First Snow

First Snow.

My alarm went off at 3:40 AM, and as usual, I hit the snooze bar. I was tired today as I had been out late last night. Julie took me out to the fancy Waterleaf restaurant in neighboring Glen Ellyn. She made the reservations at least two months earlier. The meal was a celebration dinner for my semi-retirement.

The five-course feast had an Eastern European theme. I love this kind of food, but almost never eat it. It was even more interesting to have an upscale slant on what typically would be considered peasant food. Dumplings, duck, pickled fruit, the list went on.

A big meal served late at night tends to make me want to sleep in, and I was eager to continually hit the snooze bar this morning. Instead, I put my feet on the ground and weaved my way to the bathroom.

Downstairs I checked my phone for the weather report. Twenty-one degrees and snow! I dropped a Keurig capsule in the coffee maker and cut up a Honeycrisp apple. On the cut up fruit I smeared some peanut butter. Breakfast.

We have had unseasonably warm weather in the Upper Midwest, and the thought of walking in 21 degrees was a bit daunting. I employed a simple psychological tactic to get me out the door; I wrote that I would go walking on Facebook. I’m a responsible guy who tries to honor his commitments, and I knew that such a post would get me moving.

I was already wearing a heavy Woolrich plaid, but also threw on one of the few sweaters that I own my navy blue cardigan. Then scarf, hat, coat, and gloves. The ducks came out of the hall closet since my running shoes are not good in any precipitation.

Out the door I went looking like the Stay Puft Marshmallow Man. I was bulky but warm.

There is something magical about walking in the dark after a snow. Even a dusting quiets the streets. Everything looks clean and new. My thoughts ran on as I tried to redirect myself to pray and meditate.  This was a losing battle, and I gave into the moment and allowed myself to savor the frigid air.

I’m now at Starbucks, my usual morning haunt. My friend Tom stopped in to chat, but only for a few moments as he has to supervise a kitchen demolition this morning. He looked at the photo of the menu that I sent him from yesterday’s Eastern European feast. “Mike, there should be an accent on this letter, and that h should be a z.” Tom is the Polish version of me, and like me, he is a little OCD. My mornings are always brighter after a little kaffeeklatsch with him.

And so my day starts. In a moment I’ll pack my computer in my leather messenger bag, put on my layers, and head out the door for the walk back home.

Today is a day of telepsychiatry from my basement studio. Tonight I’ll make dinner with my kids; Swiss steak, corn, mashed potatoes, rolls and butter, and a salad.

I am a fortunate man

A dusting of snow quiets the streets.
A five-course feast.


They Didn’t Teach Me

They Didn’t Teach Me

Yesterday I finished seeing patients around 6 PM.  I brought up my charts to the front reception area and returned to my office for a quick re-appraisal.  I’m trying to move out items without making the place look like a space under construction.  

On Monday I took a big 1930s style floor standing radio home.  Yesterday, it was the Ficus.  My former partner, Ralph will be taking over my office space and would like to move in before the end of the year.

Tonight my wife is taking me out to a fancy restaurant.  This weekend will be my last on-call for Genesis. Sunday there will be a little get-together at Mesa Sabinka, a fancy tapas (not topless!) bar. Monday, there will be a reception at the office.

Monday and Tuesday will be my last patient contact days at Genesis.  Dozens of goodbyes.  It shocks me how long I have been seeing many of my patients.  Ten, twenty, thirty years.  I have treated them and at times their spouses and kids.  Thirty years!  It shocks me.

There seems to be a similar theme when they thank me and tell me how I helped them.  It surprises me because what meant most to my patients was something that I didn’t give them with actual thought.  

Yes, many thanked me for getting them on the right medicine or keeping them out of the hospital.  However, most thanked me for not judging them.  For listening to them.  For guiding them without controlling them.  For being there.  For returning their phone calls.  For caring about them.

My mind focused on symptoms, medications, side effects, drug interactions, psychodynamic interpretations.  I wanted to deliver a superior service.  They needed this from me, but what they needed more was a connection with someone who would accept them, not judge them or try to control them.  They came back when their insurance changed and had to pay out-of-pocket.  They came back when they moved out of state.  They came back for the connection.

I spent four years in medical school and four years in residency.  This was after college and grad school.  Fourteen years of formal education learning anatomy and physiology, biochemistry, pathology, psychopharmacology.  Each piece of knowledge integrated into the next.  Fourteen years… and the aspects of my care that were most significant to many of my patients was something that I was not taught in a single class.  Perhaps it should be.

How many of us need to feel heard, accepted, and understood?  How many of us feel ignored, rejected, and misunderstood? How little it takes to be compassionate and accepting.  Why is it that we do the opposite with those people who we care for?

It is likely that some of my patients would never have needed to see me if they had someone who listened to them in their life. Fourteen years of education, thirty years as a doctor.  Moving forward, leaving behind.  More lessons learned.

The radio and ficus are now in my telepsychiatry studio.


Do I Need A Handler?

Do I Need A Handler?

I don’t really like change; I like predictability.  In fact, I have spent much of my life discerning how things that appear to be unpredictable are, to a high degree, predictable.

As an expert in human behavior, it is clear that even reactive people have only a limited set of “reactions.”  I’m not saying that I can forecast the future or have the insight to predict a person’s impulsive behavior.  However, once you get to know a person you can see their behavioral patterns emerge.  Reactive people tend to respond in more reactive ways.  I tend to react in predictable ways.  Some people like my steady consistency, others find it boring.  But I digress.

I now am entering the two-week countdown to the end of my private practice.  Everyone is congratulating me on my impending retirement.  They are asking, “What next?” Those who know me understand that I won’t spend my new-found time oscillating in a rocking chair.  However, dear reader, I am also asking the same question of myself.  In fact, I have been thinking about this question for years.  I have come up with, modified, and discarded some ideas.

A part of this problem is predicated on my ambivalence.  In my formative years, people (teachers mostly) told me that I was destined for great things. Hear that a few times and you start to believe it.  I have squandered an opportunity or two to do “great things” over the course of my life.  I think the “great things” portion of my life is over.  I lived my professional life doing what I felt that I should do, rather than living up to some artificial (and likely untrue) expectation. I believed that I should be a practicing doctor, who spent at least a part of his time providing services to the underserved.  I am steadfast that this was the right thing for me to do, but hardly “great things” worthy.

The current status of my retirement will only give me two extra days a week.  This is limiting.  I am battling with the idea of doing something significant vs. something significant to me. What is meaningful to me varies.  Some of it is trivial, some not.

I have started the process of organizing things in my home.  Doing these mundane tasks offers some satisfaction, but organization always tends to move back to disorganization.  The pantry that I spent two days cleaning a few months ago is once again in chaos… And so it goes.

With that said, there is a satisfaction doing concrete and time-limited tasks.  I have tackled a number of these tasks over the last year.  I have much more to do. Some I accomplished with my friend, Tom.  Others, by myself or with the help of my kids.  A few with my wife.  

But I digress again…

It is clear to me that I’m having difficulty writing this piece.  I think that it must create a subconscious angst in me.  It is one thing to dream of doing something; it is another thing to do it.

Beyond the mundane tasks, I have creative goals.  I want to get back to playing my guitar.  I am toying with taking guitar lessons. Oddly, I feel like I need to get better at playing before I take lessons, as I don’t want to waste the teacher’s time.  I know this is ridiculous.  I am thinking about learning a foreign language.  A monumental task as I have terrible auditory discrimination and even worse short-term memory.  I want to expand some of my current creative outlets. I wonder if my friend Tom would let me help him a bit.  It would be exciting to allow myself to learn from someone.

None of the above seem sufficient to me.

OK, I’m stalling. Let’s get down to business…

As I had mentioned in past posts, I was a creative little kid before I discovered science.  I could come up with fantastic stories, I could play the piano by ear, I could build and create things.  I gave up most of that when I decided to move my life in an analytic direction.

I come from a family of writers and creators.  I want to write and create.  I have always had the desire to combine multiple interests into something bigger. What, I have no idea.

I continue to try to improve my writing, but I don’t have a clear voice.  I take nice photographs, but I don’t have a distinct style.  A part of me fights having a particular voice or style as I don’t want to be limited.  I know that this ambiguity is not the road to success.

I also know that I have a passion to know the stories of others.  I see the extraordinary in the ordinary.  The uncommon in common. The treasure in the discarded.  How do I join all of these together?

I want to explore places, connect with people.  I have come up with dozens of ideas, but I have been unable to move forward due to fear and lack of protocol.  

When I founded Genesis 25 years ago, I did it with other partners.  One loved business; the other was an extrovert with superior people skills.  I came to the table with creative, technical, and problem-solving skills.  Together, we formed a formattable package.  Each complementing the other.  I think I need that now.

I need a person (or people) who have the skills that I lack.  I need to brainstorm ideas.  I need someone with connections to help me achieve my goals.  I need someone who can take my ideas and help me turn them into something that would be relatable to others, not just to me. I need a compassionate handler. I need a lot.

I have no idea how to find such a person or group.  I have no idea why anyone would want to help me in this pursuit.  I just know that this is the missing link.  The link to take me to the next step.

My life has been characterized by being fully independent and a self-learner.  My HIgher Power has slowly moved me in a new direction where I have been asking others for help.  This process has been both wonderful and terrifying to me.  When I build my courage to ask for help my childhood tapes play loudly.  I wait to hear, “I’m busy.”  “Don’t bother me.” “That can’t be done.” “Why do you want to do that!” In reality what I typically hear is, “Sure.” “Let me try.” “No problem.”  I need to use my psychological awareness to move past my old garbage and into a brave new world.  However, I need a bit of a miracle to know who or what to turn to for this great adventure.

I find life so interesting and complex.  Onward and upward.  Turn every disadvantage into an advantage. God, show me the way.


Does Size Really Matter?

Do you wonder if size really matters? Is bigger always better? If you think that is the case I would like to dispel that belief.  In fact, I would propose that sometimes a smaller size can be more comfortable, and if handled properly a smaller size can provide experiences that are more difficult to achieve with a larger one.  Well, at least that is my opinion.


My cousin Ken stood in front of the group. He welcomed everyone and offered a freestyle blessing that ended with the classic, “Bless us Oh Lord, and these Thy gifts.”  It was the kick off for Droby Fest, year 18.

What is Droby Fest? I guess you first have to know what a droby is.  A droby is a Slovak fresh sausage made of rice, potatoes, and various meats.  It is usually seasoned with salt, pepper, and sage.  It is most often baked, typically with bacon wrapped around it. Like many ethnic sausages it sounds terrible, but tastes delicious.  

The droby sausage is a connection to my ethnic past.  It is something that you can’t buy in a store, it has to be made.  The process is fairly labor intensive and involves grinding all of the ingredients several times, and then stuffing them into sausage casing.  Apparently, there are multiple recipes for droby.  At least that is what  my internet research has indicated. My family’s version contains pork and various organ meats in addition to the starches.


Growing up it was expected to actively participate in celebrations with my extended family.  Major holidays, Communions, Confirmations, they were all events to be shared with aunts, uncles, and cousins.  As our families grew the mass get togethers ended, and for decades I lost contact with my cousins.

The generation before ours was dying, and it seemed like the only time that cousins would see each other were at funerals.  Those contacts consisted of a few minutes of catching up.  At one such event my sister Nancy was talking to my cousin Ken.  “We should have a family reunion picnic,” she said.  And we all started to reconnect.

We now get together multiple times a year.  My cousins Ken and his sister Kris have become the event organizers. There is the monthly Bunco game, the summer Kuna Kampout, the fall KFR (Kuna family reunion) picnic, Pierogi making day, and of course the Christmastime Droby Fest.

We usually do have droby sausage as part of the buffet style Droby Fest meal, but the title is more about getting together with family and celebrating who we are. I used to be embarrassed to be Eastern European,  I so wanted to have a surname that reflected a more Anglo heritage. However, I now am grateful for who I am and proud of my extended family who are sophisticated and accomplished.


The attendees for Droby Fest can vary.  All are welcome, and any relative of anyone is invited.  Really, anyone is invited to partake in the conversation and food.  The only request is to bring a dish or two to pass.  Some people will cook, others buy.  There is always plenty.

I expected a big turnout this year.  The weather was mild and there wasn’t a hint of snow in the forecast.  I was surprised to discover that the crowd was smaller than in times past.  Some of this was accounted by the lack of my first degree relatives.  Several were vacationing, others had obligations.  

This fact was a potential problem for me, introvert Mike.  I naturally gravitate to my immediate family during such events, but most of them were missing.  

Dear reader, as I had told you many times, take a disadvantage and turn it into an advantage.  I really like my cousins and the smaller size of the group plus the lack of my usual cohorts gave me the opportunity to have more in depth connections with them.  

I had a nice long conversation with my cousin Ken.  Ken is one of those people who the more you know him, the more you like him.  His delightful wife, Kathy happily gave me a photography lighting kit that they were no longer using.  

I got to chat with my cousin Steve (always “Stevie” to me) and his wife Sharon.  Stevie talked about his father’s experience in WWII, and reminisced about growing up in the 1960s and 70s.  

For the first time in memory I talked with my second cousin Victoria and her Brit husband, Paul.  We shared stories about how we met our respective spouses.  

Cousin Kathy recounted her recipe for mock clotted cream (something that you can’t buy in the states, due to some sort of pasteurization rule).  Cousin Rudy told me that his photo was on the Portillo’s web site… and so it went.

By having a smaller group I was able to mingle more, and touch base with a lot of wonderful people in a way that I usually would not.

Large groups are great, but sometimes a smaller sized group is just what the doctor ordered.  It can be easier to do some things with a smaller size.

On the way home I commented to my wife,  “I really have a nice family.”  “I always thought that,” Julie replied.

A small Droby Fest