Monthly Archives: March 2014


The course of one’s life is marked by many transitions, some joyful, some full of stress, some tragic, and many perplexingly unexpected. Some happen to us directly and some to others that can affect us in the most profound of ways.
When I was in college, I was very much attracted to a certain young woman whom I felt I could not ask out. She was pretty, vivacious, and she seemed so much more socially adept than I, leading me, as a somewhat introverted pre-bloomer, to feel thoroughly inept in her presence. Even were that not the case, she was a friend’s girlfriend, and the unwritten but always to be observed buddy code absolutely forbade my acting. As a result of all this, I settled for “just friends”. In my senior year, when I got accepted to medical school, she jokingly announced that she’d never let me be her doctor, even if I were the last medicine man on the planet. Everyone who heard her say it had a pretty good laugh. Even me, actually.
Eight years later, I was the chief resident in obstetrics and gynecology in a university teaching hospital, and one day she, this same, lovely young woman whom I had not seen since college graduation, came to see me. Tragically, she had become quite ill with a chronic, debilitating disease but had gotten married before being diagnosed and now wanted a child. Her internist, several other specialists, and I were all most unenthusiastic about this, but she persisted, became pregnant and, sheepishly recalling what she had once said, then asked me to take care of her. I did, and she ultimately delivered a healthy son. She had gone through a courageous, self-determined transition to motherhood involving substantial risk but had come through it well and was now a happy mother, albeit still grappling with her disease. And I? I , too, had gone through a transition, somehow feeling validated as a doctor in a way that I had not before.
After residency, I joined a large ob/gyn practice with six other MDs. At the end of my first year with the group and three weeks after the birth of my wife’s and my first child, the group fired me, essentially because one of the partners and I had had a falling out and he wanted me gone. Once over my shock and disappointment, I decided to open an office about six blocks away, starting my own practice with eleven obstetrical patients who had determined to stay with me and a distressingly large (for my former group) number of gyn patients who also elected to remain with me. The practice became very successful but, after 7 years and for reasons too complicated to detail here, I sold the practice and transitioned my career over a period of several more years from fully clinical to the developing area of administrative medicine, a role in which I have continued to grow and establish myself ever since.
So, why do I bother to relate these few examples of transitions? Because I will very shortly be retiring and, as it is for other transitions in relationships and career activities, retirement is one of life’s major, stressful events.
I’ve been looking forward to retiring for quite some time, and I’m not consciously ambivalent about it at all. But subconsciously is another matter, and recently I’ve been dreaming.
I’ve always had certain recurrent dreams of the kind many people have – nothing unique about that. They’ve always been those in which I’m in situations for which I’m unprepared, often involving time in school when I can’t find the right classroom, keep a schedule straight, or when I’m totally unprepared for some important examination. (I’ve never had one of those dreams where I’m naked in public.)
But the recent dream is a new one: I’ve just been accepted to medical school and am planning to leave home to go to wherever the school is, which isn’t clear in the dream but is evidently far away. The catch is that I know that I’ve already graduated from medical school and I’m not sure why I’m going back.
The interpretation seems pretty obvious to me: unresolved conflict over the impending transition to retirement. Anxiety over aging and loss of a piece of my identity also probably play a role. Yet, if I weren’t dreaming about this (and remembering it), I wouldn’t know that there was any conflict.
I have much to keep me busy in retirement: family, friends, hobbies, travel, ideas about volunteer work. I know it will all turn out well, but it is going to be a different kind of transition from those I’ve gone through before, and like so many transitions – changing relationships, jobs, the loss of parents, illness, marriage, the birth of children and arrival of grandchildren — the path through it will not necessarily be straight. It will, though, always be interesting.

Today’s annoyance:
People who don’t seem to know the difference between “effect” and “affect”. Every time I see this in someone’s writing, I find that the effect on my affect is to affect me quite negatively. Somehow, we need to effect large scale correction of this common error.


Why We’re Doomed (unless we do something…)

As a leading edge baby boomer born in 1946, an unreconstructed left-wing liberal (just ask my Republican friends), a person of science, and an atheist to boot, I’ve found myself increasingly pessimistic over the world’s prognosis. Consider:

Population: We may finally be approaching Malthusian limits. Malnutrition and even starvation is widespread in parts of the world, and it exists even in our own. My conservative friends would say that this is a matter of economics but, then, what isn’t, at least to some extent? The really big problem, however, is that there are simply too many people for the earth to support. Overpopulation with attendant poverty, malnutrition, and disease is the result of a wildly out of control combination of politics, economics, religion, and lack of education, and it does not portend a future without great suffering and death, no matter how good our technology may be. If we can’t – don’t – control the rate of human reproduction, we’re going to drown in a sea of crowded misery.

Education: A significant proportion of the world’s human inhabitants is woefully undereducated, and I do not exclude our American population. How many Americans think that the world is only 6000 years old, that Fred Flintstone really rode on the back of a dinosaur,  that it was really possible for Noah to build an ark that would carry two of every living creature, including protozoans, cockroaches (cockroaches!), and hippopotami to safety? I once knew a fellow who thought that if the Earth were to stop spinning on its axis, we’d all fall off. I guess he’d never heard of gravity. Given the state of education in the U.S., I wonder what would happen if, one day, all the machines were to die? Where would the knowledge be to reconstruct them from basic principles?

Productivity: Check your bedroom closet and drawers. See whether you can find any clothing made in the U.S. No? America produces distressingly little of what it consumes these days. Most of the durable goods seem to be assembled or made in Mexico, China and BFE. China practically owns us, both by their investments here and by our dependence upon Chinese-made imports. Once, it was Nikita Kruschev and the Soviet Union threatening to bury us with the alleged superiority of their political system. Now, China threatens to bury us economically. The latter threat is far more likely to be actualized than the former ever was.

Religion: It is simply astonishing that in the 21st century people still believe in fairytales, and are indoctrinated into mindsets that are so blinded to objective reality. Most notably, the preposterous and suicidal notion that we need not worry about the environment because some god sitting on a cloud somewhere is going to determine the fate of the planet and everything else. While religious inspiration has produced some mighty fine art, it has surely taken an awful toll in human suffering and divided the world into hostile camps based upon nothing more than superstition. Our very existence is threatened by the potential actions born of unwarranted certainty and messianic zeal. Religion’s influence has had a corrosive impact upon public policy, diverting us from the objective pursuit of bringing people together in a world filled with mutual understanding and tolerance, controlling population growth, and pursuing responsible stewardship of land, sea, and atmosphere.

Arrrgh! We’re doomed…unless we do something, but the idiots of the right (and a few on the left, too), are contemporary Luddites, and an awful lot of them hold political office. We need to vote the ignoramuses out and vote some rational minds in. But where is the informed and motivated electorate that will do just that? Please, someone, tell me.

Today’s annoyance: Well, if the foregoing wasn’t enough, how about considering misuse of the term, “begging the question”? To beg the question is to make a logical error in which one assumes the validity of an unproven proposition within a statement that depends upon the truth of that proposition’s unproven nature. For example, I might say, “Of course you fell off your bicycle. It’s red, silly.” This “begs the question” (i.e., is dependent upon the assumption) that it has been proven that people fall off red bicycles because they’re colored red. To beg the question does not mean simply to raise an issue, which is how it is perhaps most often (mis)used.

On Marketing Your Opus Magnum

As a relatively unknown, self-published author, you have to face the fact that it’s difficult to gain much market traction. Advertising is expensive, major publications don’t want to add your opus magnum to their slush pile, some booksellers will rip you off for the privilege of allowing an onsite book signing (boy, do I know about that one), and getting a review from a respected reviewer is nigh onto impossible. So, what can you do?

My own personal experience with this has been spotty. I was highly naïve following publication of my first book, Spacebraid and Other Tales of a Dystopian Universe, and my marketing efforts, to be honest, sucked. I did manage a couple of short reviews in niche publications that got me no sales. Then, figuring I needed to go bigger (read: spend more), I took a several month ad in Analog, a science fiction magazine with a circulation of about 80,000. After some four months of running the ad, not a single book had sold. Was this depressing? You betcha.

As I’ve previously described at some length, the publisher of Spacebraid…  was not at all helpful in the marketing of the book. They offered expensive marketing services which mostly involved their sending out some publicity blurbs via distribution e-mail (i.e., spam) and getting the book listed in indexes seen only by bored Himalayan hermit librarians, and I got no boost from those.

Eventually, I made two decisions: spend no more on Spacebraid… and find a new publisher for my second book, Zendoscopy. The first was easy. I no longer take calls from the high pressure salespeople at Xlibris. The second took some time to find, but I settled on Inkwater Press in Portland, Oregon. The attention and support I’ve gotten from Inkwater has been most encouraging, and what I’ve liked most is that when I call them, human beings pick up the phone and they actually know who I am.

Publication of Zendoscopy went smoothly and I’ve now got a few copies in my closet with more ordered. So, how am I going to do the marketing this time? Well, I’ve learned a lot since my first experience, so now, at least, I’ve got a plan.

Immediately upon receiving my first shipment of books, I contacted Inkwater and had them set up a book giveaway on the Goodreads website. They also did a publicity release and a couple of pitch letters for me on their letterhead which I can use as I please. I had bookmarks printed up that I can distribute or leave in batches in bookstores and elsewhere. (Actually, I did do the bookmark thing with Spacebraid…, too.) None of this was free, but Inkwater’s fees were bundled into a package at reasonable cost. Next, I requested a review from Kirkus, a reputable and well known organization which, for a price (of course), will review your work and provide you with an independent review that you can choose whether distribute or not, based upon how it turns out. At your direction, they will also distribute or bury the review as you prefer. The Kirkus  review of Zendoscopy is pending as I write this, and probably won’t be available until early May. If it’s favorable, it should help sales considerably.

A few other actions. First, I will be sending a copy to the host of a local NPR radio program, hoping he’ll read it and respond to my suggestion of an on-air interview. Second, despite my prior bad experience with a local bookseller over a book signing, I will try to schedule several of these with stores that won’t cause me to lose money on every sale. Third, I’m experimenting with a new online marketing site called TweetInto that links with Twitter. The site functions to connect your tweets with other Twitter/TweetInto users who will re-tweet your advertising tweets. I’m still learning how to use the service and whether it will make sense, but for a minimal investment of $20 to get started, I figure it’s worth a try.

I am very fortunate in that I’m able to write because I love to do it and not because I need to make my living as a writer. Despite having many articles and two books in print, I’ve made very little from my writing over the years. So, why do I do it? I think the answer I would give is the same as that given by many others: because it is a need. The need to write is something internal that exerts terrible pressure to be let loose. Said in another way, I write because I have to write. Selfish? Maybe. But whether you read what I put on the page or simply ignore it is up to you and not really a problem for me. Although I care, I don’t get all twisted up over it. I’m just glad for the decompression I feel as the words escape from wherever down deep they come from to land on the page, where I can see them and, in so doing, see some of myself. For me, that’s enough.

Today’s annoyance: People at the movies who won’t shut up.