Cognitive Biases – Some Reasons Why Nothing Changes

With the sheer amount of sensory information that bombards us at every moment it is not surprising that our brains have evolved to use shortcut to help filter the important information out of the noise. These shortcut serve us well, but the automatic nature of them can present us with challenges when we neglect information or make a decision to act without getting more information.

Cognitive Biases by Drake Baer and Gus Lubin on Business Insider gives a list of automatic ways of thinking that can lead to errors in thought. The list is important, not just because it outlines some of the ways that the human brain can deflect accurate perceptions, but because of their nature, we cannot automatically notice them occurring. This is critical. You can combat them using direct conscious effort, but this will take effort and may never become automatic.

Consider the Conservatism bias, “where people believe prior evidence more than new evidence or information that has emerged,” for a moment. This bias may be active within you right now as you look through the list of the cognitive biases and think that they are false and don’t exist. The fact of the matter is, they are real, and over time your brain may begin to accept them as true and alter your understanding of the world to accommodate for their existence. But for the time being, before your brain assimilates this new information, everything you know about how the brain works says that it is a logical information processing machine that puts the same weight on all information it receives.

Why someone would feel this way makes sense. If we are still alive, everything we did before contributed to our survival. Anything new that we learn may not contribute to our survival so we resist it. Why accept untested information when the consequences can be so dire?

Okay, a few thousand years ago. But given that our brain hasn’t evolved much in the last 20000 years, it is no wonder that these cognitive biases exist. Our brain is the product of an environment that ceased to exist eons ago but is still running the same software with the same intention and now both need to be updated.

Read the list and notice some of the instances in your life were these cognitive biases has played a role in your thinking. You may not commit all of them and are likely very good at preventing some of them from happening. That’s great, it means that we are not powerless to their impact. We can, with conscious effort and practice, become aware of them, observe them happen and reprocess the impacted moment bias free. Taking this moment before acting will make your life better, and much closer to what you want it to be.

Your Self-Talk Might Be Holding Them Back

Fitness professionals spend a lot of time talking – they give instructions, coaching, advice and wisdom. They listen to their gut and to their clients say out loud the solutions to the problems their intuition identifies. And it is not just fitness professionals who do this, it is a habit of almost all people. Assume something is wrong, identify what it is and come-up with a solution.

There are many areas in which problems do need to be solved quickly – areas of survival and imminent threat – but the fitness field is not one of these areas.

The fitness industry is an area of choice and not of survival. Those who engage in fitness activities are usually working towards improving the quality of their life, NOT just surviving it. Any work in the area of choice requires a different approach than the innate problem / solution automatic approach all humans exhibit.

When we, as fitness professionals, listen to our guts and point out the problems we perceive in our clients, we kick the achieving of their potential down the road even further. Problem / solution approaches require obedience and eliminate choice.

The better approach is to give the clients choices, many of them, and let them know the ones that will lead them to the life they want to have. Your knowledge comes into play when you educate them about the impact of each of these choices, along with knowing which choices there are to make. You’ll use your skills to coach them when they make a choice and to keep them on track. Your wisdom will be called upon when you frame their previous choices in terms of serving exactly what they were about at the time – they choose the exact amount of movement and to eat the exact amounts and types of foods that made their life exactly what they wanted, needed, and what it was. Your role is to contribute to their self-awareness that they have exactly the power they need to make real the life they need to live, to shine a light on the fact that they have been wielding this power for years and that they can use it whenever they want, to make different choices and to create a new experience. They are free to choose, not because there are right choices or wrong choices, but because there are only choices.

So, when you notice yourself feeling that one of your clients needs to do something different, stop yourself from speaking and consider what is going on for a moment; is your-self talk playing out the role of problem solving when there is no problem to solve or is something else occurring? If you have identified a problem, make sure you adjust your thinking so you voice the choices that exist and leverage the clients own power to make and follow though on the choice THEY make.

Fight the urge to believe that YOU know better and accept that the client knows what is right for them REGARDLESS of what your self-talk is claiming.

Affective Forecasting

It never cease to amaze me just how wrong I can get it. So much so that as I get older I make fewer and fewer predictions about how something I have never done is going to make me feel when I do it. There’s just no point in trying to figure it out because I don’t get it right. There are just so many ways it can go, so many emotions to feel that the likelihood that I’ll get it correct is close to zero.

When I started working out again, after I moved on from being an IT manager and began working for GoodLife, I wanted my abs to be visible. Maybe I had been that lean before, but if I had been, it had been years before when I was in high school. So I worked at it. I trained and ate well and projected myself forward into a time when I would have abs conditioned myself to feel amazing about it. And when that day came when I looked in the mirror and saw my abs three things hit me. Initially I had a rush of excitement thinking that I had achieved my goal. After about 15 seconds the excitement was replaced with a feeling of loss. Now what was I going to do? And then came the realization that NOTHING had changed. Big deal, I had a six pack, I was still bitter and unhappy, looking for something that would make me better than what I believed I was.

And that’s the thing about the future. It isn’t going to be much different from the present, particularly if the present is very different from the past. Just because you achieve a goal doesn’t mean the world is any different. It doesn’t mean anything is any different. If you are a 6 out of 10 in happiness you’ll return to being a 6 out of 10 in happiness pretty quickly after you reach your goal.

Human beings are dreadful with affective forecasting. We have no idea what our emotional state is going to be in the future in response to some future event. The best predictors are how we feel right now and how we felt when a similar thing happened; which is probably going to be very similar to how we feel right now.

I’ve known a few people who have had cancer. After the initial shock of being told that they are going to die sooner than expected, their lives went back to normal. I’m inclined to say that the last 6 weeks of my dad’s life were happier than the five years leading up to them. He laughed more, ate whatever he wanted and generally didn’t give a crap about all the stuff that, when we take a real hard look at, doesn’t matter anyway. Maybe my dad was sad, but when I asked him he seemed more concerned about my mom and her future than he did about his upcoming death. He didn’t seem sad, he didn’t really seem to care in a way that I would have imagined he would have cared.

He did remark a few weeks before the end that he was wondering why he wasn’t feeling bad about it, that maybe there was something wrong with him not feeling like there was something wrong. I said maybe he didn’t regard what was happening as anything other than what was always going to happen – rather trite and useless, but my dad was a pragmatist and realized that everyone dies.

For anything other than the most extreme cases – beating cancer, a loved on pulling thought a dreadful illness, a child being recovered alive from a kidnapping for example – a human beings ability to predict their future emotional state is going to be poor, and this is something that I keep in mind when I am coaching people or talking to them about about training and goals.

I’ve seen it too many times to count, someone believing that the world will be different if they lose weight, gain muscle, do this or that thing, but their world isn’t different. All of them say the same thing after a few months: “I’m glad I did it, but not much has changed.” And this is why, in the fitness industry, there are so many relapses with body transformations – an awful lot of people return to their old habits and regain the lack of health & vitality they worked so hard to shed.

For those who are actually interested in helping their clients, it is best that they take the time to unpack the clients motivation and reframe their expectations in terms of the likely outcome. For example, every person who gains strength will notice that life just gets easier. But very few people seek out the help of a fitness professional to make life easier in the ways increasing strength will make it easier. In fact, most people do not realize the positive impact that a stronger back will have. Picking-up the laundry basket is as hard as it is, until it gets easier, then you will realize how hard it used to be.

Most of the really positive outcomes of improving your fitness are unknown until you improve your fitness. Having low energy is normal until you do the work needed to have high energy. The fog that dulls your thinking is always there until it is gone. The slowness of your digestive system is only noticed after it speeds up when you start eating real food and moving more.

Given that people are poor affective forecasters, to make sticky the changes your client makes, you’ll serve them better by finding-out why and how they ended-up in front of you and by pointing out all the good things they’ll notice that other people have noticed. You’ll help them more by ignoring or speaking very little about the things they believe they’ll enjoy about achieving their goal because they’ve probably got them wrong anyway.

Interesting Stuff About Conflicts of Interest – Post Revisited

In early October 2012 I posted Interesting Stuff About Conflicts of Interest and have decided to take another run at the topic because my feelings have intensified and evolved since then.

Heather likes sales people – well, she likes listening to their pitch and she completely admits that she is open to being taken on the “what would your life be like if you owned this” ride that skilled sellers can take you on. But she doesn’t buy anything she doesn’t want to buy. She is open, but always in control. Sellers like her up until when she says “no thanks.”

I’m the opposite of it this – I hate it when people try to sell me stuff. I rarely allow myself to consider the benefits that buying their product will bring me while I am in front of the sales person. I’m on guard constantly when I shop. It can take me a long time to buy something and I rarely use the items I buy on an impulse or was “sold”. The buying (the sales) process for me is about collecting information that I will consider later.

Both approaches work, but Heather’s seems to deliver a more joyful experience than mine.

Heather is extremely strong and has a clear vision of what she needs in her life. She is able to go along with the sales process to see if the object fits her vision. Items that do, are bought, items that do not are not. It’s very simple. At her job she says “no” to a lot of vendors so she doesn’t seem to fear the consequences of saying “no” and she is already primed with the knowledge if someone is selling something they cannot be trusted to speak objectively about the negatives of that item. She buys when her mind is made up, and she ONLY buys when she wants the thing that is being sold.

I’m different here. While I’m strong and have a vision of what I want my life to be like, I need to try things on in a more reflective way. The reason I believe I am like this is because I have spent a lot of time selling in the fitness industry and am aware that effective selling can be about doing something to the other person vs. doing something for them. Be it a gym membership, personal training sessions or supplements, these items are sold the same way, on the hope of a better life or some improvement if someone ends up buying. While I was selling, I had a conflict of interest that biased my view of what was true.

Much of how I see the fitness world now is based a need for me to live with myself. Given that, as revealed in the clip of my initial post, IF I have a conflict of interest I will have a tough time being honest, in order to live with myself I need to remove the conflict of interest.

What I’ve stumbled on, through experience and conversation with my brother and Ben, is that the industry as it presently exists is incompatible with my views. Most of the people in the industry are selling something OTHER than what the industry is offering. They are selling the hope of a better life disguised as a short-cut. Regardless of their conscious or mindless intentions, very few of them are actually being honest about what they are doing. “Join this gym and you will lose weight”, “eat this supplement and you will gain muscle”, “train with me for 6 months and you’ll become a brand new person”, etc…..

Some of what they promise might actually come true, but that doesn’t make their sales pitch an honest one because most of the people who buy from them do not achieve their goals. In the fitness industry, the sellers are leaving out two very critical pieces of information that one must keep in mind when someone is attempting to sell them something:

1) The seller stands to gain from them buying. Even if the seller is a very moral person, they will lie, manipulate, pressure, etc…. to get the other person to buy their product or service (P&S). IF the seller honestly believes their (P&S) is effective and amazing, and will help the other person get what they want, can they really be blamed for playing hardball to get them to get them to buy? After all, they are acting in the other persons best interest even if the other person doesn’t see it that way. While not necessarily malice, it does imply that the seller does actually know what is best for the other person and knows with absolute certainty that their (P&S) is the best. In the fitness industry this is rarely the case.

2) The future actions of the buyer are what will determine if a (P&S) is actually helpful. In fact, the (P&S) is essentially interchangeable for any similar (P&S), equally effective or useless depending upon the actions of the buyer. The responsibility for the outcome is solely on the buyer.

Consider these for a moment.

If it is the actions of the buyer that determine the value of a sellers (P&S), can the seller really make any statement about the efficacy of what they are selling? The answer is almost always no. The fact that so many people in the fitness industry fail to recognize and mention that their P&S are useless without the consistent effort of the user makes it a dirty industry, loaded with salesmen, cheats, lairs, charlatans and the otherwise “need to be ignored”. Given this it’s easy to understand why so many gym rats dislike the personal training industry. They don’t care that the clients are using the equipment, they don’t like seeing people getting taken advantage of. The gym rats clearly understand that the individual works hard to get the results and that no mentor, coach, trainer or paid companion will ever do the work from them.

Thoughts Are Things

Tony sent me a text the other day, it was a quote from a text book he is studying, and it basically stated that words are things and as such, they have can have an impact on others. He and I have been having an ongoing conversation about healing and the contribution that other people make. In the recovery setting, words can make a huge difference in one direction or the other.

At the very minimum, 25% of people will so some improvement simply because of some interaction with a healer. Be it the placebo effect, bedside manner, or the simple caring offered by a health care provider, just telling someone that they are going to improve is enough for a quarter of them to improve. Real pathologies are likely not going to just spontaneously correct themselves but a lot of the things that do get people down can be addressed simply by believing they are going to get better. NOTE – it is always best to get checked out by a professional if you are sick or suspect that you are as positive thinking is NOT a substitute for medical intervention.

It works by using cognitive behavioral therapy. CBT helps people get better because thoughts impact feelings and feelings impact actions. If we’re able to change the thoughts, the actions we take will change. It is very simple and has been proven to be effective at treating a variety of psychological disorders in otherwise healthy people.

What gets me excited when I think about all of this is the realization that thought are thing in both a metaphorical sense and in a physical sense – thoughts are made-up of nerve impulse and therefore have a mass. Given that they have a mass, having a repeated thought is going to have a cumulative effect on an individual. Over time, the mass moving in a particular way is going to change the course of all the matter that surrounds it.

The brain adapts to repeated thoughts by increasing the amount of neural branching in the area that is responsible for the thoughts and the subsequent feeling and actions. This makes all of these things more likely in the future and effectively conditions the thought to become the baseline.

For things that make our lives better, this occurrence is exactly what we would hope for, but for things that make our lives more challenging, it isn’t what we want and it makes changing behavior a lot more challenging that creating brand new behaviors; the old pattern will remain hardwired in the brain for years and can be triggered easily.

But given that thoughts are things and that we have conscious control of them, enough consistent effort will change the course of matter and establish a new baseline. For me, this is a much more appealing way to look at life. It gives us the power because we can control the flow of matter, we just need to choose.

User Guide for the Mind – unconscious/conscious mind

The body – your actions – takes commands from the brain. It will do everything that it is told to do. It’s the work horse that takes the brains wishes and tries to make them the reality.

This is a simple concept and it has massive ramifications when trying to improve your life.

The brain works on two levels. There is the conscious level – thoughts that we are aware of or actively controlling – and there is everything else that the brain does that we have no awareness of. Any time we are not using our conscious mind or directing attention towards something, the unconscious mind has full control over our body. Most of our actions are generated unconsciously and they reflect the will of a part of our brain that we have no awareness of.

This is a more complicated concept with massive ramifications with maintaining an unsatisfying life.

The issue is that what UM deals almost exclusively with things that have happened in the past.

It is going to process the daily information assimilating it and looking for patterns and threats. The goal is survival so creating a world view that is consistent and based on what has already happened makes complete sense because if one is still alive what they did before worked. But we aren’t in the wild anymore so we can be a lot more open to the experience and information we allow our brain to process.

Look at it this way, it’s what the brain does anyway so put it to work and create positive change.

You don’t want to prime it with things that aren’t working or things that you know are not right and won’t work for you. But doing this is going to take conscious effort and directed attention because the UM deals with things that have happened in the past and created behaviors that are based on the survival lessons learned. Given that the body takes most of its actions from the UM, these actions tend not to serve a creative or forward-looking function. If you need to change your life, you need to change the type of information that is being feed into your brain. After a period of time, the UM will begin to seek out this type of information and start to generate actions that reflect a positive change.

It doesn’t take very long for goal directed actions to begin to shape the way you view the world and overtime it can become self-reinforcing. But it does take sustained and active attention on the things that will bring you what you are looking for.

Prime the UM with new experiences and new information. Actively seek out the things that you want. Be or act and have the experiences that you want to have.

How I Changed My Life – Part One

One of my clients asked me how I changed. Slightly puzzled I asked her exactly what she meant. Turns out she was referring to the transformation after my father died when I made the decision to stop engaging in the escapist compulsive behavior and start living a more purposeful life. My answer was a little scattered because there were many reason why I changed but below is a list of the things that lined-up for me in order to begin living a life that I was a cause for:

Making the decision to do new things – regardless of what they were or what I thought about them (how scary they may be) I knew that I needed to do different things to have a different life. But knowing wasn’t enough, I needed to actually do them. I made a decision one moment and that was when things began to change.

Noticing that I have everything in my life that I believe I need to have and realizing that if I started to believe that I needed other things, I would do whatever I needed to do to get them.

Seeing my life as being a part of something bigger that involved other people. Some would call this spirituality or a sense of community or interconnectedness, but by realizing that everyone is part of the same thing, my role changed immediately. Instead of being a floater, wandering the earth, I was able to see the impact that I had on other people and the impact that they could have on me.

Realizing that there was more to the experience of life than what I had been getting. The compulsive behaviors created a predictable state change and I liked the certainty of that. But it was boring because I was doing the same things over and over again. After almost 20 years I was getting tired of it and I was becoming increasingly aware that other people were doing some pretty cool things.

Honoring my dad’s final requests of me. When I asked my dad if there was anything he wanted me to do with my life he said “look after your mother” and “figure-out what I love doing and make a life out of those things.” Looking after my mom was a no brainer, she has always been amazing so I was going to do this anyway, but the other part of it took sometime to process. The truth was that I wasn’t sure exactly what I loved doing because I spend a lot of my time out of my head. But behind all the fog and compulsions were a few things that I did often in a natural state. Those were the things that I spent more time of as a result of his recommendation and they have proven to bring me a lot of joy and gratification.

Examine my thoughts and internal dialogue to uncover generalizations, errors and negative patterns. Thoughts impact feelings that shape behaviors. These unworkable thoughts lead to behaviors that make them real. When I made a list of these things and a list of the possible outcomes of what would happen if I was to stop them, the loop was complete. My behavior was obvious and what I needed to do to get different results was equally clear.

Take a disassociated inventory of my life, my behaviors and my beliefs to bring to light any incongruities between my internal understanding of who and what I am and an external view of what I am. People said things to me that didn’t connect with how I viewed myself. I asked the question “what if they are correct and I am not correct?” and then tired-on how life could be if I decided to let them be right and just let go of what I believed. It became funny after a few minutes because I realized that both sides were right and that it didn’t matter anyway. I was telling myself a story, a rather elaborate and convincing one and at any moment, I was free to tell myself a different story. The reality is that human beings are animals that possess a keen ability to interact with their environment and make predictions about that environment based on past experiences. The other stuff I had been telling myself about it was unnecessary and was only serving an antiquated identity.

Sunk Cost – Another Way The Past Influences Your Future

Sunk cost is regarded as the amount of money / resources that have already been spend / invested into something that cannot be recouped. These costs have already been incurred regardless of the outcome.

For example, spending $5000 digging a hole in the back yard for a swimming pool. Regardless of how you proceed after the hole has been dug, you cannot get the $5000 back; filling in the hole will not return the money. Another example is working on a relationship – you can spend 6 months going to therapy in an effort to mend things with no guarantee that you’ll both grow old together.

The issue with sunk costs is that they can bias perspective and effect decision making because we can tend to place a higher value on past actions vs. future actions. A number of studies have shown that people become more certain about their decisions after they make them – those who bet on a sporting event will immediately become more confident that their desired outcome will be the eventual outcome once they place their wager.

The reality is very different. While the betting odds can change as a result of more people betting on an outcome, and while those people will become more certain about the outcome, NOTHING about the outcome has changed. The team that was going to win is still going to win. The actions of those outside of the system will have no impact on the actions inside the system.

To put is another way, what is the eventual outcome is going to be the outcome regardless of any sunk cost. Sinking cost into a bad decision will not make it a good decision REGARDLESS of any perceptual tendency to think that it does.

Given the human tendency to further invest in poor choice because of sunk cost, it’s easy to see how this can have a detrimental impact on ones life. Alternative options will not be considered or will be viewed less favorably and resources will continue to be invested into a poor decision. What is viewed as unworkable from an external and objective point of view can be viewed as worthy of continued effort by those who are involved and subjectively engaged in the process.

How do you know when you are being impacted by sunk costs?

  • You’ll hear yourself saying or thinking “well, I’ve put this much into it already” while you have a feeling that walking away will be a waste of that effort. In this instance, you have already realized the eventual outcome but rationalizing a delay by looking at the sunk cost. Immediate action is both appropriate and needed here.
  • You have a tendency to view things in terms of win:lose and not from a perspective of what was the lesson from an experience. You don’t want to lose so you continue in a failing attempt to win. In reality both are abstract and meaningless distinctions. If you choose personal growth from an experience you will be able to move forward very quickly because you’ll view the sunk cost as the price for a powerful lesson.
  • You are fearful to consider different alternatives because of a sense of wasted time / money / resources. This is an indication that you are not being objective and open minded, a clear indication that something illogical is at play.
  • You have a scarcity view of the world and believe that you may not ever have the sunk resources again. Being loss avoidant isn’t necessarily a bad thing, but when you hold a view that what has been spend cannot ever be regained, you are not looking at the future accurately. The consequence is that you end-up pouring MORE resources into something that is a lost cause; this will increase the scarcity of resources making real the very thing you are trying to avoid.

There are times to stay and persevere and there are times to learn a lesson and change your course. The right thing to do is the thing that is objectively and statistically the most probable way to achieve your goal. The wrong thing to do is to avoid unpacking your reasons for staying because you believe everything would be a waste if you were to stop.

Sunk costs impair rational thinking so if you are in a situation and have spend a lot of resources on it, be mindful that your natural tendency will be to view continuing as the best course of action. It may be, but take the time to see the potential costs of continuing and to evaluate the situation for what it actually is right now vs. what it was when you made the decision to invest in it.

Cognitive Overhead – How I Think About Thinking

NOTE: I started writing this about 3 years ago. It came out of a conversation with Des over lunch. It doesn’t represent 3 years of direct work. It reflects the results of 3 years of passively fostering a feeling that there is a truth in an idea into a more complete understanding as to why it is a truth. This past weekend it all came together for me, not just how I think about the way the brain functions, but how I think about nervous energy being the power of EVERY process that exists within the body.

Sometimes when I’m having trouble thinking about consciousness I try to simplify it by comparing it to a computer.

Consciousness is a process that is running in the background and is one of many processes that are running. Each process requires a certain amount of resources to function correctly. If it does not get what it needs, it will begin to malfunction and eventually shut down. Some processes run in the background working as much as the available resources allow e.g. the process of scouring the memories searching for patterns and relationships – these would be like the indexing for faster search type process with an operating system. Most of the other processes are called when needed and the amount of cognitive effort they take up is usually a product of how long they are being used. E.g. you are singing a song so you need to use you voice, creative and memory processes, much like a computer playing an audio file using the sound card and media player,

If you are in a flow or meditative state or if you are sleeping, your consciousness is going to require the least amount of cognitive resources. The freed up resources go towards some other brain activity. I call this the base line because the brain is effectively running with no input from your active conscious mind.

If you end up getting stuck in a loop you begin to drain the reserves.

Provided the you do not get stuck in a loop you will return the energies to the underlying processes and return to the base line once you stop thinking.

We are usually unaware of the other underlying processes that require cognitive energies but we can see the consequences when we try to use them under adverse conditions such as driving in snow, giving a presentation when you are really nervous or trying to find the perfect line while skiing when your still thinking about the work you need to do.

There are countless unconscious thought processes that get impaired when we engage in conscious thought or get stuck in a cognitive loop. It can be an obvious process like the one that renders words to speak at the presentation or it can be one you’ll never be aware of like the one that compares the visual input to memories searching for patterns. The consequence is the same in both cases, if they do not get their share of the cognitive energy impairment will begin and they will eventually shut down.

The cumulative effect of excessive calling of cognitive processes is stress and the outcome is degraded or incomplete processing.

Cancer – It Takes Over Your Mind Too

I have never had cancer so I have no notion of the first had experience of the disease. This post isn’t about the first hand living and dying of cancer, it’s about the second hand experience of cancer – being alive with someone you love who has it.

The thing with cancer is that it never goes away, even when it is gone, it isn’t ever not there – it just isn’t there right now. A piece of your peace dies with the knowledge of this diagnosis. It is a flash-bulb moment marking the end of that life and the beginning of this new one.

It is the start of a new mental process that runs unstopped until your loved one dies. It’s a process that is mostly in the background, out of the consciousness, yet very taxing on the finite mental resources that exist within each of us. It’s a process that has it’s biggest impact exactly when you forget that it’s there – it reminds you that someone you love is sick and that the blissful moments you knew before are gone forever.

It’s like having a monkey on your back – sometimes the monkey is sleeping allowing your to live a cancer-free existence, like everything is fine and life is good. The rest of the time that monkey is drunk, playing a trumpet and spilling drinks all over your happiness.

And all the while, life goes on. There are bills to pay, dreams to have and life to live. It was coming all along, maybe not the cancer, but the death. The clock of life has been ticking down. Just because some doctor tells you with more clarity that it’ll be arriving sometime soon doesn’t change the fact that it has always been rolling towards us.

This is the piece that I have the least enjoyment with. You put on your game face and try to pay complete attention to the one you love, marked for death, yet not at all different from how they were a few weeks ago. And it is always close by, the though that says “they have cancer and they are going to be dead soon,” spoken with your own voice. Words you couldn’t have imaginable last year when you were all eating at Christmas and they said “hey, who invited this turkey to dinner?”