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Thursday, January 1, 2026

WhenBreathBecomesAir

I recently read When Breath Becomes Air by Paul Kalanithi (2016).

 This book is a posthumous memoir written by a young neurosurgeon, PK, who died of lung cancer at the age of 37.

My top takeaways:

Ø  The Forward written by Dr. Abraham Verghese is some of the most beautiful prose I’ve read.

Ø  I could never be a physician.

Ø  Diseases are simply molecules misbehaving.

Ø  Quality of life has everything to do with quantity of life.

Ø  Words are just as important as scalpels in the surgeon’s tool chest.

Ø  Statistics are humans, too.

Ø  The easiest death is not necessarily the best death.

Ø  Death, like life, is process more than event.

Ø  The physician’s duty is not to return patients to their “old” lives, but to keep them living for their “new” one.

Ø  Bereavement is but another phase of marriage.

Ø  The fundamental question: How do I live a meaningful life?

My favorite quotes:

“Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?” (p. 71)

“Lucy and I both felt that life wasn’t about avoiding suffering. Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing life otherwise was like painting a tiger without stripes.” (p. 143)

“Yet I returned to the central values of Christianity—sacrifice, redemption, forgiveness—because I found them so compelling. There is a tension in the Bible between justice and mercy, between the Old Testament.” (p. 171)

“The main message of Jesus, I believed, is that mercy trumps justice every time.” (p. 171)

You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.” (p. 224)

This book was required reading for my oldest granddaughter as she was completing her undergraduate degree (as part of her capstone project). She recommended it to me. I am thankful for that, on multiple levels.

Wednesday, December 31, 2025

MeaningfulMonitoring

"That which is not monitored..............................is optional." 

Those were the words of a school administrator I once worked with. The truth therein is self-evident and weighty.

Monitoring, however, can become a burdensome tool. The process can also take on the look/feel/smell of being bogus and hollow.

How can we bring meaningfulness to the monitoring process? Consider some of the following as effective tools by which to assess the pursuit of continual improvement (aka monitoring):

  • Make clear the goals we are pursuing. 
  • Make conversations always about the goals, not the people.
  • Keep monitoring focused on the WHOLE more than just the parts.
  • Embed discussions about our goals into conversations pervasively.
  • Discuss those goals with ALL stakeholders, both internal and external.
  • Create some kind of metrics around which those conversations can be had.
  • "We" and "Us" and "Our" must always be the pronouns of use, not "I" or "You" or "They."
  • Brevity Rules! One short, informal conversation each week will yield better results than one half-day meeting each month.

We can do better. 
Every day. 
On purpose. 


Sunday, December 28, 2025

EverythingIsTuberculosis

I recently read Everything is Tuberculosis: The History and Persistence of Our Deadliest Infection by John Green (2025).

 JG is most well-known as a writer of fiction. He undertook this work as a departure from his usual foci, as much as anything out of curiosity as to why tuberculosis, with a known cure, seems so recalcitrant.

My top takeaways:

Ø  Roughly 30% of all humans have been infected with TB.

Ø  90 percent of people infected with TB will never become sick.

Ø  Inexplicably, 20-25% of people recover from active TB without treatment.

Ø  It is foolish to think that history belongs to the past.

Ø  Since TB thrives in crowded living and working conditions, it is often seen as a disease of poverty.

Ø  “Courage” and “Encourage” are powerfully related words in that they tend to call forth our best selves.

Ø  The colonial British Empire was excellent at building systems, with the intent of resource-extraction.

Ø  “Poor” is almost always multidimensional in nature.

Ø  In places where formal healthcare systems are not particularly effective more trusted spaces and people—like churches and faith healers—are often viewed in higher regard than doctors and hospitals.

Ø  Tuberculosis is listed in Guinness World Records as the oldest contagious disease.

Ø  “Inspire” = breathe in; “Expire” = breathe out, all the way out.

Ø  Many diseases exist where the cure does not; and the cure is where the disease is not.

Ø  Disease, and its treatment, are not only issues of biology; they also have nutritional, educational, economic, social, and political dimensions.

Ø  There are vicious cycles, and there are also virtuous cycles. The differentiators are CARING and LOVE.

Ø  What constitutes a good time and manner of death is purely subjective.

Ø  To effectively fight pernicious disease we need an entire set of robust systems that work perfectly in concert with each other.

Ø  We lose 1,250,000 people each year to tuberculosis. A curable illness.

 

My favorite quotes:

“Looking at history through any single lens creates distortions, because history is too complex for any one way of looking to suffice.” (p. 19)

“Once, when Isatu talked to me about her childhood, the interpreter used the word “woven.” ‘Myself and my friends were woven.’” (p. 27)

“History is often imagined as a series of events, unfolding one after the other like a sequence of falling dominoes. But most human experiences are processes, not events.” (p. 77)

“Before the germ theory of disease, we did not know that around half the cells in my body do not, in fact, belong to my body—they are bacteria and other microscopic organisms colonizing me. And to one degree or another, these microorganisms can also control the body—shaping the body’s contours by making it gain or lose weight, sickening the body, killing the body. There’s even emerging evidence that one’s microbiome may have a relationship with thought itself through the gut-brain information axis, meaning that at least some of my thoughts may belong not to me, but to the microorganisms in my digestive tract. Research indicates that certain gut microbiomes are associated with major depression and anxiety disorders; in fact, it’s possible that my particular microbiome is at least partly responsible for my OCD, meaning that the microbes are the reason I’m so deeply afraid of microbes.[*]” (p. 94)

“And this is why I would submit that TB in the twenty-first century is not really caused by a bacteria that we know how to kill. TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis is, for lack of a better term, us.” (p. 182)

“In a world where everyone can eat, and access healthcare, and be treated humanely, tuberculosis has no chance. Ultimately, we are the cause. We must also be the cure.” (p. 184)

“This is the gut-wrenching, heartrending injustice of living with tuberculosis in the twenty-first century: You live if you’re rich. And if you’re not, then you hope to get lucky.” (p. 187)

Glad my lovely bride recommended that I put my nose in this one. Enlightening.

Wednesday, December 24, 2025

Self-Deceptioin

 We deceive ourselves when...

     > We think we're smarter than everyone else.
     > We consider talking of more value than listening.
     > We accept blame and excuses as proxy for solutions. 
     > We assume that ignoring a problem will make it go away.
     > We underestimate the power of our words -- for good or for hurt.
     > We decide others need our unsolicited criticism. 
     > We lose sight of the power of genuine caring.
     > We conclude that we've learned enough.

When we tell ourselves these lies, we lose. As do those who depend on us.

Or, we can quit deceiving ourselves, and win. Which results in betterment for all concerned.

Sunday, December 21, 2025

EffectivenessRecipe

I once heard physician and leadership guru Dr. Eddie Erlandson say, "At the end of the day, we all just want to be more effective." An excellent point.

A number of years ago McKinsey & Company (a multi-national consulting firm), conducted a study of leadership effectiveness that included responses of 189,000 folks, from around the world, and from all kinds of organizations. You can read about it HERE

The researchers identified 20 key practices of effectiveness:

  1. Be supportive.
  2. Champion desired change.
  3. Clarify objectives, rewards, and consequences.
  4. Communicate prolifically and enthusiastically.
  5. Develop others.
  6. Develop and share a collective mission.
  7. Differentiate among followers.
  8. Facilitate group collaboration.
  9. Foster mutual respect.
  10. Give praise.
  11. Keep groups organized and on task.
  12. Make quality decisions.
  13. Motivate and bring out the best in others.
  14. Offer a critical perspective.
  15. Operate with a strong results orientation.
  16. Recover positively from failure.
  17. Remain composed and confident in uncertainty.
  18. Role model organizational values.
  19. Seek different perspectives.
  20. Solve problems effectively.
Interestingly, they also found that the four displayed in bold font above account for 89% of the effectiveness of the leaders of the highest performing organizations.

Note to self...

Wednesday, December 17, 2025

Standard(ized)

 Standardization is not always a good thing. 

Standardization is good when...

     > the 34" waist-sized pants have 34" waist measurement

     > the stopwatch accurately times the 400 meter race, just like the other stopwatches

     > the height of the bridge underpass is truly and consistently measured

     > the automobile tires we purchase fit the rims on our car

Standardization is not so good when...

     > We mistake fairness with equal treatment

     > Academic test scores are considered proxies for the quality or worth of the tested

     > Compliance is viewed as a moral equivalence

     > Blind obedience absent ethical consideration is expected and required

Standardization in "stuff" is an excellent starting point.

Standardization in the judgment and treatment of humans is not.

In both domains, Excellence goes beyond any attempt at standardization. Excellence is a far better goal than standardization. 

Sunday, December 14, 2025

EnforcementFailures

I worked once for an impactful leader who taught me much about how to think and behave if I wanted the best from others. Dr. Tom Gaul regularly reminded us that he "didn't hire us to enforce policy, but rather, to do what was right for our students (aka customers)." 

TG's argument comes down to the mindset of the leader, and whether it comes from an insistence on compliance, or conversely, an intrinsic commitment to worthy and noble outcomes.

The Enforcement Bosses I've worked for over the years focus on:

  • Endless compliance monitoring.
  • Layer upon layer of "permission" mechanisms.
  • Systems grounded in DIStrust.
Stagnation and self-preservation are almost always the result of compliance-based systems.

Pretty sure we can do better than that...