Of all the bad and dangerous ideas in the world, perhaps none is worse and more dangerous than the idea that there is no such thing as luck.
Proceed with caution. I’m not known for brevity and I can sometimes easily sidetrack myself. It might be one of those days; consider yourself warned, as today’s adventure may not be a straight line. Much like one of the nurses I used to work with, sometimes I get distracted by shiny things.
I’ve tried to get back into reading since I now have the opportunity and the energy to do so. I tend to read in spurts; I’ll devour several books, and then not pick anything back up again for several weeks. I’m not proud about it, but it’s just the way I am. I’m a non-fiction guy, which I think makes it more difficult if I can’t find a topic that piques my interest. I’m not much of a fan of fiction, and some things I REALLY don’t get. For example, I don’t understand the mass appeal of one Harry Potter. I think J.K. Rowling needed something called an “editor”. I also don’t understand the mass appeal of books about a “dystopian future”. Must the future of the land of make-believe always be so grim? Can you imagine if Mr. Roger’s trolley went on the dystopian tracks? I might pay to see that one.
I realize that the failings are with me and not the rest of the population. Even with my sense of humor being a little “out there” and dark, I can’t get past my own wiring when reading fiction. It’s as though my brain is telling me “You dopey schmuck! This story couldn’t happen. Put the book down and go play in traffic.” It might be why I don’t like musicals either. Because I like to tell the world about my story and all my problems, IN SONG. Because that happens routinely as well. Maybe more people would read this blog if I just had a big, closing number. Maybe I could dig up Rodgers & Hammerstein’s old bones to help me with this one.
I also find it hard to read other blogs. I think maybe it’s because I also like to envision the person’s voice when I’m reading it. If I can hear the person in my own head, I’m more likely to listen. I still hear old professors’ and attendings’ voices in my head when thinking about certain topics.
I have been recently corresponding with an old college friend. Kieran also writes a blog – http://joyousandswift.org/ (free plug, no compensation for me!) If nothing else, the 20 fun facts he lists are entertaining reading (I’m more convinced that ever that I have a boring existence), and I need to ask him specifics about #16. I enjoy his writing – he is an excellent writer and story teller, and I can hear his voice narrate the piece as I’m reading it. Maybe I just admitted to being intellectually lazy, but I wish I could get him to narrate the blog and post that on-line (then I don’t even have to read!) As a side note, I was going to do a blog called “I Said It, and it Needed to Be Said.” After I started, I noticed it was a) contrived and b) just involved me bitching more than I care to do on a daily basis, so I shelved the piece.
I was playing catch-up on his blog this past weekend, and one piece in particular grabbed me. “You Have No Idea How Lucky You Are” should be essential reading in this current climate. Here’s the link, in case you are interested: http://joyousandswift.org/you-have-no-idea-how-lucky-you-are/
Here’s the gist – if you’re able to read this blog, you’re pretty lucky. If you aren’t able to, maybe you’re fortunate to not have to read MY blog, but you have started life with the deck stacked against you, maybe more than a tad. Hard work, while important, isn’t the biggest determining factor in our lives. The conundrum is: if you are in the “fortunate”, you tend to overvalue “your own hard work” and we use it as moral judgment on those that are less fortunate. He does not make a statement about what we should do with this insight (if you happen to agree with his point, which I whole-heartedly do), nor do I think he needs to. I think it is a powerful enough piece to stand alone as it is.
As a disclaimer, I will not pursue a discussion at this time of the philosophical implications herein, and where this might put one on the political spectrum if one agrees or disagrees with his point. I’m rather interested in the point itself. On some level, I think Kieran just articulated what many (most) of us FEEL at some point in our lives. (As an aside, I also find it obnoxious when you ask someone “How are you?” and you get an “I’m blessed” as a response. It also sound contrived and a bit biased, as though we shouldn’t ever complain. I knew one CEO that said he didn’t mind his employees complaining with the thought that “people that have given up completely just don’t complain anymore.” It is acceptable to have concerns and problems relative to the situation closest to you and not to compare everything on a global scale. It’s about how wide of a lens you want to see every situation through. I digress, again!)
I have a distinct memory from clinical practice that drives the point home for me. This was 7 or 8 years ago. I had a mother bring her two children to see me. One child was early teens (I had been his doctor for a few years), and the other was not quite a toddler. When I saw them this particular morning, the mother informed me that she was moving out of town, and wanted her kids to be caught up on vaccinations and the like before leaving. She gave me a gift – it was a little piece of scotch tape with rusty colored flecks coating the adhesive surface. I laughed at first and asked her what this actually was. She said, “This is what’s on my car windshield every morning. I live so close to the factory and I just can’t take it anymore.” Evidently, this was some type of soot or particulate matter emitted from the local factory. She explained that she had tried to contact multiple agencies about the “stuff”, but to no avail (for the record, she COULD have been making this up, I’m just relating the story, but I have no reason to doubt this woman). She gave me a big hug at the end of the appointment. I’ve never seen her again, and I not-to-infrequently wonder how she and her kids are doing.
That visit messed with me for a while. I knew the area was relatively polluted. It is one reason that I never drove (nor do I now drive) really nice cars. For one, I’m just not a car guy. They just exist to get from point A to point B. But in the area I worked, there was enough pollution that I would purposely drive old vehicles. The pollution and chemicals sure seemed to eat away at a vehicle. Why drop huge bucks on a car that’s going to turn into a rust bucket even faster? But that’s a “first world” problem. This woman had literally gotten to the point of, “Hey, I’m no scientist but this $#!& can’t be good for me. I can’t get them to make it stop, so I guess I have to move.” That’s a pretty awful situation to be in.
(Another aside – I TOLD y’all that I’m scatter brained today. I don’t want to get in the discussion about climate change and whether it is human caused, human augmented but was happening anyway, or a hoax perpetrated by the illuminati. One can’t seriously think that any of the stuff coming out of factory pipes is actually GOOD for you, global effects be damned. Take a look at a map of asthma and where it hits cities, or cancer rates in urban areas, or mortality rates, and then find the factories. You’ll find significant overlap. Correlation may not be causation, but I also don’t believe in coincidences either. There’s a reason communities try not to build factories in their own backyard, but someone else’s backyard.)
I can rattle of some other situations that I’ve witnessed that I’m fortunate enough to NOT have experienced:
-I’ve never had to decide whether or not to put my 4 year old in kindergarten because the school district was so poorly funded that that they couldn’t challenge my child in preschool, and I didn’t have the money to move to “a better school district”.
-I’ve never had to choose between sending my child to an abusive ex’s place or keeping my child safe and risking arrest due to a court order.
-I’ve never had to choose between providing either food or medicine for my own family (not being able to afford both).
-As much as I had legitimate safety concerns (at times) where I was working, I’ve never had to worry about going HOME to violence (be it my home or my neighborhood).
I can spin this in the positive direction.
-While I didn’t grow up rich by any means, I certainly grew up in an area with decently funded schools that adequately prepared me for on-going education, with parents that had the time to push me in my education. Same goes for my kids.
-Going to college where I did, I had professors and mentors that actually took extra time to point me in the right direction for after college, even if it wasn’t part of their job description.
-I was taught to value saving and not to live “just for the moment” so I didn’t get hamstrung with debt and other baggage.
-Heck, I’m fortunate enough to be able to take a sabbatical. That I married a woman that doesn’t value expensive things, that my kids don’t expect expensive things, so that I can take the necessary time to follow my passion, rather than just earning a paycheck. I’m fortunate that I’m not TRAPPED. As hard as going through this process has been for me (and it IS hard), I’m fortunate/lucky to go through it.
This could go on for pages, and would get boring and depressing fast. I think, if we’re all honest, I haven’t said anything earth shattering. Kieran wrote it better than I have, but in our core, we should know this. Yes, hard work matters. Yes, drive and ambition are very helpful, and should be nurtured. One of my wife’s roommates in college talked about a raise she got at work shortly after graduation. It was a 10% raise. We asked her if she noticed a difference; her quote was “10% more of not a lot is still not a lot!” Like it or not, our starting point MATTERS, and probably more than any of us would like to admit.
Here’s the hard part. What do we about this if it is indeed true? I tend not to agree with people that say “Bring me solutions, not problems.” Sometimes, that’s not realistic, and you have to start with the problem. Is simple awareness of this enough? Do we have to make concerted efforts all the time to fix this for everyone? Is it a matter of one axiom of medicine, first do no harm if it is impossible to maximize good equally? No one single general approach seems satisfactory.
When it comes to the issue of fortunate vs. unfortunate, where is the limit with regards to who we help, and when, and how, and how often? As a distance runner, I’m interested in limits. There are personal limits for time, distance, and difficulty. There are world records, which are another form of limits. And there are theoretical limits. Will there be a sub-2 hour marathon? A sub 3:40 mile? There has to be some limit, it’s just a question of where. This discussion is really no different. I’m beginning to think that there may not be a right or wrong answer here, but I think the individual answer each of us gives reveals a lot of how each one of us conceives of the world. On a micro level, maybe that’s more important. Maybe the limit should make us uncomfortable; I just don’t know.
I don’t have a solution. I’m not telling you whether this should be a conservative vs. liberal, libertarian vs. socialist issue. And certainly, not everything we do needs to be uplifting for less fortunate people we haven’t even met. Some decisions we make never reach that realm. Sonia is a big proponent of not worrying about making any one perfect decision, but rather a series of solid, sound decisions. We have been running a small resale business during my sabbatical. We’ll get an offer on eBay for an item and we’ll debate taking the offer vs. not. The usual line we use is “some money is better than no money.” I think that same attitude applies here. Just because we can’t think of a perfect solution quickly does not obviate us from doing better than the status quo. The concepts of “good” vs. “great” don’t have to be enemies.
As I wrote a few weeks ago, I’m slowly getting closer to having this sabbatical end. It’s getting there. It’s hard, because I can’t make the end happen (I am on the time schedule of other people and entities. Willingly accepting a loss of control and being at peace with it isn’t natural). But when it does end, I do want to write (as a blog) a long list of “thank you’s”. One thing I do like writing about and reading are public “thank you’s”, because it forces us to think about how we all have been helped, even though we’re not really all that special. You get to see and acknowledge all the people that helped you get somewhere meaningful. It’s about being in the spotlight, and bringing a mirror with you to do a little reflection for others going unnoticed. I love reading acknowledgements a lot – it’s a heartwarming experience and PROCESS. If nothing else, the last 12 months have illustrated just how fortunate I am. That’s not revolutionary. I knew that a long time ago. Kieran’s blog hit me and now my gut believes it. That’s powerful stuff, now I just have to figure out what I do with this knowledge.