Stacking The Deck

“So…what do you DO?”

This question is incredibly annoying to me, and I cringe every time I hear it. I resent the fact that many people are so quick to assess someone on the basis of what they “do” for a living, as if there are no other dimensions which should be taken into account.

I completely resent the demand to pick one career that defines me. To add insult to injury, when people find out that I am a medical doctor, they struggle with the stereotype of what they expect doctors to be like, in other words, very conservative in dress and demeanor, and without any flavor or personality. Well, I’ve got news for you. I will NEVER be a typical doctor. And please don’t doubt my credentials or schooling. I am NOT a nurse (not that there is anything wrong with this highly respected profession). I am a fully licensed and board certified physician.

However, I do not consider myself to be ONLY one thing, “only” a physician. Yes, I am a board certified physician. But I am also a degreed (Bachelor’s) fitness professional, professional athlete (IFBB Pro), certified nutrition coach, writer, model, brand ambassador and contest prep coach. If that’s too much for one to process, too bad. Because I am ALL of those things, and then some. I am just as much about fitness, bodybuilding and wellness as I am about medicine, and I shouldn’t have to choose one over the others. I am damned proud of what I have accomplished in bodybuilding, especially because I was in my forties when I took things to the next level, not when I was a young whipper-snapper, and I was already established in my medical career. I will not apologize to people who are confused by the sampler plate philosophy by which I live and who don’t believe that it’s possible to be more than one thing. Truth is, I live as what Marci Alboher describes in her book One Person Multiple Careers as a Slash, and I am proud of it. I know it’s unusual, but why is that so hard for people to grasp? I mean, here I am, doing all that I do, switching gears constantly, and sending a message to the world that no one should have to be one-dimensional and boring.

I am honest. I have sass, and I speak my mind. I will NOT hide parts of myself which some overly judgmental people may have a problem with. I am NOT going to apologize for having a sense of humor, for using cuss words here and there (though I don’t use them while seeing patients). I am not going to paint a false picture of who I am. If you don’t like what I am doing, no worries. Move on.

Here’s a message to you if you find that you are someone who is compromising your own vision, dreams, or goals, because you perceive a need to choose one thing to define you. Perhaps you need to re-examine why you are allowing that to occur. If you subscribe to a no limits philosophy, then you would never even consider pulling the reins back. I will always encourage driven people to go for whatever they want, and if it doesn’t fit in with the conventions of one of their chosen careers or hobbies, even better. Break stereotypes and show people what you are made of! Don’t hide all the facets which make you who you are!

Decreasing My Blog Posting To Once A Week

After evaluating my engagement on my blog site over the past year, as well as the amount of work which goes into scheduling blog posts, I have decided to pull down my blog post frequency to one day per week. I simply don’t have the time to put up frequent blog posts, especially when engagement keeps dropping.

In an effort to accommodate reader interest, I encourage you to make suggestions on post topics so that I will have a better sense of what people want to see here.

Thanks to all of you who have been following my blog. I truly appreciate it!

Shut Up, I’m Trying to Concentrate! (Revised Repost)


There are times when I need absolute silence in order to concentrate. Since I spend a lot of time at home writing, I deal with the constant challenges of coming up with new material, and allowing the creative process of writing to develop. Perhaps the most distracting thing I face when I am trying to focus is NOISE. Whether the noise is from people talking to each other, exercise equipment banging against the floor, car horns blaring, cats playing, doors opening or closing, or people constantly trying to talk to me, any noise except music will get me to the point where I get close to losing it. I am well aware of the fact that I suffer from misophonia, and have dealt with it since med school days, when I had to wear earbuds whenever I sat for exams.

I recently read that a group of psychologists at Northwestern University discovered that highly creative people tend to be more sensitive to noise than the average person. I digested this information with relish, since I certainly hope the fact that I can be easily annoyed by noise when I am in a creative mode is indicative of creative genius, or at least something close! The assertion that creative types are more easily distracted by noise is demonstrated by great novelists like Proust, who apparently would sequester himself in his small apartment, donning earplugs and drawing the blinds while he wrote.

Cat shutting dog up

Basically, I think the general rule of thumb should be that if someone tells you to pipe down, and the person is clearly trying to focus, then SHUT UP!

These Desk Designs Are SO Cool!

Check out the five amazing desk designs which are featured on the blogsite in the link below:

I especially love the one-of-a-kind Han Solo in carbonite desk (not that I would actually want it for myself!) which Tom Spina designed for Star Wars collector Mark Hall. Evidently, this desk sold for $10,500, all of which was donated to charity.



The desk which I would love to have, especially when I am trying to focus on my writing, is the Armadillo Desk which is a prototype from designer Sophie Kirkpatrick. If she ever gets funding to produce this desk, I would probably buy one in a heartbeat! How’s this for shutting out the world when you need to concentrate?

Armadillo Desk

Life Is Never Boring


Any time I hear someone complain about how predictable, steady and boring life is, I chuckle, because I have never been able to make that statement about my own life. This doesn’t mean that my life is unstable, but that I have always had so much going on that there hasn’t been time for boredom to set in. I truly am CONSTANTLY doing something, and I have a habit of packing a lot into each day. I understand that some people are stuck in boring jobs, so I am thankful that I love being a physician, and love the environments in which I work. I am fortunate to be involved in pursuits which I am passionate about, and which give me an incredible sense of fulfillment. Whether I am doctoring, writing articles, modeling, doing booth work, creating nutrition and workout regimens, or working on business strategies or branding, so much is going on inside my head that I couldn’t possibly get bored.

I will admit that aspects of my regular daily routine could be seen by others as a bit dull, since I head to the gym around the same time, and I usually spend weeknights writing. However, I typically cram so much stuff in between those activities that I spend the entire day rushing around, trying to get it ALL done. The overachiever in me can’t seem to let go of the notion that the best days are the ones in which all the important items on the to do list are checked off. Even on the weekends, I spend the majority of my time trying to catch up on articles and plans which I wasn’t able to get to during the week.

Another feature of my life is that I wear so many hats that I have to constantly shift gears. Though it puts a lot of pressure on me, I prefer to have a lot of variety in my day, talking about medicine, fitness, skincare, nutrition, and business. My nerves can get pretty frazzled from the endless list of things to do, but I know I wouldn’t be able to deal with sitting around all day with nothing to do. I think partially because I have chosen a number of very interesting fields to pursue, and partially because I seem to attract a lot of movement and energy, circumstances also seem to keep me on my toes, and also keep boredom at bay. About 25 years ago, I remember someone telling me that I moved at a high “burn rate”, that my spirit had a lot of karmic energy which would attract lots of activity and movement. Despite its mystical tone, the statement struck me, and I can honestly say that it fits the cadence of my entire life.

If you find that you are bored with your life, it’s time to examine what might be holding you in a rut. Maybe you watch a lot of television. If so, turn off the television and read a good book. If it has been months or even years since you exercised, join a gym and commit to a regular workout schedule. Go out with friends. If you have pockets of time in which you are looking for things to do, try exploring your city or town by visiting other neighborhood stores, parks and restaurants. Cultivate a new hobby. Volunteer.

You can turn a boring life into a fulfilling, fun, exciting one by doing new things. Have fun!

Shut Up, I’m Trying To Concentrate!


There are times when I need absolute silence in order to concentrate. Now that I write content almost daily, I deal with the constant challenges of coming up with new material, and allowing the creative process of writing to develop. Perhaps the most distracting thing I face when I am trying to focus is NOISE. Whether the noise is from people talking to each other, exercise equipment banging against the floor, car horns blaring, cats playing, doors opening or closing, or people constantly trying to talk to me, any noise except music (which I listen to through earbuds) will get me to the point where I get close to losing it.

I recently read that a group of psychologists at Northwestern University discovered that highly creative people tend to be more sensitive to noise than the average person. I digested this information with relish, since I certainly hope the fact that I can be easily annoyed by noise when I am in a creative mode is indicative of creative genius, or at least something close! The assertion that creative types are more easily distracted by noise is demonstrated by great novelists like Proust, who apparently would sequester himself in his small apartment, donning earplugs and drawing the blinds while he wrote.

Cat shutting dog up

Basically, I think the general rule of thumb should be that if someone tells you to pipe down, and the person is clearly trying to focus, then SHUT UP!

When Words Elude You


I have always been a decent writer, and have prided myself on having a substantial vocabulary. So when my mind completely draws a blank and can’t find a simple word which I am trying to remember, I become rather frustrated. I will stand there with a vacant expression on my face, sifting through the memory banks, hoping for some kind of trigger. I have become accustomed to the random brain fog moment, which is followed up about an hour later with the word innocently floating into my conscious mind, as if to say, “Here I am…looking for me?” For example, I couldn’t remember the word “cryptic” the other day, but it suddenly appeared after the situation in which I needed to the remember the word had passed. I was heating up a meal, and there it was, POP, in my head. What the hell? Where were you when I needed you?

Instead of struggling endlessly to find a word, I usually give up after less than a minute. It turns out that stubbornly trying to remember a word makes it more difficult to recall that word in the future, so I guess I am giving my brain a break. Perhaps I am also mellowing with age, sinking into a resigned state, and knowing that my noggin will have its misfirings every now and then.

I have made the delayed word recall which occurs into a bit of a game now so that the word sticks. When “cryptic” came back to me, I immediately thought of Tales From The Crypt so that the word would stick, sort of like a memory glue so that the synapses might fire correctly next time and give me the word on demand. It seems to work pretty well, so I will continue to do it.

Another thing which I do is to play a word game on the Lumosity website, in which I have to enter words based on a given word root. I figure this is a good exercise for any writer, and will keep me actively thinking about vocabulary. I will say, however, that I have stepped away somewhat from the scientific mode of writing which has been required of me when I write clinical papers. I love complex vocabulary, especially multi-syllabic words which have a way of twisting the tongues of most people. Yes, I am weird that way, a bit of a science nerd. These days, though, I am not writing for an audience of physicians or scientists, so the vocabulary I turn to is a bit more basic. After all, I am not trying to talk over people or blind them with science. I am trying to inform, educate, and communicate, so I want my work to be completely accessible and easy to understand.

Even with all this word training, I still feel like a complete idiot when my mind is desperately fishing for a word or name. It can be downright frustrating to give up on trying to find a word, and settling for a synonym instead. What’s even worse is when I can’t think of a word, and can only think of a phrase which describes what I am trying to say with that one, elusive word. In that situation, I redirect my writing so that I avoid the roadblock. However, if it happens when I am speaking with someone, I am sort of screwed!

The Joy of Old Age. (No Kidding.)

Oliver Sacks swimmer
I am sharing this essay which was written by the late Dr. Oliver Sacks for the New York Times. It is a delightful essay which honors old age.

Original post can be found at:

LAST night I dreamed about mercury — huge, shining globules of quicksilver rising and falling. Mercury is element number 80, and my dream is a reminder that on Tuesday, I will be 80 myself.

Elements and birthdays have been intertwined for me since boyhood, when I learned about atomic numbers. At 11, I could say “I am sodium” (Element 11), and now at 79, I am gold. A few years ago, when I gave a friend a bottle of mercury for his 80th birthday — a special bottle that could neither leak nor break — he gave me a peculiar look, but later sent me a charming letter in which he joked, “I take a little every morning for my health.”

Eighty! I can hardly believe it. I often feel that life is about to begin, only to realize it is almost over. My mother was the 16th of 18 children; I was the youngest of her four sons, and almost the youngest of the vast cousinhood on her side of the family. I was always the youngest boy in my class at high school. I have retained this feeling of being the youngest, even though now I am almost the oldest person I know.

I thought I would die at 41, when I had a bad fall and broke a leg while mountaineering alone. I splinted the leg as best I could and started to lever myself down the mountain, clumsily, with my arms. In the long hours that followed, I was assailed by memories, both good and bad. Most were in a mode of gratitude — gratitude for what I had been given by others, gratitude, too, that I had been able to give something back. “Awakenings” had been published the previous year.

At nearly 80, with a scattering of medical and surgical problems, none disabling, I feel glad to be alive — “I’m glad I’m not dead!” sometimes bursts out of me when the weather is perfect. (This is in contrast to a story I heard from a friend who, walking with Samuel Beckett in Paris on a perfect spring morning, said to him, “Doesn’t a day like this make you glad to be alive?” to which Beckett answered, “I wouldn’t go as far as that.”) I am grateful that I have experienced many things — some wonderful, some horrible — and that I have been able to write a dozen books, to receive innumerable letters from friends, colleagues and readers, and to enjoy what Nathaniel Hawthorne called “an intercourse with the world.”

I am sorry I have wasted (and still waste) so much time; I am sorry to be as agonizingly shy at 80 as I was at 20; I am sorry that I speak no languages but my mother tongue and that I have not traveled or experienced other cultures as widely as I should have done.

I feel I should be trying to complete my life, whatever “completing a life” means. Some of my patients in their 90s or 100s say nunc dimittis — “I have had a full life, and now I am ready to go.” For some of them, this means going to heaven — it is always heaven rather than hell, though Samuel Johnson and James Boswell both quaked at the thought of going to hell and got furious with David Hume, who entertained no such beliefs. I have no belief in (or desire for) any post-mortem existence, other than in the memories of friends and the hope that some of my books may still “speak” to people after my death.

W. H. Auden often told me he thought he would live to 80 and then “bugger off” (he lived only to 67). Though it is 40 years since his death, I often dream of him, and of my parents and of former patients — all long gone but loved and important in my life.

At 80, the specter of dementia or stroke looms. A third of one’s contemporaries are dead, and many more, with profound mental or physical damage, are trapped in a tragic and minimal existence. At 80 the marks of decay are all too visible. One’s reactions are a little slower, names more frequently elude one, and one’s energies must be husbanded, but even so, one may often feel full of energy and life and not at all “old.” Perhaps, with luck, I will make it, more or less intact, for another few years and be granted the liberty to continue to love and work, the two most important things, Freud insisted, in life.

When my time comes, I hope I can die in harness, as Francis Crick did. When he was told that his colon cancer had returned, at first he said nothing; he simply looked into the distance for a minute and then resumed his previous train of thought. When pressed about his diagnosis a few weeks later, he said, “Whatever has a beginning must have an ending.” When he died, at 88, he was still fully engaged in his most creative work.

My father, who lived to 94, often said that the 80s had been one of the most enjoyable decades of his life. He felt, as I begin to feel, not a shrinking but an enlargement of mental life and perspective. One has had a long experience of life, not only one’s own life, but others’, too. One has seen triumphs and tragedies, booms and busts, revolutions and wars, great achievements and deep ambiguities, too. One has seen grand theories rise, only to be toppled by stubborn facts. One is more conscious of transience and, perhaps, of beauty. At 80, one can take a long view and have a vivid, lived sense of history not possible at an earlier age. I can imagine, feel in my bones, what a century is like, which I could not do when I was 40 or 60. I do not think of old age as an ever grimmer time that one must somehow endure and make the best of, but as a time of leisure and freedom, freed from the factitious urgencies of earlier days, free to explore whatever I wish, and to bind the thoughts and feelings of a lifetime together.

I am looking forward to being 80.

R.I.P. Dr. Oliver Sacks

Oliver Sacks

Dr. Oliver Sacks, eminent neurologist and brilliant author who explored strange neurological aberrations in books such as “The Man Who Mistook His Wife for a Hat,” died on August 30th at his home in Manhattan at the age of 82.

I was stunned when I read his post on Facebook in February which revealed that he had terminal liver cancer. The original source of the cancer was a melanoma in his eye which had been treated nine years ago.

Dr. Sacks was not only a highly respected neurologist and researcher, he was a prolific and incredibly gifted writer. More than a million copies of his books are in print in the United States, though the book he was most well known for was “Awakenings,” which was made into a movie starring Robin Williams. He was so popular that he received about 10,000 letters a year. Regarding the plethora of letters he received, he stated, “I invariably reply to people under 10, over 90 or in prison.”

I first met Dr. Sacks in 1986 during a book reading of “The Man Who Mistook His Wife For A Hat.” Though I had known for years that I wanted to become a physician, and that I had a specific passion for neurology, my meeting with Dr. Sacks re-ignited that passion. I devoured that book, and from that point on was a devoted fan, not only of his writing, but of him as a clinician and humanitarian. I have every book which Dr. Sacks wrote and thoroughly enjoyed reading them (I have yet to read “Hallucinations” and “On The Move” which were his most recent tomes). I was thrilled when Dr. Sacks had a book signing for “Oaxaca Journal” in 2002, and I made sure to attend that signing, speak with him, and have him sign my copy. I was a physician by then, and in the middle of residency training. Though I had ended up in family practice rather than neurology, my fascination for neurological cases was very much intact, and my admiration for Dr. Sacks only increased over the years.

In tribute to one of my medical idols, I am posting an essay which Dr. Sacks wrote in February of this year for the New York Times.

Original post can be found at:

A MONTH ago, I felt that I was in good health, even robust health. At 81, I still swim a mile a day. But my luck has run out — a few weeks ago I learned that I have multiple metastases in the liver. Nine years ago it was discovered that I had a rare tumor of the eye, an ocular melanoma. The radiation and lasering to remove the tumor ultimately left me blind in that eye. But though ocular melanomas metastasize in perhaps 50 percent of cases, given the particulars of my own case, the likelihood was much smaller. I am among the unlucky ones.

I feel grateful that I have been granted nine years of good health and productivity since the original diagnosis, but now I am face to face with dying. The cancer occupies a third of my liver, and though its advance may be slowed, this particular sort of cancer cannot be halted.

It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can. In this I am encouraged by the words of one of my favorite philosophers, David Hume, who, upon learning that he was mortally ill at age 65, wrote a short autobiography in a single day in April of 1776. He titled it “My Own Life.”

“I now reckon upon a speedy dissolution,” he wrote. “I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”

I have been lucky enough to live past 80, and the 15 years allotted to me beyond Hume’s three score and five have been equally rich in work and love. In that time, I have published five books and completed an autobiography (rather longer than Hume’s few pages) to be published this spring; I have several other books nearly finished.

Hume continued, “I am … a man of mild dispositions, of command of temper, of an open, social, and cheerful humour, capable of attachment, but little susceptible of enmity, and of great moderation in all my passions.”

Here I depart from Hume. While I have enjoyed loving relationships and friendships and have no real enmities, I cannot say (nor would anyone who knows me say) that I am a man of mild dispositions. On the contrary, I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.

And yet, one line from Hume’s essay strikes me as especially true: “It is difficult,” he wrote, “to be more detached from life than I am at present.”

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts. This does not mean I am finished with life.

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well).

I feel a sudden clear focus and perspective. There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming.

This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries. My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

Correction: February 26, 2015
Because of an editing error, Oliver Sacks’s Op-Ed essay last Thursday misstated the proportion of cases in which the rare eye cancer he has — ocular melanoma — metastasizes. It is around 50 percent, not 2 percent, or “only in very rare cases.” When Dr. Sacks wrote, “I am among the unlucky 2 percent,” he was referring to the particulars of his case. (The likelihood of the cancer’s metastasizing is based on factors like the size and molecular features of the tumor, the patient’s age and the amount of time since the original diagnosis.)

Running Out Of Steam

can't think woman and laptop

The frenetic pace at which most of us live these days has us lamenting the fact that it doesn’t seem like there are enough hours in the day to get everything done. It is exceedingly rare for me to get to the end of a day and think, wow, I got everything done that I wanted to get done, because somehow, the crazy pace of each day seems to derail me from checking off everything on my to-do list. Do I have too much on my list? Yes, absolutely. Do I have unreasonable expectations of myself that I will get everything done? Yes. However, I am pretty efficient and organized, and on most days, I take care of all the things which must be done on that particular day.

Here’s where I tend to fall flat on my face. I do a considerable amount of writing for my own blog and for a number of health, wellness, fitness and bodybuilding entities, so I ALWAYS have writing assignments on my plate. Occasionally, a day will open up schedule-wise, in which I don’t have to see patients or clients, and I always foolishly think that because of the so-called open schedule, I will have plenty of time to sit at my computer and write articles and posts. Invariably, some schedule destroyer will knock that idea completely out of the water, leaving me only a sliver of time in the late evening to write. The problem with late evening for me is that I have very little energy to write, and the creative thoughts fail to flow through my weary brain. I stare at my computer screen, hoping for some inspiration to hit me, but instead of being blessed with one great idea after another, I can feel the gears in my mind moving more slowly. Every once in a while, an idea might come to me, but as I begin to write on the topic, my interest wanes and I end up deleting the entry. Clearly I am NOT a night owl!