Fail, fail, fail, fail, succeed

Always Open (Part 2)

ER’s are like they the drain at the end of the health care pipeline – everything ultimately ends up there. It’s your last stop before your final disposition. There’s only three ways out – you’re either discharged home, admitted to a unit, or packed up in a body bag and sent to the morgue.

Anybody that either can’t or won’t be seen by a provider on short notice (e.g. general medicine, cardiology, orthopedics, oncology, pulmonology, neurology, urology, pediatrics, geriatrics, psych, OB/GYN, infectious disease, etc.) is simply told “go the ER.” No beds in the hospital? Send ‘em to the ER! ICU’s full? Keep ‘me in the ER! Just don’t want to deal with your patient? Send ‘em to the ER! Maybe you’re a practitioner and just want to cover your ass? Send ‘em to the ER!

We’re always open and we never turn anyone away. If you’re sick we’ll take care of you and if you’re dying you’ve found yourself in the right place.

And here’s the cherry on top – we like what we do and we’re good at it. There’s just one caveat: whoever’s in charge of staffing, for god’s sake make sure there’s enough of us working to treat these people safely.

It doesn’t seem like too much to ask.

Oy

Nada – cero – mi cerebro es vacío.

Vuelve mañana…

Asking the Right Questions

When faced with a problem, your starting point is almost always going to be the questions “What?” and “Why?

For example – say you’re witnessing some unfamiliar phenomenon. Your first thought is going to be “WTF is happening here?

Or perhaps you keep making the same mistake over and over even though you think you are doing things differently each time. With mounting frustration, you ask yourself “Why is this happening?

Welcome to the real world, where you’ll never find the right answer until you ask the right question. And knowing what the right question is isn’t always obvious…

This is why even very smart people get stuck, spinning their wheels and getting nowhere, over and over again. We are almost always blinded by what we don’t know, by our inability to reframe the question in a such a way as to give us the solution we desire.

First principles can help, but if you are stuck on something and can’t find the solution, step back and try to reframe the question from a completely different perspective.

It also helps to focus on the problem before going to bed, for as long as necessary. Let your brain work on it while you’re asleep – you might be surprised at the results.

But remember this: If you can’t crack a particular problem, you either don’t fully understand it or you’re just not asking the right question.

Holiday Jumpers

To wit: Those who commit suicide by jumping from heights on holidays.

Common enough that we have slang for it.

Thank you – That will be all.

There It Is…

Just when you think you’ve got a handle on things in the ER – system overload! Impending meltdown here boss! I love that feeling where you’re starting to drown, and then the charge nurse looks at you and says cardiac arrest, ETA 5 minutes!

From that point on, it’s all systems go baby. No rest for the weary, just hang on ‘cuz it’s going to be a bumpy ride…

Celebrate the Little Victories

I did something today I’d been putting off for a long time. It required facing a very painful reality that I really, really wanted to ignore.

In point of fact I did ignore it until I finally grew some balls big enough to face the painful truth. I opened a door today that will start a long journey, but I’m kind of proud I finally faced it.

There’s two kinds of people in this world – those who can face the truth and those who can’t.

At least I know which camp I fall in.

Me and Mrs. Jones

Ok, I don’t expect anyone reading this to understand just how great it is, but this song, written by Gamble and Huff and recorded in 1972, sung by Billy Paul for Phillly International records, holds a special significance for me. It’s just a transcendent piece of art that’s very much a snapshot of the culture from which it came. I was 15 years old when it was a hit, and like most things you experience at that age, it’s forever indelibly imprinted on my brain. As a 15 year old, I really shouldn’t have understood it, but somehow I did. I was an old 15.

It’s just a magical recording, from an era long gone. I guess this is what it feels like to be old, but I wouldn’t trade this memory for all the money in the world. I’ve kind of got a lifetime of memories like this, but like I said, I’m fucking old. It is what it is, and somehow I’ve got to come to peace with that.

I know this trip is time limited and there’s no going back, and I’m trying to be ok with that. At my age, the end is coming whether you’re ready for it or not. It’s best to understand that so you can appreciate the time you’ve got left. I can’t live in the past though – I’m not quite ready for that. There’s too much left to do.

So RIP Billy Paul, your contribution to the world is unfortunately already culturally irrelevant – but for it’s moment, it was a glorious thing, and it’s still out there for people who are so inclined to enjoy. Great art is timeless, it will always be relevant to those who open themselves up to its riches. For those of us still alive who remember what you gave us, thank you.

We’re all heading for the great beyond, whatever that may or may not be, but for your brief moment here, you made something timelessly special.

And that’s not nothing.

Under Ice

It’s wonderful
Everywhere, so white
The river has frozen over
Not a soul on the ice
Only me skating fast
I’m speeding past trees
Leaving little lines in the ice
Cutting out, little lines in the ice
Splitting, splitting sound
Silver heels spitting, spitting snow


There’s something moving under
Under the ice moving
Under ice through water
Trying to
It’s me
Get out of the cold water
It’s me
Something
It’s me
Someone, help them

-Kate Bush, from “The Hounds of Love,” 1985

Bad Day

There’s a negative feedback loop going on in my brain today…

I think you know what I’m talking about. Everything’s shitty.

Nothing’s good and it’s only getting worse. In fact – was anything ever good?

The whole goddamn thing is ready to come crashing down. And there’s nothing you can do to stop it.

There’s a storm coming and there’s nothing you can do about it. Best to just hunker down and try to ride it out.

Reality check – For gods sake, take a deep breath son and don’t get your fucking panties in a twist – decompress as necessary and remember:

Tomorrow’s a new day.

A Paucity of Resources

If you’re really motivated and smart, you can do an awful lot with very little resources. But as the complexity and scale increase, you quickly hit a wall.

What happens when you hit that wall is going to have very little with how motivated and smart you are, and everything to do the resources you lacked when you really needed them.

Let’s hope that the endeavor in question isn’t one where people could get hurt because of poor planning or lack of visionary management.

And let’s really hope that when judgement day comes, you weren’t responsible the ensuing shitstorm.

No, friendo – that is definitely not a seat you want to be in.

Don’t Run Away From Your Pain

The pain of living is one of the things that binds us together. It’s a common thread that runs through everyone’s human experience. It’s what defines and unites us.

Find meaning in it, celebrate it, learn from it, use it to tell stories – but don’t ever run from it or be afraid.

It’s yours and yours alone.

Use it.

Perception and Understanding

What we think of any piece of art (or life for that matter), is filtered through the lens of our experience up to that point in time. Although this seems to be obvious and makes perfect sense on face value, it’s not always so apparent when it is actually happening.

This has several ramifications…

First, great art will continue to reveal different meanings as we age through life. Something you loved when you were young may reveal completely different truths when you are older, simply because you hadn’t experienced enough the first time to truly understand the depth.

But this phenomenon also suggests that something you didn’t get at one point in your life can be transformative when you look at it later. This is probably one of the reasons why advice from older people seems so useless when you are young. You literally haven’t lived enough yet to understand what the older person is talking about.

It’s something to bear in mind when revisiting art again – and yet another reason to always remain flexible in your thinking. You’re not always right the first time…

Art as a Metaphor

Sometimes people get caught up in the plausibility of a story, both in film and print. This is a big mistake, and is kind of missing the whole point of art.

It’s not meant to be taken literally, it’s meant to trigger a response, to make you think about the possibilities, to see the world in a different way. Scientists can sometimes (though not always) be the least imaginative – their thought process is too literal. Art isn’t meant to be literal, so there can be a rather large disconnect.

To appreciate art requires that you open yourself up to possibility – to suspend belief. If you look at art and think well that could never happen or that’s not possible then you’ve missed the experience due to your own lack of imagination, or at least your refusal to use it.

Mind you, a lot of art just isn’t going to resonate with everyone – I’m not talking about that.

I’m just saying that great art doesn’t have to make sense, and if you think it does you need to go back and look at with the innocence of a child. Then process that experience with your adult brain and grow.

Deadpool

My wife and I are BFF with another married couple going back 33 years. Recently, after dinner and a few drinks, the discussion turned to our own private Deadpool. I’m pretty sure I was the one who brought it up, it sounds like my idea of a party game. You see, my apparent obsession with death can also be used for amusement, at least until it starts to get real. It was great fun, at least for me.

Unfortunately, on reflection it seemed clear that I would be the first to go, and my male counterpart would be the last. That left the two women – it was decided my wife would be third and his wife would be second after me. I’m not sure about everyone else, but I was somewhat amused and as comfortable as I could be with my spot at number one.

Of course it leaves me at 62 with the realization that the other shoe could drop at any moment. The first shoe dropped when I survived my bout with cancer, although when I became septic after my appendix ruptured at 58, I realized that if I had been somewhere without access to medical care that would have been curtains for me as well. Ok, for the sake of argument let’s pretend I have three shoes.

The whole point of this exercise is this: it’s good to have some awareness of your mortality, if only because it makes you appreciate the moments you have now. It also helps you prioritize what exactly is worth spending your precious time on, and clarifies what is useless bullshit.

If you can figure this out, you will be a lot happier with the time you have left.

Important Note (Part 1)

If you’re creative, most people are not going to particularly like what you do. You mustn’t let this diminish your love for whatever it is you’ve made, they’re not secretly telling you how much you suck – they’re just indifferent. This is normal.

I recently listened to the author Ben Mezrich interviewed on Brian Koppleman’s podcast “The Moment,” and he talked about being rejected by hundreds of publishers, for multiple books he’d written before finally publishing something. Brian asked him How did you deal with all that rejection, how’d you keep going?

Ben replied, cheerfully and without hesitation: I knew they were all wrong. And I’m still convinced that every book I wrote that was rejected, could, under the right circumstances, be a best seller.

To state the obvious: everyone’s not going to get it.

Maybe your audience is really small, maybe it’s just you, it doesn’t really matter. All that really matters is that you keep learning, growing, and creating.

That’s the key, because when you stop doing that, life stops.

Hey!

Whatcha got there son?

Nuttin

A big, ginormous pile of nuttin’ – watch your step, mind you – you don’t want to get any on yer shoes.

For Every Action There is a Reaction

Sounds obvious, right? We all learned this in school at some point – after all, it’s Newtons Third Law of Physics.

But this actually has a very important relevance in our daily life – understanding this concept should help guide everything you do. Because if you think about it, it kind of puts the idea of karma and luck into perspective. After all, karma and luck are just a reaction to something. A decision to be at a certain place at a particular time, or maybe the act of creating something and showing it to the world.

Sure, you have a greater likelihood of failing at whatever goal you’re striving for than you do of succeeding. But what if that’s the wrong way to look at it?

Perhaps instead you should look at it with the understanding that the very act of trying will have some reaction – you just don’t know exactly how that reaction will play out.

Because, you know, it’s physics. This isn’t conjecture.

It’s a law.