Random Thoughts from a Restless Mind

Steven Pinker’s breakthrough, at least from a commercial standpoint, was a book about human nature entitled “Our Better Angels”. It’s a few years old and I confess that I’ve skipped over it and instead have started his newer book, “Enlightenment Now” at the suggestion of Bill Gates and his annual reading list. (Gates calls it his favorite book of all time). As an aside I’m also reading “Fewer, Richer, Greener” by Siegel, a similar data driven thesis about our world being better than popular, perhaps prevailing sentiment.

Anyway, in “Our Better Angels” Pinker describes a world in which there has been a dramatic and meaningful decrease in violence (wars, uprisings, genocides, etc.) despite sentiment to the contrary. He posits that exceptions to this trend get disproportionate coverage in the press and on social media, creating a false reality that the opposite (that the world is more violent) is true. Further, he points out that at the most personal level the entirely human traits of reason and empathy have made the world kinder and safer at both the 3 and 30 foot level.

For quite some time now I have observed this in my daily travels, both at work as a physician and around the various towns of my “civilian” life. We cannot discount the effect of “othering”, the process by which the bitter and the bigoted seek to make their targets something less than fellow humans in order to justify their prejudice. But this, too, is likely far less prevalent in reality than it seems it is given the reporting we see (although “othering” and prejudice in all of their forms are loathsome and have no place in our societies). No, what I see as I move through a life that brings me into contact with people of all walks of life is a people who bear no ill toward their fellow travelers. Indeed, a people who, given the chance, choose to do acts of kindness both large and small.

What will we see over the next weeks and months in the time of Covid-19? Well, we will surely see silly, even stupid stuff judging by my Twitter feed this morning (people in bars, cattle-car crowding in airport Customs lines). There will be folks who will say stuff that will make you roll your eyeballs right out of their sockets (too many examples to pick one). Some will seek to profit from the pandemic (how about that knucklehead who bought 17,000 bottles of disinfectant and jacked up the price? Got his comeuppance he did. Maybe we should let Amazon/EBay handle the insulin market). Even more distasteful will be those who choose to use the pending upheaval for political gain (Really? Somehow we’re gonna use this global emergency to win an election?). Even our Best Angels cannot avoid the tiny number of folks who see only themselves, even when doing so is so much more damaging than it might have been last week, or last month, or last year.

But these will not be the majority of who and what we see now, regardless of what we see and read and hear from whatever sources we use to gather information about our worlds. No, the majority of who and what we will see is people who do the right thing. People who choose to be kind and understanding, who offer gestures of both in ways big and small that may be visible but will as often go unobserved. For sure there will be more of these acts of kindness now in a time when they are needed; our Better Angels will respond now because now is when we need them. We will find that things like watching a child or dropping off some groceries have been going on under the radar for, like, ever; the Better Angel within all of us will simply be more aware of the chance to help, to provide. It could be a tiny as opening the minivan door for the Dad carrying groceries and a toddler in the grocery store parking lot, as subtle as not buying toilet paper because you are set for a couple of weeks at home, or as grand as learning that you have recovered from the virus, you are at least temporarily immune, and you take every extra shift they’ll give you at work, wherever work may be.

9/11 showed Americans that we can rally around a common cause. Rally around each other. Looking back, with the exception of the greater NYC area, rallying as a nation did not require a terrific degree of sacrifice. Certainly not like those borne by our nation during our great wars or times like the Great Depression. Now, when it’s hard, when sacrifice will be asked of all, now is the time to seek the Better Angel within each of us. I’m getting to be an old guy now, and maybe I suffer from a kind of sentimentality brought on by my stage of life (rather than the cynicism of so many of my Dad’s buddies at a similar stage), but the more I look the more Angels I see around me. The more closely I look the more of what I see is kindness. Understanding. Caring. Now is the time to seek the Better Angel within.

I see you. I know you. I see the Angel within you. I know that Our Better Angels will prevail. Our Better Angels will triumph.

I’ll see you next week…

Every child is special. Right? I mean, that’s what we’ve been told our entire lives. Every child is not only special but equally special. It makes sense, really. How can you possibly label one child special and another one somehow less so, or not.Regardless of the details, the individual circumstances in which you might find any given child, each child really ought to be accorded the label “special” at the outset, and then each child should be cherished and loved as such.

I really do think that’s a pretty decent baseline position for every other human to adopt when thinking about any child. Especially parents. Each child is special. A gift. Each one deserves to be cherished and loved as such. In reality that’s often pretty much all that’s necessary once you’ve helped your child attain the status of “housebroken” and have imparted in them the basic ingredients to survival in society. You know, the Golden Rule and some version of the Ten Commandments is probably the barest minimum set of social survival skills you’d be remiss if you didn’t pass them on.

In reality once you’ve done this, as long as you continue to provide food, clothing, shelter, and the “cherish and love” thing, kids out in the wild usually turn out pretty darned well without much more in the way of prepping. At least in the developed West with public schools to pick up the pace around age 5. Sure, encouragement to aim for success, a shoulder for the occasional cry, and the odd re-direction if they drift off course might be helpful. But kids have been managing the growing up jungle gym in the face of all manner of benign neglect for well over a century, the overwhelming majority of them turning out really well.

Is that it? Am I just gonna say kick ’em outside if the sun’s out, unplug their screens occasionally, and don’t let them dine on nothing but Cheetos and Cheez Whiz? Of course not. What all of this is leading up to is that, while every child deserves to be loved and cherished, and almost every child who is will turn out pretty close to as well as they possibly can turn out, there really does exist something that can only be described as a “very special child”. Let’s abbreviate that VSC so I don’t have to type it all the way through. An VSC deserves just as much in the cherish and love category as every other child, but the stark and harsh reality is that more is required from pretty much everyone for that child to be OK, let alone blossom.

You don’t really need me to tell you what might constitute a VSC. In your mind’s eye right now you have at least a couple of kids in view. There are the obvious ones, the kids who are born with genetic defects or who have some kind of medical challenge that they just can’t handle without help. Some kids have hidden problems that you can’t see from the outside. Think Diabetes. Nothing you can see on the outside tips you off to this challenge. Or abuse. You can’t see the internal scars that affect the young victim of abuse, and yet they are there just like any other medical problem.

On the other side of the spectrum there are children who are gifted. Exceptional in a way that is simply not normal. Super smart kids. Not “gonna be valedictorian” smart but “ready for Yale at 13” smart. A musical prodigy whose talent is so blaring and obvious that they debut at Carnegie Hall or the Grand Ol’ Opry before puberty. Michaela Schiffrin’s coach in Vermont told her parents that she was destined for greatness at 10. Kareem Abdul-Jabbar (then Lew Alcinder) was recruited as an 8th grader. Kids like this are not just special, they are a VSC.

So what? Love ’em, cherish ’em, and just throw them outside, right? Nope. Whether or not you knowingly signed up for the VSC cruise, in almost all cases you willingly signed up for the kid cruise in general. Once on board that ship there is always a chance that you will become the parent, grandparent, or guardian of a VSC. Good, bad, or indifferent, the arrival of a VSC brings with it a level of commitment that is simply greater than that of parents who have a regular, ol’ special kid. It may be good and fun or really terrible, but it’s always much, much harder.

Always harder.

Again, what’s the point? Two, I think. First, as the parent (or other responsible person) of a VSC there is unavoidable sacrifice. Maybe only one parent can work. A smaller house. Less sleep. Someone has to take their VSC to the doctor or shuffle the chess prodigy to that tournament in Chicago. There’s blocking and tackling in parenting of every child. Paying the bills, making the time. With a VSC there is much, much more of everything. No matter which side of the spectrum they fall on, raising a VSC means sacrifice that most of the rest of the world just never needs to make.

The second thing is for the rest of us. Those of us doing our best to raise special kids. We should realize that no matter how hard it is for us to feel like we are doing the right thing by our kids, to make the sacrifices that we all make so that our kids have their best chance to have a happy life, there are parents out there who have it much harder than we do. They could sure use our help and support, but really all they need is for us to be kind in the face of the challenges they face. Not only the Mom who has to stop everything in the grocery store to calm her child who has autism, but yes, even the frazzled Dad trying to figure out how to manage the up-do that came undone just before the floor exercise at the Junior Olympics. Our role in the lives of those raising a VSC is simply to offer kindness.

Every child is special. Some, for reasons that may be good or not so good, are more than that. There really is such a thing as a Very Special Child. If in some way he or she is yours you have an outsized burden that you cannot walk away from, that you must shoulder every day. The rest of us owe you and your child kindness in both thought and deed.

Sunday musings…

1) Metrollectual. A city dwelling intellectual. Implies a coastal home address (i.e. not Cleveland). Likely the owner of at least 3 social media accounts. Highly in tune with the zeitgeist but woefully out of touch with the nitty gritty of everyday reality.

Should be a word.

2) Courtesy. “Punctuality is the courtesy of kings.” Louis XVIII. Paul Newman to Fay Vincent who was surprised to see Newman precisely at the time of their appointment

I like that. Reading interviews of celebrities of all sorts you always take note when the author tells you that the celeb showed up on time and prepared. Harrison Ford brought muffins to a Parade Magazine interview.

Makes me vaguely uncomfortable to think of how low the bar is for kings.

3) Miracle. 40 years ago this week. Do you remember where you were when a bunch of college kids took down the best professional hockey team in the world? I can. There was a bunch of us gathered in the little TV room at my Dorm, Tyler House at Williams College. It was pandemonium as you can imagine. I was 20, after all; those guys could have been my classmates.

Last night I watched “Miracle” for the umpteenth time, catching my breath at all of the same places and leaking tears at the end. How hard it must have been for Herb Brooks to cut kid number 21 on the roster. Don’t I remember that Brooks was the last kid cut from the 1960 team that also won the Gold Medal? Such powerful moments.

This particular showing of “Miracle” had a postscript in which Bob Costas interviewed Al Michaels, he of the famous “Do you believe in miracles? YES!” call in that game. Of all the games Michaels has called in his storied career he is clear that the U.S./USSR hockey game was the top memory. I actually know a guy who was in the booth, Pharoo, an acquaintance from Williams who was Michaels spotter for the game. Can you imagine? Not only being there, at the rink, but in the booth with Al Michaels and Ken Dryden?

The very best that sports has to offer. A miracle, indeed.

4) Sportsmanship. “It doesn’t matter whether you win or lose, it’s how you play the game.” Anonymous

How many times have you heard this phrase? Whether or not you are/were an athlete. When did you first hear it? Probably like me, super early in your life, maybe even before you picked up a ball or a racket or a whatever. Might have been playing “Go Fish” with my Mom for me, but for sure I first heard it as a 10 year old playing Biddy Basketball at our local YMCA. Respect the game. Play the right way. There are probably as many versions of that old saw as there are old coaches. I vividly remember being dressed down after a Biddy League game that we won because half the kids didn’t touch the ball enough. The right way.

A respect for the rules of any game is instilled in the young in almost every family and on almost every youth team. “Winners never cheat and cheaters never win.” Right? You wouldn’t use loaded dice to beat your grandmother at Monopoly, would you? Of course not. You learn about sportsmanship pretty early, too. About respecting your opponent. Being both a good winner and a good loser. Respect is bestowed upon both beginning at a very young age.

But as soon as you start to play to win, to really try to win, selecting and giving more playing time to the players in your sport who increase the likelihood of victory, you introduce the concept of gamesmanship, and with it the essential tension that exists between sportsmanship and gamesmanship. T-Ball and Dad Pitch baseball gives way to Little League where the score is kept and the standings are published. “Good swing!” from both sides of the field gives way to “Hey Batterbatter. Heeeey Batter. SWING!” Winning matters, and you do whatever you can do to the letter of the rules to win. The only thing wrong with taking advantage of a loophole in the rules is if someone figured it out before you did. This is partly why so many folks dislike Bill Belichek and the Patriots.

People despise Bill Belichek and the Patriots because they not only push the limits of the rules of the game but they also crossed the line. They cheated. They clearly worked under the philosophy that it’s only cheating if you get caught. This, of course, is the reason that the Houston Astros as an organization and the players on the Astros roster during the 2017 season face such universal reproach. At some point they crossed the line between gamesmanship and lawlessness and broke the rules. That they are seemingly without adequate remorse, that they mostly regret that they were caught, makes them that much less in the way of sportsmanship in the eyes of most, including their professional peers.

Did Vince Lombardi really mean it when he said “[w]inning isn’t everything, it’s the only thing”? Did he mean that winning by any means, even cheating? Heck if I know. Those Astros are learning that there is a price to pay for cheating. Did you really win that high school tennis match if you cheated on line calls whenever you needed a point? Do you deserve your title if you and your partner sent each other secret signals about what you had in your hand in a Bridge tournament? Whether or not you were caught, at the end of a day or a life you know you cheated.

As a kid I played sports at a mid-level. Medium size schools in high school and Division 3 in college. We wanted to win, for sure. It doesn’t matter whether you have 200 students or 2000, you still want to win. I never remember cheating at anything. I’m not sure I ever wanted to win anything more than a member-guest golf tournament I played in with my brother after the club pro insinuated that we would fudge our handicaps. We played angry, fire in every step over 3 days, but we played at our legit handicaps as the rules demand. Not only did we not break a single rule on the course we also putted out on each hole, sinking even 6″ putts so that there was no possible chance that we would be accused of bending, let alone breaking a rule.

Winning is important, but how you win in games is still more important.

The lesson to be learned from the MLB Astros fiasco (and the never-ending Patriots imbroglio) is that the rules matter. Gamesmanship is OK but only to a point. How you play still matters. Sportsmanship still matters. It is not necessary to like your opponent, not even a little bit. But one should respect an opponent who also plays within the rules and respects both the game and you. These are the things that my Dad, my Grandfather, and all of my best coaches taught from the beginning. What I told my kids when they began competing. These are the things we need to hear from MLB.

This is what I will tell my grandchildren if I am blessed to have the chance.

I’ll see you next week…

It’s astonishing how negative young people’s worldview has become. Let’s say under 35 or so is young. If you chat with them about the world we live in today it’s the rare young one who can bring up more than one or two things positive to say. Get them talking about the future (not a terribly difficult task) and the only variability you are likely to encounter is how bad the apocalypse will be and perhaps when it will arrive. Doom and gloom abound. I really can’t remember any talk about the future with someone under 35, even those who are generally happy, in which they didn’t tumble into hopelessness and despair.

Breaking news: the apocalypse isn’t nigh.

How do I know this? Well, of course I have the distinct advantage of having lived 60 years. Some of them without too very much in the way of income, most of them in relative comfort, but none of them in anything that could be construed as hopeless or a state of despair. Even after my “genius moment” business plan succeeded only in reducing my salary by 80% and wiping out my retirement account in my 40’s, the worst case scenario never included an apocalyptic demise. Yet what I hear from young people at an age at which Beth and I spent our last nickel each pay period is just that: despair and hopelessness.

In our age of blaring headlines always in our face it is impossible to avoid hearing the braying of all types of doomsayers. What we hear is how much better it was before, well, before pretty much everything. And yet everything that has happened in the world basically adds up to a powerful and direct repudiation of all things apocalypse. Deep down I’ve known this, but I’ve been at a loss to describe why I know this in a way that would convince, or would comfort, the young who are so distressed by what they think they see in our world.

In my search for a narrative that would convincingly combat the braying of the apocalyptic prognosticators I recently came across an interview with a gentleman by the name of Laurence Siegel. Mr. Siegel has written a book titled “Fewer, Richer, Greener” in which he proclaims “We are on the verge of the greatest democratization of wealth and well-being that the world has ever known.” I’ll share some highlights from the WSJ interview (with Jason Zweig), but I’m sure that I will have much to share after I read the book itself.

Let’s start with capitalism, at the moment the hoariest villain around. Capitalism has been roundly criticized for creating a historically huge degree of income and wealth inequality. In truth inequality of at least this degree has been with us since humans came together in groups larger than families. While it is certainly the case that the richest among us are far, far richer than the poor and middle class it is also inarguable that it is capitalism that has raised up the majority of humanity from crushing poverty. In the past year alone more than half of the world’s population has now become middle-class or wealthier. The defining level of income for extreme poverty continues to rise, and despite that the percentage of the world’s population that can be so described has plummeted. Wealth inequality is real; it’s effect on the daily existence of typical Americans is infinitesimal.

And yet like climate change it is the sheer magnitude of the issue coupled with the absolute impossibility that any one individual can have any significant effect on changing either that seems to be causing the despair I witness. “Young people can’t afford to buy a home” seems to be all the more cause for despair if you truly believe that the world will be near the end before you can scrape together a down payment. But just like in the 50’s when everyone was building fall-out shelters and every grade school kid was taught what to do when the air raid siren went off, life doesn’t come to an end, it just continues to get inexorably better.

Are there huge things out there that really could derail civilization as we know it? Sure. But every one of them is as likely to do so as every one that has come before.What about the environment?  In every country that has come up from poverty the process has, indeed, resulted in a dirtier environment. We’ve certainly seen that in Western Europe and the U.S., and for sure you are seeing it in places like India and China. Siegel: “…as they continue to become wealthier, people start to be willing and able to sacrifice some of those gains to get a cleaner environment. As the world gets richer it will continue to get greener. Switzerland is probably the most environmentally clean country in the world, and it is one of the richest.” As time goes on newly richer countries will behave more like Switzerland.

What matters when in comes to income and wealth is not so much what someone else has, but what you have and what it allows you to do. Mike Bloomberg’s wealth is unimaginable to me; his wealth came from the creation of a business which has created several other layers of wealth, and below those layers still more of middle-class comfort and security. So, too, the wealth of people like Bill Gates. His company is arguably responsible for much of the ease in your life brought about by the modern use of the microprocessor. I don’t choose to communicate with my refrigerator with my cell phone, but thanks in part to stuff that started with Microsoft I could. Bill Gates income and wealth is meaningless to those who type into Word documents like I’m doing right now; wealth inequality between Gates and anyone else is meaningless. Because of the source of his wealth our lives are immeasurably better because we can.

Climate change, wealth inequality, and the other macro issues that cannot be fixed on an individual level have always been with us. It is the fact that one literally can do nothing to change them that seems to be the cause of the sense of hopelessness and despair we hear so much of. But these macro issues have yet to come anywhere near reversing centuries of human progress. Again, Siegel: “Apocalyptic thinking is a neural mistake based on our need to survive in a cruelly hostile environment that doesn’t exist anymore. Apocalyptic thinking has always been wrong, and it will continue to be wrong.”

The world is a beautiful place that actually may be getting more beautiful by the year. It is safe, and getting safer for almost everyone every year. Fewer and fewer people live in poverty, as more and more people achieve a middle-class life or better each year. While we as a species must always strive to continue doing those things that have brought us this far, our lives would be far, far happier and more enjoyable if we directed our attention toward those things close to us that we control. Do some recycling. Buy an electric car. Vote.

To my young (and not so young) friends out there please don’t despair. We’re gonna be ok. The world is still gonna be there when you finally scrape up that down payment, and you’re gonna find a house you’ll like. There’ll be air to breath and water to drink, and we’re neither going to burn up nor freeze. You may not drive the same car as Jamie Dimon but, you know, the way things are going none of us are going to have to drive ourselves after Elon Musk makes all of our cars autonomous so they drive themselves. You’re still going to arrive on time.

Life is good. Despite all headlines to the contrary the world isn’t coming to an end. It just keeps on getting better.

Sunday musings…

1) Pickle. As legend has it the name of a dog after which the relatively new game of Pickleball is named. About 1 in 4 courts in Florida are now lined and set up for this instead of tennis.

With apologies to my buddy Ralph the tennis pro, this looks like the next adventure for yours truly.

2) Season. As in “high season” and seasoning, the act of moving lock, stock, and barrel to someplace other than home during that place’s high season,.

Beth and I headed to the southwest coast of FL to see what the big deal is. Many of our friends and acquaintances have headed there over the years, primarily the west coast and particularly the area around Naples. It was pretty nice. Lots of varied choices for how you live. We were particularly taken with Sanibel Island and its low-key style.

Still, all in all, there is too much for us here in our little NE Ohio home, even in winter, to consider “seasoning” for weeks at a time anywhere, even during the teeth of our winter.

3) Decline. I wrote an essay some years ago about my Dad and how he had become physically smaller as he aged. He was so big, big in all ways both physical and metaphysical. You know, big like you were always safe in his shadow big. Remember? As he got older everything about him go so much smaller. Mom, too, but you always notice it more with your Dad, I think.

Do you remember that famous poem “To an Athlete Dying Young”? “Rage, rage against the dying of the light”. Visiting an area that is famous for its retirement communities and amenities is to visit a bit of your own future. It begins as you step off the plane and see 5 or 10 or 15 wheelchairs lined up in the jet way awaiting their passengers as they deplane. Restaurants and shops are all “accessible”. Decline is on display. Beth: “It’s as if you can see your future.”

Ah, indeed. But which version of the future is yours? We saw some folks who had aged very quickly. Again, Beth: “It’s almost embarrassing, like we are intruding just looking at their decline. Like we’re invading our own space, they’re so close to our age.” Yet there are others like our hosts Beth and Steve and my close friend from high school Tom who push back against age and infirmity. They meet each aging milestone or setback not with quiet resignation but with firm resolve. Perhaps not “raging” but rebelling. Not today, not this year, not yet.

Those who seem to do that best, push back at the inexorable pulls of time and gravity, seem to do so not so much from plotting and planning as they do from a kind of purposeful daily pattern. A bit of movement, whether it be what one could call exercise or not, but enough to battle both gravity and gravy. Something that makes the neurons move a bit, too (I learned how to play American Mah Jong), enough to fight off the pull of the familiar. The folks we watched who seemed to stay the youngest did both in a way that seemed altogether natural. Less rage and more routine. A routine of physical and mental movement.

One need not “season” to adopt the lessons of those who season well.

4) Mature. “I love the way you two talk to each other.” Our friend as Beth and I worked through the complexities of a little family crisis.

When you think of love what almost always comes to mind first is that fiery, fierce love in the beginning of the affair. I don’t have to describe what that is, right? After all, this is a PG blog and my Mom reads it, too. Any movie about love seems to be mostly concerned with that early stage, no matter what age the characters may be at the time. Some folks never get past that stage, always and ever chasing the next endorphin rush in the barrel at the expense of the tranquility and beauty that lies just behind the breaking wave.

It’s a shame, really. There is so much beauty in the quiet, tender acts of a love that has been years in the making. The quick squeeze of a hand as your loved one walks by. A tiny, knowing smile you share when you both have the same exact thought at the same time and you just know that he was going to be in the same exact mind space you were right then. You communicate with a gentle honesty that allows for complete understanding. Your happiness is magnified if she is happier.

Love over time seems to be about space. Sharing enough space so that there is no room for loneliness, and yet leaving enough space for each of you to continue growing. It’s a cliche, often a hilarious cliche, the couple who find themselves struggling when one retires and takes up too much of the other’s space. No room to grow if your recently retired husband Velcro’s himself to your hip. On the other side Beth and I saw the sorrow in the solitude of friends who are alone, no matter how it is that they’ve come to that place. All the more poignant when you saw that loneliness in a crowd. To a person each says it’s not the fire or passion they miss but the shared passage leading to those quiet, tender acts of a love that’s grown over time. Riding the waves. Flowing with the tides. A love that’s growing, still.

As we age, growing smaller by the day, it’s that quiet love shared over a lifetime that pushes back against the decline. The love that lives on in the eddies behind the surf. A love that continues to grow. One that will carry us home.

I’ll see you next week…

Sunday musing…

1) Palindrome. 02022020. Apparently the first time in 900+ years.

Just thought you should know that.

2) Unwind. Pretty sure this is a synonym for fart.

If not it certainly should be.

3) Super Bowl. Pretty sure it’s today. Right?

Admit it, you’re just like everyone else…it’s really all about the commercials. You don’t GAS about who wins.

4) Lanai. At the moment I am sitting next to Beth x 2, a gentle sea breeze kinda sliding over me as we gaze out over the Gulf in southwest Florida. Frankly we’ve never really gotten the whole “head to Florida” thing. Seems like half of our age group just up and emigrated to the Naples area around January 2nd each year. Since we are not in Mexico (long, boring, self-indulgent story I won’t bore you with) this seemed like the  perfect time to accept Beth and Steve’s invitation to come hang out.

Super glad we did.

After a walk to the oldest continually active lighthouse in America we are slowly sliding toward a leisurely lunch as we prepare to watch commercials. Sanibel Island may also have one of the oldest bike trails in America, our next activity. Seems you can pedal pretty much anywhere here. So it’s off to the farmer’s market just because.

Is this how it is behind the scenes of all those fancy travel posters advertising the island life? I doubt we will ever know for sure. But at least for the moment it’s terrific fun to pretend that we are retired pirates, putting up our feet on tables made of wood from reclaimed shipwrecks, now only doing battle with various sea birds over the day’s catch. The best writing seems to come from some sort of hardship or misfortune.

I’m gonna write anyway. Given the circumstances I’m just gonna have to be ok with a mediocre “musings…” today.

5) Retirement. It’s interesting how often people ask me if I’m going to be retiring soon. Especially those who are aware that I just turned 60, but even patients who’ve just been in my care for a long time (usually right after remarking  on how young I look) are wondering. Lots of docs my age really are starting to bail. Heck, some of my buddies from college are already on their second stab at retiring. The topic comes up so often that I have to admit that it’s made me give it some thought.

What is it that makes some folks rush into retirement/out of the workforce, while others seem to be inexhaustible? What it is that one does for work doesn’t seem to be a factor. We all know doctors who have retired seemingly right after they finish training as well as those of all kinds who are still going strong at 70. Why are guys like Carl Icahn still in the game, striking fear in execs decades younger when they learn that they are in Carl’s bullseye? Ross Perot, or the guy who was forced out at AIG at age 90 or whatever, Sumner Redstone and all the rest. What drives these people to not only work but to work as hard as they did when they were in the process of “making it”? As I sit here with my Better 95% and our friends watching the neighborhood osprey “make” lunch I can’t help but wonder what’s missing from their lives that they don’t perceive the value in my present circumstances. Where are they finding joy?

On the other side of the ledger are people who make just enough, however much that may be for them, and walk away. The hedge fund guy who makes a killing and hangs it up at 30 or 40. Your sister’s best friend who has that one killer idea, turns it into a business, and then sells it all so that she can send the jet to pick up your sister for lunch. This weekend, heck right this minute on the lanai looking at the Gulf, it’s a little easier for me to understand these folks, the ones who literally don’t need to work in order to have what they need and do what they want. Still, I have this little bit of unease kinda gnawing at the back of my brain: what are they really doing all day. Where are they finding purpose?

As I work through this I can’t help coming back around to Lovely Daughter and the concept of “Harmony”. After all, life after we leave the workforce, or while we are leaving the workforce, is still, you know, life. There’s no real balance involved; the false construct of discrete entities put on and taken off the sides of the proverbial scale is as false later in life as it is in the teeth of your working life. Moving in and out of what we can think of as our “working lives” is in need of Harmony as much as any other stage of our lives.

So what’s the answer? Am I going to be retiring soon, as so many people seem to wonder? Well, my little taste of “retirement” as I recovered from my hip surgery in April leads me to believe that my life is much fuller, all my pieces parts in a much better state of Harmony, when I have as much unstructured times of greater leisure as I do times that are tightly structured and outcome directed. There was not enough work and too much free time on my calendar. Both seem to bring me joy, and neither on its own seems to be enough to fill me up. Harmony, for the moment, requires both. Pleasure and purpose.

Speaking of which, I’m about to hop on a bike along with”The Beths” for a little ride. We’re off to see some sights, sample some ice cream from an ancient island standby, and pick up some fresh vegetables at the Farmer’s Market for our Super Bowl dinner. More pleasure than purpose to be truthful, but likely to be a joyful experience nonetheless. Go whoever! Beat the other guy!

Enjoy the commercials.

I’ll see you next week…

“Life’s not fair.” –Scar

What does equality mean? What does it mean to be equal? This came up this week in my day job. A study was done that proports to show that male and female eye doctors are paid unequally. The conclusions are false at the outset in this particular case because by law, services in this particular arena are paid exactly the same no matter who performs them, when or where. Unfortunately, the sensational lede taps into all kinds of notions of fairness, and all kinds of perceptions about what people assume must be true, that women make less than men for equal work. There is no question that this is the case is some walks of life, but interestingly the data (some of which the authors ignore in their quest to prove their preconception) proves otherwise in medicine. An opportunity to examine real differences in how men and women practice medicine is thus lost in the pursuit of an examination of the spiritual quest to combat inequality, even where none exists.

Is this the unicorn of equality? Is payment under government programs the only place where equality actually exists? Heck if I know. What interests me is the fact that the first assumption is that inequality is present. Inequality is the default setting. That there is an inherent degree of unfairness in pretty much any and every setting. Know what I think? Equality doesn’t exist. It cannot exist if we are to have an ever-improving world. There is nothing unfair about that in the least.

A just civilization establishes a floor below which allowing people to live is ethically wrong. For example, in healthcare it is my contention that we have a moral obligation to see that every citizen has access to care when they are sick. Inherent in this contention is that there is a basic level of care that meets this moral obligation by ensuring the same outcome as any other level of care. One could apply this same concept to food, clothing, and housing without missing a beat. We can think of the rights enshrined in the U.S. Declaration of Independence as a proxy for this baseline if you’d like. Life, liberty, and the pursuit of happiness make a very fine baseline.

One’s right to “life” necessarily includes a right to be fed, would you agree? Equality would mean that if one among us dines on Beef Wellington, than each among us must do so as well. This is where unthinking and unquestioning fidelity to “equality” brings you. In so doing it forces everyone to expend energy protesting “inequality” better put toward fulfilling the moral obligation to see that no one goes without protein. In healthcare we see all kinds of protests againts the inequality of care demonstrated by the horror of a VIP of some sort or another recuperating from a procedure in a luxury suite, while the proletariat must recover in the equivalent of a Hotel 6. The reality is that the outcomes will be equal; the moral obligation has been fulfilled. Above a basic level in pretty much any domain you wish to examine, equality does not exist. Sorry. Scar is right. Life’s not fair.

Is he really though? Saying that it’s not fair is the same as saying that inequality above that level at which everyone has a right to live is wrong. Here is where I part company with those who hew to this viewpoint. What does it matter that someone drives a Cadillac while another drives a Kia? Do both not get you to work on time? Or that Beef Wellington again: do you not get the same amount of protein from a hamburger? The example I am using in another conversation about equality in healthcare is similar: if a medicine is effective taken 4 times a day, is the fact that someone can pay more for a version that must only be taken once a day a measurement of unfair inequality? I vote “no”.

My strong feeling is that energy spent in some way protesting “equality” is energy that is not expended on the much more important task of fulfilling the moral obligation of raising everyone to that acceptable basic level. In may, in fact, work against that effort. That constitutes unfairness in my opinion. Advocacy and protest should be directed there, toward making sure that everyone has that most basic obligation covered. Once universal entry is accomplished across all applicable domains, the next task is to continually raise that basic level for everyone, no matter how far the gulf may be between that level and whatever the “sky’s the limit” level might be. One need only look at “poverty” or “hunger” and how the bar has moved ever upward there to see how this might work.

We have a moral obligation to see that true rights are available to all. It is unfair to those who have not yet achieved that most basic level when efforts to help them are diverted to the pursuit of an unachievable conceptual goal that neither feeds nor clothes nor cures those in need: equality.

Sunday musings…

1)  Capitalism. “Capitalism is the worst economic system, except for all of the rest of them.” Winston Churchill

2) Randy Newman. While I was surfing around Facebook the other day I came across a page where Three Dog Night was singing their hit song “Mama Told Me Not to Come”. It turns out the song was written by Randy Newman.

Of course it was.

3) Friendship. I have been asked many times over the years when it is that I actually write “Sunday musings…” That question has always puzzled, and frankly amused me. I mean, it is called SUNDAY musings, right? I sit down on a Sunday morning and think back over the week just past and pull out the things that were interesting to me. Or things that made me think. Or things that I hadn’t quite figured out yet. But I really do sit down on a Sunday and put down my thoughts on that day.

This week I was planning on writing about CrossFit, and where CrossFit finds itself as a movement in the year 2020. I also stumbled across an article on the dangers of early specialization in young athletes. Poor Zion Williams looks like he is the most recent victim of this phenomenon, having experienced a knee injury at the tender age of 19, suffered in the act of plying his trade. Now for sure I will eventually take up both of these topics, but as is so often the case something is a little bit more important, or at least high enough on my priority list that it will bump everything else and become this week’s “Sunday musings…”

Friendship is once again foremost in my mind this morning.

Last night Beth and I hosted a group of couples we first met when our family moved to Bay Village Ohio in 1992. Bay Village is a pretty interesting place. People are born there, go to school there, return, and raise families. It’s not unusual for Cleveland natives to live in a social circle which was formed in kindergarten. This is not only particular of Bay Village, but seems to be a thing across the entire Northeast Ohio region. I have friends who went to Catholic elementary school, junior high school, high school, and then college, who will see their best friend from age 5 on a weekly basis for a beer. The particular group we had dinner with last night is not like that at all. We were all transplants from somewhere else raising our families in Bay.

Beth and I have watched this phenomenon now for several generations, as parents ourselves watching our children, but also watching some of my younger colleagues in the healthcare community. The preschool PTA group we hosted for dinner last night all had children within a year or two of one or several of our three. Most of the moms were stay-at-home mothers, a surprisingly common state that women in our generation found themselves in during the early 1990s. As an aside, the death of the stay-at-home mom was proclaimed quite prematurely, at least in the greater Cleveland area. As is so often the case the men involved became friendly as a side effect of the lives that our wives were living while they were raising children.

For the seven couples arranged around our table last night it has been at least a 25 year journey in friendship. Support given and received during the tumultuous years of raising children has evolved into the kind of friendships where trust is a given. It’s funny how these friendships built through our children are the friendships of our adult years. I have often noted that men are very bad at the game of making friends after we leave school. Particularly after the age of 30 men don’t do a very good job at making friends. Women tend to make friends by sharing experiences, sharing emotions. This can actually be done over the phone, by FaceTime, even through texting and messaging. Of course, it’s always better when done face-to-face. Men, on the other hand, are well known to make friends standing shoulder to shoulder. Our friendships are typically based on shared experiences.

Our particular group of men has bonded over the game of golf. I was really the only real golfer in the group when we started. As I have written before my dad gifted the game of golf to my brother and me when we were very young. All of the other men in our group took up golf later in life. Sessions at the driving range and rounds played at public courses all over Ohio and on trips to the South were as much about time spent together as they were about time spent playing golf. My sides and my stomach ache this morning from all of the laughter we shared last night retelling the same stories we’ve been telling now for 25 years about adventures on and around golf courses; adventures in friendship more than really adventures in golf.

What’s the point, you ask? Well, I think the point is really most about the value of these long tenured friendships. Tending to these friendships like one would tend to an ancient garden. You know in your heart that the garden will still be there if you happen to travel, to spend time away from it. And yet time spent in the garden, tending the flowers, judiciously weeding out anything that might harm the garden makes it so much better. The effort to do so really doesn’t feel like work at all, does it? The joy one gets from being in the garden is so great that the work it takes to tend to the garden just doesn’t feel like work at all. Friendships like that are a gift.

Last night we ate too much, consumed at least enough wine, and left no dessert behind. We listened, we laughed, and we loved. I guess “Sunday musings…” today is really just a long and rambling “thank you” to our friends for, well, being our friends. I always wake up every morning thinking how lucky I am. Over the course of this weekend at dinner on both Friday and Saturday nights Beth and I were embraced by our friends.

This morning I woke up feeling just a little bit luckier.

I’ll see you next week…

Sunday musings…

1) Hiatus. Been a couple of weeks. Miss me? Lots to catch up on.

2) Spotify. I love Spotify.

That is all.

3) Dragon. At the moment I am awaiting the delivery of a new laptop that will allow me to “talk” my writing. I have long known that I am much more creative when I speak than when I type (my fingers can’t keep up with my brain, especially with this gawd awful new Mac keyboard).

With the likely exception of travel this may be the last “musings…” I type.

4) Wax. To increase or grow. To thrive

Wane. To decline or shrink. To wither.

Admit it, you always have to pause for just a moment to remember which is which. You’re welcome.

5) Narrative. Pretty much just means story. Like “my story” instead of “my narrative” except that narrative has been adopted by the precious consulting/media class to upgrade the seriousness of whatever they may be discussing. It’s all so very pretentious if you ask me. “Narrative correction” is simply changing the story, usually to one that makes the changer look better or gives them some sort of edge. For some reason it just seems more acceptable, rational, and proper if you are changing the “narrative” rather than your “story”.

Remember, the folks who insist on using “narrative” are the same folks who have so brutally abused the word “so” through such massively unthinking overuse that it makes “Um” look like a comparative slacker in public speaking. I still wonder why every declarative sentence uttered when changing the narrative ends in an uptick, a verbal question mark.

If you have questions about every sentence in your narrative why should I believe your story?

6) Judy. For the life of me I don’t know why I suggested that Beth and I watch the new Renee Zellwinger movie about the late singer Judy Garland. Man, it was 2 hours of relentless beat down of both Ms. Garland and anyone watching. What a sad story. Judy was psychologically abused from her earliest teen years, emotionally abandoned by her parents and apparently physically abused by power figures (read: men) in the studio system that made her a star. Dead at 47 but by the looks of it without living for many, many years prior to that.

Ms. Zellwinger is a revelation in the title role. If you are a movie buff (and I admit, I am starting to enjoy the exploration of movies as I enter my last 3 innings) her performance is riveting. If not this is probably one to steer clear of.

The end was a relief.

7) Trifle. My day job is one that has one of the highest suicide rates of any jobs in the U.S. Physician, that is. Don’t worry, this is not any kind of plea for help as I do not suffer from what is commonly known as “physician burnout”, the umbrella term for the myriad psychological stresses felt by practicing doctors that leads to the kind of beat down felt above by Ms. Garland. (As an aside a recurring theme around Judy Garland was a kind of incredulity by people with whom she worked that anyone like Ms. Garland could have any reason to be unhappy, let alone depressed). In fact I recently gave a speech about the quest for happiness in doctors in which I state early and often that I am actually quite happy.

But as I look around at my colleagues I see so many of them succumbing to the continual micro-assaults they suffer in silence until eventually the cumulative wounds add up to a hemorrhage of the spirit that is as unstoppable as a single slash to their emotional carotid artery. As is my wont I have been searching for some vocabulary help, some phrasing, a metaphor to use that would help me to both understand and explain what I see. Reading “The Ethicist” in this morning’s Sunday Times I came across this gem:

“De minimus non curat lex.” The Law does not care about trifles.

Eureka. Every doctor is taught that nothing is a trifle when it comes to the health of their patients. Especially the patient sitting in front of them. And yet 90+% of the changes in the provision of medicine over the last 2 decades have been precisely that, the introduction and proliferation of trifles into the sacred space between doctor and patient. “Non-combatant” narrative correctors have piled trifle upon trifle into the life of your doctors. Things that have no meaningful positive impact on your health. These, in turn, have bled much of the joy from the exam room for those same doctors. Making matters worse is the fact that more and more power has been vested in those OUTSIDE the exam room, OUTSIDE the operating room. Think administrators, government functionaries, insurance and pharma executives.Those who brought you the abuse of “so”, the question mark at the end of declarative sentences, and “narrative” want your doctor to be accountable to them, not to you and your individual health.

Fidelity to HIPPA rather than the Hippocratic Oath.

Despair over the injuries of a thousand pin pricks can be hidden until the psychological blood loss is the equivalent of a head on car crash. Judy Garland was “Judy Garland” on opening night in London. No one in that audience could see the scars from her years of abuse. No one knew how much “blood” had been lost until her injuries added up to a stumbling, bumbling and mumbling catastrophe on stage. Doctors, like Judy Garland, are looked upon as pampered creatures of privilege. Generally well-paid and with at least the veneer of social prominence and deference, it is inconceivable that they could be suffering from the very thing that has given them their station. To complain, nay even to offer the observation that such a thing could be, is met with at best incredulity, at least as often with scorn and ridicule. It’s just a trifle; what’s your problem?

Each trifle is in itself trivial. Yet trifle upon trifle leads to discouragement. It is discouragement that leads to despair, despair that can lead to death. To be damaged by being buried under a ton of pebbles is no different than the damage that occurs from the strike of a a single, massive boulder.

Just this morning the solution came to me thanks to The Ethicist and my new vocabulary word, “trifle”. We physicians are more important to our audience than Judy Garland was to hers because we possess the ability to prolong life, to cure, to make well. And like Ms. Garland who could not resist the stage, we desperately want to to this, to prolong life, to cure, to make well. During a brief conversation with my colleague Barry this morning it became apparent to me that our “narrative” has been stolen, or at least our right to own and tell our narrative, and with it I fear our ability to save ourselves is gone as well.

Think about this a little bit, won’t you? My epiphany this morning was equal parts simple, straight forward, and stunning. That part of our healthcare system that that most deserves saving is the part where a doctor sits with a patient with the sole responsibility and goal of making them healthy; call it the Hippocratic Space. Saving that sacred space won’t  come from us, your doctors. This morning it became clear to me that saving that space, and along with it saving doctors, will be done by patients. All of us are patients, and it is as patients that we have the most to lose if the avalanche of trifles drives doctors as we’ve known them off the mountain.

8) Dragon 2. If I had dictated “Sunday musings…” today I would not only have been done long ago, but at the time I type these last words I would also be done with my workout, taken a shower, and finished the laundry.

I’ll see you next week…

Turning 50 was awful. I stunk at turning 50. From the minute my 49th birthday was over I began turning 50 and I was simply terrible at it. In short I had popped off in my early 40’s about all of the magnificent stuff I was gonna do when I turned 50–climb Kilimanjaro, teach cataract surgery in Nepal–but when push came to shove my life was crammed with stuff happening right here at home. And I was broke. I spent almost the whole year in a tight little angst bubble until one of my patients tipped me off to the problem as we discussed her upcoming 60th. You can read about the details in “The Hard Turn at Mile Marker 49” if you wish (as it happens it’s actually one of my better pieces. Go figure.).

My birthday is in two days and I will be 60. What’s it been like this past year, turning 60? Funny you should ask. In truth it’s been a tumultuous year of change, challenge, and loss. It should have been a real trial, to be honest. In fact it’s turned out to be kinda easy. Like it was just another year. Just another meaningless romp around the sun. If it wasn’t for all of the folks asking me about it I probably would have had it sneak up on me and all of a sudden appear in the windshield..

How come?

This year should have been the one filled with angst. Seriously, there was so much illness and loss I should have been buried. Every positive milestone, whether it be personal or professional, was paired with some sort of emotional speed bump. When I was turning 50 any one of those speed bumps might have launched me over the edge of the highway, but this year they were strangely tolerable. We lost my mother-in-law Sandy just before my 59th, and Beth and her sisters spent months cleaning up the estate. Both of Sandy’s brothers passed as well, in 13 months wiping out the entire generation of Schaefer’s. My Mom had one medical challenge after another, in and out of ER’s and hospitals and finally out of our family home and into an apartment nearby. Sadly, even though her living situation is much safer, much more appropriate to her life stage, the medical itinerary didn’t change all that much. Maybe it’s just that we’ve all had so much practice at handling the challenges of the generation before us (as opposed to those of the generation that follows us when I was turning 50), but it all passed in a rather matter-of-fact fashion.

More than that, the speed bumps didn’t take away from the joys that found us this year. What would have totally derailed me, and stolen all of the sweetness of whatever lovely stuff was happening, just kinda rolled by in a “handled mode”. Now I will admit that stuff that was happening with my grandchildren still made me anxious, and there was plenty of that. Still, the good things were really good, and I felt that goodness while it was happening. I needed a new hip (not so good), but it went off without a hitch thanks to a great surgeon and the fact that I still control every bit of my schedule. Coming back to the office was a breeze, even though we ended up being crazy busy out of the gate. Instead of pushing back against the extra work my entire team reveled in the fact that we were doing great and stepped up big time. So did I! All of my Dad’s (and Gramp’s) genetics caught up with me this year; my doctor friends all insisted that my CrossFitty lifestyle needed a little boost from modern medicine. Even this passed with little more than a tiny shrug since all three of them, dear friends, softened the blows with heartfelt hugs.

Why so much better at 59 than 49? It all kinda made sense. Middle-aged guy medical stuff? Of course there was. I think it was also about expectations. I don’t think I really had them this time, which left me free to not only see all of the roses blooming along the path to 60, but step off the road to smell them, hang out awhile among them. Seriously, I have no idea why all of the indignities of getting older were little more than a passing cloud in otherwise blue skies.

Actually, yes I do. I am openly grateful for each of the good things in and around me. Those surprises that shocked me at 49 are almost all really nice surprises this time. Seriously, is there anything better than the sound of a grandchild’s excitement when they realize you are home?The warmth of a child’s embrace as if it’s been a month of Sundays since you were last together, and it’s been less than an hour? Without conscious effort I have begun to stop and take a moment each time something is good, someone is nice, things look up, and just enjoy it. Enjoy it and be glad for it. These things are mostly small, almost insignificant (the first time I deadlifted after my hip surgery; my Man Cub writing his name for the first time in my notebook), but some of them were, in retrospect, kinda big (gonna have to trust me on these). But large or small, this time I am openly happy for the happening and grateful for that happiness.

Whereas turning 50 seemed like coming upon a hard turn while speeding along the highway, turning 60 was a nice easy cruise with my darling Beth along a gently winding road with mostly killer views. I was terrible at turning 50 but pretty darned good at actually being 50. Will I be as good at being 60? Who knows, but I have a good feeling about 60, just like I ended up having a good feeling about 50. It’s great to be here, great to have so many of my loved ones still here, so many living so close to me, those not closer wishing they were, so many genuinely happy to be with me. I have what I need and I want what I have; it’s been like that for a really long time and turning 50 seems to have awakened me to that fact.

I’m rounding an easy curve at mile marker 59, arriving at 60 in two days, and I’m very grateful for the ride.