12.22.18

the american president

Posted in Uncategorized at 7:49 pm by Administrator

in the wake of a shocking government shutdown, new revelations from the mueller probe, the announcement of america’s military withdrawal from syria, and a tanking stock market, the press is going after trump mercilessly. it is, as far as i can recall, the most vigorous news media onslaught a sitting president has had to endure, and it promises to carry into the new year and beyond.

six months ago, i (like many others) personalized the political situation of the country and harbored hatred for a president that i viewed as despotic, racist, immoral, and unskilled. but once i began to engage seriously in meditation, my feelings about donald trump began to shift, and it’s not because i came to see him in a new light. it’s because i refused to allow the collective suffering of the nation to captivate me. once i became mindful of the mindless momentum of the media-driven mockery of the masses, i was able to step out of that flow and save myself from the vitriol. that didn’t mean that individual issues stopped mattering to me entirely. but it did mean that i was no longer infected with rage about a man that i could not be present with.

the events of the past month however have enabled me to see Mr. Trump in a new light, and i find myself surprised today by how much more favorably i view him now in the context of these developments. perhaps if i were still incapable of any objectivity, i would have failed to perceive these things for what they are—landmark achievements that reflect a political approach very much aligned with my own.

first among these developments was the passage of the First Step Act, the most sweeping criminal justice reform bill of my lifetime. by all accounts, it is not enough, but even in its modest achievements—easing minimum sentences, making crack cocaine sentencing reforms retroactive, reducing barriers to rehabilitation, and facilitating the early release of many inmates—it is nothing less than a milestone. i credit not only the writers of the legislation and its chief advocates in both parties but also trump and kushner. i have previously written some unfairly critical things about jared kushner, but the fact of the matter is that he was mission-minded, persistent, and devoted to candid dialogue throughout the process of pushing the bill to congress, and i genuinely respect him for what he achieved.

second among these developments was trump’s ban on bump stocks, a long overdue but nevertheless gutsy move by an administration that relies heavily on the support of its conservative constituency. the ban is unlikely to go into effect in the near future and may be tied up in lawsuits and litigative particulars for years, but the ban was nevertheless a statement to the NRA that the government will no longer be beholden to its donor dollars. gun control activists will undoubtedly label this a token gesture, and for sure this ban will be insufficient to prevent future mass shootings, but we should see this for what it is—decisive action by a president who saw this as a matter of principle, not political expediency.

the third development was the aid package to Mexico and to the countries of the Northern Triangle, a story submerged beneath more provocative stories about this administration’s efforts to build a border wall and to deny entry to refugees. contrary to what some might be inclined to believe, this aid package is not a trivial concession in return for Mexico’s agreement to detain refugees on their side of the U.S. border, and it was significant enough to earn the vigorous praise of Mexico’s new president. more specifically, it is $10.6 billion for relief and development in the areas most devastated by decades of civil war, drug-related upheaval, and extreme poverty. on the surface, it might appear to be an effort to prevent dispossessed Guatemalans, Hondurans, Salvadorans, and Mexicos from becoming migrants to the U.S., but it is also a true sign of the U.S.’s willingness to take some responsibility for the human crisis that decades of destructive American foreign policy helped to foster. yes, the administration’s rhetoric on immigration continues to be reprehensible; but when you look at where the money is going, the mouth of this administration is expressing commitment to a longer-term solution. Trump deserves credit here for doing the right thing.

Trump’s announcement of a unilateral military withdrawal from Syria is highly unpopular among pundits and policy wonks, but anyone who has read my blog over the years can recognize how aligned I really am with him on this sudden and stunning decision. from my perspective, the best hope for stabilization of the Syrian region is the empowerment of Assad. Obama made a major blunder by directly involving the United States in the Syrian civil war through the provision of weapons and materials of war to the Syrian rebels, a fateful decision that ultimately armed the splinter factions that came together to form ISIS. is it fair for Donald Trump to blame Obama for the formation of ISIS? i believe that Trump has a legitimate case in arguing that the Obama-era policies did directly contribute to ISIS’s ascendancy in the region. in any case, the greatest current threat to peace would be a clash between Russian and American military forces in Syria, and an American military withdrawal from Syria mitigates this threat considerably.

does the decision betray america’s allies and increase Russia’s influence in the region? yes on both accounts. but what mattis gets wrong is that the best interests of the world probably do not hinge upon america’s ongoing commitment to a post-world war II balance of power formalized in alliances with Western Europe. libertarians and liberals should be able to understand this through the same lens; the hegemonic ideal preached by white neoliberals is a foreign entanglement that perpetuates colonial ambitions and systematic injustices on a global scale. already our european “allies” are entering a new era in which their collective commitment to a particular world order is being questioned, and in five years the idea of natural alignment between the Old and New Worlds might very well be viewed as an antiquated (if not frankly imperialist) ideal.

the facts on the ground simply don’t support a long-term American military presence in Syria. and among many “enemies” we have in the region, ISIS remains an arbitrary one to single out for special attention. the national governments of Israel, Iran, and Saudi Arabia as well as the militant organizations of Hezbollah and Al Qaeda are each vastly more problematic for the United States than ISIS could ever claim to be, and our complex issues with each of these entities won’t be solved by extending the plight of the Syrian Civil War by prolonging the cause of a Free Syrian Army that is destined to lose.

even in his undermining of his own political party through the government shut-down, i believe that Trump has done something oddly positive for the nation. this country is ready to move on from a certain brand of conservatism characterized by militarism, criminalization of people of color, inattention to the country’s educational and healthcare systems, and the indiscriminate deregulation of business. by refusing a spending bill on arbitrary grounds (the funding of the border wall), Trump effectively ensured that the Republican House would end its ignominious era with a whimper, while also creating a bigger wedge between himself and the Senate Republicans who openly loathe him. if his constituents follow him into this path of political conflict, it is possible that the second half of Trump’s presidency will assure the GOP of political doom—the disengagement of the conservative base from the political agenda of the Republican party. this would undoubtedly pave the way for a true Blue wave in 2020 and beyond—and the beginning of a new and decisively progressive era for American politics.

beyond these theoretical considerations, i find myself strangely excited for what Trump can accomplish with a Democratic House of Representatives in 2019. they are more aligned than they perhaps realize. Trump has no love for big pharma and has repeatedly spoken out against their pricing and unethical business approaches. unhinged and unencumbered by party loyalty, Trump might actually succeed in forcing the pharmaceutical industry to submit to price controls and regulation, which would protect American patients and reduce unnecessary healthcare spending at all levels. on top of this, Trump’s threat of all-out trade war with China is potentially aligned with the interests of the American worker (and thus the thrust of the Democratic party’s agenda), and if he can succeed in fundamentally revising America’s trade relationship with China in a manner that protects American intellectual property and its access to the Chinese market, then this would be a generational achievement that could promote the American economy for decades.

Trump is undoubtedly a flawed man, and i continue to hope that his expressed ideals and values do not represent the direction of America or its future as a nation. but there is more to his administration than meets the eye, and i would like to judge him fairly based on the good and the bad. there is good to consider—much good perhaps—and in this light, i acknowledge the efforts of our president to do the right thing. he is not perfect, but he is nevertheless the american president—and i daresay he may yet prove to be a worthy one

12.21.18

identity struggles

Posted in Uncategorized at 12:11 am by Administrator

money decisions, moments of grief, and ideas of achievement have all converged over the past twenty-four hours in a manner that has aggravated my ego and thrown me strangely off-kilter. I’m not sure writing about it is the best thing, but sometimes it’s helpful—so here goes.

in the aftermath of my father’s passing in the spring of 2017, my mother consolidated her finances and asked me to help her invest the money. my financial planner of course wanted to get intimately involved, but I decided at the time that his 1% personal charge on assets under management coupled with the 1.5% fee levied by his turnkey asset management company wasn’t reasonable for our situation. when I admitted that I was going to independently manage the investments, he gave me an earful and then proceeded to remind me every few months of the returns I was missing out on. I sat on the cash while the markets hit epic highs in the winter of 2017, privately regretting my decision but committed nevertheless to executing my plan.

based on my assessment of the market, I was convinced that the market would correct by about 15%, dropping the S&P 500 to a level around 2400 before ultimately effecting a slow, gradual rebound over 6-12 months. so when the S&P dropped below 2500 yesterday afternoon after twelve months of high volatility, I committed myself to putting a large share of my mother’s money into the market. it was heady, vigorous, and nerve-wracking work for me, and in the course of second-guessing myself, I found myself mired in conceptual thinking about the global economy, market timing, and the future of our finances. it was exhausting.

in a moment of mindfulness, I was reminded that money is about more than currency and purchasing power. it is leverage, desire, ambition, and identity all combined in one consuming symbol; it is a narrative of self that is not easily undone. the more I think about money, the more I suffer, because the more I think about money, the more my ego expresses its need for control, power, and permanence.

coincidentally, today was a very difficult day for the family and for my team. my wife got some bad news on her job applications, and a member of my team unexpectedly lost a close family member to a sudden death. normally, my grief response originates with the ego. I access personal memories, narratives about life, and ideas of the future in order to pave a path through grief and into hope. I found myself in the moment with my wife and with my colleague, but the words did not come easily, nor were my sentiments easy to access and describe. I instinctively wanted to share mindfulness with them—attentiveness to breathing, observation of self, disengagement from feeling—but I felt obliged to share what we commonly describe (perhaps mistakenly so) as empathy—a narrative of shared suffering and a common hope.

as I observe their grief, I feel a certain paralysis and inadequacy. once upon a time, I could count on a particular instinctive reflex to guide me in moments like these. it was a reflex triggered by the personalization of another person’s suffering, then magnified by a reliving of painful memories, then focused into a metanarrative of purpose and meaning, ultimately consummated in words filled with feelings, projections, and hopes. that reflex was a personal exercise in ego validation; it served no purpose but to create an emotional connection with others. perhaps emotional connection of this kind offers comfort, but I wonder if it is profoundly inauthentic. in truth, I cannot feel the suffering of another, not really. but i can experience something more profound: real empathy, rooted in a unity of consciousness that is based on a genuine awareness that is itself derived from an authentic experience of the present moment. silence, and the expression of powerful consciousness therein, can be sufficient; it can be a listening, a self-expression, and a profound mutuality all at the same time. this is the presence i find myself seeking, against my habitual tendencies.

we are nearing the year’s end, and there are many moments when i am tempted to look back on what i have achieved. there are many achievements to speak of. i have gained more than ten pounds of muscle. i can lift more weight now than i ever did as a twenty year old. i built a successful team; i managed managers and helped them to grow as leaders. I’ve raised a son who can beat me at chess. I’ve raised a daughter who can express herself articulately in words. i threw my wife a surprise 40th birthday party. i supported my friends and colleagues through difficult transitions and crises. i watched my eagles win a super bowl. i discovered mindfulness and became a transformed human being.

all of these achievements are ideas that my ego can build an identity around. being aware of my ego’s wish compels me to hold up these achievements in a different way. perhaps they are meaningless, as I’ve been recently tempted to believe. perhaps more precisely, these achievements are not things in themselves but rather reflections of moments lived. for example, my gains in strength are nothing to be celebrated in themselves, but perhaps they can be understood as the consequences (for better or worse) of many moments lived in the gym, of many moments when i chose against my tendencies to eat white rice, bread, and pasta. to consider these moments and not the achievements conceptually derived from them is to appreciate a life of infinite causes and effects, all of which are important but none of which capture any real identity

12.18.18

inspiration

Posted in Uncategorized at 8:35 pm by Administrator

I experienced three things in the past week that were inspiring to me.

the first is brandon sanderson’s new book Skyward. I’ve written about brandon sanderson before; he is without a doubt in my mind the most gifted active author that I’ve ever followed, in any genre. he’s prolific, imaginative, and seemingly capable of tackling just about anything. I wouldn’t be surprised if he shifted to historical fiction later in his career, but for now he’s producing one fantasy masterpiece after another. Skyward is brilliant. it’s not epic like Oathbreaker or mind-blowing like The Hero of Ages, but it’s readable, complex, and thought-provoking all at once. obviously, we won’t know just how important of a work Skyward will be is until it is understood in the context of its sequels, but it’s impressive as a stand-alone work. I finished it in three days.

the second thing that inspired me was the movie I, Tonya, which I finally got around to watching. it took me three separate sittings to get through the film, not because I was bored but because I was too tired to take the whole thing in at once. that’s a fairly common issue for me and the reason that I’m reluctant to catch movies in the theater nowadays. the experience of catching the movie in thirds actually made the movie that much more interesting to me, in retrospect. I found the first third of the movie to be conventional biopic material with a sardonic twist. the second third of the movie was quite a stunning depiction of domestic violence and severe spousal abuse, which at times was so graphic that I found myself wincing. the final third of the movie, and the final scene in particular, was unexpectedly magnificent—a sharp and poignant critique of america, a bittersweet reflection on a lifetime’s opportunity wasted, and a subtle admission of profound regret. I watched the final scene four times. the last time I was so struck by the conclusion of a film was when i saw Chazelle’s “Whiplash”.

and lastly, I have to admit I was inspired by the Philadelphia eagles and their upset victory over the Rams on Sunday night. I’d bought the tickets for my wife and me during the pre-season, expecting that this would be a match-up of two heavyweight NFL contenders. three or four days before the game, I thought very seriously about selling the tickets. my wife didn’t want to go, but I managed to convince my son to go with me. it was his first NFL game, and it was a fun one. with all the eagle fans in attendance, it was a rowdy crowd, and it felt like a home game at the Linc, and the team (for once this year) didn’t disappoint. BDN balled out, the defense rolled, and we had a blast.

a few weeks ago, an old mentor of mine asked me what my purpose in life is. I told her that this is a difficult question for me now, because I don’t expect purposeful life any longer. I used to fear emptiness and approach it with some sadness; I used to fill my life with plans and activities to avoid the specter of a meaningless and lonely day. now, I resist the idea of purpose, even in the moment before me. so I admitted to her that I have no purpose but to be free from suffering.

she thought that was all fine; and then she told me that my purpose is to inspire. she reminded me of my ability to connect with people, to move their hearts, and to change their minds about what they struggle with. “I’m inspired by you right now,” she said. “I think you need to know your gift.” and it gave me pause, because the examples of my impact on others that she brought to mind were things I’d stopped remembering. they were moments when perhaps I had emotionally manipulated people, to false ends and for egoic motivations. after my conversation with her, I was tempted to look at those moments differently; but it was difficult, because I have only ever known my achievements through the lens of my ego.

just last week, I delivered a speech about loss and bereavement to the three hundred and fifty management leaders at my company. and this morning, I offered my candid thoughts about what leadership really means, to eighty or so of our clinic administrators and medical directors. people told me what my words meant to them. but I do not know what to do with their praise. the person that I go home with every day is unimpressed with how I influence others, and it remains unchanged by the reactions of the people that I impact. the person that I am is very ordinary, almost nondescript. the person that I am talks to people, using words and cadences that communicate not just facts but also stories about what people do and why they do these things. these narratives at times are conceptual and possibly contrived as well. and so I do not know what the real value of my contributions will be, in the end. but that question matters less to me than it once did. I don’t matter, nor does anything that I accomplish in the eyes of others. all that matters is my experience of this moment; all that matters is the awareness that I gain, which is what enables me to experience the living unity of all things.

there was a moment when I stood on stage in front of a large crowd and stopped listening to what I was saying. I took a mindful breath; I took three mindful breaths. I saw the people who were looking at me. my mind was very clear, and I was aware of the space that we shared. I forgot about myself the performer, and I thought about myself the living human. someday soon, I will experience a moment called death, and the life that I lived will become a story for a while in the minds of the people who knew me. but my life, like my words, will disappear and be forgotten. my life will be reabsorbed into the universe of evolving life and expanding consciousness. what I bring back to the universe will be exactly what the universe gave me, minus the pleasure of breathing which I alone experienced and cannot give back to the world that birthed me. but I hope that my pleasure at living might itself have consequences for the lives of others. if that is inspiration, then that is truthful, and that is enough for me

12.13.18

Immortality

Posted in Uncategorized at 7:51 pm by Administrator

it’s quite interesting to me that a key insight from decades of medical research on health outcomes is a very intuitive one: mental health and stress management predict physical health outcomes. the Framingham tool for predicting a coronary event identifies a type A personality as a top-2 risk factor. depression has been identified as a strong risk factor for diabetes and other pervasive chronic health conditions. optimism and hopefulness predict long-term health outcomes in cancer patients. so many disparate pieces of medical evidence suggest that mental wellness predicts the health of the body and longevity.

so when my patients admit to me that they are increasingly relying upon positive thinking and “positive energy” to heal themselves, I’m all for it. most internists cynically assume that the majority of the “pathology” that they see in the exam room is psychosomatic, but another way of looking at it is that the impact of stress and unhappiness on the body is legitimately profound. when my patients learn to respect the mind-body connection in their approach to health, I assume that they’ve arrived at a real and potentially transformative truth—that we are the cause of our own great suffering. awareness in the Buddhist sense is where we begin the path to self-repair and real healing.

I’ve observed another important thing about my patients with chronic illnesses who apply mindfulness in order to improve their health. they often visualize the disease at work within them. they visualize the organs and tissues being impacted by those diseases. and they find themselves able to send positive energy to the parts of themselves that are suffering from disrepair. ten years ago when I started in clinical practice, I would have perceived this as wildly imaginative New Age thinking. but there’s actually observational evidence now (anecdotal i’ll admit) to suggest that these mindfulness approaches can be effective in reversing disease processes such as malignant tumors.

my point in exploring these observations actually isn’t to advocate for a naturopathic approach to health, though I’m more open to the idea than I once was. what actually interests me about this line of thinking is that it highlights the potential impact of conscious awareness on our level of physical functionality. to me, the implication is that as we develop mindful awareness to a deeper and more focused degree, we can integrate with our physical forms to a level that enables us to sense physiological signals and respond appropriately and even therapeutically to those signals. by contrast, as we become dominated by preoccupations and manifest psychological stress, we lose our ability to be attuned to all the subtle expressions of our body parts under strain; we lose the capacity to respond in a manner that alleviates that strain. this is how we age prematurely. this is how we gradually break down and submit to all the manifestations of disintegration—chronic pain, metabolic disorders, and cognitive dysfunction, among others.

what fascinates me is that at the microscopic level, the human cell regardless of its differentiation actually lacks nothing required for immortality. the cellular membrane has no intrinsic lifespan; the Golgi apparatus is not necessarily destined to lose its function; and DNA does not inevitably unwind and disintegrate to its component nucleic acids. the human cell has an extraordinary capacity to repair itself, reconstitute its various parts, and sustain its genetic identity and function. cells and cell lines can thus be immortalized for scientific experimentation. what causes cells to die is not something intrinsic to the cell; rather, it’s external pressures, signals, and deprivations along with the lack of a self-sustaining cellular response which ultimately lead the cell to its demise.

what if the cell was capable of awareness? it’s an extraordinary supposition but not an unrealistic one. we assume that awareness is pinned to consciousness, which itself is an emergent property of synaptic connections in the brain. but that’s theoretical at best. how exactly does a group of brain cells synergize to generate something radically different from the sum of its component parts? I would think it logical to raise the possibility that the seed of consciousness resides in the individual neurons—and that this consciousness is not created so much as potentiated by the interaction of these neurons. and if the seed of consciousness resides in the cellular identity of a neuron, then why can it not also exist in the cell of any organ of the body?

when I think of afterlife as described by the prophets of old, I consider this idea: that physical immortality is possible if awareness at the cellular level is realized. if the distal tubular cell of the nephron for instance becomes self-aware to the degree that it not only fulfills a function but also senses its responsibility to self and to others, then it can sustain itself indefinitely, as it lacks none of the basic physiological requirements for ongoing self-repair and perpetuation. and if the composite self—the consciousness built upon the consciousness of all integrated cellular life within the body—can sense the needs of all its interconnected parts, why can’t the whole of its being devote itself to the health of all organs, tissues, and interactions within, in a manner that sustains bodily regeneration? I wonder if this reality—the genuine awareness of all living parts of an inter-being—is the basis of what we would describe as redemption of the body. and I wonder if the redemption of the body does not also hint at what it means for the society of living beings to experience redemption—the profound and mutual awareness of all organisms that enables not only the dignification of all life but the interactions necessary to the eternal sustenance of their inter-being.

love, if it can be so described, resides in this awareness. after all, love without profound understanding is little more than a passion of self-projection.

12.12.18

death and the resurrection

Posted in Uncategorized at 10:09 pm by Administrator

the other day I was listening to a Miles Neale reflection on amazon music on the body. his point was simple—that there is no unitary sense of self that can be derived from one’s physical form. the body is constantly changing at the macro and micro levels, and any fixed sense of identity based on the experience of the body can be nothing other than “illusory”. I found the reflection to be unsettling and fascinating at the same time.

in a subsequent time of personal reflection, I found myself exploring this idea more closely. if I consider myself at the organic level, there are organs that I privilege in my conscious sense of self. for example, I privilege the aspects of myself than can be seen by others—my hair, my skin, my musculature. I also privilege the organs that generate sensory feedback that I find critical to my experience of the world, such as my eyes, my ears, my brain, and my genitals (oh yes, can’t forget the gonads!). but I am rarely if ever aware of the parts of myself that are no less essential to my daily survival—my kidneys, my blood, my liver, my spleen. on a microscopic level, I am never aware of the countless cells within me and hidden from view, silently metabolizing and building the things necessary to my function as a coherent organism. as far as I know, these cells do not despair at the inability of my consciousness to sense their importance, even though they are no less a part of this form than the neurons that synapse to create my conscious mental activity.

it gives me pause to consider my fear of death. what I fear mainly is the loss of my consciousness, the loss of the perceptions, idiosyncrasies of thought, and capacities for interaction that I instinctively identify as my self. the irony of this is that I do not fear the loss of the epithelial skin cells that I slough every minute of the day; or the oral mucosal cells that die every time that I eat or drink; or the endothelial cells, interstitial cells, and plasma cells that die after hours or days of life, never to be a part of my physical form ever again. I do not think of their brief lives, nor do I wish to sustain them. in fact, I would fear for myself if any of these cells sought immortality, because this would be a cancer that would put my whole being at risk. so I do want to live; but the desire to live implies a need for all the short-lived and silent lives within me to pass through me and out of me without resistance or self-assertion. I live only because the innumerable living parts of me agree every day to be left forgotten and to die.

I wonder about my nephrons. if I were to insist on immortality against all natural laws, I would certainly be dignifying the parts of me that I privilege in my awareness. but what of the nephrons, buried deep in the cortices of my kidneys? would an eternity of processing pee be the proper destiny of the cellular life consigned to the nephron? who am I to say that the life captured in this cell is properly expressed for all time in that particular function, in that particular place? if the nephron dies, then its cells can pass back into the earth. the genetic material in that cell can become part of a tree, or it can be incorporated into the heart of a lion, or it can be consumed by a child and integrated into the retinal fabric lining her eye, to translate patterns of illumination into ideas of form. unless the nephron dies, its cells cannot be anything but a plumbing system embedded in the recesses of my body; but if what I am returns to dust, then all the matter within these cells can become parts of other living things, again and again across the generations.

I am an inter-being, I realize. I am a compact between innumerable pieces of life, each of which has come together by accident or by design, some to quite visible purposes and others to obscure ones. the consciousness that has emerged from this compact wants to preserve this arrangement for as long and as well as humanly possible. but as consciousness expands and awareness becomes more and more profound, i might recognize that my consciousness is just one aspect of the inter-being of lives that is my form. to be aware of all aspects of myself, both visible and obscure, is to appreciate and to love all that is not conscious within me. it is to recognize that even when my consciousness ends, the rest of me will not simply cease to exist; and in fact my consciousness must end so that all the disparate parts of me can rejoin the universe and find dignity in its mysterious design.

as i am an inter-being, i can understand God as the inter-being, not simply in the idea of trinity but in the idea of God’s connectivity with all consciousness in the universe. honestly, i do not know what to make of the resurrection. it once caused me great fear to imagine that the end of my form would mean the permanent end of my consciousness. but when i consider the great limitations of my consciousness and the facts of my life that evade consciousness, i find myself more ambivalent at the thought of its death. i know that the biblical scripture states in more than one way that we will be raised from the dead to face judgment and to experience a state of existence that is beyond human comprehension. in a sense, this is not hard to imagine. if there is indeed a great consciousness at work in the universe, and if this consciousness is acutely aware of all conscious beings who have ever lived, then this awareness itself could be sufficient for the reconstitution of all life past and future, replete with the collective memory of cosmic inter-being. but i don’t know what to make of it, except when i think of the nephron within me. for many years, i was not aware of it; even now i cannot feel its presence. but i know it is there, and i appreciate its complex, intricate, and beautiful functions. i imagine that were i ever to come back to life, i would want to dignify this part of me, to give it expression and a voice, so that its life with me into eternity would not be a consignment to hell but rather a mutual awareness, made perfect in bliss