Thanks for Small Favors

While many will disagree with me on this (not that it matters to me), I was actually quite pleased with what happened today in the impeachment proceedings.  When this all started, all I read from Republican congressmen was that the president didn't do anything wrong.  This was all a witch hunt, and the Democrats were just trying to besmirch trump's reputation.  Given me a break!  Since he became president, trump has done plenty all by himself to besmirch his own reputation.  He's crude, he's a bully, he doesn't believe in any rules, he isn't loyal to anyone that isn't completely loyal to him, and he is clearly an egomaniacal narcissist.  Is any of that impeachable?  Probably not, because I believe that almost everyone who voted for him and who would vote for him today don't care.  This is America, and if that's who the winner of the electoral vote was, so be it.  You'll note that I didn't say, if that's who the American people chose.  While an electoral college majority made trump the winner, a majority of the American people did not vote for him.  Nevertheless, that is our system, and we are presently stuck with it.  So why am I pleased with what happened today? Why am I thankful for small favors?

When this process started, it was hard to find a Republican who would say anything negative about trump.  They kept saying that there was nothing going on when it came to impeachment.  Today, respected Republican Senators said that trump's call with the Ukrainian President was NOT perfect.  They said that what he did was inappropriate.  They just don't believe it was impeachable.  They also said that the Democrats absolutely made their case when it came to finding what trump did as being wrong!  I agree 100% that a Senator who believes everything that the Democrats said trump did happened, and that it was wrong, doesn't have a need to hear more witnesses.  Witnesses will not change their judgment.  They know he was wrong, they just don't believe it is impeachable.

The fact that there are now Republican Senators on record saying that what trump did was inappropriate gives everyone a chance to spin this however they want.  The president will say he was exonerated, which he'd say no matter what happened, because to him, everything he does is perfect.  Democrats can now point to the fact that the impeachment process had merit.  They can speak to the fact that they brought out facts that the American people can judge for themselves in 9 months.  The Republicans will say that the American people can judge for themselves in 9 months.  See, both sides agree!

It's time for each side to stop blaming the other for the partisan divide in our country.  Each side believes that they have a stronger case than the other for casting that blame.  I say put down our swords and remember that we're all Americans.  Let's all try to have a civil discourse on the issues.  Let's all try not to name call, especially with each other.  Let's try not to put each other in categories.  We're not liberal, conservative, progressive. We're Americans.  We need to revel in the fact that we have a country that allows us to speak freely, even on topics we don't agree upon.  And, at the end of the day, let's try to be thankful for small favors.

5K Goals

It looks like I'll jump into a local 5K on Saturday.  While I tweaked my back on Sunday, it's already completely recovered.  I was able to do 2 sets of my 200-200-400 intervals today, which is what my coach had suggested that I do if I'm planning to do the 5K on Saturday.  I've done these intervals on several occasions now, and I'm getting pretty dialed in.  Of course, I'm doing them on a gradual downhill, in order to allow me to get some muscle memory when it comes to pace.  My 200's today hummed along at around 5:20/mile pace, and the 400's were right around 5:40 pace.  I won't come close to those paces in the 5K, but it's kind of fun to run that fast, even for a brief period of time.

Trying to figure out my pace for Saturday's 5K is always a challenge.  According to my present interval paces, it would seem plausible that I could run a mile pretty "comfortably" at 7 minute pace.  Ideally, I'd like to get my opening mile down to ~6:45-6:50.  That would give me an opportunity to hold that pace for the 2nd mile.  If I can get through the first two miles at that pace, then it's all guts for the final 1.1 miles.  To run a 21 minute 5K, I'd need to keep 6:45 pace.  At this point, with what I've been doing in my training, I know that this is realistic and possible.  I don't know if I'm ready for it.  That will be up to my body to decide.

The run course for Saturday's 5K is relatively flat, with a slight incline for the first half an a slight decline for the second.  In some ways, this sets up well for me to aim for a pace and then try to hold it.  If I can actually hold 6:45-6:50 pace for the first mile and a half, then the slight decline over the second half of the course will give me a slight edge in being able to hold the pace.  At the end of the day, if I've gone out too fast, I'll be paying for it in the end.  That's the fun of the 5K.  I'd like to see how far I can push my pace in the first mile and then be able to hold it in the second.

My fall-back pace for the first mile is 7:00/mile.  That definitely seems realistic.  In fact, I went out at the Thanksgiving 5K in 7:17 and then in the subsequent 10K a few days later at 7:30 pace.  I've put in  a fair amount of training since then at faster paces, and 7 minute pace certainly feels reasonable.  7 minute pace would put me under 22 minutes for the 5K.  I suppose any result that starts with a 21 will be a huge success considering my best 5K in the past year is ~23:30.  We'll see what happens!

What is Obstruction of Congress?

I'm not sure that I fully understood the term Obstruction of Congress until today.  I also didn't really understand what executive privilege was in relation to the impeachment proceedings until today.  The House chose not to subpoena certain people because they knew it would delay the impeachment proceedings for months, if not longer.  How did they know this?  Because the White House forbade people from testifying or handing over documents.  Under what grounds did the White House do this?  They didn't do it for purposes of executive privilege, but rather to avoid having any evidence come forth that would be relevant to the impeachment proceedings.

Executive privilege makes sense when the topic is sensitive to national security.  That means that portions of testimony could very well be found to be protected by executive privilege, but certainly not everything.  However, a blanket refusal to share any information is what the White House did.  I've striven to be objective, but I do not understand how telling everyone that works under you not to testify doesn't represent Obstruction of Congress.

The Party or the People?

Something that really rang true to me recently, as I tried to be objective over the impeachment proceedings, was the concept of loyalty to ones business.  I have always been extremely loyal to whomever employs me.  I will stand up for them.  I won't disparage them.  If I reach a point where my opinions change, I quit, rather than remain as part of an organization. I thought about this in the context of what's going on right now.  Aren't the Republican Senators just being loyal to their business entity?

Is the Republican party just another business?  For that matter, isn't the Democratic party just another business?  Do the Republican Senators view loyalty to the party over loyalty to the people? I could ask the same about the Democrats, and perhaps that really should be the take home message from how things are today.  It's not that the age of impeachment should be ending, it's that the age of loyalty to the party should be ending.  We elect congressmen and senators to represent us, we the people.

Unfortunately, political parties are just businesses today.  It's not altogether different from how unions have become businesses.  Unions are supposed to represent the workers, but often end up focused more on maintaining the union executives power.  Maybe we shouldn't be surprised.  This is how corporate America runs.  Why shouldn't our political parties and unions run the same way?  I'm endeavoring not to be naive about all of this, but to be realistic and pragmatic.  What can we do?

Jeff Flake stood for his party while he was a Senator.  He clearly realized that his party was going in the wrong direction, and he chose to leave the senate.  He chose to leave the senate, rather than to stay and be disloyal to his party.  It's a fascinating view, and one that I actually understand, up to a point.  I have left jobs for similar reasons.  I've chosen to leave rather than to stay and fight.  I'm loyal until I can't be anymore, but then I just leave.  I must wonder, however, whether this same loyalty should apply to politics?  I personally don't think so.  We've truly lost something that we had from the founding of our country.  For all the talk of the Founding Fathers, and believing in the Constitution, most of today's politicians are choosing their party over the people.

Impeachment is Hell?

Ken Starr said today, "Like war, impeachment is hell. It divides the country like nothing else. Those of us who lived through the Clinton impeachment understand that in a deep and personal way."  After I finished dry heaving, I tried to come up with some semblance of a response to this.  I actually listened to some of Starr's testimony.  If it had come from someone else, I might have been able to tolerate the point of view. However, for the person who made Bill Clinton's life miserable to state that he understands in a 'deep and personal way' literally makes me sick.  It's like throwing a punch and saying, let's change the rules now, you can't throw a punch back.  It is one of the most disingenuous arguments that I have ever heard in my entire life.  

Another person speaking for the White House counsel went on and on about Hunter Biden and how it might 'look' in terms of Joe Biden.  Does anyone remember Jimmy Carter's brother?  Many Presidents have had siblings or children who weren't the best.  Hunter Biden used his name to get on an incredibly great paying board.  Did he actually have influence? While I doubt it, so what?  That was four years ago.  It has no relevance today except for donald trump's vindictiveness.  Furthermore, are we saying that donald trump jr., isn't parlaying his father's presidency for his own benefit? Or, trump himself, bringing government (both foreign and domestic) business to his own ventures?  Give me a frigging break.  I thought that the republicans were saying that trump didn't even bring up Biden, and that he wasn't tying military aid to an investigation of the Biden's.  If he wasn't doing this, why bring them up?  I'm definitely not following this track of persuasion.

Then we have Alan Dershowitz, who has never met an underdog (O.J., Epstein, Von Bulow) he wouldn't find a legal argument for, so long as he got money or time on television in return. He quoted historical sources to support his argument that the articles of impeachment don't hold water.  His number one source?  Andrew Johnson's attorney!  Wow! You might have picked some other constitutional scholars, but to pick the attorney of the one president who was only acquitted by one vote?!  

All of this on the day that Bolton's book is leaked and republicans are being faced with the reality of acquitting trump only to have Bolton's story told afterward and potentially having significant egg on their face.  It's looking like they'll need to call Bolton as a witness.  Ironically, he'll tell his story, which will probably be that he's worried about our country with trump making whimsical foreign policy decisions.  John Bolton has never been considered a foreign policy "dove."  He clearly cares deeply about our country.  Let him speak, and then acquit.  I'll live with that.  Don't let him speak, and have the world wonder what the result would have been if he had testified.

Impeachment is hell?  The republicans brought us into hell with the Clinton impeachment.  Maybe after we live through it again, both sides can change the rules in a bipartisan fashion?  To ask the Democrats to turn the other cheek is laughable.  Sorry, I'm trying to be objective, but I'm just not seeing it.

Can't Have it Both Ways: Part 2

As I've read the papers and heard the commentaries, it's becoming clear to me.  There's no need for witnesses because they don't add anything to what's already been said.  Actually, I agree with this.  If you take all of the existing testimony and accept it as truthful, then adding witnesses will only serve to repeat what's already been said. Or, depending on where you stand on believing what the House witnesses said, other witnesses could serve to corroborate their testimony.  Remarkably, I would concur with those who say that there's no need for witnesses, if we accept the existing testimony.

On the other hand, if the White House attempts to make the case that the House witnesses aren't telling the truth, then they MUST accept the testimony of witnesses who could either corroborate or deny that testimony.  The White House counsel yesterday seemed to be heading down this path, apparently calling into question the very premise that the Impeachment Managers put forth based on the testimony of witnesses.  Honestly, I was confused, because all I've heard previously was that the president was just conducting foreign policy his own way, and that way is supposed to be perfectly fine.

However, if you listened to the republican pundits and many of trumps supporters prior to the Impeachment proceedings, you would have thought that what the president had been accused of is a 'nothing burger."  Why shouldn't trump be able to strong arm the head of state of a foreign country?  Many presidents before him have done so.  Besides, he was just trying to fight Ukrainian corruption.  What he did and said was ok.  There was nothing wrong with it.  If the White House counsel took this approach, they would seem to have no choice but to call witnesses who were in direct contact with trump, in order to corroborate this analysis.

Speaking of analysis, a number of the House witnesses were essentially analysts.  They analyzed what the president did, and they freaked out.  Could their analysis have been wrong? Possibly, but the only people who can explain why would be the folks that the White House counsel doesn't seem to want to have testify.  Are you sensing a circular argument?  I thought so.  That is certainly one approach to defending someone when there is no actual defense.  They can't have it both ways.  Unfortunately, however, it seems that they can.  The republicans will see to that.

Ironically, this whole situation will ultimately be litigated in the place that the republicans seem to think is the most appropriate place, the ballot box.  In this, I agree.  For those republicans who say that the Democrats are subverting the electoral process, I say baloney.  They will acquit trump and there will be another election in less than 10 months.  The people will ultimately be the jury.  I'll hold my nose for 12 more months (especially during the last 2 months, when trump will hopefully be a lame duck president), and hope that our system of checks and balances will hold together just enough to prevent anything catastrophic from happening.

For my Republican friends who worry about the Democrats taking back power, I understand your angst.  I have my own concerns.  However, I look back at the last two Democratic Presidents and discover that the economy improved under both.  I'll look forward to civil discussions about the policies that the next administration puts forward, and I'll continue to try to be objective.  I always have been, and I always will be that person.

They Can't Have it Both Ways

I've been listening to president trump and his supporters for weeks saying that there was nothing wrong with how they treated the Ukrainians.  It was "perfect."  I've heard lots of Republicans say that it was ok for the president to ask them to investigate the Bidens.  It was ok to hold up aid as a way to pressure Ukraine.  There was nothing wrong with it.  Today, I heard the White House Counsel say that none of this ever happened.  There was no holding up of the military aid.  There was no quid prop quo.  The Democrats are making all of this up.  Honestly, I think that the argument that the president can conduct foreign policy however he wants holds more water than what the White House Counsel is providing.  They're saying that none of this happened.  Honestly, it's ludicrous.

Oh yes, there are no witnesses.  No one can directly tie any of this stuff that didn't happen to the president.  Of course, the president and his lackeys won't let anyone who might be a witness testify as to what was actually said.  They can't have it both ways.

Executive Privilege an Polarization

I learned today, while listening to the Senate impeachment trial, that president trump has not actually invoked executive privilege yet.  Everyone's acting as if he has, and the White House counsel will probably use that excuse as the reason for not bothering to call witnesses.  They'll just invoke executive privilege, is what they're going to say.  The more I listened to the description of what is happening, the clearer things became to me.  In the Nixon and Clinton impeachment hearings, both presidents handed over a significant number of documents.  In fact, the executive privilege argument didn't hold up when it went to the supreme court.

Here's the bottom line.  President trump and the White House counsel are going to be making the case that a president can do anything he or she pleases, and congress can't investigate.  There's no question that this is what trump wants.  It's remarkable that the rest of the republicans seems to be supportive of this idea.  The shame is that if the Democrats take the presidency, they might one inclined to follow suit.

This all really made me refocus on how we've gotten to this extremely polarized situation.  I quickly find myself going back to Newt Gingrich and what he started when Bill Clinton became president.  It's ironic, but Clinton was also pretty narcissistic.  I also never liked the way that Bill Clinton treated women.  He loved the power of being a governor and then of being the president.  Ok, so we've begun to establish some consistency amongst presidential personalities.  The republicans began an investigation of a Clinton real estate investment called Whitewater. They didn't find anything, and one thing led to another.

The Clinton impeachment was extremely partisan.  It was essentially along party lines.  The "crime" that Clinton committed was perjury.  To this day, I still question whether Clinton actually committed perjury.  His statement "I never had sexual relations with that woman," was probably what he believed.  He didn't consider getting a blow job in the White House to be having sexual relations.  Even if he did lie under oath, he lied about having sex with a White House intern.  I won't even call it an affair, because it's never really been clear whether Bill and Hillary had an understanding.

Twenty years later and the Democrats started an investigation over whether the president abused his office by pressuring a foreign leader to investigate a political opponent. They're not investigating trumps affairs, or his other most likely unethical behavior.  They're impeaching him for the same thing they investigated him for.  They have the right to do so.  The republicans in the senate have the right to be partisan and vote to acquit.  I find it fascinating that they swore an oath, but what the heck!

Both sides have gotten us to this point.  The Democrats weren't very bipartisan under George W. Bush.  The Republicans weren't bipartisan under President Obama.  Ironically, the last modicum of bipartisanship occurred in the Clinton years, and look what that got him!  Maybe that's the point. Perhaps the fitting end result will be establishing a precedent that allows a president to get away with anything they want.  Republicans and Democrats can and will live with this forever.

Republicans Aren't Responding to the Facts

I'm watching CNN and I continue to hear Republican pundits responding to the impeachment trial with "if the 50/50 Senate can't agree, then they shouldn't impeach."  I have yet to hear Republican pundits actually respond to the charges.  I'm truly looking forward to the White House rebuttal to the Democrats case.  I've been an expert witness, and it's a typical tactic for the side that doesn't have an actual case to avoid actually responding to the issues.  This isn't encouraging.  At the least, if the White House said, we did it, and why not, president's have been doing stuff like this for years, I think we could then focus on whether that's ok.  I was willing to accept such an argument until today.  My mother used to say, if everyone jumps off a bridge, should you?  Of course not!

I'm truly struggling with the concept that our president was trying to use a foreign government to investigate a political opponent, especially when the timeline was temporally related to Biden announcing that he was running for president and the polls showed him beating trump.  I just can't imagine the founding fathers finding this behavior acceptable.  The other fascinating line of reasoning was the one laying out the "there's no quid pro quo" remark by Ambassador Sondland.  Sondland had texted Taylor.  Sondland texted Taylor that the President had said there was no quid pro quo.  However, under oath, Sondland acknowledged that he lied in his text.  His text message was not sent under oath, but his testimony was under oath.

Under oath.  Again, that's a big deal.  Donald trump will not say anything under oath, because he lies all of the time and knows better.  He knows that he gets away with it.  He knows that much of the electorate has come to expect his lying and are actually immunized against the impact of the fact that our president is a lying bully.

I'll keep an open mind and listen to how the White House rebuts all of this, but I'm skeptical that they'll actually try to do so.  It's more important for them to appeal to their base, get the Republican senators in line to acquit and focus on the election.  While I agree with Adam Schiff that trump could do damage in the last year of his presidency, I pray that the damage would be limited.  I hope that the American people will be the final jury on this lying bullying, narcissistic and sociopathic president.

Impeachment Musings: Is it a Crime to be a Lying Bully?

I'm going to withhold judgement until the end of the Senate impeachment proceedings.  However, I'm definitely developing some opinions.  Those opinions actually don't have anything to do with trump's guilt or innocence.  They have to do with his personality, which I've written about before.  Donald trump is a bully and a liar.  Most people wouldn't disagree with that.  However, it's not a crime to be a bully.  It's not a crime to be a liar, unless you've testified under oath and open yourself up to perjury.  President Clinton made that mistake when answering questions about a tryst in the White House.  President Clinton was guilty of perjury (actually, he might have been guilty, there's still the question of what his definition of sexual activity was).

President trump has assiduously avoided testifying under oath.  On one hand this is pretty smart.  In my opinion, he doesn't know how not to lie.  However, if you lie on television, it's not a crime.  I heard trump's former campaign manager, Corey Lewandowski, admit this.  Where do you think he got that idea?  So, trump lies.  He lies all of the time.  But he hasn't committed a crime by lying because he never says anything under oath.

We know that trump is a bully.  Whether he's grabbing women by their private parts, name calling anyone he doesn't agree with or making fun of disabled journalists, I have been bothered by his bullying behavior from the beginning.  It's not a crime to be a bully.  It's despicable, in my opinion, but it's not a crime.

So far, I'm trying to put all of this together.  Donald trump lies and bullies.  He tells his people to undermine Joe Biden.  He tells his people to disparage a respected United States Ambassador.  He tells his people that there's no quid pro quo, when in fact there is.  It's standard bullying behavior to tell a lie in order to obfuscate the truth.

I really think that trump's supporters don't think he did anything wrong because they know he's a lying bully, and they know that's the behavior he exhibited with the Ukraine.  The people who voted for trump to become president, knew that he was a lying bully, and they're upset that the Democrats are trying to take their vote away from them.  The voted for this type of behavior!

Have other presidents been bullies and liars?  Certainly.  Have they been uncouth?  Absolutely!  Have they bullied other countries?  I'm sure that they have.  Have they assassinated foreign leaders?  Probably.  Donald trump probably wonders why he's being impeached for something that many other presidents have done.  That's a question that I'll be pondering as I digest these impeachment proceedings.

Soybean Futures

That bastion of liberal socialist thinking, the Wall Street Journal, published another piece on trade today, "Market Skeptical of China Trade Deal."  I'll cut to the chase, the last few paragraphs.  "The U.S. and China have ended up in an odd position.  China, a one-party state with communist roots, insists that market forces determine the outcome of its purchase commitments.  Meanwhile, the U.S., a voice for capitalism, depends on massive state intervention to meet purchase commitments."

After I stopped laughing, I pondered this.  First of all, we live in a world wide economy.  There's a new virus in China, and we're very worried that it might spread quickly throughout the world.  That wasn't a problem a hundred years ago, much less fifty.  The article pointed out that soybeans come to China from Brazil and the U.S..  If we increase our soybean imports to China, then Brazil will increase theirs to some other country, etc., etc. In a world wide economy, the meaning of specific trade deficits quickly seem to fall apart.

What is the meaning of all this?  So, we send more money out of our country than we bring in.  Do we bring in more products? Or, do we just spend more money on the products that we bring in?  They're numbers.  Everyone tries to make sense of these numbers.  But the numbers don't exist in a vacuum.  Is this much ado about nothing, similar to our countries federal deficit, which seems to matter except when it doesn't?

What I actually found most fascinating about this article was the point that China seems to have focused on capitalist concepts.  Their communism, has little to do with economics, and everything to do with governmental power.  Our supposed socialism, which could be seen as our price supports for soybean farmers, has everything to do with economics and little to do with governmental power.  It can't, otherwise we'd have to run the Republicans out of Washington for having converted to socialism.

Shouldn't this all be a reminder that we're all just human beings, trying to live the best life possible.  America is about the individual person, not the individual soybean.

My Dad's Prostate Cancer Story

My dad sent me his journal entries going back to 1997 today that have comments about his prostate.  I have my work cut out for me.  A document with nearly 44K words to read through and annotate in order to develop a person centered story to tell.

One of my favorite stories to tell is about my patient "Pete." Pete was 88 when the treatment for his prostate cancer was successfully killing the cancer, but also killing him.  After stopping his treatment and putting him on testosterone (a story I've told many times), Pete celebrated his 101st birthday last year.  I haven't spoken to Pete in awhile, and I always wonder when my phone call will be met with a "not in service any longer" response.

It's easy as a Geriatrician to espouse my nihilist views of treatment, but it's much more real when it's my father who's dealing with the medical situation.  Hence, the opportunity.  My dad's journal has ultimately been my own inspiration to blog on a daily basis.  That same journal may become the nidus for an incredible story about my favorite topic, a person centered geriatrics approach to care.  That's the name of the textbook for which I'm editor in chief.  It's been my passion for the last thirty years.  There's no better way to make a point than to tell a personal story.  This could be the ultimate story with a great message.  44K words.  I've definitely got my work cut out for myself!

The Empath

One of my favorite Star Trek original series episodes was called The Empath.  I've long connected with the episode and the person, to the extent that I've envisioned myself as somewhat of an empath.  On a certain level, it's a gift, and one that has served me well as a physician.  I absolutely have the ability to connect with my patients on an emotional level, one that I truly believe has been helpful.  Whether I actually take on the pain of my patients, or give them the feeling that I understand what I'm going through, I definitely have a knack.  There have been times in my career that this knack is a burden.  I have always taken the health and well being of my patients so seriously that I will lose sleep over it.  Again, this can be a burden at times, but I've always accepted it as part of being a physician.

The same empathic tendency has also followed me through my personal life.  I feel other people's pain, especially those close to me.  On a simple level, it's probably one of the reasons that I shouldn't buy a car from a car dealership.  I want to make the salesperson happy.  I don't do well when others are unhappy.  When it comes to family members, it's a real problem.  If my wife or daughters are unhappy, it can actually have a pretty profound impact on me.  It's as if I take on their pain.  If I were truly an empath ala Star Trek, this would be great.  I'd take on their pain and they wouldn't have it any longer.  I would deal with that pain and then everything would be right.  Of course, that's not what happens.  I take on the pain of those close to me, and they still have their pain.  It doesn't make a lot of sense.  So, I must focus on the breath.  I'm sixty years old and I've developed this habit of feeling the pain of those close to me.  It's not healthy.  It's a habit that I need to break. So, I must focus on the breath.

I've long had a desire and need to help others.  This comes to the fore big time when it comes to my family.  How can I help the most? Usually by listening and caring.  There's really no need to take on their pain.  In fact, that has the opposite result, because now I'm hurting as well and that doesn't make anyone feel any better.  So, I must focus on the breath. It's one thing to note the pain of others, but there's really no reason to feel it myself.  Old habits are hard to break, but you break them by forming new habits.  It's one thing to be empathic, but there's no need to be an empath.

Focus on the Breath

One of the key elements of meditation is focusing on the breath. That's actually not specifically trying to breath, or breathing hard, but actually focusing the mind on the actual act of breathing.  It's a means of being in the moment.  I've meditated every day this year.  Sometimes I do it earlier in the day, sometimes later, although, earlier is probably better, in order to set a standard for the entire day.  On the other hand, if I haven't been as successful with being in the moment throughout the day, meditating before I go to bed might actually prepare me for the next day.  At least, it helps me to sleep.  It's easy to allow the mind to wander and before you know it, it's thinking about things that you don't really want to think about.  So, I focus on the breath.

I've recently had an increase in my feelings of anxiety.  I'm not entirely sure why.  There are a multitude of possible reasons.  One of the things that keeps popping up is my sensitivity to any struggles that those close to me have.  I have this thing about wanting to help those around me. That has always served me well as a geriatrician.  It also pays off for the charitable boards that I'm part of. When it comes to those close to me, I have a strongly held innate desire to do anything and everything it takes to be of help. With that desire to help comes the weight it also puts on me.  That weight is certainly a major source of my anxiety.

Anxiety is like a pyramid.  It is built upon any number of stresses that combine to build a base that ultimately bubbles to the surface.  It can be exposed at any time and it isn't always obvious why it comes out.  Hence, the focus on the breath.  Meditation is an important tool for which to deal with anxiety.  Focusing on ones breath is a key element in meditation.  Since the root cause of anxiety isn't always obvious, the need to identify the feeling and not succumb to it, is the prime challenge.  Therein lies the need to focus on the breath.  It's a way to stay centered, to acknowledge a feeling, but not to enhance or hide that feeling.  Neither of those approaches is helpful.  Ultimately, we must find ways to deal with our emotions.  It's all part of a process.

Grandpa Ironman

It's absolutely amazing how a 4 year old can exhaust me more than an Ironman!  We've been helping out with my four year old grandson this week.  He literally has unlimited energy.  Mixing that with the other things I've been doing, I've been finding myself completely exhausted by 7 or 8 at night, and that's with some rest late in the day.  My feeling of exhaustion actually seems to begin mid afternoon this week.  All in all, I have to say that the diagnosis is pretty simple.  A four year old.

Kids have a remarkable degree of energy.  I thought that I did, but I guess that I was mistaken.  Either that, or little ones have that much more energy than I do.  Which is possible.  On the other hand, I love his positive energy and his unabashed joy for everything in his life.  It's great to break a grandpa, although, it's not great to be completely exhausted every night.

With that written, this will be a short blog.  I need to go to bed.

Trade Deficits, Deals and B$!ls$#t

From today's Wall Street Journal (U.S.-China Detente Won't Fix Everything"): "In the 12-month period ended in November 2019, the U.S. deficit with China was $56 billion lower than in the like period ended in November 2018...But the deficit with the rest of the world rose $49 billion, offsetting nearly 90% of that drop.  The overall U.S. goods deficit fell only $7 billion, and much of this was due to a falling bill from net oil imports."

This graph tells a whole story in and of itself.  What's happened to our trade deficit since trump became president?  What's happened to our deficit with China?  If you push one side of the balloon, the other side responds.  This all appears to be one big shell game. What is most notable is where the trade deficit was at the end of 2016, when trump became president, and where the deficit is now.  Clearly, our trade deficit peaked in 2012, but then it went down and stabilized.

I'm sick and tired of the political wrangling and spinning.  I'm a numbers guy. I like data.  And, I like to understand the data that I use to evaluate situations.  Today's WSJ article was pretty telling.  Our trade deficit definitely hasn't gone down.  The games that we've been playing with China haven't had an impact.  Even if there's an impact on China, this data suggests that probably doesn't mean anything for our worldwide trade situation.  We're getting our strings pulled by all of the politicians when it comes to this stuff.  Be careful what they tell us, unfortunately, starting with the president.

Meditation and Forming a Habit

I've meditated every day this month, which means that I still have six days to go for it to become a habit.  One of the key elements I've learned about meditation is a concept called noting, which is about recognizing stress or anxiety and noting it.  One of the key approaches to meditation that I've learned is to focus on my breath.  What's interesting is the fact that I tend to sigh deeply when I'm under stress.  What's interesting about focusing on my breath is that it's not about taking a deep breath.  It's about literally focusing on the breath itself.  Interestingly, the concept is not to breath heavy, or to actually breath harder.  It's literally about focusing on a normal breath.  It's an interesting concept, and an important one.

I've found meditation to be an important arrow in my quiver to deal with anxiety and stress.  There's actually a growing boy of literature that demonstrates the value of meditation.  This includes brain scans that demonstrate the actual physiologic changes that occur in the human brain that are directly related to meditation.

My dad taught me that it takes 21 days to develop a habit.  I've been meditating daily for the past 15 days.  Which means that I have six days to go to lock in my meditation habit.  I'll be meditating before I go to bed tonight.  I'm going to develop this habit.

Getting Control Over Prescription Drug Costs

I was listening to the Democratic Debate and I heard plans to reign in prescription drug costs by giving Medicare the ability to negotiate prices.  Does this matter?  You're damn straight that it does!  In 2018 Medicare expenditures were $740B.  Prescription Drugs accounted for 19% of that!  $141B.  Just ten years ago, prescription drug costs were only about 10% of Medicare's expenditures.  First of all, I will fight to my dying breath over the fact that older adults are on far too many medications, most of which have absolutely no evidence behind them.  Our first step should be in educating physicians and other prescribers in the evidence-based principles of Geriatric Medicine.  That is why I'm so passionate about reforming how we educate doctors by reforming Graduate Medical Education (GME), which is subsidized by Medicare!  I've said it before and I'll say it again.  The government spends $10B/year of taxpayer dollars to train physicians how NOT to care for older adults.  This includes training physicians to WASTE tens of billions of dollars on unnecessary medications!

While I agree with the concept of having Medicare negotiate drug prices, I still think that our best bet is to effectively educate and train physicians to appropriately prescribe.  I understand the desire to lash out at the pharmaceutical industry.  In many ways they deserve it, but that approach is a double edged sword.  We limit the industry at the risk of losing what once was the most advanced system in the world for developing new medications.  If we use too big of a hammer, we will destroy the nail.

The take home message is that giving Medicare the ability to negotiate prescription drug prices will save some money.  Is it 5%? 10%?  That would just be $7-14B/year.  Properly educating young physicians on appropriate prescribing could save $40-50B/year!  Our pharmaceutical industry has run amok, churning out new medications that are barely better than the previously unnecessary ones.  Proton pump inhibitors and antipsychotic medications are two costly examples of this.  However, if we only focus on getting rid of the more nefarious aspects of the pharmaceutical industry, we will risk getting rid of the best parts as well.

It's time for the Democrats to stop focusing on the politics of healthcare and to focus on the actual delivery of healthcare.  The only way that I know to effectively describe what needs to happen is by explaining the Geriatrics Approach to Care.  It's our time to make a difference!

Profit Motive and Greed

I continue to enjoy my subscription to the Wall Street Journal, but am certainly well aware of the biases in the articles.  Today I read about the positive impact of deregulation.  The focus was on the fact that deregulation can lead to improved efficiencies and cost savings, so that the money can be spent on increased wages, benefits, etc.  While I theoretically agree, it would have been nice to have the balance of acknowledging that the savings might go towards profit.  There's the rub.  Capitalism is about the profit motive.  That can certainly lead to innovation.  It should lead to better wages in order to hire the best people.  Todays low unemployment rates are certainly finally having some positive impact, but one has to wonder why it's taken this long.

The challenge is when the profit motive and greed intersect.  If a business can get away with not increasing wages or benefits in order to extract a greater profit, they very well may do so. While from a long term business perspective, this may not make sense, I often talk about the push to maximize quarterly earnings in todays business world.  People, including business owners, often can't look beyond today.  Take the money now, worry about everything else later.  I've written before about the fundamental problem of greed when it comes to human beings.

Greed is an obvious downside to capitalism, but socialism isn't immune from human greed.  The difference is that under a more socialistic economic system, greed results in apathy and laziness, or it results in attempts to achieve power.  Our human foibles will always be the downfall of any system, and thus government ultimately has to step in to modulate our human failures.

I just wish that the Wall Street Journal might recognize the balance in their articles.  Instead, I just have to keep it in mind.  That's ok, I'm quite capable of doing that.

Social Welfare is Not Socialism

I was talking to my dad yesterday about the fact that Republicans love to use the term socialism as a negative label.  Bernie Sanders and others don't do themselves any favors by using the term socialist as a badge of honor.  Does either side know what they're talking about?  Is anyone truly talking about changing our entire economic system to one that functions in a truly socialist fashion?  And, what does that actually mean?  Are all socialist countries made equally?  Are the naysayers being critical of socialist societies that are totalitarian in nature?  Are any of the presidential candidates supporting a totalitarian government?  Of course not!  Is there a difference between social welfare and socialism?

It strikes me that so-called liberals want to make sure that those who are less fortunate than others, whether by birth or happenstance, are not held down at the bottom of society.  We, after all, have never held ourselves out to be a country with a caste system.  America has always been about opportunity and the hope and dream of anyone to be whatever they can,  In reality, we know, that these hopes and dreams are not always possible for many who are born into poverty and don't receive the necessary opportunities to advance.  Some raise themselves up from their bootstraps, but others are just unable to do so.  What about children who are raised in poverty who are killed by rampant inner city violence?  What democratic opportunity were they able to avail themselves to?

I read today that if the minimum wage was adjusted for inflation, it should be over $22/hr.  How do we expect people to survive at one third of that?  I've written a lot about the incredible human beings who work on the front lines of nursing homes, earning less than a living wage.  We want grandma to be well taken care of in these circumstances, but do we care if the people who care for her have to work two jobs in order to make ends meet.  What does this do for the nuclear family?

Is it socialism to try to help those at the bottom?  What if the goal is to equal the playing field a little, so everyone can compete in a capitalistic society?  Is that socialism.  Or, in fact, is it a form of social welfare? Are they the same?  I would posit that if businesses function in a free market manner, we are not socialists.  I for one believe that individuals need incentives to succeed and to be encouraged to accomplish things.  I'm not a fan of giving things to people for free.  If we're going to equal the playing field, one should have work attached to obtaining that equality.  In fact, it may not be social welfare that I'm talking about, but social workfare.  Unfortunately, instead of debating these types of issues, the Republicans want to label others as socialist, so there is no discussion.  On the other hand, Bernie Sanders and the like want to proudly promote socialism as a ding on those who succeed under the capitalist mantel.  It's time we all work together to accomplish what America is all about  We're a country that believes in individuality an opportunity.  It's also a country with a heart.

Don't Get Cocky

I read Peggy Noonan's opinion in the WSJ this morning, and she nailed it.  "Soleimani had it coming, but don't get cocky." I just started subscribing to the WSJ after being away for several years.  I now remember what I like about it.  There is always a nice balance of opinions, clearly with a strongly conservative leaning.  But that's ok, I'm liberal enough at heart (which my conservative friends easily remind me of), that it's good for me to read things from a conservative perspective.  Besides, there is an underlying conservative in me, it comes out in various ways. But that's a topic for another day.

Today, I was struck by the concept of not getting cocky.  Noonan's perspective is that trump and his merry band (my words) got lucky this time.  I agree.  I don't think that they have a better analytic process that knew how the Iranians would react.  I am willing to acknowledge, as one of my friends suggested, that trump does have a crazily innate sense of intuition when it comes to politics.  And, in the end, this was a political decision.  Trump did the political calculus and went for it.  President's George W. Bush and Obama didn't make the same decision for analytical reasons.  They were concerned that the Iranians would overreact.  They didn't want to take that chance. Trump doesn't really care about taking chances.  He cares about himself and his political intuition.  I agree with Peggy Noonan, he got lucky.  Now, we have to hope that he doesn't get cocky.

There is a balance in life when it comes to the line between confidence and cockiness.  I'll admit, I'm sure that there have been times in my life and career that I've crossed that line.  One of my friends likes to remind me of a time that I was giving a talk and someone asked me how I knew the answer to a question.  My response was that I just did!  That's confidence.  It can also be cockiness.  One of my favorite lines from a 1960's television show, "The Guns of Will Sonnett," was "No brag, just fact."  If you have succeeded in something, or you have the objective or even subjective data to back it up, you can speak from a base of knowledge, and even certainty at times.  At the same time, I often say, I realize every day how little I know.  There's a reason for that.  Just because we know something now, doesn't always mean that it will always be true.  Peggy Noonan completed her article with the following, "What would be good to see now is modesty--the modesty of serious people who know they got lucky."  Unfortunately, we won't ever see that in donald trump.  But, I can remember to try to live by that concept in my own life and career.  I'll try not to be too cocky.

Good Soreness and Recovery

Yesterday's hill workout felt great, and gave me energy throughout the entire day.  Today, I was actually a little sore, and by early afternoon, I was exhausted.  It's a reminder that training is training. Yesterday's workout was solid, and it certainly stimulated my muscles.  In fact, I was a little surprised to find myself feeling both sore and tired today.  However, that's a good thing.  That's part of what training is al about, and shows that I'm using my muscles differently.  So, instead of doing another hard workout, or even a run today, I just walked a bunch.  Recovery matters.

I suppose that none of this should be surprising.  Anytime you change the stimuli, it's going to take some time to get used to it.  I'm clearly still getting used to it.  But it's all good.  It actually feels really good to feel the impact of these workouts.  On the other hand, I do feel tired today.  Which is where recovery comes into play.  And, recovery is what it's all about. Whether you're doing endurance training, or speed training, recovery matters.

So, today I rest and recover.  It's an important part of training, maybe the most important part.  And, yet, I always have to remind myself of its importance.  It's kind of funny, when I look back over the year at my blogs.  It's actually been awhile, though, since I've had much soreness the day after a workout, even if I'd run 20 miles, or ridden for a hundred.  But, I'm doing new things and my body is still getting used to doing that.  This is how I'm going to get to my goal of 20:20 in 2020!

150m Hill Repeats: Nailed it!

Last night I laid out my plan for this mornings workout.  I repeated the intervals in my head while I was in bed, and fell asleep with that visualization.  I had another night of dreams, which have really been interesting.  My brain is trying to work through a bunch of stuff, and each night's dreams seem to get more interesting.  Last night I dreamed that I was talking to Kareem Abdul Jabbar about John Wooden.  Now, I've always respected John Wooden as one of the ultimate leaders.  This is what I aspire to, so maybe that was what was in my head.  Anyway, it was interesting to wake up to that realization.

I had planned to start my workouts at 7:20 pace (or the equivalent of 5:15 pace on flat ground), which is what I'd done the other day, and what I did this morning.  Today, I carefully monitored my effort and pace, which I gradually increased throughout  ten (yes, count them, ten) intervals.  My final paces were right at 7:00 pace (or the equivalent of 4:50-4:55 pace).  In the middle, my paces were right in between (about 7:10 or the equivalent of 5:00-5:05 pace on flat ground).

My efforts were just right.  I increased my breathing gradually as I made my way up the hill, focused on maintaining my pace while increasing my effort in a reasonable fashion.  This being different from  the other day, when I increased my pace significantly on the 3rd and 4th interval.  Today, I went from 7:20 pace to 7:10 pace to 7:00 pace.  My breathing was hard when I got to the top of the hill, but by the time I got back down the hill to the start I had control of my breathing.  I might have pushed a little harder on the tenth interval, knowing it was my last, but my breathing had still settled down within a few minutes.

The "rest" interval, walking from the top of the hill down to the start, averaged about 1:50.  The intervals themselves were right about 40 seconds long.  I finished my workout feeling good. For most of the day, I felt energized.  When it comes to today's workout, I nailed it!

My 20:20 Journey: 150m Hill Repeats, My New Favorite Workout!

Tonight, I'll go to sleep thinking about tomorrow's workout.  That will serve two purposes.  First, I hope that it will help me fall asleep.  Second, by visualizing the workout, I hope that it will help me successfully complete it.  On Sunday, I did this new hill workout for the first time.  It kicked my butt!  However, there may have been some reasons for that.  Looking back, I did the first 150m uphill repeat at about 7:20 pace, which would probably be akin to my goal 10K pace on flat ground right now.  I actually felt pretty good at this pace.  After walking back down the hill, I did the second one at about 7:00 pace, which might be closer to what I would hope to achieve in a 5K on flat ground if everything was perfect right now.  Now, these goals might be a little ambitious, but I'm getting more confident with where my training has gone, so I'll go with this.  Keeping in mind, of course, that I'm doing these paces uphill at about a 3% grade for 150m.  Interestingly, my Garmin pegs these paces as the equivalent to 5:05 and 4:50 pace on the flats, respectively.  Since I love numbers so much, my 200's on a 1% downhill grade have been at about the equivalent of 5:10-5:20 pace.  So, I'm in the ballpark.  The hills give added value to building strength, but I don't want to lose the speed or the leg turnover from a neuromuscular perspective.  So, finding the right pace is important.

On Sunday, I got to the third and fourth intervals and somehow managed to increase my pace.  Don't ask me how, I just did, finding myself doing them at 6:30 pace, or the equivalent of 4:30-4:40 pace on the flats.  That's the rarefied air of what I was doing for 8 seconds the week before.  Whoops!  That's where I defeated the purpose of what I was trying to do, although I'm sure I gained some physiologic benefit from it.  Not necessarily the benefit I was setting out to achieve, however.  6:30 pace is pretty much where I'd love to be for a flat 5K later this year.  Who knows whether that's achievable or not, but for 150m, I kept that pace moving uphill.  The fascinating thing was what happened to me on the fourth interval.  I started out fast, and about 50m from the end, a switch clicked off.  I knew that my legs suddenly had no energy, my central governor was sending signals that said enough.  But, I know how to override my central governor, so I just gritted my teeth and pushed on for those last 50m, somehow maintaining that pace.  Don't ask me how, I just did it.

Of course, I couldn't catch my breath for 10 minutes. I certainly couldn't do a 5th interval.  There's the rub.  There may be a point in time that I'll try to achieve that pace going uphill for 150m, it's just not now.  Now, I need to focus on a pace that I can reasonably keep for multiple intervals.  It needs to be a fast pace, one akin to the pace I'm trying to hit right now for the 5K or 10K.  That's probably 7:20 pace for the time being.  It feels like that makes sense.  If I focus on keeping 7:20 pace for that 150m, let's see how many intervals I can do before the switch turns off.  The switch will turn off at some point, because this workout is certainly stimulating lactic acid production and engaging my anaerobic lactic system.  But there's no need to overwhelm that system and limit my training.  There's a sweet spot that should allow me to get some good neuromuscular, metabolic and physiologic benefit.

Tonight I'll think, and maybe even dream, about doing my hill repeats tomorrow at 7:20 pace.  The other day I only managed four, but I blew myself up by going to fast.  Can I do six? Seven? Eight?  Let's see what happens with my new favorite workout!

Cleansing the Mind

A good friend of mine reminded me of an adage that I have on my bathroom wall.  Don't worry about things you have no control over.  It's a great adage to live by, and one I put on my bathroom wall after reading about it stated by a 100 year old who said it was an important part of getting to 100.  Last night, I had more dreams, at least they weren't of the shark variety.  I realized, however, that they were about my mind trying to cleanse itself.  At least my brain knew what was needed.  I've also been meditating in order to cleanse the mind.  In today's crazy world, this is an ongoing struggle.

Last year, I had a single minded focus of Ironman training.  In a lot of ways, that single mindedness actually went a long way towards keeping my mind relatively clean from worry and other negative thoughts.  I typically went to bed every night thinking about the next days workout.  One of my favorite tools for falling asleep was to visualize myself doing an upcoming Ironman.  I usually fell asleep before I even got on the bike!

The mind is an amazing organism.  I continue to try to understand it, and even to try to gain some control over it.  In some ways, I really shouldn't bother.  It feels like my mind might know how to take care of itself!

Dreaming of Sharks

I awoke with a start the morning at 4am, and realized that I'd been having a nightmare.  I often remember my dreams when I first wake up, and if I write or talk about them right away, I can still remember the details.  I told my wife about the dream, which left me quite agitated, so much that I couldn't fall back to sleep for awhile.  I ended up reading for a out an hour to try to get the dream out of my head.  Still, I realized that I might want to think about what the dream was about.  First of all, it was about a shark.  Literally, a shark.  I dreamt that I was wrestling with a shark.  It was thrashing about, and I was holding on to it, literally holding on as if I was riding the shark as it was thrashing. Think bucking bronco, but instead, a shark.  I'm sure that we were in the water, I don't know if we were under water, but I know that I didn't feel like I couldn't breath.  What really stuck with me when I woke up was that I'd been wrestling the shark.

A google search quickly suggests that shark dreams are about anger and hostility, or if they are about a person, then that person is greedy and unscrupulous.  I wonder if I've encountered anyone like that in my life? Hmmm.  It really doesn't take me very long to think about this, or to recognize the underlying cause of my nightmare.  I'm surprised that I had the dream, because usually I don't dream about things if I've actually addressed them.  I thought that I'd addressed these issues, but maybe my dream was a sign that I really haven't. At least I know that the turmoil surrounding these issues is still laying under the surface and that's important.

I have for some time struggled with anxiety.  There are days that I feel anxious, and it seems to come out of nowhere.  Maybe it really isn't coming out of nowhere.  If my dream is any indication of what is laying beneath my conscious surface, then I really shouldn't be surprised when I suddenly find myself anxious.  There's a reason.  That just means I need to focus on dealing with these feelings.  They're probably not going away anytime soon.  There's still too much real life stuff to play out for these feelings to fade into the background.  I guess I'll have to live with that.  But, that's life.  We have to live with the things that come at us on a daily basis.  We really don't have a choice.  There are always going to be sharks in our lives.  We can swim away from them.  We can wrestle with them. I suppose we can be eaten by them (though I really hope to avoid that scenario).

I've started the year with a focus on daily meditation.  The first week has focused on balance. While I don't think that there is a meditation for dealing with sharks, there are meditation foci on anger.  It could be a starting place for addressing this, as sharks definitely bring out that emotion.  I'm sure there are other emotions that are invoked as we deal with human sharks.  One thing I do know.  Anger isn't a healthy emotion to have living under the surface.  So, if I am dealing with the anger brought on by a shark, then I might as well work on addressing the anger.  It's a beginning.  We'll see what it does to my shark dreams.

My 20:20 Journey: Hill Repeats and Heavy Breathing

Yesterday I did 200 and 400m efforts.  Today, I did just four all out 150m efforts up an incline.  These efforts lasted about 40 seconds and kicked my butt.  When I finished the fourth one, I found myself breathing hard for over 10 minutes.  Two hours later my breathing was still a little heavy.  It's amazing what going all out will do to your metabolism.  My new journey has me doing a lot of these short hard efforts.

Modulating one's efforts during short sprints takes some effort.  I probably went a little easy on the first one today, and then got the next two just right, pushing as hard as I could for the entire 36-37 seconds.  The last one was interesting, because after about 120m, I felt like the switch turned off in terms of how my legs felt, but I ignored that and pushed as hard as I could, actually doing this fourth effort slightly faster than the first three.  Of course, I couldn't stop breathing hard for several minutes. The first three efforts were followed by about 2 minutes of walking.  There's no way that I could have done a fifth repeat with the way I was feeling after the fourth one.  But that's ok, this was my first attempt at doing these hill repeats.  I'm always (at least these days) cautious when it comes to how I handle the first attempts at new workouts.

The challenge of doing these short hard efforts is making sure that I recover enough in between these workouts to make the next one as productive as possible.  While I'll probably be tempted to follow up today's workout with another one tomorrow, I doubt that I'll truly be fresh enough to actually do that. Still, the temptation will be there.  I know myself pretty well.

My coach knows that I love these hard efforts.  There's nothing like literally being unable to breath a the end of an interval.  Combining that with the feeling that y our legs don't want to move, just adds to the enjoyment!  In a lot of ways, this is preparation for the feeling that I strive to have at the end of a 5K. I often say that the way to finish a 5K is with the feeling that you want to throw up.  I know that sounds crazy, but it's true.  It comes with the territory.  Normally, I'm used to feeling something similar at the end of a half ironman or ironman, but that's a different feeling.  It's got it's similarities, but it's associated with dead legs that aren't moving all that fast.  Ideally, at the end of a 5K, my legs will still be moving pretty fast, but I'll feel pretty much like I did at the end of my fourth interval today.  Ironically, my pace was about 6:20/mile, albeit, I was climbing about a 3% grade, and I already had some lactic acid buildup.    So, my training continues, on my way to 20:20.

My 20:20 Journey Begins

A few days ago, I wrote about my journey this year to achieve a goal for a 5K race of 20:20.  I began my journey with my first 200-200-400 set, but the sections that I picked were a little odd, insofar as they had some portions with downward inclines.  I marked off some sections the other day that also had a slight decline, but that's somewhat by choice.  I want to retrain my legs to run fast, a 1% downward grade isn't that significant, but certainly doesn't hurt my desire to train my legs to run faster.  Today, after a patient warm up, taking extra time and attention to my right high hamstring (which has still been a little tight and even somewhat sore back and forth), I did a short warm up jog and got to the section of road for my first set.

Today I did two sets of (200-200-400) with the 200m sections being run at about 5:20/mile pace.  The 400's were run right around 5:40 pace.  If I look at various run calculators, These paces for these intervals put me on target for my goal.  Numbers don't lie, but the body still has to perform.  This is my second round of this workout, and I was able to complete two sets today.  That's already progress.  Clearly, the goal will be to do multiple sets. In the spirit of getting close to 5K volume, I would anticipate getting up to 6 sets.  I might have tried a third set today, but felt like my paces would possibly have dropped off, and so I finished still feeling relatively fresh, which is the idea.

The good news is that my first full attempt at this workout actually had me hitting paces that would ultimately put me at running a 5K in under twenty minutes.  I'm not going to get too excited about this, however.  What matters is that I've got a starting point, and it's something that I can build on.

The other key to my training is to do it rested.  While I was training for Ironman, it was almost a badge of honor to do workouts while fatigued.  As I train for a 5K, it will be the opposite.  I'll want to be doing my workouts well rested so as to maximize their value.  I feel like I've gotten off to a good start on my 20:20 journey.  We'll see what's next.

Who Really Cares?

I read a good article today about the lack of Geriatricians in this country.  Good, from the perspective that at least it shone a light on the issue.  Unfortunately, the author chose to write a relatively positive piece, pointing out the projects that are in the works to try to impact the delivery of care to older adults.  In that, she missed the point, and the opportunity to truly shine a light on what is wrong with the state of affairs of Geriatrics in our country.  This is a reporter that I truly respect, so I emailed her, offering to share my insights.  I guess I was too late.  She said that since she just wrote about the subject, that she won't be coming back to it in the near future, possibly for years. It got me to thinking who really cares?

I've spent my entire career advocating for older adults.  I've put that advocacy above my family and honestly, myself, on many occasions.  Why? Because it matters to me. Because I care.  The question is, is that enough? Or, other the other hand, is it too much?  Here's a respected journalist whose response to my offering to add insight is that she'd done with the topic.  What are her motives?  In fact, what are anyone's motives?  I often have to remind myself, most people are looking out for themselves.  I don't really expect people to do otherwise.  When I left my last job, I didn't try to bring anyone with me.  I didn't try to persuade others to leave.  I recognized that they had families, they had responsibilities.  I was fortunate insofar as I was able to leave.  I was fine in doing so.  On the other hand, I've made similar decisions throughout my life without regard to their impact.  I've usually followed my gut, and often have done what I felt was right, regardless of the consequences.  It's who I am.  Anyone who really knows me, knows that's what the get from me.  The truth, whether they like it or not.

Which brings me back to my question.  Who really cares?  I've tried to get op-ed's published on some topics that I feel strongly about. I haven't had any luck.  I certainly share my thoughts on social media, and I have to admit that I do have some people that follow me who will share what I'm saying.  Does it make a difference?  I guess only time will tell.  That's part of the challenge.  You can only try.  The results will come, or they won't. I guess that's the point, and I'm sure that I've written about this before.  What really matters is that I care.  There's really no one else that I should be concerned about.  Even if I were the only person in the world that cared about the care of older adults, which I'm not, I would still try to change things.

I shared with a colleague today that I know that I don't know everything, and that my opinions are always right.  I love nothing more than to brainstorm and have people question my beliefs.  It forces me to develop stronger ones.  Sometimes, I change my mind.  Sometimes, I'm even more emboldened than when I started.  Because I care.

Reflections on an Industry

I spent most of last year reflecting on the post acute and long term care industry.  In many ways, the conclusions that I ultimately came to are relevant to most health care businesses.  Today, I actually spent a fair amount of time contemplating these reflections, some of it with others, and some of it on my own.  The one thing I really want to focus on is that it's easy to throw stones and complain.  It's much harder to come up with effective solutions to problems.  You really should never do one without the other.  From a leadership and management perspective, that's always a credo that I've lived by.  I'm ready to apply it to my 2019 reflections and the experiences that I've had over the last thirty years.

I've identified the reality that the long term cafe industry is essentially a real estate play.  I've written an op-ed, but have had no luck getting it published, yet.  I've shared my insight during some presentations and am looking at other ways to share this knowledge in a pragmatic way.  How does one change an entire industry?  How does one change the ageism that is endemic in our society?  Taking on an entire industry and trying to change society's mores is not an easy mission to take on.

Where do I start?  Today, I reached out to identify opportunities to present my views to a relatively large audience.  I've laid out the key elements of a presentation that defines the problems and then identifies solutions to those problems.  Which brings me back to where I started.  Complaining doesn't solve problems, effective solutions solve problems.  My year of reflection has come to its completion.  It's time to figure out how to message what I've learned.

20:20, a 5K Journey for the New Year!

So, while I'd love to make running a 5K in under 20 minutes my ultimate goal, I decided that, in honor of the New Year, I'd just focus on 20:20.  Here are some numbers that align with this goal (from a Jack Daniel's VDOT calculator):  200's=45" (full recovery), 48" (Intervals), 52" (threshold);  400's=90" (full recovery), 96" (Intervals), 104" (threshold).  I could go on from here with 800's, 1km, and one mile times.  Suffice it to say, the 1 mile time with full recovery is 6:01.  I haven't been there in awhile, but I believe it's possible.  There is no question in my mind based on today's (January 1st, 2020) workout that the 200 and 400 times are possible.  In fact, I believe that's essentially where I am.  Which means that I need to build durability in relation to carrying out multiple repeats of these times.

Why 20:20?  First, it's symbolic.  Second, the numbers that seem to go into getting there make sense. Third, why put up a goal that I've only achieved once before in my life (sub-20 minutes)?  I'd rather get to the 20:20 goal first, and then work on getting below twenty minutes.  Have I set a goal that's too high?  Maybe, but that's my modus operandi anyway.  Furthermore, I believe in data and the data would suggest that this is a reasonable goal.

My coach gave me some workout ideas, including a set of 200-200-400 that can be repeated. I did my first set today, and actually hit the numbers that I've listed above.  Tweaked my hip a little, so will be careful before doing this again, but expect that will be possible soon.  The other workout is to expand my 100m uphill sprint intervals to 150m's, which will take me between 30 and 40 seconds.  From a metabolic pathway perspective, this should push the right buttons, all the while also working on building strength.

I have my goal for the year, and my new journey.  20:20:)