The new year is here and I still cannot believe it. 2014 came and went at a seemly quicker pace. The truth is that the speed of time as not changed. What has changed is how we experience it. We continue to allowed procrastination to decrease how much we achieve. We over think and neglect to take the actions that would allow us to attain more of our goals. As we second guess our decisions the universe continues forward at the same pace we found it. We are achieving less and the feeling that time is going by faster is just a reflection of our lack of focus on the important things.

For the new year we all should stop thinking and start doing. I am a parent and want to leave a better planet for my children. What are you planing to leave to your children? The discussion about climate change is just one of those issues where we could improve the world for our children. The facts are not in dispute, the climate of earth is changing. I do not dispute that human activity is the cause. If you dispute that I hope we can at least agree that the climate is changing.

With that in mind I would ask you, how do you think climate change will affect your children or grand children? I would suggest that the most likely direct effect will be on the quality and quantity of food and water available. The current estimate of people around the world going hungry is about one billion annually. Concurrent with that is the fact that some of the most productive agricultural areas are in regions whose water supply is dependent on seasonal rain and snow falls. It is already evident from current objective measurable data that these regions are close to breaking point in their water balance. The drought in California, which is the current bread basket of the United States is worrying. The gravity of the danger is not being addressed. But if the level of the water in Lake Mead Nevada is any example we should all be much more concerned.

Our water usage patterns are unsustainable and more forthrightly has led us to a very dangerous place. Agriculture is the primary user of water both for plant and animal production. Animal production is an especially egregious drain on our every decreasing available water sources. The continuing willful deafness of many of our leaders to the coming and already present crisis is criminal. The low intelligence of many of the people on mass media discussing the topic is genocidal in their effect. As we continue to neglect the obvious the problem worsens and the solutions become evermore burdensome. The unfortunate consequence is that the poor all around the world are already experiencing the trauma of food and water insecurity. Even the wealthier among us are being affected. The difference is that most of us can afford the increasing cost of our basic supplies. The larger question needs to be asked, what will happen when the squeeze truly gets to the richer among us?

I am of the scientific persuasion and believe that all the evidence points to mans central impact in leading to climate change. However, I will acquiesce to those who have not attain that clarity. I need only you agree that no matter the cause climate change is occurring and that we need to act to protect our global society.

I would suggest that we start by examining our consumption patterns. Change your lifestyle and change the world. We are all apart of the change that we need.


Once more our country is focused on the aftermath of the death of a young black man. The frequency with which this scenario occurs is alarming, disgraceful and is not likely to change in my life time. I am a 40-year-old physician without a criminal record. I have a brother who is a Veterinarian and another an Airline pilot. Neither has a criminal record, but we all have experienced the brutality of American racism. We do not often talk about it. We live it and pray that our children will have a better experience. We want them to get a good education and not be killed by the police. That is our American dream.

The truth of what happened in Ferguson is irreverent to us because we live the brutally of knowing that at any moment we could be killed for no reason. As black Americans we have come a far way, but the fundamental problem for us has changed very little. We are not seen as humans, we are seen as murderers waiting for an opportunity. We are determined to survive so we try standing up for ourselves. However, standing up for yourself as a black man is seen as threatening. Success for us is about surviving the constant attempt to institutional us. If that can be avoided material success is possible, but only if you are not convinced to give up before you have had a chance to try. Material success is about picking your battles.

As a Physician I see the contempt patients show towards me at times, I swallow and still provide them the best care possible. I love taking care of patients and that care is not about anything but my pride in doing the best job I can. Because I provide you with care supported by the best evidence I am comfortable. In spite of providing excellent care I am challenged but nurses and patients. I often wonder what I am doing wrong, but it does not matter. I am of the wrong completion, so my care is subject to review. I need to justify my decisions with evidence, while others provide poor care and are not challenged. This is my life as a black physician.

I am strong enough because I was brought up in a culture that expected me to succeed. My early years in Jamaica has given me a belief in myself that is difficult to shake. It has been shaken, but I have recovered. Unfortunately my girls are growing up in a society that does not expect them to succeed. I will push them hard because their mistakes, no matter how insignificant, will be judged and punished harshly. I need to build in them confidence that is based on competence because our country will not give them the chances they deserve. I will teach them about how not to get killed.

The sad story is that my girls and my nieces and nephews will be at risk from violence from all sides. There is more violence in black communities both from cops and criminals alike. There is nowhere to hide, there is only learning how to manage the risk. Our treatment as black Americans is dependent on the complexion of our company. While out with my brothers and nephews we are treated like predators and undesirables. The excuses for treating us like monsters are varied but none are credible. In spite of the despicable treatment I often experience, I will still treat you well. I will still give you the best health care, although I will not be given the same treatment.

Rioting will not help nor will talking. Sorry Martin, I no longer have a dream, just a reality, ” Do Not Give Them an Excuse To Kill You”.

Be safe America.


We all at some point will and have questioned the meaning life. The content of the question maybe different, but the aim is the same. We all what to clarify the reason for our existence. We all want to prove the existence of a higher power. What is the purpose of life? For a long time I firmly believed there was  a higher power and tried to convince others to believe as to did. The imperative to evangelize is strong if we are convinced of the exclusivity of our belief structure. Therein lies the problem. The conviction of exclusive attainment of insight  often paves the path to dangerous attitudes and behaviors.

As I have gotten older and gotten more influenced by a non religious milieu I have come to the conclusion that the higher power is us. It is us that will create the future of mankind and it is us that have created the present. Our world is what we make of it and not a result of divine intervention. The mythical power of belief and prayer is deceptive and dangerous. If only we spent as much time delivering care and less on praying for that change. We have to deliver the change we deserve and expect. The power of belief to affect the physical world is not in doubt, neither is the fact that the claimed results are of biologic processes. The strength of the evidence is that belief is a powerful agent of chance, but itself is not the change agent.

Some suggest that there is nothing lost in believing, but I would suggest differently. Belief is wonderful as long as it does not detract from the facts. The loss of focus on the present and the fatalism of the religious is a consistent and persistent drag on society. Thankfully, we live in a country that for a long time has professed religion without allowing the religious to impose their will and fatalistic determinism on the rest of us. This escape has provided a fertile milieu for development. The dependence on evidence is and continues to be the basis of a properly functioning society. As noted in our current political debate the more religious the participants the less our leaders get done. The lack of productivity from the political class is a win for many believers, but only highlights the fatalism of their belief structure.

The troubling trend is that the religious and the professed have gained power and are attempting to reverse our gains. I hope we realize this troubling trend before it completely changes our country for the worse. I hope logic, reason, and evidence continue to guide us.


The march forward of human knowledge continues at an alarming pace. This in spite of the efforts of many in the political class. Science is continuing to shed sunshine into the dark places of myth and superstition. Although there is still much work yet to be done to cleanse humanity of petty and dangerous myths, we can have hope. We can have hope because the decreasing size of the global community affords even those in distance places the ability to enlighten themselves. Most strikingly, the young unencumbered by their parents constraints continue to push the boundaries.
The arrival of the computer age provides an avenue for the young and curious to explore without the rails of superstition.
We are living through a golden age of innovation, but most done realize it. Science is continuing to push the frontiers of knowledge and many believe that we know a lot about the world. Unfortunately, the truth is not as straightforward as we may think. For those on the front lines the void between what we think we know and what we would like to know grows with the more data points we attain. I would propose that as we push the boundaries we are awakening to how little we actually know. I would call our current position a kind of informed ignorance. I mean by that, that as science advances the natural world opens allowing us to realize its depth and breathe. As we advance we are confronted by the unmistakable conclusion that we truly are in the dark. This darkness prompts the curious to explore. The more we think we know, the more we realize we do not know. Knowing that, is more than half the battle.