On Consistency

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I recently went to watch a movie with a couple friends. One of my favorite parts about the cinematic experience as a whole is the trailers at the beginning of the movie. With only a few exceptions, the two or three minute trailers promise a great story line, interesting characters, and a great balance between intense drama and lighthearted comedy; however only a small percentage of the full-length films actually lives up to such promises.

For a while I have wondered what the trailer of my life would look like. After some consideration I actually think it could be rather good. Adventure sequences in the great outdoors, travels to different countries, a handful of awards, and touching moments with friends and family would be stitched together into a compelling two or three minute spot. And the same could go for anyone. It is easy to look good in a highlight reel. It is simple to hide our cracks, our humanity when only our best moments are shown. Whether that be in the trailer of our lives, our social media outlets, or our carefully maintained appearance as soon as we step out the door we can, without much imagination, create an image of ourself, a story we want others to believe that hides the confused, the broken, the disillusioned.

After listening to one of my mentors give a talk at a breakfast meeting, a close friend of his spoke up and called attention to the consistency he demonstrated in everyday life even though the two of them were so close that they could clearly see one another’s cracks, their imperfections. Consistency is what takes good trailers and makes them into great movies. Consistency is what changes acts worth momentary applause into world altering movements. Consistency is what engenders trust in those around you, faith in those nearest to you, and respect from all who know of you. When all is said and done, everyday I want to work to make my two minute preview into an even better story.

Considering Our Breaths

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“the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.”

“The main message of Jesus, I believed, is that mercy trumps justice every time. Not only that, but maybe the basic message of original sin isn’t “feel guilty all the time.” Maybe it is more along these lines: “We all have a notion of what it means to be good, and we can’t live up to it all the time.”

– Paul Kalanithi (from When Breath Becomes Air)

So far I have gone through the recently published book, When Breath Becomes Air ,  three times. The book is the first hand account of Stanford Neurosurgeon Paul Kalanithi as he is diagnosed with, battles, and later dies from, EGFR+ lung cancer. So much more than a narrative or account, the book brings sees the intertwining of a great literary mind and an outstanding member of the medical field in one of the most demanding venues. More interesting than just what he went into was why he went into it. To study the questions of the life, the essence of what it means to be human, to understand the processes that make us who we are, and to discover meaning, Paul investigated first literature with graduate degrees at Stanford and Cambridge before deciding to attend medical school and specialized training as a neurosurgeon. Diagnosed with cancer midway through his training as a surgeon, the critical questions he had been contemplating in the abstract became material and imminent.

While modern life makes it easy for us to distract ourselves from the important questions of life, examples such as Paul bring us back to contemplate what is important, to remember that life and health hang in delicate balance, and to consider the strengths and limitations of our loftiest endeavors. Among other themes, one consistent thread throughout is the ceaseless, constant pursuit of perfection coupled to the understanding that grace and mercy are necessities- that we will never be good enough. Grace and mercy from God, grace and mercy for ourselves, grace and mercy for those around us are required.  But in the midst of this, while we are given the gift of life, a life for which we will give an account, that we strive not just for good, but perfect.

On Enough

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“Just because you can, doesn’t mean you should” 

Most people have probably had this said to them by a parent, friend or mentor; however this is often easier said than done. Growing up my dad would say occasionally say this to me. Then it was easy to act on as it usually pertained to not eating as many cookies or candy bars as I possibly could before an adult intervened. Now as an adult, I find the concept to be more difficult.

The majority of those living in the industrialized world now lives with the unique privilege of excesses in some area of life whether that be in food, money, houses, cars, other possessions, or even free time. Through the previous centuries and millennia, only a handful of the elite had the ‘problem’ of such excesses. Today, a significant amount of the population must grapple with the question: What is enough? 

Talking with young and middle aged people planning for retirement, everyone has a minimum amount, no one has a maximum. Many people work tirelessly for more houses (of which they can only live in one at a time), more cars (of which they can only drive at one time), more club memberships (of which they can only enjoy one at a time), more collections (most of which will sit in a closet or garage), and more free time (most of which will need to be filled with hobbies). It is these excesses that will need to be suppressed for the global good as the environment.

When, not out of economic necessity, but moral responsibility we are willing to stop at what we need instead of consuming all we can out greed, then we may have a chance at a sustainable earth.

In the words of Gandhi:

“The world has enough for everyone’s need, but not enough for everyone’s greed.”

On Thankfulness

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The uniqueness of the time in which we live, the short decades we will grace this planet, is something to not to take for granted but to take hold of and throw ourselves into. The lives of most of those in the world is better than at any other time in history with lower rates of disease, longer lives, and greater opportunities than at any other time in history. Although we must be careful lest we be accused of chronological snobbery, we can, with confidence based on quantifiable measures, say that the majority of the world is living in circumstances better than at any other time in the past.

As many live in these historically optimal conditions, it is easy to take for granted the trappings and trimmings of modern society. During the summer I have caught myself thinking, although I would never voice this, that air conditioning is something I deserve, not a benefit I enjoy. The same can be true of clean water delivered directly to my residence, a truck to take refuse away once a week, and a handful of antibiotics or antivirals when I become ill. Conversely I have recently also caught myself wishing for more- newer electronics, larger numbers on my bank statements, and other such ‘toys’. As I thought more about what live would have been like even a century before, desires for ‘new and more’ fades, replaced by thankfulness for what I have and the opportunities I have been given. Today and everyday, let us be thankful for all that we have.

“And having food and clothes, with these we shall be content.”

 

On defining ourselves

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The true soldier fights not because he hates what is in front of him, but because he loves what is behind him.”

–  G.K. Chesterton 

Let us not be defined by our enemies but by those we love. There will always be more enemies, more hate, more terror. Instead let us define ourselves by those we protect, by the people we stand for, by all that we love. Let us be willing to stand, willing to fight not out of fear or hate but out of love. 

Finding Functional Faith

IMG_0012.JPGLife as we understand it, life as we know it, is largely a construct of human invention. Steve Jobs commented on the importance of breaking out of the scaffold of invented human life such that we can begin to drive our lives instead of our lives being dictated for us (video link below). One aspect of invented human life that we appear to be entirely constrained to, yet is an invention of humans and requires the constant faith of other humans in it to continue to work, is money.

Looking at the lives of those around us, those in the news, and within our own lives, we can readily see how important money can be. Even when money is not an obsession, it drives our lives in important ways. We exchange our time, our lives, for pieces of paper that we trust can be turned into objects of value at a later time. We save up these paper promises, invest them in portions of companies or promises of returns at a later time (stocks, bonds, etc), and base much of our lives around the hope that, decades down the road, other people will consider these representative notes to be of sufficient value to give us items of actual value at that time. To the end of gaining more of these pieces of paper we work long hours, put ourselves in dangerous positions, and in some cases, risk our freedom by attempting to obtain them through illegal means.

I have always been baffled by the athiest-agnostic argument against religion which is often stated as “faith is irrational, I only believe in concrete truths and science.” Allow me to make two primary objections  to that argument, although the focus is on the first:

  1. While I appreciate the sentiment of this, an honest observer must admit that so much of life as a human being relies upon some manner of faith, whether that be faith in our monetary system or faith in other figments of human imagination and construction. 
  2. While one may aspire to only believe in concrete truths and science, we as a scientific community and as humans with a limited capacity for processing and remembrance, cannot possibly claim to achieve this.

In our limited human capacities we strive for objectivity, but are dominated by subjectivity. Consider that the monetary system we have today, especially the stock markets, are not well understood not just by the lay person, but also by the expert. Original monetary systems worked in a similar way toChuck-E-Cheese’s where you could use an object of no value (tickets) to trade for something of value (let’s be honest, nothing at Chuck-E-Cheese’s has value). Now, with much of the world’s wealth in stocks, bonds, and the like, this system has become vastly more complicated with even the sharpest financial analyst or economics expert admitting that we have a system that we do not fully understand. Our faith in our financial system relies upon the fact that we expect others to value those pieces of paper as much as we value them. If Chuck-E-Cheese ‘s stopped accepting tickets in exchange for prizes the system would collapse. Conversely, if the child stopped working (playing the games) for paper promises and instead demanded the actual item of value the system would collapse. Faith in our financial markets and system is the basis for the work we do, the retirement we plan for, the security we strive for, and yet few people who balk at faith in religion give more than a passing thought to placing enormous faith in a volatile and finite financial system. Money is not the only place this is apparent; rather, as Steve Jobs asserts, these systems and constructs of human invention surround us.

The problem then is not with faith itself, but in the reliability of the object in which we put our faith. Our financial systems may very well be a good object in which to put our faith for handling wealth. The test for faith is whether or not the system, the object, is reliable and effective. I have faith in money because the paper from my wallet seems to be accepted in exchange for the items I would like on a regular basis. If I ever doubt this, a short jaunt to the store will reprove this point to me. Faith in religion must be handled in a similar way. Given that a plethora of options for faith exist in the world, we must continually seek and redefine our faith in our religion based upon the functionality and reliability of the object of our faith. If our faith repeatedly and reliably causes us to love God and love others more genuinely, more sacrificially, and more generously then this is a faith worth returning to. If our faith repeatedly and reliably finds us peace in a tumultuous world, hope in a hopeless struggle, and love in an otherwise dark world, this faith is worth returning to. 

 

On Balance

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In any undertaking, determining the goal is essential; or, in the words of Steven Covey, “begin with the end in mind.” As I look ahead to my hopes for my future, one of the most important is to have both a successful career as a physician scientist and a spend quality time with my family and friends. In observing those around me who have attained both of these- a balancing act to say the least- I have noticed one repeating theme. Most, if not all of those who have a successful career and time with their family front loaded their career. This is to say that the elegant work-life balance they maintain now, did not extend back to the beginning of their career. Instead, most have a phase when long hours were spent devoted to their craft, their training. Whether as a single person or a young couple, the early years of those with work-life balance now is characterized by a high investment into their vocation. Long work hours early in one’s career can then be seen as a form of investment enabling investment into family later.

Tradeoffs: Early in one’s life time spend in the hospital, lab, and workplace is largely subtracted from time being entertained by a series of hobbies. However later, this time detracts from being a spouse, parent, and responsible adult.

The danger to long hours early in one’s career seems to be that this becomes a habit, a necessity. Instead of an investment into career and family later, it becomes an addiction, a way of life in and of itself. In medicine, as in every other field, one does not need to look far for an abundance of examples of those who sold out to career at the exclusion of everything else. It would seem that only by holding to the end goal of a balance of career and family can one transition from the early career aspirations to a healthy, sustainable life.

The true tradeoff then seems to be entertainment and hobby time in one’s young years for critical family time in the later years. This is not to say that some semblance of work-life balance should not be sought in the younger years of career and personal development, but that ultimately a few years of feeling unbalanced may pay dividends not only in money and promotions (penultimate goals), but in relationships and a strong family later (ultimate goals).

Note: As life is a journey of constant reassessment, one should be evaluating both short term and long term goals. I hope this post is helpful in maintaining a view of the long term while slogging through the short term; however all paths are different, and each goal individualized. So live as you are called and love everywhere you are able. 

On Striving

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One of the defining characteristics of being human is striving. The angst driving us to do more, to be better. The pursuit of greater; the desire for progress. Sitting at a retreat for 60 MD/PhD candidates I can think of few other groups of people so defined by striving. Although striving itself is by no means unhealthy or wrong, it is a path fraught with unhealthy detours and distractions. Striving pushes us to greatness, to persevere when it would be easier to give up, to act when we would rather be still. However our striving can easily become a pursuit of fame, a need to look good in front of other, a desire to be ‘special’ and significant. As soon as this striving becomes derailed the elegance and beauty of the task in front of us is lost and all that remains is our exhaustion, frustration, and despair. No matter how well we strive or how hard we pursue, the end of such derailed striving is joyless stress and oppressive expectations.

Instead, whatever you strive for in life…

Do it because it brings you joy.

Do it because it brings you peace.

Do it because it benefits others .

Do it because you love the process, the journey, and the hope of what is to come.

Thy Neighbor: Isolation (Part 1)

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There are occasionally, perhaps even often, days when I reach the evening and my overwhelming desire is to be left alone. Recently, as demands during the day have been increasing, I have found this desire occurring more often. While time alone to recharge, rejuvenate, and relax can be good and healthy on occasion, I began to realize that perpetual time alone can be detrimental. As I pondered my increasing desire to be left alone, the writings of two authors immediately jumped to mind and convicted me.

In the Great Divorce, C.S. Lewis describes hell as a place where the inhabitants are constantly moving farther and farther away from each other, increasing their isolation. The periphery of hell is therefore constantly expanding as the inhabitants attempt to put more and more distance between each other.

The theologian Martin Luther further emphasizes the danger of isolation and the importance of turning towards others. One could summarize the faith based life then as the movement from in curvates in se,  a turning in on oneself, to opening oneself up to God and to others.

Time alone to think and rest can be extremely beneficial; a refusal to engage with one’s neighbors and a goal of increasing isolation is dangerous. The overall movement of one’s life must be towards loving God and loving others, moving towards God and towards others.

Answers we should not seek

IMG_0878Remarking on the reason for writing the book, Diarmaid Macculloch provides the following comment in the Introduction to Christianity: The First Three Thousand Years. 

“It (the book) tries to avoid giving too many answers since this habit has been one of the great vices of organized religion.”

Often false certainty is easier, more appealing, than thoughtful consideration of what we know for certain and what we do not know. The crowds flock to confident, assured personalities where platitudes are mixed with humor and occasionally inflammatory statements delivered with all the arrogance of a UFC fighter talking about the upcoming fight. Few are the people who will patiently ponder the intricacies of the true nature of reality in all that is known and all that has yet to be discovered. It is far more popular to offer confident assurances and sweeping generalizations than it is to think deeply and independently.

But if confident assurances are beloved by so many people, what harm could it be?

Far from a negligible harm, it can be seen that the art of drawing crowds and followers with impassioned, overconfident speeches has been the cause of nearly every global debacle in the past centuries. Religious and irreligious alike have been drawn in droves to these leaders resulting in some of the bloodiest conflicts in the history of the human species. It would not be an overexaggeration to say that if everyone patiently pondered their place in the world, the goals for their lives, and their hopes for the future, in the absence of a demagogue offering confident assurances and inciting mantras, these conflicts could have been largely avoided. The majority of Germans were not in favor of genocide and would have openly fought the notion prior to the inciting nationalism of Hitler and the Nazi party. The Japanese, an honor culture, was in many ways duped into believing a similar form of ethnic superiority sold by leaders who were certain in their convictions.

Perhaps if we were drawn by good questions instead of confident answers, thoughtful dialogue instead of fiery speeches, and quiet contemplation instead of broad overconfident assertions, we would see a more peaceful global climate.