Feeling down

My December
Linkin Park (Hybrid Theory)

This is my December
This is my time of the year
This is my December
This is all so clear
This is my December
This is my snow covered home
This is my December
This is me alone

And I
Just wish that
I didn't feel
Like there was
Something I missed
And I
Take back all
The things I said
To make you
Feel like that
And I
Just wish that
I didn't feel
Like there was
Something I missed
And I
Take back all the
Things I said to you

And I give it all away
Just to have somewhere
To go to
Give it all away
To have someone
To come home to

This is my December
These are my snow-covered trees
This is me pretending
This is all I need

And I
Just wish that
I didn't feel
Like there was
Something I missed
And I
Take back all
The things I said
To make you feel like that
And I
Just wish that
I didn't feel
Like there was
Something I missed
And I
Take back all the things
I said to you

And I give it all away
Just to have
Somewhere to go to
Give it all away
To have someone
To come home to

This is my December
This is my time of the year
This is my December
This is all so clear

And I give it all away
Just to have somewhere
To go to
Give it all away
To have someone
To come home to

Planning, Stage 1

Things to do before I travel

  • Find the price for tickets: I think we're far enough into the year to be able to get consolidator prices for them
  • Get passport
  • Find places to stay
  • Find how much it is to rent a car for at least part of the time

How to Stop Checking Email on the Evenings and Weekends

Via (Lifehacker)

Best-selling author Tim Ferriss offers digital minimalism tips to reduce the amount of time you spend in your email inbox.

Investment bankers aren't known for their impulse control. Several global firms in Zurich don't allow their bankers to check email more than twice per day. The reason is simple: the more they check email, the more compelled they feel to send email. Technologist Robert Scoble has said that for each email he sends, he gets 1.75 to 2 messages in return. This phenomenon highlights the unscalable nature of most time-management approaches: striving to do more just produces increasingly more to do.

Fifty email messages beget 100, which beget 200 and so on. It's impossible to manage this with a results-by-volume (or frequency) approach. There are two cornerstone behavioral changes for reversing this trend: check email less frequently (so we send fewer messages) and send fewer messages when we do check (so we trigger fewer exchanges).

Here are eight concrete tips and services for digital minimalism that can help eliminate—as a start—compulsive inboxing during the evenings and weekends.

Treat all of them as short experiments and customize.

  1. "Batch" email at set times.

    Have an email-checking schedule and do not deviate. There is an inevitable task-switching cost otherwise—U.S. office workers spend 28% of their time switching between tasks due to interruption, and 40% of the time, an interrupted task is not resumed within 24 hours. Use template autoresponders to alert people of your email schedule and encourage them to call if something needs faster attention. The "urgent" email-to-call conversion is usually less than 10%.

    This gives you breathing room to focus on predefined to-do's instead of responding to manufactured emergencies and ending the day with nothing to show for it.

    Alternative approaches include appending your signature with your email schedule, having only email from certain contacts forwarded to your Crackberry/PDA, and—if a manager of a small group—setting an inbox checking schedule for internally-generated email. Ensure that your first batch is around 10 or 11 a.m. and never first thing in the morning, as you want a meaningful volume (1/4-1/3rd of the daily total), and you should accomplish at least one critical to-do before going into reactive mode.

  2. Send and read email at different times.

    Go offline and respond to all email from a local program such as Outlook or Mail to avoid having the outgoing flow interrupted by immediate responses.

    Ever noticed how effective it is to respond to your email while on an airplane? Manufacture that environment by going offline to batch send.

  3. Don't scan email if you can't immediately fix problems encountered.

    One simple example: don't scan the inbox on Friday evening or over the weekend if you might encounter work problems that can't be addressed until Monday. This is the perfect way to ruin a weekend with preoccupation. Remember that just as income has no value without time, time has no value without attention.

  4. Don't BIF people during off-hours.

    "BIF" stands for "before I forget" and refers to emails sent on evenings or weekends out of fear of forgetting a to-do or follow-up. This sets a mutual expectation of 24/7 work hours and causes a plethora of problems. There are a number of better alternatives. First, use a service like Jott.com instead that allows you to send voice reminders via cell, which are transcribed and sent to your inbox or someone else's. If to someone else's, be sure to add "no need to respond until [next work hours]." Second, if you prefer low-tech, externalize follow-ups and to-do's in a small notebook like a Moleskine instead of entering the "bet you can't eat just one" inbox.

  5. Don't use the inbox for reminders or as a to-do list.

    Related to 4 above. Don't mark items as "unread," star them, or otherwise leave them in the inbox as a constant reminder of required actions. This just creates visual distraction while leading you to evaluate the same items over and over. Put them into a calendar (or Moleskine or other capturing system) for follow-up and archive the email, even if that calendar item is just "Respond to 2/10 email from Suzie." (Editor: See Lifehacker's "Trusted Trio" system for moving email messages out of your inbox and into one of three places: Archive, Hold (calendar item for a later date), or Follow-Up (your to-do list.))

  6. Set rules for email-to-phone escalation.

    One Senior VP in a Fortune 500 company recently told me that he's established a simple policy with his direct reports that has cut email volume by almost 40%: once a decision generates more than four emails total in a thread, someone needs to pick up the phone to resolve the issue.

  7. Before writing an email, ask yourself: "what problem am I trying to solve?" or "what is my ideal outcome?"

    Unclear purpose, usually a symptom of striving to be busy instead of productive, just requires later clarification from all parties and multiplies back-and-forth volume. Be clear in desired results or don't hit that Send button

  8. Learn to make suggestions instead of asking questions.

    Stop asking for suggestions or solutions and start proposing them. Begin with the small things. Rather than asking when someone would like to meet next week, propose your ideal times and second choices. If someone asks, "Where should we eat?", "What movie should we watch?", "What should we do tonight?", or anything similar, do not reflect it back with "Well, what/when/where do you want to...?" Offer a solution. Stop the back and forth and make a decision. Practice this in both personal and professional environments. Here are a few lines that help (my favorites are the first and last):

    "Can I make a suggestion?"
    "I propose..."
    "I'd like to propose..."
    "I suggest that... what do you think?"
    "Let's try... and then try something else if that doesn't work."

Remember: in email, the small things are the big things. If you can cut an exchange from six to three email messages, that's a 50% reduction in your inbox volume over time. This can make the difference between working all the time and leaving the office (both physically and mentally) at 5 p.m.

Less is m

Timothy Ferriss is author of the #1 New York Times bestseller, The 4-Hour Workweek.

Read More:

Practicing Patients

Published: March 23, 2008
Todd Small was stuck in quicksand again. It happened, as always, on the floor of the Seattle machine shop where he worked. His shift complete, Small was making the 150-yard walk from his workstation to his car, when he realized that his left leg was sinking deep in the stuff. Though this had happened before — it happened nearly every day now — he stopped and glanced down at his feet. His Nikes looked normal, still firmly planted on the shop’s concrete floor. But he was stuck, just the same. His brain was sending an electrical pulse saying “walk,” but as the signal streaked from his cerebellum and down his spinal cord, it snagged on scar tissue where the myelin layer insulating his nerve fibers had broken down. The message wasn’t getting to his hip flexors or his hamstrings or his left foot. That connection had been severed by his multiple sclerosis. And once again, Small was left with the feeling that, as he described it, “I’m up to my waist in quicksand.”
For the 400,000 Americans with multiple sclerosis, Todd Small’s description will most likely ring true. Muscle stiffness is a hallmark of the disease, and “foot drop” — the term for Small’s quicksand feeling — is a frequent complaint. The condition is usually treated, as it was in Small’s case, with baclofen, a muscle relaxant that works directly on the spinal cord. Every day for 14 years, he took a single 10-milligram pill. “My neurologist always told me if you take too much it will weaken your muscles. So I never wanted to go over 10 milligrams.” It didn’t seem to have much effect, but he carried on as best he could.
Small would have continued just as he was had he not logged on last June to a Web site called PatientsLikeMe. He expected the sort of online community he’d tried and abandoned several times before — one abundant in sympathy and stories but thin on practical information. But he found something altogether different: data.

After choosing a user name and filling out a profile, Small was asked to list his symptoms and treatments. He entered the 200 milligrams of Provigil he takes daily to fight fatigue along with the Tysabri injection he takes to slow the progress of his disease. And then he clicked on baclofen, and the Web site informed him that nearly 200 patients registered at PatientsLikeMe were taking the drug. He clicked again, and up popped a bold bar graph, sectoring those 200 across a spectrum of dosages. And there it was. Contrary to what his neurologist told him years ago, 10 milligrams wasn’t the maximum dose. In fact, it was at the low end of the scale. “They’re taking 30, 60, sometimes 80 milligrams — and they’re just fine,” Small recalls. “So it hits me: I’m not taking nearly enough of this drug.”

A few days later, Small asked his neurologist to up his dosage. Now Small takes 40 milligrams of baclofen a day. His foot drop isn’t cured — there are no miracles in M.S. — but he has found that after 14 years, he can walk to his car without sinking into quicksand. “Oh, man, I really dreaded that walk,” Small recalled when I spoke with him recently. “All shift, it’d be in the back of my mind. Am I going to have trouble? Is it going to get me? Now I almost got it figured it out. I don’t struggle like I used to.”

There are a little more than 7,000 Todd Smalls at PatientsLikeMe, congregating around diseases like Parkinson’s, multiple sclerosis (M.S.) and AIDS, all of them contributing their experiences and tweaking their treatments. At first glance, the Web site looks like just any other online community, a kind of MySpace for the afflicted. Members have user names, post pictures of themselves and post updates and encouragements. As such, it’s related to the chat rooms and online communities that have inhabited the Internet for more than a decade.

But PatientsLikeMe seeks to go a mile deeper than health-information sites like WebMD or online support groups like Daily Strength. The members of PatientsLikeMe don’t just share their experiences anecdotally; they quantify them, breaking down their symptoms and treatments into hard data. They note what hurts, where and for how long. They list their drugs and dosages and score how well they alleviate their symptoms. All this gets compiled over time, aggregated and crunched into tidy bar graphs and progress curves by the software behind the site. And it’s all open for comparison and analysis. By telling so much, the members of PatientsLikeMe are creating a rich database of disease treatment and patient experience.

And that’s no small thing. As modern medicine has reduced infectious disease in the U.S., the country’s population — like those in other developed nations — has shifted to longer-term, chronic ailments like heart disease and diabetes, diseases that patients must cope with for years and even decades. What’s more, conditions like high cholesterol and obesity demand years of vigilance to minimize their chances of leading to more serious health problems.

Disease management has become a national reality, a common experience that demands uncommon attention. And PatientsLikeMe is a tool that allows patients to manage their disease with a sophistication and precision that would have been unimaginable just a decade ago. The
7,000 members of PatientsLikeMe, in other words, are beta testers — they may be the vanguard of how we all will care and treat our résumé of chronic diseases. They’re not typical patients, in the sense of waiting for advice from a doctor. They are, rather, co-practitioners treating their conditions and guiding their care, with possibly profound implications. “People who use it will live longer; people who don’t won’t,” boasts Jamie Heywood, the provocative co-founder of PatientsLikeMe. “That’s evolution.”

Of course, turning patients’ experiences into usable data raises a host of questions for medicine. When patients take the reins of their own treatment, what role do doctors play? What’s to keep patients from misinterpreting the streams of data and finding false hope — and what’s stopping them from embarking on unproven and even risky treatments or dosages? And what happens if the real-world information at PatientsLikeMe contradicts the clinically proved protocols of medical science?

For many in the medical community, these are unexpected and unsettling questions. And they reflect the broader concern that many doctors have with the Internet’s emergence as a powerful source of medical information. According to a 2006 study by the Pew Research Center, 80 percent of Internet users, or about 113 million adults in the U.S., get health information from the Internet. Some physicians disdain this trend, bemoaning their hyperinformed patients as “Googlers.”

Yet even doctors who consider themselves advocates of online medical information raise concerns about patients self-medicating or self-treating. Erik Ensrud, a neurologist at Brigham and Women’s Hospital in Boston, specializes in many of the diseases that PatientsLikeMe focuses on. “The nervous system is the most complicated system in the body,” he says. “It’s so often much more difficult to quantify and study than we think it will be.”

For the members of PatientsLikeMe, though, the Web site can seem like a revelation — it’s a community forged not only around shared circumstance but also around a shared purpose. They say they are part of a project that may change the way their disease is treated and could change the way medicine is practiced. It’s an experiment in the future of medicine, running in real time.

PatientsLikeMe started with a single case of amyotrophic lateral sclerosis. In 1998, Stephen Heywood, a 29-year-old carpenter, learned that he had A.L.S., a neurodegenerative disorder commonly known as Lou Gehrig’s disease. Jamie, his older brother, quit his job to find a cure. An M.I.T.-trained mechanical engineer with a knack for neuroscience, Jamie founded the A.L.S. Therapy Development Institute in Cambridge, Mass., the following year. So began a radical quest to save Stephen’s life. They tried experimental drug therapies, they tried a stem-cell transplant and they tried a neural implant, each effort building on the previous one. After six years, Stephen was among the most documented A.L.S. patients in the world.

The sheer volume of Stephen’s data gave Jamie an idea — a notion hatched while browsing Match.com, the online dating site. The aspiring singles there had posted a trove of information about themselves — their likes and dislikes, their dating histories, their height and weight — all to find a perfect match. Jamie realized that a similar tool might be useful in the realm of disease, for treatment rather than romance. If patients shared their information and could find someone with a similar symptomatology and disease history, then they might better plot their own course of treatment and care. And it didn’t just have to be A.L.S. — it could work for any disease.

Jamie tapped his brother Ben, who also went to M.I.T. before earning his M.B.A. at U.C.L.A., and Jeff Cole, a college classmate of Ben’s who’d spent several years building dot-coms. They started with Stephen’s own case history, breaking it down into drug dosages, symptom severities and so on. In March 2006, PatientsLikeMe opened for business. Within a few months, the company added communities for M.S. and Parkinson’s disease. Last fall the company opened a community for people with H.I.V. Earlier this month, the company placed its biggest bet on the model of collective experience, creating a community for the millions of Americans with a mental-health condition.

The Web site gathers patient information on two levels: first there’s a quantitative breakdown of symptoms and dosages, data that the software instantly turns into charts and graphs. Second are the forums, where members share advice and provide more nuanced feedback on a certain drug or treatment issue. The site is designed so that relevant data bolster the conversations in the forums and vice versa.

“Our job is to allow a conversation with the computer that will match a conversation between two patients,” Jamie explains. “Then we capture that dialogue and turn it into useful, clean data.”

Stephen died the day after Thanksgiving in 2006, but his profile, under the user name ALSKing101, still contributes to that dialogue. Like many people with advanced A.L.S., in his last three years, Stephen was living in a wheelchair, completely paralyzed and breathing through a mechanical vent. One night his breathing tube snagged and disconnected, and he suffocated while he was sleeping. Such a death isn’t unknown for A.L.S. patients, and many PatientsLikeMe members — about 75 are on ventilators — have expressed fears about dying that way. Their main concern is that suffocation is a painful, unpleasant way to go.

As it turns out, the PatientsLikeMe community tries to allay that fear. At least two other members of the site have, in fact, had their breathing tubes accidentally disconnected and suffocated until passing out — only to be found and resuscitated, just in time. They have, in other words, almost died in just the way Stephen did, in the way so many have feared, but lived to tell about it: “Long story short, my vent hose came off in ’97, and I was certain I was going to die. I stared at the clock for exactly 10 minutes until I got tunnel vision then passed out. Nothing painful, stressful or anxious about it. It was like I just got sleepy and went to sleep. Suffocation was nothing like what I expected. Lol.” Laugh out loud, indeed.

The company is located in the brick-walled basement of a former twine factory, less than a mile from the M.I.T. campus in Cambridge. With just 15 employees, it is very much in start-up mode. Cole, who is 36, manages the site’s design and software team; Ben Heywood, also 36, handles overall operations and management; Jamie, 41, is the frenzied visionary, ever eager to sketch out how powerful a database of 7,000 patient
profiles can be. The company, which is financed by private investors, eschews advertising; the business model instead seeks to exploit the value of the databank itself. By and large, this means working with pharmaceutical companies. The company has had discussions with several drug firms to sell anonymized patient data on various symptoms and treatments. They have also recruited PatientsLikeMe members to be participants in clinical drug trials. Ultimately, the company expects that the data will generate insights with considerable scientific — as well as economic — value.

One afternoon in late November when I visited the office, Jamie turned to a nearby whiteboard and traced out an x-y axis, slashing a descending line from left to right. “We have the ability to run a probability engine,” he said. “We can mathematically model each patient. We can tell them what’s going to happen in their life. We can tell you when you’ll need a wheelchair.” He made a mark along the line. “And we can even tell you the day you’ll die, with remarkable certainty.”

Of course, Jamie’s spiel is part bravado. The company hasn’t started to predict specific patients’ prognoses — though they have filed for a patent covering such prediction tools. And not all quests for scientific precision are likely to succeed or prove worthwhile. But for the patient coping with the cascade of day-to-day decisions that come with managing a disease, the site’s aggregations offer a remarkable tool.

Every day, like 453 other members with M.S., Laurie Fournier gives herself an injection of Copaxone, a drug that impedes the disease’s progress. Together, the group has generated what amounts to a checklist of best practices. Fournier has learned that by doing the injection herself, “John Wayne-style,” rather than using an auto injector, she can avoid some of the bruising that’s a particularly aggravating side effect. And she has learned that the optimal needle stick goes through the skin and into the fat layer — but no further. “You don’t want to get muscle,” she relates. “Last time I did that, I couldn’t use that leg very well for a day and a half.”

Fournier, a self-described information junkie, relates all these details with a blasé precision. Her willingness to put so much information about herself online may seem immodest, even imprudent. But not to her. “I don’t worry too much about that,” she says. “Pretty much everybody I know over 45 has some kind of medical condition. Some people have had cataracts surgery, or they have high blood pressure, or high cholesterol or diabetes. Everyone has something. And if everyone has something, that really levels the playing field.”

“Any disease that is treated as a mystery and acutely enough feared will be felt to be morally, if not literally, contagious,” Susan Sontag wrote in 1978, in “Illness as Metaphor.” “Contact with someone afflicted with a disease regarded as a mysterious malevolency inevitably feels like a trespass; worse, like the violation of a taboo.” The antidote to such stigma, she suggested, is “to rectify the conception of disease, to demythicize it.”

But the myths surrounding disease are hard to dispel, our impulse to hide in metaphor difficult to shake. We still talk of wars on cancer and plagues of lawyers. “Leper” endures as a metaphor for stigma, long after leprosy itself has been eliminated from most of the world.

Stigma endures in more material ways, as well — most pointedly in concerns over medical privacy. For decades, our personal health information has been protected largely by disorganization and chaos, suggests Mark Rothstein, a bioethics and health-policy professor at the University of Louisville. But now, with major health-maintenance organizations and hospitals finally adopting electronic records, fallow storerooms of paper records are being converted into neat and portable digital form. “Technology is racing ahead of society,” says Rothstein, who advises the Department of Health and Human Services on electronic privacy. “If this is sensitive information — sexual history, mental illness, substance abuse — even if nothing bad happens, people are subject to stigma and embarrassment.”

The government has tried to protect patient privacy, most notably with the Health Insurance Portability and Accountability Act, or Hipaa. Enacted in 1996 to help streamline the adoption of electronic records, Hipaa was modified in 2002 to address concerns over how those records might be misused or distributed to unauthorized people. The law stipulates that if 18 categories of personally identifiable information are stripped from records then they may be transferred for research purposes without a patient’s consent.

Perhaps not surprisingly, Hipaa satisfies no one — not the privacy advocates, who argue against most any form of electronic record, and not the medical researchers, who now face onerous restrictions on their work. PatientsLikeMe upends this dialectic; in technology terms, it routes around the problem. Since the company is an opt-in service and not a health-care provider, Hipaa doesn’t apply. Good thing, really, since the site identifies members’ cities and their ages, two of Hipaa’s 18 prohibited categories of personal information.

But Hipaa is extraneous not just legally but philosophically as well. Many PatientsLikeMe members volunteer even more information from those 18 categories. They not only post their photos but also post photos of their children and spouses. They add brief autobiographies and describe their conditions in precise detail — including potentially embarrassing particulars on sexual function, bladder control or constipation. And though they all have user names, most go by their first names on the site’s forums.

PatientsLikeMe’s privacy policy clearly sta
tes that this sharing carries risks. It acknowledges that since anybody can register at the Web site, anybody can look at member profiles. It makes clear that there’s no guarantee that registered members are, in truth, who they say they are. And it nods to the fact that, yes, this is a business, not a public service — some personally identifiable information may be sold to “approved vendors.” But this is boilerplate. The most striking notice is the company’s Openness Philosophy, a manifesto posted prominently on the site.

“Currently, most health-care data is inaccessible due to privacy regulations or proprietary tactics,” it declares. “As a result, research is slowed, and the development of breakthrough treatments takes decades. . . . When you and thousands like you share your data, you open up the health-care system. . . . We believe that the Internet can democratize patient data and accelerate research like never before.”

In 1990, Alan Westin, a political scientist at Columbia University and an expert in privacy issues, offered a useful taxonomy of Americans’ attitudes toward privacy. On one end of the spectrum were what he called privacy fundamentalists — the 25 percent of Americans who feel that their privacy is paramount and that no one, not the government or corporations or their family, should have access to their personal information without explicit permission. At the other end of the spectrum were the privacy-unconcerned — about 15 percent of Americans — who paid no mind to privacy issues and didn’t figure they had anything to hide. In the middle were the vast majority, the 60 percent whom Westin called privacy pragmatists: those who felt that they could give a company they trusted some information — birth date, ZIP code, telephone number — for particular benefits.

The members of PatientsLikeMe aren’t all radicals culled from the privacy-unconcerned, though no doubt some are. Most more likely fit the profile of pragmatists. “I know it sounds like really personal information, but it’s not like I’m putting my phone number up,” says Jennifer Jodoin, a hotel manager in Palm Beach, Fla., who has changed her M.S. medications based on information gleaned at PatientsLikeMe. “I’m not posting my address and saying, ‘Come on by.’ It’s an exchange of information to get help and to give help.”

That pretty much defines pragmatism, and it exemplifies these strategic information-for-benefit exchanges people make like taking a blood test to get life insurance or consenting to a background check to secure a new job. Only now, at places like PatientsLikeMe, information has a currency that’s far more liquid than ever. Converted into data and bundled with information from those like us, private information can be invested for both immediate gains and long-term returns.

And there’s a fortunate side effect to converting your health history into data — it strips it of metaphor, of secrecy, of stigma. It becomes concrete, manageable and valuable. It becomes, just as Sontag suggested 30 years ago, demythicized.

As diseases go, A.L.S. or M.S. or Parkinson’s or even H.I.V. are relatively rare afflictions, at least in the United States. Mental illness, on the other hand, afflicts a vast swath of the country. Nearly 60 million Americans have a diagnosable mental disorder, according to the National Institute of Mental Health, a population that includes everything from depression to bipolar syndrome to anxiety. For PatientsLikeMe, that population represents a huge market, not to mention the potentially lucrative bounty of data related to antidepressants and other mood-disorder drugs. But it also presents a challenge.

Creating a PatientsLikeMe mental-health community — or as they call it, a “mood community” — requires a new strategy for measuring mental health. The challenge is in part semantic. Where the argot around A.L.S. or M.S. is largely clinical, the vernacular around mental health is more subjective. The official diagnostic criteria for major depression, for example, include “feelings of worthlessness” and “indecisiveness.” So PatientsLikeMe faces an input problem: how to convert the ambiguities of mental illness into metrics?

Whatever its ultimate worth, the site’s answer is elegantly straightforward. Members can update their mood status every hour on a scale of 1 to 4, from very bad to very good. How they feel may be subjective, but the resulting data can be mapped across time. The site treats sessions of therapy as if they were a dose of Prozac; the type of therapy (say, group or individual) stands as the treatment, and the length of a session (say, 50 minutes a week) as the dosage.

Such efforts at precise measurement and comparison are not the norm in evaluating mental-health treatment. Americans spend about $12 billion a year on antidepressants, but we still have little understanding of how or whether they work. In 2006, the National Institute of Mental Health released the results of the largest and longest depression study ever undertaken, the Sequenced Treatment Alternatives to Relieve Depression Study, or Star-D. Star-D rejected typical clinical study design and aimed to create a real-world representation of how patients actually experience and treat depression: through trial and error, taking one drug after another, searching for one that helps.

The results were mixed. Star-D found that if you’re depressed and spent three months on a potent psychotropic drug, you had a one-third chance of achieving remission. After almost six months on drugs, your chances bump up to about fifty-fifty — a coin flip — and you still risk side effects like sexual dysfunction, insomnia and weight gain. Those may be good odds for the industry, but it seems a poor bet for a patient.

At PatientsLikeMe, Ben Heywood sees pure opportunity in such statistics. “Those odds just aren’t good enough,” he says. “So you try Wellbutrin, and after six weeks it doesn’t work. Then Prozac. Doesn’t work. Now what? Where do you go next?” Plugged in to a community of patients sharing their depr
ession histories and treatments, Ben argues, patients could readily find someone with symptomatology close to their own, compare drug regimens and go straight to the drug that may be more likely to work for them.

This, for patients, is the promise of a mental-health community: better tailoring of treatments. It is also the promise of the site as a business. The pharmaceutical industry should be eager to improve the accuracy and efficacy of its treatments. After all, sometimes side effects can turn into blockbusters, most famously when Pfizer scientists learned that their hypertension treatment was causing erections in men, leading the way to Viagra. Since PatientsLikeMe forgoes advertising, selling its data to pharmaceutical companies is its best apparent way to make money. But so far, it seems, the drug industry has balked at the prospect of knowing so precisely what happens to their products after they reach the market.

If Jamie Heywood talks about his company as an incendiary force in the health-care industry — “This is the way it worked before ethics destroyed medicine,” he told me at one point — the American Medical Association would pretty much agree. From the perspective of many doctors,

PatientsLikeMe raises many more questions and quandaries than it answers.

Joe Heyman, a practicing physician in Amesbury, Mass., and the chair-elect of the A.M.A.’s board of trustees, praises the potential benefits of a tool like PatientsLikeMe for patients. He’s just uncomfortable with who’s minding the toolbox. “The idea of them is a wonderful thing,” he says. “But you know, as a physician I have a code of ethics. We have licensing boards and accreditation and all these people keeping an eye on us.” Heyman suggests that if physicians themselves aren’t sole stewards of the patient data — his first choice — then there should be some national standards or a law that covers a company like PatientsLikeMe that traffics in such data.

Heyman is also uncomfortable with how PatientsLikeMe encourages patients to take their medical information and then act on it. “Sometimes patients misunderstand what a doctor says to them,” he says, “so by the time it gets to the third or fourth party it’s like a game of telephone. It’s not as reliable as coming from the horse’s mouth.”

Heyman may be speaking from the perspective of the injured party — PatientsLikeMe could be seen as a direct challenge to physicians’ omniscience — but there’s still something to his concerns. PatientsLikeMe not only lets members track their disease; it also tacitly encourages them to take action. While PatientsLikeMe advises users to consult a doctor before changing their treatments or dosages — patients can print out an exhaustive status report, replete with graphs and charts, to take on doctors’ visits, and personal physicians can register as caregivers on the site — there will inevitably be patients who treat the Web site’s apparent rigor and depth as a substitute for a physician’s training and expertise.

Erik Ensrud, the neurologist at Brigham and Women’s Hospital, worries that patients could spot an animal study or early-stage trial investigating an off-label usage of a drug and then start taking that drug in the hope that the researchers are onto something. “Even if a treatment seems promising, it could result in a very serious reduction in lifespan,” he suggests. “We’re talking survival.”

In fact, some PatientsLikeMe members have already started doing pretty much what Ensrud warns against. Last November, the A.L.S. community was abuzz with word that researchers in Italy had found that taking lithium seemed to slow the progression of A.L.S. significantly. The Italian study hadn’t actually been published yet, but that didn’t stop 34 members with A.L.S. from soliciting lithium prescriptions from their doctors and coalescing into an ad-hoc clinical trial. There are now 109 members using lithium and tracking their progress with the data tools on the site. The company has rolled out new features to monitor the group with the hope that they will be able to lend a little credence — or cast a little doubt — on the Italian study in a matter of months.

Jamie insists that PatientsLikeMe isn’t encouraging A.L.S. members to start taking lithium. But he is unmistakably excited by the endeavor. As he sees it, the experiment perfectly illustrates how PatientsLikeMe might complement large-scale and long-term clinical research by conducting observational research “on the fly.” Drawing on the notion of personalized medicine, Jamie calls this “personalized research.” And it has a certain logic: for those who already have A.L.S., traditional science works at far too plodding a pace. “The system is broken for terminally ill patients,” says Hanns Riederer, a music producer in Los Angeles who has joined the group of A.L.S. members taking lithium. “It makes us wait five to seven years for results, when we don’t even have that time. Even if it’s half-true, it’s still groundbreaking. I don’t want to wait for something else. I don’t have time to wait.”

While the members of PatientsLikeMe may seem exceptional today, they will be fairly typical tomorrow. As we learn more about disease and are able to identify it earlier, more and more Americans will fall under the rubric of “patient” and will need to navigate an array of confusing health decisions. Doctors don’t like to admit it, but “most treatment decisions right now are still based on doctors’ judgments that don’t have real research behind them,” says Jodi Halpern, a physician and bioethicist at the U.C. Berkeley School of Public Health. “But it takes real data to make the right decisions, especially for patients. There’s a powerful improvement in health outcomes, people’s quality of life, when people are better-informed.”

Physicians, of course, have known this for decades; the idea of “evidence-based medicine” — that all decisions should be based on real data — was hatched in the 1980s. But the pace of traditional research is slow, and the number of outstanding questions far exceeds the body of evidence to answer them. Only now, with technologies like PatientsLikeMe, is the pace accelerating. What’s more, it’s becoming evident that data — the foundation of evidence and research — are present not just in laboratories or universities or the proverbial halls of science but in everyday life.

Really, when you start looking, information can be found everywhere. If we could gather in structured communities and create databanks to inform our approach to life decisions, not just health decisions but also gardening or parenting or car-buying decisions, we could do everything in a more informed manner. Were we all to avow a philosophy of openness and churn our experiences into hard numbers, we could presumably improve our odds in all sorts of decisions. Why not a PregnantLikeMe or
a ParentsLikeMe or even, really, an all-encompassing PeopleLikeMe?

One evening, I suggested this bigger idea to Jamie and Ben. They shared a glance and a mock-conspiratorial smile, and then looked back at me. “We know,” Ben said. “We already own all those domain names.”

Thomas Goetz is the deputy editor of Wired magazine.

Priorities and questions

Beyond the Sea
Bobby Darin

Somewhere beyond the sea,
Somewhere, waiting for me,
My lover stands on golden sands
And watches the ships that go sailing;

Somewhere beyond the sea,
He's (She's) there watching for me.
If I could fly like birds on high,
Then straight to his (her) arms I'd go sailing.

It's far beyond a star,
It's near beyond the moon,
I know beyond a doubt
My heart will lead me there soon.

We'll meet beyond the shore,
We'll kiss just as before.
Happy we'll be beyond the sea,
And never again I'll go sailing!

I think that's one of the things that Tim brought up that I need to seriously consider, again, as I move forward with whatever the hell it is that I decide to do.

"Where is your relationship life in comparison with personal and work" (badly paraphrased but close enough).  At first I said that I wasn't really interested in relationships, that I had subordinated relationships and, to a degree, my personal life to the altar of work. But as I de-emphasize the amount of time that I dedicate to work, I find a growing hole in my life... can't tell if it's a professional (there is plenty of frustration to go around), relationship-based (maybe), or even personal (triggered by one of the other 2) or if it's all 3 hitting the fan at the same time when I'm not in the best position to rebuild or more specifically, rebuild what?

I want to clear something. Where I said professional in the paragraph above. it was deliberate: I don't equate work with professional growth, particularly not in the situation I currently find myself at work.

I was at a conference in Salt Lake City, UT most of last week. The conference was awesome and really motivating; yet it is the motivating aspect that makes it depressing as hell. It's really hard for me to look at all the awesome things that people are doing when I know that by the time I present ideas to Scott, Laura and Kathy it'll be "that's awesome but we don't need that kind of work here at this time so we won't even give you the time to research it." Granted, that's what I'm hearing and not necessarily what is being said, but without a bigger picture, what other conclusion can I draw?

As I wrote in my response to the review I had I said I wouldn't do any "extra curricular" activities as it seems that they are interfering with my work for the University. Now I'm bored to tears 90% of the time and busy as hell the other 10.  And to top it off, I am having to deal with a very difficult faculty member who's letting everyone know how unhappy she is with the way things are being handled, conveniently forgetting to mention that I wasn't given any way to deal with the problem, she didn't get a reply in what she thought was a fair timeline and then she raised all 27 kinds of hell (apparently 9 were not enough)

For the first time in ages, I'm dreading CATS (the conference I'm going to next week). I am looking forward to seeing the people and but not to getting in the "damn, that sounds to nice, wish I could be doing that kind of development" funk that I got while I was at the SVU conference.

Detachment... I think that's the best way to define it. Detach the conferences from your job and your work-related interests.  Also detach your work-related interests from your actual job 🙂

You can still have your interests that are related to your job; you just can't use them at your current job but, at the same time, you don't want to let them rust because of lack of use...  I'm coming to terms with having to start from scratch as a trainer. That's the price I've had to pay for what I'm doing and for having enjoyed it for a couple years.  Now that I'm reinventing myself some of the choices I've made don't look all that smart after all.

Yet that is the issue, right?  In talking with Tim I've learned that there is no such thing as a wrong choice.... The choices you make are correct in as much as you think they are; they are the best decisions you can make with the information that you have available. And perhaps the most important part of all, they are always subject to revision and change 🙂

There are 2 areas where this has become important: Relationships and Expectations about life.

Expectations are a tricky part. What your expectations and goals are tend to shift, morph and evolve but, at least for me, the expectations of myself and what it is that I want to do and how I want to do it are hard to change.  I mean, I invested a lot into my theater life before one series of bad encounters made it clear to me that as much as I love theater and as much as I wanted to continue working there, it wasn't for me.

Instructional Technology is getting to the same level. Can't tell if it's the job itself or if it's the discipline that I'm tired with. One of the things that I'm looking at is where do others see my position going in the next 3 months, 6 months, and 1 year. If it matches what I'm looking at it being, then I may consider waiting, but I also have to keep reminding myself that I probably will not be the only person competing for the job so I have to be realistic and keep my options open. If it doesn't match then I can fully dedicate to graduate school with a clean conscience.

At least I'm getting a better idea of what questions to ask and a better idea that it might be me who's causing the problem. SK is right when he says that one way or another we will have to work together and that the options are to be miserable while doing it or to really step out of my comfort zone and look at who I am and how I relate to people. 

An interesting exercise will be to stop and write down the ways I relate to people. Stop and write it down no matter how weird it sounds or how weird it looks to people around you.  At the end of the week, reflect on what you wrote and plan accordingly. I think you can and should do this periodically and see if this changes over time or not but the first time is going to be the hardest. Perhaps having an outside person who understands the field I'm working on and/or who knows me well enough can offer an objective review of what I write and help me improve.

(4/3/2008) Does she really fucking want my job? I agree that we need to do better training but if you think you need to jump up and decide how to train DLT students then, by all means, be my guest. One less thing that I need to worry about and more time I can dedicate to what I really enjoy doing... research.

On that note, I have decided that I can't live with the uncertainty of not applying to Grad School in GA. I know I've seesawed on this one for a while but I feel that if I don't apply to UGA and/or USU now I'll always be wondering what if I had applied, what if I had been accepted and how would that have changed my life and that of the people I care about.

I have to be strong in the focus of my life. What is important and what can I live without be it people, places or situations.

What is important?

  • Right now I think I want stability so I can prepare myself for the challenges ahead. Even if it gives the impression that I gave up, I need to dedicate and concentrate my energies to do well on the GRE and the application
  • Mentally prepare myself for the GRE, take it twice before the end of November
  • Complete the applications to USU and UGA
  • Continue to cultivate friendships and relationships while I'm still here
  • To be honest with myself and whit those who have pissed me off as to why they have pissed me off and what I want to do about it

What I can live without?

  • People who think they are the center of the universe. Particularly those who are not even close to being important in my life and who let others make choices for them
  • Unneeded stress
  • Arguments for arguments' sake. I love a good debate and a healthy exchange of ideas between mature people who are open to get their egos bruised and will learn from the experience. It's when people take it personally and make their responses personal that I draw the line

What's next?

I think that the main thing is to get off my ass and do things rather than say I'll do them and sit on them.

  • Take the GRE. It doesn't matter how well or poorly you do... just do it
  • Apply to UGA and USU.  Again, it doesn't matter if you get accepted or not, just do it and get it over with rather than be stressed about it (application to UGA started)
  • Continue to try and work things out with the team here. As long as I'm here I need to do the best job I can, regardless of how much I like or hate the job. Perhaps being miserable occasionally is the price to pay for doing what you love in the long run

But going back to the relationship part. What's more important, long term or right now? myself or both of us in the relationship?

Find the river

Hey now, little speedyhead,
The read on the speedometer says
You have to go to task in the city
Where people drown and people serve
Don't be shy. Your just deserve
Is only just light years to go

Me, my thoughts are flower strewn
Ocean storm, bayberry moon
I have got to leave to find my way
Watch the road and memorize
This life that pass before my eyes
Nothing is going my way

The ocean is the river's goal,
A need to leave the water knows
We're closer now than light years to go

I have got to find the river,
Bergamot and vetiver
Run through my head and fall away
Leave the road and memorize
This life that pass before my eyes
Nothing is going my way

There's no one left to take the lead,
But I tell you and you can see
We're closer now than light years to go
Pick up here and chase the ride
The river empties to the tide
Fall into the ocean

The river to the ocean goes,
A fortune for the undertow
None of this is going my way
There is nothing left to throw
Of ginger, lemon, indigo,
Coriander stem and rows of hay
Strength and courage overrides
The privileged and weary eyes
Of river poet search naivete
Pick up here and chase the ride
The river empties to the tide
All of this is coming your way

Geek Love

Sam Potts

Published: March 9, 2008

San Francisco

GARY GYGAX died last week and the universe did not collapse. This surprises me a little bit, because he built it.

I’m not talking about the cosmological, Big Bang part. Everyone who reads blogs knows that a flying spaghetti monster made all that. But Mr. Gygax co-created the game Dungeons & Dragons, and on that foundation of role-playing and polyhedral dice he constructed the social and intellectual structure of our world.

Dungeons & Dragons was a brilliant pastiche, mashing together tabletop war games, the Conan-the-Barbarian tales of Robert E. Howard and a magic trick from the fantasy writer Jack Vance with a dash of Bulfinch’s mythology, a bit of the Bible and a heaping helping of J. R. R. Tolkien.

Mr. Gygax’s genius was to give players a way to inhabit the characters inside their games, rather than to merely command faceless hordes, as you did in, say, the board game Risk. Roll the dice and you generated a character who was quantified by personal attributes like strength or intelligence.

You also got to pick your moral alignment, like whether you were “lawful good” or “chaotic evil.” And you could buy swords and fight dragons. It was cool.

Yes, I played a little. In junior high and even later. Lawful good paladin. Had a flaming sword. It did not make me popular with the ladies, or indeed with anyone. Neither did my affinity for geometry, nor my ability to recite all of “Star Wars” from memory.

Yet on the strength of those skills and others like them, I now find myself on top of the world. Not wealthy or in charge or even particularly popular, but in instead of out. The stuff I know, the geeky stuff, is the stuff you and everyone else has to know now, too.

We live in Gary Gygax’s world. The most popular books on earth are fantasy novels about wizards and magic swords. The most popular movies are about characters from superhero comic books. The most popular TV shows look like elaborate role-playing games: intricate, hidden-clue-laden science fiction stories connected to impossibly mathematical games that live both online and in the real world. And you, the viewer, can play only if you’ve sufficiently mastered your home-entertainment command center so that it can download a snippet of audio to your iPhone, process it backward with beluga whale harmonic sequences and then podcast the results to the members of your Yahoo group.

Even in the heyday of Dungeons & Dragons, when his company was selling millions of copies and parents feared that the game was somehow related to Satan worship, Mr. Gygax’s creation seemed like a niche product. Kids played it in basements instead of socializing. (To be fair, you needed at least three people to play — two adventurers and one Dungeon Master to guide the game — so Dungeons & Dragons was social. Demented and sad, but social.) Nevertheless, the game taught the right lessons to the right people.

Geeks like algorithms. We like sets of rules that guide future behavior. But people, normal people, consistently act outside rule sets. People are messy and unpredictable, until you have something like the Dungeons & Dragons character sheet. Once you’ve broken down the elements of an invented personality into numbers generated from dice, paper and pencil, you can do the same for your real self.

For us, the character sheet and the rules for adventuring in an imaginary world became a manual for how people are put together. Life could be lived as a kind of vast, always-on role-playing campaign.

Don’t give me that look. I know I’m not a paladin, and I know I don’t live in the Matrix. But the realization that everyone else was engaged in role-playing all the time gave my universe rules and order.

We geeks might not be able to intuit the subtext of a facial expression or a casual phrase, but give us a behavioral algorithm and human interactions become a data stream. We can process what’s going on in the heads of the people around us. Through careful observation of body language and awkward silences, we can even learn to detect when we are bringing the party down with our analysis of how loop quantum gravity helps explain the time travel in that new “Terminator” TV show. I mean, so I hear.

Mr. Gygax’s game allowed geeks to venture out of our dungeons, blinking against the light, just in time to create the present age of electronic miracles.

Dungeons & Dragons begat one of the first computer games, a swords-and-sorcery dungeon crawl called Adventure. In the late 1970s, the two games provided the narrative framework for the first fantasy-based computer worlds played by multiple, remotely connected users. They were called multi-user dungeons back then, and they were mostly the province of students at the Massachusetts Institute of Technology. But they required the same careful construction of virtual identities that Mr. Gygax had introduced to gaming.

Today millions of people are slaves to Gary Gygax. They play EverQuest and World of Warcraft, and someone must still be hanging out in Second Life. (That “massively multiplayer” computer traffic, by the way, also helped drive the development of the sort of huge server clouds that power Google.)

But that’s just gaming culture, more pervasive than it was in 1974 when Dungeons & Dragons was created and certainly more profitable — today it’s estimated to be a $40 billion-a-year business — but still a little bit nerdy. Delete the dragon-slaying, though, and you’re left with something much more mainstream: Facebook, a vast, interconnected universe populated by avatars.

Facebook and other social networks ask people to create a character — one based on the user, sure, but still a distinct entity. Your character then builds relationships by connecting to other characters. Like Dungeons & Dragons, this is not a competitive game. There’s no way to win. You just play.

This diverse evolution from Mr. Gygax’s 1970s dungeon goes much further. Every Gmail login, every instant-messaging screen name, every public photo collection on Flickr, every blog-commenting alias is a newly manifested identity, a character playing the real world.

We don’t have to say goodbye to Gary Gygax, the architect of the now. Every time I make a tactical move (like when I suggest to my wife this summer that we should see “Iron Man” instead of “The Dark Knight”), I’m counting my experience points, hoping I have enough dexterity and rolling the dice. And every time, Mr. Gygax is there — quasi-mystical, glowing in blue and bearing a simple game that was an elegant weapon from a more civilized age.

That was a reference to “Star Wars.” Cool, right?

Adam Rogers is a senior editor at Wired.

Plan the flight and fly the plan

Plan The Flight, Then Fly The Plan
By Dale Brown

25 July 2001

This was a response to a reader in the Navy who told me he was a little down because he just finished this long, intense training course, but was far away from home and his family and was afraid of getting discouraged and giving up:

The answer to your question is not an easy one, because there's all sorts of variables involved, but the basic idea is simple: you need to sit and think about what it is that you want to do, what it is that will make you happy.

You need a PLAN. You need a concrete, SPECIFIC thing you want to do or want to accomplish. Then, you need a SPECIFIC, ATTAINABLE, WRITTEN-OUT, and SCHEDULED plan of action to carry it out. Third, you need to BELIEVE you can carry out your plan.

[IMAGE]The first and most essential task is the most obvious but often the most This is more than infomercial psycho-babble--in fact, it's the ONLY thing that will keep you from feeling down, no matter what your circumstances are.

Unfortunately, the most important part is usually the hardest part--deciding what it is you want to do or what you want to accomplish. That's why it needs a lot of thought.

When I was in grade school, I discovered I wanted to write. I knew I enjoyed military stories, but I didn't believe I could do it. I started writing in middle and high school, but it was non-fiction stuff for the Grand Island high school paper or the local town paper. It was OK, but it wasn't the stuff I wanted to do.

In high school I wanted to fly, but again (I think because I wore glasses and folks who didn't know what they were talking about told me) I didn't become a pilot--I went into the Air Force as a navigator. I was flying, and I was pretty good at it, but I still wasn't happy.

Three years before I got out of the USAF, I started writing "Flight of the Old Dog." I was still writing non-fiction, for the base newspapers and for computer magazines, and I was even making money as a writer. But as I got into writing fiction, I realized this is what I really wanted to do. I wasn't making a dime as a fiction writer (in fact, I didn't make any money at it until long after I got out of the Air Force), but I was enjoying it.

Other things started to be affected as I pursued fiction writing, but it didn't matter because I was happy writing fiction. I admit that I was not the Air Force's most highly motivated officer back then. I did my job, but as the Air Force and my commanders often reminded me, they can train a chimp to drop bombs--what the Air Force was looking for were leaders, innovators, guys and girls excited about serving their country and anxious to carry on the traditions and expectations of the American military.

That wasn't me. I didn't care about working on my professional military education or other "square-fillers" expected of rising officers, because it had nothing to do with writing. I didn't care about getting "face time" hanging around the squadron or the O-Club or the golf course. I flew my sorties, pulled alert, and did my additional duties, and when I was done, I went home and wrote. I soon realized that I probably wasn't going to get promoted, so I got out.

I feel I did the right thing by resigning my commission. I had no right to stay in if I wasn't going to live up to the Air Force's expectations. It was my responsibility to follow their doctrine, not to expect them to conform to mine. But I did the right thing for myself also, because now I had a chance to do what I wanted to do.

Things were not wine and song after I got out. My ex had a job, but I was virtually unemployable at my Air Force salary level. I was 8 years behind my contemporaries in education and job experience. I wasn't even good at being a house-husband, because all I wanted to do was write. My new plan was to go to flight school to get my commercial license and instructor ratings. But soon after I got out I signed my first book contract, and I've been writing full-time since.

Yes, there was a little bit of luck involved getting that contract, but as Arnold Palmer once said, "The more I work, the luckier I get." The ONE THING I had going for me when I left the Air Force, the ONLY ADVANTAGE I had that no one else had, was a finished manuscript called "The Flight of Old Dog Zero One" (later renamed by Don Fine as "Flight of the Old Dog"). I was lucky enough to realize that the one thing that truly made me happy was writing, and I pursued it, even though it meant leaving other stuff behind--like a good Air Force career. As it turned out, pursuing that one thing that really made me happy was a turning point.

I didn't know it at the time that it would be so important, but that doesn�t matter. The thing that mattered is I was doing something that MADE ME HAPPY.

So that's the objective: figure out whatever it is that MAKES YOU HAPPY, and then figure out a plan for getting it. Everyone talks about the "Mission Statement." You need your own "Mission Statement"--a succinct, understandable, specific goal.

Notice I didn't say "Whatever makes you happy that you can earn a living at." Notice I didn't say anything about money. Rarely does anyone have a goal of earning money and that's it. In fact, many times a thing is not even a goal. Things are usually sub-goals.

Once you figure out what it is you really want that will make you happy, then you have to figure out how to get it. In my case, it was relatively easy: I wanted to write fiction, so I wrote. Notice I didn't say "I wanted to be a best-selling novelist" or "I want to be a millionaire by writing fiction." All I wanted to do was write fiction. Once I started doing that, I was happy. The rest happened because publishers and readers were willing to pay for the stuff I wrote, and because I had a family to support. The goals changed a little bit, but the basic objective stayed the same: write fiction.

This begs the question: How happy could I have been if by doing this, I threw away a perfectly good Air Force career and was earning minimum wage as a security guard while doing it? How could I have been happy if I wasn't earning any money doing it? And isn't it easy to tell other folks to "do what makes you happy" now that I can earn a living writing, something which only a fraction of novelists do?

The answer is a little weird, but it's still true nonetheless: true happiness rarely has anything to do with money. Yes, some folks have earning money their goal in life. They might even have a specific number in mind--a million dollars, or ten million dollars, or they want to be independently wealthy. The problem happens when you achieve the goal. What do you do once you earn a million dollars? You had better have another goal in mind, because a guy with a million dollars and nothing else is pretty much a zero. You think you could stand to be a zero with that kind of money--but you meet a lot of zeroes, and everyone recognizes them as such. Still, if it makes you happy just to have a bank account with a million dollars in it, go for it.

The bottom line is this: if you figure out what it is that makes you happy, and you pursue it, and you achieve it--EVERYTHING ELSE DOESN'T MATTER. You have done what you were put here on Earth to do--make yourself happy.

Sound incredibly self-centered? Sound incredibly selfish? Think you were put here in this life to do things for others, to raise a happy family, to be a good upstanding responsible son, or to make society a better place than it was before you arrived? Then you will always be unhappy. IF YOU ARE NOT DOING WHAT MAKES YOU HAPPY, YOU ARE WASTING YOUR LIFE. We can all stand to be more self-ce
ntered, because then we'd all be happier and the world would be a happier place.

You went to this school because--why? Because you wanted to? Did someone talk you into it? Or was it a stepping-stone to where you really want to be? If it's just a thing you need to do to attain your ultimate goal--and education is often an important part--then simply keep your objective in mind, remind yourself that the loneliness and isolation you feel is part of what you need to feel to achieve your goal, and press on. The feeling of dread will pass. Visualize yourself attaining your goal. Remind yourself that it's necessary to do this thing or go to this school to attain your goal, and focus on the GOAL, not the stepping-stone.

But if you are feeling left out and down because you're not working towards any specific goal, but you grabbed an opportunity or got talked into it or did it because you thought someone expected it of you, it's time to re-evaluate your goals and re-do the plan. Re-discover what it is that will MAKE YOU HAPPY, make a new plan, and get busy carrying out the plan. Nothing else matters.

I don't know what your school is, but let's say your goal is to become a Navy SEAL. Nothing else matters. You sleep, eat, and think SEALs all the time. You see yourself in a RHIB doing an assault. You see yourself setting charges, killing the bad guys, rescuing fellow sailors.

But you apply for SEAL training, and you're denied. You apply again, and are still denied. If you really want it, you'll find out why, and you'll fix it. Yes you're discouraged, but you'll keep on trying because you really want it. You will learn what it takes to become a SEAL. You'll train harder, get in better shape, toughen your mind and your body, study harder. You will keep on working towards your goal because that's what you really want. You'll talk to other SEALs, talk to SEAL instructors, go in to see the commander and talk about SEALs, go to open houses, show your face. If you want it bad enough, you'll do all these things, and more.

I know this was a long-winded answer to your question, but it's what I believe, and it's helped me through tough and confusing times. People get depressed and discouraged either because they have no goal or because what they are doing is not helping them achieve their goal. But if you focus on the goal and the attainment of that goal is what you really want, then even major setbacks won't matter.

Write anytime! GBA, Dale...

Things I miss

There are things that become so integral to who you are that when you miss them it's hard to articulate.  I just had one of such moments yesterday.

Hazard Sensei called me yesterday (3/5) to let me know that Tanaka Sensei was retiring from Federation work.  It made me think about those things that I miss and those things I've said I didn't want any more.

I miss Naginata terribly.