Lessons From A Simple Average Day

Stumbling downstairs I greeted Mercury, our jet black cat. She meowed an acknowledgment and followed me into the kitchen. Her affection a guise for her true motives, the acquisition of a treat. Her goal met, she looked up at me in a thank you glance and sauntered off to perch herself on top of her favorite comfy chair.

Sticking a K-Cup into my Bunn single serve coffee pot I pressed the brew button. Hot brown liquid squirted into my Smoky Mountains earthenware mug. With each sip, I became more alert and focused.

Grabbing my old brown leather messenger bag I shoved my MacBook into it. I knew that I would not be seeing my friend, Tom, for coffee, and for an alternative activity, I stuffed several articles on Medicare into the bag’s back compartment. I have to admit that I had been avoiding reading these articles, as the fear of making a catastrophic health insurance mistake had immobilized me. However, it was time to take my head out of the sand and move forward.

Heading out the door I was instantly smacked in the face by a blast of cold, wet air. I glanced up to the streetlight in front of my house to see a fine mist silhouetted against its bright backdrop. For an instant, I thought about returning for an umbrella, but the mist looked light, and my red Columbia jacket has a weatherproof hood. As I walked the mist turned to rain. I continued to move forward.

Greeted by a friendly, “Hello,” I entered Starbucks and ambulated to the counter to order a Tall, Veranda. It was then time to coordinate my Medicare articles with their corresponding websites. One YouTube video offered a fee Medicare guide, and I signed up for it, an action that I regret, as their salesforce called me at least a dozen times.

It was election day, and I determined that I would walk to my polling place from Starbucks. Unfortunately, the rain had increased in ferocity. My jacket had reached its saturation point, and the dampness now enveloped me.

At the polling place, an unknown elderly lady election judge recognized me. “You are Doctor Kuna! You delivered my Mary! She announced this to several other officials around her. I could not place her, but I surmised that I possibly treated her in the distant past. I smiled and quickly moved away as I didn’t want to get into a conversation that would reveal that I was a psychiatrist, not an obstetrician. Her private life was hers to keep.

Back home, I contemplated taking a hot shower but elected to drip dry instead. On the computer, I watched a few videos from Dale Calder, a retired man from New Brunswick. I stumbled on his videos by accident, and find his slow and deliberate style peaceful and engaging. He often records his videos from a tiny micro cabin and chats with his viewers while he makes comforting meals on a wood stove. He has a quality about him that makes me feel like he has invited me into his cabin for a cup of tea and quiet conversation. I value his Zen-like “appreciate the moment” way of living.

Watching his videos inspired me to explore camping cooking, and I pulled out my little butane stove, the one that I bought at H-Mart over a decade ago. I then assembled my 20-year-old Coleman camp oven. If Dale could make shortbread on a wood stove, certainly I could do more than warm up a can of soup on my little burner.

I elected to make breakfast and decided on blueberry pancakes, as I had a small clutch of dehydrated berries left from a previous camping adventure. Flour, egg, baking powder, salt, milk, melted butter, each item was measured then mixed in a big red melamine bowl. Last went in the blueberries, and my yellow slurry instantly turned a bright purple.

I lit the butane stove and placed on it my 10” GSR camping fry pan. If I was going to do camping cooking, I was going to use camping equipment! I heated oil until it popped with a test drop of water and then poured in three pancakes. I only made a small amount of batter, and the job was quickly completed in two runs. A pat of butter, a smear of sugar-free apricot preserves, and a squirt of sugar-free syrup, breakfast was served.

Encouraged by my success, I placed the Coleman oven on top of the stove and lit the fire. I mixed another batch of batter, this time for sugar-free muffins. Fingers crossed, I set the muffin tin into the Coleman.

As my muffins baked, I searched the basement for my GoPro video camera. I located it and contemplated how I might use it in a “Saving Savvy’ video that I was thinking of making. The muffins continued to bake as I searched for my tripod and audio recorder. My nose informed me that they were done. Success, and a perfect complement for the vegetarian lentil soup that I was planning for lunch!

Guilt overtook me as I looked out at my front lawn, which was covered with a thick carpet of leaves. My next door neighbor has a meticulously kept lawn, and the wind was blowing my leaves onto his grass. I really despise raking leaves, and so I decided to turn my task into an experiment. Learning something new always makes a dull job more interesting. The question: “What is the best gadget to remove leaves, rake, blower, or lawn mower?” Each section of the lawn was tackled by a different method. The result: Mowing was the fastest, while raking gave the best overall results. I knew that this was no great discovery, but it kept me at the task, and I finished the job.

A few more random jobs ebbed away the rest of the afternoon. Will returned home from school, followed by Julie coming from work. I sat with them as they supped on a dinner of leftovers: spaghetti, bits of turkey breast, and reheated crescent rolls. I nibbled on some of the turkey but deliberately avoided a full meal as I was having dinner with my sister later in the evening.

At 6:45 I hopped into the Promaster and drove 15 minutes to Panera Bread. Nancy had already arrived, and I sat down across from her as I waited for my order of squash soup. It eventually came, and I sipped it while I caught up with the news of her family. I have been meeting with my sister every Tuesday night for the last few months. We are both writers, and our meeting’s purpose is to mutually support each other as we try to improve our writing skills. Beyond this function, it is wonderful to regularly meet with Nancy, as we genuinely enjoy each others company.

By 8:30 our meeting had concluded, and it was time to head back home and to the pleasure of a long, and scorching hot shower. Julie and I chatted a bit, and the day concluded.

All in all, a wonderfully average day.

Dear reader, you may be asking why I am writing about my day. There are several reasons. The first is that I am ever trying to appreciate being in the here and now. The day that I described above is never to be repeated. To dismiss it would be a negation of 24 hours of my life. Although typical, the day was filled with learning new things, experiencing new things, connecting with others, and doing productive work. How often have I ignored such days, as I focused on vacations and other spectacular outlying experiences?

I am making an earnest effort to celebrate each event and every connection. I am getting better at this effort. This improvement was not caused by a significant life event; instead, it was seeded by the ticking of time. When I semi-retired in January, I felt an urgent need to do the next big thing. Over the last 11 months, I have come to realize that life isn’t about the big stuff, it is about all things. Happiness can be found by appreciating and savoring every experience. Making breakfast becomes an adventure, raking leaves an experiment, meeting with my sister a growth experience, taking a hot shower a pampered luxury. Everything has significance. It is crucial for me to focus on this truth, instead of discounting a typical day as just something to get through.

I am uncertain if my writing and photography will ever reach a broader audience. However, it gives me pleasure to think that you have taken the time to travel on this journey with me. Along the way, I hope that you will also open your eyes and your heart to all of the experiences that you are given on a daily basis. One step in front of the other, moving forward together, not alone.

Peace.

Feeling proud (and damp) after voting.
Camper blueberry pancakes with sugar-free preserves.
My 20-year-old Coleman oven seated on my camp stove.
Yummy sugar-free muffins, camper style.

Chinese Halloween

I grew up in the 1960s, and at that time Halloween was a minor holiday celebrated by young children. My costumes were usually homemade and pieced together from existing house items. A favorite resource was our kitchen closet, which was never pruned of its contents and therefore it was a treasure trove of costume building materials.

I would often adopt the persona of a hobo. I would find a worn flannel shirt and a beat up fedora in the closet and paint on a pseudo-beard with a piece of burnt cork.

Costumed, it was then time to meet my best friend, John, for our trick-or-treating adventure. Our goal was to get as much candy as possible, with our journey ending when the street lights came on. Once home I would pour out my bag’s contents onto the living room carpet and start my sort. If I had gone to enough houses, there would always be a few full-sized candy bars, and these would be my most prized finds. I was guaranteed to have a lot of mini-candy bars and other cellophaned sweets. Naturally, I would have random Many Janes or peanut butter kisses, so disliked by me as they were usually rock hard and inedible. And then there were the items that would make a direct trip to the garbage can: apples, homemade popcorn balls, loose candy corn. These items were considered dangerous as some maniac could possibly alter them with razor blades or injected rat poison. This urban myth fueled by the annual TV news story of kids having their candy x-rayed at a local hospital for pins, razors, and shards of glass. As far as I know none of the above were ever found, but I wasn’t going to die by biting into a poison apple, and so I willingly tossed all suspicious items.

Sorting done, it was now time for hiding. Seven of us lived in our small Chicago bungalow, and hiding spaces were scarce. Despite my efforts, it wasn’t uncommon to find the best candy treasures missing by the next morning, stolen by my older brothers. With limited recourse, the only option was to move on and focus on the next big holiday, Thanksgiving.

My Halloween adventures abruptly stopped in the 5th grade when a crabby lady loudly shamed my friend John and me for being, “Too old to trick-or-treat.” It was time to move on.

For many years Halloween was insignificant. I would attend an occasional Halloween party, but that was about it. This latter fact changed when I started to date my wife, Julie. Together we experienced what we now refer to as the Chinese take-out incident.

Twenty-seven years ago Julie came over to my house on Halloween, and we decided to order Chinese carryout for dinner. I had in my possession a giant magnum of very high-quality champagne. It had been gifted to me by a friend the prior Christmas. I have to confess that I know little about champagne and that I’m a pretty lightweight drinker. However, I knew that champagne does not improve with age, and so I decided to uncork it for our Halloween feast.

We sat at the kitchen table noshing on Mongolian Beef and potstickers while we drank the champagne, served up in paper cups. I couldn’t detect much alcohol in the beverage which tasted a bit like apple cider, and I kept on pouring out drinks because I knew that its fizzy goodness would be gone by the next day. No sense wasting it!

Every 30 seconds the doorbell would ring. Initially, Julie or I would go to the door. However, in short order, we were both rushing to the door to hand out candy. With each paper cup of champagne, our food seemed more delicious, our conversation more fascinating, and the costumes more amazing. Who knew that Halloween could be so much fun! Unfortunately, the joy faded and was replaced by headaches and significant malaise. That evening I learned that champagne and carbonated apple juice are two very different things.

Years passed, we married and had children. It was time for new traditions. When my kids were younger, there were the requisite trips to Bengston’s Pumpkin Farm, which seemed to get even more commercial and expensive with each passing year. Then there was pumpkin carving day. Each of our kids would tell me what kind of face that they wanted on their pumpkin and I would do my best to create it. In the early days, I did all of the carvings, but each child was expected to eviscerate the slimy innards from their respective fruit. I always seemed to carve just a day or two too early, and by Halloween, our masterpieces were gooey messes.

My kids made mostly homemade costumes, not by need, but by choice. Sometimes they would dig through our box of dress-up clothes, at other times we would go searching the Halloween store for the right wig or grease paint. I recall one Halloween when I was covered with red spray paint, the result of the Lego costume that I made for Will. One of my favorite memories is walking with my kids as they went door to door. Although I stayed on the sidewalk, I was still able to relive my own Halloweens from days gone by.

Just like me, they would pour their bounty on the living room floor and sort. The girls were especially happy with this protocol, as William didn’t eat chocolate. In addition, he was the youngest. Four mini Snickers for a single Twizzler? Will was delighted to make the trade. Where I came from a “want” model, my kids live in a “plenty” one. Their candy would sit on the floor for days until I would set a strict limit. I have to say that my anger was tempered by their generous gifts of Kit Kats and Reese’s Peanut Butter Cups, two of my favorite candies.

As I write this my oldest daughter has a family of her own, the next two are in college, and my William is almost 18. This year there was no Pumpkin Patch, no Carving Day, No costume creation, no Halloween walk, and indeed no champagne.

Instead, we sat around the kitchen table eating Chinese carry-out, having fascinating conversation, and running to the door to see the kids dressed up in their amazing Halloween costumes. Some traditions come, some traditions go, but it seems like Chinese Halloween is here to stay.

The kids were expected to eviscerate the fruit’s innards.
Grace as a grape

 

Kathryn as a doctor, Grace as a cat
Will as Santa. His friend James as a mushroom.
Yes, we did have Chinese carry-out this year

The Highly Selective College Myth And The Terrible Student Loan Crisis

For my 50th birthday, I gifted myself with a real doctor’s car, a Mercedes. When I pulled out of the dealer’s lot, I felt like I was the king of the world. After a month of driving my new car, I realized that it was just another box on wheels.
_______________

The house lights dimmed and my eyes focused on the panel of experts sitting at a long table. The host introduced each member, starting with the representative from our local community college, and ending with a counselor from the University of Chicago. She represented all of the “highly selective colleges.” It appeared that the panel members were positioned in a classic good, better, and best order.

You may be wondering what a highly selective college is. A selective college is one that accepts less than half of its applicants, and a highly selective college is a college that accepts less than one-third of its applicants. I attempted to determine who coined the selective and highly selective terms, but I was unsuccessful. However, these names have the ring of a good advertising campaign slogan.

A school can become a selective or highly selective simply by refusing more applicants. The Washington Post in an October 2017 article listed some of the ways that colleges become selective and highly selective. One way is to buy the list of names of individuals who have taken the ACT and SAT college admission tests, and to then market your school directly to those students, even when your college has no intention of ever accepting them. This not only reduces the percentage of individuals accepted, but it also provides revenues to the college via application fees. A second technique is to use multiple applications cycles, like early decision.

As an example, Vanderbilt University filled 54% of its freshman positions via early decision rounds. In other words, only 46% of first-year slots were available for the majority of the applicants, thereby reducing the percentage of students accepted. It is unlikely that applicants accepted by early decision will be offered merit scholarships, as they have agreed to a binding commitment to attend. The college has them and doesn’t have to worry about the student getting a better offer elsewhere. This makes it more likely that a higher percentage of these students will come from affluent families who can afford to pay full tuition.

You may hear statistics that promote the benefits of attending a highly selective school. In a 2010 article, the New York Times cited a study from the RAND corporation that showed strong evidence that graduates from highly selective colleges did very well. The study looked at participants who had graduated ten years prior and found that individuals who attended highly selective colleges made 40% more income than individuals who graduated from the least selective colleges. On face value, it would seem that highly selective colleges possess some “secret sauce” for success. However, isolated statistics rarely tell the full story. Students from highly selective colleges are often very motivated and enter college as excellent scholars. In addition, they can be more affluent and thereby have greater social and business connections. Graduates for the least selective colleges can be at the opposite end of the success spectrum.

A 2017 Atlantic article revealed that when students with similar SAT scores were compared there wasn’t a significant difference in overall earning between highly selective and less selective colleges. Factors that have a more direct impact on someone’s earning potential include the type of degree (engineering vs. social work) and the individual’s drive, talent, social skills, and motivation.

You may also have heard that 30 of the top 100 CEOs from fortune 500 companies come from Ivy League schools. This sounds impressive, but note that 70 of the top 100 CEOs did not. And let’s not even talk about university dropouts like Microsoft founder Bill Gates, and Facebook founder Mark Zuckerberg.

Do graduates from highly selective colleges have higher job satisfaction? A Journal of Labor Research article states the opposite. Highly selective college graduates were less satisfied with their job than individuals from less selective schools.

The subgroups that did seem to show a positive financial benefit from attending a highly selective college included individuals whose parents did not have a college degree, as well as blacks and Hispanics. The article speculated that these students benefited from the networking and connections that they made at their universities.

Highly selective colleges are typically more costly than other schools. Harvard’s 2015 average annual cost for a student was $64,400.00, compared to $24.673.00 at the University of Wisconsin, Madison. Both schools offer excellent educations, but a year at Harvard is almost three times as expensive. Many universities offer some financial need aid, but highly selective colleges typically do not provide academic merit scholarships.

The pressure to get into a highly selective school can be enormous and can be both internally and externally generated. I have known students who felt that they would be a failure if they didn’t get into the highly selective school of their choice. Parents sometimes use their child’s college acceptance as a personal point of pride, as well as a license to brag. High schools loudly celebrate when one of their students is accepted into a highly selective school. Parents talk about giving their kids the “college experience” as if going to an institution of higher learning was akin to a ride at Disney World. All of these factors contribute to the myth that a degree from such an institution is magical, which it is not. In my work life, i have talked to parents plagued with guilt because they didn’t have the resources to send their child to the school of his/her choice. It should be noted that the student’s choice often had little to do with academic reasons and more to do with setting, and social life.

A 2018 Forbes article headlined that the price of college is increasing almost eight times faster than wages. A 2012 report from the Huffington Post cited that the cost of a college degree has increased 1120% over the last thirty years. These numbers apply to all colleges, but highly selective institutions (as stated above) are the tuition leaders. There are many factors for these outrageous increases. However, a significant factor has been the increase in “easy money.” Students can take out almost unlimited secured and unsecured student loans, as can their parents (Parent Plus loans). This surplus of cash has allowed colleges and universities to raise their tuition and fees to unprecedented levels.

College loans have become big business, and lending benefits both schools and loan institutions. Sallie Mae was under the control of the government, but in the 1990s a private lender bought the Sallie Mae name for five million dollars. The new private Sallie Mae has been reported for unethical practices, but many parents associate the name with secured government loans and assume that their child will be treated reasonably and fairly.

Student loan debt is currently at a staggering 1.5 TRILLION dollars and rising. There are countless stories of student and parents who signed for loans, later noting that they had no idea what they were doing at the time. Students get not only subsidized loans but also unsubsidized ones. If the borrower can’t pay back the loan due to hardship, it may temporarily go into forbearance. This may sound like a good idea to the student, but it isn’t.

If a loan is in forbearance, it continues to accrue interest. That interest can then be added to the principal of the of the loan in a process called capitalization. There are cases where a loan has almost doubled from its original value. Imagine that you borrowed $60,000.00 and later discovered that you now owe $100,000.00. For lenders, the more money you are in debt, the more money they make. The government guarantees many student loans, so if you don’t pay them back, they will get that money from the US treasury. There is little incentive for companies to work with borrowers.

Forbes in a 2018 article noted that student loans are now the 2nd highest consumer debt, behind mortgages. The average debt per student is a staggering $37,172.00, but this only tells part of the story. Over two million students owe over $100,000.00, four hundred and fifteen thousand students owe over $200,000.00, and there are currently one hundred students who owe over $1,000.00000 in student loans.

It is easy to blame students for the loan crisis, after all, they signed on the bottom line. However, the massive scope of the problem suggests that the blame also needs to be placed on lenders and colleges, as they did not inform students and their parents adequately. Many students approach college decisions emotionally. They sign for loans with the perceived idea that they will make good money after graduation, and that they will have no problem paying the loan back. Yes, students need to be responsible, but so does both the lender and the college.

Many college students study majors that do not provide a path to a high paying job. Also, many students who start college never obtain a degree. Both student and Parent Plus loans cannot be eliminated by bankruptcy. This law was enacted in the 1970s with the industry citing a 20% student loan default rate at that time. However, only a tiny fraction of that default rate was due to students filing bankruptcy. A student loan debt is yours for life and it will impact everything from your credit score to your ability to get hired.

When a person stops paying a loan, it continues to grow with little chance of forgiveness. Search, “Dave Ramsey, student loans” on YouTube, and you will find the story of a teacher who owes $160,000.00, and dentist who owes over $1,000.000.00 in student loans. Couples that marry enter that union with their combined student loan debt, sometimes making it impossible for them to live independently.

We have a generation of graduates who are often underemployed and hopelessly in debt. They can’t buy a new car or purchase a home. They wonder if they can ever afford to have children. These are the young adults who did the right thing, they delayed their lives and got an education. Now they feel betrayed. Their financial insecurity impacts all of us and has a negative impact on the US economy.

Colleges are run as big businesses and employ those same marketing techniques as fortune 500 companies. It is essential to approach higher education as a consumer, rather than a student. It is crucial to squarely examine the cost to benefit ratio when making any college decision.

It is ridiculous to think that everyone should go to college; there are other paths to being successful in life. I know of many individuals who are skilled tradesmen. These people do very well financially. As bonuses, their earnings started after high school, and they have zero school loan debt.

When a college degree was less expensive, it made sense for some individuals to obtain less marketable degrees. Students were encouraged to pursue their passion and to broaden their horizons. However, college is becoming a trade school; a place where you gain a marketable skill. It makes no sense to saddle yourself with $100K of student loan debt for a profession where you will only be making $30K a year. Passion for an area of study can run cold when you can’t afford to put food on the table.

College is supposed to prepare you for life. However, massive debt cripples you. To circumvent the debt problem students and their parents need to be creative and think outside the box. Applying to a college because you liked the look of the campus, its sports complex, or its location makes little sense in today’s market.

  • Consider a community college for your first two years. English 101 and Math 101 are pretty much the same wherever you go. You may get more personalized attention at your local school.
  • Explore any scholarship options. Merit scholarships can be given by outstanding schools who want to attract the best and brightest to their institution. If you are a top student, it is nice to be the big fish in a little pond.
  • Strongly consider the cost-benefit ratio of your chosen major.
    If you choose a low paying major, think carefully why you are doing this, and have a clear idea on how you plan to make a living that includes paying off your student loan debt.
  • For-profit online schools often have high tuition and a low graduation rate.
  • Your community college may offer the same certificate program that a private school provides at significant savings.
  • Realize that many interesting sounding careers have few job openings. You may want to become a music recording engineer, but good luck in finding a job in that field. Check job availability before you start a degree or certificate program.
  • Choose the best school THAT YOU CAN AFFORD, rather than the best school that accepts you.
  • Consider attending a commuter school to save thousands on room and board fees.
  • It is likely that you will need to take out a loan. Stick with government subsidized loans, and set a limit to the total amount that you will borrow throughout your degree. Don’t use loans for everyday expenses.
  • Use online calculators to understand what your monthly payments will be.
  • Understand loan terms, such as forbearance, un-subsidized/subsidized loans, and capitalization, and know how these terms impact your loan.
  • Schools and loan companies are looking out for their interest, not yours. Accept this fact and approach any offers accordingly.
  • Consider a certificate program instead of a baccalaureate degree, if appropriate. Community colleges offer many such programs.
  • Consider a trade. A practical skill combined with ambition and a little business sense can make for an excellent life.

I currently have two daughters in college. The oldest of the two attended IMSA, which is considered the top math and science high school in Illinois. Also, she was a National Merit Scholar. This latter fact granted her free college tuition at some colleges and universities. When we met with her guidance counselor, we were surprised when the counselor informed us that the majority of the school’s National Merit winners did not take advantage of free tuition, opting to set their sites on selective universities. I am thankful that my daughter bucked this trend and she is now completing her degree in Chemistry and Russian at an excellent state school.

My other college student was accepted at Vanderbilt and Washington University, both selective schools. She is also an accomplished student, but neither school offered her any merit-based money. However, many other colleges and universities did offer her money based on her academic performance. She is currently attending a wonderful Midwest university, majoring in Public Health. I am so grateful that they will not have the burden of tremendous debt that many students face. My graduating daughter is strongly considering applying to the Peace Corps. She would not have this option if she were facing the repayment of massive student loan debt.

Dear readers, it is essential for all of us to explore our dreams. However, the wise person makes this discovery sensibly and thoughtfully. Happy school hunting, and please share this post as I believe that the information it contains can help many parents and students who are facing the challenge of college.

Sleeping In My Driveway

If I were a car, I would probably be a minivan. Sensibly designed with just enough flash to make me interesting. Ferrari’s are exciting, but if you need to get the job done you hop into a reliable and roomy Honda Odyssey.

Are you a person who likes to fly by the seat of your pants? I don’t fit into that category, I’m a planner and a tester.

A few months back my friend Tom and I installed a mains power port on the side of my campervan, and in the weeks afterward I created a simple power distribution system for the vehicle. However, I never operated it.

Dear readers, a Midwest October is upon me; perfect to do a little van exploration. With nighttime temperatures in the high 20s (-2C) it was time to test several different camper systems.

Early yesterday I pulled out the 30 Amp extension cord from the camper’s storage bin and attempted to connect it to the van’s receptacle. Crap! It wouldn’t go in. The pins on this type of plug are circular, and with some study, I was able to determine that they were slightly out of alignment. A little bending with my multi-tool and the plug slid in and mounted.

I went back into my van’s storage and located the $16 Walmart electric heater that I had purchased a few weeks earlier. I plugged it in, turned it on and… it worked! I was then off to the basement to find my 25-year-old sleeping bag. It is old and flattened, but it is also extra-long and thereby perfect for my 6’3” frame.

With heater and bag in place, I was ready to do a test run. The wilds of a National Park, you may ask?  No, my driveway, of course! When I told Julie about my plans to sleep in the driveway, she nodded in acknowledgment. After 25 years of marriage, she didn’t feel it necessary to comment on the absurdity of my vision. My more adventurous friend Tom thought that I should try to sleep in the cold with the heater turned off. Likely, as some sort of manly exercise. It should be noted that Tom possesses an ultra high quality and very warm REI sleeping bag, as opposed to my 25-year-old “pancake.”

As bedtime approached, I gathered my camping essentials:  water bottle, laptop, and iPhone. I traversed the 30 feet from my front door to the camper and entered with anticipation. It was cold! On went the electric heater powered by my garage’s outlet. I reached down and powered up the van’s 12V power system, and then flipped on its interior lights.

The heater seemed anemic, and I thought I would be spending the night freezing. But, in short order the van warmed up. I settled in my sleeping bag, fully dressed including a stocking cap. Like any other wilderness he-man, I opened up my laptop and checked Facebook, braving a weaker wifi signal from my house.

I worried that I wouldn’t fall asleep, as I fell asleep. Comfortable, warm, sleeping in a van parked in my driveway Silly for Dr. Mike, a 65-year-old physician, exciting for the 9-year-old Michael inside of me.

The outside temperature dropped to 29 degrees, but my little heater plugged on. In fact, I had to turn it to low in the middle of the night because I was getting too hot.

I write this the next morning after following my tradition of walking to Starbucks. Here I sit at my usual table, typing and sipping coffee. Mission accomplished.

My adventure may seem childish to you, or it may not. However, it was fun and informative for me. I tested out several of my camper’s systems and felt the security of reassurance. I had a “backyard” camping adventure. I had a good time.

Dear reader, so often we get locked into doing only “appropriate” behaviors. We don’t allow ourselves simple pleasures because we have deemed them childish. We criticize our children, “You are too old to do that.”

I am here to tell you that it is OK to explore the child in you because that is the part of you that still possesses wonderment. I challenge you to rediscover that aspect of you. I believe that you will grow just a little bit more in the process.

My $16 Walmart heater, and 25-year-old sleeping bag.
View of my front door from my sleeping quarters.
Plugged into the house’s AC power.

September Song

Oh, it’s a long, long while
From May to December
But the days grow short,
When you reach September.
When the autumn weather
Turn leaves to flame
One hasn’t got time
For the waiting game.
September Song
M. Anderson-1938

———

We sit around the kitchen table. Julie, my wife. William, my 17-year-old son. Diana, my 3-year-old granddaughter. Sebastion, my 9-year-old grandson. Me.

In front of Sebie is a large stack of conversational cards. He pulls one and reads it. “If you could always live in your favorite season, would you?” We go around the table, and all participants answer, “No.” We agree that each season possesses its own magic. As we tire of one season, we are given the gift of a new one.

——–

I pick up my sister Carol from her apartment and drive to Arrowhead Country Club to celebrate her 80th birthday with a Saturday lunch. We talk, nibble, sip, and talk some more. “I have never been happier. This is the best time of my life,” Carol says in earnest.

——–

I walk to Starbucks in the pre-dawn. I pass by a tree, its leaves turning a golden orange.

——–

The fall of my life is upon me, the days are growing shorter. Time is accelerating.

Would I want to go back to any other time in my life? Childhood? Early adulthood? Middle age? I don’t think so. Each phase of my life had its advantages and its disadvantages. Each stage of my life added to my wisdom and to my appreciation of the gift of life. I don’t want to give up the present to live in the past.

There are disadvantages to being 65. I have more wrinkles on my face than hairs on my head. My stamina is a percentage of what it was when I was 30. My short-term memory is less acute than in the past. I am more inclined to take naps.

There are advantages to being 65. I care less what others think of me. I am less concerned with what I don’t have and more satisfied with what I do have. I realize that most happiness lies in small things: dinner with my family, coffee with a friend, learning new things, giving back.

In January I left my private practice of 30 years and gained perpetual 4 day weekends. As a person who likes to move forward, I had developed a productivity plan in anticipation of this change. That initial plan has been only partially realized. Frankly, I’m OK with my partial compliance.

I am writing, taking pictures, and converting a van into a camper for future adventures. I have made a weak effort to organize a basement storage room. I’m not practicing the guitar, and I have not started the process of learning a foreign language. I think that this latter objective may be on a permanent hold.

I am spending a lot more time socializing with people who I care about. I am stretching my introverted boundaries. I am learning about construction and power tools. I know that this last fact may seem odd for an old retired doctor, but I assure you that it is not. I come from a blue-collar background, but I was never mentored in the art of the Sawzall. One of the reasons that I gravitated to science was that it was an entirely novel discipline in my family, and somehow that fact made it OK for me to teach the subject to myself.

There is a joy in learning those things that I was so curious about as a child. I see the similarities between medicine and construction. Each discipline requires training and practice. Each discipline follows a specific methodology and is protocol driven. However, with building the fruit of your efforts is immediate and tangible.

I have spent much of my life goal-directed; focused on practical knowledge. However, I appreciate learning something that serves no personal purpose in my life. Learning for the sake of learning is my cocaine.

At 65 my world isn’t shrinking, it is expanding. I wake at 4 AM anticipating what that day will bring. What will I see on my walk? What will I write? What new thing will I learn? What projects will I tackle? What adventures will I have with those people that I care about?

The days may grow short in the September my life, but they are still days to be celebrated. Today I know more than I knew yesterday. I have connected with others more. I have done more. Each day is a gift, never to repeat.

Dear reader, celebrate today!

Change Your Life With A Gratitude List

Why is it that I can focus on a single negative in my life while ignoring so many positives? How can I change this waste of energy?

I think my thinking pattern is similar to many others. I can let a single worry dominate me. Typically, I find that this stance is a waste of my time and energy. Yet, I continue to do it.

I have made attempts to change my behavior, and some of my efforts have been more successful than others.

I have gotten better at letting go of trivial slights. The driver that cuts me off no longer spoils the rest of my morning.

I also employ cognitive techniques to correct my perceptual distortions. When I get upset about something, I will pull back and logically explore the problem and reframe the information at hand in a more realistic way and less catastrophic way.

Also, I work hard to let go of situations that I have no control over. I’ll, “Let go and let God.”

The above techniques all fall into what I would call a pathology model. In other words, they focus on lessening my current worries. The problem already exists, and so I actively treat it.

Good doctors not only treat problems they also practice preventive medicine. I would like to think of myself as a good doctor and what I advise my patients can also apply to me. So how do I prevent worry? There are many ways, but the one that I would like to share with you today is called a gratitude list. This technique is simple, but it does require some practice and thought.

The positives in my life far exceed the negatives. However, I can take my blessings as expectations and thereby ignore their significance. A gratitude list is one way to acknowledge these good things, and when I do this, I automatically have a more positive outlook of my life.

Here are the steps I use.

-Once a day I think of 3-5 things that I’m grateful for. They can be significant things or minor things. For instance, I might be thankful for my health (major thing), and I also may be grateful for having coffee with a friend (minor thing).
-I make an effort to vary the things that I’m grateful for. In other words, I don’t repeat the same list every day.
-Sometimes I’ll write down my gratitude list, sometimes I’ll only make a mental note.
-I don’t just write down a list, I also think about each example on that list. I may recall that I’m no longer on any medication and that I’m able to walk long distances once again. I might think about a walk that I took and how much I enjoyed it. For my second example, I may be grateful for having people in my life who want to spend time with me. I might remember the conversation that I had during my coffee klatsch, or how much I enjoyed the taste of the coffee.
-If possible, I recall my gratitude list during the day, repeating the above technique.

When I first started this daily exercise I had trouble coming up with unique things to be grateful for. However, over time, it became easy. The trick is to limit your list to a manageable number. I find that 5 examples works for me. I want to have time to think about my list, I don’t want to write down a lot of meaningless examples.

By doing this exercise regularly, it has become evident that I have much to be grateful for. When I think about my life in positives terms I feel more positive about myself, I attract more positive people, and many of my problems feel more trivial. All of these benefits for the cost of a little time!

I would encourage you to make a gratitude list every day for the next 30 days. Let me know if it makes a positive difference in your life. If the answer is yes, it is easy to incorporate a gratitude list into your daily routine.

Dr. Mike

The American Dream: Have You Been Lied To?

Are you feeling overworked, and undervalued? Here are a couple of facts.

Fact #1: We have more leisure time than ever before. Life is good!
Fact #2: Fact #1 is a lie.

Mid-century prognosticators predicted that good times would lie ahead for the people of the 21st century. They believed that automation would make work more meaningful and efficient. It was predicted that work weeks would shrink to 15 hours, and leisure time would expand to fill the void. The United States, with all of its industrial might, would be at the forefront of this change, and its educated and skilled workers would benefit the most.

Data suggest that overall leisure time has increased in the US, and we are working less than we did a few decades ago. So, life is good, right?

Dear reader, do you have a job? Is your life easier in 2018 than it was in 1998, or is it harder? Do you feel that you have more free time, or less free time? Are you enjoying life more, or enjoying it less? I hope that your answers indicate a continued movement towards a positive and meaningful life. A life where you have time to do those things that you find personally satisfying and rewarding. However, for many of you, I doubt that this is the case.

Random statistics are like other generalities, they make great bullet points, but they only tell part of the story. Data suggest that our lives are better now than 50 years ago. We have less pollution, we live longer, our houses are bigger, we have more stuff. In addition, our lives have become more automated. We can order a new shirt with a click of a mouse. We can summon Alexis, Siri, or Google to start our favorite music playlist. We can cook a meal in minutes with the touch of a microwave button.

We have been told that to have a good life we need to become skilled and educated. We have been told that using our brains instead of our backs will give us lives full of meaning, and an abundance of leisure time.

So why are many of us stressed? Why do we feel that we have no time for ourselves; that we are on a hamster wheel frantically running but never moving forward?

Erik Hurst, University of Chicago economist, looked at leisure time and found that there are individuals in our society that have an abundance of leisure time and that this abundance makes them happy. However, they are not highly trained or educated. In fact, they are at the opposite end of the spectrum. A 2015 study found that twenty-two percent of undereducated males between the ages of 21-30 had not worked in the previous 12 months. These folks were typically living in a relative’s home (think parent’s basement), and they often filled their free time with cheap entertainment, usually video games.

On the opposite end of the spectrum were men who he referred to as “elite.” They were skilled and educated. Elite men had less free time than their fathers did. They often defined who they were by their work life, rather than other interest. They worked long hours and produced more than similarly skilled men in other developed countries. They did not rate as high on the happy scale.

I believe it would be reasonable to claim a similar outcome for elite women. More work, an extended workday, less free time, less happy. Many Fortune 500 companies expect their workers to work longer and to be more productive than previous generations. We can never escape work, as we are always accessible via our smartphones and laptop computers. A long commute used to be a time to listen to music or catch up on the latest sports news. Thanks to mobile devices our cars have now become our second office. Vacations served as escapes; now wifi and laptops help us to catch up on work emails when we should be catching rays.

We are stressed and tired, so we use services to supplement our energy gaps. We pay someone to watch our children, cut our grass, and clean our house. We go out to dinner or buy premade meals. We use our credit cards to procure an expensive vacation or buy an unnecessary item with the false belief that these things will make us happy. All of these behaviors cost us money, which means we need to work even harder.

Social media makes us feel that we don’t have enough. We see pictures of Jerry’s new car, Mary’s exciting trip, Bob’s bigger house. The visual images make us feel dissatisfied and want more. Our new purchases make us feel better, but only for a short amount of time. We live a bipolar life of working hard and playing hard. There is no middle ground. There is no balance.

Stressed, our normal life jobs become burdens. Routine tasks like helping our kids with their homework turn into annoyances. We ease our frustration by distracting ourselves with texting our friends or playing games on our phones when we should be focused on the task at hand. This multi-tasking disconnects us and we become less present, which makes us feel alone and lonely. Affairs, addiction, increased debt, compulsive eating, compulsive sleeping, compulsive buying, and other fixes serve as temporary ego patches that often result in long-term negative consequences.

Despite the evidence to the contrary, we continue this cycle with the magical thought: “If I only could make a little more money I would be happy” However, this is often not the case. Money is like heroin, whatever you make, you want a little more, and like heroin, cash promises much but delivers little.

So what is the answer, dear reader? Should we quit our jobs and move into our parent’s basements? For most, that is not the solution.

What do you really want out of life? Ask yourself, “Do I want”…

More time with my family? A safe living environment? Good health? A sense of real purpose? or Fill in the blank?

Are your actions consistent with your wants? Don’t make the mistake of thinking that making more money will automatically solve your problems.

Things that you may want to consider:

-Try to find a balance between work life and personal life. I have known some people who took lesser jobs or gave up careers, with a resulting increase in happiness and wellbeing.
-Realize that more stuff will not make you happy
-Practice being in the present.
-Designate times to silence your phone.
-Spend time with people who you love and cherish, and who love and cherish you.
-Avoid people whose connection with you is based only on what you can provide them.
-Develop a spiritual life.
-Connect with others in a meaningful and giving way. Consider helping someone for the pleasure of helping, without any expectation of a return for you.
-Realize that most of the things that we do are work, but the type of work can make a big difference not only in how we feel but also how others feel about us. I have heard many an adult talk glowingly about their parents. Beautiful memories of doing a project with dad, or baking cookies with mom (Feel free to reverse gender roles, if so desired). I have never heard an adult lovingly talk about an absent parent who bought them a new car on their 16th birthday. Further, I have never heard someone say, “My parents were awesome, they each worked 100 hours a week!”
-Write down a list of things that you are grateful for, and read it twice a day.
-Be thankful for what you have, instead of always thinking about what you want.
-Stop watching shopping networks; stop reading ad papers.
-Limit your time on social media.
-Leisure time is that time that we can devote solely to personal interests. It doesn’t have to be expansive when our lives are filled with other meaningful activities. Yes, those unemployed 21-30-year-olds may find happiness playing video games for 10 hours a day, but for most of us, a life of leisure would be unfulfilling. Consider leisure time like a desert. A bowl of ice cream can complete a meal. However, a diet of only ice cream would make most of us sick.

Life is short. Decide how you want to live it.

Dr. Mike

Rat race traffic.

An Odd Morning

I find fascination with simple lessons.

I alerted my Google Assistant that I was up, and she wished me a good morning.  She informed me that it was cooler and that there was rain in the forecast. I figured that the rain prediction was for later in the day.

I put on my running shoes, donned a jacket, and stepped out onto my front porch.  It was raining! Back in the house for waterproof duck shoes, a raincoat, and an umbrella.  Off I went.

Cold, and raining, I expected to have the streets to myself, but this was not the case.  Animals were darting here and there in the pre-dawn, including a skunk with a tail raised just for me.  I crossed the street and counted my observational blessings.

As I approached downtown I walked past our public library.  A lone car sat in the empty parking lot, its hatchback up, and the radio blaring out a political radio station.  Odd.

I continued my walk and saw two middle-aged ladies sitting on a wet park bench having a loud and animated conversation. It was 5:30 AM.  Odd.

I moved on to the next block, and it sounded like someone was calling to me.  I turned my head to discover a mom talking to her baby, who was in a stroller. She was walking her baby at 5:35 AM! Odd.

I started to cross the street, but  I had to jump back as an elderly man wearing full high vis rain gear barrelled past me on his bicycle. He seemed oblivious to my presence. Odd.

I arrived at my Starbucks and was greeted by a barista, who looked up, smiled,  and poured my coffee without ever asking for my order.  Finally something familiar.

As humans, we try to predict the future.  What team will win?  What will the stock market do? What will that lab test show?

This morning I predicted that I would have a very quiet walk, but that was not the case.  In fact, it was not only much busier but the type of “traffic” was completely different from what I normally observe at this very early hour.

Many logical prognostications turn out to be erroneous guesses. I am great at projecting in the future, and sometimes that leads to unnecessary worry.  Dear reader, I assume that you have done the same.

It is good to plan for problems, but that planning should be a sidebar, not the primary focus in our lives.  When we live in the worry zone we waste valuable energy that often serves no purpose.

How should we face potential problems?  That rule has been long established.

  • Accept the things you cannot change.
  • Change the things you can.
  • Pray to know the difference.

Have a good day, dear reader.

Mike

A colder and damp morning in Naperville.

A Coffee Date With Nancy

The date was set, we would meet at Starbucks at 7 PM. Not the Starbucks that I usually go to, but one on the far side of town. We had talked about this for months, and now we were finally doing it. At the very least it would be a fun adventure; I had nothing to lose.

I arrived at 6:59 and found a quiet table. I went up to the counter and ordered a Tall Pike’s, decaf. Moments later my phone rang, it was Nancy. She was outside the store trying to park her car, but the available spots were all blocked by a police prowler. The officer was apparently thinking that his convenience was more important than preserving three open slots for other customers.

Soon Nancy was sitting across from me, and we started to talk. First small talk, then more about what was going on in our lives. However, this chit-chat wasn’t the reason that we were meeting, our conversation was just a common preamble.

We reminisced and evoked memories from past years. Nancy, 7 years my senior, my friend, my older sister. We had decided to meet to explore our creativity. Like me, Nancy is a writer. Like me, she is trying to find her voice. Unlike me, she has studied her writing motivations though workshops and creativity groups.

Nancy tried to focus me. “What do you want to write? Fiction or nonfiction? What is your passion? Who is your audience? What is their age range? What topics have gotten you the most hits?” Questions that I never thought about.

So, dear reader, what is the purpose of this blog?

Drmikekuna.com was created as a writing exercise to see how far I could push myself in a public forum. As an introvert, I’m naturally reserved and private. However, to write effectively, I need to break through these limitations without fear of judgment from others. I also created this blog as a record of who I am. Eventually, I’ll download its contents onto a memory card and place it with other momentoes of me. Cards and letters that were written by patients when I left my private practice, notes from loved ones who wrote memories of me to commemorate my 65th birthday, and other things. I want my children and grandchildren to have a broader understanding of me. I want to be more to them than a few scattered recollections.

Like most things in life, my blog has evolved. It continues as a writing experiment, but there has been a shift. I now let my flow of consciousness take over as I write. It seems that my posts eventually evolve into some sort of life lesson. I find this new process interesting, but I have no idea if anyone else does.

I am trying to find myself, and redefine my purpose. My professional life has been a life or providing service to others, and I feel fortunate that I have had the opportunity to do so. However, I am entering a new season of my life, and my energy has shifted. I still want to contribute to the world, but I want to do so by engaging other talents. Specifically, writing and photography.

I need to determine what my goals are. Am I writing for an audience of one? Has my blog become a journaling exercise that would be better accomplished if it was done privately and within the confines of a spiral notebook? Should I abandon the blog and start the daunting task of developing a book? If so, what would my topic be? It is clear that my writing would reach a broader audience if I focused it on popular issues and selected demographics. Do I want to do that? Do I want to become more commercial in my writing? Would such a change remove the pleasure that I derive from my current spontaneous musing?

It is clear that I have just started this journey. I will meet again with Nancy next week as we continue to examine how we can support and help each other in our pursuits.

Dear reader, as I move into retirement, I am aware that I not only need to be flexible but also realistic. Grandiose ideas and plans can fuel the genesis of any new project. However, work, reassessment, and realignment are the real building blocks of growth.

Do you have goals and dreams? How are you approaching them? How are you redefining them? Let’s grow together!

How Doctors Should Talk To Patients About Obesity, An Open Letter To Doctors

Last week I had surgery, a long surgery that required over an hour of operating room time, but the operation was not my greatest fear as I approached this process.

What concerned me the most? I feared having to get a pre-op clearance from my internist; a simple visit that would require less than 10 minutes of contact time. You may be thinking that my primary care physician is mean, rude, and evil. Of course, this is not the case. He appears to be a nice man and a good doctor. If I felt otherwise, I would not work with him.

So Dr. Mike, what is the problem? First a little more background information.

As a person who has battled obesity all of my life, I have become acutely aware of the stigma that comes with weighing excess pounds. Few human attributes can be ridiculed and condemned in the millennial “microaggression” culture of 2018. Imagine criticizing or mocking someone because of their race, sex, religion, sexual preference, gender identity, physical stature, or a multitude of other differentiating human characteristics.

Making fun of “fat people,” is an acceptable national sport, even though the CDC reports that over 70% of adults in the US are now overweight. Of course, as the overweight population explosion redefines the concept of what is normal weight, there will always be those outliers who exist beyond a standard deviation from that norm. There will always be a group to abuse with fat jokes, both overt and covert criticism, and outright disdain. If you are obese, it appears that it is OK for others to assume that you are lazy, dirty, and stupid.

We would never make such assumptions for other medical epidemics. Imagine someone undervaluing you because of your high blood pressure, or your fasting blood sugar? Just like obesity, these illness are caused by multiple factors: genetic, environmental, and lifestyle. Unlike obesity, there are good medical treatments for these ailments, making them easier to treat. The majority of folks with high blood pressure can significantly reduce health risks with medication management alone. However, the majority of obese people will continue to be fat despite diet plans, medications, exercise, and shaming television shows.

I lost over 100 pounds about 3 years ago. I did this after failing many traditional techniques of weight loss. I feel that my weight loss was indeed a miracle that was fueled by common sense, rather than modern medicine.

We are humans, not machines. We are motivated and influenced by a multitude of factors. This variability can be considered a weakness, but it should also be acknowledged as one of our greatest strengths. We are complicated, and as such simple blanket solutions have marginal utility.

Over the three years since I lost weight, I have regained a small percentage of my weight. Most people have told me that I look better with a few extra pounds. They say I look less gaunt, and more vital with this increase. Additionally, I have long shifted from judging myself based on a number on a scale. My lifestyle changes have been just that, they are not strategies to lose weight and thereby achieve some sort of false utopia. “My life will be good if I am not fat.”

Three years into this process:

I still can wear my same wardrobe.
I still exercise every day, walking from 3.5 to 8 miles.
I still avoid all forms of concentrated sugar.
I still practice healthy eating.
I still make an effort to eat more natural foods.
I still assess and correct hidden forms of weight gain, like emotional eating.

When I determine my current status I would say that my efforts continue to be successful, but what about the matter of my small weight gain, does this one objective parameter signify failure? I would say, “No.”

************

I sit in a chair opposite from my primary care doctor who is staring at a computer screen.

“You have gained weight.” My doctor says. My initial impulse is to apologize for my failing. I resist. My second impulse is to defend my position. I resist and remain silent. “Are you exercising?” I reply that I am and had already walked four miles before our appointment. “But what about cardiovascular exercise?” He retorts. And so it went. Three minutes of questioning that felt like three hours of interrogation. Pain always feels worse when inflicted on an open wound.

***********

Dear readers, I’m am a resilient person. Besides, I am good at using the counterbalance of logic when dealing with my emotional exaggerations. However, there is more to this story than just a detailed account of me stepping on the scale and my emotional response to that event.

Being a physician, I understand the power that doctors have over their patients. Patients come to us in an extremely vulnerable state looking for help. Studies have shown that a statement like, “You need to quit smoking,” will convert some active smokers into former smokers. Unfortunately, in medicine one size does not fit all. It is easy for physicians to generalize the above truth and think that simple pronouncements can be used to motivate all lifestyle change. However, a doctor’s command is a partial solution at best, and should only be used when wielded within a broader understanding of what causes people to change.

Many of the illnesses that physicians treat on a daily basis have a strong lifestyle component. My weight loss eliminated my need for blood pressure tablets, high cholesterol medication, and a CPAP machine. So why is it that physicals don’t learn and employ simple motivational techniques so they can move their patients towards health? I don’t ascribe to know all of the answers to this questions. However, I do know some of them.

Physicians in the US work in a production model. We get paid by the volume of the work that we do. See fewer patients, make less money. As medical practices get bought up by business investors the push for physicians to do more continues to increase. A good business model consists of finding ways to spend less and make more. This fact is contrasted by a simple truth; we are caregivers, and most of us want to provide care.

Our contact with patients is reduced by the use of physician extenders. Someone else takes our patient’s blood pressure and obtains their chief complaint. We employ electronic medical records (EMRs), which provide a clear notation of our treatment plan, but does so at the cost of patient interaction. Patients now have the “privilege” of answering our questions as our eyes are focused on a computer screen instead of them. Patients want care from us, and we want to meet their needs. There is a pill for everything, and today’s EMR makes prescribing absurdly easy. Is writing prescriptions the same as providing care? I believe that it is only a part of our job, and it should not define us in total.

When I retired from private practice, I was fortunate to have patients write goodbye letters to me. Almost universally they said that they valued their time with me because I listened to them, didn’t judge them, and guided rather than controlled them. To do these things I needed to spend time with them. I would have made more money if I saw 6 people in an hour, rather than the two that I scheduled. However, I would not have known my patients as well, and more importantly, they would not have known me as well. Trust is a function of integrity multiplied by time. Trust by itself offers a positive corollary to patient satisfaction and well-being. Besides, a career that includes connecting with others is eminently more satisfying to we providers than one that does not. A win/win.

One factor needed to motivate change is time. Unfortunately, extending the length of appointments may not be possible in today’s corporate medicine climate. There are indeed a variety of stop-gap strategies that doctors can do to build a connection, such as deliberately spending a few minutes directly with the patient before turning to a computer screen. Such simple changes can make a patient feel more connected, but they still don’t address the elephant in the room.

How should doctors interact with patients to create change? Fat people know that they are overweight, and should lose weight. Alcoholics know that they drink too much, and should stop. Diabetics realize the importance of blood sugar control, and that they shouldn’t eat that extra donut. We live in a culture that shames, and it is likely that some will avoid being humiliated by their physician by avoiding seeking necessary medical care. I admit that I have been an avoider in the past.

Big problems become smaller when shared with someone. I am willing to tackle projects that I would not usually attempt when I have someone at my side. This phenomenon is even more evident if that “someone” has expertise that I lack. If you have been reading my prior post, you know that I have been converting a cargo van into a camper. I dare to significantly modify my van because I am doing the project with a friend who has expertise far beyond mine in such manners. We, physicians, have expertise far beyond our patients in such manners as health. Most reasonable patients accept this, despite the advent of the Internet. A colleague of mine has a cup in his office that reads, “Please don’t confuse my medical degree with your Google search.” However, most patient’s intrinsically understand our expertise, which is why they are seeing us.

Doctors need to connect with their patients as human being to human being, and they need to do this on a level that patients can relate to. We need to become trusted knowledgeable friends rather than overbearing, critical parents.

We need to understand where our patients are coming from, and how willing they are to make change. We need to problem solve with them. Imagine if my doctor asked me, “Are there any barriers that prevent you from seeking medical attention?” Or, “Are there any ways that I can help you with your lifestyle change?” Those simple questions would instantly change my relationship with my care provider. I would want to meet with him, and I would look at setbacks as problems to be solved, rather than justifications for criticism.

Once a patient’s cards are on the table, all things are possible. Is the doctor’s goal the same as the patient’s? What are the barriers to achieving the desired goal? What steps should be tried? How will progress be measured? How is a reversal of progress addressed? Empathy joins, criticism divides.

A meaningful connection with a patient doesn’t happen all at once. Relationships develop over time. However, imagine helping your patients make a significant and real change. Imagine the satisfaction of having a substantial connection with them. What would it be like to work with real people instead of being a reviewer of lab data? What would it be like to end your workday with the knowledge that you truly connected with someone in a meaningful and significant way that changed their life? What would it be like to move from treating diseases to treating people?

We blame our patients for their failings, while we steadfastly hold on to methods and techniques that simply do not work. Imagine if our relationships with our patients were more as a knowledgeable and caring peer rather than a stern and critical parent? Imagine yourself as the patient. You are aware that you have a problem and you need help. Who are you going to ask? Someone who tells you what you already know, makes you feel bad, and offers no real help? Probably not.

Patient Mike

Random thoughts and my philosophy of life.