Fail, fail, fail, fail, succeed

Category Archives: Nursing

The Failed Hail Mary

First of all, the Hail Mary should never be a strategy – it’s only a last resort – your last shot when all seems to be lost. Under those conditions, you really have no choice. It’s either do nothing, or go for the Hail Mary and hope for the best (hope for the best is never a good strategy either, BTW). So throwing a Hail Mary and losing the game isn’t really a big surprise – the game was already lost, you were just hoping for a miracle (hoping for a miracle – also not a good strategy).

So I just threw a Hail Mary in life and came up short. Losing sucks, but nobody got hurt and I’ll live to fight another day. Take a deep breath, remember all of the things you have to be grateful for, pick yourself up, and move the fuck on.

Tomorrow is another day.

No One Owes You Anything

Your parents don’t owe you anything

Your lover doesn’t owe you anything

Your boss doesn’t owe you anything

Your friends don’t owe you anything

Your profession doesn’t owe you anything

Your teacher doesn’t owe you anything


Whatever you get in this life, you’re going to have to fucking work for it.

And you better be prepared to get banged up in the process…

Listen Closely…

Here’s a secret “life hack” that is so simple yet so powerful most people are unaware of it. I didn’t really discover it until I was in my 40’s, but I have literally used it several times a day since – to great effect.

So here’s the trick – you tell yourself ahead of time how you are going to feel, and your mind is now primed to interpret whatever experience happens with the perspective you have prepared it for.

In other words, you feel how you think you are going to feel.

The ramifications of this are obvious, and extremely powerful. To a large degree, we choose how we are going to interpret life. We are unfortunately unable to control many of the bad things that we experience in life. We would like to think we can control whether or not we get cancer, or whether a loved one dies, or any number of the horrible fucking things life throws at us. But the reality is that, for the most part, we can’t.

But we do have complete and total control of how we respond to these events, and that is something no one can ever take away from you.


In very general terms, an agent is a being with the capacity to act, and ‘agency’ denotes the exercise or manifestation of this capacity.”

I love this term, because it empowers an individual to act, while forcing the same individual to reason why they are acting. In other words, instead of passively waiting for someone to tell you what to do, you must use your own agency to figure it out and act on your own. We all have agency to some degree as humans, while individual professions each have their own defined sphere of  autonomy based on one’s training and expertise.

The problem is, some people are afraid of exercising their agency. At it’s most basic level, we all have the power to try and make things better. We all have the power to help others. We all have the power to help ourselves. As long as our intentions are good, we have an obligation to exercise our agency.


Part 1: When you are a nurse and someone who just had a stroke says to you “Thank you for taking care of me.” I can’t think of anything that makes me feel better than that.

Part 2: Intoxicated trauma patient with severe facial wound secondary to knife injury looks up at me on the trauma room stretcher and says “Thank you doc,” I reply that I’m a nurse, to which he responds “I’m sorry, thank you anyway doc…”

It’s a good day in the ER…

When Your Best Isn’t Good Enough Part 1

Ok, let’s frame this and put it in perspective. You wanted to do something, and were unable to do it. So you failed to accomplish your mission.


The word that hurts, the thing we all will do anything to avoid. If you’re like me, “I failed…” is like a psychic punch to your soul.

So what does this mean? Does it mean that because you failed to accomplish your goal, YOU are a failure? I would argue no, it most definitely does not. It means you stepped up to try, and you didn’t succeed. You could have done nothing and protected yourself from failure, but instead you chose to try.

There is no shame in that, although in the moment it sure can feel like it. This is how we learn and grow in life. Fail, fail, fail, fail, SUCCEED. Failure keeps us honest and humble, and if we keep trying, we demonstrate that although we are an imperfect human, we have the strength, resilience and tenacity to eventually succeed. We do not fold like a cheap suit. Failure is not about us, it is not personal. It is not a reflection on who we are as humans.

But how we handle failure is a reflection of who we are, failure is our chance to pick ourselves up, learn from our mistakes and grow. Dare to fail, and don’t beat yourself up when you do. OWN IT and move on…


If you are going to do something, do it like you fucking mean it. No pulling your punches, no halfway measures. Full out going for it.

This is what people want to see – this is what people respect. This is what makes something compelling. Invest completely.

Once you make a decision to do something, do it with enthusiasm.

See what happens.

Work Family

One of the nice things about working in an ER is the relationships you develop with your coworkers. The nature of the work requires a high level of trust & interdependency that, over time, develops into a unique and singular bond. You begin to depend on each other, sensing when something is wrong & making allowances as needed. In a highly charged environment where anything can happen at any moment, where life and death decisions must be made quickly, you learn the strengths and weaknesses of your peers. You begin to know these people & how they respond in a deep & fundamental way.

I am grateful to have the opportunity to work with the people I do. I believe we are all trying to do the right thing, to the best of our abilities. For better or worse, we all need each other.

Compassionate Detachment

I never heard this term until recently – A Hindu friend of mine used it during a conversation we were having about my disengagement from all politics. She thought it was a “stage of life” thing, I don’t deny there isn’t an element of that. My reasoning goes like this: I’m 60 years old and in the last six years I survived two illnesses that could have killed me, making me very aware of my own mortality. Life ain’t going on forever folks – the clock is ticking, and I hear it loud and clear. There is no shortage of injustice, cruelty, and hatred in the world, and on a macro scale there isn’t a goddamn thing I can do to fix it. The things and people that are broken are beyond my control. So I have made a conscious decision to pull back and disengage from everything negative that I can’t change. I’ve got a limited number of years left and I would like to focus my energy on things I can change.

I can try to spread positive energy through my day to day actions, and that’s about all I have control over. I’m hoping that by being a good human I can change things for the better on a micro scale. And that’s about it. The rest I’m just letting go. Now, having said that, I’d be the first to tell you that I’m not sure this is the right thing to do. But the reality is that I don’t know what the right thing to do is, and this is the best I can do for now. Maybe I’ll change my viewpoint at some point in the future…

I used to read the New York Times every day, and was somewhat of an internet news junkie. It was really hard just stopping all of that cold turkey; I still struggle with it. But ultimately I think it’s better for me. The constant influx of negative and biased bullshit that I was impotent to change wasn’t doing me any good. If humanity is hell bent on destroying itself, so be it. I’m choosing to try and not be part of what’s wrong, and attempting to do the right thing in whatever small way I can.

For the time being, I’m practicing compassionate detachment.

The Gift of Cancer

OK, bear with me a minute here – I just had a great session with my psychiatrist (of 21 years), and I actually made this statement: “I think cancer made me a better person…” I know this sounds weird, it sounded kind of crazy when I said it. And it took me by surprise, it wasn’t a premeditated statement. But I think it is undeniably true…

It’s been six years since I was diagnosed and treated, so it took me a while to arrive at this point. I should state that my treatment was successful and today I am cancer free. But it wrecked me a bit physically and I still deal with the repercussions – the parts of my body that were diseased are now gone. So there’s that. The years following treatment were psychologically rough and I am still finding out who I am and how I’ve changed after the experience.


The relative importance of everything in life seems much clearer now. I constantly feel grateful – it’s not forced, it’s just my general state of mind. I don’t worry about what might happen, because I know what’s coming. I don’t worry about whether I can handle some tragic event because I know I can. All of the ridiculous bullshit in life I just cast aside. Don’t care. I try to treat everyone I come in contact with with respect, and I try to help people to the best of my ability. Everything else I just let go. Somebody treats me like an asshole? Rolls off me like water off a duck’s back. Means nothing, I genuinely don’t give a fuck. I might briefly think “it must really suck to be you.” No one is important enough to have the power to psychically hurt me (except maybe my wife.)

There’s no shortage of horrible fucking things in the world. If there is anything I can change for the better, I try my best to do it. But if it’s something beyond my control, I just let it go and don’t ever look back. Life is too short, and I don’t have that much time left. And the realization that what I have could end tomorrow is not an abstract one  – it’s all too real, ‘cuz I’ve already been down that road.

The weird thing is that instead of making me anxious, bitter, angry and frightened, it has had the opposite effect. Life is better and I don’t really worry about anything. Some things in life you just can’t predict.

It’s Important to Know Your Limits

Some people melt down quickly under stress while others seem to have almost infinite reserves. There is no good or bad here – everyone is different. The one whose ability to cope disappears at the first sign of trouble might possess some highly specialized and invaluable skill. But for those who are able to think clearly and remain calm under extreme duress, here is a warning. KNOW YOUR LIMITS. Eventually, all reserves are finite.

Proceed with caution…

Present AND Engaged…

If “just showing up” is half the battle, what happens when you show up AND are fully engaged? Things begin to happen, and opportunities start to appear, that’s what. Why does this happen? I think it’s because most people just show up and do what is expected of them. That in itself is not always easy. So when someone isn’t just present – but actively engaged – it really stands out.

Something weird and almost magical happens when you really become engaged with what you do. It almost seems as if your active engagement creates some kind of vortex of energy that begins to draw other people and opportunity to you. I’ve observed this phenomenon over and over again in life.

OK, so what does this mean “to be actively engaged?” I think it’s really just an attitude, a way of perceiving your place in the world. Are you curious and always trying to make things better? Then chances are you’re going to be actively engaged. Your curiosity will always be driving you to learn more, and your desire to make things better will focus that acquisition of knowledge to specific problems you encounter. It doesn’t mean that you will always know how to solve these problems – but the fact that you are actively working to find a solution will set you apart from most. It’s even better if you fail at something, pick yourself up, and start again. Instead of people saying “what a failure,” they will begin to see you as a formidable person. It’s the getting up after failing part that is looked on with more admiration than the winning part. Because someone who can do this over and over WILL EVENTUALLY WIN. Everyone recognizes that failure is a natural part of life. Overcoming failure is an entirely different matter. It’s what champions do.

So, let’s recap. Showing up is half the battle. Being actively engaged moves you up to maybe the 80th percentile. But being actively engaged, failing at some initiative, and then getting back up and attacking the problem from a different perspective? Now you are in the top 5%. Now you are a formidable person.

And everyone wants to align themselves with someone who is formidable.


Being a charge nurse in an inner-city ER can, on a busy day with high acuity patients, begin to feel a bit like what I imagine leading a field disaster unit might. You are literally running the whole show; controlling who gets seen and when, assigning patients to nurses and doctors, determining the course of action for each case – you are the last word and assume complete responsibility for everyone who walks through the door. Some of them go home, some are admitted, and some of them die. Sometimes you are triaging patients and making preliminary diagnoses guiding their care at the same time.

In ERs in the U. S., there is no limit to the number of patients we admit (mind you, I strongly believe this is a just law). We are bound by federally mandated legislation to accept everyone who walks in through the door (or is brought in by EMS). This can create some very dangerous and stressful dilemmas – you quickly run out of resources and then my friend, you are flying on your own. And it is a lonely flight – you spend every moment expecting and preparing for the next disaster and putting out fires.

Right now I feel like I’ve been beaten with a stick, like my brain is cotten candy, like I am so tired I can’t go to sleep. Today I was charge.

I am grateful and privileged to have my job, and I’m happy with every opportunity I have to help someone. I think we are all capable of rising to this level, whether we think so or not.

Charge – it’s a state of mind…

The Best Thing About Being a Nurse

The whole purpose of my job is to help people. No matter how shitty things are – in my life or in the world – I get to go to work knowing that I am part of the solution and not part of the problem. I get paid to do the one thing that is virtually guaranteed to make you feel better.

Make no mistake, it is an almost impossibly difficult and exhausting job. And really dirty where one has constant intimate contact with every possible fluid, tissue, odor and substance that can come out of a human body. In the ER there’s constant yelling, alarms, physical threats, death, and verbal abuse. But I love being the person who is not phased by any of it – because I am on a mission. If you truly need help, I’m your guy.

It doesn’t get any better than that.

Did I mention that I also get to work with a team of really smart and dedicated people?

The Fragility of Life

Believe it or not, quite a few of the residual effects of surviving cancer are positive. But one negative (maybe I just haven’t evolved enough yet to see it as a positive), is that one becomes acutely aware of just how fragile and temporary our health (defined as the absence of disease) is… You are constantly aware that your current phase of health is transient. It will end. And you’ll eventually be sick and back in the hospital (I’m sorry folks, but this is coming for all of us). And when you are there, you’ll desperately wish for the time you had when you weren’t sick. I know, because I’ve been there. I guess it’s kind of a blessing in a way. Most people are blissfully unaware of what’s coming, which I suppose is as it should be. It’s a protective mechanism. But once you’ve had to reckon with the very real possibility of your imminent diseased deterioration and death, had that dreadful moment when your oncologist says “I’m sorry, but the news isn’t good,” everything changes. You become more grateful for your time, but more acutely and painfully aware that it won’t last. It’s a gift and a curse.

I guess I’m just saying, be grateful for every minute you’ve got. The reality is that it’s eventually coming to an end.

Better get busy…

The Long Game Versus the Short Game

Long game: Working for four years to get a college degree. Payoff: Having a greater understanding of the world and how it works. Acquiring knowledge and having the ability to apply it makes one more able to contribute in a meaningful way. Sacrifice: Consistently applying oneself over a period of years represents a lot of time that could be spent doing something else.

Short game: Studying for a week to pass a test. Payoff: You get to stay in school. Sacrifice: A weeks time.

We see these concepts over and over in our lives. Some people are psychologically able to delay gratification while pursuing goals more easily than others. But having the discipline to stay in the long game isn’t enough. You also need to have a credible vision of where the long game is taking you, otherwise you risk wasting time on an unobtainable goal. It’s easy to see why people avoid this strategy.

It’s almost impossible to predict the final results of any given long game pursuit. But the alternative is leaving the outcome to random chance. My money is on those playing the long game. People who are able to stay focused, disciplined, and flexible tend to be the  formidable leaders who get things done.

Who Are You?

Know this: every moment of every day, you are defining yourself by the actions you take. And everyone who watches you is judging who you are based on what they see.

From a psychosocial perspective, here’s the interesting thing about people. Nobody is really that interested in you, at least not superficially – they don’t really care if you dye your hair, or what clothes you are wearing, or what your sexual orientation might be. But they do care about what kind of person you are, because we are social creatures who need to know our environment and who we can trust. If shit goes down, we want to know who we can count on – who has the personal strength and fortitude to survive and still maintain a moral compass that will help us keep our humanity intact.

So, whether we are conscious of it or not, we all watch everyone around us for clues as to who they really are. It’s probably a survival mechanism that has been with us since we became sentient. And once you become aware of it, it’s not that hard to see who people really are based on their actions. Not on what they say they are going to do – but on what they actually do.

What kind of person are you?