Vacation Kinetics: Purging the Matrix, Cleansing the Senses, Awakening the Spirit

Overloading

Vacations are a way to get away – in every way.  Yet in today’s hyperconnected, hyperkinetic modern world, it is more difficult than ever to disconnect, decelerate and rejuvenate.  Our two-week family vacation was strategically planned by my lovely wife to allow rejuvenation of mental energies away from work concerns near the end of summer, including long stretches in the car; in remote rural areas; and being out the country – in part, to discourage on-line time.  The 24/7 maw of the social media world that is drawing us into a Borg-like meta-community has a gravitational pull into its growing sphere of influence.  Disentangling from it has become the primary challenge for a successful vacation.

Academic physicians seem evolutionarily conditioned to have our attention swallowed up by the immediacy of our daily work lives.  Our nervous systems seem finely-tuned to reflexively respond to our daily sensory input of general need.  At work, we are confronted with the “emergencies of the moment” that consume our carefully planned schedules.  For me, this includes urgent emails from my boss, cell phone texts from mentees needing deadline-driven feedback on a paper, voicemails from professional groups on sudden changes to upcoming conference calls, faculty members unexpectedly out for personal reasons needing coverage, or a page[1] from a nursing home on an immediate patient concern.  The amygdala-jarring, guilt-reflex that each of these inputs ignites, reinforced by years of professional acculturation demanding immediate responses to all needs, makes ignoring them genetically impossible. Adding the barrage of input from overseeing a section in a department of medicine at a large academic institution (read: middle management) only raises the cortisol levels further. It is no wonder why, among academic physicians, burnout and turnover are so high.

Sometimes the only way to break the cycle is to eliminate the sensory input.  Everyone I told that I was going on an extended vacation enthusiastically encouraged me to “avoid all work-related activities”. Easier said than done!

Weaning

I was excited about our planned trip, even with the prospect of being locked in a car with my Eveready-bunny young boys for hours on end.  When I was a kid, we would jump in the old Datsun station wagon and drive to grandma’s house, twelve good hours of complete family immersion and outer-world isolation.  Playing “counting cows” and finding state license plates are over.  In our car, there are three smart phones, three tablet computers, and 2 regular computers, all internet-connection compatible. Perhaps the one advantage of my cell-phone service with Sprint is the relatively poor coverage it provides in non-urban areas and the ghastly charges they have for international service.[2]  Even worse, having identified “internet access” lying at the very base of Maslow’s hierarchy of needs, every place you stop along the way provides WiFi services.  It’s truly amazing watching people wander slowly about public places, slack-jawed staring at a phone, bumping into things.  In protest, I carry a book around with me everywhere, sitting and reading something in the open periods available.  Like other addicts, I spent hours each day in a cold sweat, trying not to connect my nervous system into the Matrix, slowly weaning myself off the electronic juice.  At the beginning of the trip, I wasn’t sure two weeks would be enough time.

Everything triggered a reflexive need to connect.  In reading a rest stop sign on the local history of Rome, NY – was it really the starting point for the building of the Erie Canal?  In seeing someone wearing a LeBron James jersey in Cleveland – how were the FIBA team practices going?  Had we heard back from anyone on our journal articles, especially the one to the Health Affairs Blog?  Slow, deep breaths…count to ten…ask someone a question…read your book…  This was work!  When did vacation become such hard work?!?

Purging

Recognizing the challenge ahead, my wife had brilliantly planned for us to spend many hours a healthy distance from the Matrix. First, living cozily in a small, rustic two-story motel on Old Orchard Beach — a lovely, genuinely historic locale inhabited primarily by thin, smoking French-speakers from Quebec. Meandering a mile barefooted down the silica, confronted by the sine-wave eternity of sandy saline, is a wonderful psychic purgatory.  We spent the first part of the trip at a local joint, catching an unexpected glimpse of a favorite celebrity, and hanging out with the bride and groom, moves the electronic buzz into the hazy periphery.  Being forced to stop at a local gas station, all gussied up, to get directions to the ceremony at “The Barn at Flanagan Farm” from a woman with a knowing smile, because the GPS won’t connect,  injects a healthy dose of humanity.  Spending the day-after brunch with across-the-country friends you’ve only interacted with on Facebook in over 20 years, and discussing foreign policy among the wild flowers with an intensity social media precludes, reconnects the vivid present to the unseen future through the past.  Hiking up a mountain, along sheer ravines with my adventurous sons, calves aflame, unable to send a reassuring text to my wife, calls forth a focus of intensity to block out the world. Staring through the cool, swirling mist of pulverized water on rock from the deck of a boat staring up at Niagra’s relentless falls, unable to snap pictures with your smart phone, forces you to simply enjoy the moment. Exciting the senses and calming the soul.

Awakening

As the sensory apparatus was revived by salty ocean breezes, fresh seafood, bright wild flowers, prickly briars, and cool mist, the cognitive gears began turning again.  Freed from the character confines of Twitter chatter, narratives of new friends emerged.  Shared struggles up a steep, rocky mountain invited bonding discussions of oceanside views.  Meeting Ricki inside her beachside Place, quicky, discombobulated bookstore/motel/knick-knack/beach-equipment rental encouraged bibliophile bonding, and some more books for the collection. Open enjoyment of a new marriage in a field of clover led to wide-ranging discussions of the entrepreneurial spirit altering the landscape of international relations. Touring the Joshua Chamberlain museum, some more pieces of history clicked into place, as the WWII-vet docent filled in more details.  And another Civil War history book went into the collection. Stopping at the Fort Erie historical site, engagingly led by a young local woman in period clothing, and punctuated by the firing of a mortar shell ordered by my son, I could almost feel the neurons reignite.

Contemplating

As the vacation flowed along, as my senses revived, as my brain engaged, I found the need to write creatively emerging.  Using my long-dormant blog, I spent time each night piecing my thoughts together, gratified to find others who shared my thoughts.  Why was I so intrigued by professor-turned-soldier Joshua Chamberlain?  What did I enjoy so much about used book stores? Why was   I found myself feeling happier than I have for some time, enjoying the simple vitality of being alive, letting my inner self choose the topic, rather than responding to the “emergency of the day”.

I finally had some space and energy to contemplate – to, as Dr. Suess would say, “think about thinks”.  The true value of an extended vacation is less to get away from things like the matrix, but to get close to one’s inner self.  The “getting away” is really just the first part, to clear the playing field, to blow out the engine, to pull the plug on the tub full of dirty water.  Or like a beach after high tide, when all the sand sculptures have been melted down, and the canvas again lies pristine. Once that’s done, one can really get to work, focusing all of one’s energy on the creative task at hand.   I now feel like I imagine my kids do when they start on the new sandcastle or master a new skill, happily creating something anew from nothing, investing all of one’s ample energy in the project at hand.

I’m grateful to my wife for planning this vacation, finding a way to detach us from the persistent buzzing of our Web-ensnared devices, nudging us out into the wilderness of reality, allowing us to engage with the wider world.  I’m thrilled that she was rewarded in many ways: recognizing a favorite sit-com star who flashed across her field of vision, re-engaging with an old friend at the wedding (both wearing beautiful lavender dresses), playing on the beach with her boys, and enjoying another birthday dinner with me.  We’re now a little older, a bit wiser, and more thoughtful – and perhaps, a smidge happier.

[1] Yes, a pager. I suspect doctors are the only professional group that has failed to give up this antiquated, annoying form of communication.  Mostly symbolic, like stethoscopes and white coats, that allow physicians to maintain a professional identity, to the detriment of job function.

[2] As we discovered during our recent trip to the Black Hills of South Dakota, Sprint has absolutely no interest in providing any cell service whatsoever in that area.  They really ought to change this into a “feature” for vacationers like me, guaranteeing “absolutely no service, no matter the urgency of the matter”.

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Filed under Aging, History, Philosophy, psychology, vacation

Robin Williams, Jimmy Wales, and Holes in the Universe

Many years ago, during my first stint living in the Windy City, Jimmy Wales of Wikipedia fame lived with us.  During that time, he told us a funny story.  He was in a park in a major city, I believe it was Central Park, but I can’t be certain.  He saw an aggressive mime bothering someone in the way mimes do, although this one seemed even more active and annoying than usual.  Suddenly, the man serving as the “audience” for the mime just slugged the mime, knocking him down.  I laughed – haven’t we all wanted to do this at some point in our lives?

This would have just been a cute story, except that Jimmy related seeing Williams on a talk show many years later – TELLING THE SAME STORY!  Only in that version, Williams was the mime being slugged.  I was laughing hysterically now, imaging my favorite comedian, being punched by some stranger who never knew his brush with fame.

All these many years later, I’m as stunned as everyone else at Mr. Williams’ death from suicide. Even as a physician who cares for many patients with depression, knowing the dangers it brings, I feel as sucker-punched as Williams-as-mime must have.

I vividly remember the first time I saw Williams on TV – in his role as Mork from Ork on my favorite childhood show, Happy Days.  His appearance on that family sit-com, in justice, should have been the “jump-the-shark” moment for the original “jump-the-shark” moment.  We would be calling such derailments of successful shows that have over-run their course the “alien-from-Ork” moments, I believe – except that Williams was just so damn funny.

I heard that, during the try-outs for the part of Mork, each applicant was asked to sit like an alien.  Williams spontaneously chose his now-famous head-down/ass-up posture, which nearly won him the role by itself.

There is nobody I can think of who filled my life with laughter as much as Robin Williams.  I watched Mork and Mindy religiously.  Even as a kid, I would stay up late, after begging my parents, to see him on the Tonight Show with Johnny Carson.  I watched every one of the charity specials that he co-hosted with Billy Crystal and Whoopie Goldberg.  I have seen virtually all of his movies, especially the comedies. I love to laugh, and nobody made me laugh more than he did.  The manic craziness, combined with the abstract flight-of-ideas, and the obvious delight in response of an audience – any audience – was infectious beyond belief.  There is just nothing like it.

I have read that one of the “reasons”, if such can be adduced after someone suffering from depression kills themselves, that he committed suicide was a recent diagnosis of Parkinson’s Disease. Since I treat many people with this disease, I wanted to comment that I hope that’s not true.  Many people with PD have a wonderful quality-of-life with the diagnosis, receiving treatments for it.  But I can’t help but wonder if, after playing the role of neurologist Oliver Sacks in the movie Awakenings, Robin was reminded of the unfortunate outcomes from that initial episode of using carbidopa/levodopa to treat a variant of PD.  But it is haunting to watch that film and not wonder a bit.

Now that Mr. Williams has written the final chapter of his life, he has left a hole in the universe, it seems.  His life, as much as anyone’s, was a singularity – and like the outer space version of such, it has left a black hole behind.  I wonder at this feeling of loss, this presence-of-an-absence, that some people leave behind.  It’s the converse of the bright flare of joy such people bring to our lives, and I’m going to try and le that shine on in my memory, as much as possible.  He really was the funniest person I’ve ever seen, and I see in my mind’s eye, him being punched for being TOO good a mime, with an astonished Jimmy Wales looking on, heading out to change the world in another way.  And you can read all about one due to the vision of the other.

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Filed under Comedy, Decision Making, End of Life Care, Philosophy

Visiting Joshua Chamberlain’s House (Part 2)

(Part 1 can be seen here).

A Remarkable Life

By any measure and for any time, General Joshua Chamberlain lived a remarkable, dramatic life of adventure – especially for a professor of religion.  Most famously, he was the colonel leading the 20th Maine Volunteer Company in the Civil War who defended the far left flank of the entire northern Army of the Potomac on Little Round Top at Gettysburg. With a left-wheel, bayonet charge down the rocky hillside, they are credited with saving the army, and perhaps the war, on that July 2nd day.  He endured one of the six serious wounds he ultimately received in the course of the war, leaving him in constant pain for most of his long adult life.  One of those wounds was a .50 caliber minie-ball through two pelvic bones, which nicked his bladder, and was universally considered fatal.  When General U.S.Grant heard about the grievous wound, he had Chamberlain promoted to General on the spot in the field, in order for him die as a general. From the hospital, Chamberlain wrote a lovely “last letter” to his wife as he lay awaiting death.  Against the odds, he recovered and rejoined the war effort, despite a significant limp and severe difficulty in riding his horse.  He continued to lead his regimen so well, as fate would have it, he led them to trap General Lee and the Army of Northern Virginia as they retreated from Petersburg to Appomattox Court House.  The Fighting Professor was then asked by General US Grant to be the regimen to receive the official surrender of Lee’s army.  At the crucial moment of the surrender, as Lee’s army approached to lay down their swords, heads’ bowed in grim defeat, Chamberlain ordered his men to “present arms”, a gesture of honor and respect to a worthy opponent.  It memorably altered the moment’s tenor, converting it from a conquest of a hated enemy to a hat tip to a future colleague, and becoming a symbolic offer of “charity towards all” harkening back to Lincoln’s Second Inaugural Address. Chamberlain had a kind of “perfect pitch” for history’s pregnant moments.

Following the war, Chamberlain returned to Maine, serving four terms as Governor, followed by a lengthy stint at President of his alma mater, Bowdoin.  Much of this time he spent writing his memoirs, particularly of his exploits in the Civil War, mostly from within the house on Potter Street, just off the Bowdoin campus.  This is where the Chamberlain Museum is now located.  We turned in.

A Remarkable House

We arrived just in time to sign up for a tour of the facility, which overlooks the Bowdoin campus.  The tour is enthusiastically led by a loquacious volunteer, an 80-something docent – my absolute favorite kind of historical guide.  The WWII vet, so reminiscent of the men I cared for during my clinic during residency at the University of Pittsburgh VA hospital, is full of facts, opinions, and a gleaming eye for the kids on the tour. As he limps through the house, holding on for support, he offers an authoritative opinion on anything and constantly asking, “What other questions do you have?”

The lovely old mansion is somewhere between dilapidated and magnificent, with cracked walls competing with restored, original furniture.  The on-going, underfunded restoration effort is battling with an on-going process of weathered decay, with the final outcome standing in the balance, a distant echo of Little Round Top itself.  The lady up-front tells me they just received a small private grant to restore the chimney, but need about 50 times that much to complete the full restoration. Two of the rooms have significant recent water damage, making one of them, the kitchen, off-limits for the tour.

The house itself has an unusual history.  Built originally in early 1800s, the original structure was later moved en masse and pivoted, rotated from facing Maine Street to facing Potter Street and the Bowdoin campus.  Later, when Chamberlain became college president, his wife refused to move into the official president’s house a short distance away.  In order to maintain the desired living quarters while adding an area to conduct official business, the entire structure was then jacked up 11 feet, and a new ground floor was added, a predecessor of Chicago’s later raising of its downtown buildings from the sinking muck they were built upon.

A Remarkable Collection

In the first room, the docent asks the kids, what U.S. President with the initials J.Q.A. was in office at the time of Chamberlain’s birth.  To my delight, my 11 year old nails it – John Quincy Adams.  I’m especially tickled because the kids rarely pay attention at these history tours I inflict upon them, but because I’m reading a biography of John Adams right now.  Which leads to another of those “can-you-believe-it?” facts of history – Chamberlain’s wife “Franny” is related, in a tangential way, to the Adams family.  She was born to a relative by marriage of John Quincy’s, then adopted by another, childless member of the family.  A tenuous tie between the Revolutionary Generation and the Civil War generation – I absolutely delight in such connections.  The docent is equally delighted that one of the kids got the answer to his question, and we’re off and running.

The displays within the house mirror the contrasting quality of the overall building. The displays are not the polished work of, say, the Lincoln Museum in Springfield; rather, they are competent descriptions of the items. They are arranged loosely by themes in specific rooms, but they are not thematically arranged or organized into a narrative.  Our guide points to items that strike his fancy, but completely overlooks some others.  But what a selection of items!  There is a room that contains his actual Medal of Honor – the most prestigious medal given by the military, one that Truman reportedly said he’d have given up the presidency to receive.  It hangs, unprotected, on a wall and receives a short mention by the docent.  In a case, there is a bullet fragment – that was removed from Chamberlain!  The docent doesn’t mention it, but when I ask, he says it’s from the foot wound he received at Gettysburg while fighting on Little Round Top!  We linger over portrait paintings of his parents, while the original Tojani oil painting of the bayonet charge on Little Round Top goes undiscussed.  I have to confirm the authenticity of the painting as we move out of the room.  The house is simply full of amazing artifacts, openly displayed for inspection, and the docent offers great anecdotes.  But one is best served with a prior knowledge of the relevant history in order to fully appreciate the value of many items.

As we meander through the house, we learn more and more quirky facts. The odd-shaped rooms with rounded walls and no corners was designed by the ship-builder, not an architect.  Among those who sat on the furniture in the dining room are U.S. Grant and Harriet Beecher Stowe, author of Uncle Tom’s Cabin; Ms. Stowe’s father taught as Bowdoin.  Speaking of Bowdoin, Chamberlain had Henry Wadsworth Longfellow as a teacher, and student Chamberlain’s signed book from class is there.  A red velvet-lined chair sitting at a desk looks like a throne – and it is, brought there by Chamberlain as a gift from the Queen of England.  These details provide a rich tapestry to the intertwining lives of history.

Remarkable Legacy

Chamberlain and his wife were something of medical marvels of the age.  His wife had strabismus, which left her with a lifelong vision problem, despite attempts at surgical correction.  Chamberlain’s pelvic wound, which left him with a permanent limb for life, also left him with a damaged urethra, requiring a catheter.  Having received 6 wounds in the course of the war, he lived a remarkably active, long life and was a “happy man”, by all accounts, according to the docent, shaking his head in disbelief.  Like many of the day, several of their 5 kids died of “consumption” – tuberculosis – in part because all 4 boys slept together, since the cause of the disease was not known.  Chamberlain has a personal nurse for much of his later life, to help given his mobility limitations.  The challenges of growing older echo across the ages.

One reason we know so much about Chamberlain’s life is that he wrote so much of it down for us.  While the Civil War soldiers were a remarkable literate lot, Chamberlain was an academic and gifted prose stylist well beyond average.  He left behind vivid, first-hand accounts of his experiences, and he was happy to take a starring role in the script.  Some have criticized him for this, complaining that he, and his defenders like Shaara, have glorified his place in history, while pushing others equally worthy to the side.  People like Gouvernour Warren and Strong Vincent, equally valiant and arguably more important participants on Little Round Top, have been relegated to supporting roles in the story, despite their actual importance exceeding Chamberlain in historical fact.  There’s something to be said for making sure to get your own side of story out – which I try to use as inspiration.  I also encourage those with time and inclination to read the relevant history and decide for themselves the truth.   By any measure, Chamberlain had a fascinating story to tell, and we are lucky to have it to learn from.

Chamberlain’s remarkable life has been an inspiration for this academic over the years.  His bold decision to leave the safe confines of the academy – his took a leave of absence, promising his bosses and his mother he was going to Europe to study – and raise volunteer troops to fight for the noble twin causes of “union” and “abolition” challenges me to pursue my inner beliefs.  That he taught himself the military arts and rose to the rank of Major General, even in those times of rapid ascension via attrition, illustrates true self-sufficiency and personal growth.  His magnanimous gesture to his defeated opponents showed a generosity of spirit, especially coming from someone nearly killed by those adversaries-turned-countrymen.  Would that we all could muster such courage and grace when the telling moment calls.

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Filed under Aging, Civil War, History

Visiting Joshua Chamberlain’s House (Part 1)

My second favorite historical figure from the Civil War, after Abraham Lincoln, is “the fighting professor”, Major General Joshua Chamberlain.  Like many, I became a fan after reading the classic Michael Shaara novel Killer Angels about the Battle of Gettysburg, in which then-Colonel Chamberlain plays a starring role as the rhetorician-turned-soldier who saves the union army on Little Round Top.  Like some Nietzchean philosopher-warrior come alive, he “refuses the line” at the far end of the Union left flank, with a desperate bayonet charge down the rocky hillside, all while contemplating the meaning of it all.  Straight out of central casting, what academician wouldn’t salivate at admiring this action-hero figure?

But was it too good to be true?  Could a rhetoric and religion professor really become a military hero?  The academic skeptic in me just couldn’t rest without separating the rhetorical chaff from the history wheat. In my typical OCD way, I started reading about Chamberlain, Gettysburg, Lincoln, and the Civil War overall in hopes of answering these and other questions. I also made the trip to Gettysburg, stood on Little Round Top – on the very large boulder from which Chamberlain anchored the “wheel” for his company’s charge down the hillside – and tried to imagine that burning hot July 2nd so many years ago.  Would I have been able to measure up?

In addition to spending much time on Little Round Top in Chamberlain’s shoes, while moving about the park, I lingered at two other places that day that invited introspection. The first, not far from Little Round Top was the national cemetery where Lincoln stood to deliver his great speech. It sent chills down my spine to imagine being there that day.  The second was standing in the woodline where the young Confederate soldiers in Pickett’s brigade would have stood, preparing to march across a near-mile long, open field into the teeth of the Union line, looking across the way to tiny copse of trees where the Union lines waited.  How could they do it?  What could possibly motivate them to make that march of death?  Would I have been willing and able to do it?

These questions, and many others, led me to explore a reasonable chunk of the available Civil War literature.  This includes multiple books on Gettysburg, another handful on other battles (and visits to the sites), a dozen or so Lincoln biographies, and another 10 on other significant figures.  Regarding Chamberlain, I’ve read several of his own first-hand accounts of the war he provided, but I haven’t read a full biography.

But I was tingling with excitement about seeing the house he lived in, now converted to a museum about his life.  What items did they have within?  What new facts would I learn about his extraordinary life?

In the next post, I’ll describe the museum visit itself.  As is so often the case, the truth is a little different than what I thought I knew.

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Filed under Books, Civil War, History, Risk

Trust and Behavior – Personal, Professional, and Political

Personal

My wife and I are placing significant trust in two young people we’ve never met before tonight.  We’re going to dinner together and leaving our boys — ages 11, 8, and 8 — with two strangers we’ve only met on the phone.  We’re even doing so in a place we’ve never been before.  Hopefully, we won’t be arrested for parental negligence, like a Florida mom was for allowing her 7 year old to walk to the park.

In addition to the trust we’re placing in these two young women strangers, we’re placing a significant amount of trust in our young boys, especially our eldest son.  He’s a smart 11 year old kid, with reasonable judgment, generally cautious, but with bouts of immaturity. We’ve gone through contingencies, he has a phone to contact us, and he wants to be more “grown up”.  He’s done well given appropriate leeway in the past.  Unfortunately, as Nicholas Nassim Taleb and others point out, successful past performance isn’t always a reliable guide to future success – a problem when large consequences are at stake. Our 8 year-old twins are rambunctious boys, one is very risk-averse and the other is risk-seeking; both are argumentative.  All of this was relayed to the babysitters.  They seemed perplexed that we were telling them all of this – apparently recognizing the extreme risk-aversion in the parents as more important than that of the kids.

The paradox of trust is that it involves a judgment of people in the face of insufficient evidence and lots of uncertainty.  Human beings make choices, and past action in similar circumstances is no guarantee of similar future action.  Even more difficult is predicting how people will behave in brand new circumstances. Trust when applied to human beings requires a judgement about character – that their virtues/values will guide their actions in a consistent, life-affirming way.  But there is no guarantee.  And mistakes are brutal in their consequences.  And yet, the greatest rewards flow to those who take the biggest risks.  As someone who studies decision making in a medical context, I’m hyper-aware of all of these issues.

Professional

I spend much of my professional life as a physician counseling people on risk.  As a physician caring for older patients with cancer, I’m constantly trying to provide my best advice for patient to balance the risks of having cancer with the risks of being treated for cancer.  One of my personal practice patterns is not only to tell patients and families what I think they should do, but to explain at some length WHY I suggest this.  Most appreciate knowing this additional information, although some find it overwhelming and confusing.

Over time, many of my patients have come to trust my judgment, even to the point of insisting that other doctors contact me before they allow a procedure or a treatment to take place.  I believe this trust comes from three sources: my willingness to explain the uncertain trade-offs they face, my constant reassurance that their quality of life is my highest goal, and my willingness to support whatever decision they ultimately make.  Also, my track-record is pretty good, in telling people what to expect, which tends to inspire trust.  The investment of extra time in clinic is worth the improved outcomes down the road.

Political  

I often marvel at the willingness of politicians to make definitive statements about uncertain events involving many people.  Having to act on issues that affect millions, or even billions, of people in the face of such uncertainty would be virtually impossible for most people, and certainly for me.  Yet we ask our presidents to do this on a nearly daily basis.  Today, I read in the news that we’ve decided to use military force, in the face of rising violence by terrorists, in the form of bombs, in Iraq.  Having supported our on-going troop withdrawl from that country, I’m unsure this is a good idea or not.  Hopefully, it will help the beleaguered people in the north of the country being brutally killed by the terrorists.  On the other hand, it might lead to escalation of violence in the country, increasing the overall violence in the area, to little effect.  Even worse, it appears to be a concession that our current policies in Iraq specifically, and the Middle East general, are failing.  I’m not sure whether this is a good thing to do, and I do not trust our government to choose wisely.  In the face of all this uncertainty, I truly don’t understand how to feel any trust.  As Ronald Reagan reminded us, when it comes to the politics of foreign policy, “Trust, but verify.”

Follow-up

Throughout the night, several people asked us, “What did you do with the kids? You didn’t leave them alone, did you?”  We received several text messages from the kids, including pictures of them having fun at the amusement park.  We had a fun, relaxing time, even seeing a celebrity from a favorite TV show, proving that Black Swan events aren’t always negative events.  We returned home from our event to find that the kids had a great time — and to our surprise, so did the sitters!   The kids spent many hours playing on the beach and riding rides, playing games, and eating ice cream.  The sitters had many delighted stories to tell. A win all around – we were right to trust the young ladies.  Professionally, my clinic continues to grow, enough that I need more time and space to see everyone we need to see.  Referrals continue to pour in.   Politically, unfortunately, I see no end to the problems, which continue to grow as we  drop some more bombs on Iraq.

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Filed under Decision Making, Philosophy, Risk, Trust

Used Book Stores

Wherever I happen to be, I have a special instinct for finding book stores, especially used book stores.  I love everything about used book stores – the musty smell, the happy clutter, the unassuming people.  The best combine the alarming pseudo-organization of mom’s garage with the anticipatory excitement of digging for treasure.  Heaven on earth!

The first vacation day here in Old Orchard Beach, Maine, my bibliophilic antennae picked up a lovely book nook: Ricki’s Place. It contains a potpourri of items – it’s a motel with beach supplies, games, CDs, wool, kites, needlecraft…and used books in English and French.  There a loose organization to the place, with books piled on shelves in quirky categories — political, French, thrillers, “antiques”, biographies, and sports to name a few.  There are others jammed into milk crates and cardboard boxes, sitting alongside paintings, magazines and various knick-knacks. Several of the boxes are piled in front of the shelves, requiring extra effort to dig behind them to find more books. Obviously, money-making from the books is a low priority.  I was tingling.

As I walk in, an older woman with a cigarette-stained voice greets me from behind a desk piled unevenly with a mountain of…stuff.  “Just looking at the books,” I say.  She says to “have a ball”, and points out that there is “good stuff for beach reading”.  Also, she points out, there is a special deal – if you return any of the books you purchase later, you get a 50% credit to get more books. I wonder: is this the actual Ricki from the sign?  I resist the urge to ask.

I start pawing through the shelves, my 11 year old son waiting patiently, longing after the Stephen King and Koonz novels his parents won’t yet let him read.  The semi-random organization of the books is thrilling; I feel like the Pickers guys from the History Channel, hoping to turn up a treasure among the debris.  There don’t seem to be any prices penciled inside the books, and I’m about to ask, when I come across an orange piece of paper tacked to the wall: a price list – paperbacks $2, hardbacks $4, and “antiques” $6.  Hallelujah!

I have multiple categories in my mind as a surf.  Category 1: Better copies or earlier editions of books I already own and love, like Killer Angles or Battle Cry of Freedom.  Category 2: Books I’ve heard about or by previously-read authors I’ve liked, especially older, out-of-print versions.  Category 3: Extra copies of books I like to give to others, like Ender’s Game, The Poet, or Fountainhead. Category 4: Genuine collector’s items, older books, especially first editions, that I can add to my collection that includes a first edition of U.S. Grant’s Memoirs and Mark Twain’s Roughing It.  As I’m squatting down like a catcher behind the plate, sifting through the stacks of the “antiques” section, my son walks up, looks at the titles over my shoulder, “Those are boring.”

Over the next hour or so, I turn up three treasures I can’t resist. From Category 2, I find two things. First, having just finished Peter Matthiessen’s magisterial Shadow Country, I turn up a nice paperback version of his National Book award-winning Snow Leopard. Score!  Also from Category 2, I discover a very nice, nearly pristine first edition, of The Reckoning by David Halberstam, author of Best and the Brightest fame.  As a bonus, the volume is likely worth more than the price as a collector’s item alone. Boom!  Finally, from Category 4, sitting randomly in a box off to the side, rubber-banded together, are three volumes of high-quality early editions (1885, 1886) of books by the writer and father of a future Supreme Court Chief Justice, Oliver Wendell Holmes, Sr.  While not hugely valuable, they are worth far more than the $18 they will cost me and make a lovely addition to my collection. Booyah!

Ready to check out, it takes some time for me to catch the addition of the gravelly-voiced woman in charge.  She starts ringing me up, reminding me of their half-price trade-in deal.  Half-way through the transaction, she gets distracted by a phone call and wanders off talking on her cell.  She returns, and as she’s admiring the Holmes volumes, she stops suddenly to yell past my shoulder at a kid standing in the doorway, which is causing the tone-alarm to chirp repeatedly.  Someone from the back of the shop yells to her, “Ricki, you have to take care of that!” confirming that she is the namesake owner of the place.  She then checks me out, including change with several $2 bills, and offering to put the Holmes’ volumes in a separate bag to protect them.  I happily accept, and turn to go.  My son says, “finally” and we head out for the day.

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Reflections on the Anniversary of the Flight of the Enola Gay

Walking on the Old Orchard Beach in Maine with my kids, enjoying a break from the challenges of work, preparing to attend a wedding, a plane flew over.  I was reminded that today is a poignant day in history involving a plane.

On this day (Aug 6) in 1945, the Enola Gay, on behalf of the US government, dropped the first atomic bomb in world history on the Empire of Japan.  It is estimated that 50,000 people instantly lost their lives, with many more dying in the coming months directly from the radiation effects.  The instantaneous loss of human life is staggering.

I recently visited Singapore for a medical conference on geriatric-oncology.  Across the street from where we were staying, there was an austere Memorial, a towering, four-sided white spire.  It commemorates the massacre of 50,000 Singaporeans, most of Chinese descent, by the invading Japanese during WWII.  It is a powerful symbol of human tragedy.  Standing there, I was stunned to realize I had no idea about this event, wondering how many other similar examples had been hidden from my awareness. The toll from this war became even more staggering to consider.

Both of these events from WWII are mind-bogglingly sad to reflect upon.  The equivalent of a football-stadium full of people, the majority of which were non-combatants, destroyed in a few moments or a few days.  Considered out of context, it appears to be two more instances of the mental instability of humanity.  So many individual lives wiped out, with us never to know what greatness may have lurked within some of those lost forever. The awfulness of war seems ridiculous when considering these events.

Yet, it is difficult to argue against our countries’ involvement in that terrible war and our efforts to end it as swiftly as possible. The moral worthiness of fighting against the genocidal Hitler and the appropriateness of responding to the bombing of Pearl Harbor seem reasonable responses to irrationality.  If anything, the consequences of failing to respond appear worse than what ultimately occurred.  Considered in this wider context, doling out a utilitarian, Realpolitik calculus of abstract lives lost, individual events like the dropping of The Bomb to end further bloodshed seem justified, strategically. But what about morally?

How are these two views – the unjustifiable loss of largely innocent life from total warfare and the justified use of force to achieve pragmatic ends – to be reconciled?

I’ve long been uncomfortable with utilitarian justifications for actions; it’s too easy in this few to reduce individual human beings to interchangeable, expendable parts.  My original juxtaposition of the Japanese civilian deaths due to the atomic bomb with the Singaporean deaths due to conquering armies hints at such a justification.  In truth, this obscures the tragedy of the lives snuffed out on both sides. It also personifies countries, of nationalistic fervor, as if the loss of a part of a country, a certain number of citizens, is a legitimate “trade” for a similar loss of life by another country.  This way of thinking can’t be right.

More concretely, we too often fail to consider what an individual life is about.  How people are more than interchangeable parts whose further existence is justifiable in the name of “national goals”.  That people like Adolf Hitler can consider certain people, due to happenstance of birth, is an extreme example.  But a similar version allowed the Emperor of Japan to consider those living in Singapore to be extinguished on similar lines.  Whether our use of the atomic bomb to help end the war with Japan was strategically justified, we should not forget the individual lives snuffed out with the effort.

We now exist in a world full of philosophies that too easily think of people as members of specific groups, that those in other groups are “inferior” enemies to be destroyed, rather than as individuals living out their lives as best they can.

Finishing the walk with my kids, I spent an extra few minutes to talk about their individual plans for life, to better understand what makes them each individually happy, and to think about how to better encourage us all to avoid being overly utilitarian regarding others.  My hope is that their future will involve less “trade-offs”, especially at the level national governments, of some abstract lives for other abstract lives – with the consequent loss of too many individual lives unlived.

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Filed under History, Philosophy, Utilitarianism