The Calm Despite the Storm, 10 Steps to Living with Hurricanes

The weather forecast? Pleasant today, all hell breaks loose tomorrow. Enjoy the Sunshine State!

If you live in Florida as we do, you’re going to face hurricanes. We’ve had a good decade or so, but now they’rrre back! Hurricane season runs from June through November, but collectively we Floridians hold our breath in September and October, the heart of hurricane season, when the worst can be expected. This September we are off to an early start with Irma, expected to hit early tomorrow morning.

It’s time to breath out. Now take some slow deep breaths. In and out. Stay calm. Yes, we do have more to fear than fear itself, but fear isn’t helpful. My family is as ready as we can be at this point and here are some of our “secrets” to serenity as the storm approaches. (disclaimer – this is soley my personal opinion)

  1. Get educated and keep things in perspective – Hurricanes are terribly destructive and dangerous, but the actual chances of serious injury or death are very small if you are in a structure built to current code and not in an area subject to storm surge or flooding. Take appropriate precautions and you are unlikely to be injured.
  2. Avoid the news media  The media is not your friend. They live for eyeballs and eyeballs come from exaggerating the threat, exciting emotions and exploiting fears. We check the National Hurricane Center for updates, which are issued every three hours, and some local news sources for information on closures and resources but stay away from much else.
  3. If necessary, evacuate to an appropriate shelter – meaning one built to current code and not in an area subject to storm surge or flooding. That might mean just 20 miles inland as opposed to, say, North Carolina.
  4. Be prepared all the time so you don’t have to struggle to obtain needed items in short supply.While everyone’s situation is different, here are a few key things that we do:
    – keep the pantry well stocked.
    – own several 5-gallon collapsible water jugs (designed for camping) thus eliminating the need for bottled water. Fill before storm. After the storm, empty, collapse and return to storage.
    – use my Prius as an emergency A/C power source with a prewired inverter. It’s limited of course, but we can power the refrigerator, lights, and the cable modem and charge our devices. For those of you with hybrid vehicles this is very easy to do. See here.
    – store 20 gallons of gasoline in the garage at all times (in appropriate containers, with fuel stabilizer, and changed out every 6-9 months)

    Get some of these

    Prius Power!

  5. Cook and clean – Get some meals prepared in advance, do all the laundry, and neaten up the house. It keeps you busy; you’re ready in case you lose power; and you feel better in a clean and neat home. Make some treats while you’re at it. While prepping the yard, we got the limes off the tree yesterday, and Sharon’s going to make key lime pie for us today.

    Soon to be a key lime pie

  6. Accept the possibility of loss/hardship – Hurricanes are destructive. You are likely to lose something in the hurricane. Perhaps it’s just your landscaping, but it might be your roof. Your power might be out for weeks. Hopefully the damage will be minor, and if so, feel blessed! Personally, I’m pre-mourning for my palms (many newly planted) and trees. If they do okay, how good I will feel!
  7. Don’t go outside during the storm – Yes, you want to know what the wind feels like, but it’s just a bad idea. I’m sure it feels exhilarating right up until you are hit by flying debris.
  8. Connect with family and friends – most everyone could use some physical and emotional support. Shelter together as a family. Stay in touch with your friends and help one another as needed before and after the storm.
  9. Be careful after the storm – Chill. You don’t need to be the first to take a driving tour of the destruction. Cleanup should be performed thoughtfully and in an orderly manner. Think safety! Stay away from downed power lines. Be careful around felled trees and those wielding chainsaws.
  10. Pray and trust God

Good luck to all my Florida friends. Stay safe and we’ll see you on the other side of Irma.

Pete

I hope these guys make it.

 

 

 

 

 

 

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Feeling Small (but peaceful)

Events have got me feeling small lately. Perhaps you too. From hurricanes and floods to shifts in the economy and culture, we are all caught up in natural and social forces beyond our control. Way beyond our control. Beyond our influence even. America has over 300 million residents of which I am just one. The world has 7½ billion. I will not be changing the world or the country.

Our American culture and media don’t encourage thinking of oneself as small and relatively powerless. On the contrary, people are encouraged to worry about numerous issues over which they have no (or exceedingly little) influence. We’re told to “stand up,” “be heard” and “make a difference” on every new “crisis.” I think all that does is get us agitated and shouting at (or worse – fighting with) one another. And the media feeds off the fighting. Regardless, the vast majority of us are just along for the ride as large-scale history is written.

Yet here I am. I’m alive! I can enjoy my life, and I’ve got plenty of personal and local issues on which I can, and should, make a difference. Issues such as my health, wellbeing, marriage, family, friends, church, finances, home, and neighborhood. The more I focus on these and the less on geopolitics and major cultural shifts, the better I get. Thinking small is working for me.

However, even at the personal level, many events are still outside of my control. For example, I’ve recently developed an irritating case of ocular rosacea (fortunately minor, but illustrative). Illness comes. Aging continues. Accidents happen. Jobs end. The kids are going to do what they’re going to do. That’s life.

Truly, I am small. I can’t control much, but I trust in the one who can. Therefore, I can be at peace. I wish you the same.

Pete

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Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes?  Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?  Can any one of you by worrying add a single hour to your life?

And why do you worry about clothes? See how the flowers of the field grow. They do not labor or spin.  Yet I tell you that not even Solomon in all his splendor was dressed like one of these.  If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you—you of little faith?  So do not worry, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’  For the pagans run after all these things, and your heavenly Father knows that you need them.  But seek first his kingdom and his righteousness, and all these things will be given to you as well.  Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

– Jesus (Mathew 6:25-34 NIV)

Finding the Safe Space

I’m not a big believer in the concept of “safe spaces,” at least not as it’s being advanced by those (mostly but not exclusively young) people who seem endlessly offended by thoughts, ideas and words which conflict with their thoughts, ideas and visions for the world. On the other hand, full intellectual engagement with the media, social media, friends and associates on the topics of the day is certainly draining. So it’s reasonable to seek to protect oneself, to create one’s own “safe space” for rest, recovery and renewal. That’s what I’m trying to do.

I’ve been withdrawing a bit from the media and social media, skipping newspaper articles and Facebook posts that I would ordinarily read. Too stressful to engage. And really, what’s the point? Does anyone care what I think? What concrete actions would I take in response? Why inflame or depress myself if there is nothing for me to do about things?

At the same time, I feel the need to work on my character and draw closer to God. Wouldn’t it be great to have more peace and equanimity regardless of the actions of others and the stories of the day? Sure it would. And God promises that, but we have to do the work. To that end, I’ll be participating in a new men’s discipleship program on the spiritual disciples (source text here) beginning next week. I’m pretty excited. It’s just what I need! I wonder, did my church leaders create it just for me? Seems like it. Maybe they did. Who knows how God is working in this?

Praise God! Although he’s mysterious, we do know that he is working in all things for the good of those who love him. All things. Each of us will experience at least some very distressing things in our lives. This world can be a cruel place, and no amount of social engineering is going to cure oppression, poverty, sickness and death. Shit happens, and it happens to the weak and the powerful alike. Yet, God is here and he is good.

Hence Jesus. Has not Jesus reconciled us to God and overcome the world? Is not Jesus the safe space? I think he is. Find him. Follow him. And, as always, let me know if I can help.

Stay safe,

Pete

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I have told you these things, so that in me you may have peace.
In this world you will have trouble.

But take heart! I have overcome the world.

– Jesus (John 16:33 NIV)

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…And we know that in all things God works for the good of those who love him,
who have been called according to his purpose…

…If God is for us, who can be against us?…

…For I am convinced that neither death nor life, neither angels nor demons,
neither the present nor the future, nor any powers, neither height nor depth,
nor anything else in all creation, will be able to separate us from the love of God
that is in Christ Jesus our Lord.

– The Apostle Paul (Romans 8:28;31;38-39 NIV)

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A Vacation Reset

Sharon, the kids (adult kids) and I just returned from a weeklong vacation in northern California, Santa Rosa and San Francisco to be specific. We spent time connecting and reconnecting with various branches of our extended family and seeing the sights. It was a relaxing and restful time. Now that we’re home, I’m reflecting on my experience, and here are some of my takeaways.

I worry too much. The trip took my attention away from all of my usual responsibilities. No thinking about home or work issues, just staying “in the now” as they say. I enjoyed visiting people and places, and he most critical daily issue usually was “what are we doing for lunch?” Life got simple and immediate. It was nice. How can I bring this simplicity and immediacy back home with me? I’m resolving to be more attuned to the present and spend less mental energy on the future.

My family is worth my time. Not just my immediate family but also the extended family. People are relational creatures,designed to be in community with one another, and that starts with our families. If all we do is “see the family” that alone is worth the trip. Seeing the sights is not as important as seeing the people. I’ve got to remember that.

Disconnecting from the media is a good idea. While gone, I didn’t read the morning newspapers and didn’t miss them. I didn’t watch the news, and I didn’t engage in much social media. Although, we remained aware of breaking news and current events through the internet, we didn’t put much energy into analysis or discussion of the latest “crisis.” That was refreshing.

I was still thinking about our media-driven, feverish culture on the way home. During a three-hour layover in DFW, watching many hundreds of people (of all shapes, sizes and colors) go by, I got to thinking about them. About how each one of them, like me, had a life to live, and perhaps a family to care for. And about how each of them needed to think about getting home, eating lunch, and also the larger issues in their lives. And finally, about how little that most of the “crisis news” has to do with that.

The well-lived life is mostly an internal affair. I need to keep working on myself. And, with God’s help, I shall.

Pete

 

Fat – The Enemy Within

Well the new consulting career is officially begun!  I’ve just returned from a two-day engagement as a member of an advisory panel for a pharmaceutical manufacturer seeking input on the future of medical treatment for obesity and its complications. It was an interesting and enjoyable event. Most of what we talked about is confidential of course, but our more general discussions covered much of what is commonly known about the conditions of obesity and overweight. Common or not, two things struck me as worth writing about to an audience interested in health and wellness.

First, if you’re significantly overweight, your fat cells are working against you.  It’s easy to regard fat as just so much excess baggage, perhaps causing some bodily wear and tear, but otherwise inert.  It’s really a much more serious situation.  Fat cells are anything but inert.  They’re highly active metabolically, releasing and causing to be released chemical factors that adversely impact your internal physiology in multiple ways. I’m not going to go into the details, take my word for it, these guys are bad actors. To use an analogy from the headlines, think of your excess fat as tiny cellular Russians working to disrupt your body’s politics. You don’t want Putin hijacking your physiology’s executive branch.

Second, most obese and significantly overweight people suffering from diabetes or other physiologic disruptions never get much better.  Why not?  Well, that was an interesting discussion!  We all have our thoughts.  You’ve heard most of mine before, but here they are again:  People are weak, temptations are hard to resist. Life is hard, people are stressed out, and food is emotionally comforting; often the more comforting, the more unhealthy. Losing weight is hard work, and mostly we don’t like hard work.  Like water, we tend to take the path of least resistance, and the wide river of American popular culture empties its contents into the lake of obesity.  (And there are also some more “hard-wired” biological reasons that it’s very difficult to lose weight – hence the interest of pharmaceutical manufacturers)

But, as we also all know, some people get remarkably better.  We all know a few. How did they succeed where others try and fail or fail to try?  Once again, an interesting topic with no exact answers.  Here are my observations:  Some people simply “wake up” or “snap out of it” – having a sudden recognition and acceptance of their issue along with a willingness to do whatever it takes to get better.  (Maybe caused by a medical event or health crisis – e.g. a heart attack or needing to start insulin.) Some have a more gradual building of their awareness and resolve to levels sufficient to enable positive action. Many appear to need to hit an emotional and/or spiritual “bottom,” admitting their defeat and enlisting the help of God and others. The common theme is that some sort of internal shift occurs and then it’s a whole new ballgame.

If you’re struggling with your weight, or if you’ve even given up the struggle, have hope, because some people get remarkably better.  It can be done.  You too can do it, but first you need to have that mysterious “internal shift” and I can’t give that to you.  However I can invite you to shift, perhaps you’re almost there already and just need a nudge over the line.  Consider yourself invited – snap out of it and get going!

Most importantly, know that God can change you.  God wants to change you, and he has all power.  He never fails.  Turn to him to become the person you can’t be on your own.  And, as always, let me know if I can help.

Grace and peace,

Pete

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PS – for you movie fans – snap out of it!

More Compassion, Less Piling On

compassionnoun
sympathetic pity and concern for the sufferings or misfortunes of others

Sharon was out of town last weekend, and I thought I’d relax and watch a late night movie. Perusing our small DVD collection I ran across MASH, a film I’ve preciously enjoyed, and thought “that’ll do.” Sometimes it’s nice to just go mindless for a while with a movie that I know already. So I hit the play button and settled in for the evening.

Twenty minutes later I was unsettled. The film wasn’t sitting well with me. The lead characters are arrogant and mean, and their meanness bothered me. I’ve seen MASH before, many times, but this time was different. I was uncomfortable trying to enjoy it. It didn’t seem like something that I should enjoy. Eventually I hit eject and went to bed.

Although this seems to mark some sort of internal shift for me, I have been thinking about meanness versus compassion for the last few months. My social media feeds have way too many mean spirited posts and comments about people suffering the consequences of drug addiction, criminal behavior, or just plain bad judgment. Some comments are shocking in their nastiness. Do the posters truly think that the foolish young man deserved to die (probably after torture) at the hands of North Korean officials? God help them.

In healthcare, and in life, we all see a lot of undeserved suffering. Disease and misfortune befall people for no reason other than “bad luck.” Knowing that we too are vulnerable, we can be moved to compassion. But just as often, or maybe more, people create their own mess. Smokers get lung cancer. The texting driver crashes and dies. Shall we be indifferent to their suffering, or even cruel, piling on with hurtful commentary? Apparently a lot of people believe we should.

I don’t think Jesus would agree with that. We are to be compassionate, and we should be able to see that “there, but for the grace of God go I.” That doesn’t mean endorsing bad or foolish behavior. Some things are simply wrong. Nor are we compelled to fix everything (even if we could) for those suffering harsh consequences of their behavior.  But we can be compassionate.

I don’t know if  anyone can summon compassion in every circumstance; some behavior is truly heinous, but ending the piling on in social media seems like a good place to start. God help all of us.

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“Do to others whatever you would like them to do to you. This is the essence of all that is taught in the law and the prophets.” – Jesus, (Matthew 7:12 NLT)

Back to the Books

Now I remember why I didn’t want to be an endocrinologist!

My internal medicine board certification is set to expire at the end of this year. It lasts for ten years at a time, which seems pretty long until the end gets in sight. Well, the end is now in sight. Bummer.

The internal medicine certifying exam is quite hard. A lot of the questions end with a twist. I’ll be reading the clinical vignette thinking – “I’ve got this! Yes it’s an unusual case but clearly the diagnosis is __________” only to find the question at the end is not “what is the diagnosis? but rather “the best treatment is __________” and five potential treatments (all of which are good for that condition) are listed. Which is best? Why? Back to the story for more clues. It can be pretty frustrating.

I don’t really need to be board certified anymore. My clinical practice days are over, and my most recent administrative jobs have been very high level. But it feels bad to let the certification go. So I’ve decided to hit the books and take the test.

I’m enjoying the studying. It reminds me of when I was a “real doctor” and medicine is indeed very interesting. But it’s also a bit intimidating. There’s so much to learn. A lot of new things in ten years, but even reviewing the basics is a massive and daunting undertaking. Did I really know all this once?

Honestly, I put my chances of passing at 50/50 with the amount of work I’m willing and able to accomplish in the next 4½ months. More will be revealed.

In any event, I’m trying to learn more than just the facts. What higher-level messages am I getting during this process? Here are a few that I already knew (and you probably do too) but are coming to me with renewed force:

Your physiology is very, very, very complicated and finely tuned. Everything interacts with everything else. It’s all connected. Your body really is extraordinary, a marvel, even a “miracle.” If you’ve never studied biology, it would be worth it to learn just enough to be convinced of this through your own study. It could change how you think about your health – or your life.

When something goes wrong, other things are apt to go wrong. This is a natural corollary of “it’s all connected.” I learned this from simple observation in resident clinic. Serious conditions occur together. If you have one, you’re likely to have a bunch. Not all of them are avoidable, but try not to get that first one. Take care of yourself.

Many serious illnesses don’t have an identifiable cause. Some are autoimmune conditions, but then what exactly causes auto immunity? Others are more obscure. Perhaps unidentified genetics or environmental issues are at fault. We just don’t know, and perhaps some cause will be identified sooner or later. For now, sometimes what you get is what you get and there just is no explanation. That’s a hard message.

Doctors have a tough job. There’s so much to know and a great deal of judgment is necessary to balance risks, benefits and competing priorities in managing any reasonable complex individual patient’s situation. Normal physiology is complicated. Pathophysiology is more so. Then you’ve got the various diagnostic tests – sensitivity, specificity, risks, indications, contraindications, etc. – and the treatment options come with a similar set of issues. Back when I was a doctor, this was everyday stuff, not something to moan about, but now that I’m out of practice I have a growing respect for those who are still in the trenches.

As my studies progress, I’ll try to revisit what I’m learning, but this seems like enough for now. My basic message – It’s no fun to be sick, and sickness often snowballs. Take care of your health as best you can. Even then, things might go wrong for no apparent reason. If they do, find a doctor you trust to walk with you on your journey.

And, although it’s not in any of my study materials, trust God.

Pete

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You made all the delicate, inner parts of my body
and knit me together in my mother’s womb.
Thank you for making me so wonderfully complex!
Your workmanship is marvelous—how well I know it.
Psalm 139:13-14 NLT