Visual Meditations

Rest Inspiration


Near the path, one of the tall maples has fallen. It is early spring, so the crimped maroon flowers are just emerging. Here and there slabs of the bark have exploded away in the impact of its landing. But, mostly, it lies as it stood, though not such a net for the wind as it was. What is it now? What does it signify? Not Indolence, surely, but something, all the same, that balances with Ambition.

Call it Rest. I sit on the branches. My idleness suits me. I am content. I have built my house. The blue butterflies, called azures, twinkle up from the secret place where they have been waiting. In their small blue dresses they float among the branches, they come close to me, one rests for a moment on my wrist. They do not recognize me as anything very different from this enfoldment of leaves, this wind-roarer, this wooden palace lying down, now upon the earth, like anything heavy, and happy, and full of sunlight, and half asleep.

Mary Oliver

The bit and the radiance

I’ve been working with some meditation teachers on the topic of knowing or intuitive guidance. It has struck me that I have been living my life with one part of myself running the show. I’ll call this part the competitor.

The competitor believes in success and failure. He believes that you can win at life. That if you achieve X (e.g. grades, money, job, children, house), you are a winner and if not, you are a shameful loser. This part came online after getting bullied a bunch in my school years. If I was a loser according to my school’s social pecking order, then I could at least win at academic games, the competitor reasoned. I’ll show them!

And so, I would stay up until 4am on some high school nights, studying, pushing myself. I wanted acceptance, love, and this was the best way I knew how to get it. By memorizing AP biology facts.

In this process of memorizing stuff, I forgot something much more important: how to listen to my deepest self.

My therapist once asked, “Where do you live?” She meant this not in the physical sense of my home address, but in a psychological one. In what kind of mental/subjective spaces do I reside?

I think, for much of my life, I have been living in the bit. 

By this, I mean: a hyper-rational, goal-oriented part of my brain. A part good for making lists and paying bills, but less good in making decisions that don’t have “right” answers: How should I live my life? How should I spend my time? Where and with whom? 

The bit likes to convince me that I will only be OK if I succeed at the goal du jour. The bit is in a constant chasing project: learn this skill, run this distance, clean the house, have a family! When the bit is steering the ship, life is not alive.

When I was small, my grandpa Shulim and I would go on long walks around Buffalo. We would talk, explore. The world seemed safe and open. Full of wonder. All I had to do was be. This was a time pre-bit.

The bit has other names: conditioning, adaptive strategies, parts. Thought and emotional patterns that were helpful for survival at one point, that are driving the boat a bit too much these days.


In college, I read the book “The selfish gene,” and somehow, my competitor bit got the idea that success at life meant distribute my genes as widely as possible. A new objective came up. 

It came from a place of fearing death. Another part of my brain, another bit, has been arguing, lately, with this as a worthy goal. If I think carefully, I can see that this objective is actually already accomplished: my genes are already diffusely distributed among all people. If I did have lots of ancestors, this would be the effective result, just generations later. 

The above analysis was two cognitive bits working against another. Two bits competing. This isn’t a bad thing: it’s a useful skill to be able to challenge distorted thinking. One big cognitive distortion that’s been useful for me to get over has been the denial of death: that there is some accomplishment out there that can make me immortal, respected, powerful forever. 

But getting cognitive ducks in a row only gets you so far. It doesn’t take you to joy, to living in radiance. 


Radiance is always available, and it can be used to make decisions. I am practicing the simple skill of attuning with radiance now. The main distinction between the bit and the radiance is how they feel in the body. The bit feels tight, in my throat, head and shoulders. The radiance feels relaxed, diffuse, surrendered, in my heart, shoulders, throat. Radiance is having, and acting from, good intentions. Radiance is heaven on earth, available right here and now.

This year, I met a patient who was the embodiment of dying well. She hadn’t become famous, powerful, or immortal, but she felt ripe, content with how she had spent her life. She’d lived, a good amount of her time it seems, in her radiance.

We are both cosmically insignificant and cosmically significant. My patient was significant to the people she met, including me. She motivates me to continue the work of living in radiance, not letting the bits unconsciously run the show. Yes, I still might be jealously looking over my neighbor’s fence quite often, but I don’t have to stay there, I can catch myself. 

I pray that you live in your radiance as much as possible, in this life.

Two paths to contentment

Awake early this morning, I thought about life, about pretty much all human behavior, and I saw two major paths to happiness / contentment. I called them the default path and the alternative path.

The default path is what pretty much everyone is doing all the time.

I thought of different aspects of my life:

  • The size of my kitchen
  • The size of my muscles
  • The size of my bank account
  • The love in my life

Whether or not I am content in that area depends on if reality meets my “enough” point, wherever that is.

The problem is that we don’t think consciously about our enough point. I certainly don’t. Advertising + society + hedonic adaption tend to move the enough point toward the right, toward more. If we are not conscious, we can end up as a “hungry ghost,” always searching for more, never satisfied.

The alternative path to contentment involves moving the enough point lower. Some ways to do this:

  • Deprivation. For example, long-distance hiking, fasting, taking cold showers, sleeping on a mat. Once you do this for a time, you become more grateful for what you do have. A small kitchen is amazing in comparison to the kitchen that’s available while thru-hiking, for example.
  • Diversification (of your models). We naturally compare ourselves to our social circle. If our social circle consists of one type of person, with a clear metric of “success” and we don’t fit in to that metric, we might think of ourselves negatively. An antidote is making friends with humans of diverse cultures, ages, perspectives, life stories. There is not one way to live life, there are as many ways as fingerprints.
  • Gratitude. Start a jar of awesome to celebrate small moments of amazingness in life.

If you’re not good at celebrating small things, you won’t be good at celebrating big things either.

Tim Ferris.

Both paths can be useful, and they both have a downside. Relying exclusively on the default path makes you a hungry ghost. Relying exclusively on the alternative path may make you not take steps to improve life. A good life, I think, utilizes a combination of the default path and the alternative path.

Glimpsing true nature

I woke up last night because the cat was going crazy. I started reading Be As You Are, a spiritual book by an Indian guru named Sri Ramana Maharshi.

I’d heard Sam Harris talk before about nondual awareness, and I’ve been in Zen communities where there is a lot of talk about the relative and the absolute, but it was all sort of murky and abstract.

Somehow this passage from the book made these ideas click for me:

…The belief that there is a person who experiences a state…is not true. It is merely a mental construct. The truth of the Self is that there is only jnana (reality)…

What is dualism? It’s the distinction between ego and experience. This is baked into our language:

  • Instead of saying, “There is fear,” we say, “I am afraid.”
  • Instead of saying, “There is craving for chocolate,” we say, “I’m craving chocolate.”

What is non-dual awareness? It’s taking experience as the only thing that is, not telling ourselves stories about how this experience affects a character called “I.”

For example, if the cat wakes me up, I might tell myself any number of stories:

  • “I’m going to be so tired today” or
  • “I should have closed the door” or
  • “The cat as an inconsiderate asshole.”

From a nondual perspective, I would just accept the bare experience of being awake at 1:00 AM, which could be anger, tiredness, excitement about having the chance to read, what have you.

Old habits die hard. And the habit of seeing the world dualistically is probably the oldest of all. So the path of awakening involves repeatedly glimpsing nonduality, true nature, the absolute, no-self, whatever one may call it. The claim of my meditation teachers is that by doing this during everyday life, moments of presence will become longer and continuous. And after a moment of presence, my job is to see it as the grace that it was, and let it fully absorb into my being.

What’s the benefit of this? Well, relief of suffering for one. Grasping the pleasant (cake and approval) and running from the unpleasant (broken arms and disapproval), can make life a drag if that’s all you do. Buddhists call it suffering. Bob Marley calls it a rat race.

A common criticism is: how can you take action without an ego? I think it’s possible that action can come from a stiller, wiser place. But I’m not sure. The only way is to try it out and see.

Dishonest anger

Anger is like coffee, but more effective. I was sleep-deprived today, but after a shot of anger, I’m wide awake. I feel it in the back of my throat. So much energy.

The bright side of anger is that it can give me energy to stand up for myself when a boundary gets crossed. I feel the need to roll up my sleeves and defend myself. Draw blood, even.

But there’s another kind of anger, a dishonest kind, that functions to feed my ego and keep me from feeling things I need to feel. Like feeling guilt and taking responsibility, for instance.

This kind of anger came to me the other day when I forgot a meeting with a friend. What was my response?

I got angry at her for not calling me!

What was this anger covering up? A bunch of things I didn’t want to feel:

  • Guilt about forgetting the meeting
  • Fear that my friend will be mad and break up with me
  • Shame about being a bad friend

The guilt was an appropriate feeling: I forgot the meeting. I should feel guilty. But in the grand scheme of things, it wasn’t a huge deal. Everyone forgets things. It happened to be a not cool thing to forget, but it was still part of the reasonable fallibility of humans, not evidence of my evil nature, worthy of perpetual shame. It would have been good to feel my guilt, learn my lesson, and move on.

But instead, this is what happened:

My anger got bigger and louder, to the point where it was the only feeling I was aware of.

Mark Manson talks about becoming an emotional ninja. This means being someone who is capable of identifying, feeling and learning from all the emotions, pleasant and unpleasant.

This experience taught me that I’m not good at feeling guilt. My ego doesn’t like it.

Also, I’m not good at talking myself down from fear or shame. That’s why I got so angry (more specifically righteously indignant) at my friend. So I didn’t have to feel those feelings.

Here’s to getting better! Self-awareness is the first step, which is why I wrote this post. Here’s a checklist for myself:

The next time I get angry, I should ask myself:

  • Is this anger covering up something I don’t want to feel, like fear, guilt, or shame?
  • Do I share some responsibility here?
  • If neither are true, then the anger is honest. I should go for a long walk, vent to someone separate from the situation, sit with the feeling, or set a boundary, but certainly not suppress the anger. It will change into something else eventually, as all emotions do.


It seems to me that every emotion can have these two varieties: one that’s legitimate, and another that’s covering up something we don’t want to feel.

Work that’s enough

Work that’s enough threads the needle of joy, utility and meaning. Source

I’ve been through my share of career angst, but today I had an interaction with a patient that made me realize how far I’ve come in answering the question: in the domain of work, what is enough?

For a long time, I had this unconscious belief that my job had to be special. I would say things like, “Yes, I helped this person, but anyone could have made that diagnosis.”

My therapist called me out on this: “Yes, but you made the diagnosis.”

Humans are deeply interdependent. If I have a car problem, a mechanic would be useful to me. In the same way, I am useful for people with neurological problems. It’s meaningful for me to help people, to do my part, even if my contribution is something small.

I derive joy from meeting diverse humans and learning about their lives. My patients give me the gift of their perspective on life, in the interstitial spaces of our visits. These stories enrich my soul.

It’s helpful to have reasonable expectations about what good work is. For me, good work threads the needle of joy, meaning, and utility. For a long time I had a fourth circle in my Venn diagram: doing something unique, something that would blow the status quo out of the water. Now I see that this fourth circle is not necessary; it’s an egoic desire to look good, to be a rockstar on the TED Talk stage.

As I reflect on my day today, my highlight was super normal: diagnosing carpal tunnel syndrome in someone who needed surgery, connecting with a him and hearing his story. There are other meaningful things I want to do in the future, like environmental work. But that’s for the future. Today, as I reflect on a simple hour with my patient, I know that my work was enough.

Life is too hard without a refuge

 Life is too hard without a refuge

Reflecting on 10 years with, and 25 years without, my grandpa, Deda Shulim

This year marks a quarter century since I’ve been without Deda (Russian for grandpa) Shulim. Quarter century! When I think of my current life dilemmas in comparison to that block of time, they seem positively insignificant, like flits in the ocean water. So much has happened in 25 years.

It feels strange to be writing a piece about Deda in English, a language he did not know. And it feels good to be writing this. How did those ten years affect me? How did they shape the next 25?

Deda was 88 when he died, at our home in Buffalo. He only lived in that house for a few years, and they weren’t the best years. He would mostly stay in bed all day, with a giant radio that could pick up Russian stations. He was becoming less mobile those years. Spending more and more time in bed. Going up and down the stairs was getting harder with each passing season.

He said our house was a “Zal,” which roughly translates in Russian to “gymnasium.” By US suburban standards, the house was normal-sized, not extravagant, but it was unheard of to have such a large house in the USSR.

I’ll always remember that he made me feel safe. I was bullied in elementary school, and I would come home from many tough days, crawl into the crevice between him and the bed, and just read. In 3rd grade I read 40 books. I’ve never read that many in any year since. Pretty much all of them, I read in that crevice.

After Deda died, I divided time into two parts: Before and After. I would especially cherish the physical items from Before, as if they were imbued with Deda’s spirit. After the funeral, I returned to his bed and lay there in the crevice, but it was different without him there. Still, I smelled him on the sheets and that made me feel calm.

I thought with sadness that as I got older, more and more things would be from After. This was true of physical things, but it was true of memories too. As I got older, those memories of him would become less used, and smaller in proportion on the hard drive of my brain.

I strived to keep the memories of him alive after he died. For many years, I had a ritual of going into his room and saying “spokoynoy nochi” (good night in Russian) to his empty bed, as I had done the night before he died. I would visualize his face to remember him before I fell asleep.

As the years progressed and I got busier with high school affairs, I would still go into his room and wish him good night, but I would do this in a perfunctory manner, saying “spokoynoy nochi” from the door quickly, and then get back to my homework. I was getting farther from my youth.

As the years progressed, we re-modeled his room, gave away his bed, and I stopped the doing “spokoynoy nochi” ritual.


Deda had spent his entire life being frugal and saving, only to lose his life savings in the runaway inflation that happened when the USSR collapsed. In the US, he was still frugal, saving pennies in a yogurt cup in his drawer. He would eat all the leftovers, making a soup that to me seemed unpalatable, a mix of things like carrots, fried potatoes, and hot-dogs.

For exercise, he would do morning calisthenics and squeeze a rubber O to work on his grip. But mostly, he’d walk. At one point, I remember him losing balance and scraping his face on a solo walk. He started to walk less after that.

He’d go to the Shul on Shabbat and pray. I loved going with him, to both the Shul and long walks around Buffalo. Our walks would last hours. We’d see and experience so many things: hills, sumac trees, his friend who was missing a leg. And we’d talk. I felt the same sort of feeling talking to my grandpa as in that crevice between him and the wall: fully accepted and supported.

One of my first memories is walking in the woods with my grandpa, back in Moldova before we left. There was a burned car in those woods, and a dirty stream that someone was swimming in. I remember a green pocket knife that I lost.


Lately, I’ve been getting into meditation, and one of the things that I’ve been playing with is finding a mental refuge, a place that makes me feel safe. I think that Deda was my first refuge. I feel grateful that I had him in my life for 10 years. He gave me a space where I felt safe and supported.

My childhood was filled with difficulties, but it was made bearable by having Deda around. When he died, this was a huge loss, more than I realized at the time.

Now that I am an adult, I feel the need to return to this crevice between Deda and the wall. I feel the need to start saying “spokoynoy nochi” again. I’m realizing that even though Deda is gone, I need not go through life with an attitude of steely toughness. I can have a refuge once again. In my mind, I can always return to the crevice in Deda’s bed, between his body and the wall, whenever I feel lost and exposed in the world.

Deda passed away on 9/29/1996

What non-attachment means to me

The term “non-attachment” has always confused me, because it seemed synonymous with:

  • Not caring
  • Being callous or cold
  • A state of idiotic, lobotomized bliss
  • Not being engaged in life

On a walk this morning, I had some flashes of insight, which made the term make a lot more sense. I want to share them here.

Attachment to Identity

A few weeks ago, I was taking an outdoor shower in a beautiful retreat center on the big island of Hawaii, and I was pissed. Why? Because my girlfriend put my clean clothes in the wash. Why did this bother me so?

  1. This was a waste of resources
  2. This was bad for the environment

The fact that I was so angered by such a small thing revealed that I was grasping very tightly my identity as an environmentalist (and my related identity as a frugal person who doesn’t waste). As I think back on this moment, it dawned on me that I have parts of myself that are deeply attached to certain identities, and can get quite upset when these identities are threatened.

Attachment to Outcome

Attachment to outcome is super common for me. When I was making the artwork above, I scoured the apartment for an eraser to get rid of the pencil lines. But I didn’t find one. I got angry. I was attached to the outcome of finding an eraser.

The host of this podcast talks about having a traumatic brain injury and how his attachment to the outcome of feeling good made him suffer much more. When he let go of this, he was able to accept that he was feeling crappy, and then the healing process started.

If I am not happy, I will concern myself with doing something that encourages joy.

Brian Cornell

People often think they need to do something about their feelings…Instead, what if you just let the emotion sit there? Accept that it’ll be there for awhile, and trust that it’ll dissipate when ready.

Lesley Sim

Caring about process

“But if I’m not attached to outcomes, won’t I stop caring about excellence? Won’t I condemn myself to a life of mediocrity? Won’t I stop accomplishing things?”

These are common anxieties of the ego, but they are not true, because we can take the energy we were wasting on grasping identity and outcome, and invest it into the process. Process happens in the here and now, and it’s all we have control over.

Caring about process is empowering. If we feel down, we should go for a walk, exercise, or give a friend a call. It’s just that we shouldn’t expect that after doing these things, we will feel 100% better. In the words of Modest Mouse, “work a little harder, work another way.”


All too often, my suffering comes from wanting people to be a certain way. I just walked past the house of my friends who moved away in 2017. Part of me still wants things to be the same as they were back then, with them living in the neighborhood. But this is not possible. Change and impermanence are facts of life. Sometimes change brings beauty, and sometimes it brings pain and grief, and that’s OK.

If I try to force the future into the shape of the past, it won’t work. I’ll start trying to control things and people, I won’t stay current with reality, and I will be constantly disappointed.

When I went to Wonder Wander 2021, I implicitly acknowledged that these people were their own people, had their own lives. I appreciated them for who they were, and did not have specific rigid expectations for how they ought to be. I can take this open energy and apply it to all my relationships. People will disappoint if I expect from them an overly specific outcome.


All this is a path. I believe it’s the best path forward in life for me.

Three Inspiring Humans

In honor of my mom’s 62nd birthday, we took a wander around Buffalo, NY. 

Buffalo is where I grew up, and is where my mom, dad and grandma live. After many years away, Buffalo is still the place in the world that feels the most like home for me.

During our wanderings about town, the universe brought my mom and me in contact with three inspiring humans, who each taught us lessons about life. 

So, without further adieu, I introduce you to David, Tobias, and Dale…

Part 1: David’s kind words

“You are an environment that functions inside a larger environment. 

So everything that goes on in you is important.” 


What creates a sense of place? 

For me, one answer is constancy over time.

Like the regulars who, when you come back years later, are still there and recognize you. When I landed in Buffalo, I took a stroll down Allen street, peeped into bars, and chatted with humans. Despite COVID, The Pink is going strong in its delicious filth.

“This place is still the same!” I remarked to the group of day drinkers at the bar.

“It never changes,” the bartender said.

Next, I came to Intersection Cafe, which used to be called Cafe Taza back when I lived here. Despite the name change, the vibe and people were still the same. 

David was still there.

David has a traumatic brain injury from being shaken as a baby. He goes to Intersection daily, filling up massive paper cups with coffee and drinking it out of a straw. Coffee cup after coffee cup, cigarette after cigarette, the day passes. 

In my exuberance, I snapped a photo of him. Then, feeling bad, I asked him if that was okay.

“You should have asked me first, because I would have said NO!” he said. 

I felt a rush of shame. 

“In fact, I’m surprised that you were able to get a photo,” he continued, “Because that usually cracks people’s camera lenses.”

“Yes! My phone is heating up and about to explode,” I returned, finally picking up on the dry humor.

David plays word games with himself, seeing how many small words he can make out of big words (see the photo above). He has a heart of gold. In Yiddish, you’d call him a mensch. From a Buddhist perspective, he’s a bodhisattva.

Some people spread good in the world through tangible acts. David does it through words. I wrote down a few phrases that came up as David had coffee with my mom and me, in hopes that they will give you some new eyes on the world. 

Here is David’s dictionary:

  • “Keep it going!” 
    This is what David said to my mom when I told him it was her 62nd birthday. I love the playfulness of Keep it Going! as a birthday greeting. I don’t know why, but it feels so jumpy and alive.
  • “What’s the worst that could happen? I don’t know… the world blows up?”
    I love this phrase because it underscores how small our ups and downs are in comparison to the whole wide world. Something about this soothes my anxiety, reminds me that my fears can be put down. It’s a funny way of talking about the cosmic perspective.
  • “Precious cargo.”
    “This coffee shop used to attract a lot of bikers, and they didn’t like to wear helmets. I used to tell them: You are carrying precious cargo.” David said, and pointed to his forehead. The brain really is freaking precious cargo. All our memories, loves, hates, proclivities, stories are housed up here.  It’s the most precious cargo we’ve got.
  • “Work for demons”
    “When I see young people working at this coffee shop, trying to figure out what they will do, I hope people can find work that they enjoy, and they don’t have to work for demons.” Then David changes his voice: “Here, embezzle this money…heee heee heee,” he says in an evil voice. Then he takes on the body of the worker, makes his hand into a gun and faux-shoots himself. Compromising one’s ideals is a sort of death. 
  • “Intellectual indigestion”
    “The news gives me intellectual indigestion,” he says. This sums up perfectly how I feel with information overload in the modern world. 
  • “Re-motivation”
    “I think that burnout is terrible. Every doctor, policeman, nurse should have a therapist. The work is not normal! And sometimes you need re-motivation, to remember why you went into it.” When David asked me about my motivation for doing medicine, it took me a while to “locate” my altruism, to remember that I was in medicine to help people. The phrase “re-motivation” normalizes the experience of losing touch with the reasons for why you are doing something. Similar to losing focus on your breath in meditation, the only thing to do is to gently re-focus and begin again.

Part 2: Tobias has Enough

Since time immemorial, people have been asking the question, “What is enough?” Meeting Tobias provided as close as I’ve ever come to an answer. 

Tobias was middle-aged and bald, a fairly nondescript white guy in a t-shirt. He was sitting in front of Hoyt Lake at sunset, playing beautiful music on a mandolin. This perked my ear, so I walked up to him and complimented his sound. The conversation flowed easily, and soon hellos morphed into his life story.

Here are some excerpts: 

“I’ve always done something artistic,” he told us. “I started off playing music, travelling up and down the East Coast. But after a while, you get tired. The crowds get younger, and stupider, like I was when I started playing. So I took a job at a lumber yard. For the last 20 years I’ve been making furniture and flooring. Now I’m retired and I just play for fun.”

“My family is Hungarian, but I’ve never visited there. I think Europe would feel like home. I don’t think I’ll get to Europe in my life, but that’s OK. I’m 63. That means I’ve only got 40 years left to live. I don’t have enough money to go to Europe. I spent all my money on stupid stuff, like guitars and drugs. I did a lot of drugs before I was 25, but then I quit. I don’t even drink now. I do drink coffee.”

“I pick up old furniture from the garbage and restore it. The other day, I picked up an old wash basin from the trash. I sold it to an antique dealer for $100. It was beautiful, with a gold inlay. Artists must all have OCD. Otherwise they wouldn’t spend so much time working on stuff. We can watch paint dry. I paint something and 8 hours later, I’ll still be looking at the paint.”

“When I was 17, I had my first kid. And my daughter had her first kid at 15, so I’m a great-grandfather.”

“I live on the West Side [of Buffalo]. People judge the West Side by the worst things they hear. Like there was some gang-related shooting and people think everyone who lives there is bad…”

“There are no races. We are all Homo Sapiens. There should be one global government so we don’t have wars.”

Sitting there, on that lake at sunset, with his mandolin, chatting with strangers about everything from his own story to his vision for society, I could feel that Tobias had nowhere else he wanted to be. Such a relaxed vibe. Not trying to go to Europe, or make a buck, or get a high. He’d been there, and done, or not done, all that. Most importantly, he was satisfied with how it had all played out. He had many more years of simplicity ahead of him: playing music, restoring furniture, watching paint dry and taking satisfaction in the moments. Tobias was a living embodiment of enough.

Part 3: Dale’s Instant Karma

I’ve always resisted cosmic accounting systems, be they in the form of Santa, heaven and hell, or the law of Karma and reincarnation. They all seem so carrot-and-stick: don’t do good for its own sake, do good to get points, redeemable for a present from Santa come Christmas or a roomier seat on the Afterlife Express (a.k.a. heaven, if you’re on the Abrahamic train, or reincarnation as a higher life-form if you’re travelling on the Eastern line). 

But when my mom and I met Dale, and I heard him talk about karma, something in me softened. 

Dale is a professional jazz musician, but we didn’t know that. When he called out to us, he was just a regular-looking guy standing by his car. My mom and I were rolling my grandma in her wheelchair down a hill at Delaware Park.

“Roll the chair backwards down the hill,” called Dale.

“You know the trick!” I exclaimed.

“I took care of my great-grandparents, since I was the only one in my family who could,” he told us. 

“I worked one day per month playing music for NBC, and the rest of the month I was free. I would drive up to Buffalo after my gig and for the rest of the month I’d take care of them.”

Dale told us about his life as a jazz musician:

“My parents told me, if you want to be a musician, you have to play every instrument. They thought they’d scare me off, but they didn’t. I learned it all. I’ve been all around the world. Hawaii. You name it.”

“The best place I’ve ever played was Biloxi, Mississippi. The clubs there close for just one hour a day. I would play all night, sleep for a few hours, then go out and listen to music all day and then play all night again. I don’t have any savings. I plan to work until I die…”

“When I was working at NBC, I wanted to take care of my great-grandparents. I decided I didn’t want to be selfish. If you are putting good energy out into the universe, good energy will come back. It might not seem that way, but it will.”

One way to see this quote is that the motivation for doing good is receiving good back at some point in the future. I call this the “carrot-and-stick reading of Karma.” But another view is that simply in the act of giving, you are getting the good energy back, right then and there. This collapses the distinction between selfish and selfless, and is similar to the Dalai Lama’s quote, “Be selfish, help others.”

And so it was with us: my mom and I were simultaneously putting out and receiving good energy by taking my grandma out on a walk. 

As an added bonus, this action connected us with Dale, a jazz musician quite unlike us in demographic details or lifestyle, but who shared a common humanity. For he too, at a different point in time, had pushed an elderly family member down a hill. And he showed us the right way to do it: backwards!

My mom, grandma, and Dale

Part 4: Who inspires you, and why?

It’s common advice that to discover our values, we should look at who we most admire. In this piece, I went a step further, and wrote an essay. The writing process forced me to think deeply about why I admired David, Tobias and Dale.  I also posted this piece in a writing group called Foster, and two generous souls gave me feedback that helped me to go even deeper.

The amount of time I met each of these people in real life was as little as 20 minutes; most of the insights came out in the writing and reflection.

When someone’s behavior or way of being inspires us, we get a hit of awe similar to the feeling of seeing a magnificent mountain or sunset. We are witnessing something bigger than ourselves. There is a gap; we are not the way this person is, we are not yet who we most wish to be. And this person is a living, breathing proof showing us that yes, it is possible to be this way.

It’s one thing to abstractly stare at  a list of values on a page: words like “kindness,” “generosity” and “gratitude.” It’s another thing to actually meet people who embody these values. That is what changes you. You meet somebody for twenty minutes and go, holy shit, I want to be like this.

Not long ago, my girlfriend and I were staying at an AirBnB. In the midst of dishwashing, she broke a glass pitcher. Ryan, the owner of the AirBnB didn’t get angry or want any compensation. He let it go, saying, “It’s already broken.” 

I felt myself seething inside, but when I saw his reaction, I softened and didn’t lash out. Holy shit, I thought. I want to be like that. I don’t want to be so attached to things that I forget that broken dishes are small potatoes in the grand scheme of life. I don’t want to seethe for hours about them. It doesn’t do anyone any good. 

So yes, before this moment I might have said that I valued “putting people over things,” but at that moment, it wasn’t true. I was feeling the opposite. It was only by seeing how Ryan responded that I saw a new possibility, a new way of being. 


Here’s a homework assignment for you, should you choose to accept it. The next time you find yourself feeling all warm and fuzzy after interacting with someone, stop and journal. Write down what happened, and ask yourself what in that interaction was inspiring. Think long and hard. This is how we mine our lives for our values. 

Humans are mimetic, meaning that we mimic others. This truth comes out in many oft-repeated quotes. For example: “You are the average of the five people you spend the most time with” or “Be careful with the company you keep.”

By reflecting deeply on our social interactions, even and especially on our mundane ones, we can keep the people that we most admire close, even if we only meet them briefly. As I’ve tried to show in this piece, these small moments can be golden, for within them are the seeds of who we want to be and become. 

But as with any seed, care is needed. For me, writing is helpful, and I’m planning to keep a log of inspiring interactions that can serve as seeds for essays like this one. You might find a different way that works for you. The crucial ingredient is to stop and ponder your inspiring moments long enough to let the everyday saints into your heart, so they can do their work in there.


So much gratitude to my Foster editors, LaKay Cornell and Jillian Anthony. This piece would have been much less if not for your input.

Mid-Year Review 2021

This is my first time writing such a review, and my first time sharing it publicly. Also, this is my first blog post in about 5 years. I’m excited to be rekindling this blog.

When I first started reflecting on 2021, I thought about how I’ve fallen way short of my wishes for the year. My conflicts did not magically dissolve. But as my friend John beautifully put it:  “Might it be that not being able to be true to our values all the time creates the necessary and healthy conflict we need to progress in deeper understanding of who we are?”

One of the lessons I learned in 2020 was that making meaning takes time and work, but is worth it. Writing a long review like this is a form of meaning-making, writing therapy, even. I feel better about the last six months after having written this.

My word for 2021 was nourishing. So, how’s it going?

Some things that have been nourishing to my soul so far this year: travels, reading, writing, getting into a “groove” in my job, slowing down, embodiment and starting a shabbat practice. 

One realization I’ve come to is that life is a lot more fun when I see it as an adventure rather than a checkbox. It’s easy to get into the checkbox mentality when living in an intellectual monoculture of people who think the same way as me, strive for the same things. My competitive / comparative / “I am deficient” neurons seem to light up quite easily in these circumstances.

Travelling gets me out of the checkbox mindset by illuminating alternative lives and the vastness of the world. Even meeting new people at a party can have a similar effect. This past 6 months I’ve met expats and natives in St. Thomas, board game enthusiasts in Philly, musicians living the van life in Acadia National Park, and a 14 year-old-anime enthusiast at a Christmas-in-July party.

On the work front, I have found a groove in the outpatient world. I love connecting with people and hearing their stories. I’m filled with wonder at the diversity of people I get to meet, the diversity of worlds I get to enter. I’m realizing that you really cannot judge a book by its cover. People are so unique: if you keep asking questions, they will tend to surprise you.

Outpatient work feels like travelling at times. I’m like a cab driver or barber in that I get to hear many different people’s stories. With less time-scarcity and interruptions than inpatient work, my compassion for people’s suffering can blossom. I’m somewhat of a neurologist, somewhat of a counsellor, and this mix changes depending on the patient’s needs. At times, I find myself daydreaming about pursuing therapy or environmental work or teaching, but for now I’m very grateful to find work that pays the bills, is energetically sustainable, gives me a sense of wonder, puts me in flow, and helps others.

I started reading physical books this year, a different experience than listening because multitasking is impossible when reading (though I do on occasion see read-walkers!). Some standout books so far: Existential Psychotherapy, The Choice, The Dispossessed, The Alchemist, On Friendship, Love and Will, Designing your Life. I also started watching more shows. I’ve enjoyed Crazy Ex Girlfriend, Tuca and Bertie, Shtisel, Soul, Shrill. It’s been great to co-watch and discuss.

It has been challenging but rewarding to practice slowing down this year. Some things that have helped me slow down: making my calendar more airy (leaving space between things, doing less), outsourcing laundry, cleaning, and taxes (I’m lucky and grateful to be able to do this). I spent quite a bit of time this past 6 months toying with “productivity systems” and they all seem to be glorified versions of the dictum: write it down. Over time — and it does seem to be taking a lot of time — I am developing a trust that the pieces of my life are accounted for in the system, and most notably, I will be OK.

I started writing with more regularity this year. In my blogging days I got sucked into the dark side of online writing: seeking likes. I realize now that what I enjoy most about writing is its ability to help me connect the dots of my life. I also enjoy interacting with people about my writing. Thank you to anyone who replied to my emails.

I want to let go of the idea of developing an online following/monetization. I have a main career that I’m reasonably happy with, so there’s no reason for me to stress out seeking a side hustle, as fashionable as that may be these days. Here’s to embracing my identity as an amateur writer who makes no money but enjoys writing.

Getting in touch with my body was a major theme of the first half of my year. I started many movement practices: running, free movement, HIT workouts and Yin Yoga.

Running is a liminal space where “the body moves and the mind grooves,” in the words of Henry. It is so easy to get caught up in the screen-world, the world of other people’s ideas. On a run, I love to experience my ideas and emotions bouncing up against each other freely. It’s a great space for daydreaming. It’s also nice to practice loving-kindness on runs, silently wishing strangers well as I encounter them, and sometimes cheering them on with a smile or word of encouragement.

I’ve also enjoyed alternating running with high intensity interval training workouts. Sweating is surprisingly fun and enlivening. Especially followed by a cold shower in the summertime. 

Cory Muscara terms the “pain box” the place where we stay because we are afraid of discomfort. By moving towards the experiences of discomfort, a greater array of life is possible to explore. Cold showers / running in the rain are simplistic ways to demonstrate this to myself. I skinny dipped in cold ocean water in Maine – initially uncomfortable both physically and socially. I “faced my fears” and felt great. I don’t think I would have done that without the prep with cold showers.

Free movement is something I’ve done in various forms before (AcroYoga, Contact Improv, Ecstatic dance) but I realized that the simple practice of listening to my body and moving where it wants to go is great for feeling embodied. It’s amazing how much joy I can feel in a few moments of this free movement. It’s a similar feeling to doing improv exercises. Both help dissolve rigidity and help me enter an open, curious, joyful head/heartspace.

Related to embodiment is not self-medicating. For instance, if I get bad sleep and avoid self-medicating with coffee, I might be more motivated to optimize my sleep. I started the year with a bit of exuberance toward drugs when I read Carl Hart’s Drug Use for Grown-Ups and gleefully watched Hamilton’s Pharmacopeia. As the year progressed, I saw several young people hurt by opiate overdose, including one young man who died in a heartbreaking way. To be sure, drug testing, decriminalization and stigma reduction can save lives, as seen in Portugal. However, it seems to me that any mind-altering substance can become a distraction from the project of living a good life (as the Greeks knew). I’m grateful to have discovered Focusmate as a tool to help me focus on boring work, which helped me avoid using stimulants as a crutch. Wim Hof put it best: “Get high off your own supply.” 

I did a workshop called VIEW. The workshop was marketed as revolutionary, but really, it wasn’t. That said, I learned some useful things: don’t have emotions at people, ask how/what questions from a place of curiosity. Notably, at one point I rigidly applied this mindset in a context where it did not fit, which taught me that context really matters. It seems that I default to being a “diligent student” around personal development. But life is not AP biology class. Real personal development involves cherry picking what works for me, and judiciously applying the good stuff in the appropriate context. As my mom wrote to me in a poem when I graduated high school: spit out the junk and gulp down what’s right. 

I also got back into meditation, after several years away from it. I re-entered the practice more flexibly than before. I listen to a smattering of guided meditations, and occasionally do silent meditations. I dived into self-compassion meditation, and it has been a jarring experience to see that my self-talk is often quite cruel. 

I’ve tried many new things the last 6 months that I’ve let go of: expressive writing, Obsidian, yoga practice, “learning in public.” For a time I was filled with a verve and vigor about these things, but they have not stuck. Maybe I’ll return to some of these in the future, and maybe not.

The phrase for the next 6 months is active choosing

I realized this year that I have been outsourcing my decisions to an “expert” (e.g. coach or therapist). By and large, I have chosen the life that I have. It is ultimately me, not some credentialed consultant, that must actively choose what’s in my life. 

I want to be engaged with my life, not somewhere in my head thinking of some better fantasy reality. Another way to phrase engagement is going from between to in, from FOMO to JOMO, from decision paralysis to choosing and letting go. 

I painted the above watercolor of myself running to represent what engaged, active choosing feels like. When I start a run, I am excited. I choose to do the run. I commit and go for it. I want to bring this active choosing to more areas of my life.

One tool I think can help is a prototyping mindset, which means wholeheartedly trying something out (grokking a choice as the book Designing Your Life puts it) and seeing how the choice lands experientially.

Things I’m excited to explore / keep exploring in the second half of 2020:

  • Self-compassion meditation and a regular meditation practice
  • Embodiment (free movement, listening to my body)
  • Running, HIT and cold showers
  • Connecting with my patients (specifically in the outpatient setting)
  • Reading (fiction goals for 2021: The Dispossessed, Two Brothers)
  • Prototyping my decisions wholeheartedly
  • Moving towards discomfort (physical and emotional).
  • Slowing down
  • Creativity (poetry, art, writing)
  • Group therapy
  • Improv games
  • Time in nature (bird watching/mushroom hunting too)

Open Questions for the next 6 months, and beyond:

  1. What makes life worth living?
  2. How can I increase the love, joy, and gratitude in my life in a way that feels natural and true to myself?
  3. How can I improve the health of the planet? How can we raise children that do this too?
  4. How can I keep my strengths (e.g. curiosity, honesty, appreciation of beauty) top of mind, and use them on a daily basis?
  5. How can I weave my interest in therapy / authentic connection into my work as a neurologist?
  6. How can I get in closer touch with my feelings and act skillfully in alignment with them?
  7. From the vantage point of old age, what would a life that is “ripe” look like (aka a life with minimal regrets)? What would a life with maximum regret look like? 
  8. What do I want to feel in my life?
  9. What is enough (money, freedom, job satisfaction, friendship, love etc.)?
  10. What attributes of myself are core to my identity and things that I should not compromise on? Related: How do I want to be remembered? How can I live my life in a way that I know I’ll be proud of?
  11. How can I better align my chosen path with the things that truly matter to me?
  12. What are the birds saying to each other?

That’s a wrap for this review. Thanks for reading!

The simple meaning of life

Gabriella.jpg“That was when I realized I was losing consciousness. All right then. At least I had held on long enough to do some good.”- Lauren Olamina, from Octavia Butler’s novel, Parable of the Sower

Today at work, my patient’s husband was a prison guard on Riker’s Island. He told me about his job. The prisoners on Riker’s are often kids that get into toxic habits and instant gratification. Gangs, crime. The more perverse your offense, the greater your respect on the island, he told me.

“I’m having fun with it,” he said. “I was an electrician first. When you’re blue collar, you try to get a good pension for your family. I’m pretty grounded in my morals and beliefs, so I do well with the kids. Some of the guards use an excessive amount of force, but it’s not as bad as it was. That said, some of the officers really should watch their backs on the outside.”

“When I break up a fight, the kids pretend to hate me, but later they thank me, especially the weaker ones. They don’t actually want to fight and I give them an out.”

“This is my second career. I’m not taking this job that seriously. But I like it. I think I’ll leave the place a little better than when I found it.”

As he spoke, I wasn’t really listening. I was focused on getting out of the room. Getting my work done. Only now, pouring over these memories of the day, six cups of tea deep on my porch, the meaning and beauty of the story gets to sink in.

So often, our consciousness is closed. It has to be, I guess, so that we get work done. But sometimes, we have to chip through the eggshell of goal-orientedness that surrounds our brains and let the beams of light stream in.

In zen, a koan is a question where the answer is not words, but a state of awareness. The awareness, now, is the lighthearted, practical attitude of the guard, and of Lauren Olamina as she is bleeding out. The guard is doing what he can in a deeply troubled world. That’s the journey we all take. Hopefully at the end, when we lose our consciousness, we can all have the feeling that we’ve held on long enough to do some good.

The photo is from a small wedding I had the joy to attend a few months ago



Talked to a juggler last night, who said: If you practice 15 minutes every day that’s better than practicing for 2 hours for just one day a week. Your brain needs time to process what it’s learned.


A powerful thing. You carry a few ideas through life and keep coming back to them. They get polished and change in your head as they change you.

Buster Benson’s Codex Vitae is his brain upload. In it, he comes up with a system for revisiting: a list of things he revisits every day, a list he revisits every month, a list he revisits every year.

Above is a picture of the 6 ideas I’m experimenting with revisiting each morning, on index cards by my bed (a few of these were stolen from Benson):

  1. Priming – just the title card, to remind myself of what I’m doing: revisiting, priming my brain with ideas I like
  2. Quality time – the point of life
  3. Mindfulness, mind wandering, focused thinking – each is a good brain mode, but not all are equal for all jobs
  4. Addictions – a reminder to avoid them
  5. Aliveness – “Don’t ask yourself what the world needs. Ask yourself what makes you come alive. The world needs more people who have come alive.” Good example of this.
  6. Soloverse – what I think isn’t the truth

These ideas are in some ways obvious, and easy to forget. Here’s to (hopefully) many years of remembering them!

Things I’ve noticed that I like

Things I've learned about myselfWe go through life and all it’s strife, and we learn about things and we learn about ourselves. A big part of learning about ourselves is learning what we like. We are wired differently and sometimes we like different things.

So here is stuff I’ve noticed that I like:

1. Direct experience. I spent 3 hours today on the internet with a simple question: Is the flu shot a good thing? Came across a paper saying no, then a few blog posts (1, 2, 3, 4) saying the guy who wrote the paper was wrong and bad and not an expert. At the end of the experience, I still don’t have an answer about the flu shot, but I have an insight:

You can only know something by counting your own beans. By this I mean, you count flu-related harms and you count the effect on the harms of the flu-shot, and you make a conclusion. And this takes a whole lot of work to do yourself.

“See I have the advantage of having found out how hard it is to get to really know something. How careful you have to be about checking your experiments, how easy it is to make mistakes and fool yourself. I know what it means to know something…I see how they get their info. I have a great suspicion that they don’t know. They haven’t done the checks, the care. And they intimidate people by it. I think so. I don’t know the world very well. But that’s what I think.” – Richard Feynman

People on both sides of any issue are arguing and arguing, calling names, but really it comes down to disciplined, often tedious, work.

But because time is finite, you have to trust your friendly neighborhood scientist to count your beans for you. To count the flu shot beans and write them up in a pdf file that gets distributed to doctors who then gently nudge their patients to do what the file says. That’s how medicine works: “A hierarchy of trust.”

I don’t like it. I like to be close to the earth, mining my own truth.

This is only possible for a few truths, because life is so short, and mining is such hard work there’s no way around trusting others. In the olden days we just trusted others to do some work for us, like farming and making clothes. Now we trust people at desks to farm knowledge. Maybe I belong as a scientist so that I can at least mine a few truths in my life…Or maybe I belong as a farmer.

I was walking down the street and saw some grapes. I picked them. It was a lot more fulfilling to me to eat these fresh grapes than drive to a store and pay for food with the papers I got deposited in my bank for doing certain tasks in the hospital.

I guess, be it in data or in food, I like being close to the source. Being part of making the thing and not just trusting that the truth or the food gets delivered to my door by some expert.

2. Spontaneity. Skipped yoga today. Poo you, plans. “It’s good to exercise, it’s good to do this, it’s good to do that.” It’s good to take the plans and ignore them. To do what flows. It feels good to be a time anarchist.

3. Aesthetics. I poured my tea into a jar. The tea was pretty cloudy yellow-green. I looked outside. The leaves made a gradient along the branch:


I pointed this out to my roommate, who said he hadn’t noticed it.

I like pretty things. Going down the stairs in my house, the sun peering through the blue stained-glass window gets me high in the mornings.

4. Dalai Lama Goop. Basically he advocates a compassion for all people. A concern for all people, no matter their walk of life. After reading the argumentative name-calling-type posts of anti-vaccine people vs. pro-vaccine people, it just becomes very clear that the world needs more Dalai Lama substance in it.

Dalai Lama goop agrees with me. It’ll take a lifetime of work to be able to secrete more of this stuff inside my brain.

And that’s a wrap, folks!

Let’s play and see what gets done


Work to do.

Gotta do it.

Gotta get it done.

One of my favorite things is hangin’ home.

Not planning doing anything.

And seeing what gets done.


Gibbs free energy.

\Delta G = \Delta H - T \Delta S \,

Change in free energy = Change in heat – Temperature * Change in Entropy.

A process is spontaneous (negative delta G) if heat is released (negative delta H), if the temperature is high, if the universe becomes more disordered (positive delta S).

That’s basically how I feel about work.

Don’t push it.

Hang out, play, and see what gets done spontaneously.

Picture is a selfie that happened spontaneously during a sunny work / play session.

Watching the same movies

“If I didn’t have you someone else would do…If I might conjecture a further objection love has nothing to do with destined perfection, the connection simply grows over time like a flower or mushroom or guinea pig or a vine or bigotry or a banana. And love is made more powerful by the ongoing drama of shared experience.” – Tim Minchin

My family went to Costa Rica. We had disasters. We had good times. We watched people tell stories. We veered off the road and got lost in the fog on a steep cliff. We got scared together and we turned back and we survived.

We were on an adventure. We saw the same crazy stuff. We watched the same movies. And we grew closer to each other

So if you want to improve your marriage or friendship, go on a really uncomfortable road trip or skydiving or go to a bad restaurant together, just as long as you have a shared experience and are forced to turn to each other and say: “This is a crazy movie, right? It’s not me who’s crazy, right?”

And they’d say, “No, you’re not crazy. I’m seeing the same thing. This is a crazy movie.”

And you’d bond and love each other.

Drawings of ruins


The comparing yourself-to-others bug is a dangerous bug. A nefarious bug. Here are two little cases in point:

1. I worked in a clinic on the west side of Buffalo. This clinic helped a lot of refugees. I thought: how great it would be to help so many people. And I started seeing my path as one that would need to have this big splash in the world, help a lot of people. I would de-value paths that didn’t directly help a lot of people.

2. When I first read Richard Feynman, I thought: whoa, this guy is really creative, he really gets into the deep truths of the universe. And I thought: how great it would be to be to learn mathematics and find out new parts of nature. And I started to de-value parts of life that were not science.

I have a patient being treated for cancer. She has a chihuahua that she misses. She thinks of her chihuahua when she goes to sleep.

She wants to get out of the hospital so she can be with her chihuahua. But in the meantime, she smiles and is really nice to everyone taking care of her.

It’s OK if the things you do are simple, if they don’t make this big glamorous splash.


A big (paraphrased) quote from Alan Lightman:

“I used to think that if you write a book that people read in 50 years that’s better than if you write one that lasts only a little while. But now I’ve realized that nothing lasts. I believe we are material beings. When we die, we are gone. We only exist for a short time in other people’s memories. Pretty soon those people will die and no one remembers you. So any meaning in life can’t be from any idea of permanence. It has to come from something that’s moment-to-moment. I know that I feel pleasure and pain. Not just physical pleasure and pain, but intellectual, philosophical pleasure and pain. And when I help someone, I feel pleasure. When I insult someone, I feel pain. So I try to do things that, in the moment, bring me deep pleasure. That’s where I am with meaning.”

And one from a song by Jeffrey Lewis:

I hope that the art school enjoys your big drawing of ruins

We’ve all got good things to do and it’s good when we do them

– Jeffrey Lewis, Alphabet

But maybe this song should go:

I hope that you enjoy your big drawing of ruins

It doesn’t matter what you do, as long as you feel deeply that this is the right thing to do right now.

The photo is of a sculpture I made in 5th grade. I think it still encapsulates me pretty well.

Figure out your own damn hierarchy


Maslow had this thing called the hierarchy of needs. The basic idea is that people need certain basic things (e.g. food) before certain other things (e.g. romantic love).

Problem is, the hierarchy isn’t the same for everyone.

Some may be able to run on 3 hours of sleep. I need 8.

Some may be fine not talking to others. I like connecting.

Some might not care about creating. I need it.

Sure, Maslow is generally right. The musical Cabaret is generally right:

Words sound false
When your coat’s too thin
Feet don’t waltz
When the roof caves in

– Cabaret, I don’t care much

We all need the same basic things. But when you get a level up, there’s diversity of hierarchies of needs. If we take someone else’s hierarchy as our own, we won’t feed our soul.

I’ve done this for too long. Waking up early anxious about being hungry later and shoveling food into my mouth before work.

Yesterday I woke up with my head full of ideas. I started doodling. I drew this pyramid and hung it on my wall. Then I realized: I won’t have time to eat.

That’s ok.

For me, spontaneity, creativity, are more important than food.

At work I got hungry and downed some unhealthy food as my blood sugar crashed. But I had fed my soul.

Figure out what feeds your soul, and do those things first.

Not what Maslow told you you should do, but what makes you feel good, on a deep, spiritual level.

Don’t trust Maslow. Figure out your own damn hierarchy.

Burning dead dinosaurs

way out inc

A geophysicist told me about fracking today:

To frack, you take a metal tube and drill it under the ground 10,000 feet. You then blow up a plate of shale and you liberate the gas underneath the shale. The gas comes from plants millions of years old. Same idea with oil. That’s what runs our computers and farms and cars and widgets galore (that’s what’s running this blog post).

That’s what our whole civilized experience is based on: creatures that have died long, long ago.

I didn’t argue with the pro-fracking geophysicist man. You learn a lot more if you are curious, and you don’t try to force your opinion on people. He knew a lot more than me about fracking anyways.

I learned the problems that can arise with fracking (the cement around the well leaks, the detergents need to be disposed of, the drivers disposing the stuff sometimes flush it out on the side of the road to save themselves a trip to the treatment plant).

I listened and learned a lot more than I would have learned had I beat him over the head with my pre-formed opinion.

But my opinion is still the same: I don’t care about fracking. I don’t care about global warming. I don’t care about any one specific issue. I just think our whole capitalist game is flawed.

Here’s my opinion, that I didn’t tell the geophysicist guy. This is a blog, a soapbox, so I think I’m fine preaching here:

We modern humans are short-termites, chewing on our wood way too fast. Optimizing for colorful sparkles in our limited lives, not realizing that it’s possible to keep living on this rock in a sustainable way if we just cool it a little.

The earth is getting eaten up by us as we race with each other.

As we sprint around the track, focusing on winning, the track gets torn up.

But in the cosmic motion picture show, earth is just one planet out of many, many. It’s OK if we mess it up. Still, we can’t really leave our planet, so why not try to keep it a little tidier?

A few years back, my brother and I were taking a long walk at night in a snowstorm. The roads were illuminated by orange streetlights.

Where did the energy for these lights come from? I asked myself. Then the answer came: this suburb was burning the plants and animals that had lived on the very same land millions of years ago.

And the burning process was happening very fast.

In a way, these dead things were being resurrected to light the snowy streets.

And in another way, maybe there is a better way.

A way out.

Let’s find it.

Wabi Sabi


What’s the difference between people in the first world and those in the third world? I would argue that one big difference is first world people (myself included) are obsessed with control.

Control is the default setting that has been wired into us from day one, living in this push-button “first-world” civilization.

A story:

I was driving the other day, trying to meet a friend, and rain started. It was a hell of a rain. Streets getting beat down by sheets of water from overhead.

But for me, instead of standing in awe of the rainstorm, I just got frustrated. This will slow me down, make me late. This rain that 100 years ago would have meant crops would have had water now meant nothing to me. Just something I could zip through in my hermetically-sealed car.

Our cult of control is pervasive, present in nearly every part of our lives.

Some more examples:

  • Death isn’t a natural part of life, it isn’t celebrated. It’s something to be battled against with medical interventions, which sometimes bring their own brand of suffering.
  • Hunger is remedied by prepackaged protein bars.
  • Tiredness is medicated by coffee.
  • Lawns are kept green by calling the guy who sprays and fertilizes.
  • Even in the day-time, we put blinds on the windows and use electric lights.

And this is how we live. But it wasn’t always like that.

^ ^ ^

In Japan, there is the concept of wabi sabi. Roughly, this is an appreciation of imperfection. For the transience of life. A wabi sabi bowl is one that has cracks. And the cracks are beautiful.

In the first world, we don’t appreciate the beauty of the cracks.

^ ^ ^

Here’s one for you: Organic apples are not apples that have “organic” stickers. Organic apples are apples that have worms. Unless humans intervene, apples will have worms. I’ve seen it with my own two eyes, I swear, it’s true. Wormy is the natural state of apples.

But somehow, somewhere, we decided that apples should be worm-free. And by golly, we’ll blast ’em up with chemicals until they look just right.

The crappy thing is that by trying to control it all, we suffer. In the wabi sabi perspective, we shrug our shoulders and say “Shit happens, that’s life.” But in the control perspective, we are so, so serious. The apples are shiny and the streets are clean and we get so much done it’s true, but the catecholemines rush through our vessels and harden our arteries and mess up our brains.

^ ^ ^

My friend Greta and I were talking about natural building the other day.

I’ve been thinking about why it’s important for me to have natural building materials (e.g. unfinished wood, straw) visible inside my house. You could say: what’s the big deal. Who cares?

I think it’s a constant reminder that I’m just a part of nature.

Some people say “I keep G-d in my heart.” But I flip it and say to myself “G-d keeps me in his heart.” It makes me think that I’m not so big and important. That I’m just a little part of this world.


Wash your intentions, trash your goals

take utopia seeds_stitch.jpgIntentions vs. Goals

What’s the difference between intentions and goals? Here’s a story that hopefully illustrates the point:

Let’s say that today, I have the goal to go to the gardening store and get onion bulbs to plant in my garden. Underneath this goal is an intention: to be closer to nature, to be more self-sufficient.

Now maybe, on the way to the gardening store, a three headed monster pops up out of the earth. The monster provides me with secret seeds that when planted will lead to an ecological utopia. If I am focused on my little goals, I will say to the monster: sorry, no thank you, no time. I have to buy these onions.

But if focus on my intentions, maybe I can let go of my goal and take the seeds.

The fantasies our brains dream up are just so flat and boring compared to the unexpected realities that come. When we fetishize and grasp goal number 1, we shut off possibilities 2, 3, and 4.


Wash the dirt off your intentions

It takes a long time to make a fake

We night swam down in the lake

Washed the dirt off our intentions

Prattle on ’bout bad inventions

-Modest Mouse, I Came as Rat

Mainstream society often worships fame and money and looking good. It’s hard to be free from wanting these things. One way to wash the dirt off your intentions is to state your intentions publicly. If you write your intentions on the walls for everyone to see, then you are more likely to adhere to them.

For example, with this blog I had the desire for fame and money for a time. But then I wrote my intentions for the blog on my about page. When I get side-tracked, I can read this page and say to myself, “Oh yeah, that’s why I am doing this.”

Pure intentions are useful

Let’s face it, we can’t control outcomes. But we can control our intentions to an extent. And having good intentions is quite useful. Here’s why:

1. Intentions give you a general direction to walk. It’s helpful to have a direction when you set out walking, or you can end up in some pretty dark swamps.

2. Intentions motivate. As a doctor, I work in a stressful environment. Sometimes in the rush of things, I forget why I’m doing the job. So I write my intentions down on a card. I tape this card up above where my white coat hangs. It puts me out there. And it motivates me to study and to listen. 


3. Intentions help you understand why you want what you want. Sometimes, the goals we have come up unconsciously and cause stress. Focusing on intentions helps deconstruct them.

Recently, I had this goal come up in my head: “I want to have 2 kids.”

“Why do I have this goal?” I asked myself. Here were some things I thought of:

  • I want people to care about me in my old age
  • It would be cool to pass along my values
  • I want to pass on my chromosomes
  • I like playing with kids
  • I don’t want so many kids that I destroy the environment

Some of these are my real, deep intentions. Others, I think, are intentions that passively diffused into my head and they don’t feel good for me. So I can now start the process of purifying these intentions, washing off the dirt.

Also, I need to trash the specific goal. Maybe 8 kids or 0 kids will be in my future, but as long as I’m walking roads guided by my intentions, then I’m walking good roads.

Trash your goals

In college, I saw people growing up too fast, going towards careers like little packages travelling down pneumatic tubes. I wrote this poem about it:

       Ode to the Unambitious

       The arrow of your life is not locked, yet
       Thoughts within your mind still freely swim
       The key to make you speed has not been turned, yet
       You look up at the tall plants as a seed
       You have not been pressure-packed and shipped, yet
       There is no single place you want to be
       Wishes that stream out from you have not been capped, yet
       There is no need for practicality
       You stand above the helpless souls
       Who kick their way to some small goal
       My friend, you watch the arrow sway
       And delight at the directions

If we don’t grasp goals, and instead have clear, but general, intentions, then we we can walk the journey with delight. We know generally where we are going, but where we end up will be a surprise.

The key to all story endings is to give the audience what they want, but not the way they expect. — William Goldman

The entropy of people

The entropy of peopleOn the TV show House, House is this brilliant guy but he needs his team to talk things through to get ideas.


I recently was cleaning the kitchen and moved the paper towels. My roommate said: “Great idea putting them here [on a ledge behind the sink]. There’s more counter space.”

I wasn’t even thinking to do anything in particular, but cool, I helped solve a problem, I thought.


A few minutes later I was in a bit of a rut, wandering around the house. 

“You should go on a bike ride,” my roommate said.

I did, and it was a great bike ride. I wouldn’t have thought of it without my roommate.


People have different perspectives and what’s obvious to one is not obvious to another and we all collide and bump into each other and through sheer entropy we create better ideas.


The picture is one I drew in first or second grade. 

You wasted life, why wouldn’t you waste death?

To shake things up a little on this blog of visual meditations, here are some audio and gustatory-meditations:

I went to a mindful eating dinner last night.

The leader of the dinner said: “For the next 5 minutes, eat your food slowly. Think about where it comes from. Think about the land, the farmers, the truck drivers, the stores, the cashiers, everyone. Savor the textures, spices, sounds, smells.”

And that meal lasted forever. At some point, my brain said: “Gorge! This food is healthy and tasty and you should get more!” I noticed this but didn’t move on it.

In and out of mindfulness I went. I noticed a lot about the meal. The rice was the best rice I ever had – vinegar notes and crackly sounds between chewy grains.

This morning, I tried to replicate the exercise. I ate an apricot. Then a carrot with almond butter. I really savored them.

I wasn’t hungry at the end of the small meal. But somehow my brain said: “Gorge! Or you will be hungry later.” And I gorged, out of fear.


It strikes me that I often can’t remember things. Like what I ate, or whether I closed my car doors or locked up my bike.

This is a symptom. It’s a symptom of lack of mindfulness. Of not paying attention.

Getting lost in thoughts is great, but constant fear-based thought loops that prevent perception of the world are bad news bears. Why? Because life is memory:

If you don’t remember your life, it’s like it never happened. – Derek Sivers


So mindfulness is not some new agey thing for hippies with too much time on their hands. First of all, it takes 5 minutes. Eating takes 15 minutes, let’s say. Five of those minutes can be spent eating mindfully. Same goes for any other activity.

I love the angry tone of this Modest Mouse song, which is really about mindfulness I think.

My interpretations are in parentheses:

The ocean breathes salty, won’t you carry it in?
In your head, in your mouth, in your soul.

[Pay attention to the ocean. Let it in to your sensory organs – to your head, mouth, and soul.]

Will you tell me what you saw and I’ll tell you what you missed

[Hey Dude, Tell me what you saw. Nope. You missed a lot, because you weren’t paying attention.]

For your sake I hope heaven and hell
are really there, but I wouldn’t hold my breath.
You wasted life, why wouldn’t you waste death?
You wasted life, why wouldn’t you waste death?

[If you aren’t present during life, then I hope you get another life. But I wouldn’t hold my breath that this will happen.]

You wasted life, why wouldn’t you waste the afterlife?

[And even if you did get another life, you’d probably waste it, because you are in the habit of wasting your life.]

So now it’s time to practice mindfulness. It’s time to get in the habit of NOT WASTING LIFE.


If you miss the here, you are also likely to miss the there. If your mind is not centered here, it is likely not to be centered just because you arrive somewhere else. – Jon Kabat-Zinn

Found a few buddhas, hanging out under logs

MonsterWhen I come before the judges of the heavenly tribunal, they are not going to ask if I lived my life like Moses or if I lived my life like Abraham. They are going to ask if I lived my life to be the best Zusha’s could be. – Rabbi Zusha

I feel like I met Buddha the other day. He was overweight, wore bright Hawaiian shirts, and owned a hostel in a touristy part of Costa Rica. His name was Conrad. Here’s a picture.

I don’t know why I thought he was Buddha, but I did. He wasn’t particularly ascetic. I’m sure he loved life’s worldly things. But I just got the feeling he was living really true to himself.

“I left California. Everyone there is so busy and obsessed with stuff. Nobody enjoys life,” he said.

Yesterday I walked the path my dad and I often walk. I was barefoot. I thought: life is good. I have enough food to eat. And I have time to do something pointless: go for a walk. Pointless as in: not directly involved in the process of getting food. For a minute, I felt like Buddha.

Then we visited my family friends. This couple is loud and boisterous. They have 2 dogs, 2 cats. They yell at each other in comic ways.

An excerpt:

Husband: This dog is so old and sick…but he doesn’t die.

Wife: Just like you!

Husband: Me and the dog will both die at the same time, so then you can have just one funeral!

Wife: Do you think I’m planning a funeral for the dog?

I think this couple are enlightened too. They are perfect for each other and they come alive when they fight. They watch crappy TV shows, don’t live very healthily, but something about them, I don’t know, they are just real.

I feel like life’s enlightened ones aren’t the gurus spouting wisdom. They are the real people that I happen on unexpectedly. I can lift a log and find some grubs and monsters that are maybe ugly, maybe hairy and slimy, but they are perfect. No airs. Just fitting their shirt perfectly. Fitting their life. Living their truth.

Found a few buddhas, hanging out under logs.

Wine on the winemaking pages

“Since I first wrote it [The Complete Book of Self-Sufficiency], the book has certainly gotten about. I have traveled in at least dozens of countries since I wrote it (to say nothing of four continents), and in every one of them people have come up to me with their copy to sign. I have been delighted to find wine stains on the wine-making pages, and good, honest dirt on the gardening pages.” – John Seymour

Theory is fine and dandy, but practice is where it’s at.

You have to do things, not just philosophize and “understand” things.

My goal this vacation is to get my copy of the Complete Book of Self Sufficiency covered with wine and dirt. I’ll be taking pictures, and will post them below when they are taken.


Kimchi I made (with guest appearances from my mom’s zucchinis and my dad’s home brew kombucha):


A towel holder, made by my dad (mostly) and me: 


My dad turning wood on his lathe:


Gardens I worked on weeding at the mind-body retreat in Ithaca (Travis Knapp was the main garden master – check out his soulful music.):



Public and private

love thrives without pressureSharing circles are a thing. After a yoga class or camping trip or whatever, people get into a circle and share their feelings.

This blog is basically a sharing circle for me.

But there’s the trap with sharing if you focus too much on how you will be perceived. Maybe, you feel a pressure to say something interesting or significant so that other people go OOOOHHH and AAAAHHH.

I thrive on feedback. Screaming into the world and getting some kind of response. I have kept notebooks for many years, and it’s nice to cull entries and put them into this blog which is like a soapbox on which I stand and share my thoughts.

But there should always be a place that’s private. A diary that no google algorithm can access, that no other people know about.

I need both public and private. Without a venue for sharing, I feel lonely, like I’m all by myself screaming into the desert and maybe I’m a crazy person here, alone with all these thoughts. But sharing everything makes me feel like I am not my own person, like everything is on display, like I can’t have a thought that’s unfinished or unflattering or ugly or pointless. Without the freedom to doodle and make bad work, there’s just too much pressure.

So sharing circles are nice, but staying quiet is nice too.


Quit what you don’t love

Quit What You Don't Love

After quitting his job, my brother sent me (and his co-workers) a link to this punk rock song, which has the lyric: Quit what you don’t love.

Recently, I have been getting into the concept of minimalism — reading blogs on it, going to talks on it, giving away stuff I don’t use — but today the concept really clicked for me.

Minimalism is not owning 3 pairs of pants. Minimalism is quitting what you don’t love. Whether that be people, places, things, or mental states.

As soon as I had this epiphany, I wrote “Quit what you don’t love” on a white t-shirt, put it on, and drove myself to yoga class.

I was late, but I didn’t rush. With my new minimalist t-shirt on, I thought: do I love rushing, or do I love going slow?

I love going slow.

Then I got to the class and the door was locked. I peered in: the class was well underway.

I asked myself: Would I love breaking the flow of the class, or would I love going with the flow and maybe doing yoga outside in the nice weather?

Of course, outside!

Then I got outside and was too lazy to do yoga, so I sat on the bench and watched the people walk by. Outside on that bench, after having quit a bunch of frames of mind I didn’t love, and I had the space to just be.

I might not know what I really love. But if I quit the things I don’t love, then maybe there will be space for the things I love to move on in.

I did some excellent people-watching sitting on the bench there.

A delightful old man walked very slowly out of the building. He said to me: “Have you exercised already?”

“No, I was late to yoga and got locked out,” I said.

“Oh yoga, there’s a lot of pretty girls doing that,” he said.

“That’s not why I come, but it is an added perk.”

He laughed and walked slowly towards his car. I really enjoyed meeting him, and seeing lots of other people, as I sat outside and watched the sun set.

Minimalism is about not being afraid of what happens when you quit.

The world won’t end. The world won’t end. The world will open up.

(I hope.)

The internet people I have seen go the minimalist route have all survived at the very least, and many have thrived.

So I’ll be wearing my home-brew t-shirt, quitting things, seeing what remains, and what else comes in.

quit what you don’t love cause we’re enough
live as you make it up cause we’re enough
you’ll never go without cause we’re enough
we’ll buy a house cause we’re enough
we’ll grow some food cause we’re enough
we’ll slam some dunks cause we’re enough
don’t be afraid cause we’re enough
you’ll always be ok because we’ll always be enough.

 — Wingnut Dishwasher’s Union


A cute little video that’s relevant, if punk rock isn’t your thing.

Time to say wow


A story about deja vu in the Intensive Care Unit:

A guy was on the ventilator (a machine that inflates and deflates the lungs for a person through a tube that goes down the throat). Suddenly, the oxygenation of his blood dropped. I listened to his lungs. Breath sounds on the right, none on the left.

An x-ray showed a complete white-out on the right hand side.

I called a bunch of people: senior doctors, the radiologist.

The radiologist said: he has fluid around the lung.

One of the senior doctors ultrasounded the lung and said: “There isn’t actually that much fluid around the lung. Probably there is a mucous plug upstream that is causing the lung to be filled with fluid.”

So the patient didn’t have fluid around the lung, he had fluid in the lung.

We increased the pressure that breathing machine puts into the lungs, and the oxygenation of this blood went back to normal.

Then the deja vu moment: we got called to see patient number 2.

He had almost the same picture: a complete white-out of a lung on chest x ray.

But the ultrasound for him showed that there is fluid around the lung (not inside the lung like the first patient).

Patient number 1 could benefit from removing the mucous plug, patient number 2 could benefit from draining the fluid around the lung.


These 2 episodes happened within a single hour. After that, I rushed off to do more mundane things: writing orders, checking labs.

I went home after this night shift, ate a bunch of ice cream, and passed out. When I woke up, I thought: that was really cool.


In medicine, the thing I lack is time. I’m always running around.

Life is really freaking cool. Space is great. It helps you say wow.

Good listener

good listener

An interaction happened today.

A patient died. This was a sick person who had been in the hospital for over a month.

The family wanted an autopsy not for themselves, but to “improve medical knowledge.” Our team thought that this didn’t make sense because the disease the patient had was not a mystery.

A desire sprang up in my brain to call the family and convince them to see things our way. Luckily, my colleague called the family.

This is what she said:

“I just wanted to call to let you know what an autopsy involves. An autopsy will involve removing the organs and examining them. We do autopsies when there is a medical mystery, but in this case we had a pretty good idea of what was going on. But if you want an autopsy that is completely your right.”

She gave her thought process but was open to accepting whatever they wanted to do. She didn’t have this rigid: I-WILL-CONVINCE-YOU! – Homer-Simpson-strangling-Bart-Simpson – type vibe that I had.

A long quote from Leo Babuata:

“A lot of the time, we come to a decision to make a change, and we want to get our spouse on board after we’ve already made the decision. But the decision didn’t just happen in that moment…You’re going through all this thinking process and reading and finding inspiration…So you’ve gone through this process but your spouse hasn’t…You have to help them go through the process on their own. They might not make the same decision as you, but you have to give them the opportunity to go through a process.”

This is what my colleague did with the family. She gave them her thought process but she let go. She allowed them to go through their own process.

One aspect of being a good listener could mean being present to the cues people give you, “smelling the air.”

Another aspect could be being receptive to other people’s process, journey, truth.

Let’s not taco ’bout it

Had a tough day, lots of unresolved emotions. Talked about it. Worked through them. Resolved them. Thankfully I had someone to talk to.

But when I got home I was so guilty I couldn’t sleep. My family wanted to talk about it some more. I said no.

At a certain level, it’s good to talk about it, but this hits a sweet spot when nothing more productive will be gained and you have to take a break. It’s tough to walk this line between ignoring problems and wallowing in their muck.

I hope you know that I’m not trying to complain / It just gets hard to explain / To people that I know / And the kids who come to shows / That I just don’t want to talk about the office today Wingnut Dishwasher’s Union

Update (7/28/2014): Yesterday I was able to talk about the “bad day at work” with my grandma freely and realized that in the moments when things are undefined in my head it’s hard to talk about them with question-asking people. But after a while, things become a cohesive story, and I can talk about them. I just need my alone time to process and let things gel.

Put aside time to re-interpret your past events, as a powerful reminder that you can re-interpret your present and future, too. – Derek Sivers

It’s the ones who’ve cracked that the light shines through

eyes of the world

There is something to crazy people.

Two stories, from two places, on this theme:

1. Costa Rica

I met a guy in a hostel who seemed crazy. He saw cosmic meaning in everything, from the arrangement of decorations at the bar, to times of day when the internet cut out.

He took my brother, me and a girl to a secluded beach. While we swam, he found a plastic spoon, a cigarette butt, and a medication wrapper, which he put into a coconut. He lit the coconut on fire and had the girl march into the ocean with it and let it float away.

“It’s just a little pollution, but it’s OK,” he said. “These represent man’s evil: plastic, pharmaceutical medicines, addicting drugs. In the future, we will purge ourselves of them.”

“The biggest lie is that we can’t break the cycle. That we have to keep on making mistakes.”

2. Buffalo, NY

A girl was sitting in a park, talking about how she hates her apartment because it has bugs in it – silverfish, cockroaches, ants, earwigs, the works.

A guy comes up to her and says, “You don’t really hate bugs, you just have probably been conditioned since childhood to say that you do. Bugs are so small, they can’t hurt you. When I see them, I say, ‘Oh, you poor thing, you probably want to go outside.’ And I take it outside.”

The girl walks away.


We all agree with trite sayings: love nature, love your fellow man. But what happens when these sayings are taken to their extreme?

Extreme compassion, extreme environmentalism, looks a little crazy.

In truth, we’re not living by our stated morals a lot of the time. The world is unjust in a million ways and we numb ourselves to this on a daily basis. When people bring this fact up, it’s a defense mechanism for us conventional folk to label them as crazy in our heads.

In truth, crazy folk sometimes make good points. We should listen to them. They can be like cold water on our faces to wake us up.

It’s kind of like the Joker quote from Batman: You know what I’ve noticed? Nobody panics when everything goes according to plan. Even when the plan is horrifying.


The picture is inspired by the song Wake up to find out that you are the eyes of the world. The world is an eyeball with a yellow optic nerve coming out. This optic nerve might well be a “crazy” person, who is seeing things that other people won’t see.

Or they are a child.

Or an alien with an unbiased mind.

We get biased as we grow up. We don’t see the light a lot of the time. “It’s the ones who’ve cracked that the light shines through” is the title of a Jeffrey Lewis album. But maybe they haven’t cracked. Maybe it’s just us who have stopped seeing.


I am working on this — living within my morals. I don’t want to preach, but I have some control over not doing things that bother me just because they are convenient or accepted.

Inspirational quotes from patients

So a week of intern year is behind me. It’s a steep learning curve. Luckily my patients have some words of wisdom:


Lady after big surgery is having a new symptom: hoarse voice possibly due to vocal chord damage from intubation.

Me: I’m sorry this happened to you.

Lady: I hope it goes away, but if it doesn’t go away, then I’ll learn to live with it.


Alcoholic guy comes in with new onset fatigue (sleeping 5 hours during the daytime for no good reason).

Me: How’s your mood?

Alcoholic guy: I’m happy. Life is grand! Life is what you make it. If you’re not happy, then fix it. If today is bad, then tomorrow will be better!

What I’ve Learned About Habits

less horrible things

Over the past month, I’ve gotten pretty deep into the study of habits. I’ve joined 3 habit-building programs (Zen Habits SeaChange – $10/month, Tiny Habits – Free, Pavlok’s Hack the Habit – Free, but no longer available). I don’t want this article to be a pitch for any particular program, though I do think they are great and recommend SeaChange and TinyHabits highly (haven’t tried Pavlok, a device which hasn’t yet come out).

Why care about habits?

A person = his habits + his principles. Principles define conscious acts, habits define unconscious ones. I want to be a good person, but being a good person is tough if you have bad habits.

If you want self-esteem, you have to do esteemable acts. You need a basis on which to hang that self-esteem. -David, former alcoholic

So think: what kind of person do I want to be? A person can have lofty principles, but if he needs coffee every day just to function, watches porn, cuts people off on the road, doesn’t pay attention to people when they talk and instead surfs his phone, then there is room for improvement.

People have this attitude that what we like is fixed. When I was a vegetarian, I often heard people say: “I couldn’t live without steak.” Honestly, I was just as happy without steak as with steak. We can change what we like and what we crave. A heroin addict craves heroin, but wasn’t born craving heroin. He rewired his brain to crave it over years of use. So it is with our habits. Yes, we crave our coffee, our facebook. But we can train ourselves to be better. We can train ourselves to crave flossing teeth and exercise and work.

So many of the patients I see have destroyed their health with bad habits (eating, smoking, drinking, drugs). I don’t think it’s enough to just say to someone: lose weight, quit smoking, floss every day. We need to give people tools to change their habits.

So without further adieu, here are some of the tools I’ve learned:

  1. Change one habit/month. Make one habit your absolute habit for the month. Focus on doing this every single day. All the other habits you can experiment with, but they are icing on the cake.
  2. Keep a list of more habits to change. As you think of more things you want to change, write them down. I use Wunderlist as a to-do list and keep a running list of habits to change in the following months. But I only hold myself to changing 1 habit/month.
  3. Triggers. Triggers are things you already do, and you put a habit after doing them. For instance, if you want to build a flossing habit, your trigger can be brushing. The most reliable triggers for me are waking up and going to sleep. This month, I meditated before going to bed. After a while, I grew to expect my meditation time. When you start with a new habit, the best trigger is one that you do exactly once a day because it’s nice to know that you have gotten your habit done for the day and can celebrate and move on.
  4. Tiny Habits and Consistency. Consistency is super important for doing habits. It’s easier to do a habit every single day than 3 days a week. It’s also really motivating to have this kind of consistency. So make it impossible to fail at doing your daily habit. How? Make the habit tiny. My habit this month was meditating every day. I set my goal as 2 minutes/day. Anything else was gravy. Some days I meditated longer, but this was not required. The goal was doing the habit every day, not doing anything heroic. If your habit is flossing, make it your goal to floss one tooth. You will eventually want to floss more, but the goal is to train yourself to always expect some flossing after brushing.
  5. Social Support. Humans are social creatures and social support works. I have an accountability buddy who was assigned to me, and it is nice to text her after I do my main habit. You can ask a friend to be your buddy, or shell out 10 bucks and join SeaChange and scour the forums for someone who wants to be your buddy.
  6. Reward. Drugs are addicting because you feel good immediately after taking them. In the same way, a habit can be addicting if you build a reward after. This reward can be as simple as saying “Good Job” to yourself, or doing a dance, or texting your accountability buddy.
  7. Change your habit or trigger or reward if it isn’t working. Every habit you build should have a trigger and reward that you are using, but if these aren’t working, you can change them. For instance, I started meditating in the morning but this was too hectic and I was always in a rush to get somewhere. So I changed my time to the evening and that worked a lot better. I started off texting my buddy every time after meditating but now no longer need to.
  8. Do less horrible things. Negative habits are really hard to break because there are multiple triggers at play. For instance, a cigarette smoker might be tempted to smoke every time he sees a smoker, or whenever there is stress, or whenever he drinks. One thing I’ve learned so far is replacing the bad habit with something less horrible. This is what the picture is about: replacing coffee with tea, beer with carrot juice, stress-eating with stress-drawing.

And that’s a wrap for now! Happy habit building.

Venn Diagram Dating

venn diagram dating So dating is an emotional roller coaster, of course, of course. Here’s a little perspective that might make it a little more comprehensible, and maybe a little less sad when it doesn’t work out.

The goal of dating is to find a long-term partner that you have synergy with. That means you have to get to know someone, and get to know yourself, and see where the overlap is, like a venn diagram. Some venn diagrams overlap more than others, and the best pairs have the biggest overlap. But every pair overlaps somewhere, and disconnects somewhere. It’s just a matter of degree.

Dating is work. Specifically, the work is to figure out a list of synergies, and a list of differences. So step back and be thankful for this opportunity to learn about someone else and learn about yourself. After dating for a while, you have to go with your gut about whether long-term is in the cards. And if it is, it can’t be totally rational, either. Such a crazy thing as signing up with one person for the rest of your life requires some crazy faith to carry you through (like this story of a girl who won’t break up with her husband because he found a dollar bill that she wrote her name on a decade prior).

And if break-up happens, this is OK for two reasons:

  1. You and your partner have grown, you’ve learned about yourselves.
  2. The ultimate goal is to do good things for the universe. Now that you and your partner are apart, you are free to meet other people with whom you might have even greater synergies and do even greater things. Adopt the attitude: “If we’re not meant to be then there are other people that are better for us to fulfill our life missions, and that’s awesome! That means the world will be an even better place.”

Hope this perspective helps someone “get” the whole dating thing just a little better.

PRACTICAL TIP: With your partner, make a venn diagram of your similarities and differences. It will give some nice perspective on the relationship.

I judge people for being judge-y

you are so judgemental

I HATE judgmental people. Oh wait…that’s kind of judgmental.

An antidote: if I don’t like how someone behaves, I can just not encourage this behavior. I don’t need to get all hateful and judge-y on them.

My system (new one)

My System

So I’m experimenting with a new system for planning out my days.

First thing in the morning is to write in my notebook (if I feel like it). I used to use 750words.com but then decided that my notebook is just as good. It’s good for me to do a brain dump first thing in the morning with no judgement. Often, this helps clarify what I want to do during that day.

Second thing is work (if I’ve decided to do work that day). Work means pre-planned activities. This generally means going to a library or coffee shop. The main thing about work is that it has to be uninterrupted. Exactly zero electronic distractions are allowed. No phones, no web browsing. If I do a distraction, I pay 100 bucks to an accountability buddy. This shit is serious. (Breaks are allowed as long as they are in the 3-d world.)

Third thing is free time. This is time with no plans at all when I can do whatever I want.

Then sufficient sleep is in order.


My reason for doing this system is that I get addicted to the internet and then feel guilty and unproductive. A lot of the stuff I read online is good stuff, but I shouldn’t use the internet to procrastinate. We’ll see how many hundreds I lose…

The only respectable position is a hunch

kombucha 4

I had a guest over at my house the other day, and my dad offered her some home-brewed kombucha. She tried it and said: “I like kombucha…I hear it’s really healthy, and it doesn’t taste bad.”

That quote just about sums up dietary science for me. You have a hunch, but you can’t really test it. In medicine we run experiments to measure things like mortality improvement after a treatment, but it’s hard to run long-term experiments with food as the treatment because of logistics, money, and time.

You could do quicker studies where you see how foods affect a lab value, like cholesterol, but it’s hard to know what that means. We don’t know that high cholesterol is bad. Here is what we know:

Statins -> Lower cholesterol and improve mortality in heart disease

But this doesn’t mean that everything that lowers cholesterol is good for your health. Unless you measure real outcomes like mortality, you can’t be confident saying that something is “healthy” just because it lowers cholesterol.

I overheard this conversation in a coffee shop:

Lady: So this hibiscus tea is supposed to be good for you?

Barista: Yeah. It’s got…anti-oxidants.

Lady: They say green tea is the best for you. Is that true?

Barista: I don’t know.

That’s just how it is. We usually don’t know. Super-confident isn’t the truth.

Every day, we decide a million times what to put in our bodies, and there isn’t much science to base these decisions on. So we go with our hunches. We stay away from car exhaust, drink our kombucha, and shrug our shoulders a lot.

kombucha 3

*Healthy = We have a hunch that these snacks are healthy, but haven’t done experiments to prove this. We are a small company, and doing experiments that control diet in a randomized way over a long period of time is way out of our league.



Planetary skin care

planetary skin care One central problem with our globalized world is that immoral things get done far away, out of view. My use of this computer right now might be made possible by fossil fuels extracted from off-shore drilling of waters that I would really like to go swimming in.

Maybe the ideal future is a bunch of villages, where we love thy neighbor and we don’t take a dump on the guy halfway across the world. A smaller world, a not-so-big society. A place where we understand how the resources flow and who gets hurt and helped by our walks through life.

I’m not talking politics. I’m talking size. We all want to do the right thing, live by the golden rule. It’s just easier when things are smaller and more transparent.




fishtankThis has been said a million times in a million ways, but here’s my way of saying it!


Hands-dirty system

Lately I’ve been surfing a lot of internets…This has been fun, but I have the creeping feeling that I want to do things in the real world not just watch internet people do things.

My grandma said: did you see a lot of things in the hospital?

I said: Seeing a lot of things doesn’t count, you have do things, get your hands dirty.

Here is what I promise to do, every day (except Shabbat), before residency:

1. Understand medicine better. Read some medical books for an hour a day, and doodle about them for an hour a day.

2. 15 minutes of handstands, workouts, or yoga practice per day.

3. Get my hands in the dirt growing things, when the weather gets better.

I will not touch the internet any day, until these get done.

Righteousness Programming

values 1values 2

I used to resent religion because I focused on the ways that its myths were unlikely, given what I understood about science. Science seemed so pretty, so nice. It explained protein synthesis and the inter-relatedness of animals on earth.

But science gave me no real advice about how to live life. How to be a nice person, not an asshole.

The Jewish religion says that there is a godly soul and an animal soul. The animal soul wants to do self-interested things. It wants to eat, sleep, and might even want to help others (but its motivation for helping others is feeling good about it). The godly soul wants to do good things for their own sake.

In the ideal case, religion helps the godly soul shine. Its prayers and artifacts and philosophy and rules and communities are righteousness programming. Religion is the original life-coach. You bring the motivation to be good, and it helps you get there.

Disbelief in magic can force a poor soul into believing in government and business. – Tom Robbins

In the day-to-day trenches of adult life, there is actually no such thing as atheism. There is no such thing as not worshipping. Everybody worships. The only choice we get is what to worship. And the compelling reason for maybe choosing some sort of god or spiritual-type thing to worship–be it JC or Allah, be it YHWH or the Wiccan Mother Goddess, or the Four Noble Truths, or some inviolable set of ethical principles–is that pretty much anything else you worship will eat you alive. If you worship money and things, if they are where you tap real meaning in life, then you will never have enough, never feel you have enough. It’s the truth. Worship your body and beauty and sexual allure and you will always feel ugly. And when time and age start showing, you will die a million deaths before they finally grieve you. On one level, we all know this stuff already. It’s been codified as myths, proverbs, clichés, epigrams, parables; the skeleton of every great story. The whole trick is keeping the truth up front in daily consciousness. – David Foster Wallace

And hence, the twice-daily practice of tefillin.

Done with tropical vacations

nothing left to do

I’m at the end of 4th year of med school, and most of my “work” is done. My to-do water bottle is empty. So, what do I do? Go to the beach?

I like the beach, but I think it will be more cool to expand my brain. My brain was directed towards one thing for the past few years. Maybe I should expand types of puzzles my neurons can work on over the next few months.
working on myself

Tropical vacations are nice. It’s nice to be careless and play. But…

It’s good to take something home with you from your vacation. I remember one vacation 2 years ago I had a choice: go to Turkey and travel around, or go to an AcroYoga immersion thingy. I decided the latter because I could learn something that I could bring back with me into my daily life.

Not long ago, I was in Austin, TX. In the pretty weather, I got lonely. I wrote this in my notebook:

lonely in the beautiful weather

In cold-dreary Buffalo, a tropical vacation provides a sweet chemical pick-me-up. But pure escapism ‘aint good. It’s nice to use vacations as opportunities to develop parts of yourself you don’t normally get to develop.

Can we all just help each other?

values 3

I wish I worked for Good, Corp, where I could just show up to work and be confident I was doing good for the world.

For years I’d thought about working for a non-profit company…At long last I landed a job with a non-profit healthcare provider. It didn’t turn out to be much different from the for-profit sector…A few weeks ago I was in the elevator with a manager who has worked there for years. She was practically giddy about the layoffs: she said they’d make the non-profit more efficient, which would enable it to fulfill its mission statement more effectively. Here it was again, the mantra of shareholder value in a new form. As long as organizations serve abstract ends rather than flesh-and-blood people, it doesn’t matter whether those abstractions represent stockholders, customers, or even the common good. Work, Crimethinc (Bold-ing mine)

Abstraction is the problem, not capitalism, not communism, but serving abstract ideas rather than real people.

The news is mostly fear and voyeurism

the news

I was stuck in an airport with CNN blaring on the TV, so I wrote down the news stories in that hour-long period, many of which centered around voyeurism and fear. These were the stories during that hour:


  • Woody Allen sex abuse scandal.
  • Phillip Seymour Hoffman death.


  • Is Obamacare bad for the economy?
  • Woman loses second son to guns in 19 days.
  • City sues online meetup site.
  • Chemical spill in West Virginia.

After an hour of watching the news, I was over it, because:

  1. I feel powerless when the news tells me, rapid fire, 10 bad things in the world. Most of the time, being aware of all this stuff just clouds the brain. This perspective is not “head in the sand,” it’s keeping my neurons available for the stuff I have power to affect.
  2. Just because there are horrible crazy people doesn’t mean I need know about every last one. Being aware of all of them will make me scared to do things that I think are perfectly safe (e.g. Couchsurfing).
  3. With the internet, I can track things I care about without ever clicking on CNN.
  4. Of all the things that happen on earth in a day, the news curates those that will grab attention and sell ads, not what is actually most important.

We just watched the nightly news, blah, blah, blah, what wars we’re winning
and all this left wing right wing left my head spinning

Alex Mead, an awesome musician from Buffalo

Religion and Bikes

spirituality bicycle

With bikes, some people will:

  1. Buy their bike pre-assembled and will go to an expert to fix it.
  2. Buy their bike pre-assembled and will fix it themselves.
  3. Assemble their bike themselves from parts of their choosing.

With religion, some people will:

  1. Stick to their religion dogmatically, and go to experts for guidance.
  2. Stick to their religion, but think about it for themselves. They may stray from dogma if the dogma doesn’t work for them.
  3. Study many religions and try to find the parts that work for them, to create a personal spirituality. The kid in the picture is doing this.

I’m somewhere between 2 and 3. I need to think about things for myself.

Puzzle time: How many different religious symbols can you spot in the picture?

Depth Perception

depth perception

Internet girlfriend

using the internet to get a girlfriend

I was watching March of the Penguins and the mating sequence came on – penguins standing in line, approaching each other, then moving on, until finally finding mates. Morgan Freeman’s voice over said: We don’t really know what they’re looking for in a partner. We only know that they are, in fact, looking.

I thought it would be awesome to put footage of people going on dating websites in a split screen with the penguin footage. I don’t have the energy to embark on such a project right now, so please accept this cartoon as a substitute.

Circle of Life Escalator

circle of life escalator

I stayed with a Couchsurfing host in Albuquerque, New Mexico who was a farmer. We got into talking about technology and he told a story of a Native American chief, a Pawnee, meeting a white guy. The white guy was showing off his gun, and the Pawnee said: why do I need that when I have my knife? He then used the knife to butcher an animal very efficiently.

The Pawnee was not quick to adopt a new technology because the old technology was plenty good, and the effects of a simple technology like a knife are much easier to predict than the effects of a complicated technology like a gun. Western culture is interested in the “what” of technology. We introduce new tech super-fast and call it progress. Other cultures are more interested the effects of technology. They are slower to let new technology in.

A few hours after this conversation, another Couchsurfer came. This guy was driving across country to move to the Bay area. He wanted to make it as an entrepreneur, and he was filled with a bright excitement that technology will change the world.

He told a story of how someone broke into his car and stole his backpack from his trunk. His solution was innovative: he wrote a script that scoured craigslist for the stolen backpack. Amazingly, he found it, and then used his script to recover other things this guy had stolen.

Technology can do neat things, but it doesn’t change the basic facts: we’re humans, we live, and we die. Our molecules go into the ground and become other things.

My host had a composting toilet, which I thought was a cool reminder of the circle of life. It’s easy to forget about the circle of life when you live in the modern world and spend years without touching the earth.

I drew this comic as an imaginary conversation between the farmer and entrepreneur. The farmer is on an escalator, which symbolizes the creation and destruction of life as it goes up and goes down.

Two Modest Mouse quotes:

  • Someday you will die and someone or something will steal your carbon. (Parting of the Sensory.)
  • So we carried all the groceries in while hauling out the trash and if this doesn’t make us motionless I do not know what can. (Spitting Venom.)

Well, motionless for a while, but we age and we die. The high we get from technology is cool, but life is interconnected and circular and, despite what the transhumanists say, I think will stay that way for a long, long time.

Little Jewish Brain

Little Jewish Brain

I said that I had a hard time making decisions, and Dr. Lopez, my couchsurfing host, said the quote above. She actually amended her quote to be: left jewish brain, since the left brain is apparently the judging, analyzing brain. “I don’t think you have a little brain,” Dr. Lopez said.

No matter if it’s left or little, it’s something to work on. Learning how to feel is a hard thing to do.

The most important part of a pullup

This is my first workout video, whoooooo!

The most important part of a pullup is not pausing to hang at the bottom. Pausing at the bottom causes inertia, tires you out. It actually gets kind of addicting to try to go down and up without a pause.

This can be applied to other repetitive exercises such as pushups, situps, etc.

A side note: my dad made this pullup bar. Isn’t it sweet?