me to the possibility that the answer could be ‘yes’, had died. And last night, when I knew that I would write about this again. I confess that, while hopeful, I am still not entirely sure what my answer would be now, 10 years on, were I to be confronted with such a question.

I’ll see you next week…

This piece appeared in Random Thoughts 8 years ago as I contemplated my 40th High School Reunions. Funny that it comes up today. I have been trying to rally the troops in my medical school class for our 40th scheduled for this coming October. It’s hard to believe but my 50th high school reunions (I went to two high schools because of a family move) are only 2 years away! Good, bad, or ugly, the 10 years between 40 and 50 have seen plenty of personal evolution, too.

“2018 is the year of my 40th high school reunions (we moved after my freshman year so I have two). It’s a nice time to return to one of my frequent themes, identity. Who are you when you are all alone, just you and the mirror? Who are you when you are in any particular group of people? Do you feel that there is more confluence between those versions of you than not? How much confluence do yo think there is between who you think you are and who it is that those around you think you are? As this is my 40th year away from my classmates, have you evolved from who you thought you were and who your classmates thought you were over the years?

First a couple of disclaimers. One should not be all that too terribly concerned about the thoughts of others since this gives all too much power to individuals who may not have your best interests at heart. Sorry, but our world is altogether too filled with people who will opt to climb over your downtrodden psychological carcass if you allow them to do so. Also, there is no reason for you to ossify as an individual at any stage of your life. Indeed, if you haven’t evolved since high school you’re probably doing it wrong.

Over the years I admit that I have not made much of an effort to remain in contact with the vast majority of my classmates in either of my childhood towns. I could certainly lay the blame for that on my Dad who held that true friendships were rare and the effort to stay in touch with acquaintances too arduous for the ROI. The truth is more that I’ve always done the deepest dive possible into whatever ocean of opportunity I happened to be sailing on at any given moment; those oceans have always been rather distant from the shores of my youth.

Facebook has made it rather easy to re-forge ties, however delicate the fibers may be. These tiny, tenuous connections have left me very curious about my childhood mates. Much to the surprise (and amusement) of my family I have found myself moving all kinds of the chess pieces of my life so that I can attend both reunions. Who will I meet when I do? With the exception of a very few people I still do chat with, literally everyone I see will be someone I am pretty much meeting for the first time.

40 years is a lot of years of growth and change.

Who will my classmates be meeting when they see me for the first time in at least 30 years (I went to one school’s 10th)? Judging by a post on our Reunion FB page in which a classmate unearthed some commentary about our class from graduation I will be largely unrecognizable. You see (and this gets back to who you think you are and who others see you as being) what I once thought of as self-assurance and confidence came across (to some people at least) as self-centeredness and arrogance. This is not really a revelation mind you, nor is the re-appearnace of this item distressing. I’ve long held that I was an arrogant putz when I was a young man, although that may have been a part of whatever successes I may have accrued over the years; I pretty much always assumed I was gonna turn out OK.

What does bother me though, at least the me of the last 20 or so years, is the possibility (probability?) that my younger self may have run roughshod over people who didn’t deserve anything rough out of me at all. That does make me sad, frankly. You see, a large part of my own personal development, the ongoing changes to the person I try to see in the mirror (and project for any and all to see in me) is a foundation of kindness in all that I do and in all that I am. It’s hard–no, impossible– to be good at all times, and I’m not sure at all that you can be truly kind always and everywhere. But you can try, and it is in the trying that I have evolved over the years.

Who will my classmates remember as they think about our upcoming reunions? Will our memories of the children we were be so strong that we will be prevented from seeing the adults we have become? Regardless it’s been an interesting part of the journey to be reminded of who people thought I was so long ago and to peruse the pages of each intervening “Yearbook” as I’ve gone from cocky teenage jock to whatever it is I am today.

Wow. 40 years.”

1) Ambush. A group of adult tigers.

We all needed to know that.

2) Podcast. Funny phenomenon, podcasts. Some are a great way to learn about a new hobby. For instance, Beth and I will listen to 3 new ones on birding I discovered in today’s Sunday paper as we drive to our southern outpost next month. Others expand on stuff or people you already know; my friend Uday has a very cool weekly podcast that lives in my day job’s space.

Then there are the ones that are just fun. Smartless, Strikeforce 5 and others that are basically like being a fly on the wall at a good hang. Come to think of it, isn’t that what Amy Poehler calls her podcast? Ones like “And the Rest is History” are a little bit of both. For whatever reason I find podcasts much easier to digest than books on tape.

Got any favorite Podcasts to share?

3) Old. Inimitable essayist Roger Rosenblatt has written a book, I believe, called “Rules for Aging”. Seems he also has a sequel, “More Rules for Aging”. I stumbled across an excerpt from the latter in the paper this morning (the Sunday papers appear to be fertile ground for musings) entitled “How to Stay Old”. As opposed to stopping being old, which bodes for a rather dismal future.

There are 11 rules, all of which I found interesting, some more compelling than others. I think I’ll muse on one or two each week until I make it through the list.

The first rule is “Run when you hear ‘We must do this again.'” Nail, meet head. This is precisely the equivalent of “let’s get together sometime”, or “we should play some time” after crossing paths with someone you may have once played golf with. Whoever says any of these doesn’t mean it. Admit it, if you simply agree, you don’t mean it, either. Believing otherwise chips away at whatever reservoir of happiness you are harboring. It ain’t gonna happen.

If you do truly want to convene, over a glass of wine, on the first tee, or wherever, pull our your phone and toss out a couple of dates. For sure not a one of those present will have enough information to pull the trigger, but the older I get the easier it is to just say ‘yes’ to a date and then work it out later.

Don’t run from “Let’s do this again Friday after next.” Meet sincerity with sincerity and plan like you mean it.

4) Founder Mode. This is how the CEO of Airbnb Brian Chesky describes his management model even though his company is almost 20 years old and now has some 8,200 employees. How he defines Founder Mode and how he implements it is very interesting. My first inclination was that this was a form of micromanagement. A fancy term that simply meant an inability to delegate authority and responsibility to capable people further down the org chart. Even for famous control freaks like Steve Jobs a company eventually becomes too big to micromanage.

Which is what makes Chesky’s expanded definition interesting, and actually makes it applicable to our tiny 25 person shop. His thesis is that the CEO needs to be at least conversational with the operating details of the company. “As a leader, you’re in the details,” in the weeds as one of my co-founders used to say. There are times when a business needs to evolve, occasionally times when something revolutionary is occurring, and the only way to effectively lead is to be “into the details” enough so that a lack of understanding is not a reason to make a wrong, or less right move.

There has always seemed to me a concrete difference between the job of the CEO (30,000 and 3,000 foot views and “big picture” decision making) and that of the COO or GM (300 and 30 foot view directing implementation). I don’t think the CEO of a company with $12BB in sales and 8,200 employees can actually know any more than a fraction of the details, Founder Mode or not. Frankly, I’m pretty sure Chesky doesn’t, either.

But what DOES make sense to me is that in the face of a major decision or inflection point for a company, the lead dog really does need to know the details if for no other reason than doing so saves everyone downstream from the need to bring him or her up to speed. In my world that presently means a deeper, more granular understanding of how we manage information.

In order to ask the right questions and then come to the right conclusion, after more than 20 years I, too, must return to Founder Mode.

5) Second Chance. “The Midnight Library” is a novel by Matt Haig in which the main character visits the eponymous library. Considering suicide, in the library she finds books that tell how her life would have been different had she chosen alternate paths along the way. In the just released sequel “The Midnight Train” the 81 year old hero is grief-stricken by the missed opportunities over his lifetime. He boards the train and is transported to pivotal moments in his past, allowing him to reflect on his options with the wisdom of his years.

Both are a romanticized take on my beloved multiverse; both, in the author’s take, are ruminations on a second chance.

Now, to be fair, I’ve not read either of the books, but from what I have gathered from the interview and from other reviews I’ve read, both offer a kind of second chance. The author survived an attempted suicide in his 20’s; he views the 25 or so years he has lived since then as a second chance. I’m going with the assumption that the heroine in “Library” chooses life, and for the sake of this bit of musing I’m going to assume that the hero in “Train” gets a mulligan, getting off the mystical train as a younger version of himself bestowed with the perspective of the 81 year old who boarded the train.

Of the three, the heroine in the library, the older man at the train station, and the author, the only one who truly received a second chance was the man on the train. Riddled with regret he chooses to re-boot at some very specific intersection, convinced that he will do his life “the right way.” Again I have not yet read the books and so I don’t know if the story does, indeed, have him disembarking in the past. But neither the author nor the heroine in the library really got a second chance.

For what I hope are wonderful reasons they continued on from that terrifying decision point to live with and for those in their present.

This is all fiction, of course. A thought experiment, if you will, one that I have proposed and parsed here before. “The Midnight Train” directly addresses the concept of regret. The hero travels through his life and feels a deep regret about decisions he made, and why he made them, and concludes that he is willing to trade all that occurred after each one for a second chance. He is willing to forego everything he did and everyone he met the first time around. Does the heroine in the library get to choose to start again on one of the alternate paths she sees in the books? Again, I didn’t read the book yet, but I’d bet like George in “It’s a Wonderful Life” that she learns how much she means to those around her, and how much better her life is than she realizes.

And like the author, how glad she is that she is still living her first chance.

Perhaps there really is a multiverse, and in the infinite iterations of the universe there are versions of our lives that are in some way better. Or we live an infinite number of lives through some kind of reincarnation, either in the traditional sense or by traveling between different slices of the multiverse a la “Dark Matter”. Perhaps there is an afterlife, a joyful place we go after our earthly journey is concluded. I surely don’t know. What I do know is that regret, wishing that you’d zigged that one time instead of zagging, means that you are willing to change everything and everyone from that precise moment on. Everything and everyone.

Is a second chance truly worth that?

I’ll see you next week…

1) Monday. Yes. I am fully aware that today is Monday. Busy weekend (more in a moment). First road trip in the Electric Batmobile (more in a moment). I know that it isn’t Sunday.

Sue me.

2) Electrified. We took our first road trip in our first EV this weekend. 300 mile battery and a trip longer than 300 miles. A good test, really, since we weren’t in any particular hurry either out or back, and the more likely one to be anxious (that would be me) was accompanied by the one special thing that inoculates me against getting that way (that would be Beth).

In these weird times of gas prices north of $4.00 (as weird as the $1.37 during COVID) it’s kinda cool to drive by gas stations and not have to turn in and pay to fill the massive tank on my last car. Still, this is yet another example of the great Heinlein’s economics. Yes, I drive by the gas stations and don’t have to turn in, and my home gas bill has gone up a fraction of what my monthly pump charges were. But we have paid in time. Time sitting at a charging station that is 5X what it would have taken to pump the gas.

There ain’t no such thing as a free lunch. Still.

3) Joy. Beth and I traveled to Buffalo for one of the most moving and meaningful weddings we have ever witnessed. Lovely Daughter Megan officiated in the wedding of her best friend from college, Steve, to his partner of 11 years, Omar. We have known Steve for nearly 18 years and we met Omar very shortly after he and Steve became a couple. Over the years we have shared countless dinners at home and out on the town with Megan and Ryan, Steve and Omar. We were incredibly flattered and honored to be there to witness the ceremony.

And Megan just crushed it in the ceremony. I mean, she quoted RuPaul with the most perfect exhortation at the most perfect time in the proceedings!

It’s hard to describe how heartwarming the entire affair was. Mind you, not only was this a first for Beth and for me, but so, too, was the marriage of two men a first for both of the husbands’ families. But for whatever challenges family members may have had or may continue to have, the prevailing emotion was joy. Pure joy, overflowing from and between everyone present. Not a dry eye in the house when the boys embraced and kissed after being pronounce “Husband and Husband” or during the first dance. Nothing but joy, just the way it’s supposed to be at a wedding.

Congratulations to Steve and Omar!

4) It’s Memorial Day weekend. We are prompted to recall the sacrifices of our fallen soldiers, Marines, sailors, and airmen, to be ever thankful for the lives they led and lost in the service of their fellow citizens. Men like SSgt. Povilaitis, gone at age 47, and Corporal Ryan McGhee, age 21. The loss of both men was tragic, but the timing of their loss speaks to a different kind of tragedy, one that is a particularly painful part of Memorial Day and all it stands for.

Our War dead are often buried by their parents.

One of my sisters-in-law lost her Dad a few weeks ago, leaving our assemblage of remaining parents among all or our siblings and their spouses at two. All of the timing in this seems to be pretty much standard fare: a much older parent departing and leaving adult children who are now later-in-life orphans. Alas, the losses we remember on Memorial Day are upside down, with parents and sometimes grandparents the ones in mourning. The loss is all the more stunning for its lack of warning, the inability to even perceive its possibility let alone prepare for its arrival. 10 or so years ago I visited my Dad over Memorial Day; apart of me “pre-mourned” my Dad each time I saw him, there being no mystery but the all to soon to come “when”. But the men and women we remember on Memorial Day were ripped from families that saw only the future when they gazed upon their sons and daughters.

Here then lays our focus today, to attend to the survivors. Remember the fallen to be sure, but do so in the context of remembering what their loss meant to those left behind, and attend to the survivors.

I’ll see you next week, probably on Sunday…

A rather unlikely combination of players got me to thinking about “having it all”. You know, the perfect job, marriage, home, life. Like Streisand when she sings “Everything”, the life of “I don’t want much, I just want more”. Friday night and Saturday morning were spent in the company of 5 or 6 of what can only be described as “Alpha Females”; this morning’s reading included a piece on Michigan’s football coach, Jim Harbaugh.

What do Harbaugh and my young professional colleagues have in common? Well, they are in the midst of trying to have it all. While the ridiculously successful eye surgeons are more aware of the costs of their quest than Harbaugh, when pushed they are no less apologetic, no less committed to seeing it through to its logical conclusions.

On the surface it would seem that Harbaugh is poised to live a comically outlandish exmple of a successful coaching life. A winning record at a traditionally over-run college program (Stanford) followed by a Super Bowl game in the NFL (losing to his brother’s Ravens), and now head coach at his Alma mater. It’s all so very believable if you read the article quickly, but there it is in the fine print: “…his 14 year old daughter remains in California with her mother, Harbaugh’s first wife.”

Rut roh. A little bit of Heinlein creeping in here.

Much has been written about the plight of the “successful woman”. Indeed, I’ve written on women in medicine and the fallacy of “having it all” (and been quite enthusiastically eviscerated for having done so). My female colleagues sat with me around a table and over wine we talked at length about their lives. How busy they are in their day jobs. How the added time requirements of being acknowledged super-experts in parts of our shared field add to the challenges of being mothers and wives in nearly direct proportion to the gravitas it adds to their professional stature. We were all away from home on a Friday night for a meeting Saturday morning and the privilege of flying home that afternoon.

“N”, a colleague nearly 15 years younger who is also (I hope) becoming a friend, opined that she felt like she was “half-assing” everything except our shared endeavors as subject experts. That she only felt fully successful, comfortable, and in some way validated, in the company of her expert consultant peers. The moment, shared with knowing nods by each woman present, was brief.

Personally, I am late to this consulting game, roughly at the same “level” as colleagues in their mid- to late-30’s (I am 55). Barring some unlikely stroke of good fortune (e.g. I might actually be as smart as I think I am, and someone might actually agree), I will end my career rising no higher than the middle of the pack. Why is that? Well, let’s spend a moment with Heinlein, as Mrs. bingo and I did when I was ~34.

Just like my very impressive young colleagues, when I was in my early 30’s I was approached to offer insight into the needs and desires of my generation of physicians. Being a male physician I acknowledged the advantage of fewer societal expectations regarding responsibilities outside my career, and the massive leg up from a spouse who left her career behind to run the domestic side of the team. Good, bad, or indifferent, what we did then was explicitly calculate the cost of that success.

In “The Moon is a Harsh Mistress” Heinlein’s lunar society is run as a nearly pure libertarian experiment, fueled by a single philosophy: There ain’t no such thing as a free lunch. Your mother told you the same thing: there is a consequence to everything you do (or don’t do). What Beth and I did, what Harbaugh didn’t do and what my colleagues only later have done, is prospectively calculate the costs of success in one domain on the rest of a life’s domains. Gains in one almost always come at a cost of loss in others. Certain of the effect on our family (despite my gender-driven advantages), we opted to forgo the opportunity.

Who knows? I might have been a certifiable big deal in the world of my day job. For sure, Clan bingo left a lot of money on the table. Harbaugh chose differently and left a 14 year old daughter, and all that represents, in California. My young colleagues, the Alpha Females who are quite rightfully sitting at the table of experts despite their tender years? And you, my CrossFit friends met and not yet met? What will be gained, and at what cost? We shall see…we shall see.

In the end, Heinlein (and your mother) continues to be right, no matter what the currency in question might be: TANSTAAFL.

On one Sunday each year we celebrate the Hallmark Cards Mother’s Day. My work buddy Ken actually has it closer to the mark when he says that there are actually 363 Mother’s Days, the other two being Father’s Day and his birthday. While I love that sentiment we all know that a super-majority of mothers actually give a super-majority of their working hours to their kids, either directly or through the prism of worry while they (the mothers) are at work. There’s not much celebration going on there. For all of its gifts, motherhood the vocation is chockablock filled with hard work and worry.

In my day job a large percentage of my peers, especially my younger peers, are women who are also mothers. I have said (and written) that the pressures on these women is infinitely greater than that on those of us who are fathers because of the fundamentally different expectations of what constitutes the minimal expected parental involvement of a mother. Heavy stuff. It is especially daunting to attempt to climb a career ladder that is in addition to what must be done just to do a good job each day in the office. To be a physician leader on the national level is to commit to countless days and nights away form home on top of those that are standard fare for a “regular doctor”. Face it, not a single dad in the same situation is ever asked how he feels about the stress of being away from his kids.

Not a single mom goes through a day without having multiple people ask them just that.

Listen, there’s just no easy answer to this dilemma. One need only look at the tragic epiphany Sheryl Sandberg of Facebook had after losing her husband to an accident shortly after her book “Lean In” took every woman who ever worried or wondered about the cost of success to task was published. Ms. Sandberg was adamant that women had no choice but to compete on a level with men. Indeed, that it was their duty, for themselves and for all other women who would follow. She and her book were tone deaf to the realities of life outside the bubble in which every executive/professional was married to a wealthy entrepreneur and had nannies, housekeepers, and cooks. Single mothers, in particular, had trouble finding themselves in her philosophy. One leaned in without a thought to what one might be leaning OUT of.

Ms. Sandberg just published another book, “Plan B”, in which she deals with her grief at losing her husband. To her credit she also revisits her original thesis on what it means to be a mother as well as a woman who has the potential to reach the pinnacle of their respective careers. The pain of her realization of the time she could have spent with her husband and children but didn’t fairly drips off the page. It is truly heartbreaking. Although I was quite frankly repulsed by the arrogance of her first book I can find nothing but the deepest sympathy and sorrow that it took such a loss to open her eyes to what she now realized she’d missed.

You can only lean in to one thing by leaning out of others. You can’t really have it all, at least not all at once.

There is no right or wrong answer here my friends. Certainly no right or wrong answer that I would ever be so presumptuous to offer, for sure. Only that each of us, mother or father, makes a decision about what it is that we have to do in our own little families. Those of us outside someone else’s family should simply be as understanding as we can possibly be about another’s family, you know? I wish for Ms. Sandberg sake that she’d been a little more sympathetic before she was tragically forced to be empathetic to those folks who walk in different shoes. For my professional friends I simply wish for a few moments of thought so that they may make a conscious decision about the path they will take; a career will drive away with you if you don’t take the wheel.

Being a Mom is hard work. I’ve not seen anyone in my life work harder than my mother or my darling wife, both of whom stayed home with their children until the school years had passed. They, too, sacrificed, in their cases leaving careers behind, as did my sisters. By leaning out of the traditional workforce their choice was to lean in to their families. Men do that, too, you know, but that’s probably fodder for Father’s Day musings, right?

So for today let us all wish a Happy Mother’s Day to all of the Sheryl Sandberg out there, to all of my professional colleagues who are trying so hard to balance their professional potential with their desire to be the best moms they can be. Happy Mother’s Day to the moms who spend each hour of their day in the full-time pursuit of the being a mom, looking wistfully at careers that once held so much potential. Happy Mother’s Day to each and every one of you who wake up each day and go to sleep each night thinking and dreaming and hoping and worrying about your kids. That’s what moms do, no matter what else they also do, right?

And Happy Mother’s Day to Beth, mother to Danny, Megan, and Randy. We are the family that we are because you chose to be the mother you are.

Dear Mom,

Happy Mother’s Day! We’re all together on Mother’s Day again. Last year it was Tim’s wedding and we all gathered at Tracey and Steve’s home in South Carolina to celebrate. It was sure weird though, that first Mother’s Day without you. This year we are all at Randy and Joanne’s new place in Montana. We were up late last night, sitting around a fire, drinking wine and telling stories. It was really nice, being together all four of us and our husbands and wives. It had a very Cape Cod vibe. We’re all a little foggy this morning.

Not gonna lie…it’s still pretty weird waking up on Mother’s Day and not being able to call you. That was always the center of the day, calling you. Even though we talked most days of the week, especially after cell phones became a thing, there was always something just a bit more special about the Mother’s Day call. Remember when all we had was landlines, phones attached to a wall or cordless phones that were still tethered to a box wired to the wall? You and Dad let us call collect or reverse the charges when we were all too broke to be able to afford long-distance calls. We sure were a “talk on the phone” family.

I guess this letter will have to do now.

How’s Dad? What part of life, what stage have you two settled on in Heaven? Did Dad pick up donuts and pastries before he headed out to play golf? No matter how old I am when I think about Mother’s Day when we all still lived together it always started with donuts! Even in Southbridge, those chocolate-covered glazed donuts in a box sitting at your seat at the kitchen table. We probably won’t eat donuts today but we all have a vision of you treating yourself to an extra donut on Mother’s Day.

We’re all headed to brunch in a bit. More like Mother’s Day after we all grew up and had jobs and families and maybe all gathered at the Club for brunch in front of the big fireplace in the clubhouse. You’d be happy about how often we get to see each other. Darric and Nick are getting married so we have two big events on the calendar coming up. But we seem to be pretty good at finding ways to be together without an event, too, like this weekend in Montana.

Everybody’s good Mom. Everybody’s happy. For sure each one of us has stuff going on we wish we didn’t have. Who doesn’t, right? That parts a little bit harder now that we can’t just pick up a phone and chat with you and Dad about whatever that happens to be. You can be sure that we all remember a call or two when we could let you do a little later in life parenting. But really, we’re all pretty OK. You’d be proud of the people we’ve become.

It’ll be weird again not hearing your voice today. Probably always will I guess. We’re all thinking of you and of all the Mother’s Days we had together. Joanne and Randy are hosting brunch at the clubhouse. If we’re very lucky, maybe they’ll have chocolate covered donuts, just like we used to have. I’d sure like to hear your voice though.

Happy Mother’s Day, Mom. Tell Dad we all said hi.

Love,

Darrell, Randall, Tracey, and Kerstin

Greg Popovitch, former coach of the San Antonio Spurs, has a pretty good handle on what it takes to get a team to function as a unit rather than a collection of individuals. At the core of his strategy is the necessity for teammates to care about not only the team but also about one another. Before this can happen, though, they must first be interested in each other. They don’t need to hang out; they don’t even really have to like each other. Just be interested in who the other folks are and what makes them tick.

Interesting, huh?

Makes some sense, and seems to be a pretty actionable thing for any of us who work in or with a group. You know, like an small fitness club. Or a doctor’s office. Or whatever team you might be on at work. Think about your gym. Chances are you really know all kinds of stuff about the people you work out with. You probably know more about them than your neighbors, co-workers, or even some family members. Not only that but you’ve come to really care about whether they are meeting their goals not only in the gym but also outside. This wasn’t anything you set out to do, but once you were interested it just kinda happened as a matter of course.

Popovitch has found that when his players have some degree of caring about and for one another, they tend to be more successful. This is probably a universal truth if you think about it. Caring about your teammates means being concerned about not only your success but also the general success of your team. My bid is that this is just one more bit of the CrossFit experience that is transferable from the Box to everyday life, bringing that interest in your teammates out into the world and letting that interest morph into caring.

It’s easy; all it takes is a little interest.

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.