Balance 2.0?

So, a wannabe author/writer walks in to a writer’s conference…

Sounds like the beginning of a not very funny joke.  But, that was me earlier this month as I attended the Harvard’s Writing, Publishing and Social Media Conference for Healthcare Professionals.  Quite a busy three days. Started at 7AM and  finished after 8PM. A lot to learn and absorb: Improving writing style, understanding the publishing and self-publishing landscape, using social media effectively and with purpose.  During the three days, met some great people that I now know in IRL (in real life).

There were so many take aways but a few things did strike a chord and stand out.

  1. This blog is “static.” Once or twice a month I write something. Probably a little too long and a little too moody (more on that in a minute). Right now, it’s really a one-way communication between myself and you the reader. I would like there to be more engagement and build on what I have started. I would like to provide more content that hopefully YOU the reader find either useful and interesting or entertaining.


  1. So I am asking you, the reader, what more you would like to see? How can I  make this more of a two-way conversation? I am looking to post:


  • Shorter thoughts and musings on life and themes such as burnout.
  • Write on End of life issues / advance care planning / introduce thought leaders and game changers in this space
  • Timely topics of the day.
  • Interesting book reviews or articles in paper or journals on critical care, end of life care, burnout.
  • Guest bloggers with strong clear voices on interesting and important topics.


  1. The last part that threw me for a loop was how morose or weighty my writing must feel to most people. I often dismiss as a joke, when my long-time friends send me a text checking in to make sure I am ok after a typical post. During the conference, it was commented on that IRL I seem different than the “voice” that comes across on the blog (ie: I have a sense of humor, funny/sarcastic and quite social instead of morose, melancholy, moody or morose)

So, to be brief, my BLOG and website is a work in progress (similar to my life in general). But I hope to grow it into something more.  So maybe call it Balance Redux, or Balance 2.0

Come to think of it, lets get this conversation started.  Thoughts on a new name? Anyone….

Change Redux

It started almost as a little hum… a vibration in my head, felt more than heard.  A connection between some deep part of my brain straight to inside my chest. In the days leading up to my college graduation I mostly ignored it. Easy enough in the midst of goodbye parties, long nights at the Terrace drinking pitchers of beer while the sun set over Lake Mendota. Graduation parties, visiting family to entertain… there was plenty to be distracted by. But the hum turned to an ache. A growing uneasiness. An angst. I tried to drown it. Alcohol, music, sleep. But graduation came, and as day turned to night, and evening settled in, I saw Liza, my friend, forged on those first few nights in the dorm freshman year, across the street from my apartment on her porch. I walked over and sat next to her and buried my head on her shoulder and just cried. Tears flowed with the pressure and force of the angst that had been percolating inside me now at a full boil. She held me as I just let go. And for a few moments at least I had relief from the discomfort that had entered my perfect world.

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Harbinger : “one that presages or foreshadows what is to come”

It had become somewhat of a fixture in our dining room. I’d pass by it pretty much daily. Can’t help notice it. It’s not small, my bike, given that I’m 6’3″ and it’s a custom frame. And although when clean, it does look somewhat like a piece of art, by no stretch can one pass it off as part of the room decor. But I wasn’t ready yet. Served me well last race, but just didn’t have it in me to get her ready to ride again. Fall came and went. Winter arrived along with the holidays and still it sat…collecting dust, patiently waiting.

The calendar year turned, and with it, renewed resolutions, dark days and cold weather. Ingredients to make indoor morning bike trainer rides somewhat more palatable. So the bike was moved (no roots had set) to the basement, and we (yes..for those on the outside of the world of biking, bicycles are people too) said hi to the computrainer.  Forty minutes later, in full biking attire (no small feat, trying to find my bike “kit” buried in a pile of summer workout gear), with the Husker Du song “New Day Rising” churning in the back of my head, I’m ready to go. This is it. Rising from the ashes…building a new “bridge” to 2015. I start spinning easily to warm up and then…ouch!

A few months ago, it was just a little “niggle”.  A little bit of pain in my right knee. Nothing too horrible. I mean, in general, the rest of the 5am workouts with the trainer (see Limits) overall were much more uncomfortable. But the right knee thing kept popping up. Harbinger. On sled drills, squats and so forth, it would rear its head. I’d work around it, go home. Rest, Motrin, repeat workout. After a month, these morning workouts were turning more into physical therapy sessions with the trainer than the beat-downs I had grown accustomed to. So I decided to take a little break. And after a few weeks, perfect timing to hop back on the horse (bike). Who would have thought that with every downstroke of my right leg, my knee would say (hey…don’t do that…what…cut it out…do you hear me…WTF are you doing…do u not understand English…hey…hey… HEY!!!) about 85-90 times a minutes (if the cadence monitor on my bike is accurate). So all dressed up and nowhere to go, I dismount the bike and directly walk into a state of denial.

Now “denial” for me is my “go to” mechanism for dealing with unwanted things.  Not very sophisticated for sure, and frankly quite counter-productive. Sarcasm is my other method of choice but that takes energy and thought…which is not my initial reaction. I mean it is hard to use sarcasm when late with one’s taxes. The IRS is not particularly known for its sense of humor. Returning challenging patient phone calls always seems more palatable tomorrow than tonight. Bills…well they can be paid next weekend. Comcast usually is nice enough to give a few warning calls before shutting cable down and sending my kids into a tizzy.

Now don’t get me wrong.  I am a relatively high functioning, procrastinating denialist. (By the way, I think that would make a great name for a punk band.) The house has never been foreclosed on. I have managed to maintain my board certifications in medicine with some hours to spare before midnight deadlines. And if you allow for ALL of 2014 to pay 2013 taxes, then I’m doing pretty good. (Yep…I set the bar pretty high). But as a 44 year old child at times, it might be time to rethink this approach.

There is something about the shortening of days, the constant gray skies, and a perpetual chill in the air that makes me turn more “inwards”.  What else is a “niggle” in my life right now? What am I pushing off till “tomorrow”. Work is not hitting on all cylinders like it has in the past. Missed connections with friends keep popping up. My kids are growing up so fast. I find myself looking at their pictures from what seems like a lifetime ago, with my mind frozen in the past…But am I missing some of their present?

I had an MRI of my knee yesterday. I went and saw the doctor. Had the scan done in less than 24 hours. The meniscus is fine. No tear. Some bone contusion and a cyst of some type. Not “career” ending or threatening. I guess more Motrin or PT or rest or all of the above. But all will be good. But I think it’s time to start working on some of the other “niggles” in my life. Closing my eyes and looking in the other direction when things are suboptimal at work is not a successful nor fulfilling long term strategy. And just hoping for chance encounters with long time friends is a poor way for maintaining contact. Being present and in the moment with my teenage kids…well that’s always a work in progress.

So when my knee started to hurt, I thought it would be a harbinger of the “big” injury. The one that that tells me “you’re 44 years old, dude…you’ve done 5 Ironman races. Maybe it’s time to dial it back. Can’t cheat father time…”  But I think it’s telling me something else. Something far less ominous, but more subtle. That it’s time to stop ignoring the “niggles” in my life and start doing something about them. Maybe as a 44 year old adult, it’s time to move on from denial to action. From passivity to activity. At work. With friends and my family. Time to get started… But if only I knew where I put this years W-2’s?


My chest is heaving. The air I rapidly suck into my lungs does not seem to be adequate as I immediately gasp for another breath. My heart is pounding, trying to escape the confines of the sternum that lies over it. The waves of nausea are somewhat overshadowed by a brewing headache. To put it bluntly, I feel like crap. My eyes gaze towards the clock on the wall and to my dismay it’s only 5:40 AM. Twenty more minutes of hell stand between me and relief. And I can’t help question for a moment why am I here again?

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