Random Thoughts from a Restless Mind

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

Wet or dry, that’s just hot.

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

They seem to like the heat.

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

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

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

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

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

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

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

And what this AI taketh is my time.

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

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

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

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

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

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

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

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

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

It’s all just stuff.

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

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

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

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

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

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

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

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

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

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

This entry was posted on Sunday, June 14th, 2026 at 3:58 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.