Who Am I?

A cooler morning today. More fall-like, more in tune with the expectations of the season. When I left the comfort of my home I was met with 50 degrees of briskness. It felt right.

I don’t usually plan what I write about, I typically hope for some sort of inspiration. This morning my thoughts were cluttered, none able to gel into a ball of coherence that could be expanded into a missive.

If there was one theme it would be, “Who am I at 64.” I’m not sure beyond a laundry list of titles: father, husband, friend, doctor… none seem to define me very well, likely because many of them are in transition.

The other day I told Julie  of my inability to be. It is almost impossible for me to not be productive. I always feel an internal push to do something. I always have a need to justify my existence. I don’t attach a “good” or “bad” valence to this quality. With that said, there are times when I wish that I could just shut it off and be.

And so it is with my next chapter of my life. In two and one-half months I will enter phase one of my retirement. What will become of me?

In the 10 plus years of planning, I have held onto the idea of returning to my creative roots. Writing, taking photographs, teaching. As I approach phase one these goals start to seem like folly. I can certainly do them, but will they have any meaning if no one connects with them? I don’t think that this is grandiosity on my part. Rather, my practical mind sees little point in expending energy that doesn’t have a purpose.

Problems that I thought that I solved years ago present new. Should I travel for inspiration? How do I connect with strangers and convert them into friends? What should I write about? Should I pick commercially viable topics, or should I write from my soul? How much should I reveal about myself? How vulnerable can I be?

At the moment I am trying the “blunt instrument” approach. I take photographs, I write, I make videos, I do podcasts. I hope that one of these outlets will catch fire with me. That somehow the act of doing will show me the course to follow. That my actions will have meaning.

At 64 I still want to change the world. There is an urgency to this idea, combined with the reality of my life. If I haven’t changed it during the majority of my life how can I change it with the minority remaining?

To be honest with you dear reader, I’m not even sure what that change would be. The themes that flow through me today include: tolerance towards others, understanding others, the common core of humanity, our planet… the list goes on. I chuckle as I read my list. Still altruistic. Still a little boy trying to do something big. Still holding on to what the nuns said, “Michael, God has plans for you.”

My time is running out. I should have acted sooner. I should have been braver. I should have been stronger.

Dear reader, if you have read this entire piece, I thank you. My writings aren’t three sentences of inspiration. They don’t have the funny punch line of a meme. The don’t polarize you and force you on one side of the fence or the other.

When you read my writings you enter the mind of a common man who thinks and wonders, “Why am I here? Is success based on how many marbles that I have at the end of the game? How many friends have I acquired? How many papers that I have published? Sadly, this common man doesn’t know the answer to these questions, even after 64 years of thinking about them.

For now, I’ll keep hacking away with my blunt instruments, if only because I have no other tools at my disposal.

Growing Pains

This morning I feel like I am moving into the unknown, change is afoot. Many aspects of my life are in motion. The kind of random motion where it is impossible for me to determine the eventual destination.

Being a creature of habit this unknown is difficult for me. Clearly, I am the agent of some of my change. Clearly, some of my change is happening without direction or effort on my part. Overall, the process feels uncomfortable.

Front and center is my work life. It has now been two and a half months since my private practice retirement letter went out. Every day I am saying goodbye to patients, some who I have worked with since 1989. I am still at the point where most of the people that I see are first-time goodbyes. It is difficult.

We live in a world of depersonalized services. We buy things off the internet. We deal with unintelligible customer service reps thousands of miles away. We connect with people using apps on our phones. Plug in a few statistics and hook up with a stranger. Even intimacy has become a commodity.

Doctors practice a production model. The more patients that you see, the more money you make. I want a good life, but if money was my only goal I would have gone into a more lucrative field, like business. It is clear that a major part of me wants to help others, and be a positive influence of change in their lives. Some of that desire is altruistic, some to justify my carbon footprint.

I have established connections with my patients, and now those connections are about to be broken.

Trained in the psychodynamic milieu of my residency at Northwestern University, I am acutely aware of my role as doctor and caregiver. Aware of the necessity of a professional connection with my patients that includes boundaries. Aware that my position gives me power, and that it is my responsibility to treat that power with respect.

Despite this artificial barrier, I have developed connections with my patients. Now it is my responsibility is to help them transition to a new doctor. Now, I have to say goodbye, over and over.

The vast majority of them congratulate me and thank me. Some are tearful, which makes me tearful. A few are angry. Some have just moved on, heralded by a “release of information” from a new doctor requesting their medical records.

The latter group has surprised me the most. Some of whom I have known for decades. Their way of coping has been to simply change to the new provider. I guess the word “provider” says it all; an interchangeable thing that provides a service. It isn’t their actions that surprise me, it is my reaction to their actions. I find myself hurt and discounted. A part of me quickly buries these emotions, another part acknowledges them. Another chunk of self-awareness to add to my self-awareness vault. This piece has sharp burrs that bump up against me and cuts me. I would like to discard this piece, but I know that I can’t because it is part of me.

As my life moves in a new direction, so does my wife, Julie’s life. As she stretches her professional wings, I close mine in. More change in my recent sea of change, but that is the topic of another post.

Every experience in life helps me grow, a process that never ends. Unfortunately, sometimes growth involves growing pains.


Tuesday morning 5:51 AM finds me sitting at a small metal table on a narrow cement sidewalk in front of Starbucks, sipping coffee. Sipping coffee and thinking.

I have been watching the PBS Vietnam special for the last week. It has been riveting, and disturbing. I feel compelled to view it like I am compelled to stare at an accident on the side of the road. The emotions when I watch the screen trump any rational reason why I should, or should not, view the series.

It surprises me how fresh the half-century-old photographs are to me. I saw many of them in real-time when I was a child and adolescent. When I view them now I am instantly transported back to those days. In many ways, I traveled the same journey that the storytellers did.

As a child, I believed that the government’s only purpose was to protect us. That they always told the truth, and that they were transparent in their actions. As an adolescent, I became progressively more jaded by the reality that I saw on the nightly news. The body counts based on political currency, rather than necessity. The dehumanization of an entire nation of people. The devaluation of American lives. Winning the war became the goal in Vietnam, the reasons why lost in political rhetoric and catchphrases.

The stories of the soldiers, many children, brought back memories of me sitting in the kitchen of the house on Francisco Avenue listening to WGN as my year’s draft lottery numbers were being announced. My number was 108. My best friend John’s number was in the high 200s. Predictions were that they needed to draft up to 160 or 180 that year. I was relieved for John but terrified for me.

I remember the sick feeling in my stomach when I became aware of my number. A feeling of being completely out-of-control. By that point, I had lost faith in God, the government, all authority. I was too afraid to separate myself from my family. Too afraid to escape to Canada.

It felt like my life was over that day. One more trauma in a series of traumas, but one that would likely be my demise. I had survived others in my young life, some formidable. However, the US government and my perceived expectations of my family appeared to be insurmountable. A barrier that I did not have the strength to breach.

During my draft year, the war deescalated and they never reached draft number 108. It was still a year of hellish waiting.

I’m not sure what was more painful. The thought that I could be sent off to war and most certainly die, or the realization that those who pledged to protect me had clay feet. It was a time of transition for me. A time where I decided that the only way that I could move forward in life was by taking control of my own life. A time of abandonment of naive, but comforting beliefs. A time of doubting everything. When you doubt everything you are alone, and so it was a time of great loneliness.

It was one more step in me becoming ever more independent. A blessing and a curse. It was one more step in me becoming expert in areas that I found necessary or interesting. A blessing and a curse. It was one more step in me becoming skeptical of other’s motivations in their interactions with me. A blessing and a curse. It was mostly a terrible time.

I have softened over the years. tempered by life experience and maturity. I view authority with a reality that is more nuanced, less absolute. I have more trust with people in my life, and I realize that most individuals, agencies, and authorities have many facets… some good, some bad.

I tend to focus on the positive of people and things, not the negative. I tend to see the good in others, more than I see the bad. But I still have a wary eye.

I am aware of the damage caused to real people who were exposed to horrific atrocities at an age where they should have been focused on weekend parties and fast cars. I lost a cousin because of the trauma of Vietnam. I have worked with countless vets at the VA who lost functional lives because of their experience. I currently work with successful men who seemed to beat the odds, only to crumble when the structure of their work lives ended. That vacuum filled with memories and nightmares from a time better forgotten. It saddens me. It sickens me.

I am aware that knowledge without action means little. We can learn from the past, or we can repeat the past. This rule applies to big-picture stories, like the Vietnam war. It also applies to small-picture stories, like our personal lives. So many times we repeat cycles of futility, hoping for a different outcome. I want to move forward. I want to learn and move on. I don’t want to be cynical or paranoid, but I also know that I can’t be all trusting either.

My wife Julie sometimes criticizes me as I can come off as being an expert in many things. It is true that my obsessive nature drives me deep into topics. It is true that my professional life places me in a position where I am expected to be knowledgeable, an expert. I wonder if my intrinsic nature fueled this quality, or if it was formed by the traumatic realities of my young life?

I move on, forever growing, forever questioning. I want to believe, I want to trust… one step in front of the next, moving forward.


My senses are confused this evening.
I walk the path from my house to the river.
The air is hot and moist. The air of July.
The fragrance is of fallen leaves. The fragrance of October.
The DuPage is shallow and slow-moving. The river of August.
The dusk is early. The light of September.
The memory is of schooldays. The memory of childhood.
I walk aware. Aware that all moments are unique.
Transient, never to be repeated.
I walk and I celebrate the gift of today

The mighty DuPage river. Slow and pondering.


Walking in the dark, I think. First random scattered thoughts, without theme or form. Then ideas more focused, still loose not gelled. Slowly, a greater theme emerges as I silently plod forward. The environment around me synchronizes with the milieu inside of me.

Today’s theme started to consolidate as I passed a truck stopped in the middle of Jefferson Avenue. It was out of place in the pre-dawn morning. I spied another truck out of place, then another.

As I approached the Starbucks on Chicago Avenue their reason, and my theme appeared. The last truck was stringing holiday lights in the trees, preparing for Christmas season ahead. The season was changing, change happens.

My life is not static. I am not fixed in time like the photographs that I take. The world around me is changing. I am changing. Often I have little control over either.

The lights are being strung in the trees. In a few months they will be removed. I celebrate their appearance, and I will mourn their removal. My life moves forward and I celebrate and mourn my changes simultaneously. Change like so many things is neither good nor bad, it just is.

What will change bring me today? How will I view it? Will I accept it or fight it? The only certainty is that it will occur.

On Retirement

Dear reader, please note that I wrote the following post in late July, as I was flying from Seattle to Chicago.  My retirement letter was just sent out, and I was returning back to my practice (from vacation) in a few days.

I have to admit that I find it uncomfortable. Probably more so than others. I dislike the uncertainty of the unknown. I bask in the comfort of routine. It has always been that way for me, but I feel that this tendency has increased with the increase in my years.

I am a creature of habit, not one to seek adventure unless the benefits were great. Like most stances that are reasonably reasonable, my position has both served and hindered me.
My conservative ways have given me security, comfort, and a degree of financial independence. My conservative ways have prevented me from new experiences and new growth. In some ways, it has been a toss up. Like most, I am a product of my personality. I accept this truth much of the time.

My life has been changing, my years have made me ever more conservative. My spirit has made me ever more adventuresome. I view this phase of life as both exciting and confusing.

I realize that I have to push myself if I hope to move forward. I have had the comfort of a professional persona. A role that allowed me to be instantly identified. A title that gave me immediate status. That is now about to change as I redefine the fundamental essence of who I am. I look forward to this change, but I am also fearful of it. It is easy to quote, “With power comes responsibility.” This is very true, but it is equally true that with power comes power. Soon I will lose that power and once again I will become the working class kid from the Southwest side of Chicago who wonders if he can make it in the big world.

I made my decision to leave private practice over 10 years ago. A lifetime ago. A decision made out of desperation. Overweight and physically sick I saw no other option.

My subconscious aware of my spouse’s financial insecurity combined with my own ambition to be successful, I worked ever harder. The more that I worked, the sicker I became. Finally, I realized that my only solution would come from moving outside my established norm and to a new equilibrium.

I told Julie that I would leave private practice 10 years ago. I’m sure she took my distant prediction with a grain of salt. Ten years sounds like a lifetime. For me, it allowed a window of hope off on the horizon. A window where I could work less and explore those things that I felt I was intended to do.

Then things started to change. I have chronicled many of them in previous posts, so I won’t belabor their details again. I reduced stress, faced traumas, worked through traumas, moved towards health. Slowly, my overweight and sick body became thinner and healthier. Slowly my energy increased and my mind cleared.

Now my fear of becoming ever sicker has been countered by the reality of what I am leaving, and what I am moving towards. My distant goal served an abstract purpose. My current reality not only comforts me, but it also challenges me. What if I can’t do what I have set out to do? What if I lose myself as I lose my professional self? What if….?

Such fears serve no purpose, and so I make effort to place them in their proper perspective. However, more challenges continue to emerge.

My retirement letter has been sent to my patients; patients will react. For some of them, I am just a commodity that can easily be changed out for a newer shinier model. For others, I will have to absorb their anger. I have been a “provider of services” for them and my leaving will be an inconvenience. For others, both patient and doctor will have to deal with the pain of the ending of our relationship.

I have worked hard to maintain professional boundaries with my patients, but that hasn’t
prevented me from forming bonds with them and having them forming bonds with me. I will miss them, and I suspect that some of them will also miss me. This part of my transition saddens me deeply. For every action, there is an equal and opposite reaction. The positives of moving forward are countered by the negatives of what I am leaving behind. A life lesson that is ever repeated.

I have some general plans for my future. Now more physically fit I can see some of them moving from theory to reality. Yet, I am still hindered by myself. My shyness. My fear of intruding on others. My desire to succeed and to be recognized.

I know that I need to conquer these hindrances, or at least quiet them. I have to move past my shyness, I have to move past my childhood based fear that I offer little, and therefore I am a waste of time to others. I have to recognize that success comes from achieving my goal rather than how many accolades that are sent my way. These changes sound simple, but they are not for me. They are my new Mount Everest. I have claimed mountains before, I will climb this one too. Climbing mountains is what I have done all of my life.

My immediate plans are simple. To continue to hone my basic creative skills and pray. Pray that one of the 100 amorphous ideas that I have floating in my brain solidifies so I can focus with greater purpose and energy.

I have to accept that I will need to grieve many losses. The loss of my professional life. The loss of patients who I have been able to connect with. The loss of power that my profession has afforded me.

I will also have to accept the uncertainty of a new life and direction. One in which my efforts may be met with rejection or ridicule.

I move ever forward, grateful that I have been given another chance to rediscover myself. A chance to grow. A chance to think new thoughts.

Today my goals are to realize that change happens and that I am at the exact place that I should be at this very moment.