Fail, fail, fail, fail, succeed


I’ve always known my body wanted to kill me. It’s just that when you’re younger, sheer youth and vitality can hold things in check. Once age starts to kick in, things become more and more precarious. You begin to realize the whole thing is about as sturdy as a house of cards.

As a result, my body and I have circled each other warily, always watching the other one for a sign of weakness. Me doing everything possible to strengthen and build my constitution up, while my body gleefully breaks something, hoping to muck up the works.

But I’ve always managed to rally, to put the traitor in its place. “Not today” I shout. “You’ll have to do better than that.” My body, unfortunately, takes this as a challenge. It’s imaginative.

And so we go, locked in a fight to the death. The conclusion hasn’t been written yet, my treacherous friend. A little bit of duct tape and some spackle and I’m good to go. This isn’t going to end well, but for the moment I’ve got the upper hand.

I’m not dead yet.

“I Couldn’t Do Anything”

These were Dr. Breen’s haunting words in her last conversation with a close friend, “I couldn’t help anyone. I couldn’t do anything. I just wanted to help people, and I couldn’t do anything.”

Today’s article in the New York Times highlights both her personal devastating experience with COVID and the overwhelming onslaught of patients in our ER with the same disease that we were ill-prepared to treat. But all of us – doctors, nurses, and ERTs, tried our best in a hopeless situation.

I’ll always remember her as a commanding and dignified ER medical director, someone I could turn to for help and guidance. She was fiercely dedicated to her patients and staff, a natural leader.

Her loss is still unreal, but reading this helps me process it. Life is short and precious.

Enjoy it while you’re here – you never know when your time is about to run out.


When we die die, we turn into stories. And every time someone tells one of those stories, it’s like we’re still there for them.

We’re all stories in the end.

John D. MacDonald (Part 1)

Holy fuck is this guy an amazing writer. Get a load of this:

Her back felt lean and fragile under my hands. It was like kissing a corpse.”

“We discarded the social and sexual taboos of centuries, and mislabeled the result freedom rather than license.”

“The world outside was a drab travelogue, without sound track, poorly edited.”

”The thing called Me is on that stage in every scene, in every act. I am the lead in a pointless drama.”

”A million million things have gone into my head, and memory is one of those toy cranes which can dig at random and never come up with as much as ten per cent of what must be there, buried under round candies.”

“Most men give up seeking an answer to the riddle of their own existence.”

”I felt like a child being bathed by an evil nursemaid.”

”August was a squat, bald, imperious little weasel in a soiled scurfy beret, Bermudas, Indian sandals and a sports shirt emblazoned with pastel fish.”

– John D. MacDonald, from “The End of Night”

Returning to Baseline

Today was the first time the ER started to feel like it did before COVID. Busy with the usual complaints, mixed in with some legitimate emergencies.

Kind of felt good, except for the ever-present viral threat. I’m always aware it’s lurking, watching for a moment of weakness, waiting for an opportunity.

Not today my treacherous friend. Today I’m wide awake with other fish to fry.

The Question of COVID-19 Mortality Rates

We don’t really know is the short answer – but experts are now estimating 0.6%. If everyone was infected, that would mean approximately 2 million deaths in the U.S. Of course, not everyone will be infected – herd immunity kicks in with an infection rate of around 70-80%.

Great Britain and Italy have reported a mortality rate of 14%. Again, because no one is accurately tracking the virus here in America, our numbers are still a moving target.

But even the conservative 0.6% mortality rate resulting in 2 million dead in America is a holocaust. A 6% mortality would mean 20 million dead. And if Great Britain and Italy are accurate, the numbers would be well over 40 million.

In all 8 flu pandemics that hit the U.S. since 1764, the second wave came approximately 6 months after the first one, and it was this second wave that proved to be the deadliest. With the 1918 Spanish flu, one third of all deaths came in a 3 month stretch from September to December of 1918.

But the coronavirus isn’t the flu, is it? No, unfortunately it appears to be more infectious. So what’s the good news?

Sorry, I don’t have any.

Nothing Ventured, Nothing Gained

There’s nothing like rejection of your writing (or anything you do for that matter) to make you re-evaluate your work. Is it good, or does it suck? Does rejection answer these questions?

I’m going out on a limb here: if it’s good to you, it’s good period. You’re belief in what you’ve made is pretty weak if you need affirmation from someone else as to whether it has any merit.

On the other hand, things can always be improved. The craft of writing is no different from music – it’s definitely a learned skill. The problem with rejection of fiction is that there’s often no critique with it, and a simple “no” leaves you with no choice but to make your own conclusions.

Therefore, absent any meaningful guidance, I’m going with the the belief that what I’ve written is good, at least to me. I worked hard on it and expressed something with words to the best of my ability. I got it to the point where it worked for me. Whether anyone else agrees is beyond my control.

The thing I learned a long time ago is this: you’ve got to love and feel fulfilled by the things you do. Filtering the world through your mind and creating something out of that process makes life richer.

Don’t ever let someone take that from you. Of course most people aren’t going to get what you do – you knew that going in. But don’t give others opinions more weight than your own.

Artists tend to judge their work harshly, so if you like something you created, go with that and let your belief in what you’ve created be unshakable.

The process of doing is the fun part anyway. If the rejection came with criticism, examine that closely – you may be able to learn something and grow.

Otherwise, try not to take it personally, because it definitely wasn’t meant that way. Just keep grinding and enjoy the process. And remember what Kurt Vonnegut said

Finding Joy in What You Do

Obviously, you’re not going to find it in everything you do – but it should be easy to find in the important parts of your life. You know – your relationships, your job, your creative life, your mind.

Sometimes you lose the joy you once had. It may be necessary to change your perspective but if you look hard enough you’ll find it.

It’s usually right under your nose.

You’re Welcome

I love podcasts. There is no other long-form medium where interesting people get to explore ideas in a free flowing format – uncensored. At their best you feel as though you’re eavesdropping on a private conversation.

Eric Weinstein’s “The Portal” is a case in point, and this particular episode really tweaked my mind. Eric (and his brother Brett) are both extraordinarily brilliant humans whose curiosity leads them to very interesting places. Nothing interesting is off limits.

On this episode Eric is talking to his friend of many years Stephon Alexander, a physicist and jazz musician who played with Ornette Coleman. They share a wide-ranging conversation over two hours with a couple of bottles of red wine, and I would be lying if I said I understood all of it. But holy fuck is it interesting.

The fact that this stuff is available for free is just mind-blowing.


COVID Fallout (Part 1)

Over two months after the peak of the COVID crisis here in NYC, the fallout is starting to become more and more obvious among my colleagues in the ER. We tend to be a stoic battle-hardened bunch under normal circumstances – but the experience of attempting to treat patients during the pandemic seems to be breaking even the strongest among us.

It’s becoming clear there will eventually be a mass exodus of healthcare workers traumatized by what they saw and were forced to do, by the feeling of utter helplessness in a mass casualty event. I’m beginning to hear docs I work with talking about “exit strategies.” Many nurses I’ve worked with and admired as role models for years now possess an eerie “1000 yard stare.” There’s a photo of myself taken during the height of the pandemic where the disassociation in my eyes is haunting and obvious.

This, BTW, is how I will look for the next several years at work, until there’s a reliable vaccine. For 12 and a half hours each shift no one will ever see my face again. I can smile but no one will know it. It’s difficult for patients and colleagues to hear and interpret what I’m saying because of multiple layers of PPE. It’s like trying to administer care in a scuba diving suit under water.

I’m not exactly sure how I feel about the whole thing yet. I’ve learned not to ignore internal trauma, yet I also understand that healing and perspective take time and work. Sometimes a lot of both – the mind works and heals at its own pace.

The biggest mindfuck for me is knowing my job could kill me. But I counter this thought with the fact that this is what I do – and besides, nowhere is safe. At least at work I have protective gear.

This is just the new reality. At the end of the day we have no choice but to adapt. At least in my job I can attempt to help others in need.

So there’s that.

Why Be Optimistic?

Because good people outnumber shitty people. I really do believe this is true. However…

It’s also true that shitty people monopolize the public conversation – they just tend to be louder.

And of course the anonymity of online discourse only empowers the vocal minority of the intellectually-challenged. The whole thing is like a nightmarish self-full filling example of the Dunning-Krugar effect in real time.

But if good people spoke up more often…

You Know What Bothers Me?

When someone walks into the ER with a complaint that sounds benign, like abdominal pain or constipation, and we do a CT scan that ends up showing metastatic carcinoma.

It just seems like life can be so randomly cruel.

I don’t know if it’s because I’m still processing my participation in the COVID disaster here in NYC or because I had cancer, but I seem particularly sensitive to this shit now.

I used to think that it was harder for younger nurses to process the random tragedies we see every day in the ER, but now I’m not so sure.

When you’re young you feel invincible – death and disease aren’t on your personal radar. As a 63 year old cancer survivor who also had a potentially fatal run-in with sepsis, I don’t feel invincible at all.

I already know what it feels like when you’re not sure if death is imminent, but it’s so close you can feel it in the room.

Nothing is ever the same after that.

Own It

You know that shit you love that you’re embarrassed about because you think no one else would get it? You’re probably right, but that doesn’t mean you can’t talk about it. It’s part of what makes you unique.

Own it.

What about those things you believe strongly about but keep to yourself because you don’t think other people would understand?

Own it.

The music you love that no one seems to know about?

Own it.

The things you’re interested in that no one else seems to even be aware of, therefore you think they wouldn’t be interested?

Own it.

Your age?

Own it. You’re not kidding anyone anyway.

Your sexuality or gender preference?

Own it.

Here’s why: In the long term you’ll feel better about yourself and have more friends and respect.

Just do it for christ’s sake. Treat other people with compassion and don’t judge, but be who you are.

Let your freak flag fly.

To Go From Suck to Not-Suck

Pixar films are not good at first, and our job is to make them so—to go, as I say, “from suck to not-suck.” This idea—that all movies we now think of as brilliant were, at one time, terrible—is a hard concept for many to grasp. … Creativity has to start somewhere, and we are true believers in the power of bracing, candid feedback and the iterative process—reworking, reworking, and reworking again, until a flawed story finds its throughline or a hollow character finds its soul. 

– Ed Catmull

Listen Up: Betty Davis (Part 2)

Kinda havin’ a Betty Davis riot here – this is just some of the coolest, most ridiculously slamming ‘70s funk ever. I think I’m in love – no, I know I am:) Betty Davis is the real deal. One of a kind – original.

Let’s start with Nasty Gal. Once the band hits the groove (maybe beat 3 of the first bar), this might be the deepest pocket I’ve ever heard. I find it impossible to stop listening to.

Then maybe check out the first two tunes off her second album: Shoo-B-Doop and Cop Him and He Was a Big Freak (“I beat him with my turquoise chain” is the first line of the song). WTF?!! Clearly the groove is no accident because every tune, on each record, with different musicians – all have a pocket deeper than the Mariana Trench.

Musically you can hear her influences but the way she puts it together is unique to her.

Betty Davis – she’s a motherfucker Ya’ll. Dig it.