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The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.

Katrina Blog Project

Notre Dame de Paris

Notre Dame, Paris, rear view. Photo by the author, 2015.Our first and only trip to Paris was in 2015. As is true for most Americans traveling to France, we left on a connection flight from New York to Paris in the late afternoon. With the seven-hour time difference and eight-hour flight time, the flight landed us at DeGaulle Airport the next morning.

Since we arrived at our hotel many hours before check-in time, we left our bags at the front desk, and, having nothing else to do, made our way straight from Place de la République to Notre Dame. (I recommend this, by the way; when you travel to a foreign city, always go to your number one destination as soon as you get there. The longer you stay in a place like Paris, the more things you find to do. You never have more time to linger than before you make plans.)

We crossed Seine river via the St-Louis bridge and approached the famous church from the back. It was a cool and wet summer morning and the sky was a ponderous gray that would later yield to a parfait French bleu. Here I took the very first picture I would take in France, in a little park with a green lawn and pebble walkways behind the Cathedral. The rays of flying buttresses looked like Notre Dame, but not really; approaching the church from the back is like seeing the back of Mount Rushmore before coming round to the front. It only looks like the place because you know what’s on the other side.

One of the things that impresses about Notre Dame, as with many gothic churches, is the detail. The sides of the church, as you walk around it, are a forest of gables, buttresses, minor spires, gargoyles, and sunburst stained glass windows that look dark from the outside. The details from every angle, including in recesses not easily seen from the sidewalk, suggest the craftsmanship not of construction crews paid by the hour, but by artists who were prepared to spend a lifetime on a building for the ages. Every person who worked on Notre Dame in the Middle Ages was in his mind creating something that would last a thousand years, at least. Today, I doubt there are many builders who give a thought to their work lasting even to the end of this lifetime, much less a millennium.

Now days, we think of an 80 year-old building as ancient. When Notre Dame was finished, the foundations were already a century old, and at least two generations of builders, probably more, had expended their lives on it. If how much you get out of a work depends on how much you put into it, the builders of Notre Dame must have put faith and love into every tap of the chisel, because if the building itself was not everlasting, it certainly fooled tourists like us into thinking it was.

The cathedral inside was everything I expected it to be. It was dark, as gothic cathedrals in my experience tend to be. Although we all read in school that flying buttresses create a support network that allows for vast walls with large stained glass windows, the reality is that flying buttresses can only do so much, and stained glass only allows in a limited amount of light. Even in full daylight, the inside of Notre Dame was cool and relatively dim.

The famous Rose Window in the north transept, which I read has survived the fire, was a masterpiece. I knew it from the pages of many Catholic texts I have read though out my life — it, like the Statue of Liberty, is so representative of the beliefs that undergird it that it is often reproduced, without explanation, as part of theological writing. I stood for a long time just to one side of the main altar and basked in its transcendence. Because it is so high up it can be observed from a distance away, which sets it apart from many of Paris’s great works of art (I’m talking about you, Mona Lisa) where one must compete with huge crowds to look at it. At a distance I could linger over it it as long as I wanted to, without interference. There is nothing I am more certain of than that the builders of Notre Dame designed the window precisely for that purpose, so anyone could spend as much time with it as he or she likes, in apprehending silence. Even eight centuries ago, they were thinking of sleep-deprived travelers like me.

Notre Dame, Paris. Photo by the author.The Rose Window’s glass cast red and yellow and blue resplendent shards of light on the marble floor. I don’t know if the builders thought they were creating an earthly imitation of heaven, but if heaven is a peaceful place, this was captured perfectly. Although Notre Dame stands at the center of one of the busiest places on earth, central Paris, it shut the noise of the world out more effectively than any secular building I have been in. Dark, cool, cavernous, silent, with puzzles of colored light in crossing beams from one end to the other, nothing in this world could say God any better.

Notre Dame is one of the most well-documented buildings on earth. It has been photographed and measured from every possible angle. Reconstructing it after the recent devastating fire will not be a problem. It will eventually look the same, feel the same, and possibly even smell the same as the church it once was. And I will be eager to see it again.

I have experience with reconstructed buildings. The Rotunda, the Thomas Jefferson-designed 1822 building that sits in the heart of the University of Virginia, was gutted by fire in 1895. It was completely restored in 1976 to its original specifications, and for the most part looks like its original self. France will do even better with Notre Dame, which I fully expect will be recreated in every detail, and, if you like things like electircity, running water, and sprinker systems, it will in some respects be better when it re-opens than it was the day before the fire.

If you are a materialist, and you believe that atoms are just atoms, that there is no God or transcendent meaning, the new Notre Dame will be the old Notre Dame. If one atom is as good as another, reconstructing it with new materials physically identical to the old will create the same old building. Wood, after all, is just wood, and rock is just rock. Glass is glass. One brick is as good as another. Perfect imitation is perfect re-creation.

If however, you are like me and believe in transcendence, you will believe that the new church will be worthy and beautiful, but not quite the same as the old. The new church will be built by secular carpenters, masons, and architects who are mainly interested in imitating the lost elements of an injured building. They will not be working with the same intent as the original carpenters, masons, and architects who built the cathedral in the thirteenth century. The original workers were not recreating an old idea; they were expressing their faith in God. The question is, can the new building be an expression of belief as well, and if so, what kind of belief?

For me, this is the heart of it: Will the new Notre Dame be the same building or not? This is a question not of exactitude, but of faith.


SNL, R. Kelly, and the Catholic Church

Sainte-Chappelle, Paris. Taken by the author.There is a circle of purgatory reserved for people who blog about popular TV shows. Most TV shows aren’t worth the attention they get, or the amount of effort required to write intelligently about them. But I have decided to go there today.

On the March 9 broadcast of Saturday Night Live, comedian Pete Davidson decided, as he often does, that snarky controversialism is a good substitute for funny. In a Weekend Update segment about rapper R. Kelly, Davidson joked, “If you support the Catholic Church, isn’t that the same thing as being an R. Kelly fan? I don’t really see a difference, only one’s music is significantly better.”

Setting aside the question of whether R. Kelly’s music is really better than Mozart, Bach, Beethoven, and the African American Spirituals, all of which have been adapted for the Mass, let’s address the big question.

It is a fair one, in the sense that a lot of people share the same opinion. Why do people keep going to Catholic churches after all of the sex scandals? Isn’t that simply lending personal support to systematic sex abuse?

But to say this is to make a mistake, one most easily characterized as what I call the lumping error. The lumping error is the assumption that people you think of as “the other” are all alike. While your side may be nuanced and complicated, the other side is lumped together as simple, monolithic, and predictable.

It’s an error people make all the time. Ask a Democrat what he thinks about Democrats, and he will paint a picture of a diverse, complex group that agrees on many things, but disagrees about a few as well. But ask him what he thinks about Republicans and he will paint a picture of a pro-gun, religiously fundmantalist, anti-woman, anti-labor, anti-environmentalist tribe with very little internal dissent.

This tendency to lump people we don’t like into simplistic categories leads down unfortunate paths. People we know and identify with may make mistakes for complicated reasons, but people we don’t know are simply seen as bad characters. A friend caught doing something wrong is “a good person” who “meant well” and “should have known better”— more a disappointment than a bad person. But someone we don’t know who stumbles is just a “bad character” who broke the rules and needs to be punished. It is this tendency that explains why white collar criminals get short sentences in minimum security prisons, and drug addicts spend decades in federal penitentiaries.

A good example is Bill Clinton. For Democrats he was a person who did good things but happened to get caught in a bad act. That’s judging by situation. For Republicans he was a lawbreaker, liar, and philanderer who deserved to be in jail. That’s judging by character.

It isn’t hard to see that judging by situation is fairer than judging by character. To judge a person’s situation, one has to be acquainted with the facts — to know something about the person’s upbringing, background beliefs, culture, and underlying pressures like money problems or stressors. Anyone who wants to evaluate wrongdoing in a fair way would want to know these things. The alternative, to say, “He’s just a thug,” or “She’s just a spoiled rich girl,” or “She’s a drug addict, that’s all” seems shallow and unethical in comparison.

Davidson, who I think at one point hinted at being a lapsed Catholic, nonetheless falls into the lumping error. He takes the role of an outsider, making broad judgments about the other side, without nuance. He lumps all Catholics together, assuming every churchgoer willfully overlooks sex scandals in the Church, and for the same reasons.

Are there nuances here? Of course. First, let’s not forget that R. Kelly is a person, and the Catholic Church is an institution. Although it is often personally satisfying to equate one with the other, it is seldom helpful to do so. Some American soldiers committed atrocities during the Vietnam War. That doesn’t mean that all Americans today, or all Vietnam veterans, ought to be held accountable for that. Many Southerners opposed racial desegregation in the Sixties, but that doesn’t mean all of them did. (In fact, if all of them did, there would have been no progress at all. But there was.) We don’t generally hold entire groups responsible for the actions of one, or some, of its members.

None of this is to say that we should ignore past atrocities. But it does suggest an important point — responsibility for a crime rests primarily with the person who committed it. As such, responsibility for the crimes of Catholic priests resides primarily with the priests who committed the crimes, and secondly with the leaders of the Church who willfully ignored the problem. There is some tertiary guilt that goes to people who should have been aware of what was going on but ignored it because they could not believe an ordained priest would do such a thing.

But putting all those together, that is still a small number of people. It may be a significant percentage of priests, but when you add in the entire Catholic congregation of over a billion people, it is a fairly small number. I have been going to Catholic churches all my life, and I have never met a Catholic, priest, or layperson who I honestly thought was covering up a sex abuse case. I don’t think I am alone. Most of the people who attend weekly Mass have been as ignorant of the abuse that went on as people outside the church have been.

Although lumpers like Davidson would like to have it otherwise, the vast majority of churchgoing Catholics are just as appalled at sexual abuse as anyone else, if not more. Ask them, and they will give you many reasons for continuing to attend Mass, but none of their answers will include a willful approval of what the Church did.
Most of us continue to go because we continue to believe in the dogma of the Church. Beliefs don’t suddenly become false because members of the Church commit serious crimes, any more than the principles of the Constitution cease to be valid because a group of American generals napalmed a Vietnamese village in 1968.

There is a lot more to the Catholic Church than sexually deviant priests. A lot more. I give money to the Catholic Church, and these days I worry a little about that fact, but I am fairly closely connected with the church groups I give to and have a fair amount of confidence that the money is being used the right way. I do not have a hundred percent confidence. But I don’t see any organization on earth that I could give to with 100% confidence, so in that respect, the Church is no different from any other charity.

This should not be seen as letting the Church off the hook. The last time an issue of corruption came up in the news, our church pastor responded obliquely by saying “the Church is wounded” and needs our help. While this is an acknowledgment, it is not what I and lay Catholics are looking for. I don’t care if the Church is wounded. I want the Church to fix the problem and stop describing it as a tragedy. It is not a tragedy. It is a crime that a group of evil people perpetrated. As in any crime, I expect the perpetrators to be punished, and the situation that caused it to be rectified.

For people like Pete Davidson, it would be preferable that churchgoers like me stop going to church and stop sending the Church money, allowing the Church to die out completely. But this ignores the real problem. Allowing the Church to go away won’t end sex abuse. It won’t help the victims. And it is a disservice to the people who are Catholics and had nothing to do with this whatsoever.

A billion Catholics can’t be exterminated or made to walk away from their faith. I, for one, refuse to walk away from my faith because a priest chose to sexually molest a child. Such an action would be irrational and ludicrous. It is accepting Pete Davidson’s claim completely. That all Catholics are the same, and that every person who walks into  a church on Sunday is a child molester. It implies there is no moral difference between a person who commits a grave sin and a person who is part of that same community. It implies that organizations are monolithic, and that guilt does not lie mainly (if not solely) with the person who commits the crime. I don’t know what the solution to sex abuse is. But blaming innocent people for the acts of the guilty is definitely not it.

There is much good to be rescued from the Catholic faith. One of the main teachings of the Catholic Church, one I very strongly resonate with, is that human society is fallen. Humans were created by God and are thus good, but since our creation we have become corrupted, partly by our choice but also through human nature, which is necessarily imperfect. Religion is the method of extracting the good from the corruption and fashioning a new, more perfect human.

The Catholic Church needs to set the situation right, at least as right as it can. This can best be done by those people who still go to church and are not part of the sin. Those people, who Pete Davidson thinks are indistinguishable from the fans of R. Kelly, are the Church’s best chance of getting things right, much as the firefighters who are willing to get closest to the fire are most likely to extinguish the conflagration once and for all.


The Virginia Guv

"It is setting a high value upon our opinions to roast men and women alive on account of them."

—Michel de Montaigne (1533-1592)

We know the story, and if not, I can wait while you feast upon the salacious details elsewhere: The governor of Virginia is in trouble because a yearbook picture of him either in blackface or in a KKK costume has surfaced. The Governor has denied he is the person in the yearbook picture (even though the yearbook identifies him by name), but has admitted he has worn blackface elsewhere. This semi-demurral does not is not interesting in the least, since there is no difference between someone who would attend a party in a racist costume and someone who would allow a racist photograph to appear on his yearbook page, whether it was of him or not. (His _medical school_ yearbook page, by the way. Not high school, not even college. Medical school.)
He did something racist, either way. That is settled. The more interesting question is if there should be a change of government in Virginia because of a thoughtless act thirty years ago. My answer is no, and I know I am in the diminishing minority. But I have two reasons for arguing this: first, because I don’t think the governor is more or less racist than the average southern white man (and Virginia knew it was electing a Southern white man in the first place, and so ought to have known what it was getting); and secondly, because I don’t think sending him plunging from the heights of heaven into the depths of hell is going to help the civil rights cause. And it could harm it.

I have lived in the South all my life. I lived in Virginia for 12 years, and the rest of my time is split between Mississippi and Louisiana. Suffice it to say that I have extensive experience with racist whites and can pretty much tell you anything you want to know about them. They have been my neighbors and my patients. A KKK Klavern tried to set up an office next door to my father’s small business when I was in grade school (my father briefly considered moving, but the Klavern shut down before he did anything). I had a patient who insisted on calling a Syrian colleague physician and friend a “camel jockey” (I briefly considered punching him in the mouth, but he soon moved on to another doctor). I’ve heard worse, from neighbors and relatives, a good deal of it after the year 2000, which is sixteen years after the Governor did what he did. If time of a racist act really matters, as some people think it may.

Racism is all around. Hard racism, soft racism. I met a nurse in New Orleans who said he was stockpiling guns in preparation for the day that the black people moved into his neighborhood (hard racism), and people who hinted when I married my Indian wife that I would have “social problems” trying to live between two cultures (soft racism).

But I don’t pretend to be free of racism myself. All I claim is that I am aware of my prejudices, and would prefer to be rid of them. That’s about the best someone raised in the South at my time in history can hope for. Maybe my kids can hope for better.

We are all racists, to some extent. Some more, some less, but none of us are completely free of it. Judging people by their appearance is the easiest thing in the world to do. Sometimes appearance is all we have of people. If I see someone on the street and know nothing about that person at all except what I see, how often do I consciously choose to make no judgment at all, rather than a negative one, no matter how slight? Almost never. To completely withhold judgment is almost impossible. It requires a conscious effort to say, I know nothing of this person, I will not judge him in any way. Much more effort than to allow judgment to slide surreptitiously into place. It’s what humans do; they judge. None of us can help it.

Back to the governor. So now we know he is racist. Or at least was in 1984. Do we know something about him that is not true about just about everyone else? Does anyone really think Virginia can replace him with a non-racist governor? Or if non-racist, with someone who has no other prejudice? At this point, his value over any another candidate is that we know he is racist. Unlike the average racist, who cannot be distinguished from a crowd, we know the governor’s racism because we can see it.

Virginia is mired in racism, as is every other state. Realistically, no governor, no legistlature will ever eliminate it. That probably cannot be done, but even if it can, it can’t be done through politics. The fight to end racism is about changing hearts, not laws. The very best that lawmakers who espouse the values of the civil rights movement can do is to represent the rights of African-Americans in Virginia and to make sure they have a fair say in government. What Virginia has now is a governor whose racism is proven. The Virginia Black Caucus has the Governor exactly where they want him, and can probably extract more from him than from any other governor Virginia could have. Forgive him, or at least commute his sentence, and he will be your friend forever. These kinds of opportunities don’t present themselves every day.

Let the man apologize, and let him admit he is a racist. Then work with the racist. Isn’t that what race politics is really about, learning how to work with racists? Every time something like this happens in the political arena, a mass of talking heads emerge to tell us that America needs to have a “conversation about race.” Now, I’m not sure I agree with the ethos of having conversations, because a conversation is only worth having if a decision is made and a problem is solved, and that never seems to happen. But this is what folks say. So let’s have this conversation. Conversations are two-sided, I think; though I have been known to talk to myself from time to time, I don’t pretend that is really a conversation. If you eliminate the racist from the conversation about race, you aren’t having a conversation, you are giving a lecture. If the Virginia governor goes into the dumpster, we haven’t had a conversation at all. We have had a lecture. We get lots of those. I haven’t seen it change anyone.

The Virginia governor is broken. So what? We are all broken; I know I am. I only function because I choose to function broken, and because the people in my life are kind enough to allow me to carry on broken. If the people around me wanted a perfect person, I would have to bow out of society and take my broken self to a hermit’s cave. Virginia has a chance to admit its governor is broken, and thus that Virginia itself is broken. That would be a huge advance to admit that. No other Southern state has ever admitted so much — we spend most of our time down here talking about how much better things are than they used to be, and by extension, how “people” need to “get over racism” and “get on with life.” There are no conversations or solutions in that — just another lecture.

Running a state with a governor who has admitted he is a racist and then going on from there is uncharted territory. I like uncharted territory. When I am trying to solve a problem, if I keep finding myself in the same place, I know I am failing. When I am lost and keep seeing the same landmarks over and over, I know I am still lost. When the landmarks change, when the land looks different, I could still be lost, but at least I know I am getting somewhere.

The civil rights movement, as best as this lily-white Southerner can tell, is about improvement. It is about making racists less racist. If a racist can’t be changed, if he can’t be taught, there is no reason to have a civil rights movement at all. Why bother trying to change what can’t be changed? If the governor, and, by extension, every other white person, can’t become less racist, there is no reason at all to fight against racism. In that case the only way to get rid of a racist is to kill a racist. I don’t think that is the point of the civil rights movement.

At least I hope not, because I can’t support a social movement that holds that people can’t change. Such a movement replaces one kind of intolerance (racism) with another (intolerance of racists). While that may be a kind of improvement, it isn’t much of one. It is still based on hatred, and hatred of bad things is only slightly better than hatred of good things. It is still hatred, and hatred always brings you back to the same place.
The civil rights movement has always been about high ideals. Sometimes having high ideals means doing things that are hard to do, and there are precious few things anything harder to do than pass on punishing your enemies. But if opposing racism isn’t about avoiding the easy road and taking the hard one, it has lost its way. There has been too much sacrificed by too many people (not by me, to be sure, but by many people of color) to take the easy road now.

Let’s get this done. Let’s pass on the easy answer, revenge and public shaming, and move on to the hard one. Let’s acknowledge the prejudice in ourselves so we can tolerate the prejudice in others. There is a higher standard. We can allow people to acknowledge past racism, and agree to work with them as long as they do not hide what they they are. What I am.  Once all the ugliness is on the table, real progress can begin.

For myself, I am weary of people quick to shame and punish. Not that I don’t understand it — it feels good to condemn a person who has done wrong because it allows you think you are better than someone else. But thinking you are better than someone else is pretty much what racism is made of.


New Year’s Resolutions Already in the Dumpster? Good. Here’s How to Turn Them Into Something Useful.

By mid-January, most people have given up on, or are about to give up on, their New Year’s resolutions.  It’s an American tradition more predictable than a drunken New Year’s Eve. And that’s a good thing. Attempts at self-improvement can’t succeed until they first become failed attempts. You don’t succeed by succeeding. You succeed by failing and resolving to try again.

But how to try again? This is the challenge of failure — when you fail, aren’t you right back where you started? It is hard to regain focus and purpose when you made an effort and have nothing to show for it. But the truth is, failure is rarely empty. Most of the time, if you achieve nothing else, you at least learn from the experience. Failure isn’t total failure if something has been learned.

If you haven’t achieved your goal, and especially if you haven’t come close, consider the possibility that the goal may have been all wrong in the first place. Not that your intentions were wrong, but the goal may have been. The first step back from failure to achieve a goal is often to throw the goal away.

The problem with goals is that they are black or white — you either achieve them or you don’t. This leaves no room for flexibility, for the small successes, failures, setbacks, and rebounds that are substance of most human endeavors. Goals leave no room for commonplace improvement.

An example: I run regularly. My commitment to running, however, took years to establish. I would run for a few weeks, maybe even a few months, and then fall back into months of inactivity. I would set goals: Run 5 miles, run a 10K, run a marathon. I always had a goal. And I didn’t achieve any of them. Finally, I did what any sensible person does in the face of constant failure. I surrendered. I flushed all my goals down the toilet and decided that instead of worrying about goals, I would just decide to be a runner.

What does it meant to be a runner? It means I go out 3 or 4 times a week and run. Five minutes, five blocks, five miles, no matter. It's all running. Just as long as I put on my shoes and go out, it counts. And the interesting thing is that this simple change in approach worked.  

Before, when I ran, I was not able meet any of my goals, and so my passion for exercise lessened with each failure. I would quit. Then, I would feel guilty in couch-potatodom and set up the goals again. And the cycle would repeat. In this cycle, there was no chance I would ever succeed as a runner. Why would I keep doing something if I kept failing again and again? By simply telling myself I would run for the sake of it, for the heck of it, and that there were no goals at all, I was able to change my frame of reference. If my only criterion was to run — any distance, any place, any day — that was something I could succeed at. This thinking replaced long-term goals that I might never achieve with small, simple ones, achievements that formed a modest base that I could build on.

One might object: What good does it do to run for five minutes? Five minutes is nothing. Yes, it is nothing if your attitude is “Boston Marathon or bust.” But that is not my attitude. My attitude is, five minutes running is not everything, but it is five minutes better than nothing. It makes me a runner. I may not be as good an athlete as someone who runs five miles, but I am still an athlete. I don’t stop being an athlete if I can’t run five miles. I stop being an athlete if I stop running altogether.

And with that I had uncovered a secret that, while new to me, I have since heard other writers allude to. Rather than goal setting, it turns out that it is often more useful to change your personal story. Rather than saying, “I will achieve X,” it is better to say “I am now Y.” In other words, improvement is not an act of will, picking a goal and driving towards it, but an act of identity, deciding to be a changed person.

Let’s look at how this works. You can set a goal of writing a hit song. Or you can just choose to be a guitarist. You can set a goal of bench pressing 500 pounds. Or you can just choose to be a weightlifter. Setting a high goal sets you up for failure: if you don’t have a hit song, or if you never bench press 500 pounds, you have not succeeded in your mind. But if you choose to rewrite your story, you can turn repeated failure into sustained success. You may never bench 500 pounds, but if you spend as little as five minutes in the weight room three days a week, you are a person who lifts weights. Who has a right to say otherwise? No one can take away your identity as a weightlifter. You can only fail at that if you stop lifting.

Nike had it wrong. You don’t just do it. You must be it.

Need some more examples? Consider some common New Year’s resolutions.

Lose 10 pounds. What kind of person loses ten pounds? Someone who is a healthy eater. So instead of trying to lose weight and being disappointed when you can’t, just choose be a better eater. Decide to have a vegetable with every meal. Choose to drink plain water with your lunch. You can do that every day even if you never lose weight. And one day, it might help you lose weight.

Travel to Paris. What does it take to travel to Paris? Money. How do you get money? By saving. So instead of setting the goal of Paris, choose to be someone who saves. Any amount is fine. Like running, if you save anything, you are a saver. Recently someone showed me a very simple weekly savings plan. For one year, every Friday you set money aside. On week one, you save one dollar. The next week, you save $2. At 52 weeks you will set aside $52, and have $1,300 in your bank account. That’s enough for a plane ticket to Paris.

Get a promotion at work. That isn’t up to you. But doing a better job at work is. So pick a simple habit that will make you a better worker. Choose to be someone who is always at work on time. Being at work on time might not get you a promotion, but it won’t hurt. Or maybe choose to be someone who dresses well. Too simple? Choose to be someone who listens at meetings.  Prove you have been listening by reflecting back what people say to you before you make your opinion known. Everyone values a listener.

Learn to play the piano. Consider being a musician instead. What does a musician do? A musician listens to a broad range of musical styles, and learns about them. That’s easy. A little harder: A musician sits at the piano every day, even if it is just for a minute. Every minute counts. Do that, and the skill will eventually follow.

When I started writing this blog fourteen years ago, there were hundreds of doctors hosting blogs across the internet. We had a network, and we linked to each other’s blogs and even had a weekly online Grand Rounds that served as the “best of” posts among blogging docs. Now, all of them are gone except me. I don’t have the most popular blog on the net, and probably not the best one either, but I have been here 14 years and counting, and have no plans to stop. The difference between me and the dropouts is that the other guys wrote for a goal. To vent their spleens. To call attention to their medical practices and attract patients. To make money. To pass on medical knowledge (or show it off). Those are all goals. You either meet goals or not. If you do, your reason for blogging goes away. If you don’t meet your goal, you get frustrated and quit.
But for me, blogging is a way to be a writer. That’s what I am, a writer. What does a writer do? He writes. Every day. So I write every day. Some says I only write a single sentence, and sometimes a write for an hour or more. But I write.

And the reason my blog lives on is because I write to be a writer, and not for any particular goal. I do it because writing is what I want to do, and because a writer is what I want to be. One day, I expect to find myself on my deathbed ginning up another article for my old blog. And I will do it because writing is an expression of my being, not the fulfillment of a goal. Goals are for quitters. If you want to succeed and keep succeeding, you have to do something because you have made a part of what you are, a part of your personal story, and not some arbitrary finish line.

And that, my friends, is how you keep a New Year’s resolution. You ask yourself not what you are trying to achieve, but what you want to be. Do you want to be a writer, exerciser, healthy eater, spiritual thinker, saver, friend, spouse, father, doctor, teacher, mentor?

It is not possible to achieve everything. But it is possible to be many things. Choose to change your identity, and you will find your life changed in ways that you did not think were possible.

I am telling you: it works. I have been running regularly for eight years now. I am still terrible at it. But it keeps me fit, it keeps my mind sharp, and I will keep doing it as long as I can, not because running will take me anywhere, but because running makes me what I am, right here.


2018: My Year in Books

My list isn’t as well polished as Barack Obama’s, but keeping track of books read isn’t just a job for ex-presidents. This year’s crop includes thirty-four complete books, plus innumerable short stories and essays that I don’t have time for here.

I am embarrassed to say that the self-help genre is over-represented. I have a weakness for these kinds of books, especially titles about personal productivity and organization although I seldom get true wisdom from them. But sometimes I do, and it makes all the digging worth it. Among these, Outsmart Yourself, which is an audio lecture collection from The Great Courses, was probably the best.

1. The Two Towers by J.R.R. Tolkien
2. The Aeneid of Virgil by Elizabeth Vandiver (Audiobook)
3. The Untethered Soul: The Journey Beyond Yourself by Michael A. Singer
4. Northward Towards Home by Willie Morris
5. The Moviegoer by Walker Percy
6. White Trash: A 400 Year History by Nancy Isenburg (Audiobook)
7. Nausea by Jean-Paul Sartre
8. Runaway by Alice Munro
9. The Science of Energy by Michael E. Wyeesion (Audiobook)
10. White Rage by Carol Anderson
11. Morte D’Urban by J.F. Powers
12. How Democracies Die by Steven Levitsky and David Ziblatt
13. Just Friends by Shirley Glass
14. Every Single Day by Bradley Charbonneau
15. Return of the King by J.R.R. Tolkien
16. The Soul of America by Jon Meachum
17. Ask the Dust by John Fante
18. How to Change Your Mind by Michael Polian
19. The Unbearable Lightness of Being by Milan Kundera
20. The Procrastination Cure: 21 Proven Tactics by Damon Zahariades
21. Outsmart Yourself: Brain Based Strategies for a Better You by Peter Vishton
22. The Benedict Option by Rod Dreher
23. Fire and Fury by Michael Wolff
24. Beautiful Ruins by Jess Walters
25. Hyperfocus by Chris Bailey
26. Fear by Bob Woodward
27. The History of Jazz by Ted Gioia
28. The Joy Luck Club by Amy Tan
29. Aware by Daniel Siegel
30. Atomic Habits by James Clear
31. My Man Jeeves by PG Wodehouse
32. The Prince of Tides by Pat Conroy
33. Joy to the World by Scott Hahn
34. Classic Philosophy for the Modern Man by Andrew Lynn

Best Book: Close race, very close. I will go with Runaway, by Alice Munro, a beautiful collection of short stories about rural Canada. But also, Morte D’Urban was wonderful, and the Moviegoer.

Most Surprising book: I stumbled on Ask the Dust accidentally. It is a rarely read book these days (as is Morte D’Urban), but it deserves better. Read it, please.

Most Disappointing Book: Fear by Bob Woodward. It had some interesting information about the Trump White House, but there was no arc to the story, no narrative drive. It was like, “Hey, let me tell you a bunch of crap I learned about the White House.” I would have preferred Woodward had kept his notes to himself.

Worst Book: Fire and Fury sucked. Wolff’s book was was like Woodward’s book, except that Wolff can’t write well enough to keep wet on a fish. I hope the book made him so rich that he will never bother to write again. Every Single Day was a short read but very shallow. The title is all there is: To establish a good habit, do it every day. It was good cheerleading, but that’s it.

Rereads: The last two installments of Lord of the Rings were even better than I remembered them. Better than the movies. Unlike the movies, where good and evil simply pose against one another for the purpose of conflict, in the books evil was a real thing, sinister, purposeful. Evil written by a man who understands what sin is.

Anything else? The History of Jazz was very good until the 2/3s mark. Up to that time Ted Gioia told the life stories of many of the great jazz pioneers. But towards the end, there were so many names piled in that the book became nothing but a catalog of one jazz musician after another. It seems that Gioia had a story to tell, a great one, and at the beginning kept is personal enough to make it the compelling story of a few innovative musicians. But towards the end he panicked, and, afraid to leave anyone out, packed so much into the last part that there were no human stories left in the last few chapters. I understand the impulse, but it weakens the book.


Happy New Year!