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Archive for December, 2012

Sunday musings…Others

Sunday musings…

1) Ninjabread Men. The world’s coolest cookie cutters!

2) Back-up QB. The most popular player on every losing team in football.

3) Role-player. Every team has a structure of sorts. In every sport success depends on players filling certain specific roles, the sum of which hopefully leads to success. It is only the most unusual team, either a “one-off” or that most special of teams that is the harbinger of a truly new paradigm, that doesn’t have all of the same pieces parts in the same place doing the same things. Whether tradition-bound or cutting edge, though, the roles assigned and accepted on a team are designed with only one thing in mind: winning.

We all play on a team of sorts, one we call The Family. Just like team sports there are roles assigned in The Family, and just like a team sport the role you play is likely to be one in which you are locked for your entire “career”. The difference, of course, is that the assignation of roles and the execution of those roles in The Family have absolutely no association with the pursuit of winning. Odd, huh? But essentially true.

Other goals certainly apply, other outcomes. Peace, or maybe detente. Quiet, or maybe just calm. Loud, boisterous, the (outward) picture of success. At various points in the “season” the roles assigned and played may actually produce something that DOES look like winning. That’s really cool.

The other difference between team and The Family is that the players on the team are ever changing, added and subtracted as necessary to continue winning, and any given player may actually take on a different role in this pursuit of victory. Not in The Family, though. Ooooooh no, not there. No, the role you’ve been assigned never, ever changes. Nor does it change for anyone else until someone is retired forever.

It took me years–many years– and an observant Mrs. bingo pointing this out, before this sunk in. There is no evolution, no paradigm shift, no revolutionary coach or system on the way when you go home this Christmas. Everything will be the same, a little Groundhog Day for the Holiday. The team will not have changed and every role player will play the same role.

Even you.

4) Other. The original “word” for this thought was to be “enemy”, but the more I thought about it the less that seemed to apply. You see, “enemy” is really a very simple concept, one that is just too black-and-white in this world of grey in which we live. An enemy is nothing more or less than someone who has openly declared intent to do you harm. Nothing too very ambiguous about that.

This is very different from a person who dislikes you, or someone you dislike. It’s fundamentally different from someone who is angry at you. These folks can simply be ignored; they can be consigned to the trash heap of indifference. I’ve been known to say that it’s perfectly OK to make an enemy as long as you’ve done it on purpose so that you can assess the ramifications beforehand. Re-thinking this in light of a more accurate definition of “enemy” probably changes my tactical advise to “it’s OK to make someone angry at you.”

This is important today as we traverse our lives with our “situational awareness goggles” on high, important when we identify someone who is better described as “other” as “enemy” or “possible enemy”. By any measure we actually live in a world which is incredibly safe. We are not surrounded by legions of enemies but rather by “others”, people who stand apart for one reason or another as different. Maybe even odd.

If we view our world as one which is inhabited by only friends or enemies we are at risk to categorize these “standouts” as dangerous until proven otherwise, all data to the contrary. We are at risk to extrapolate the actions of one “other” to all, even those who share nothing with those villains besides their “otherness”. Is this really necessary?

Frankly, my worldview as a young man was very narrow, my willingness to even let the “others” be something less than zero. No, “others” were to be feared or ridiculed; they were certainly not meant to be ignored, let alone accepted. Now? Most of the “others” are just varying degrees of different, nothing more. Pick a number…99point whatever % are just that and will never be anything more diabolical or dangerous than a friend might be. They will never be an enemy, no matter how much their “otherness” sets us apart.

For most of us the world is filled with friends and others. We just don’t have that many enemies known or yet to be discovered. I do not advocate replacing our “situational awareness goggles” with “pollyanna specs”, but we really don’t need to have the setting on “high alert”. The risk of the false positive, the risk of identifying an “other” as an enemy is very, very high because there really are very, very few real enemies. Very few people who mean you, or anyone, true harm.

Don’t let the cacophony resulting from the rare sighting of an enemy, of evil, blind you to the fact that those who will not be your friends are almost always just “others.”

I’ll see you next week…

Posted by bingo at December 23, 2012 8:26 AM


Lessons In Doctoring Learned On The Golf Course

I’ve been thinking a lot about health care recently. Real health care, not Health Care as in “Health Care Crisis” or “Health Care Reform”, but the kind of health care that is provided by doctors and nurses and all kinds of other health care providers. You know, like making sick people better, and keeping healthy people healthy. The kind of health care that old guys like me (I’m 52, in case you were wondering) got from pediatricians like Dr. Roy in Southbridge, MA in the 60′s, or like my sons get from Dr. Gerace in Westlake, OH today.

I did a lot of thinking about this some 7 or so years ago, too, when I developed the concepts that eventually resulted in Skyvision Centers. My mini-epiphany at that time is that medicine is the ultimate consumer service business. At its core medicine is about one group of people providing a service to another group of people who either want or need that service. It’s the most intimate type of service, too. One to one. Face to face. You and me.

There is a remarkable lack of difference between doctors (and hospitals, for that matter) when you look at the outcomes that arise from that service– how many people get better after receiving medical care for their illnesses. The difference between the top 1 or 2% of doctors and the 50th percentile in terms of real medical outcomes is remarkably small, and much smaller today than it was in the days of my Dr. Roy.

Sure, there are differences in how people arrive at getting better. Some very instructive studies from Dartmouth have shown dramatic regional differences in the U.S. in how much money is spent on treating heart attacks, for instance. By and large, though, the same number of people get the same amount of better no matter where they are treated or from whom they received that treatment, and the quality of those treatments is several orders of magnitude greater and better than it was in my youth.

So what was it about Dr. Roy that people in my generation seem to have so much trouble finding in medical care today? If the treatment of diseases is so much better now why do so many people complain about medical care today? Why is it that Dr. Gerace has people lined up waiting to see him while other doctors don’t? Why do people rave about their experience at Skyvision Centers and complain so bitterly when they need to have a consultation at some of the most famous medical institutions in Cleveland?

I think it’s because Dr. Roy, Dr. Gerace, and I were all, once upon a time, caddies.

Seriously. We spent the earliest part of our working lives on the lowest rung of the service ladder, providing one-on-one service for a single customer. Because of that I think each of us realized that what really sets doctors (and hospitals) apart is what a patient experiences when they visit. The most successful doctors and the most successful medical practices are those who have realized that the central character in the play is the patient. The most successful caddies never forget that the most important person on the course is the golfer. The job of the caddy is to help the golfer perform a well as possible (maximize the health of her game) while at the same time making sure that she has a wonderful experience on the golf course.

Ben Stein wrote a column in the NY Times about his first real job; he was a shoe salesman. Imagine, at 17 years of age, selling shoes. Days filled with all manner of customers and handling the foot of each and every one of them. Customer service and sales is “learning the product you are selling, learning it so well that you can describe it while doing a pirouette of smiles for the customer and talking about the latest football scores” no matter who that customer might be. Tinker, tailor, soldier or spy, junior partner or janitor. Be they humble or haughty, gracious or grating. Totally focused on that one customer in front of you in order to provide them that service. The same can be said for any front line service job. Waitress in a diner, car mechanic, you name it.

My first summer job was caddying, and I caddied for parts of each summer through medical school. As I think about it now after reading Stein’s article it’s amazing how many parallels there are between my first job as a caddy and my career as an eye surgeon. I toted the bags for one or two golfers at a time; I usually have a patient, patient and spouse, or parent and child in the office. I was a better golfer than almost all of the men and women for whom I caddied; I know more about the eye than every patient who visits, google notwithstanding. In both circumstances my success was/is determined by my customer’s (golfer/patient) outcome, their “score”, as well as their view of the experience. Even a career-best round doesn’t feel quite as enjoyable if it took place over 6 hours in the company of a surly caddy!

I’ve told the story of how being a caddy turned into Skyvision Centers; it’s a neat story and I love telling it. For the moment, though, I have a little experiment for anyone who might be listening, and a modest suggestion for the powers that be in medical education (who most assuredly AREN’T listening). The next time you visit a doctor ask him or her what their first couple of jobs were. See if you can predict which of your doctors or dentists (or nurses) had what kind of jobs before their medical career based on the kind of experience you’ve had in their offices or institutions.

Let’s add a little time to the education of the folks who take care of our medical problems, especially our doctors. How about 6 months selling shoes at Nordstrom’s. Or a year of Sunday mornings slinging hash at a local diner. Better yet, let’s get all of those pasty washed-out interns out on the golf course with a bag on their shoulder and a yardage book on their hip, golf hat slightly askew and Oakleys on tight. Let ‘em learn how to take care of a customer without the huge advantage of all that medical knowledge. We’ll take the best of them and turn them loose in offices all across the land. Those who can’t hack it, the ones who can memorize the history of Florsheim but can’t bring themselves to touch a foot, who are scratch golfers but can’t bring themselves to congratulate the hacker who sinks a 30 foot double-breaker, those we’ll hide in the lab, or put them in huge, anonymous medical centers, one more anonymous member of an anonymous team hiding under the brand umbrella of some “World Class Clinic”  where one-on-one customer service never really happens.Because the ultimate consumer service business is medicine.

Just ask a caddy.


There Is No Word…

I’m the words guy. There’s no word here. You’ve probably heard or seen this before. In every language, as far as I know, there is a word that describes the state of having lost a family member. Widow or widower, orphan.

There is no word in any language that I know that so names a parent who has lost a child. Think about that. This is such an unnatural state, so upside down, that the a signature trait that defines us as a species (complex language) is silent. All of the various languages that reflect countless cultures both current and long gone, and not a single word that immediately conjures an image as accurately as “orphan” for those who have buried their offspring.

Not a single word.

We are now in the middle of the Christmas holiday season in the Christian world. The suburban version includes various and sundry versions of the “Christmas Party”. Beth and I attended two last night. I had, oh, 50 or so distinct conversations. 50 little “Groundhog Day” chats catching everyone up on my own children. For my part I asked only one question: “how are your kids?” I imagine something more similar than different everywhere in the world when parents gather.

“How are the kids?”

My son Randy (Lil’bingo) and I attended a really moving CrossFit event yesterday, one in which a really significant sum was raised to aid the family of a handicapped child (kudos to CrossFit Cleveland). We met a couple of brand new Moms with first borns velcro’d or strapped or otherwise attached in parenthood 1.0. I’m one of the “wise old men” of the local CF scene (hey, when did THAT happen?), and I shared with these young Moms my view that the arrival of your first child is the single biggest life-changing moment one can experience. I always say that, and the young Moms and Dads always shake weary heads and sleepy eyes in agreement, and I silently pray as I speak that the words I’ve spoken will ring ever true, for I know in my heart that I am lying to these children holding their children.

The single biggest life-changing moment one can experience is to learn that you have lost your child.

You know someone who has heard this news; we all do. They are never the same. They will never be the same. I meet people in their 80’s who lose a child in their 60’s and honestly, it looks the same. It’s unnatural. It’s not the way it’s supposed to happen, no matter how it happens. It’s so upside down that we have no word for the survivors.

I know that I am lying to these young parents because I once stood on the edge of this abyss. Stood so close that if I let myself lean just a little bit I could look over the edge, see the blackness, the emptiness, the cold. Nothing, and I really do mean nothing, has affected me ever in my life as profoundly as that one quick look, that one peek that I just couldn’t keep myself from taking at what life would be like if I’d lost my child. I can’t shake it. It’s been years and I can’t shake it. It informs everything about my life, how I live my life, how I find the good in most everything, the fact that I was not plunged into the abyss. I did not lose my child. My child lived.

There is really no lesson here, Dear Friends. No teachable moment today, just a most sincere hope and prayer for each and every parent among you that you will never stand at the edge of that abyss, let alone be plunged into its depths. Just the most sincere hope that there will continue to be a word that describes you throughout your life, as my wife Beth and I have thankfully continued to be blessed. Indeed, there is a word in every language in the history of our species to describe those so blessed, a name for each of us.

Mom or Dad.


The Irish Sports Page

“…Little Boy Blue and the Man In The Moon. When you coming home son? I don’t know when…”

None of us gets out of this life alive, eh? Here on the West Side of Cleveland the obituaries are known as the “Irish Sports Page”, read by all on a daily basis. My older patients like to joke that they read it each morning just to make sure their name isn’t on it. Old joke, but like all good jokes it cuts just close enough to the truth.

Typically a couple of pages, the “Irish Sports Page” is often 3 or 4 pages long for a week or two in early January. It’s funny how that happens, how so many folks simply will themselves another month or two, another chance to gather round the Yule Log, usher in another New Year. Those of us who are younger either wish for that one more Holiday together or are caught short in surprise when the post-Holiday departure occurs. Or both.

We all live on borrowed time, borrowed for yourselves and borrowed on behalf of our loved ones. Some teeter on the brink of ultimate disaster, each hour alive somehow cheating the Grim Reaper, every day a bit of a pleasant surprise. If this goes on long enough it’s possible to forget just how tenuous is the lifethread that secures that particular life. We can forget how thin is that one, fragile line if it holds firmly enough, long enough.

So it is that I find myself this year as a thread already thin begins to fray. How fortunate we have been, my siblings and I, on borrowed time for decades. How blessed to have our entire family, still, so long after the first calamity that we had begun to pretend that it would just be this way forever.

I have seen this play before. Indeed, I see it every January at work, every January in the Irish Sports Page. There’s an almost out-of-body sense, a “looking in someone’s window” feeling like Ebenezer Scrooge accompanied by the Ghost of Christmas Future. There’s a dull ache in my soul when I think of this coming January and the Irish Sports Page.

Time waits for no one my Brothers and Sisters. We plot and we plan and we offer “we really should get together”, and the seasons…well…they just keep coming and going. I am as guilty as you, as guilty as anyone. We put off our gatherings, “we’ll get together at Christmas”, and eventually Christmas stops coming. Prepare for a long life, but at some point, for someone who is important to you, life is short.

“…we’ll get together then, Dad. We’re gonna have a good time, then.”



Sunday musings 12/2/12

Sunday musings…

1) DH. “Designated Husband.” I accompanied Mrs. bingo to Athleta last night for a retail bl00dbath. As I sat in the “husband chair” in the fitting room I offered “assistance” to all of the women shopping without male accompaniment.

Imagine the value of having someone who will honestly answer “do these leggings make my bum look fat?” without fear of the consequences.

2) Microcategorization. The new advertising field of ever more exacting and minutely defining a marketing target. The more that is known about you (age, gender, address, income, subscriptions, job, size, etc) the less varied are the ads directed to you.

My question, for the marketing but also for anyone in their perusal of available new information, how can you grow, how can you become whatever it is that constitutes the next best version of you if all you ever see is stuff that represents who and what you are now?

3) Dreamcatcher. I have been having two sets of recurring dreams, or at least dreams with two recurring themes. Do you get these? Is the dream always the same (not me) or just the theme (definitely me)? Do you try to figure out why they keep happening, and why those dreams or those themes?

One of mine is probably pretty easy, the theme of impending loss. My kids are getting older, becoming young adults, and beginning to start their post-college lives. Standard fare, and easy to see how I would find this both wonderful and sad because I am blessed to have very nice friendships growing with my kids. I am also soon to confront the loss of a parent, and this is quite sad, as inevitable as it might be.

Nope, it’s the other dream theme that’s bugging me. This one finds we with unfinished business, or a task that I just cannot start or complete. It often takes place in a school setting, a test I haven’t studied for, or did not know was scheduled, a project due in hours that will take weeks to complete. Again and again, night after night.

Something’s up in that ol’ subconscious, eh? Does this happen to you? My dreamcatcher isn’t up to the task of late.

4) Peer Pressure. Why is it that some folks, particularly younger people, succumb to peer pressure while others somehow find the will to resist? Why, for example, does one kid accept the offered illegal substance while another says ‘no thanks’? What is it that compels the group to pile on, but one outlier says ‘enough’?

Millions of words have been spilled on this topic of course, and I’m certainly not qualified to add to the psych canon, but I’ve noticed a couple of things in CrossFit Kids groups that remind me of how a certain guy I knew walked away from an entire peer group, twice, rather than cave to pressure.

It’s easy and simple, hard and complex all at once. It has to do with success and succeeding, and getting ‘caught’ in the act of that success. Kids who regularly and routinely succeed at difficult tasks of any kind start to have a stronger belief in themselves that transfers to other stuff. Kids who are held to standards that they must self-police tend to develop a stronger sense that they can make an ethical or moral call without the need for the external confirmation of the group. You count every rep; you move through a full ROM. You make the call, or if judged you accept the call of the judge. CF Kids does not hold the sole franchise for this, of course. The “First Tee” golf program, school chess programs, lots of other places exist where this type of belief in self gained through achievement and accountability exist.

It’s never too late to start this process, of course, because the dangers of peer pressure, groupthink, and the psychology of the mob do not magically disappear when we reach the age of majority. Where do you fall on this continuum? Can you think for yourself in the face of peer pressure? Do you have that inner sense, that mental muscle memory that lets you be confident when you are sure that the group is wrong?

When the time comes are you strong enough to stand alone?

I’ll see you next week…

Posted by bingo at December 2, 2012 8:39 AM


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