The Burden of Clinical X-ray Vision

2019 has been a year of reflection.  I woke up this morning thinking about x-ray vision.  It's not exactly what you might think. A little over a year ago, as the CEO of a organization that oversaw a nearly billion dollar nursing home operation, I chose to walk away.  The main reason was that I had clinical x-ray vision.

One can only imagine what it would be like to have x-ray vision.  While at first it would seem cool, there's a significant burden that comes along with being able to see what no one else can.  There's the rub.  If you have x-ray vision, you can see behind walls, you can see behind the curtain, you know answers to things that others can only surmise.  There are different levels of business acumen that apply to this concept.  Some people have financial acumen that allows them to look at numbers and see answers that others can't see.  I have always had an uncanny knack of being able to look at a profit & loss statement and see underlying trends and problems that took others hours of analysis to see.  Some people have operational acumen that gives them the ability to look at workflow and know how things will turn out operationally.  The best managers combine these two skills to create financially effective operations.  It also helps to be a good leader under these circumstances, because, if you have x-ray financial and operational vision, you must be able to translate that acumen to others.

Some leaders will help other see what they can see.  Other leaders just tell others what they can see.  Both methods work, but can have a widely varying impact on morale.  In some ways, it's the difference between a benevolent and malevolent dictators.

I strongly believe that many leaders in healthcare industry are glad not to have clinical expertise and clinical x-ray vision.  This provides them with plausible deniability.  On the other hand, not all physicians have good clinical instincts, and not all physician leaders are able to translate financial and operational decisions to their clinical impact.

I was in a position where I knew the potential clinical impact of operational and financial decisions.  I shared my knowledge with the powers that be, and they chose not to respect my insight.  Ethics demanded that I leave.  At the end of the day, clinical x-ray vision is not a burden, it's a gift.  And I'm fortunate to have that gift.  I'll always be ready and willing to use it!

Loving a Great Story

My daughter read several of her stories today to me while we were driving.  I love the character development and the writing.  I always have.  My daughter has a gift.  A great story is such a great thing.  That's why I've always loved reading.  But reading is only worthwhile if the writing is good, and that's why I love reading or listening to my daughter's stories.

Growing up, I loved to read.  I especially liked real life true stories and biographies.  But I also enjoyed fiction.  My fathers love of Jack London had me reading The Call of the Wild at a pretty early age.  It's still one of my favorites.  The other was my father's favorite book, Martin Eden, which I first read when I was in the 4th grade.  It was pretty advanced for a nine year old, but I've always set that bar high!

I remember coming home from he library, yes the library, regularly with several books.  I'd read them all.  I couldn't read enough.  When I moved onto medical school, my reading suffered, but it came back as soon as I had some time to read.  I enjoyed a good thriller, and particularly liked Ludlum and Cussler's early works.  Now, I'm fortunate, because I have my daughter's writing to enjoy.

While I do most of my reading online, I still prefer reading from an actual book.  For some reason, I've been less interested in fiction in recent years, and prone to be more interested in non-fiction, except when it comes to my daughter's writing.  I love the fiction that she writes! I can always see the characters from the words that she puts on the page.  That's a gift unto itself.  I love a great story.

100 miles

Tomorrow will be one year since I participated in my first and only 100 mile event.  It was the experience of a lifetime, and I'd actually signed up to do it again this year.  A month ago, I realized that my body not only wasn't prepared, but that I'm not sure my body will ever be prepared to put myself through that experience again.  The main reason is what walking and running 100 miles takes out of your body.  While I managed to do two Ironman's this past year, despite starting the year off with a 100 miler, I'm not sure that it did me any favors in relation to my overall fitness and how my two Ironman's ultimately affected me.

With all of that said, I will always respect 100 miles.  And, I'll always remember the pride I felt in completing 100 miles.  I'll never forget where my brain was with about 6 miles to go.  The thought of going easy,  which would have been doing a mile in about 20 minutes, just seemed interminable.  So, I put my head down and buried myself with an effort that I can only compare to what it feels like to run as hard as I can during the last two miles of an Ironman.  That's what I did for the last six miles of the event a year ago, and I was only burying myself at a 17 minute per mile pace.  So, I saved about 20 minutes, which in the scheme of a 40 hour effort doesn't seem like much.  However, it felt like forever.

The other thing about those last 6 miles was how quickly it went by, because I was burying myself.  The brain is a remarkable organ, and how we perceive certain stimuli depending on our surroundings is amazing.  Tomorrow, many of the friends that I made a year ago, including my good friend Robert, will be making the 100 mile journey.  I will follow along vicariously over the next two days.  To some degree, I'll be a little jealous, wishing that I could be there with them.  On the other hand, I know that it's healthier not to be putting myself through it.  100 miles.  Wow.

My Pushup Journey

Two months ago, while recovering from Kona, I decided to start doing push ups.  The simple reason was that I'd never really gotten into a push up habit in the past, and that it seemed like something relatively simple to do.  My push up journey has already taught me a few things and led me to a new goal.  It turns out that Pushups in One Minute is a metric used by a variety of organizations as a qualification goal or measure of fitness.  It turns out that there is actually a body of literature and information in regards to one minute pushup numbers.  There is evidence that a certain number of pushups offers evidence of protection from cardiovascular disease.  That was from a study of firefighters.  Of course, it's not clear whether training to do the requisite numbers noted in the study will confer additional protection from cardiovascular disease, or whether those numbers were demonstrative of the fitness level of the firefighters.

To be able to be in the Coast Guard, a man needs to be able to do 29 pushups in one minute.  Army ranger recruits need to perform 49 pushups in two minutes.  A navy seal needs to do 42 push ups in two minutes. The average twenty year old can do about 25 pushups, the average 60 year old man can do nine.  Where am I?  As of today, I can do 44 pushups in one minute.  I'm hoping to see if I can improve that number.  In the meantime, I've discovered that doing pushups is a great form of regular exercise.  

I've developed a routine that I now do most days.  I particularly do it as my warm up for my sprint efforts.  It includes 20 pushups, 20 air squats, 20 lunges, wall sits, planks, leg raises and back extensions.  Sometimes I'll do more than one set of these, depending on how I feel or what my plan is that day.  One thing has become clear to me, and that is the fact that pushups are a great workout.  They get my heart rate up, and they absolutely impact the entire body.  I've developed different pushup routines.  I'll tend to do my pushups in groups of 20.  I've spent an entire day doing 20 pushups every hour.  Today, I did two 1 minute all out pushup sets, doing 44 the first time and 43 the second.  In between, I did my uphill sprint workout.  In order to get the blood flowing and have positive stimulation on my body, I can just drop down and do 20 pushups.  It will be interesting to see where this pushup journey will take me in the coming months.

Are the Democrats Screwed by the Stock Market?

Perhaps the question should be, are most Americans screwed by the stock market?  But, I'll stick with my premise.  Is the average American even in the stock market?  It turns out that the majority of Americans have some money in the stock market, either in a retirement fund, or some other type of investment.  It also turns out that the average American doesn't actually have much money in the stock market, certainly not enough to make a difference in their lives.  That may be the most important thing that I verified in writing this blog.  The average American doesn't have adequate savings, much less the disposable assets to put in the stock market.  A vast amount of stock market assets are owned by the wealthiest people.  That shouldn't be a surprise.  From a trickle down perspective, the pundits would say that benefits the rest of Americans.  Maybe.  That might have to be the topic of another blog.

Today's blog is about politics, but from the perspective of the stock market.  The stock market reacts to psychology.  Irrational exuberance was a term used by Alan Greenspan.  The stock market went up during the Obama administration. Why?  The market liked what was happening.  The banks were bailed out.  Interest rates went down.  What's not to like?  During the trump administration, the market has been happy, except when it isn't.  The market looks like an EKG, because trump says one thing one day and another thing the next, roiling the market.  Over time, the market has factored this in, and realized that the net impact of what's going on, which isn't really a lot in my opinion, is good for the market and therefore good for the stock market.

Why are the Democrats screwed?  Because the market has bought into the idea that Democrats will be bad for the economy.  Whether it is true or not doesn't matter, if the market believes it! The more progressive Democrats are not doing the market any favors by embracing socialism, even if what they're talking about isn't even close to being socialism.  Socialism is a nasty word to the U.S. market. It always has been, and it always will be.  Elizabeth Warren could have taken a more measured, capitalistic based approach, but has chosen not too.  She could have taken a Teddy Roosevelt Republican approach, but she has chosen not too.  Bernie Sanders...what more do I have to say.  This is probably why Biden seems to have staying power, even though you wonder when he's going to collapse every time you watch him.  He's the status quo, he's not a socialist.  He's a tinkerer, not a transformer.  The market abhors major changes.  The market hates the word socialism.  And that's why the Democrats are screwed.  Even if the Democrats win, the stock market will go down. Not because of fundamentals, but because of psychology.  The Democrats need to understand this and begin rewriting their playbook, lest the next president will also be a one term president.  Understand the stock market for what it is, and use it to your advantage.  That's one thing that I must admit that trump is good at.

Leading by Example

I was listening to a caller on a talk show this morning and he talked about leading by example.  The caller came from a military background, which is often where I ground my leadership thinking, especially as it relates to chain of command.  It's ironic that yesterday I was writing about work ethic, and today I 'm writing about the importance of leading by example. I consider it one of the most important aspects of leadership.  One of my favorite lines from the book and movie, We Were Soldiers (Once and Young), was the concept that the leader was the first to step onto the field of battle and the last to step off the field.  I have always tried to embrace this concept as a leader.  When my family was producing a television pilot a decade ago, I prided myself on being the first person to open the set in the morning and the last to leave.  Often, this meant I was getting up at 4 am every morning and going to sleep after mid-nite.  While that was leading by example, it was also exhausting, and nearly led me to a nervous breakdown.  A story for another blog.

One of my favorite books of all time is Call of the Wild, where the favorite refrain of the protagonist, Buck, is "I am a leader, and a leader must lead."  Leadership skills can be learned, but for many, they come naturally.  Insofar as that is true, I think that one of the key elements for any leader is to model the behavior that they expect to see from their subordinates.  It's a very similar principle as parenting. You shouldn't expect your children to act any differently than you do.  In fact, that's the best example. Children will tend to imitate their parents actions and behaviors.  It's primal.  We shouldn't expect any less.  It should never be do as I say, not as I do.

While the talk show caller was specifically speaking about politics, and of course, the president, that isn't my main goal for today's blog.  However, since we can't ignore today's political landscape, I will make one comment.  The president regularly makes comments on subjects, and then immediately acts in a fashion different than those he espouses.  I've often wondered what this presidency would have been like if that weren't the case, if the president could control his ego and narcissism long enough to actually live by the principles he occasionally talks about.

We see this in business as well.  I posted an article about the fact that there are wealthy businessmen who give a ton of money to charity, all the while allowing or even fostering poor working conditions for people who can't even earn a living wage.  They might even talk about supporting these very workers, but their actions do not speak nearly as loudly as their words.  While I can understand the strategic nature of philanthropy at times, charity should begin at home.  Leading by example means focusing attention on those at the front line.

I've often said that I never expected more from people who worked for me than I would give myself, and in fact, never expected anyone to work as hard as I did.  Of course, I'm a workaholic, and I didn't think it was fair to expect that from anyone.  I will admit that I've always appreciated the people who worked for me who gave me a run for my money in that regard.  It's easy to lead from the ivory tower, but it's not an effective means in the long run, for many reasons.  As a leader, one needs to hear what they need to hear, not what they want to hear.  It's hard to achieve this if you don't engage the front lines.  It's also hard to achieve if you're not seen as being willing to listen to,  and actually hear suggestions and idea.  That's leading by example.

Work Ethic

Today is Christmas, and so I watched one of my favorite movies, White Christmas. The score and the main song itself were written by Irving Berlin.  Irving Berlin was born in Russia in 1888, and came to the United States with his family at the age of five in 1893.  He grew up poor, and often found himself singing for pennies.  It's a pretty classic story, but it's a reminder of the work ethic of many immigrants, many of whom never forgot their roots.  Throughout his life as a composer, Irving Berlin would write a song every day, starting in the evening and staying up sometimes until 4 or 5 in the morning.  That was after a full day of work.  He lived to 101.  Not too bad.

Working has always been important to me.  I'm not sure why.  Maybe I just felt a responsibility.  Perhaps I wanted to make sure that I was self reliant.  All I know is that work has always been an essential part of who I am.  When I was 15, I went to camp and worked part-time in order to have a lower tuition.  I actually tried to see if I could work full-time instead once I was there!  I didn't really have much interest in the other camp related activities.  As soon as I turned 16, I got my drivers license and I got my first part-time job working behind the counter of my cousin's Baskin Robbins.  I continued to do that until I went to college, where I worked in the library at UCSD.  After dropping out of school (a whole other story for another day), I worked making brake parts for the F16 fighter jet, coming home covered in carbon fiber at the end of every day.  After a short stint in Israel, again working in the dairy farm while learning Hebrew, I was back in school, and back at work.  This time, my job was a technical writer for Allergan.  I even worked in a lab during my first year of medical school.  Ten months into my second year of residency, I started moonlighting at Kaiser, working urgent care during the day, and covering the hospital at night.  I continued to do this during my Fellowing, where I actually earned more moonlighting than I got paid for my Fellowship.

When I started working at Kaiser, I took extra shifts, but also took on greater responsibilities that weren't associated with earning more money.  I often say that I'm a workaholic.  I guess that goes without saying.  Flash forward to today.  I tell people that I've failed retirement three times.  No kidding.  I need to be working.  And, when I work, I take it seriously.  I didn't grow up poor, or lacking in any way.  But I have always had a strong work ethic.  Is it genetic? Perhaps.  No matter, it's who I am.

Nine Point Five Seconds

The other day, my wife asked me how long of a run I was going for.  I told her 9 seconds.  What I meant was that I was running 9 second intervals.  This is very different than going out and running for 3 or 4 hours straight.  It's my new way of training.  It's different, but it's got its own challenges.  I've been working my way up from doing two of them to four, to six, and today I managed to do eight.  I'm pretty much locked into running my approximately 55m stretch of asphalt in 9.5 seconds, give or take 0.15 seconds on either side.  I mentally try to go faster, but my body won't let me.  It's very interesting.  I know from my coach that 8 seconds is really the physiologic time frame that these intervals are focused on.  From a mitochondrial perspective, it's about 8 seconds of sprinting.

An eight second sprint effort engages the anaerobic-alactic system.  There is something called the phosphogen system, which is basically ATP being generated by ADP and creatine phosphate without oxygen.  That's what happens.  After 8-10 seconds, you need to engage other systems. We'll talk about that another day.

In order to go faster during my 55m sprint, I probably need to continue to increase the strength of my muscles. At the same time, the exercise itself is strengthening, insofar as a few weeks ago, I couldn't have done 8 of these.  Today, I was very happy that I began to mentally engage my muscles for the effort and maintain my speed throughout the 8 intervals.  I did this by breaking down the interval into segments.  Since the sprint is done flying, I am already moving at the start, though comfortably.  At the moment I hit the starting line, that's when I hit the first jetpack and take off.  Over the course of my intervals today, I identified a couple of more spots on the segment where I mentally hit the booster rockets.

By hitting the booster rockets along the way, I managed to maintain my speed through 8 intervals today.  Somehow, I'd like to see if I can go faster than my fastest interval, which has been ~9.35 seconds.  Right now, 0.35 seconds might as well be like improving my 5K time by 3 minutes, or my marathon time by half an hour.  Which is pretty remarkable, in and of itself.  So, I'll stick with the fact that I've been able to hold 9.5 seconds eight times, and see where that takes me.  Improving my 5K speed, one metabolic system at a time.

Brain Fog

I'm writing yesterday's blog today, as yesterday I had brain fog.  The 24 hour GI bug that I suffered through, left me without the ability to think for most, if not all, of the day yesterday.  My son-in-law told me today that this bug impacts men more than women, I told him that women are just stronger than us.  At least mentally!  I know that certain syndromes such as fibromyalgia and chronic fatigue syndrome are known to cause brain fog, and I'm sure that I've felt something like this in the past, especially when I've been overtrained.  However, I didn't fully appreciate what this was like until yesterday.  I was feeling better in general, but my brain wasn't responding.  That's what brain fog feels like.

I have some projects that I've been working on.  There was no thought of working on anything yesterday.  When my wife and daughter were talking to me, I had trouble comprehending what they were talking about.  All I could do was watch television.  I don't really remember much of what I watched. I needed to be mindless, because I didn't have my mind.  I guess that's what brain fog feels like.  Fortunately, I'm doing better today, and can write an actual blog again, so as to keep up with my daily writing mission that I began in February.

It Sucks to get Sick

I had a great workout yesterday.  Managed a Strava PR on a 1.07 mile uphill stretch near my house, which was fun being that I set out to do that once we moved in April.  In fact, looking back, when we first moved in, my very first attempt was done in 12:38.  Of course, I wasn't trying to go hard or fast that day, and, in fact, waited until June to make my first attempt to setting a PR.  Two months later, there it was, my baseline, 9:25, with a all-out attack on the hill.  A month later I took the hill on and managed 9:08, tantalizingly close to the sub 9 minute goal that I'd tentatively set for myself.  After that, it was time to train for Kona, and there was no room for an all out assault on the climb.  Obviously, after Kona, I was in no shape to do that either, but for the last few weeks, I've been working on my speed.  Yesterday was the day.  I'd do my regular warm up and then attack the climb.  I had a strategy in mind, which was to start fast and hard, but not completely all out.  It was, of course going to be close to 9 minutes of effort, and going out too hard would trash me at the very end, which, by the way, is the steepest part of the climb.

That was the other strategy.  The climb starts out relatively flat, then with an incline, and then it flattens out again before hitting the steeper sections at the end.  By setting my Garmin watch to Lap Pace, I'd be able to glance down and see how I was doing.  I figured that I would start closer to 6 minute pace, on the flatter section, and that would go up to about 7 minute pace once I hit the first climbs.  I knew from past experience that I'd furiously want to stay below 8 minute pace for as long as possible, and that the final part of the climb would be the hardest.

I wore my heart rate monitor, in order to extract data that I could look back at.  I paid no attention to my heart rate during the run.  Within two minutes, my HR was at 151.  At three minutes, I'd popped up to 170.  For the next three minutes, I held my HR right there, my pace, on sections as steep as 5% initially remained under 9 minute pace, but started to drop on these sections.  The next two minutes embodied the steepest sections of the climb, going up to 9% grade.  My HR peaked at 175, and my pace on the steepest sections remained under 11 minute pace, and actually stayed relatively close to 10 minute pace.

I'm not exactly sure where this Strava segment ends, so I was planning on pushing until I couldn't.  It turns out that with about 35 seconds left, I switched over to walking, and my HR had actually dropped to 167 when I hit the end of the segment.  There was one major reason that I needed to stop.  It wasn't that my breathing couldn't handle it anymore.  It wasn't that my legs couldn't handle it anymore  It was that for the preceding 30 seconds I'd been extending a lot of effort to avoid crapping my running shorts (sorry to be so explicit).  Something had been triggered that was causing this feeling.  I held out for about 30 seconds before making the decision to start walking.  The feeling subsided.

What was my final time?  It was 8:56.  I broke that 9 minute threshold, averaging about 8:20 pace per mile.  The 1.07 mile segment has 200 feet of climbing, making the average grade about 4%. The steepest sections, which come at the end, of course, hit 9.4%.  Here was the coolest thing.  It's why I love Strava from a goal perspective.  From a forever perspective, the CR, or course record is 7:08.  My 8:56 time is 67th all time (of 417 people who've tackled the climb).  However, Strava also allows me to look at how my time fared this past year, of which we have one week to go.  On that, my time was the 10th fastest of the year (of 104 people).  The fastest time this year was 7:19.

I'm not sure what next year will bring, but I have something to shoot for.  Without my bodily function breakdown at the end, I might have gone as low as 8:45.  Somehow, in the back of my head, I want to work on my speed, especially my climbing speed, and my 10 minute speed endurance, and see if I can bring this time down to 8 minutes.  It's ambitious, but it would put me in the top 25 all time.

Oh yes, why does it suck to be sick?  I was going to do another speed session this morning.  Got my warm up in.  Within 3 steps of trying to run, my body told me no.  It turns out that I've finally got the GI bug that went through my family last week.  Fortunately, I've got very little in my stomach, because I don't eat much in the morning, and there's not too much in my colon, thanks to last week's colonoscopy.  So, I just feel crappy.  I'm laying in bed while I write this, hoping that this will be a typical 12 hour hit to my body and I'll feel better by late tonight, and certainly by tomorrow morning. Maybe it doesn't suck too much to be sick, if this is how it happens.  I also realize that the body aches that hit me last night and this morning weren't from yesterdays workout.  I'll always blame my workouts before I admit to being sick!

The Key to a Successful Economy

Republicans are touting the most successful economy in this country's history.  I recently blogged about how the economic metrics might not actually reflect the true nature of the economy.  However, let's assume that the economy is doing pretty well.  Is it Trump? Is it the Republicans? I have another suggestion.  It's the Democrats!  The fact of the matter is that the economy is doing well with divided government and gridlock.  Maybe that's the key to a successful economy!

I believe that the U.S. economy hates one thing. That one thing is uncertainty.  A divided and gridlocked government assures certainty.  Nothing happens. Nothing changes.  Yes, the present administration is reducing regulations.  Honestly, in the big scheme of things, with the amount of regulations that are in the books, I find it hard to believe that the regulatory changes are having a significant difference.  In fact, in the one industry that I'm most closely attuned to, the nursing home industry, the regulatory changes are a mixed bag.  I doubt that they'll have much of an impact on the economic well doing of the industry.

I have been hard pressed to see a direct correlation between the tax cuts that the Republicans rammed through and the economy.  Honestly, as it was intended, the wealthy got wealthier.  Except for some of the somewhat wealthy people in states like California and New York, who lost their state income tax deduction.  They didn't benefit.  Congress definitely targeted blue states with that one.  Overall, though, I really doubt that tax cuts have much of a long term impact on the economy, and history supports that.  On the other hand, as I've stated, the economy loves certainty.  And certainty has a new norm under president trump.  He's all over the place on a daily basis, but nothing gets done.  The market has factored in his tweets and policy machinations and has figured out that nothing is really changing, which the markets like.

My quandary in regards to the economy is whether I want to see the Democrats control all three branches of the legislature, the executive, senate and congress.  That actually hasn't turned out that well for either side throughout our history.  Maybe, if the Democrats win the presidency and the house, and the Republicans hold on to the Senate, maybe, just maybe, we can find a way to some degree of common ground and working together?  Maybe? Or, maybe not. Hope springs eternal, but either way, if we continue with divided government, the economy will probably continue on its present path.

Deplorables

I was never a Hillary Clinton fan.  While I think that she was the smarter of the Clintons, and I thought that she would have been a good President, I never liked the arrogance of the Clintons when it came to power.  I'm actually an equal opportunity political junkie.  I tell it like it is.  With that in mind, today I wanted to talk about the "deplorables." Hillary took a lot of flack for using that term to describe a group of people during her campaign.  While Clinton quickly apologized for putting the number of Trump supporters who were deplorable at half, one has to wonder what the actual number was/is.  If one uses the fact that 63 million Americans voted for Trump, then the number of deplorables would be around 31 million.  That would essentially represent 10% of the population. Is that possible?

Today, I had an experience that makes me wonder.  I took the initiative to try to share a balanced, objective opinion on the impeachment process in response to a friend's FB post.  The post was positive towards Trump, which I'm certainly ok with, and I decided to take the chance to reply in a very respectful manner.  While his response was very respectful, we caught some collateral damage from one of his FB friends.  This person responded with racist language aimed at President Obama.  Needless to say, I immediately blocked someone on FB for the first time in a long time.  I have no choice but to put this person in the deplorable category.  It made me think about how many people there are who are like this in the United States.

Looking at social media, it isn't hard to find people who are clearly racist and lack in any sort of social tolerance.  Do these people represent 10% of the U.S. population?  I don't know, but I don't find it hard to believe that might be pretty close.  This is a country that had segregation when I was born.  I'm sixty years old, so there are plenty of people in the United States who were supportive of segregation who are still alive today.  Not to mention neo-nazi's, skin heads, etc. I'd even have to list the former governor of Kentucky on this list, and I'm not so sure that their aren't Republicans who might agree with me.  Deplorables exist in the United States.  Hillary Clinton was being honest, and she was correct. It was, politically speaking,  a huge mistake. But it was true.  I continue to be concerned that the worst outcome emanating from Trump is that his behavior seems to empower the deplorables.  I stand by that opinion.

Just one word.

I pasted my last blog onto a social media post.  There's always a bit of a risk in doing something like that.  I haven't completely scrubbed my FB family to assure that I don't get into political discussion with people of different views.  FB is an interesting platform.  I use it primarily to keep up with my friends and family.  I have friends from my past life, I have friends from my triathlon and running lives.  I have friends from work.  We don't all see things the same way, but we tend to be civil with one another and we certainly care.  I find myself using the "heart" emoji more often than not.  I sometimes use the "sad" one.  I enjoy using the "happy" one!

Today's political environment lends itself to disagreement.  I have always prided myself on being able to talk to anyone of any political persuasion.  I often try to see things from all sides and when I write politically oriented commentary, I really try to keep it balanced.  What frustrates me is when people pick on one word or one sentence in an entire blog that has a different, and balanced conclusion.  I usually avoid getting in a back and forth with anyone, but I think that I understand why something like this triggers me.

I'll never forget the day the my boss, picked up a letter from another doctor, complaining about our geriatric clinic's wait time.  It was just one small complaint, surrounded by a lot of other good things. I held my own in response.  But I've encountered this behavior before, usually when dealing with bullies.  They pick one thing, one word, one action, and go after it like a dog going after a bone. They ignore the totality of everything else surrounding the one thing, so as to distract from the truth.

Anyway, I couldn't let this response go.  I replied, and replied, and replied again.  Hopefully, I'm done with the replies.  I generally ignore these types of things, but when someone picks on just one word, no, I won't let it go.

The Will of the People?

As I listened to Republicans argue against impeachment, I heard a common refrain, that the Democrats were disregarding the will of the people. What people? Don't these guys read the newspapers or watch television. Poll after poll after poll has shown that the majority of Americans are in favor of impeachment.  Why isn't that the will of the people?  The Republicans keep talking about how the voters matter.  What about the Democrats who the voters voted into office a year ago to give the Democrats a majority in the House?  Wait a minute!  I get it.  It's only the will of Republicans, or rather, the will of Donald Trump supporters!  The rest of us don't matter!  It's the same reason that Mitch Mcconnell wouldn't allow a Supreme Court appointment vote with a year to go before an election, because he wanted to allow the will of the voters, but has said that if there is a Supreme Court opening this coming year, he'll push a vote through. How's that for the will of the voters?

For those Republicans who say that the voters will respond to this next November, I say, bring it on!  I think that's wonderful.  Instead of complaining about an illegal impeachment, which in fact is perfectly legal, I think they should just stick to the opinion that the voters will cast their vote next November.  I agree that the people who voted for Trump, and who will vote for Trump, couldn't care less about the behavior that got him impeached.  I disagree with them.  But if Trump gets reelected, then clearly an electoral majority (not a popular majority, which I can not imagine happening) doesn't care about his behavior.  That's why we elect Presidents every four years.  It's why we elect Congressmen every 2 years and Senators every six.  If we're in a never-ending battle between the Executive branch and the Legislative branch, that too will be the will of  the people.  Get over it, I would say to Republicans and Democrats alike who don't like it.  It's the United States of America, and it is our constitution. Like it or not, what we're dealing with today is exactly the will of the people!

Political Courage

It's fascinating today to watch politicians respond to the impending impeachment vote.  The question arises as to who has the courage to actually vote their conviction. There are a lot of people who act as if the answer is obvious, apparently about 90% of the electorate seems fit this view.  Of course, 44% (those who would vote for Trump no matter what), and 46% (those who would vote against Trump no matter what), know what to do.  What about the remaining 10%?  Perhaps this vote will truly be a harbinger of the next election.

A New Jersey congressman has decided to switch parties, apparently over the impeachment process.  I respect his right to vote against impeachment.  I respect his right to switch parties, although I find the timing both curious and concerning.  Clearly, many of his key staff disagree with his decision, because they're quitting.  One can only wonder if this congressman has done the political calculus, and decided that changing parties is the best way to get reelected.  That's wrong.  At the very least, he could have taken the approach of Congressman Amash and become an independent.  I could understand that.  I'm not sure I have a political party that truly represents me today.

There are tens, if not dozens of democratic congressmen and women who are in Republican leaning districts who appear to be making the decision to vote for impeachment.  Is this toeing the party line? Or, is this the definition of political courage.  I lean towards the latter.  I appreciate the fact that there may be a few Democrats that vote against impeachment.  I don't think that lends credence to the fact that the Republicans are right and the Democrats are wrong.  I think it shows that the Democrats have truly not been strong-arming its members to vote for impeachment.  On the other hand, not a single Republican appears to even be considering voting for impeachment.  They have fallen in line, lock step, like a bunch of sheep, following a leader who has done nothing to earn my respect.  I can't and won't respect someone who disparages women, children, disabled people, and anyone who doesn't agree with him on a daily basis.

This whole impeachment process has fascinated me.  I haven't been pleased by some of the approaches taken by the Democrats.  At the same time, the Republicans have only obfuscated the entire time, which in my experience is what lawyers do when they don't have a case.  Impeachment is a political remedy.  Those who try to make it otherwise are disingenuous.  I understand that the people who voted for Trump actually want him to behave the way he's behaved.  I personally think that his behavior is bad for our country and that he consistently borders on violating the constitution.

Here's my bottom line.  I believe that the defection of a few Democrats against impeachment, and the votes for impeachment by many in swing districts demonstrates political courage.  Whereas, the Republicans all voting against impeachment demonstrates a party that is so stuck in partisanship that it supports a president who has stated that he could shoot someone on 5th avenue and get away with it.  This isn't a political party, it's a gang of thugs.

Following Your Passion

I'm really enjoying watching my older daughter follow her passions.  If you don't do the things that matter the most to you, what's life all about?  It's funny, but I often tell my daughter how much I learn from her.  Maybe that's the way it should be.  We learn from our children.  I suppose that if we raise them the right way, it will actually lead in that direction.

I'd like to feel that I've followed my passions for most of my life.  I hope that if there's one thing that has defined me, that would be it.  As I look toward the future, I need to remind myself of this fact.  I made a comment to my wife the other day that when it came to the textbook that I'm editing, I don't consider that task to be work.  In fact, I don't want to work anymore, nor should I.  I don't need to work, which is fortunate to begin with.  However, I want to do the things that have meaning to me.  If I actually do that, I won't ever work again.

There is the real focus.  If I'm doing the things that I'm passionate about, that I care about, I'll never work another day in my life.  That's a great sentiment, and I probably need to break some old habits in order to follow that path. For starters, I need to look at the tasks at hand through a lens that allows me to determine if I'm doing a task not whether I want to or need to, but because I'm passionate about doing it.

I watched my daughter provide the tech support for an improv show.  I could see in her eyes how engaged she was and how much joy she had in figuring out what to do.  After all, it's really art.  Its creativity.  That's what we all strive for in life, whether or not we're actually artists, or whether or not we're actually creative.  She's able to do it from behind a computer or on the stage, where her skills doing improv are continually growing.  She's always done it with her writing, which is the one place that she's always been able to demonstrate both her creativity and talent.  I actually realized why she has never wanted to look at writing as work, the same way that I don't want to look at projects that I'm doing as work.  I want to feel my passion, and I want to follow my passion.  Just like my daughter.

Why Do We Procrastinate?

Procrastination is a common human trait.  Why do we do it?  I can only ask myself why I procrastinate in order to try to answer this question.  It's somewhat ironic.  I'm a workaholic.  I don't know how not to work.  Yet, I often put off a project until the last minute, but eventually get it done on time.  The only problem is a project without a deadline.  It's easier to procrastinate when you don't have a deadline.  This type of procrastination can lead to never finishing such a project.

Somehow, over my lifetime, I've made a habit of putting things off until their deadlines.  I've also made a habit of getting those things done.  Suddenly, I'm living a less structured life without many deadlines.  Procrastination becomes a more significant problem under these circumstances.  Hence, why it's time for me to understand my propensity to procrastinate.

I know that there are times that I procrastinate out of some type of innate fear of failure.  Yes, it sounds crazy, but I know it to be true.  Either I'm not sure how I'll do with something, so I put it off until I reach a point in time where I have to get it done anyway.  Then, I get it done.  It really doesn't make a lot of sense, but making sense isn't the issue.

Over my lifetime, the world has evolved from one where there were delays in communication.  One sent a letter.  One left a message with someone.  One left a message on an answering machine (which didn't really start until the 1980's).  The advent of emails changed the timing of communications.  Today, we carry our phones with us.  We struggle with the immediacy of answering calls, emails or texts.  Do we answer them immediately, hence, keeping up with our messages in a timely fashion?  Do we wait, whereupon new messages come in and the old messages start piling up?  This begins a new procrastination process.

How we fit projects into this further complicates the situation.  Our opportunity to procrastinate increases with the complexity of our lives.  Perhaps finding ways to simplify our lives would help.  I've often wondered what it would be life to go off the grid, so to speak.  There is something appealing about getting away from the morass of communications and information that hit us daily.  Something to think about.

Work and Life Balance

The natural follow up to yesterdays blog is to talk about how to balance work and life.  For me, it's actually a little simpler.  I don't have to work.  I'm quite fortunate in this regard, although in many ways I do have to work.  Having purpose is one of the most important things in our lives.  Yes, being a grandpa, husband and dad are all purposes.  But what about the remaining hours in the day?  I know myself pretty well, and those remaining hours also need to be purposeful.  Hence, the topic of work and life balance.

One of the things that I've learned, perhaps finally, after three attempts at retirement, is the importance of having some type of schedule.  When you're working, you have a schedule.  When you're retired, you take your day as it comes.  For me, that's not the best thing.  I do better with a schedule.  I've continue to struggle with actually scheduling my days, but I think that it's time to attempt to do that.

The fact of the matter is that being a grandpa, a husband, and a dad are my greatest priorities.  That means that I need to schedule my other activities in a way that allows me some degree of flexibility for my most important priorities.  That's how I'll more effectively approach achieving that balance in work and life.

Who Am I?

We had an interesting exercise in the faculty development session at UCLA today.  It was about our identity and what we identified most with.  There were about twenty items on the list, including race, ethnicity, religion, marital status, political affiliation, gender, sexual orientation, etc.  We started by eliminating seven of the items, and then three more, before picking the one item that defined us the most.  The decision on that one item was never in doubt.  Being a grandpa.  If I have to pick one thing these days that defines me, that's the one I would pick.  Being a husband is next.  My wife understands.  I'm pretty sure that she would pick being a grandma first as well.  Ever since my grandson was born, it's been clear to me what my job is.  To have his back.  I made that promise to him on the day he was born, and I will adhere to that promise as long as I'm on this earth.  In only four years, I know why I made that promise.  I feel it every time he says he loves me or that I'm his best friend.  I feel it when he's not around.  There is truly something unconditionally special about a grandchild, and I love that feeling.

It is interesting that he was born shortly after I had gone back to work.  During his four years of life, I've been in a few different work related positions, each of which took up varying amounts of my time.  I am, after all, a workaholic.  How did I balance that?  What was the importance of my work life during this time?  Where does that life fit in now?  One thing I know for sure, is that as he gets older and more communicative, having time to spend with him and enjoy being a grandpa is rapidly growing in importance.

Being a husband and a best friend to the person who has been with me for the past thirty seven years is certainly a close second.  As I will allude to next, married life is complex, balancing work, children, hobbies all at the same time.  But, I know one thing.  Without my best friend and companion, I would be lost.  I know that.  If there's one truth that I have always understood deep into my core, that is the truth.

My work life has defined me for the last thirty six years.  How can it not? Working 100 hours a week as an intern doesn't leave time for much else.  I've never been a 40 hour a week employee.  I certainly wasn't ever a 40 hour a week executive or business owner.  The reasons are and always have been complex.  A desire to make a difference, feeling a responsibility to work hard, a need to provide for my family, being driven to help others, in particular older adults, who have always been important to me.  All of these things have defined me for many years, they have been my identity.  For the first ten months of this year I converted that identity to one of being an Ironman.  I enjoyed that journey, but have decided that it was just one journey in my life.  As I blogged yesterday, I am on to new journeys.  I don't expect these journeys to be nearly as consuming as the Ironman journey was.  I don't want them to be.  I want to be a grandpa. I want to be a husband and best friend.  I want to be a dad.  All of those things feel right.  They are who I am.

My New Journey(s)

Someone asked me today what I wanted to be doing with my life.  The question brought out lots of emotions and ideas.  I've been thinking about this back and forth for some time.  I know that I want to have fun.  I know that I want to help older adults.  I know that I want to utilize my brain and think.  I'm a thinker.  I love project development.  I also love to share my passion and inspire others about doing things that make a difference.  How can I put all of these things together?

After completing my journey to Kona, I've recalibrated my exercise goals.  It is my intent to see how fast I can run a 5K next year.  I have begun that journey in the last couple of weeks.  My two staple weekly workouts that relate to this goal right now are sets of 40m flying sprints and 100m uphill sprints.  My fastest pace for the 40m flying sprints is presently around 4:20 pace.  My fastest pace for the 100m uphill sprint is presently around 5:50 pace, which actually translates to about 4:20 pace on flat ground.

My coach tells me that in a few weeks, I can do a 200m sprint in order to set my pacing goals more accurately.  I'm looking forward to doing that.  I love having goals.  I'm excited to get a measure on where I'm starting, so I can aim for some specific goals in the coming year.  I have a pretty good sense of my starting point based on my recent 5K.  Now that I'm doing some speed work, it's interesting to correlate that.  It will also be interesting to see what kind of progress I can make with the shorter distance (40-100m) speed and how that will translate to my 5K speed.

I enjoy seeing what the human body can do.  I especially enjoy seeing what I can do at the age of 60, because that's part of my personal goal of advocating for the health and well being of older adults, of which I'm soon, if not already one.

Being Oneself When Having Power

It struck me today that while I was reflecting yesterday on the challenge of speaking truth to power and money, that I've been on the other side of the equation. I've been the owner of a company.  I've been the President of a company.  I've been the CEO of a company.  How did people around me react?  How was I perceived?  What have I learned over the years?

The first thing that I thought of was a nickname.  There was a time, over two decades ago, when I was President of a geriatric physician practice management company, when one of my employees shared with me that I had been known as "The Hurricane."  Now, the reason was pretty clear.  I would literally blow in and out of the office, that's how busy I was.  I didn't really take the time to look in the mirror and see what it looked like.  I also came to discover that I was very intimidating to my employees.  So, the very attributes that I discussed in my blog yesterday were probably impacting the people who worked for me.  Kind of blows ones mind, doesn't it?

On the other hand, I heard the feedback, and over the years, factored it into my leadership and management style.  I've learned to be more cognizant of my own persona.  I used to joke that I didn't see what others saw when I looked in the mirror, but upon further reflection (pun intended), I realized that I wasn't looking hard enough.  If I was focused or busy, I might come across in a more intimidating manner, especially when I factored in my position of authority.  That's part of the key to this.  Recognizing that the position of power is part of the power itself, whether I realized or saw it myself didn't really matter.

I ultimately realized the importance of actually being myself when I was in a position of power.  There's obviously a balance that must be achieved, but I know who I am.  I also know the importance of effective teamwork.  Achieving that teamwork requires effective communication between a leader and their people.  I've always encouraged those working for me to tell me what I need to know, not what I want to hear.  It comes with the territory.  Otherwise, you'll only be a team of one.

Being Oneself in the Face of Power and Money

I was listening to a talk show today with a host who clearly doesn't easily fit the conservative or liberal label.  My kind of guy!  He made an interesting comment regarding the present Attorney General and his prosecutor, Durham.  He said that he supported both of them in being in the positions that they're in.  He also said that he was surprised and disappointed by their actions regarding the IG report.  A caller didn't understand why he wouldn't just take their side, because in todays day and age that's what is expected.  You support people in your political party regardless of whether they're right or wrong.  The talk show host couldn't understand why Barr and Durham seem to be different people than the ones he supported to be in their jobs.  I think that I understand.  Why? Because, in some ways, I've been there.

I can look back over my life and career and think of situations where I was face to face with someone with power or money.  In that situation, you're not yourself.  I recall specific instances early in my career when I know I didn't say what I should have, or what I said was influenced by whom I was speaking to.  It's ironic, because I pride myself on my willingness to speak truth to power, which I've also done many times in my life and career.  Still, I have to acknowledge that I'm human.  Sometimes, I've adjusted what I might have said.  Other times, I just haven't said anything.  I don't believe that I've ever lied.  At the same time, I've allowed myself to believe things based on the influence of my surroundings.  I think that's pretty normal.

If one is in a job that they like, or even more importantly, that they need, how easy is it to be influenced by ones surroundings?  As human beings, we're all pretty good at rationalizing things when we need to.  Again, I am not unique in this, nor is anyone else.  Which brings me back to the topic at hand.  Barr and Durham are presumably good people, trying to do good things in their job.  Like many others before them, they assume that they can do good in a chaotic environment.  What they don't realize is what that environment is truly about.  When you have people like Rex Tillerson and John Kelly, no slouches in their own right, run headlong into the world of Donald Trump and ultimately fail, you've got to ask yourself a question.

I believe that the question comes down to how Trump influences those around him.  It is 100% clear to me that Donald Trump has an obsession with being right.  If someone disagrees with him, that is immediate cause for him to lash out at them.  Today was a primary example.  His FBI chief said some things about the IG report that Trump didn't like.  He immediately tweeted some very negative things about a person that he personally placed in that position.  I would ask my Trump supporting friends if they can site a single instance where Trump is supportive of opinions that are not lock step with his own?  In fact, Trump goes out of his way to bash anyone who disagrees with him.  That's one thing that twitter has allowed us to see.  Furthermore, I would argue that he also has little to no impulse control, and therefore doesn't take the time to process information in a way that would allow him to look at all sides and ponder the consequences.

This leaves us with a President who has enormous influence over the people around him, who abhors and lashes out at anyone who disagrees with him.  What type of environment does that create? Sounds like a monarchy to me.

Hills, Strength and Speed

Yesterday I did my first set of hill repeats.  I'm enjoying doing warm ups that aren't just about running.  Doing some pushups, squats and lunges get my blood flowing and my body prepared to run.  I then jog half a mile before starting my sprint intervals.  Hill intervals are a little different than sprinting on flat ground.  Since you can't go as fast, you also can't stress the muscles and tendons as much. It's till hard, trust me on that, which has some added benefit.  

My first set of hill repeats consisted of running uphill on ~3% grade for 100m.  The first one was done at a 7:30/mile pace, and the subsequent ones were at 7:00, 6:30 and 6:10 pace.  I gradually increased so as not to stress my body too much.  After four of these, I was done.  I walked down the hill as my rest interval.

Tomorrow, I'll do my second workout doing 40m all-out sprints.  I'm curious to see how it goes this week.  I'll follow it up later this week with more hill intervals.  Over time, I'll increase the number of these.  At the same time, I'm paying close attention to my body. I've managed to cause myself problems in the past with overzealous attempts at improving my speed, and I'm not about to repeat that mistake.  

Hill repeats improve strength, but they also help with speed.  They're one of my favorite workouts.  At some point, I'll go back to doing some fast downhill efforts as well.  I've done a fair amount of that in the past few years and there's no question but that they've made me stronger and more durable.  I'm intrigued by the thought of preparing myself for the half marathon in St. George next November.  Last year, on minimal training, I managed a decent time, which included a pretty fast 5 and 10K during that race.  Imagine what I might do with adequate training?  But, first things first.

Capitalism, Government and Taxes

I read an interesting article yesterday about Finland.  The bottom line was that capitalism has thrived in Finland while not only accepting the role of government, but investing in society through the government.  Universal health care, subsidized day care, paid parental leave, excellent schools and tuition free colleges.  The Finnish people have accepted higher taxes in order to provide for all of these things that ultimately strengthen their society and provide a healthier, well educated workforce. When we look back at the history of the United States, what do we find when it comes to the impact of higher taxes?  The average tax rate on the top 0.1% was over 50% in the 1950's.  The highest marginal tax rate was 91%! The corporate tax rate was 50%.  Wait!  This was the 1950's, one of the greatest economic periods in the history of the United States.  Father Knows Best, Happy Days, the advent of rock & roll.  The 1950's is the time period most often looked back upon with nostalgia.   It was a time of economic growth and expansion.  What's up with this?

Numbers don't lie.  Data tells the truth.  The myth that higher taxes are bad seems to be just that, a myth.  Granted, if the money that government takes in is ineffectively utilized, the people have a right to complain.  I've got no problem with reining in waste.  On the other hand, we also need to look at the impact of government effectively investing in people and our society.  Isn't that what the New Deal was?  Isn't that what the government's investment in the space program was?  Isn't that why government should invest in infrastructure?

Governmental regulations should be for the protection and benefit of the people.  Isn't that what a government by the people, for the people, should be all about?  Can regulations go too far? Sure it can, but nothing is perfect.  Would we want to have nuclear power plants completely unregulated?  Of course not.  Theodore Roosevelt is known for regulations that ultimately reduced the existence of sweat shops.

It strikes me that a lot of complaints about government and regulations are disingenuous.  Just as complaints about the Federal Deficit and high taxes have been.  At the same time, those who put down capitalism may not actually know what they're talking about.  Capitalism itself is not the problem.  Just look at Finland.

Is it the Economy, Stupid?

There has long been a political adage that the only thing that matters in a Presidential election is the economy.  If the economy is going well, the people will vote to maintain the status quo, because at the end of the day, the economy is all that matters to people.  There's a lot of truth to this concept, as there should be.  At the end of the day, what do most of us care about? Our own lives.  The question then should be, how do we measure the economy?  What metrics truly represent whether the average person is happy with their economic situation?  Unemployment rates have long been a staple measure of the strength of our economy.  Inflation, or rather, a lack of inflation, has been another measure.

Here we are, in the longest economic expansion, from a jobs perspective, in the history of the country. Lest we forget, this economy began under President Obama.  It has continued under President Trump.  Are both of them responsible? Are neither of them responsible?  One might argue that a common theme for the past ten years has been gridlock in Washington.  There was greater regulation under Obama, and less regulation under Trump.  Most of the economic indicators that Trump touts began an upward climb during President Obama's tenure.  Under President Obama, what were Republicans most concerned about? The Federal Deficit.  What was Trump most concerned about? The Trade Deficit.  Ironically, these are the only major economic indicators that have gotten worse under Trump.  Go figure.

What about the stock market?  Trump and his supporters often tout the fact that the stock market is at an all time high.  I'm not sure what this represents since I consider the stock market akin to gambling for the average person. The average American is not getting major benefit from the stock market.  Which begs the real question.  What does the average American feel about the economy?  I often think about what the average person thinks about their life.  One of my favorite pastimes is to ask taxi (or Uber) drivers who come from foreign countries what they think about the United States.  It still appears to me that most people in the world would rather live in the United States if given the opportunity.  Which actually brings us to the immigration question.  If our unemployment rate is at an all-time low, why shouldn't we want to supplement our workforce with immigrants?

What about consumer confidence?  The University of Michigan Consumer Sentiment index peaked during the Clinton Presidency, bottomed out during the Great Recession, only to finally come back to George W. Bush levels towards the end of the Obama Presidency, and it's pretty much held steady since.  Consumer Sentiment has clearly been comfortable with the Trump Presidency.  They were also comfortable with the Obama Presidency.  Fascinating.  Of course, Consumer Sentiment was fine during the George W. Bush years, until the bottom dropped out.  Which begs the question regarding the Federal and Trade Deficits.  Do those measures matter?  Does gridlock matter?  Does unemployment matter?  Does the stock market matter?  Does deregulation matter?  Does it matter who is in the White House?

Why don't the Democrats talk more about the economic boom of the Clinton Presidency?  It was the last time that the Federal government ran a surplus.  Consumer Sentiment hit an all time high.  Yet, the Republicans impeached the President overseeing this economic boon because he supposedly lied about having sex with a White House intern.  Is it the economy, stupid?

360 Degree Training Change

For the past decade, my run workouts were focused on how long I could run.  Speed was an afterthought.  Yesterday, that changed.  My run workout yesterday, while it did include a half mile warm up jog, was essentially four 50m sprints.  What a difference!  Ironically, as I look up the impact of such workouts, I'm finding that there are distinct metabolic and physiological benefits to short, hard running workouts.  Of course, my goal is to run my fastest 5K in years.  You can't run 5K fast if you can't run a fast mile or 400m, and so on and so forth down the line.

My workout yesterday started with a warm up.  My warm up consisted of 20 push ups, 20 air squats, 20 hip raises, 20 lunges and a wall sit.  I then went ahead and jogged a half a mile and followed that with some short bounds, high knees and butt kicks.  My first two 50m sprints weren't truly sprints, as I wanted to warm up into this new approach.  They were just fast flying 50's.  My first one was done at ~6:30/mile pace, close to how I started my 10K last weekend.  A few minutes of walking and I did my next one at ~6:00/mile pace.  A few more minutes of walking and it was time to do my main set, which was only going to be two sprints.

For these sprints, I start out with about 20m of gradually getting up to speed and then fly into the 50m as fast as I can go, not thinking about my form, but also trying not to be too crazy or violent with my running form.  Think smooth, but fast and hard.  Bingo!  My first 50m effort was done in just under 10", and my garmin says that my pace was 4:54/mile.  Sounds about right.  I'm not sure I've been at this speed for any distance in quite some time.  I then took 6 minutes to recovery, just walking comfortably, before doing my second sprint.  This one was slightly faster, and the pace shown was 4:51/mile.  Of note, as I hit my last stride, I did feel a little tightness in my right "glute," which may in fact, have been my right hamstring insertion.  This is a spot that I triggered a couple of years ago when I tried to do something similar.

I had already decided to only do two full out sprints, so I was done.  If I'd meant to do more, I would have been done.  I must pay close attention to my body so as not to injure myself in this new process. Fortunately, as the day went on, the tightness in the right side of my butt gradually dissipated.  I'll be good to do this again next week.  Coming up before that will be short, fast, 100m hill repeats.  Hills sprints are another great way to build speed and strength.

My run volume for a week of this type of training will generally not exceed 10 miles of running.  In fact, it may be much less, depending on what I choose to do in a week and whether I do much in the way of running for a warm up.  This is going to be an interesting new journey!

The Impeachment Reality

Yesterday I wrote about why Congress shouldn't impeach Trump. Today, I'll write about why they should. On July 25th, the President had a conversation with Ukrainian President Zelensky. I'm going to quote directly from the White House transcript (obtained from the White House website):  "Germany does almost nothing for you.  All they do is talk and I think it's something that you should really ask them about.  When I was speaking to Angela Merkel she talks Ukraine, but she doesn't do anything."  While this is not an impeachable offense, I find it incredibly distasteful that the Trump is casting aspersions about an important ally to another head of state.  This goes against everything that we should stand for as a country.  

"I would like you to do us a favor though because our country has been through a lot and Ukraine knows a lot about it. I would like you to find out what happened with this whole situation with Ukraine, they say Crowdstrike... I guess you have one of your wealthy people... The server, they say Ukraine has it."  Again, why Trump is wasting his time asking a foreign country to investigate an American company based on rumors is just unprofessional, again, not impeachable.

"The former ambassador from the United States, the woman, was bad news and the people she was dealing with in the Ukraine were bad news so I just want to let you know that."  Again, questioning our own diplomat with a foreign country is unprofessional.  Also, not impeachable.

"The other thing, There's a lot of talk about Biden's son, that Biden stopped the prosecution and a lot of people want to find out about that so whatever you can do with the Attorney General would be great. Biden went around bragging that he stopped the prosecution so if you can look into it... It sounds horrible to me."  This is where things get interesting.  Trump is clearly targeting a political opponent and asking a foreign government to investigate him.  This does get into potentially impeachable conduct.  The President of the United States should not be asking a foreign government to investigate a political opponent.  It's wrong on many levels.  

As some of the other witnesses ultimately testified, it definitely appears that the President asked the Ukrainian leader to announce an investigation into the Biden's.  It also appears that he made military aid dependent on this announcement.  

Here's the deal.  If this were a one off, and Trump acknowledged that he had overstepped his bounds, I agree that this might not rise to the level of impeachment.  However, this behavior is quite consistent with a pattern that Trump has.  Furthermore, Trump clearly believes that he is above the law (his 5th Avenue shooting remark is only one of many statements that reflect this).  

The Democrats are well within their rights to impeach Trump.  The Republicans are well within their rights to believe that he shouldn't be impeached and the Senate will make the ultimate determination on whether to convict or not.  The American people will ultimately be the judges during the next election.  That is what American is all about.

Impeachment Hearing Musings

It struck me today that people who voted for Donald Trump, or most of those that support him today, believe that he hasn't done anything impeachable.  Even the Republican's legal scholar in todays hearings doesn't like Trump, but somehow buys into the fact that Trump is just, well, Trump.  That's the problem.  One of the law professors today made an inappropriate joke that involved Trumps son.  She ultimately apologized.  Those on the right will skewer her for her joke.  Those on the left will ask her to apologize, not wanting to seem insensitive!  There is a definite double standard surrounding Donald Trump.  He can say inappropriate things.  He can do inappropriate things.  No one takes him seriously.  That is, none of his supporters take these things seriously.  Anyone else who would say these things or act this way, well that's another story.  But Trump gets to be Trump.  Maybe that's where the Republicans are right.  Forget about impeachment, we have an election in 11 months.  Let the voters decide.  They decided 3 years ago, and this is the guy we have.  We have an electoral college system that Democrats don't like at the present moment, and Trump will never have a majority of Americans vote for him for President, but may very well win again.  That's the will of the American electoral system, its voters and our election process.

Is Trump trying to influence the next election?  Absolutely!  Again, his supporters think that's ok.  They think that he knows how to fight other politicians better than anyone ever has before him.  By being more corrupt and more despicable than all of them combined (in my opinion, sorry for the transgression).  But there are a lot of angry voters who are mad as hell and don't want to take business as usual anymore.  Trump is their answer to that.  And not only don't they care how he gets it done, they'll support anything that he does.

In many ways, I have to wonder if this is just what our political process has become, and whether this is the beginning of the end of extreme partisan politics.  I hope so.  Unfortunately, it always hurts when you rip off the bandaid.  Laying bare the lowest elements of our political system may be the greatest challenge to face our country.  Enough voters agree with, or will put up with, Donald Trump to have allowed him to become President.  They certainly disagree with impeachment and will feel like the rest of America is taking away their decision as voters.

I can't believe it, but I just made a case for the Democrats not to vote to impeach Trump.  Perhaps they need to go out and get a dozen Trump supporters and have them testify.  Maybe only then will they realize that impeachment is against the will of those who voted Trump into office.  This is the behavior they voted for.  It sounds screwy to say that, but it's clearly true.  Are we supposed to impeach 40% of the electorate?  That can't have a positive outcome.

I think that the Democrats need to rethink their approach.  Why not censure Trump for what he did?  Unfortunately, in todays partisan political world, that won't get a single Republican vote.  But maybe?

A Completely Different Training Approach

I got my marching orders today from my coach.  In reality, I chose them, but he started explaining what I have laying ahead of me.  Wow! What a difference from Ironman training!  The fact that I want to focus on my 5K and 10K times is essentially the polar opposite of long distance endurance training.  Which makes sense.  It also makes sense for me at this point in my life.  I have set some goals, but, in fact, I have no idea how this will turn out.  What I do know is that I want to be healthy.  I have a longstanding tendency to overdo things that I get into.  In life and work, this has its advantages, but in physical training, all it really does is set me up for injury.  That is not what I want to do.

My three main run workouts every week are as follows:  First, a workout with short (initially 10 seconds, ultimately working up to ~40 seconds) essentially all-out sprints, followed by full recovery, which means several minutes!  Initially, I'll only do two of these.  That's pretty much the complete opposite of running for 3 hours.  Of course, I'll be warming up and cooling down.  My second workout is more normal.  It's a 6-7 mile run where I warm up for 3 miles and run fairly hard for 3 miles.  Finally, hill repeats, running fast uphill for up to 100 meters.  That's it!

My goal is to work on my top end speed, without which, there can be no fast 5K time.  It makes sense.  Obviously, this is only the beginning of the process.  However, even the latter parts of my training this coming year will not include lots of slow running volume, which is completely different from what I'll be doing.  I'm excited to see what my body can learn at the age of 60.  I'm reminded of someone I met 25 years ago who ran his first sub-3 hour marathon at the age of 60.  Now, I'm not thinking about my marathon times, that would have me going in the other direction!

Kona Reprise

I watched NBC's coverage of the Ironman World Championship in Kona today.  I have to admit various emotions. First, I'm reminded how special Kona is, and how much Ironman means to me.  Watching the professional race, as well as the age group athletes compete on the Ironman world's greatest stage, brought back a lot of memories.  First, there's no question but that the swim conditions were more challenging than normal.  Watching the swells at the start of the race on television made me realize how much movement there was in the water, and how I really didn't pay attention to it an just focused on my swim.  While it would have been nice to feel better on this special day, I will always be proud of how much I ignored how I felt, lived in the moment and appreciated every moment of the day.  I was also reminded of the fact that I actually swam in a group for half of the swim, which was truly in the spirit of Kona.  Watching the professionals weaving on the bike course was a reminder of the ferocious winds that we had to deal with.  I ran the first 12 miles of the run in sunlight, before completing the run in the dark, so it was nice watching the professionals race while the sun was still out.

While watching Kona gave me some feelings about doing an Ironman again, I also feel ready to get away from the Ironman grind.  I've enjoyed the 5K and 10K races that I've done in the past few days. I've enjoyed not having to bike and swim.  I'm not doing La Quinta in one week, and I won't be doing Oceanside in April, choosing today to participate in the Ragnar Relay with my favorite team!  I want to have fun.  I imagine that I might have some urges to get back in the Ironman game over time.  It's kind of hard to get away from this addictive sport.  But I can replace those feelings with the endorphins I get from running.

Kona will always have great meaning to me.  It was a lifetime achievement, of which I'll always be proud.  But the Ironman life also takes a significant toll.  Focusing on shorter run distances will be good for me both mentally and physiologically. And, it give me something to focus on this coming year!

2020 5K and 10K Goals

Today, just three days after running a 5K, I ran a 10K.  I wrote about my race plan yesterday, and I tried to execute it today.  My 2.5 mile warm up went perfectly, with the first mile starting off at over 10 minute per mile pace, but by the time I finished, had comfortably run the mile in 9:12. I picked up the pace and effort gradually over the second mile and finished it in 8:12, and I felt good. I threw in a couple of short strides at about 6:30 pace.  I then got in one last restroom break and got to the start line with several minutes to spare.  I went out the front with a 65 year old guy who proceeding to gap me pretty quickly.  Of note, he won the 10K, with a time of 42:30.

The first two miles of the race were relatively flat, and I went out a little too fast, but throttled it down and backed off until I hit the first mile marker in 7:31.  I backed off during the second mile, and my breathing was still around every fourth step, though my legs were already fighting me a bit.  I hit the second mile in 7:58.  At this point, I figured that I'd modulated my effort enough and tried to maintain as best I could that I could keep close to my goal pace.  The third mile was slightly uphill and it was definitely tougher, but I resisted the temptation to back off.  I maintained a hard breathing effort of around every 3rd step to every 4th step and finished the third mile in 8:28.  During the next mile, I hit the turnaround and was hoping topic up my pace on the slight downhill sections that followed. Mile 4 came to 8:18 despite my effort to go faster.  My hamstrings were feeling tight an my legs weren't very cooperative at this point.  Still, I kept pushing, and my breathing for the next mile was every 3rd step, when I hit the end of Mile 5, I'd managed an 8:11 mile.  I believe that I was pushing as hard as I could.  I continued to push the last mile, breathing every 3rd step, but my legs really wouldn't cooperate and I only managed 8:32 for mile 6, despite it being slightly downhill.  The proof in the pudding was the final two tenths of a mile, where I couldn't go much faster than 8 minute per mile pace, despite giving it everything that I had.  I crossed the finish line in 50:53, about a minute slower than I'd expected, and two minutes slower than the Daniel's race calculator would have predicted from my 5K, but considering that I'd done this 10K just 3 days later, I'm good with.

So, what are my goals for 2020.  I'm a goal oriented person, and while I won't completely hold myself to these goals, I'd like to have a target this coming year.  I'd like to get my 5K time below 22 minutes, and as close to 21 minutes as humanly possible (if it is possible).  The 10K should follow naturally, as I have a considerable endurance base with which to realistically base my 10K time off of my 5K time.  A 21:50 5K would translate to a 45:16 10K.  Those are my goals.  It also translates to a 6:25 mile.   I have my starting point, now it's time to work with my coach to make these happen!

On a fun note, in an albeit small group of 12 men today, I was 3rd overall amongst the men.  The 60 year olds ruled, with a 65 year old finishing first and me finishing 3rd.  It's always fun to come home with overall and age group medals, no matter how many people are in the race!

10K Goal

Two days ago I did a 5K.  I'm pretty happy with my time, considering I really haven't trained at all for running a 5K in many years.  Just 3 days later, I'll be doing a 10K.  Why? I'm feeling good, and I want to see where my 10K pace is.  My fitness is still pretty solid as I recover from Kona.  It's been seven weeks, and I've had my ups and downs.  On Thursday, I didn't really set any time goals, and I never looked at my pace during the race.  Tomorrow, I'll change that up.  I'll set some pace goals and try to focus on holding them.  How do I set these pacing goals?  A few months ago I did a half marathon on the same course as the 10K.  That day, in the midst of Ironman training, I actually ran seven miles before the half marathon as my "warm-up."  I actually did a 10K at ~8:40 pace in the middle of what was to be a 20 mile run.  That tells me that I can do a 10K at a faster pace than that.  The first two miles of my 5K were at 7:17 and 7:35 pace.  I certainly don't want to go out that fast at the beginning of a 10K.  So, what will I do?

First thing to think about is the warm-up.  Warm ups are an absolute necessity for a running race, otherwise you start the race "cold."  Since it will be cold out, warming up will be even more important.  The 10K starts at 8:15 am, so I'll need to get there around 7:30 am if I'm planning to do a 3 mile warm up, which is the most appropriate amount of warming up.  That gives me time to do the first mile really slow, the second mile comfortably, and the third mile with some short fast efforts thrown in to get my lactate system engaged.  That also means I need to leave my house by 7:15 am.  First part of planning done.

After the warm up, it's actually a matter of trying to minimize the time between warming up and starting the race.  That shouldn't be too hard to figure out once I get there.  The course is relatively flat, though it's very slightly uphill for the first half, and then slightly downhill for the second half.  That really shouldn't impact my pacing, in fact, it might help me a bit since the last few miles will be slightly downhill.  Runner's World has a race predictor.  Based on my 5K time three days ago, my 10K pace should be 7:55.  If I'm actually capable, which I think I am, of having run 23:00 for my 5K on a flatter course, my predicted pace would be 7:43.  That appeals to me, because my goal time would be 48:00.  On the other hand, just to be safe, I can start the first couple of miles slightly slower and see how I feel.  There I have it.  I can start the first couple of miles at 7:50 pace, and see how I feel.  If I feel good, I can pick up my pace and keep it closer to 7:45 for the next few miles.  The last mile is always a "guts only" mile anyway.  Whatever I have left, it will be what it is.  I'll be quite happy with a 10K under 50 minutes, but would love to get close to that 48 minute mark.  We'll see what happens!

Motivation

I woke up today thinking about what motivates me.  It's actually pretty simple.  I've always been motivated by the desire to help people. This goes back as far as I can remember.  As I got older, I "narrowed" this desire somewhat in terms of wanting to help older adults live better lives.  I often relate that to the close relationship I had with my grandparents and the fact that I've always had an affinity for older adults.  As a child, I'd hang out with the older adults at family get togethers.  Once I was on the path to becoming a physician, geriatrics was the natural course, despite my initial thought that I'd want to be a pediatrician.  Everything that I've ever done in my work life, and honestly, even in my personal life away from work, has been driven by my desire to help older adults.  That is my primary motivation.

There have been times and circumstances in my life where others have questioned my actions.  Recently, I've encountered a situation that may cause some to pause and ask why I am doing what I'm doing.  My response will be the same, consider who I am and what motivates me.  I've always lived by that credo, and will continue to do so. We all make decisions on a daily basis.  I like to tell people that being a geriatrician, I've never made a clinical decision where I had 100% certainty about the outcome.  I think that's pretty much the norm in or lives.  Rarely do we make decisions where we are 100% certain about the outcome.  There are always mitigating factors, complications, and complex dynamics involved in making decisions and finding our path.  Under these circumstances, I know one thing, and that's my moral compass and what motivates me.

I have never shied away from taking on highly complex projects.  Being a geriatrician, that almost goes without saying.  When I started my primary care geriatrics practice, many people told me I was crazy.  'You can't make money doing primary care geriatrics.'  When I became the CEO overseeing a nursing home chain with a very complex history, some people questioned why I wanted to do that.  In both cases, the answer was actually quite simple.  I wanted to make a difference in the lives of older adults.  That has always been my prime motivation.  It's easy to question anyones decisions, especially without all of the facts. Unfortunately, none of us ever have all of the facts.  We are left to make decisions on the best available evidence.  But we also make our decisions based on what motivates us.  For me, that motivation has always been clear.  It should be clear to others as well.

Turkey Trot 5K and 5K Memories

Twenty eight years ago I ran my first 5K.  It was in Canoga Park, I don't remember the exact date, and I don't remember my exact time.  It was 24 minutes and change.  The documentation of this race is long gone.  What I do remember is going out too fast and dying during the second mile, getting enough energy back to finish relatively strongly at the end.  I was hooked.  I've done countless 5K's since then.  In many ways, the 5K is my favorite distance.  You get up in the morning, put on your shorts and running shoes, maybe do a 3 mile warm up run on the course, race, and head home.  If I want, like this morning, I'm back in bed as I write this blog and may even take a nap!  And I still have the day ahead of me.  This is very different from an Ironman, or even a half ironman.  It's different from a triathlon and everything that goes into one.  It's simplicity. And, it's still a solid challenge.

Over the years, the 5K was my running north star.  In the 90's, as I began running and focused on marathons, I still made time for 5K's.  I got my 5K time down into the 21 and 22 minute range.  Somewhere along the way, I don't remember exactly when, I did a 5K at UC San Diego and managed a 20 minute and 12 second finish.  Tantalizingly close to the 20 minute mark that I'd set as my 5K goal.  Yet, that goal was elusive.  I worked on my one mile time and managed to do a mile on the track in under 6 minutes.  Then, in 2008, on the weekend of my 49th birthday, I ran a 5K in San Pedro, California.  I was living in Denver at the time, so there was a benefit of coming down to sea level.  My coach told me to "run like you stole something."  I was in the zone that day, and remember how easy it felt to run fast.  I crossed the finish line in 19:30.  My first, and only, sub-20 minute 5K.  They never published the results of that race online, but I still have the data.

In the last several years, my focus has been on Ironman training, and my 5K times haven't been under 23 minutes for quite awhile.  I wasn't sure what I could do today.  I'm still recovering from Kona, but I'm finally starting to feel like myself.  It was cold and raining today, which helps in some ways, but not in others.  I did a solid 3 mile warm up comfortably and got in a couple of 45 second strides at around 7 minute pace.  There's always a difference between training and racing, however, and once the gun goes off, the adrenaline kicks in and helps.

I ran the first mile today fast and relatively comfortable.  I like to call it comfortably hard.  I wasn't looking at my watch at all, and was pleasantly surprised to see 7:17 for my first mile, which had a slight net downhill to it.  I upped my breathing over the second mile, which had a slight net uphill, and started feeling the strain of a 5K.  Fortunately, I didn't "die," like I did in my first 5K twenty eight years ago, and felt very positive to see 7:35 pop up on my watch for my second mile.  Unfortunately, the third mile didn't turn out to be the kind of mile I'd wanted.  I had hoped to bury myself during the third mile, but my legs weren't feeling it, and honestly, I wasn't either.  I didn't slow down too much, and managed 8:17 for the third mile.  Somehow, if I'd left everything out there today, I might have gotten the third mile under 8 minutes.  I was able to run fast for the final tenth of a mile. about 7 minute pace, to finish the 5K in 23:37, my fastest 5K in five years, and not too shabby for a 60 year old.  It's a great starting point for the upcoming year, where I'd like to focus on my speed and seeing what I can do with my 5K time.  While I love goals, I think I'll just let this one come about naturally, and let it be whatever it will be!

Bullies are my Weak Spot

My weak spot is bullies.  They make me feel like I'm lacking in control. Ironically, worrying about being in control isn't really necessary if you can accept the fact that we're never fully in control of anything.  Still, it's a challenge.  Most of my life I've really struggled with bullies.  At the same time, I've usually been fine in standing up to bullies, but that doesn't change the underlying internal discomfort that they cause me. It truly has always been my weakness.  In 7th grade, I was bullied, and actually stood up and fought with the bully. In college, I was involved in a summer research program and a graduate student bullied me, and I quit.  There are many examples over the years.  When I've tried to accept a bully and not quit or fight back, it hasn't been healthy for me.  There are exceptions, though.

If I don't have to directly deal with a bully, or if they have little to no actual impact on me, I don't need to confront them.  That's where life balance comes into play. No matter what, though, the key is to not let bullies control ones life in any way, shape or form. Whether that is something I can control, or not, is really beside the point.  One thing that I know for sure, is that I don't do well when I let bullies take control of my life.  It's never felt good, and it never turns out well.

Bullies are my weak spot.  Standing up to bullies has defined most of my life.  I can't change that, and therefore, don't want to.  A weak spot isn't necessarily a weakness.  It's important to know your weak spots so you can address them. That's what I try to do.