Random Thoughts from a Restless Mind

Master’s Sunday is the day I think I miss my Dad the most. We’d be on the phone dissecting the action, second guessing each decision and reminiscing about our respective visits to Augusta National (sadly, neither one of us ever played there.). In many ways the game of golf was the tie that bound my Dad to my brother and me. In Jr. High School he invited us into his world; we did whatever it took to stay there.

The older I get the more important my “who” becomes. Thinking about golf today has really brought this home for me. I walked away from golf 9 years ago because I couldn’t stand to be average, let alone not very good. Doing so put way, WAY too much emphasis on the “what”, on the golf itself. It was entirely reasonable for me to take a break from golf after my injury because it literally hurt to swing a club. But 9 years?

Let me be really clear: I don’t miss the game of golf. I played in high school and a bit in college, and I’ve played literally thousands of rounds on some of the most famous courses in America. The game of golf doesn’t owe me anything at all. What I do miss, though, is being in the company of other people (mostly men, I’ll admit) who are doing something that makes them happy. More than that, since you almost always get to choose who you’re playing with, you are always in good company.

It’s been a wonderful day to remember that “who” is so much more important than “what”. I am part of a bunch of middle-aged knuckle-heads who met as fathers of pre-schoolers and then bonded on some of the most God-forsaken dogpatch golf courses imaginable. No matter. We were together. We celebrated the 60th birthday of one of our pals at breakfast where my guys regaled me with side-splitting tales of this year’s golf trip to South Carolina. If they’ll have me, next year my “new game” is likely to produce a few follies that we can laugh about during a breakfast to come.

My brother is an extraordinary golfer, as is my best friend of 40 years. My sister’s husband, too. My son will eventually become a very good golfer; his pride will accept nothing less. Lil’bingo and “Lovely Daughter’s” husband are both eager to play as well. My game will sadly fail to match up, but that’s no matter. How I play is a “what”. It always was, even though it took me an awfully long time to figure that out. What I now hope to get, and what I hope to give each time I get a chance, is to be part of a group that understands that the “what” they are doing is so much less important the “who” that they are doing it with. All of these men have asked me many times to join them, and this year I will finally do just that.

Golf, CrossFit, Cards…whatever. “Who” is the reason you are there.

Sunday musings…

1) Brexit. Certain to show up in the next “Hangover” sequel.

2) Hangover. Man, who thought THAT was a good idea?

3) Ritz. “I had the feeling you get when exiting a cinema after a matinee, blinking at the light and still half-living in the film.” WSJ on a stay at the Ritz Hotel, Paris.

Lovely writing, that. A bit hard for me to relate, though, since my last matinee was “The Jungle Book” with my 79yo Mom.

4) Sincerity. “The key to life is sincerity, and if you can fake that, you’ve got it made.” –Robert Steed 1936-2016

Man, how good is that in this election cycle?

5) Edge. Whether or not you know it, or knowing it whether or not you acknowledge it, everyone is always on the lookout for the edge. Everywhere. The edge has lots of names, but by any moniker we all seek it. Our Puritan ethic sends some of us in search of the edge in more, or harder work. Lots of that around here, chez CrossFit. Others of a different ilk seek the edge through shortcuts and work-arounds. Think PED’s and the Olympics, or access to information about a trade or a deal milliseconds before the competition. In some ways, at some times, getting the edge is about coming out on top in a zero-sum game where winning means also not losing.

What’s puzzling is when the edge is freely accessible to everyone, and yet there are legions who either ignore it or actively turn away from it. Think health. There’s some pretty easy stuff out there that will give you the edge, stack the deck in your favor if you will. Yet there are many among us who are militant in their refusal to take their piece of the edge, even when it is freely given and nearly free. You don’t need me to point out the obvious here.

I find myself torn between an intense need to teach those I care about to grab the low-hanging fruit, and an equally intense desire to not be around those who chase an irrelevant 0.01% edge in one domain while giving up10% in another. More and more I find that avoiding the latter gives me an edge.

6) Dad. A long-time columnist in my home town paper writes this morning about making it to his Dad’s bedside for a final hug, just hours before his father passed away. I’ve been thinking about my Dad quite a lot recently. He left us very quickly, his long, slow slide into oblivion interrupted quite unexpectedly and quickly. Only one sister was there. It’s kind of strange, but I find myself missing him more and more, both in the literal sense at gatherings, and the more emotional sense in his just being gone.

We missed him at both of my sons’ weddings, for example, and the space at the table next to my Mom still doesn’t look quite right 9 months on. There are 8 grandsons on my side of the family, and all of them took turns swinging their Gram across the dance floor at last week’s wedding. I found myself looking over at her table, looking for that little twinkle in my Dad’s eye, the one he always got when his wife was happy. Even as his mind betrayed him toward the end, that part of him remained. The part that so loved my Mom that her happiness brought him more joy than pretty much anything else. Alas, no twinkle. Just an empty space and the hint of his shadow.

It’s been 8 years since I’ve swung a golf club. After thousands of rounds in the company of hundreds of very fine people, the game of golf doesn’t owe me anything, and I only rarely give it any thought anymore. That’s why it’s so strange that I’ve found myself dreaming about playing golf. Like every night dreaming about playing golf. I admit that I miss the camaraderie of the game. The tomfoolery on the first tee as you haggle over the bets to come bookending the jackassery in the bar afterward as the lies grow and the round becomes so epic in the re-telling that Harvey Pennick himself couldn’t have made us better golfers. I do miss that, but the playing? For whatever reason, the game itself has left me.

Or so I thought, until the dreams began. It doesn’t take a Freud to figure out that the dreams have little to do with golf, of course. They are about missing Dad. You see, after seeing my Mom happy, it turns out that the next best thing for my Dad was to see his kids happy, and on the golf course we tended to have happiness as we got old enough to care less about our scores and more about our foursomes. Thinking back I recall lots of twinkles in my old man’s eyes in the company of his sons on a golf course.

It’s Masters weekend in the golf world. Today, for one day of the year, I will allow myself to want.

You see, golf, like baseball and other games, is woven into the fabric of certain families. Taught either game by our fathers, we are filled with memories of times spent in and around our game. Mileposts are tagged with golf-related markers for the men in my family. Some are from outings of our own, and some from trips to watch others play. Most simply revolve around the simple act of watching a tournament together on TV. Fortunate are those who have something like this.

My Dad was very generous with his sons when it came to golf (one sister took up the game after she grew up and got married). Generous with access (club, equipment) and generous with his time. The golf course was the one place where we knew he’d be OK with us. Oh sure, our shenanigans and occasional tantrums provoked every bit of his Dickensonian parenting style, but still, the golf course was where we eventually bonded as 3 adult men. Joined by my sister’s husband we made up a very special foursome, indeed. We 3 younger men repaid my Dad for his generosity by taking him on epic golfing boondoggles, and by sharing that space in front of the TV as often as we could.

What does this have to do with ‘want’, you wonder. Alas, no one needs to play golf, save perhaps for a few hundred pros of course. Over the years our family foursome was buffeted by the economic winds of life, just like all other families, but we were able to sail through and continue our odyssey. We all wanted to play, and our respective families wanted it for us, too. In time, at least for two of us, our bodies failed and what it would take to play impinged on true family needs. Worse, my Dad’s mind has failed him as well, and the memories that tie this story together are as lost to him as the proverbial duck hook into the woods.

There, in a nutshell, lies the ‘want’. I’ve long since lost the desire to play golf, and I can honestly say that I do not miss the game itself. I’ve played thousands of rounds; I’ve had a good run. The game of golf owes me nothing. No, it’s not the act of playing that I miss, the physical aspect of the challenge that I allow myself to want on this one day. What I want, of course, is one more round with my Dad, my brother Randy, and my brother-in-law Steve.

On this one day I allow myself to want the surgery that would return me to the game regardless of all the needs that would suffer because of it. Just for one day. I pretend. I imagine the joy on Steve’s face as he shoots even par on the the back nine of the hardest course we ever played together, winning the family grudge match. I can see the evil grin on Randy’s face as he gets deeper and deeper under my skin and beats me for the 1000th consecutive time, his game as flawless as ever. I hear my Dad cackle as he drops yet another long birdie putt on top of one I’d just sunk, sure that I’d beaten him this time, cringing at the thought of him telling and retelling the story for years to come.

In the end that would be enough, I think. When I call my Dad late today and we “watch” the back nine of the Masters together it would be enough to know that he remembers. We’ll talk about our adventures with Randy and Steve, and we’ll pretend that he remembers those times when we marked our journey by the exploits of the golfers on TV. Jack’s putt on 15. Tiger’s improbable chip in on 16. Ben sobbing on the 18th. Pretend that he remembers laughing at me after dropping that putt on top of mine, that one fine day when all we wanted was to play golf together.

Today…just today…club in hand, phone to ear…I will want.

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

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

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

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

CrossFit Kids programs are one way to provide youngsters with the inner strength necessary to stand up to peer pressure.

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

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

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

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

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

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

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

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

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

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

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

Just ask a caddy.

“Hilarious…a sensational novel.” –Golf Magazine

“Will leave you howling.” –Florida Times-Union

“An entertaining, revealing, thought-provoking, and cautionary tale.” –NY Times

“A must-read.” –Yahoo! Sports

Really? Did they all read the same novel I read? “The Swinger” by Michael Bamberger and Alan Shipnuck? Can’t be. The book I read was exactly none of the above. In golfspeak it was that most horrific shot imaginable…a shank.

“The Swinger” is the story of Herbert X. “Tree” Tremont, the best golfer on the PGA tour, who happens to be black, married to a beautiful white woman from Europe, who manages to blow up the most ideal life imaginable by being a selfish, self-centered serial philanderer. Hmmm. Sound familiar? Of course it does. The veneer covering this “fiction” is thin to the point of non-existence. We are invited, nay, led to believe that we can assume that all of the details are true; the names have been changed to protect the guilty.

Laugh out loud funny? Please. I picked up the book mostly for the amusement. I looked for the funny parts. I don’t think I got so much as a chuckle out of 200 some odd pages of drivel. The hilarity of near misses and hair-raising escapes? Nah. Each sordid episode was more soulless than the last, and each escape only dulled any inclination that I might have had to find some tiny iota of sympathy for Tiger…er…I mean, Tree.

“Is this how it really happened?” asks one of the reviews? Well, that part is at least a little bit interesting, at least as far as the writers are concerned. I found myself wondering which one of the authors was/is “Josh”, the aging, good guy golf writer who gets sucked into the cesspool and becomes Tree’s publicist/apologist. Which one got suckered and is now trying to weasel his way out of accountability?

Nope, in the end “The Swinger” was a disappointment in every respect. Simple prose steeped in simile and bereft of metaphor, the writing equivalent of a cheap muni course not worthy of joining the Muirfields of golf literature. The characters were as flat and two dimensional as an Oklahoma City track. Where is all the complexity in Tree? The Americablinasian,n,n,ness? Is THAT part true, too?

I felt empty. Cheated. Did you ever pay to play a really famous course only to find out that you have to take a cart, you have to keep the cart on the cartpaths, and all the greens and tees were just plugged? Pretty pictures on the scorecard but nothing but “no fun” from the 1st tee. Yah…that. It was totally contrived, like a porn movie without the goofy, repetitive jingle in the background.  I neither laughed nor cried, and I couldn’t work up an ounce of “I care” for a single soul in the book.

Frankly, I get more emotionally involved in Satellite Tour events on the golf channel in the middle of a sleepless night. My most prominent reactions were sadness and boredom, and I really like golf. And I really like Tiger. My advice for someone looking to pick up “The Swinger”? This one’s as gimmicky and trivial as a vacationland miniature golf course; it’s not worth the green’s fee.

For Mike and Alan? Take a mulligan, boys. That was one, ugly shank.

It’s been 10 years since the 9/11 attacks on America. One wonders what lessons have been learned in those intervening years, lessons that may be either personal or societal, or indeed lessons that might be so universal that they are both. This kind of stuff doesn’t happen all the time, a life-changing event that informs and transforms entire generations, a game-changer that sets the table, lays down the rules for all of the “play” to come. Looking back over the years it’s clear that I had an epiphany during those days right after 9/11, a personal insight that was so significant that it changed the very vocabulary I have used to discus my life since. How about you? Did anything like this happen to you?

I should set the table here I suppose. Where were you on that day? Where were you…what were you doing when the planes hit? When the buildings came down? It was a Tuesday. I was in the operating room when one of my assistants told us about the hits, and I was in the lobby watching as the first building came down. Everything shut down here in Cleveland; it was rumored that another plane had diverted and was on its way through our airspace. We shut down the offices, retrieved the kids from school, and set about hunting down friends and family all over the world. There was a little panic as we waited to hear from my brother (stranded in Chicago, eventually to rent a car to drive to Connecticut) and my closest friend Rob (safely at lunch on business in Rio di Janeiro), and then…nothing.

Remember? Remember how weird it was for a few days? Businesses closed, schools closed. All air traffic came to a full and complete stop. It was sunny in Cleveland, an odd stretch of bluebird days with nary a cloud in the sky. This, of course, only made it all the more eerie and obvious that the sky was empty, not a single airplane, not a single entrail to mark someone’s path from some here to some there. My kids begged me not to go on a business trip long planned for that Friday, their impassioned pleas rendered moot by the shut down of North American aviation. We all stayed home. Remember?

The world cautiously and gingerly re-opened for business that next week which allowed four of the White men to keep their golf date at  Kiawah Island. Not that the world had returned to business as usual, though. Not by a long shot. I flew out on September 20th I think it was, Cleveland to Charleston. Just me and a skeleton crew of workers at CLE for the departure and the closest thing to a private jet trip I’d ever taken. They weren’t closing the cockpit doors yet; I spent the whole flight chatting with the flight attendant and the pilots. They were very friendly, seeing as I was the only other living creature on board at the time.

The Kiawah resort had a 99% cancellation rate that weekend. That’s not a typo. NINETY-NINE PERCENT. We had the place to ourselves. I’ve never had better service. Walk in for breakfast and sit…anywhere. Stroll up to the pro shop at courses that typically have months-long waiting lists for tee times, and then proceed directly to the first tee. Lunch and a re-load? No problem fellas. What time would you like to play this afternoon? Unprecedented, and unlikely to be repeated short of the Apocalypse.

It was while playing the Ocean Course at Kiawah, the course made famous by the epic comeback by the American Ryder Cup team to re-claim the Cup after several pastings at the hands of the Europeans, that I had my epiphany. I hated it. I played poorly, but not as poorly as I scored. The course was so penal that shots little more than 2 or 3 yards off target begat unplayable or nearly unplayable lies. It’s not just that it was hard, either. Heck, the River Course at Blackwolf Run absolutely slaughtered me, but I enjoyed everything else about that venue. I hated the everything about the Ocean Course itself. If you are a golfer you understand what it means to say that a course “sets up well to the eye of the golfer”. Not there. Not for me. I never liked what I saw in front of me; the course never set up for my shot in a way that pleased my eye, let alone my game.  In the afternoon I played Panther quite well, and enjoyed everything about the walk, too.

We discussed our plans for golf for the rest of the weekend at dinner, a discussion that was made possible by the absence of any competition for tee times. My brother, brother-in-law, and Dad all wanted to play the Ocean Course again. Nope. No way. Why, I asked them, would I willingly return to some place or some thing that I knew I disliked? I then expressed my epiphany, my gut reaction to 9/11 and all that had come with it, identified and crystallized by a round of golf on the Ocean Course: the things that make me UNHAPPY make me feel worse than the things that make me HAPPY make me feel good. The bad feelings from the bad stuff are worse than the good feelings from the good stuff are… well… good. Furthermore, once identified, the bad things could very likely be avoided with greater accuracy and success than the good things could successfully be made to happen.

WHAT?! The table fairly exploded. Stuff like “glass half empty” and “not playing to win” flew around, a veritable carpet bombing of my revelation. I made a couple of half-hearted efforts to explain, to expand on my epiphany, to defend my position, all to no avail (which if you know any of the extended White family is not the least bit surprising). Nonetheless I stood my ground on the essential tactical decision that came from the strategy of avoiding things identified as “unhappy”–I continued to vote “NO” on another round at the Ocean Course.

Was I right? Am I right? Well, my partners definitely didn’t think so, and might still not agree if they were asked today. But here’s the rub: the epiphany was so clear, so obvious, so definitive and logical and right for me that it didn’t and doesn’t matter all that much what others think or if others agree. Given the game-changer that was 9/11 I was obviously open to this kind of revelation, though I was not in any way seeking this, or any OTHER sort of revelation. It arrived unbidden, and once there was like finding that thing you forgot you were looking for.

My epiphany? The things that make me happy can always be sought, can always be chased when they are visible, can always be welcomed if they arrive. Who wouldn’t fill their glass with that kind of stuff whenever they had the chance? The easy thing, I think, is to avoid the stuff that, once identified, you now know will make you unhappy. No matter how full your glass may be, THAT stuff always drains the glass.

Some times playing to win means playing defense.

I’ve been thinking a lot about health care recently. Real health care, not Health Care as in “Health Care Crisis” or “Health Care Reform”, but the kind of health care that is provided by doctors and nurses and all kinds of other health care providers. You know, like making sick people better, and keeping healthy people healthy. The kind of health care that old guys like me (I’m 49, in case you were wondering) got from pediatricians like Dr. Roy in Southbridge, MA in the 60’s, or like my sons get from Dr. Gerace in Westlake, OH today.

I did a lot of thinking about this some 5 or so years ago, too, when I developed the concepts that eventually resulted in Skyvision Centers. My mini-epiphany at that time is that medicine is the ultimate consumer service business. At its core medicine is about one group of people providing a service to another group of people who either want or need that service. It’s the most intimate type of service, too. One to one. Face to face. You and me.

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

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

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

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

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

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

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

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

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

Just ask a caddy.