Random Thoughts from a Restless Mind

It takes very little effort to observe the intersection of cultural norms. Indeed, it takes a substantial effort NOT to notice them when they collide, as they must, in the polyglot that is the United States. Physicians, it’s been noted, are little more than paid observers; I see these collisions daily. What are we to do when cultures collide?

Now, I’m not talking about the “old as eternity” cultural divide between teenagers and their parents; in the end the teens will either hew closely to the cultural norms of their heritage or fall more in line with those of their present address. What I am interested in are those cultural norms that remain an integral part of the fully formed adult one might encounter in a rather typical day, and by extension whether and how one should respond to any cultural dissonance. Or for that matter, WHO should be the one to respond.

It’s the tiny ones that catch my attention. Personal space for example. The typical American personal space extends one arm length between individuals. Something shorter than a handshake, more like a handshake distance with bent elbows. The Mediterranean space involves an elbow, too: put your hand on your shoulder and point your elbow to the front and you have measured the personal space of a Sicilian. Asians on the other hand occupy a much larger personal space that can be loosely measured by a fully extended fist-bump. Something which would be anathema in polite Japanese company, but no matter.

My favorite little example of the variety of cultural norms that swirl in the soup of the great Melting Pot is the affectionate greeting. You know, what most fully acclimatized Americans would recognize as the “bro hug” shoulder bump and clasp, something that would be appalling to a Parisian or Persian, or indeed even to a Princess of the Antebellum South. Yet even here there are differences. The Princess, joined by legions of Housewives of Wherever and Junior Leaguers everywhere are ninjas in the practice of the single-cheek air kiss. It should be noted that ~90% of men are NOT ninjas in this particular art, and are expected by its practitioners to bungle the act.

Persians and Parisians, on the other hand, find the one-cheek air kiss to accomplish only half the job. They, and others who share centuries old cultures, warmly greet each other with a two-cheek kiss. I am sure that there are nuances involved here that remain unseen and unknown to both most men and certainly most (all?) who don’t share the heritage. (As an aside let me just say that I am a huge fan of this particular cultural norm because it means that one of my very favorite colleagues, Neda, always arrives bearing TWO kisses).

So what’s the point here? Two, I think. First, there is a certain boorishness in the failure to observe and recognize the existence of these cultural norms when they are encountered. Some, like those I’ve mentioned, are the relative equivalent of a soft breeze, neither strong enough to fill a sail nor de-leaf a tree. Recognizing them, even in the tiny manner that one tries not to trample on them even if they will be ignored, is a tiny gesture of kindness, respect, and courtesy.

The flip side, number two, is deciding which of these norms is the default setting. Here things get a bit stickier, especially when cultural norms run afoul of SOP on the particular ground they occupy. Think air kiss in Afghanistan, for example. Bowing in the boardroom of Samsung in San Clemente. There are more, and bigger examples, but you get the idea. Here I think geography holds the trump card: “when in Rome” should be your guide, especially with cultural norms where the collision may be substantially more impactful then whether or when you turn the other cheek, a tornado to the above tickling breeze.

After a 2 1/2 year struggle, at 8:07 PM EDT 10 years ago, I lost my Dad.

Four of us did, actually. Four middle-aged adults lost a father-in-law. 10 young adults are down one grandfather. Young Landon, the Lil’Prince, lost a great-grandfather whom he never met.

I am gutted.

My Dad’s been sick, really sick, for quite a long time. First hospitalized in January of 2013 he never recovered from an illness that we were told should have killed him every week since then. We’ve had two and a half years to prepare, a kind of “pre-mourning” if you will. Don’t believe it. There’s no such thing. Staring at the specter of a slow, tortuous decline with all of the indignities associated with it, I was still wholly unprepared for what turned out to be an unexpected and surprisingly quick demise. Nothing of these 2+ years of knowing left me the least bit prepared.

Some time ago I attended a talk on end of life care, the first in a lecture series honoring the friend I lost to cancer a few years ago. The talk was surprisingly moving, not only because it brought back memories of Ken but also because I knew I would likely lose my Dad in the not too far future, and I thought of my folks throughout the talk. What the speaker discussed as end of life care and end of life preparations also offered a very important take-away that I have tried try to apply every day since, especially with my parents.

The speakers thesis is that one should say 4 things often and with ease, not only in the course of completing a life’s work or concluding a life’s relationships, but in the course of living a life:

Please forgive me.

I forgive you.

Thank you.

I love you.

Sounds simple, huh? Maybe even a little trite. But each one of those little phrases is a bit of a minefield, each one laden with a hidden meaning and a back story, each one the mid-point in a little journey with a “before” you know, and an “after” you can’t possibly predict. There’s a little risk in that “after”, too, and that’s why those 4 little phrases aren’t really all that simple, and why considering this is not at all trivial. All 4 of those little phrases make you look outward, look at another, and in the stating they force you to put yourself at the mercy of that other. Each one of those phrases is a little opening in our guard, an invitation to accept or reject not only the sentiment but the sender.

I’ve now spent several years thinking about those 4 essential things and about how they fit in a life that is not necessarily concluding (at least I hope not!). We are, each of us, part of a tiny little ecosystem; thinking about using these phrases encourages us to look outward and see the others in our own worlds whether we are approaching the conclusion of a life or smack dab in the middle. How will my parents react if I approach this when I visit? Do they/did they know it’s now the 5th act, that we are tying up all of the loose ends in the story?

How about my friends, my kids, my darling bride? Actually, without really knowing it I’ve been on this path for some years now, probably guided by Beth and her inherent goodness. Friends come and go; either way I’ll likely feel a sense of completeness in any relationship if I remember these 4 things. Patients and staff do, too. I think I’m a pretty good boss and pretty user-friendly for patients as far as specialists go. Bet I’ll be better at both if I’m thinking about these, even just a little bit, even now.

Please forgive me.

I forgive you.

Thank you.

I love you.

I hope, sweet God do I hope that I remembered enough, said these enough. I pray that I remembered to say them to my Dad before he lost the ability to remember that I said them. Don’t wait as the end of someone’s life approaches to say these four things. Don’t wait for the conclusion of your life before you think about these.

I can’t believe it’s been 10 years. Richard E. “Dick” White 6/21/31-10/9/15. I really loved my Dad.

The secret to success just might be failure. Not abject failure, of course (although it’s always cool to use the word ‘abject’), nor consistent failure. But failure while pushing one’s limits or while exploring the new and the unknown might be the magic ingredient in the success recipe.

Why? Success is not simply the absence of failure, it is the defeat of failure. Success is over-coming failure. Indeed, without having failed at something some time, how do you know what success is? How do you know what it’s supposed to feel like?

Neither success nor failure need be any particular size. Small successes build confidence, and smallish failures teach. It’s important to qualify acceptable failures, though. Failure caused by sloppiness or laziness is ALWAYS bad. On the other hand, failure encountered while stretching beyond one’s limits, while reaching for something new, large, important…well…that’s the type of failure from which lessons are learned.

It takes a certain chutzpa to put one’s self at risk to fail while in the act of reaching further. I like Churchill’s take on it: “Success is never final. Failure is never fatal. It’s courage that counts.”

Be brave.

Quiet house. Quiet lake. Quiet mind? Not so much.

When you are riding high, hitting all of your numbers, looking out over a quiet lake as far as the eye can see and embarking on another stretch of smooth sailing, are you the type that rides the crest of that wave with the carefree joy it deserves? Or are you rather the sort that cannot shake the awareness that below your tranquil waters there lies a hidden reef that portends despair should you happen upon it? The question is more than just the old “are you an optimist or a pessimist” saw, I think. At its core lies one of the keys to happiness: can you live in a happy moment without simultaneously giving space to another darker, sadder moment?

During the dance are you always on edge waiting for the other shoe to drop?

None among us lives a life filled with only joy and happiness. Indeed, there are those whose lives are a proverbial slog from one tragic moment to another. Blessedly, in our developed world, these “treadmills of tragedy” are actually quite rare. Likely as rare as the Unicorn lives filled with nothing but rainbows and Skittles. No, for most of us it’s simply a question of degree leavened by, I dunno, attitude I guess. Do we approach the smorgasbord of our lives as ones of “quiet desperation” as so many novelists propose, or do we rather travel in a state of “careless joy”?

Beth and I are hosting friends this weekend at Casa Blanco, the invitation having come spontaneously months prior and quite amazingly accepted and consummated. The one, a classmate from college, I’ve known for 40 years. The other is my classmate’s relatively new love. How they’ve arrived together at Casa Blanco is quite fascinating. One has lived a life which from the outside seems to have been charmed beyond belief, while the other has struggled mightily to overcome significant childhood traumas. One looks back and muses on choices made and how things might have turned out if present day insights might have been available when earlier crossroads were encountered, while the other has doggedly worked through each treacherous road into and out of those crossroads.

What they have in common, at least this weekend, is the apparent ability to live fully within the joy of whatever moment they are experiencing right now, without allowing the intrusion of the “other shoe”. I am quite sure that each has some something that weighs on the balance toward the negative side of the ledger, but for the life of me I haven’t seen it. Pollyanna or a gift? I’m going with “gift” and furthermore I’m going with being able to watch this couple give themselves completely to each moment we’ve shared as one of the most meaningful “hostess” gifts Beth and I have ever received.

Those couple of things in my life (or yours, or my friends’) that are sitting there ruining your winning streak? That other shoe you just know will drop at an inopportune moment? Meh, they aren’t going away regardless of how you decide to engage with the joyful steps in your life, on your journey. Right now there’s a workout to plan and a lake to jump into. Bacon’s on the griddle while I watch the chickadees eat breakfast. Tapping or shuffling, the sound of the shoes is that of happy dancing, and I am taking my cue from our guests and simply listening.

That other shoe will drop whenever. I’m too busy dancing to worry about it.

“When he lost his life, it was all he had left to lose.” –from “Curtis Low” (Lynard Skynard)

At the moment I am in a hotel in Las Vegas preparing to depart. This weekend I congregated with some of my closest professional colleagues and friends as we prepared ourselves for a rather large cooperative project with one of the larger companies in my part of American healthcare. While the weekend seemed to fly by, now that I am alone in my room ready to travel alone to the airport on my way to fly alone along with 200 or so other folks, it seems like an awfully long time since I left home.

Vegas tends to make me feel that way. It’s hard to imagine the real people who live there for real (apologies to my good friends Eva and Doug who do, indeed, happily live there). It always seems to me that everyone is either arriving or departing. Maybe it’s because I was so deeply affected by the Nicolas Cage and Elizabeth Shue movie “Leaving Las Vegas”; Cages character went to Las Vegas in order to leave, forever.

Catching up on newspapers piled up while I was away I happened upon an article written by David Gregory, former moderator of “Meet the Press”. Mr. Gregory was on a bit of a spiritual quest, one that coincided with some turmoil in his professional life. As part of this journey he spent some time with an Erica Brown, a Jewish educator. After listening to his professional laments she offered this stunner: who would you be if you lost it all?

Stopped me right in my tracks, that one did.

Think about that for a minute. How the question was phrased and what she was asking. Not “what would you do?” or “how would you handle it?” but “who would you be?” The implication is that who you are at any given moment is only one version of who you might be capable of being given different circumstances, however wonderful or unpleasant.

Spend a few more minutes thinking about what it means to lose it all. For Mr. Gregory it meant losing his dream job, a job in which who he was became inextricably linked to what he did. I get that, but Mr. Gregory is still able to seek employment as a journalist, still able to work in his field. What if you could no longer do that? Say you’re a doctor and you lose either the ability or the right to practice medicine? Think “The Fugitive”. Trust me, doctors are way more wrapped up in the “what I do is who I am” thing than journalists. Just thinking about that makes me sick to my stomach. Imagine if you couldn’t work at all. Couldn’t support yourself or your loved ones and had to depend on others. That’s starting to close in a little bit more on “losing it all” I think. Who would you be then?

There’s no way of knowing if Ms. Brown meant to go this deeply, but in the developed world we live pretty well, and there’s actually a boatload of stuff we take for granted that could be lost. What if you lost your freedom? You are incarcerated, or in some way someone gains so much leverage over you that you must do their every biding. Who would you be, what part of who you have the capability of being would come to the fore if you were no longer free? Joe Coughlin, the central character in a Dennis Lehane novel I just finished compromised his father’s position as a police captain in order to buy favor and therefore survive in prison. He lost his freedom, and then he became a man without a moral compass, ruining and even taking lives in pursuit of other men’s goals.

But even at that, Coughlin hadn’t yet lost everything. What brought him to that precipice was the loss of his people. You’ve watched “Law and Order” I’m sure. I don’t remember many individual episodes of any series I ever watch, but one “Law and Order” dealing with loss comes to mind. The detectives discover a man in an institution who is mute, nearly catatonic. They need his testimony; he is the only witness to a heinous crime. In order to gain access to his memory they obtain a court order to treat him for his depression. His recovery is miraculous, and initially he is grateful for his awakening, grateful to meet distant relatives who are delighted for the return of an uncle they’d lost. All well and good until it is time to testify and we learn that he lost his job, his ability to work, and his entire immediate family in that heinous crime. Awakening means remembering that he has truly lost it all.

Who would you be if you lost it all? This poor man had nothing, and he discovered that without his people he was no one. Who would you be? His answer was no one at all. He refused treatment and slid back inward to nothing.

There’s a point here. A couple of them, actually. The first is that each one of us has much, much more of pretty much everything than we realize. Most of what we might lose is not really all that close to any type of “everything”, and that should inform how we view what we do have and what we are willing to do to keep it. Who would you be BEFORE losing something in order to not actually lose it? To know this is to know what we are willing to do if we need to fight not to lose everything.

Read this backwards from here. It hurts to lose stuff. It’s hard to get by with less money if you’ve tasted more, especially if you think you’ve become someone else because of that stuff, and worse if you kinda like that someone; losing that kind of job stings. Time and again, though, we see that true loss is less easily quantified than a spreadsheet or income statement or title. To lose your people is to truly lose everything. No amount of fight is too great to not have to learn who you would be after this type of loss. Losing your freedom makes it easier to lose your people. Someone else plots your every course. Who you are needs to be someone who does as much as humanly possible to remain free.

Mr. Gregory seems to have made this leap. In the end his job was simply what he did at the time for work. Losing it actually brought his spiritual quest home, to his people. That’s the other point, right? It’s your people. You’ve not lost everything if you’ve not lost your people. Know who your people are and hold them close. Cherish and nurture them. Do it out loud and without either fear or shame.

Do whatever it takes to never have to learn who you would be if you did, truly, lose everything.

I landed on “Cool Hand Luke” while surfing yesterday. Man, was Paul Newman something, or what? For all of his faults, and despite being guilty of whatever landed him in that prison camp, Luke was resolved to fight the injustice of his existence. He was resolved not to lose the essence of who he was, despite the hardships imposed on him by those who would break him, break his will, make him relinquish that which made him, well, cool.

Movies are usually an escape for me. I’m not often prompted to terribly deep thought while watching. But I wondered, what of my life that occasionally seems so hard, is actually hard enough that I must bend from a true course? And if it is, indeed, that hard, how long could I hold out against the constancy of the difficulty, like Luke, before I broke?

Luke, knowing that he may finally be broken, seeks answers in the church he forswore. He stands in a doorway. “What we have here is a failure to communicate”. A last act of defiance, or a capitulation? One is left to wonder: did He answer?

1. Summer. Since the dawn of empty-nesterhood I have maintained that without school-aged children in the household, summer is over whenever we decide it’s over. We took our little antique runabout “Jet Ski” out of the water yesterday.

Summer is over.

2. Why do you “put your 2 cents worth” in, but it’s only “a penny for your thoughts”? Where’s that extra penny going?

3. Plinth. A heavy base supporting a statue or vase.

No way I guess that.

4. Cellphone. The only question I have is why did it take so long for public schools to ban cellphones during the school day? It’s patently ridiculous to allow children to have anything that might distract them from the two tasks at hand: acquire the education that has been made available to you, and learn how to live peacefully side-by-side with people who do not live with you under the same roof. It’s ludicrous to expect that children who cannot be counted on to tie their shoes will demonstrate the discipline necessary to ignore this singular temptation of the present era.

Heck, when I was in grade school chewing gum in class was considered inconsistent with the ability to acquire familiarity with the 3 R’s. Somehow a cellphone is ok?

What is astonishing is that the only meaningful (if you can call something so ridiculous meaningful) push-back has come from parents who are concerned that they cannot contact, or be contacted by their children. When they are in school. In the classroom. Sorry, but this is patently ridiculous. Actually, not sorry at all. I simply cannot envision something so earth-shakingly important that I as a parent would need to text or call my school-aged child. Got a true emergency? Call the principal’s office. They still have a landline for Heaven’s sake.

Cellphones have no business in school. One could make the same case for literally any internet-connected device from kindergarten through grad school.

5. Discourse. How has it come to this? How could we as a country, as a people possibly have arrived at a place where people can respond to an assassination of an American citizen on American soil with anything other than horror and sorrow? Where once every such event was followed by universal calls for calm, for peace, for prayers for the deceased and their families, what are we to make of elected officials in our nation’s capital screaming at each other over whether they will offer condolences and prayers? How is it possible that we have people who openly rejoice that someone was shot and killed in public? Who share video of the killing as if they were there to witness it?

How has it come to this?

We have been here as citizens of a country at least twice before. A true Constitutional crisis in the 1860’s led to The Civil War. The 1960’s were a time of War, a time when a generational schism over an unpopular war in which thousands of Americans died, an unpopular draft sent thousands of young Americans into that War, was tinder for the embers of the flames that were lit during that Civil War. The battles over The Civil Rights Act and the rest of Lyndon Johnson’s Great Society legislation set large blocks of Americans against one another.

And yet the assassination of the Martin Luther King, Jr., the leading figure in the Civil Rights movement, did not lead to the kind of malevolent declarations from both public and private figures we witnessed either this past week, or when a legislator from Minnesota was killed. No, with the exception of small radical groups that spoke for a splinter of American citizenry, back then what we heard was universal shock, universal horror across all of the population. Leaders at all levels counseled calm. Pleaded for it. Robert F. Kennedy (v 1.0) gave a speech in which he fairly begged for peace, for the kind of respectful and measured public and private discourse that Dr. King was rightly famous for.

Those most deeply wounded by the assassination declined to take up arms. With only small exceptions, declined the urge to seek, or even speak of revenge. That RFK himself should perish at the hands of a madman was almost too painful to comprehend, and yet here, too, the nation responded not with revenge but with profound sadness. To be sure not everyone loved either MLK or JFK, and yet what we heard and saw after their horrific deaths was sorrow.

Where in the world has that instinct disappeared to and why?

None of this makes any sense to me. None of this “if you’re not 100% with us we are 100% against you” makes any sense to me. I do not pledge any type of fealty to any “100% or 0” group but rather live in the great center along with what I’m willing to bet is an overwhelming super-majority of Americans. It matters not whether I am center/left or center/right, like so many I seem to be able to find less radical aspects of both camps that make sense to me.

Even at times when I have a deep visceral dislike for an individual for whatever reason–I found, and continue to find former President Clinton to be a man without a moral compass, and yet some of his domestic positions seem almost Moses-like now–I am a man of ideas and I decide where I stand by parsing ideas. Because of this there are 100%ers who would say I lack the standing to comment on anything, let alone how to address what is today being called political violence.

I respectfully disagree. I am an example of someone with the perfect standing to respond.

To do so we must first discuss what it is that is so very different in the 2020’s compared with the 1860’s and 1960’s: today it is altogether possible, nay easy to become cloistered among others who skew 100%. We hold in our hands the key that unlocks a chamber that is no less secured from other voices than any medieval monastery, convent, or coven: the connected device. Where once you simply couldn’t avoid contact with what the elders of my wife’s youth would call “them others”, now all it takes is a cellphone and earbuds. What might begin as a bit of a leaning turns into an algorithm-driven echo chamber. One begins to see smaller and smaller deviations from that 100% fealty as the flag of otherhood.

Until “other” becomes “enemy”.

This is nothing new coming from me. I have said time and time again that those things that we share, the ideas that we have in common, overwhelmingly dwarf those that we do not. We do not need anyone’s help to find out where to start: start by talking about the things we agree on. We can start by agreeing that shooting people with whom we disagree is wrong. It’s just bad. This is really low-hanging fruit. It’s sad that it even needs to be said. When someone is actually killed over the stuff that is getting folks on both sides of our political spectrum shot, we can start by agreeing that the proper thing for everyone to say, especially our political and cultural leaders, is that such a death is wrong. It is a bad thing. It is something that we should be profoundly sad about, and we should say just that.

Out loud and often.

Doing this is something that literally all of us can do. Left, right, somewhere in the middle, wherever Libertarians would say they “live”, all of us can and should do this. Governor Cook of Utah got it right. Secretary Buttigieg got it right (Sorry, none of the prominent Libertarians weighed in on the Sunday talking heads shows). The other stuff is really hard and requires an equal effort from the spineless (most of our elected officials) and soulless (the cretins who deliberately set loose the algorithms that seduce and capture) to take actions that do not solely result in their own good fortune. While I continue to assert my standing I admit to the probability that I lack the knowledge and the expertise in things on a national or societal level to reverse the drive to dive inward, and to replace it with outward.

I confess that I do not know how to lead the movement to take interactions that happen over an electronic connection that is disconnected from geography and time and replace them with those that happen in person. At arms length. It’s just really hard to see nothing but “other” or enemy in someone who is sharing their ideas and their feelings while sitting across a table, staring over a couple of beers or a cup of coffee. It’s so much easier to remember how much we share with each other, how much more we have in common than not, when we get off our computers and our tablets, turn off our phones, and talk to one another.

Or maybe I do. Maybe all it takes is to talk to one another until arms length turns naturally and inevitably into an embrace.

I’ll see you next week…

It was a Tuesday. For sure. Tuesday is an OR day for me, and I was with my work people on what looked to be a pretty vanilla Tuesday morning. That’s how you like it in the OR: vanilla. A good day is no memory of the operations whatsoever. A great day is one where you remember some interaction with your teammates, something good or funny or nice.

9/11 was definitely a Tuesday. What I remember is being with one group of my people.

Everything about the day was going just like every other Tuesday. Fast cases with great results. Stories flying back and forth between doc, nurses and patients. Just a joy to be doing my job. Until, that is, one of the nurses came into my room and said a plane had hit a tower. To a person our collective response was something like “huh…that’s weird. How tragic,” and then back to work. Back to normal until that very same nurse came back and said a second plane had hit the second tower. We all stopped after that case and headed to the family lounge, a TV and CNN.

I remember being in a similar place when the Challenger blew up, surrounded by colleagues, patients and families. That’s where I was when the first tower collapsed. After that nothing was normal about the day at all. There is literally nothin in my memory banks about the rest of the morning. I know we finished the cases, but then everything came to a full and complete stop. Clinic hours were cancelled, schools let out, and the wheels of American life ground to a halt. The rest of the day was spent in tracking down my brother (traveling now by car from Chicago to Connecticut), and best friend (stranded in Brazil). The skies were empty for days.

Our new normal had just kicked in.

My parents worried about an attack on our soil from Germany to the east (U-Boats off the coast of New England) or Japan from the west (a friend posted the story of a Japanese pilot who actually fire-bomb Oregon!). As a child our politics and our lives were spent worrying about the specter of a communist attack. As an adult, a father and a grandfather, it is now the fear of Jihad unleashed. The post-Reagan/post-Berlin Wall years of relative peace and security seem so very long ago now, don’t they?

The reality, of course, is that we are far safer than we think we are. Yet our own personal realities are driven by the same psychology that led our parents to fear a coastal invasion, for us to fear Russian bombers. We march on each day, as we must. We march on so that each day’s completion becomes one more tiny victory in yet another long war fought for us mostly between the ears, so much like the Cold War before it. We seek victory once again in the daily act of living our normal lives.

We remember, though. Like I remember that it was a Tuesday. We never forget, nor should we try to forget. It is in the remembering and carrying on despite the remembering that we do our tiny part to honor those who were lost. Today is a day to take a moment away from normal to remember.

I remember.

“Billy Ray (not his real name, of course) turned off his implantable defibrillator (ICD) yesterday. Billy Ray is 44.

In my day job I was asked to evaluate him for a problem in my specialty. I was told he was about to enter hospice care and assumed that he was much, much older and simply out of options. I admit that I was somewhat put out by the request, it being Saturday and the problem already well-controlled. Frankly, I thought it was a waste of my time, Billy Ray’s time, and whoever might read my report’s time, not to mention the unnecessary costs. I had a very pleasant visit with Billy Ray, reassured him that the problem for which I was called was resolving nicely, and left the room to write my report.

44 years old though. What was his fatal illness? What was sending him off to Hospice care? I bumped into his medical doc and couldn’t resist asking. Turns out that Billy Ray has a diseased heart that is on the brink of failing; without the ICD his heart will eventually beat without a rhythm and he will die. A classic indication for a heart transplant–why was Billy Ray not on a transplant list? Why, for Heaven’s sake, did he turn off his ICD?

There is a difference between being alive and having a life. It’s not the same to say that one is alive and that one is living. It turns out that Billy Ray suffered an injury at age 20 and has lived 24 years in unremitting, untreatable pain. Cut off before he even began he never married, has no children. Each day was so filled with the primal effort to stop the pain he had little left over for friendship.

Alive without a life. Alive without living. Billy Ray cried “Uncle”.

I have been haunted by this since I walked out of the hospital. How do you make this decision? Where do you turn? Billy Ray has made clear he has no one. Does a person in this situation become MORE religious or LESS? Rage against an unjust G0d or find comfort in the hope of an afterlife? Charles DeGaulle had a child with Down’s Syndrome. On her death at age 20 he said “now she is just like everyone else.” Is this what Billy Ray is thinking? That in death he will finally be the same as everyone else?

And what does this say about each of us in our lives? What does it say about the problems that we face, the things that might make us rage against some personal injustice? How might we see our various infirmities when cast in the shadow of a man who has lived more than half his life in constant pain, a man alone? The answer, of course, is obvious, eh?

The more subtle message is about people, having people. Having family, friends, people for whom one might choose to live. It’s very easy to understand the heroic efforts others make to survive in spite of the odds, despite the pain. Somewhere deep inside the will to live exists in the drive to live for others. The sadness I felt leaving the hospital and what haunts me is not so much Billy Ray’s decision but my complete and utter understanding of his decision.

Billy Ray gave lie to the heretofore truism that “no man is an island”.

Go out and build your bridges. Build the connections to others that will build your will to live. Live so that you will be alive for your others. Be alive so that your life will be more than something which hinges on nothing more than the switch that can be turned off. Live with and for others so that you, too, can understand not only Billy Ray but also those unnamed people who fight for every minute of a life.

Be more than alive. Live.”

What is the meaning of a marriage? More so, what does it mean to enjoy a long, happy marriage? Today is the 40th Anniversary of the happiest day of my life, the day I married the love of my life, Beth. 40 years! Big number, that. We’ve been together for 43 years in all. I’ve written and talked about our marriage and our decades-long love affair many times before. Today is a day to visit once again how wonderful it’s all been.

Much ink and many electrons have been spilled lately on the topic of marriage. The demographics of marriage are said to have shifted. Young people have been putting off marriage until they have reached certain very specific milestones in their lives. Education, job, savings, a self-defined state of security, and only then, marriage. This pattern has been dubbed the “capstone” marriage: once the structure of a life is built the celebratory “edifice” is added. As an aside since this leads to first marriages that occur after age 30, this pattern has been blamed, at least in part, for the decline in the national birth rate in the U.S., especially among the college educated.

For the most part our generation seemed to look at marriage more like our parents and grandparents had. Beth and I met at ages 21 and 22, dated, lived together for a bit, and then married at 24 and 25. In our extended circles of friends and acquaintances we were kind of in the middle of the Bell Curve age-wise. Judging by the number of weddings we attended together, admittedly a very suspect data source, it sure seems in retrospect that a majority of the weddings in an around our groups and our families took place around 24 or 25, give or take a couple of years. Likewise, when it came to starting our families, it sure seems like we all got to it within a year or two after getting married.

Pundits of today describe marriages like ours as “cornerstone” marriages. It’s not just that they are similar to patterns described in prior generations when it comes to things like age at marriage and first offspring, it’s that they are the primary building block of our lives as we became adults. Marriage and all that comes with it was, and is, both the foundation of adulthood and the gravitational center around which we lived our lives. For Beth and for me, and for our siblings and so many of our friends, this is pretty much nail on the head.

Our marriage began as our cornerstone, and for 40 years has been the touchstone of our life.

So what’s the secret? How do you stay happy, stay excited, stay married for so long? We both get asked this all the time. Have been asked since very early in our marriage, actually. When asked we both start with the leg up that we had from having parents and grandparents who had very long one-marriage lives. Having role models, especially ones you loved and looked up to was a huge head start.

From the gift of a good start what came next was the commitment to build around our marriage by putting it first whenever we had decisions to make. Beth likes to say that the adage that everything has to be 50/50 in a marriage is wrong by 50%; putting your marriage first means that you both need to be 100% committed to both the marriage and to each other. It’s 100/100! 50/50 might be a very workable strategy when you are divvying up the household chores, but it’s only a halfway commitment.

As much influence as our parents, grandparents, and their married friends had on our outlook on marriage we were also very aware of the classic life stressors that seemed to lead to divorce, especially in medical families. So many marriages that seemed so successful during the child-raising years seemed to fall apart just after the nest emptied. In my mind’s eye I imagined an empty-nester couple sitting at the kitchen table, drinking coffee. They turn down a corner of their newspaper and realize that they don’t really know the person sitting across from them as anyone other than their parenting partner. Without conscious effort it seems all too easy to expend most or all of your time and energy supporting and raising a family, with little left over to support the marriage.

How can a couple avoid having to start all over again? The cornerstone only supports the house you’ve built if you continue to revisit it, touch it, and remember what it means. For us we declared that our courtship had never ended and so we never stopped dating.

Those dates were comical in the earliest days of our lives as parents. In those days of no time and less than no money a date might mean playing board games, holding hands while we watched “Hill Street Blues” or laughing together at silly stuff like “Alf”. We declared that Wednesdays would be “date night”. Out together as boyfriend and girlfriend, perhaps with another couple of two, never with a child in tow. Our first dates were pretty spartan affairs. With enough money for either a babysitter or an activity we opted to spring for the sitter and get out of the house. I remember holding hands at Burger King while we shared a cup of coffee. A “fancy” date might be sharing a cappuccino and reading magazines at Barnes and Noble.

Date night took wing when we moved into our first real house in Ohio and a neighbor gave us the phone number for the sisters who would be our babysitters for more than 10 years. Kerry and Chrissy became big sisters to our kids and little sisters to us, so much a part of the family that our kids were invited to both of their weddings. Beth and I signed up for ballroom dancing lessons. The perfect date night activity: hug your soulmate for 90 minutes every Wednesday so that you can practice dancing in your furniture-free living room every night after the kids go to bed!

And we still go out on dates every single week.

Was it easy getting here to year 40? Meh, nothing in life is easy, right? It never felt hard, though, and looking back it sure seemed like almost all of it was fun. I mean, every week I went out on a date with my girlfriend! No matter what was going on at home or at work we went left Mom and Dad at home and went out as Mr. and Mrs. And now here we are, married for 40 years, 43 years together. Put marriage first, 100% commitment, and never stop dating. As I drink my morning coffees and I turn down the corner of my newspapers I look at the woman who gave me the first happiest day of my life on Saturday, September 7, 1985.

And every day since.

Happy Anniversary, Dollie. I love you to the moon and back.

I’ll see you, 7 more happiest days of my life later, next week…