December 2017

“Always do what you are afraid to do.” -Ralph Waldo Emerson

TASK AT HAND: This week I’m thinking about success; specifically, the fear of success. Success, this nebulous and enigmatic concept, fascinates me in that it is desired and revered but, at the same time, can create fear and depression.

In a previous Sunday Surgical Scrub, I defined the achievement of success in one of two ways: either you spend your days doing what your love or you craft a life where you subsidize – with money, creativity or effort – time for that which you love (you can find the blog post here). In my opinion, there are no other acceptable definitions of success.

But where do the elements of fear come from when we discuss success?

Is fear just an apparition of objectives that have not yet been achieved? Or does fear and success represent a more complex interplay?

There are two aspects of the fear of success that we will discuss here. First, as the Emerson quote above states, there is a natural fear of the unknown. Success, usually in terms of achievement, represents a journey we have not yet completed. Consequently, a fear of unknown outcomes is a common reaction and akin to the fear of an adventurer seeking discovery. One should use this fear as a motivator for that which we desire, pursue and value.

The second aspect of fear in the context of success is more troubling and is applicable to instances where some success has already been achieved. Whether it be in business, sports, arts or simple hobbies, past success can confound further progress. The fear of success here is dependent on emotional factors where previous success leads to expected future success. The fear of not being able to “back it up” can leave us feeling like an imposter. This fear can cause us to shy away from opportunities which limits our ability for success. This can create stagnation and hinder our willingness to take on fresh challenges.

Stagnation breeds depression which creates paralysis.

How do you overcome the fear of success?

The answer, and I’ve touched on this with the Sunday Surgical Scrub before, requires a commitment to acquainting yourself with the energy and passion to move beyond this fear (check out this Sunday Surgical Scrub blog post here). Remember, worst case scenario is you don’t back it up and fail. So, what? There is no apocalyptic outcome here. There is no fatal end. You will still move on but maybe at a slower pace or in a more prolonged route. Take your task or objective seriously but realize that this fear is miniscule and let it not hold you back from that which you define as success.


MEDICINE & MACULA: Last week I played in the Beyond Walls Squash Week held at the Commodore Club in St Paul MN.

Beyond Walls is an incredible organization aimed at promoting academic excellence, healthy lifestyles and access to meaningful opportunities for all youth. It is a year-round scholar/athlete approach to youth development and out-of-school time for 6th to 12th grade students. It uses a one-to-one academic mentoring with physical fitness via the racquet sport of squash aimed at community engagement and college-readiness. You can find more information here.

I won the amateur A singles squash draw with a bevy of tough matches! I won this tournament in 2016 and was very excited to repeat in 2017. I’ll keep working hard and try for the three-peat in 2018…

In addition to amateur singles, there was a professional singles tournament, a pro-am doubles and an amateur doubles draw.

With sincere gratitude, I thank everyone involved for their energy in growing the sport of squash in the Twin Cities!!


GRATIS: “Courage is resistance to fear, mastery of fear, not absence of fear.” -Mark Twain


My best to you,

David Almeida

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“More matter with less art.”

Queen Gertrude, speaking to Polonius, in Hamlet (Act 2, scene 2)


TASK AT HAND: This week I’m thinking about Shakespeare’s Hamlet. Specifically, in Act 2, there is long speech by the verbose politician Polonius. Queen Gertrude, Hamlet’s mother, quips: “More matter with less art.” She is calling for Polonius to tone down the fancy speech and get to the point.

In both modern times and past cultures, the ability to get to the point is valued but unfortunately underutilized. Thomas Jefferson wrote, “The most valuable of all talents is that of never using two words when one will do.” Language allows humans a medium of communication unmatched by any other species; however, it also has the potential to create misunderstanding and confusion. Clarity is many times lost in excess.

What is the best strategy to pursue this principle of “more matter with less art”?

How do you remain direct without over-simplification?

Albert Einstein perhaps best describes the optimal approach to answer this question: “Everything should be made as simple as possible, but not simpler”. Be deliberate in your content and message. Be as specific as possible in your brand. But don’t dumb it down. Be surgical in your commitment to cut out that which lacks value, purpose or breadth.

Let us conclude today’s Sunday Surgical Scrub with a call to action of more substance, less rhetoric! Nothing more.


MEDICINE & MACULA: Here are some images of me using Alcon’s NGENUITY 3D visualization system for removal of epiretinal membrane (ERM, also known as a macular pucker).

An ERM occurs when there is cellular proliferation over the macula. In many instances, this membrane remains mild and does not have any significant effect on the macula or the person’s vision. However, in other cases, membranes become prominent leading to vision loss and metamorphopsia. For visually significant membranes, vitrectomy with membranectomy is needed to remove the proliferative tissue and restore the normal macular anatomy.

The Beaver Dam Eye Study (Ophthalmology 2015;122:787) showed a prevalence for ERM of 34.1% so this is a very common surgery I perform. Above is a high-magnification image of the ERM being removed with microsurgical forceps.


GRATIS: “Less is more.” -Ludwig Mies van der Rohe


My best to you,

David Almeida

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