Category: Makes You Think

This category covers things that relate probably require some reflection and some time to allow your brain to process more completely. It will be the largest category because the aim of this site is to get people to shift their thinking in some way and to create a new “normal” state. It is safe to say that any post that is included in this category will probably present you with a new piece of information, a new way of looking at something, or a different take on what is already considered common sense or common knowledge.

Grief Is Like A Concussion

For someone who hasn’t experienced grief it is tough to get a handle on what it is like to go through.

Astounding is the amount of pain you can feel and the lack of control you have over it at times. Science covers it – the experience of grief is chemical and it is dynamic in both time and make-up such that you experience different things at different times and the interval between the spontaneous grief moments is random. You cannot expect a linear recovery when a loved on dies. Some moments will be filled with a paralyzing sadness, then you may feel a wave of guilt followed by laughing. Your wit can be sharp and draw out the humor of the situation then you can seems to chew on your words unsure of what they mean and why you are saying them. Healing from it is not like the recovery from a broken leg.

Healing from grief is like healing from a concussion as the symptoms and nature of the injury are very similar. With head trauma, the brain has been injured changing mental function and forcing recovery / adaption. With grief, mental functioning has been changed forcing adaption and an enormous revision of your world view. In both cases, other people can’t see the injury and both are all in your head.

The experience of a concussion isn’t nice. You feel wrong and dumb. There’s something missing from the way you think, it’s slower, not as sharp and the spontaneous answers seem grid-locked inside a haze. Emotionally you’re fine, then you’re crying wanting everything to be over, then the mania or elation, followed by being fine….It is crazy behavior. It feels real enough as all of it happens, but during the fine times the lows don’t seem possible.

The part of the reason why I find healing from grief so unpleasant because the pain is coming from inside me and in an ongoing way. With a traumatic body injury, a broken leg for example, there is a linear improvement once the injury has been stabilized. With grief, months later the pain can feel as fresh as the moment when you first heard the news.

Someone could get good at the grief process because it is a skill. There’s a way to manage it that reduces the stress to those around you while letting you continue to be fairly productive. But as processes go, it is one with no clear end point. Flesh and bone heal in 2-3 months, the brain recovers when all of the old functionality has been restored through reorganization and rewiring.

Nothing Means Something

I forgot to charge my iPod before the gym. This is usually a pain in the ass because the music at the gym doesn’t always inspire. And it didn’t on this day, though it didn’t matter, the place was January busy. A glut of new members is all that many long term lifters need to get it going. When contrasted with the new people we look outstanding and this makes us trying harder. The average of the place drops creating new outliers and it’s nice to suddenly look and feel a little more successful. We try to pay it back by bringing our best and being polite and helpful.

This day it was a couple of the new members that made my day.

Two average early 20’s guys. The one who knew more about training was setting the tone for their workout; the only thing that struck me about the program was that the new guy didn’t seen to need the amount of rest, and that only registered because I was able to hear them talking.

The more experienced guy (J) is pretty confident. He looks like he does well with people. What he’s saying is fast, funny and non-offensive. The new guy (H) is kind of rigid, being out of his element, but as the workout continues it seems like the confidence is rubbing onto him. He seems taller, his laugh gets deeper, there is an emerging swagger.

The hot female trainer walks past them being trailed by her client who is sort of slugging a trail of sweat behind her. “Huh, she does have a clue,” my thought, is not copied by the two training dudes. The confident guy thinks something that fires him up. There’s a slight twitch and his energy grows. He seems larger now, maybe taller, I don’t know, but there just seems to be more of him. The opposite seemed to happen to the new guy. It wasn’t just the contrast thing, it wasn’t just that he seemed less large, it was that he was actually smaller. His shoulders were rounding again, his face was longer and the floor was in his line of sight. The trainer killed the fan of this wacky waving inflatable arm-flailing tubeman. I keep lifting, slightly unsettled.

I pick-up the conversation between the two guys a few minutes later. J is giving H the gears. He has seen the same thing as me and he is now telling H the reason he needed the gym was because of girls like her.

“You don’t feel equal or worthy of them. She’s interesting, not my type H, but honestly, she’s got your sense of humor. Lift hard, level the field and everything will be fine. Oh, and actually talk to her as well.”

“How?”

“Like that, Jesus Christ man, what the hell did someone do to you? Smile, say hi, ask a stupid question, tell her something stupid, or interesting, see what she does.”

“What am I waiting for?”

“The Kool-Aid man. That’s how it goes, he crashes through the wall when soul mates find each other…. I actually sometimes hate you. You are waiting for anything. Think about it, if you ever go out with her you’re gonna need to talk about stuff. On dates, most of that stuff is just questions. But before you get the chance to bore the hell out of her with your life, you need to find-out if you can talk to her about anything. Actually, you need to know if she’ll talk back to you at all. It’s pretty obvious man, people who are interested in you will talk to you. If she doesn’t talk back or it’s too much effort to get her to talk, you shouldn’t have taken your shirt off.”

I’m laughing inside. There’s wisdom in his words.

People communicate with those they are interested in. If the girl thinks the boy is interesting, she’ll talk to him. If a guy starts to like a girl he’ll make the efforts to be around her. All of my relationships have started with a smile and a hello, and then us riffing on something. Every relationship that I didn’t have started the same way but with one or both of us not getting enough out of the conversation to bother having a second one.

Kathryn Schulz: On being wrong – TED Video

What does it feel like to be wrong? The answer will probably surprise you.

Another fantastic TED video, this one by Kathryn Schulz and the topic is “On being wrong.”

How does it feel — emotionally — how does it feel to be wrong? Dreadful. Thumbs down. Embarrassing. Okay, wonderful, great. Dreadful, thumbs down, embarrassing — thank you, these are great answers, but they’re answers to a different question. You guys are answering the question: How does it feel to realize you’re wrong? (Laughter) Realizing you’re wrong can feel like all of that and a lot of other things, right? I mean it can be devastating, it can be revelatory, it can actually be quite funny… But just being wrong doesn’t feel like anything.

I’ll give you an analogy. Do you remember that Loony Tunes cartoon where there’s this pathetic coyote who’s always chasing and never catching a roadrunner? In pretty much every episode of this cartoon, there’s a moment where the coyote is chasing the roadrunner and the roadrunner runs off a cliff, which is fine — he’s a bird, he can fly. But the thing is, the coyote runs off the cliff right after him. And what’s funny — at least if you’re six years old — is that the coyote’s totally fine too. He just keeps running — right up until the moment that he looks down and realizes that he’s in mid-air. That’s when he falls. When we’re wrong about something — not when we realize it, but before that — we’re like that coyote after he’s gone off the cliff and before he looks down. You know, we’re already wrong, we’re already in trouble, but we feel like we’re on solid ground. So I should actually correct something I said a moment ago. It does feel like something to be wrong; it feels like being right.

That resonated with me. Mistakes only feel like mistakes when we realize them to be mistakes. Until the error is realized and accepted by us we feel like we are correct. We can roll through years of life after a mistake is made before the light goes on and we change direction.

Emotions are handy. There’s a very good reason why a human being will feel confident after they make a decision. ANY decision that is made that does not injure us IS an effective action because we did not get injured. It feels wrong to make the decision to do something that we know will injure us. The spontaneous emotion (feeling wrong) tells us that there is a pattern in the immediate environment that matches something from the past in a particular way. In the absence of both an emotional response and a logical reason not to do something, we feel nothing, which is to say we feel correct.

Experts in an area understand this more than most because very often they feel the errors before they can identify them. When coaching movement, seasoned trainers will tell you what the issue is with a client before they can tell you how they know. When you ask them about this many will say that they got a feeling about the imbalance or recruitment issue and then noticed the symptoms.

Sadly though, this doesn’t just apply to work. It applies to ALL areas of life. Everything that feels right does so ONLY because you didn’t get hurt before. But this is a very low quality way of moving through life as it only helps us avoid situations that were injurious. Things that are an aggravation, cause us to remain average, or simply don’t work for us anymore don’t feel wrong because they aren’t hurting us enough to register that way.

7 Days To Die

When we took my dad to the hospital on Sunday January 22nd it was to get his cough looked after. It didn’t seem serious at the time.

He had pneumonia and was put in single room. On Monday evening, he, Des and I hung out and joked around. It was easy to laugh, my dad was laughing as hard as us. The jokes were funny as they came from and went places. The back of my head hurt from laughing. As I said good bye I was looking forward to seeing an improvement in the pneumonia at lunch when I saw him next.

Tuesday at lunch didn’t reveal the improvement in energy I had been excited to see. There wasn’t the same vitality that had been there the night before. The symptoms of the pneumonia seemed to be less, he wasn’t coughing as much, but he didn’t really want to get up. His appetite dropped and while he ate the hospital food and some of the stuff we brought from home, he wasn’t attacking it anymore. Before I left that evening we chatted trying to get out by the weekend. We believe what we want to believe and that colours how we remember things. I know I felt that there was a good chance we’d be home for Saturday or Sunday and he could be back to dying from a brain tumor.

Wednesday he was moved to a double room although it didn’t make much difference. My dad slept most of the day, only getting up to go to the bath room and when the staff needed him to do something. He talked quietly and very little. It was almost peaceful because I didn’t know what I was seeing. To me Dad was sleeping off pneumonia, the medication was working and rest was what was needed. I left optimistic again for Thursday.

I would have missed something about this day had Des not pointed it out when it was happening. The patient that my dad shared the room with on Wednesday night moved out before noon on Thursday. The staff seemed to change the way they engaged my father. I didn’t really notice it at first, although I realized I had seen it when Des said “they seem to be regarding this as a palliative case now.” They were.

Friday was the same thing. The family at the hospital as much as they needed to be. The doctors and nurses doing what they do. IVs to help with this and that. I’m starting to feel my grief cycle ramp-up. Great early, good for most of the day and then the low points later in the day. The walk to the car as I go home this night chills my optimism more than it chills my skin. I know he’ll be there in the morning, I just don’t know how much more of this he can take.

Saturday, mom and I meet Des at the hospital. Nothings changed. The IVs are current. Dad is breathing and resting. Lunch, some other stuff, talk with the nurses. Do whatever it is we do, but as the day progresses, it feels different. The day light fades, and I have what I believe are to be my final moments with my father. It’s close to 10 pm as I get off the phone with an old friend who had shared a mutual fondness with my dad. The room is quiet except for the IV and the oxygen. My dads breathing is slower and lacking the consistency it held this morning. I hold his right hand, look at his face and wonder why I didn’t think it would be like this in the end? When we were in Ireland and he would pick me up and carry me, I couldn’t have imagined that between that moment and this one, the path our time together would take. Strobbing through my mind are pictures I have of my dad doing the things I remember. Laughing, working, driving, cooking, teaching, everything that my brain seemed to ever experience with him taking its moment to reveal itself and the memory that has become a piece of my personality.

There had been a linear decline over the last 7 days. I don’t know how someone leaves a parent knowing that they’ll never see them again but I did. When the phone rang Sunday morning I knew why I left.

The Potential For Energy

Powering the creative mind is the optimal use for energy. You will get no bigger return from anything else you can direct energy towards.

Consider that a creative mind needs two things, energy and opportunity.

The energy of the brain is glucose. It gets this from the food we eat. When we move, glucose is used up. If we don’t eat, our blood sugar level drops and parts of our brain shutdown while the rest of it will begin to function less effectively. If we are able to keep our blood sugar level stable we have the potential to power-up our creative functioning and manufacture thoughts and ideas that didn’t exist before.

The opportunity for creative expression is a lot more complicated but it really comes down to having a lifestyle that includes time for self actualizing, creative and trivial pursuits. In order for this to happen we need an alternative way to get the work done. Enter oil and machines.

Right now that most useful energy source is oil. Think of it as moderately concentrated stored energy. It is very stable so it can be transported around the world with little inconvenience and is valuable enough to justify massive infrastructure projects that pay for themselves quickly. Contained within it is the energy needed to refine it into hundreds of useful products of which we primarily use it for plastic and fuel – we build and move things around with it. When it is turned into plastic, it maintains some of its energy potential; this can be salvaged through recycling or burning.

When it is used as fuel it can be viewed as a stored form of kinetic energy. When it is combusted, the energy is converted into heat and through the workings of an engine, movement. It exists as kinetic energy for as long as the car is moving and as potential kinetic energy as long as gravity can pull the car down a hill or off a cliff. From a practical standpoint, after it has been burned the energy that was contained within the oil is gone.

How much energy is in oil? Assume that a man can push a car as far as it can drive on a single tank of gas, in one year. Oil can do the year of work for a man in 6 hours assuming the speed limit. Assuming you drive 18000km per year, in two years the amount of work the car has done is the equivalent to the 60 years (the working life) of an able bodied human. Framed in the context of this article, getting a human being to do the work of driving a car for 6 hours a week for two years will be the equivalent to one human beings creative influence – given that all of their time and energy will go to pushing the car. Run the car nonstop and you’ve surpassed a humans’ LIFETIME potential in just over 2 weeks.

The problem our species is going to run into is a consequence of a finite amount of oil given the extreme length of time it takes for oil to form. As it is removed, it is not replaced. It will become more difficult and therefore expensive to extract from the ground. A reduction in supply will result in an increase in price. Over time, oil will become cost prohibitive as a fuel. Unless there is an alternative, trillions of hours of potential kinetic energy will be removed from the global supply. As it stands now we have not implemented a self-sustainable energy source and what we do have in terms of solar, wind and water does little to satisfy the minimum survival energy needs of 7 billion people, let alone supply energy needed to power their creative minds. Until this self-sustainable energy source is created / discovered our species will continue to consume growing portions of the planet that are near the surface and easy to get to. Once they become harder to get to, we’ll begin to see humans return to moving the things that the machines are currently moving. Then we’ll have a lot of work to do, particularly given that 1 week of fuel = 1500 weeks of human effort (~30 years).

Without the energy to move things about the planet, human beings are going to need to sacrifice their creative time in order to get things done.

We will have less of everything and what we have will be a lot more expensive to acquire. The boom days will be gone and the speed of technological advance, intellectual discovers and creative applications and solutions will slow. The drop in the quality of living is going to be a drag but we’re not likely to be starving and shelter-less. We’ll have jobs, some will be the same things we are doing today while many will be similar to those of jobs of 50-100 years ago. It will be different, the pace will be slower, and the different societies will begin to become less homogenized as it becomes increasingly difficult to move resources from one country to another. Information will continue to be exchanged, but the groups who currently process and refine resources on a mass scale (the labor) will not have the chance to do this because shipping resources back and forth across the oceans will simply cost too much.

Oil has given humanity a great opportunity to advance because it freed-up the energy from doing work that lets people to more creative things. The pace has been remarkable and worth continuing.

Your Brain Talks To Their Brain

Let’s take a moment to consider what is actually happening during a conversation; we’ll take a few passes at it striping away the layers of narrative to reveal something wonderful.

Two people are talking, exchanging ideas and information.

The ideas and information are created, stored and processed by the brain. The ears and mouth are the tools the brain uses to transmit and receive information.

The sound waves are manufactured by the vocal chords based on the nerve impulses that represent the information the brain is trying to transmit. The sound waves are received and shake the ear drum of the other creating nerve impulses that are channeled into the brain for processing.

The brain is the center of all information processing, the body is a tool that the brain uses to give-out and take in information.

During a conversation, two brains are interfacing to trade information. Any other distinction we add serves only to complicate what our understanding of what is happening.

So what?

This simplifies things. The fact that you are talking to the other persons brain, and that it is actually your brain talking to it, opens-up the ability to alter the way the other persons brain processes the information. The brain does not do the same thing with all the information that comes in. First off, different parts of the brain do different things with information. These parts are all interconnected so the combination of possible routes through the brain is limitless. Next, not all parts of the brain are active all of the time – the ramifications of this are that certain types of information / information processing services may not be available all of the time. This can be due to lack of fuel, chemical inhibition, or the conscious by-passing of processes.

It also complicates things. After all the narrative stuff has been stripped away we’re left with two of the most powerful information and pattern matching machines interfacing to exchange ideas. But how often does one really consider this fact during a conversation? Rarely. For most of us, there are two people, separate from each other and their environment. They are talking, exchanging stories, facts and feelings. They likely believe that what they are talking about is important and of significance in their lives. The impact of these narrative layers is powerful and it can bias the way the information is received, twisting the way one perceives facts. Imagine, for example, the impact a volatile relationship can have on the stories one tells their brain about what the other person is doing.

What does this mean?

Well, if you have the self-awareness to realize that there’s a lot going on in your brain and that you are only aware of a small portion of what it’s doing, you’ll see that there is a big difference between knowing this to be a fact and not knowing that it is a possibility. Those that know gain insight and control over their thinking simply because they accept that the brain is a machine and that consciousness and spontaneous thought are just consequences to it being a brain. Emotions are other consequences and they reflect a match of a pattern that is significant for some reason. Pattern matching isn’t perfect, and miss pairings are very simple given the amount of sensory input flowing into the brain while something is happening. Realizing that you are your brain is liberating. We can learn new patterns / pairings, we can stop thoughts at will and direct our mind onto the things we want, we can accept that some of our automatic behaviors are based on poor information collected years ago and we can replace them by doing the things that work for us.

Those that know that they are their brain are at a distinct advantage when they engage other people because they know how the other person can approach the world – as self-aware or not. This distinction is very important when communicating effectively with others. If a person doesn’t have much self-awareness, you are talking to their mind, their understanding of the world, all the assumptions and lessons they hold. With a self aware person, you are talking to someone who realizes that their mind can add or remove the different levels of narrative (those mentioned above when describing what is happening during a conversation) so you are able to engage the each other in the most effective way – your brain talking to their brain.

How To Sprain Social Development – Incorrect Attribution of Why

Our abnormal psychology professor admitted to the most dreadful thing to our class. “As a psychiatrist in the 60’s I told parents of schizophrenic children that their parenting caused the illness. I feel horrible still for having said it, but that was the understanding then. The theory was based on the science at the time. The science advanced then the disease became chemical with environmental stress being an agonist.” The good in this evolution of understanding is the realization that the social environment of a child in not likely to create physiological brain dysfunction – the thought processes will be created and shaped, and volumes of information will be stored but the brain is developing according to the genetic plan.

Childhood does not change the brain, it shapes the processes that run. It helps to create an understanding of the world that allows the brain to plan and coordinate the body’s interactions with the external environment. This internal representations of the world is based on an interpretation of all of the information known and assumed about the world. When there isn’t enough information, the brain generates possible reasons, and one of them eventually fills in the missing info. What gets rendered into ones world view is a mixed stew of real and make-believe. Needed are answers to the “why” of what happened so we can move on to the next experience and we’re willing to make-up stuff not provided.

This is how most development gets sprained – incorrect reasons attributed to why things happen.

The biggest offender is sexual abuse. Young person gets molested by a family member, friend, or coach. It’s new to them so they have no idea what to make of the whole thing. It feels wrong but it’s so far from the norm that there’s no reconciling it with real information. The assumptions begin and the underlying thought processes start to morph. “My care givers don’t love me because they let that happen” is a common assumption to make as it answers the why question instantly. The children don’t talk about it either out of fear or because they are now sure that their parents don’t love them. The parents don’t talk about it because they don’t know anything about it. They’ll ask the child about any change in behavior (the withdrawal that occurs when your parents don’t love you enough to protect you from bad things). When the parents continue to expose the child to the abuser it serves to reinforce the assumption and can change the narrative from neglect to enabling. These assumptions can get traction and write themselves into interesting areas of their future.

Personal relationships can become a mine field as one advances with incorrect assumptions about cause and effect, particularly ones involving feelings of love. In some cases the person never allows themselves to get close to anyone and lives a fairly isolated life full of efforts to avoid receiving love from others as that ultimately means suffering because people who love you let bad things happen. In other cases the person will begin to experience what most would call true love with someone and they will begin to do things that will make the other person change their view of them. There is an element of what seems like sabotage but it is simply the persons desire to be unlovable so that they can be the way they believed they are supposed to be; an assumption made in the past to help manage the experience of being abused.

Love hurts more than anything else in the world because there is a need to feel it, but it has become associated with so much suffering, cognitive-dissonance and a mis-pairing of cause and effect. For those who are willing to try romantic relationships as an adult, they will often leave a sea of damaged and bitter people in their wake as the recovering party recreates the relationship dynamic of the past. Without the knowledge and acceptance of what happened, the past becomes the future and the emotional pain rolls on.

Pressing Reset

Sometimes life, like your computer, can just lock-up and stop almost dead in its tracks. I’ve asked some computer guys why this happens and while they didn’t say for sure they said it’s usually because some process gets stuck in a loop and all of the resources are being feed into it. I think that’s kind of what happens with life sometimes; you get caught in a thought process and over time it begins to sap away the energy needed to do anything else. The brain is a computer so of course this will happen.

With a computer it’s easy to fix, you just reach forward and push the reset button. The computer reboots. There’s a good chance things will be fine when the computer starts-up again, but you know you’ve lost any unsaved recent data. Pressing reset is rarely the end of your computer or its operating system.

Pressing reset on life is a lot like that. You are going to lose a lot of recent information and what remains after the reboot is often just a little bit more than was there after the last reboot. The body and the brain are fine, running more smoothly for having stopped and restarted. Some recent stuff is sticky and will be there when you walk back after pressing reset on life. A lot of things won’t be and these are likely the things that didn’t need to be there in the first place. Life is simpler and you may be slightly wiser if you don’t ever think about it again.

But the wisdom lies in realizing that the things that were not working for you were just symptom of a problem that likely still resides within you. You need to be fair with yourself here and admit that the brain does a ton of stuff that we know nothing about; if we did know something about it we might actually be able to change our behavior when we need to.

The reason for the life lock-up is the result of something inside of you that manifested itself as unworkable situations, behaviors, relationships or people in your life. None of those is good or bad, they simply are things. The issue is in the interaction between them and you; given that these things do not causes problems with everyone. What are YOU doing with those things that is creating or recreating the loop that drains your energy and causes the lock-up?

“Have you pressed “F8″ after you reboot?” was one of the questions the computer guy asked me. My “no, why?” was greeted with “it’s a little safer. You don’t get all of the functionality but it’s a lot easier to figure-out what went wrong.”

In The Wake Of Destruction

When I paddled with the Mississauga Canoe Club I would see the good ones riding the wash that another canoe or kayak was creating. They’d get into the wake and keep their body weight on the down side of the wave coming off of the other boat so it would push them along. It was a skill and when it worked, it saved a lot of energy. When the wave passed you though, you were screwed. Paddling a sprint canoe through the wash of another boat is a different sport. Point the front of the boat, paddle hard and hope for the best. Most of the time they would open up water between you and you’d find matching their speed became possible only when you drift back and out of the random waves they’ve left. It was messy water if you ended-up falling behind. Washed-out is what it felt like.

I did find some comfort in the calmness of the water after the wash goes away. There was a lot of frustration there because there could be. It was easy to berate myself for falling off the wave because I wasn’t trying to hang on anymore. The choppy water was gone, as though it needed some time to regroup and consider its options before trying to tip the next person into the drink. The washed-out survivors were spared the waters torment and given the chance to think or learn from the previous few minutes. The great ones stuck by the water and became national level athletes. I moved on, replacing relationships and work for the water and trying to ride their wash. Sometimes unsuccessfully.

In the wake of destruction there is silence. There is a flattened landscape void of potential, void of anything that was how things just were. If left standing, one is lucky and slightly damaged. That’s all that’s needed. The damage means they’ll try to avoid that type of thing again. They’ll be a little wiser when it comes to the wash of life, at least in terms of how their  choices got them this time round. They’re lucky because they got washed-out and can take a rest in the calmer seas. That race is over, the lesson given. They can now look around with a shifted attitude that lets new or previously impossible thoughts bounce around. There’s a liberation in failing that you don’t get with continuing. There is a massive boost in mental resources. As the brain releases from the battle it can focus on managing the lessons and taking the most out of the experience.

In time things begin again and with enough time those things will be new.

How Doctors Die

How Doctors Die: It’s Not Like the Rest of Us, But It Should Be by Ken Murray is a very interesting article about how doctors respond to the news that they are terminally ill. It goes into the costs associated with keeping someone alive when their bodies can no longer keep the disease in check – financial, social and suffering costs.

One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

The author recaps a number of stories about doctors who get the news and simply stop working and spend their remaining time doing things they like that make them happy. He feels that for many of them, having seen the suffering caused by futile care for years, the choice to just say “no thanks” is not just easy but the only choice they can make and still do no harm to their patients (in this case themselves).

The article reminded me of doctor Mark Greene in the TV show E.R. He had ended up getting cancer and having a new wife and a young child he fought it and beat it into remission. It did however come back and he made the choice to not fight anymore. It had been hard and he didn’t want to do it again. Dr. Greene spend his dying days in Hawaii with his family and died peaceful in bed.

When I watched the show I remember thinking that it was odd that a doctor would choose not to fight again given that he had been successful the first time. But there was also something that resonated with me that sometimes the distinction that you have a battle to win is simply not true. Even if you are not sick, you will never be new again. Your body has been falling apart since you were born. If you are sick, you will never be cured, even if they cut it out, zap it with radiation and stop the bad cells from dividing. Getting cancer is a one way street and no matter what they do, it can come back. You can fight the toughest battle, but without a new body, the old one has that weakness and the cancer has time on its hands.

There isn’t anything wrong with fighting, there isn’t anything wrong with wanting more time for yourself or your loved ones. There isn’t anything wrong with being grateful for the warning and having the time of your life as it winds down. That’s what a lot of doctors do and I get the feeling it’s what most of my dad’s doctors would do.