Social Media Is Not The Problem.


I’m an introvert, and I’m happy.  I’m comfortable with my own company and don’t ever feel the need to be entertained. Why others need to is a mystery to me. Sometimes, that lack of understanding is a disadvantage, but I am most of all happy with myself.

Recently, as I have watched the news, I have been struck by how needy people are, especially those in power. The need to be noticed and to be seen to be noticed is in my opinion perverse. However, coming from someone that prefers his own company you may not agree with my analysis. We are social beings and have a need for company and companionship. There is research to show the benefits of our social nature. I am not so naive as to discount the work but I have concerns about the direction of our community building. I’m not sure we are building the communities we need. Your smartphone should not be the limit of your social group.

My favorite pastime is walking in nature alone, and I have spent hours walking alone listening and observing the life around me. I don’t pretend to have any greater skills of observation than others, but I find peace in those moments I’m alone.  Like most, I have my smartphone connected at all times and within easy reach. I am connected and enjoy the ability to interact when needed. I just don’t think I need to interact at all times. In recent years I have paired back and have tried to live more “in the moment” than via my connectedness. Yes my phone is connected but my notifications are off. There are no email notifications, app notifications are off too. Only those who may need immediate responses are allowed.

I hear the complaints about social media making us less social. Social media is not the problem, we are. Smartphones, tablets, and computers are excellent tools. The problem is the workman. The connected world is still new, and society is still learning how to manage these tools. We need to teach our children how to use technology to enhance their lives while also not being overwhelmed. The commercialization of the tools, including the internet, is a push to make you the product.  Social media is a tool, don’t be the product. Use these tools to make your life easier, use it to your benefit. Use the internet as intended by its inventors, a means to communicate over unbridgeable distances. If we direct our children to see computers as a means not an end we will all be better for it.

As I see it, this intersection of valid use and addiction to connectivity is where we need to intervene. I don’t pretend to have the answers, but I would suggest the answers must start with us being able to be alone without being bored. We must learn to be with ourselves.

The ability to introspect and to self evaluate is essential to loving and accepting who we are. Loving ourselves and accepting our flaws is the beginning of understanding and acceptance of others. Acceptance of others does not mean we acquiesce to their opinions, but it allows us to be comfortable with our differences and not be stressed.

If we first learn to accept ourselves then we can more easily accept others. If we can become more comfortable with silence and our own company we will not need the approval of people we don’t know or will never see. Let’s spend some time with ourselves and unplug a little. I’m going to follow my own advice.

WE ARE WITHOUT SANCTUARY.


I am happy to be living in a country that affords me the opportunity to succeed. As a parent I am happy that my children will have more opportunities open to them than I did. My job is to guide them into success. As I look around America I am worried for my children in spite of all the opportunity that exists. The recent string of killings of men and women of color has helped to refocus my attention on the details. I, like many people of color in this great country have been lolled into a false sense of achievement. Worst is that we have allowed the wider society to accept the fallacy that racial justice as arrived. We have failed in teaching our children the important details.

As a parent of girls of color I have focused on making sure they are confident and well-educated, that is not enough. Over the last few months I have had to re-evaluate everything I have come to believe about equity in America. The history of people of color in this country is one of brutality and subjugation. There has not been enough change in our situation. In the last several month several studies have shown the depth and pervasiveness of our disenfranchisement. Our girls are 6 times more likely to be harshly punished in school compared to white girls. Americans of African heritage with master degrees are paid the same as whites with bachelors degrees and even doctors of African heritage are paid about 10 % less than similarly educated white doctors. Why is this so? I have come a conclusion, that question is not relevant. It is not relevant because those in power do not care to fix the problem. I have given up on the idea of equity in my country. The continued inequity makes me angry and concerns me for the future of my girls. I am angry but I will not be deceived into violence. Protesting does no good. Voting does almost as little.

So, in my quest to find a better answer I have looked around and think I have found the only viable route in the Jewish experience of World War 2. No one is allowed to forget the Jewish Holocaust and so too no one should be allowed to forget American Slavery and Jim Crow. The end of the Jewish Holocaust is celebrated but the brutality of it is what is referenced most often. This is what we all are reminded of daily. As people of color we need to teach our children about the brutality of the American enslavement of out ancestors and the continued brutality of Jim Crow America and the current discrimination. We need to have them understand that the current celebration of Martin Luther King Jr is fake and serves only to assuage the guilty. It is not a sign of contrition, it is hollow and designed to distract from the ever-present and pervasive discrimination against people of color. Our children need to know about the Martin Luther King Jr struggle before they can appreciated his success. They need to know and see the pictures of America brutality to their ancestors. They need to know the name Emmet Louis TIll along with Martin Luther King Jr. The goal is not anger, it is empowerment. Our children need to understand that things have changed and that we have many opportunities, but they also need to understand that they need to succeed in spite of the many race based road blocks. They need to succeed to honor their ancestors.

Violence is not the answer, it is only a way to continue to enslave us in the prison complex which is designed to strip us of the rights our ancestor died to attain. Our children need to understand the context of their lives in this land of opportunity. We need them to take the opportunities and make progress while making sure no one forgets the brutal treatment of our ancestors. We should honor our ancestors for their willingness to stand up for their rights and we should build on their success by taking the opportunities available and making the most of them. We know that we will not be treated fairly nor paid equitably because this is the current state of America. There is no real hope of progress beyond the eventual death of the merchants of death. As parents of children of color we need to prepare them to survive and thrive until that day of Martin Luther King Jr’s dream arrives. Don’t get violent, get angry and achieve.

WHERE IS THE CHECKLIST?


I have loved health care for as long as I can remember. I cannot imagine doing anything but providing care . What I have learned in the trenches is that the love of providing care is not enough. Over time i have realized that a fundamental problem with health care is not in the expensive of it but in the nature of the people in it. We want to provide care, but we bring into the system our biases. Those biases allow for less attention to be paid to some patients because of their language or skin color. We may say that we provide the same care to all patients, but as a black physician I see otherwise. My experience of the system at institutions where I am not known by members of staff is vastly different. The consequence of this uneven care is a system where those that can afford care and are the correction completion receive care that is more compassionate and timely.

How do we overcome the inherent bias in the system? The answer is not more training nor necessarily more diversity. The answer will be in the wide-spread use of evidence based payment structures. Our medical systems are complicated and expensive but are systems in name only. We have a complex string of components. All the parts are mostly well-trained and competent. However the results we obtain are not commensurate with the level of training nor the level of expense. The incongruity of expense and quality of results continues because those attempting to improve the system have not acknowledged or do not recognize the biases of the system. The gap in quality of outcome is most obvious in communities of color. The often given excuses are truly just that. Recognizing that there is a problem is the first step to a solution.

Paying for quality work is the only avenue to improved results. The question as to how we get better care for all patients is simple and complicated, but we have a great example in the aviation sector. My brother is an airline pilot and his training is extremity rigorous, but he starts his day with a checklist. He does not feel that his autonomy is being challenged, but that he is making sure that he does not kill himself. We in health care do not have any real skin in the game. Until the decision makers have some skin in the game we will not embrace what is necessary to make our constellation of components into a functioning system. Let us start delivering quality care by implementing checklists. Checklists are reminders of the quality in our options. The checklist is not for you it is for your parents and friends. That checklist is not for you, it is for that provider that is on her sixth surgery of the day. It is a nudge because she is tired. A checklist is for every one of us. It helps us by removing silly mistakes from our systems. For me the checklist is my hope that I will be treated like a patient deserving of care on the off-chance that I am a patient in a strange place where all that can be seen is the color of my skin.

WAR and PEACE


The cycle of war and peace continues like the flow of water. Unlike the processes of nature, it is not inevitable. The process of life is about choice. We have the ability to choose the path we take. The decisions we make are not preordained, we are our life’s directors. As we direct our life we must take care of the vulnerable among us. War is a selfish act, resulting from the disregard for the many. It is the result of disordered thinking, that justifies killing as a means of protection. The incongruity of that argument is evident if we would reflect on it. Our reflection must consider the social nature of our species where we will follow those among us that profess caring and loyalty to the group. Unfortunately, the malicious and selfish among us have and will continue to exploit the majority, until the majority decides to be as concerned about the stranger as we are about the ones closes to us.

The more important question that needs examining concerns what will our future be if we do not break the cycle. War may bring a temporary peace, but the underlying discord will resurface. The cycle must be broken, if humanity expects to survive. The cycle can be broken when we address the root causes. Where the root of war is usually the exploitation of the many for the benefit of the few. We must reconsider our use of the planet’s resources. It will be painfully to many, but will be beneficial to the most. We may not think that we are exploiting anyone, but if we examine our life it will become clearer that many of us are consuming excessive quantifies of the available resources.

If we all consider and re-order our life’s the great masses of the deprived on our planet could have the possibility to improve their lives. The cycle of war with interludes of peace could be broken by each of us say no to exploitation. We all have a responsibility to our species. Our care needs to extend further than down the street. We need to extend our care and concern to the father thousands of miles away that cannot feed his family, while we dump more food that we eat.

War is and always will be about resources. Let us all take a stand and share.

LOVE ALL EQUALLY


There is a continuing fight all over the world today. It is mental, intellectual and physical. I’m not talking about terrorism in its State and Non-State forms. I’m talking about the continuing fight for equality and civil rights. This fight is getting simultaneously easier and harder. The right to embrace our individual sexual orientation is to me a basic human right that is worth defending. Although homosexuality has gained much wider acknowledgment and in many countries is no longer a sentence to death or deprivation, there is still much to do. The improved prospects have been won by hard intelligent work. As with any progress, only vigilance will maintain the momentum and keep our society honest. Many will disagree but I will continue to wholeheartedly support the equal rights of all in our society.

The deprivation of rights from any member of our Society makes us all less free. Fortunately the fight for the future is already won because a much maligned generation, generation Y, has fully embraced equality. The continuing battle is to define a clear and open future for those who are unfortunately living under less equitable systems. Many in our culture still have not gotten the “memo” but the momentum is not with them, this movement is irreversible. As irreversible as the general direction of progress is, there will be setbacks. These setbacks will be reminders of how far society as traveled.  I am proud to be living in an age where we are having the discussion about living up to the ideals of equality expressed in our constitutions. The march of progress is evident in the many same-sex couples that are out and open. I am proud and happy to take care of the same-sex couples in the hospital. Many are older and the acknowledgment of their decades old relationships is something that many wanted to see but never expected. They have all lived extraordinary lives because their love survived the ugliness of an intolerant society. Other groups can claim similar experiences and we should celebrate together the maturing of global culture.

As a young person growing up in a proudly homophobic society I saw many around that were different but never judged nor did I defend. I was confused by the incongruity that was religious society. On one hand extolling the love of Christ while also calling for the death and persecution of others. It was obvious to me that the love of Christ should extend to all his creatures, but that was not the a prevalent opinion. This divergence is still a puzzle to me. Older and not necessarily wiser I would not change the culture of my up bringing, but I say now with much confidence that we had it wrong. I never spoke openly about my opinion, but treated all around me equally. The truth is that there are people of varying orientations in the Church and our Father has directed us to love all equally.

WHAT IS YOUR AMERICAN DREAM?


Every July 4th I remind myself of the courage of the founders of my country. The beauty of the declaration of independence is in the broad inclusiveness of the sentiments expressed. The global equality of mankind as expressed is at the root of the American dream. However, the history of our country is littered with the carcasses of failed policies and leaders who have not lived up to the lofty expectations of that celebrated document. The 4th should be used as a time to refocus on the sentiments expressed. This land of immigrants is not about where you were born, but about what you believe in. It is about fairness, equity and the continuous match toward a more perfect union.

The dream of America is alive and prospering despite all the attempts to distract. Some have lost hope in the self-evident greatest of the American experiment. I am not one. For people of color the American experience is that of continued heart-break, but there runs a determined strain of hope that as continued to improve our lot in this union. I read the declaration of independence on the 4th to be reminded of the promise and the progress. This is a marathon not a sprint, and we dream of true equality as we march toward that goal. This is my American dream.

I have hope because I have to be hopeful. I have young children and I know that the world has changed for the better and that change will continue. Most importantly I know that the growth in American society is irreversible because my generation and the following have made it so. As the country ages those who express the old prejudices have been out numbered and embarrassed into submission. There will always be a few stubborn ones. There will always be some expressions of darkness, but the light of equity is here to say. Progress has been slow and inconsistent but it is here to stay.

The continuous expression of hope and growth is why I continue to love my America. American greatness is derived from the philosophy of her people. If you were born in this land or emigrated the dream is the same. We are a people buoyed by hope and the understanding that we can be the best and always expect to be.

What is your American dream?

GIVE THEM THE FACTS.


I have been thinking about where we are going as a country and I do not like the trajectory. In spite of it I think we are not lost. There is still time for a late rescue. Examining the most recent employment data both encourages and worries me. The overall number and trajectory is good, the devil is in the details. Most of the jobs created are in sectors that have been and continue to be low paying. These jobs are low skilled and some would call them dead-end. The service sector is growing and has produced more jobs than it lost during the great recession. Job creation is great, except these are not the jobs needed to create a viable middle class. These are the types of jobs that create short-term corporate profits and shareholder value.

Many pundits with their ideological blinders on have “trashed”  the report while hailing the profitability of wall street without acknowledging the interdependence present. They are correct to be worried, but they have not taken the next step to discern the reasons. It is easy to say the government of the day has not provided the incentives for the creation of high paying jobs and that maybe correct. However, where are the high skilled workers? Why are there many high skilled job vacancies? I would like to suggest that the dearth of high skilled potential employees is a result of our ambivalence to and in many sectors disdain for scientific education.

We are a country of magical thinking and low expectations. Many believe that the magician from the heavens created everything and do not encourage their children to learn the foundations of science. These same people have been elected to positions of leadership and continue to lead many into the darkness of ignorance and scientific illiteracy. Our ignorance has allowed for the export of many potential jobs to countries with much less dependence on magical thinkers.  We need to put the work in that ensures that all our children receive a myth free first world science based education.

I am hopeful for America because our young people are willing and able to take on the challenge of a more competitive world. They will deliver if we are willing to allow them access to education without the misleading influence of our pervasive mythical belief system. I do not worry about our kids, I worry about the ignorance of the adults charged with guiding them. Our children are a reflection of the education we allow them to access. Educate them well and we will all reap the rewards.

“12 YEARS A SLAVE”


The best movie of 2013 was “12 years a slave”. It is a well told story with wonderful cinematography. The material covered is apart of American history and was necessary to be told. The beauty and tragedy of the story is that it is not fictional. It is the true story of one man and allegory of many. In telling the story the filmmaker presented the complexity, brutality and the tragedy that was the life of Africans in “slave” America. The representations of violence are not gratuitous, but instructive and do not feel contrived. They do however have you asking why and how? Why did slavery exist in a country that professed equality of all men and how was this system justified for so long? Gladly no attempt was made to answer those questions.

The power of the story can be seen in the reaction of the Africans to their loss of self-determination. The over simplified version is that there were two types of enslaved, the demoralized and the resistant. The demoralized made peace with enslavement and would not resist because he had seen the lot that fell upon those who resisted. While the resistant would continue to resist in spite of the consequences even to his death. The story of loss of freedom is tragic, but illustrates well the fleeting nature of physical freedom. The main character was betrayed by the trust that exists that allows free societies to function effectively. The trust that ensures that all are treated ethically and are equal under the law.

This is a wonderful movie that should not be missed. See it with your children. Make it a community event. Discuss it openly. The essential truth is the revelation that our physical possessions cannot keep us from bondage. The only freedom is that of the mind. The ability to move freely is significant, but the freedom to think as one likes is vital to the establishment a fully free society.

WHAT GUIDES YOU?


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.

IT IS OUR MORAL DUTY.


The curious nature of the American electorate once again fascinates me. The ongoing discussion of health care coverage and delivery is schizophrenic at best. The most recent pools show a population in need of health care coverage but the same group most highly skeptical of the most recent attempt to improve their ability to access coverage. Furthermore those who are most in need, and treated the most poorly by the current system are still willing to hold onto the failed system. It is unfortunate but the same the tactics developed and used by the cigarette industry to convince us that cigarettes are safe are being used to undermine the ACA. Many are against the ACA without investigating the potential benefits.

The cable talking heads have succeeded beyond their wildest dreams. They have so muddled the facts that it seems no one has a grasp of the services that will be improved. The problem with that assumption is that it is far from being a fact. The data are there if we as consumers would only look beyond the imbeciles on cable T.V. The problem is that our attention is firmly planted on the imperfections and not the goals. We are not being true to the fundamentals of American cultural strength, the belief that we can do it if we want to. I can only suggest that the opponents do not want Americans to succeed. The success of American Corporates is not the same as the success of Americans.

The intellectual dishonesty of the talking heads and those in charge of the news media is disheartening. They have no regard for the uninsured. The consequence is that the people who need help the most have been convinced that there is no help to be had. The truth is not deceptive nor is it hidden. The ACA is good for Americans. The ACA aka Obama Care is good for American business and will be a success. Success will not be achieved overnight, but will be a long hard fight. The fight is against those who do not believe that government has any part to play in the delivery of services and those who do. The battle is against the deceitful. The battle is against the business lobby. The battle is primarily against the ignorance that parades in fine suits on 24 hour cable T.V.

Those of us objectively looking on need to not only look but need to shout down the liars and the dishonest. How do we inform those that need the information the most? I would suggest a grassroots election style campaign. We need to start by informing ourselves. Each of us needs to study the benefits and pitfalls of the law. Without in dept knowledge we cannot be effective advocates. Go advocate, it is our moral duty.