The Next Two Weeks

I lived my life in four-year blocks of time for a long time. 

I went to high school for four years, enjoying the studying, the teams, the football Friday nights, the dances, the classroom experiences, the crushes, my first real love, and the teen years. A small mill town in the south. A big fish in a little pond. A girlfriend. A handful of dreams. 

I went to college for three years (yeah, I got credit for four years because I CLEP tested out of a year, but that’s a story for another day). I lived in the organic chemistry lab visited by my professor’s Great Dane, studied late at night at the local Krystal eating chili and cheese Krystals, agonized over making enough As to get into medical school, then took the MCAT to make that dream a reality. 

I went to medical school for four years. I endured the hell of year one, when classmates drop out after two weeks because it’s just too fucking hard. Most of us made it to year two. We made it past professors that told you no matter how you tried you would never get more than a C (then gave you a B if you were lucky). We made it past anatomy, microbiology, pathology “pot cases”. (No, those were not studying people who smoked marijuana, but looking at the diseased tissues of those who had donated their organs to be placed on carts in formaldehyde filled pots for medical students to study in detail.) We enjoyed electives after enduring the compulsories. We graduated, doctors in name only, not knowing how little about life and medicine we actually knew. 

I did a four-year internship/residency/chief residency in psychiatry. I learned just how little Freud knew about people who I now treat who have real psychosis, real depression, and who really kill themselves. I learned more about how to manage and navigate the future systems in my life than I did about the medications available at the time, which is good really, considering that people and systems don’t change that much over the years, but medications become obsolete and get recalled. I learned to work ninety hours a week on very little sleep. I learned who I could trust to have my back, and who would stab me in it. I learned to love my patients for what they would teach me, real things about life and love and sickness and death that no two-hundred-dollar medical textbook could ever show me. 

My preparatory years were measured in four-year increments. 

Now, we are all gathered on the battlefield of a great pandemic. 

There is a virus out there that can infect me, make me sick within fourteen days, and kill me in just a few more. If I am exposed, I must count fourteen days. If I make it that far, then I will likely make it farther. If I don’t, who knows. 

I used to look forward to the next four years.

Now, I count myself among the lucky who make it through the next two weeks. 


I have been enjoying an hour of reading each morning before work, and Thomas Friedman’s Thank You for Being Late is my latest fare. It is a fascinating book that addresses the many different types of accelerations that we are experiencing in the world right now, and how we had best conceptualize and cope with them in order to survive and thrive.

One thing that Friedman makes very clear, and that other writers are echoing, is that our assumptions, the things that we have always taken for granted and have counted on to be eternal, have started to erode. We have always assumed that if we played our cards right, kept our noses clean, and played by the rules, that life would turn out pretty well for us. We were always told that if we worked hard, went to school, got an advanced degree and met the right people, we would land that nice job with benefits in a company that was too big to fail and that would see our careers through until we could take a retirement package that would let us ride softly and gently into the sunset of old age.

The world is changing. Rapidly. Fundamentally.

Previous assumptions do not hold true any longer. Previous plans, tried and true, that everybody followed, do not work. Traditional training, preparation and thinking that used to get us firmly attached in industry and the world of work now provide little except for artificial trappings that say what we should know and what we should be able to do.

Tradition, once the bedrock of our predictable lives, is changing faster than most of us can keep up.

This is the age of You 2.0, or maybe even 3.0.

You are now the startup. You are the company of one that is making the pitch out in the world. You are the one trying to convince someone important that you have the knowledge, skills, training and flexibility to perform, to produce.

There is now the need not only for a specific amount of schooling and training, but for continuous learning throughout your working lifetime. Finite training and degrees, static and sterile, are entering a phase of obsolescence. Continuous self assessment, pivoting to meet the current needs, retraining and skill acquisition are the watchwords of You 2.0.

You must not only be prepared and properly trained, but you must have fully developed emotional intelligence, the skills necessary to handle groups of people, exemplary communication skills, and flexibility. You must be willing and able to turn on a dime, to meet new challenges and take on new projects that in years past you would have thought were out of your league. Continuous self assessment will be your watchword, and adaptation and skills acquisition will be your goals.

As Friedman said in a previous book, the world is flat. It is also fast and furious, changing at the speed of Moore’s Law and then some.

Those of us who are overwhelmed by this rapid change will fade away, some fast, some slowly.

Those who embrace change, who thirst for knowledge and who adapt to different landscapes and environments will be successful and drive the next wave and the next and the next.

You 2.0 will look nothing like the prototype.

Then again, did we really expect it to?


First Things First

Our mental health center building was built, oh fifteen years or so I guess. Although the the brick building with steel studs for a skeleton is still quite solid and will stand and serve for years to come, that was not the case for the outside landscaping. The plants around the building were leggy, the grass was pulling away from its borders and turning brown or disappearing and the pine straw or other mulch had long since disintegrated. The trees were still standing, but were also getting unwieldy and misshapen.

As we had some money that needed to be spent by the end of the fiscal year, the decision was made to purchase a large scale landscaping project in toto. There would be a new plan to beautify the building, the old would be ripped out, and the new installed. This would take weeks of time, not to mention tens of thousands of dollars, to accomplish, but of course the desire was to come away with a building that looks as good on the outside as the services provided on the inside. We want both to be excellent. 

Now, on the face of it, one would think that you could just cut down dead trees, pull up scraggly plants, and dig up brown grass, replace them with exactly the same thing, water it a week or so, and call it done, right? (Those of you who have done any degree of yard work or landscaping yourselves can’t answer!) The fact is, if you do this, the same problems will resurface one year, five years, ten years down the road. You will have spent a lot of money, been superficially happy for a decade or so, but then realized the error of your ways. Problems that are addressed superficially, with applications of bandaids or cheap landscaping, are not solved. They are merely hidden, and the goal of fixing them completely is postponed. 

The answer?

A good foundation. 

Like the strong structure itself, our landscaping plan needed a  strong foundation. 

There had been soil erosion problems, water accumulation, poor drainage, and flooded parking lots for years. Changing out a few box woods or throwing down some fresh pine straw was not going to fix it. We were going to have to dig deeper. Literally. 

So what did the landscaping contractor do first? He took weeks to dig out a wide, deep ditch all around the main building. He put a sub layer of gravel in the bottom of that ditch. He installed large drain pipes, sunk several feet into the ground, and then ran other long pieces of pipe from the drain to the parking lot drainage areas. He filled the rest of the deep ditch with another layer of rocks, ornamental and practical, and shored up the whole thing with metal channels to keep it in place. He made sure that the whole filled ditch was wide enough so that at times of heavy rain the water coursing off the metal roof would still fall squarely in the rocky area so that it could be collected and drained away from the foundation of the building quickly and safely. He put flexible drain pipes from the downspouts to the drainage conduits away from the building and its sidewalks. 

This took hours and hours of work, many pieces of big machinery, multiple men, and a lot of raw material. Why did he do this?

Because professionals know that if the underlying foundation of a project, the part that shores up the whole project but is not even seen by those visiting the building, is shoddy, then the pretty part that we will end up seeing later is doomed to crumble in short order. A hastily completed job, with shortcuts and poor workmanship, is a very poor investment of money, time and effort. 

I started thinking about this blog post a month ago, making notes in my ever-present small black Moleskine for later. I thought about it even more when the current presidential contest started to shape up more definitively and then even more when the shooting in Orlando happened yesterday. 


Because we have forgotten how to put first things first. We have lost our way. We have no strong foundation to protect us anymore. Like flora that is dying and soil that is washing away, the values that made out country great are leaching out of the fabric of our democracy.

Do you know what is similar when you form a new country, when you train a new Marine, or when you teach a medical student to be a doctor?

You take them all through a very similar process. You start with raw materials: a group of rebellious colonists, a scrappy eighteen year old who can shoot a rifle, or a nerdy college student who thinks he will be the one who finds the cure for cancer. 

You break them down. You strip away everything that defined them before, and you make them uniform. You take away their previous conceptions of normal, of right, of proper, and of individuality. 

Then you take those empty vessels, those men and women who are ripe for change, and you teach them. You teach them new skills, a new culture, a new set of rules that defines good and bad, right and wrong, tolerable and intolerable, things that are good and proper and pure and things that are flat out evil. You make sure that they know these things backwards and forwards, that they can recite the creeds in their sleep, and that they can demonstrate the skills you taught them under great pressure, with their eyes closed and their minds numb with pain or fear, and that they will never break. 

Next, you take these new warriors, these new recruits, these rebels, and you make them a unit. You rely on esprit de corps and a sense of pride in who they are and what they are and how they are. You make them a team, a group that will do nothing at all if not protect each other and who understand that if one of them is injured, ALL of them are injured. If one of them is hurt, then ALL of them are hurt. If one of them dies, THEY ALL DIE. 

Lastly you challenge them. You stress them. You test them. You drill them. You stress the very fabric of the organism that all of them make up. You make them so aware of their interdependence (not their dependence, mind you) that they know, they KNOW, that if one of them lets down his brothers that all are in great peril for their lives. 

You don’t feed them with fear. 

You nourish them with pride. 

What happens to these people, these rebels, these rabble rousers, these smart asses, and these ridiculously intelligent geniuses who think that individually, they can do anything, solve any problem? 

They become a unit.

A class.

A nation

They emerge fundamentally changed. They are powerful, not in what they can do alone, but in what they can do together

Like a building that looks good on the outside but is slowly being threatened by seepage, rot, and undermining forces of nature, only a wholesale gutting of the bad and replacement with a strong foundation of good will save it from eventually crumbling into a heap of useless brick. 

Tuckman wrote about this same process in the 1960s, when he outlined his theory of “Forming—>Storming—>Norming—>Performing”

Our country is at a crossroads. 

We now consider ourselves too big to fail. One only needs to read about the Roman Empire and other ancient civilizations to know that this is folly. 

We must break ourselves down, down to the bare dirt and the soil that gave rise to this nation. 

We must teach a new new generation, every generation that follows from here on out, what it means to be American. We must go back to the basics, making first things first, and teach them the skills, the culture, the rules, the values and the ideals that made us great in the beginning. 

We must learn to live and love and work as a unit again, not a hodgepodge of squabbling, fighting, backstabbing factions who value their differences more than their similarities. We must repudiate those who would fan the flames of hate and prejudice and death, and find that esprit de corps that once made America a proud, strong, upright nation. 

We must take these challenges that we face and use the stress on our system to come out stronger, prouder and more protective of our neighbor, whoever he or she may be, than ever before.


Because we are Americans. 

We do not give up.

We do not shrink from the battle, whether on the field, in cyberspace, in church, in nightclubs, in schools, or in the streets.

We do not quit.