sss-sunk-cost-2

“Don’t dwell on what went wrong. Instead, focus on what to do next. Spend your energies on moving forward toward finding the answer.” -Denis Waitley

 

TASK AT HAND: This week I’m thinking about sunk costs. Also known as retrospective costs or the fallacy of commitment to sunk costs. Do you own an old pair of shoes you don’t wear any more but, because you spent a pretty penny on them, you refuse to throw them away? This is the sunk cost fallacy at work. It is an erroneous approach to strategy focusing on trying to recover your past investment by holding onto something because you cannot accept it is no longer working (Psychology Today, 24 September 2014). By definition, it is a cost that has already been incurred and cannot be recovered. In other words, it’s time to throw away those shoes!

When trapped by the sunk cost fallacy, you become concerned with what you “paid” for something in the past, rather than what you will get out of it in the future. The fundamental problem with commitment to sunken costs owes to it being a backward looking decision. Consequently, it does not offer you any prospects or opportunities for the future. Interestingly, humans are the only animals who honor sunk costs. Other animals will look for new opportunities as soon as previous ones have been exhausted (Psychological Bulletin 125(5):591–600).

The fallacy of honoring sunken costs resides in our old nemesis of insecurity. The insecurity that changing or giving up on a sunk cost will show others we made a mistake. This relates directly to the phenomenon of loss aversion: we all fear loss and we all want to avoid it. However, you need to see beyond this. That submerged boat, let it sink. Feel stagnation in your current job but afraid start over? It is time to consider your options. Is there a void in your relationship but deny it because of the “time you have already invested in it”? Abandon old rationalizations and bring yourself to realization.

The mindset to best eliminate loss aversion and bypass the sunk cost fallacy is to consider only future benefits and costs when pondering a decision. Assess what you need to invest moving forward. Minimize the desire to include resources, capital or emotion that has been previously spent. The latter is baggage which can weigh you down. By letting go of past costs incurred, you can frame your strategy de novo with improved clarity.

MEDICINE & MACULA: I was in Chicago this week for the American Academy of Ophthalmology (AAO) annual meeting!

aaoembolectomy1-copy

On Friday I presented a talk on our technique for retinal embolectomy at the AAO Retina Subspecialty Day. Retinal embolectomy involves the removal of emobli from the retinal vasculature in selective cases of arterial occlusions.

embolectomy2-copy

Thanks to everyone for their interest in our technique!

GRATIS: For those who know me, a common place to find me is on a squash court. This past week was the Beyond Walls Squash Week in Saint Paul MN. My home club, The Commodore, was the host club.

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In addition to playing in the A singles draw, davidalmeidamd.com was a proud sponsor of this fantastic event benefiting Beyond Walls.

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For more information, check out the MN Squash Week page.

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-forgive-enemy

“Always forgive your enemies; nothing annoys them so much.”― Oscar Wilde

 

TASK AT HAND: This week I’m thinking about forgiveness. Whether we accept it or not, it’s easy to forgive our family for errors. It’s convenient to forgive our loved ones for most omissions. We want to let transgressions from friends disappear. But, how about your opponents or those you distrust? What happens when these transgress against you? The simplest strategy for this complex intonation is forgiveness.

1. Forgiveness annoys those who attack you. As the introductory quote above explains, forgiveness – to the closed arms of an opponent – is extremely annoying. Your sporting opponent, corporate rival, or feuding adversary attack you to elicit a reaction. The hope is your reaction is irrational, hastily conceived, and poorly executed. This is the benefits of an attack and why we don’t just engage in predetermined deliberations. By responding with forgiveness, you disarm most of the possibilities your opponent is trying to elicit from you.

2. Forgiveness is strength. Forgiveness is not about being a doormat. Forgiveness is not about being a pushover. “Forgive your enemies, but never forget their names” (John F. Kennedy). Forgiveness is about strength!

By forgiving, you show restraint and the ability to strategize counterpoints. Forgiveness, in this context, is counterintuitive because of our overriding desire to tap into primal reflexes in moments of duress. But, “the weak can never forgive. Forgiveness is the attribute of the strong” (Mahatma Gandhi). Your opponents will be dumbfounded by your act of forgiveness and your enemies will be confused by this show of strength. Then, consider what the attack was based on and begin to develop a plan that addresses the reasons for the existing adversarial relationship and how it can be mutually overcome.

3. Forgiveness is a sustainable overarching strategy. No one can survive with grudges against all who have ever crossed them. No one can grow while holding anger and resentment in their hand. Strategy, without the ability to forgive, eventually falls to some stronger opponent. However, one who shows forgiveness can broker relationships based on trust. The latter is a fundamental part of a long-term successful strategy.

MEDICINE & MACULA: Check out our new photo essay in the October 2016 issue of Ophthalmology entitled, Pigmented Paravenous Retinochoroidal Atrophy (Lucas T. Lenci MD, D. Wilkin Parke III MD & David R.P. Almeida MD MBA PhD)

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This is a great example of prominent atrophy of the retina and choroid surrounding the retinal venous circulation. You never know what’s going to walk into clinic…

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Check out the publication here.

GRATIS: There is another benefit to acts of forgiveness. “If you haven’t forgiven yourself something, how can you forgive others? (Dolores Huerta) If you can forgive others, it means you can forgive yourself. That you can accept events beyond your control. That you can let go of the errors we are all bound to make.

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-forget

“Even if a minefield or the abyss should lie before me,

I will march straight ahead without looking back.” Zhu Rongji

 

TASK AT HAND: This week I’m thinking about hindsight and the ability to forget. You know the old adage, “hindsight is 20/20”? This is not the whole story. Yes, you can look back and sometimes find explicable nature to events. However, looking back can leave you in an abyss of insecurity. The discrepancies of past actions can hinder our future movement by leaving us stranded on an island of insecurity. This plagues our ability to decisively carry out optimal strategy.

Why is looking back harmful? I heard Andrew Lincoln, the actor who plays Rick Grimes in the television show, The Walking Dead, say: “I would find myself getting deeply distressed if I lived in hindsight all the time”. I like this. Past events, while they allow you to learn and thus are of value, they can also paralyze you from future action if you do not let them go. They create bias in your vantage point that can then preclude you from realizing the potential of events not yet happened.

The ability to forget. The skill of not remembering allows us to move forward with confidence. “It is not possible to go forward while looking back” (Ludwig Mies van der Rohe). You cannot look back and move forward at the same time. Incessant retrospection is as deleterious as never looking back. At some point, you have to forget past triumphs, errors, wins and losses, and strike forward. Leave the past as rough notes on a story that you continue to develop.

I am a surgeon, and I believe the difference between good surgeon and great surgeon is a great surgeon has no memory. He or she forgets both the complications and successes of previous cases, and continues to work for the best possible outcomes. Whenever I operate, whether it be a straightforward procedure or a high-risk complicated case, I draw on collective experience and knowledge – but at the same time – I remain free of any worry of that which has happened before. For, if you look too far back, you might stumble into tomorrow without living the time that exists today. Besides, looking back for too long is bound to hurt your neck.

MEDICINE & MACULA: Check out our new feature in the September 2016 issue of Retina Specialist entitled, MIVS and Post-op Endophthalmitis: A look at evolving trends and techniques.

retina-specialist

Thanks for the continued interest in our microincisional vitrectomy surgery (MIVS) technique for infectious endophthalmitis. Early vitrectomy for endophthalmitis provides significant benefit in removing infectious material and look out for a study we are putting together on this topic.

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Check out the publication here.

GRATIS: If you enjoy the Sunday Surgical Scrub, sign up with your email and receive a new Scrub every Sunday in your inbox! Also, I’ll keep you posted of updates and new material planned for 2017!

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-long-game

“I don’t think anyone is thinking long-term now.” -Thomas Mann

 

TASK AT HAND: This week I’m thinking about long-term plans. Strategy based on delayed gratification and personal investment. Plans that require patience, pragmatism, and perseverance. Playing the long game. Taking the long road.

We are endlessly inundated with short sells, quick fixes, and the lure of easy money. These are but myths, blasted on billboards, and endlessly running on our screens. Beware of those selling overnight success; sometimes they work, but most times they do not. Behind the overnight success, you can usually find years of work and dedication.

With everyone working the fast hustle, don’t be afraid to contradict and make long-term plans. Instead, hone strategy that takes time and consequence to develop. Having a long-term plan dramatically increases your chances of success solely because most are playing some version of the  fast hustle.

Obsession with overnight success. The want for short-term success is rooted in the desire to avoid pain. It is much easier to create a flash in the pan than stoke a fire. Inherent within us is a low baseline threshold for pain. This is a biological design so that we don’t get hurt. But don’t let this biology disrupt your ability to navigate complexities that require time.

We all know those who start out on a plan, only to abandon it as soon as they feel pain. Discomfort forces a switch to another project. I have found that one must train and accept that negative short-term pain is acceptable. It is merely a method to make us slow down and take notice. Then, upon realizing this, we can evaluate and look to overcome. It is a necessary (painful!) reminder of importance.

Planning for the long road. Personally, “we don’t mature momentarily, but over the long-term” (John C. Maxwell). Having long-term plans gives you significant advantages due to increased maturity and improved comprehension of the emotional intelligence inherent in relationships. In professional life, remember that “good decisions can have bad short-term outcomes but be great for the business long-term” (Gerry Schwartz). Excessive focus on short-term gains – and the inability to sustain short-term pain – can hinder your ability to prepare for long-term survival as business landscapes evolve.

How do you survive the long-term plan? Patience, perseverance, pragmatism. And when failure occurs, “keep your face always toward the sunshine – and shadows will fall behind you” (Walt Whitman). Night will come, and with it, darkness and doubt. Keep walking, and surely if you play the long game, you will see the sun come up again, and the shadows will once again fall behind you.

MEDICINE & MACULA: Check out our new publication in the September 2016 issue of the Canadian Journal of Ophthalmology entitled, Low power and type II errors in recent ophthalmology research (Zainab Khan MD, Jordan Milko MD, Munir Iqbal MD, Moness Masri MD & David RP Almeida MD MBA PhD).

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We show that a large proportion of randomized clinic trials contain statistical errors. The results of the studies have dramatic effects on day-to-day clinical practice and need to be designed and evaluated carefully. Check out the publication here.

GRATIS: “I believe it’s less risky long-term to embrace change.” Charlie Ergen

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-fear-failure

“Fail early, fail often, but always fail forward.”

John C. Maxwell (Failing Forward)

 

TASK AT HAND: This week I’m thinking about failure. A word associated with massive negative connotation. Imbedded within insecurity, fear of failure enforces the concept that we need to avoid failure if want to be successful. That failure is for the weak and lazy. That if you are intelligent and industrious, failure can be avoided. This is wrong and ignorant. Failure – and how we cope with it’s force – is of crucial importance to our character development.

Why is failure important? Failure is part of the iterative process of learning. Like trial-and-error, it is a basic process that we master in order to develop higher forms of reasoning and decision making. Thomas A. Edison writes, “I have not failed. I’ve just found 10,000 ways that won’t work.” Failure allows us to improve processes and techniques and is essential to the learning of individuals, growth of organizations, and coherence of cultures. “Ever tried. Ever failed. No matter. Try Again. Fail again. Fail better”; these words by Samuel Beckett see failure as this fundamental process of learning.

Why is fear of failure debilitating? The shame of failure comes from the pervasive negative assumption that failure is an ultimate end. In truth, failure is just another step in the process. I’m a vitreoretinal surgeon and I regularly operate on blinding diseases. I am humbled by the eye and the gravity of complications that may, without notice, occur during surgery. I orchestrate every movement to avoid complications, but I do not fear them. If so, I would be paralyzed with fear and overwhelmed by the weight of possibility. This would dramatically hinder my performance and limit my ability to help patients. Show me a surgeon with no complications, and I’ll show you a surgeon who never operates. Failures are not final but part of evolving solutions and strategies.

How can you erase your fear of failure? If you fail at something, the first step is to give yourself the opportunity to learn from it. There is a twisted irony in the failure to learn from your failures. Don’t do this. Take ownership of your failure. “A man can fail many times, but he isn’t a failure until he begins to blame somebody else” (John Burroughs). Realize your error. Take ownership of the failure. Accept responsibility for the consequences. This provides you with immense learning. See this as a temporary event and in no way a synopsis of your life.

MEDICINE & MACULA: Check out our new feature in the September 2016 issue of Retina Today entitled, Postoperative Infectious Endophthalmitis: Evolving Trends and Techniques.

retina-today-sept-2016

Infectious endophthalmitis is a vision-threatening condition that involves inflammation of the entire eye. Early vitrectomy for endophthalmitis provides significant benefit in removing infectious material. We describe how vitreoretinal practices have changed with the adoption of small-gauge surgery.

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Check out the publication and video here.

GRATIS: If you’re not failing often, you’re not trying hard enough.

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-good-relationships-study

“Nothing is perfect. Life is messy. Relationships are complex. Outcomes are uncertain. People are irrational.” -Hugh Mackay

 

TASK AT HAND: This week I’m thinking about relationships after reading Harvard’s 75-year study of human happiness. Called the Study of Adult Development at the Harvard Medical School, but better known as the Grant Study, this recently published investigation is the longest-running study of human happiness. You can find the study here.

The Grant Study began in 1938 as a counterpoint to the disease model of medicine and sought to ascertain the conditions that enhance wellbeing or happiness. It followed the lives of 268 healthy sophomores from the Harvard classes between 1939 and 1944. There is no other study like it in length of follow-up.

The conclusion after 75 years of study: good relationships make us happier and healthier! There is of course significant bias in a study with a homogenous population based entirely on privileged white men. While the latter serves to emphasize the need to critically interpret any piece of information, it reminds me that relationships – how we collide and interact with others – has the potential for massive impact on our happiness and health.

Relationships are complex, but there are certain strategies that give you the best chance of cultivating a matter of significance with other people and groups.

1. Enter relationships without expectations. Entering a relationship with expectation is akin to degrading human encounter to transaction. As I’ve written before on anticipation (see here) – rather than expecting – look to give. “Relationships based on obligation lack dignity” (Wayne Dyer), so enter them openly, without bias, and contribute rather than collect.

2. Everybody hurts. REM was right. If you enter a relationship with honesty, there is always the chance of getting hurt in the process. Bob Marley’s words: “truth is everybody is going to hurt you: you just gotta find the ones worth suffering for” strikes at this chord. Committing with honesty is an exemplary way to build relationships. “Be honest, brutally honest. That is what’s going to maintain relationships” (Lauryn Hill).

3. Work at it! Relationships require work. In the economics of human emotions, a zero-sum game is of no value. A balanced budget has no use. There is an ebb-and-flow that occurs with communication – and you have to work at this. Failure to communicate leads to failed relationships. When communication and conversation stall, remember: “you can discover more about a person in an hour of play than in a year of conversation” (Plato). Every young child knows the meaning of these ancient words. I have learned this principle best from my children.

Enter relationships without expectation. Don’t be afraid of getting hurt. Cultivate, communicate and work towards building strong relationships. With this, I hope you find some elements of happiness.

 

 

MEDICINE & MACULA: I’m in Copenhagen, Denmark this week for the EURETINA annual meeting – one of my favorite meetings! I love conversing and contrasting new therapies and techniques with my European and International colleagues.

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Yesterday I presented two talks and enjoyed the discussion immensely. I presented, Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis in one of the morning sessions and Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis in the afternoon session. Thanks EURETINA!

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GRATIS: I have discovered the concept of hygge in modern Copenhagen. It is of serious gravity here! The best English word seems to be “cozy” or “coziness”. It’s about feeling comfortable like one is at home or in a “homely state”. Thank you Copenhagen!

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My best to you,

David Almeida

david@davidalmeidamd.com

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SSS face punch

“Everyone has a plan ’till they get punched in the mouth.” Mike Tyson

 

TASK AT HAND: This week I’m thinking about strategy setbacks. We all have to soothe the bumps, bruises, blisters and burns associated with negotiating the often rocky landscape of our evolving strategies on the way to successful solutions.

But what happens when you hit a wall with your strategy? Or as Mike Tyson aptly summarizes – what happens when you and your plan get punched in the mouth? As much as your strategy may be well-being, it’s at this point that we must clarify core principles to break through.

What do you do when your best laid plans, your carefully tailored approach, your curated strategy stall? I have found 3 approaches to help navigate these difficult times.

1. Realize and accept that you will eventually get punched in the mouth. It will happen sooner than you think. It will happen multiple times. “Any time you think you have the game conquered, the game will turn around and punch you right in the nose” (Mike Schmidt). Denial of this truism will cause you to hold faulty strategies and you will fail to see the emerging landscape. Don’t bother with the padding…

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2. When you get hit, be receptive and flexible. This is counter-intuitive because the first reaction is to get defensive. The ability to be receptive allows you to discover what details you missed. Then, flexibility allows you to adapt your strategy to the new conditions. Being flexible does not mean quitting on your plan. “Take things as they are. Punch when you have to punch. Kick when you have to kick” (Bruce Lee). Be open and receptive but remain committed. This is counter-intuitive but is of immense advantage.

3. The ability to take a punch is good, but the ability to avoid one is best. Your ability to navigate assaults is a defining property of your defensive strategic framework. “In the battle of existence, talent is the punch; tact is the clever footwork” (Wilson Mizner). Your strategy is your footwork – it will provide you with the needed defence for when you under duress, and it will allow you to counter when an opening occurs.

In chemistry, a transition state is a temporary high-energy configuration existing between two stable forms. The transition state corresponds to the highest potential energy along a reaction path. It is often violent and tumultuous but the potential energy allows for the formation of new stable forms. Think of these periods of your life – times of setbacks and shock – as transition states and look for ways to harness the potential energy to form an improved baseline.

 

MEDICINE & MACULA: Check out our most recent publication, Retinal Injury Secondary to Laser Pointers in Paediatric Patients. Our study describes children who had laser-related retinal injury to the macula due to the mishandling of the laser pointer devices.

Peds citation

Peds laser figure

Thank you Pediatrics for publishing our study! Check out the study here.

 

GRATIS: There is no shame in taking a punch, and there is much character growth in our ability to transition into an improved form during the difficult transition states. However, there may be times where you find yourself constantly under assault. If this occurs, you may have to punch back. Unfortunately, this is the only currency some understand.

“You punch me, I punch back. I do not believe it’s good for one’s self-respect to be a punching bag.” Ed Koch

 

My best to you,

David Almeida

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smartestintheroom?

“If you’re the smartest one in the room, you’re in the wrong room.” -Richard Tirendi

 

TASK AT HAND: This week I’m thinking about the company we keep and the people that influence us. There is a sentiment that we should strive to be the smartest person in the room. That this is a worthy goal to aspire to. That, somehow, if we are the “smartest” or “best” in the room, we will be able to exert influence or hold power over those around us. And thus, we will be successful. This is a dangerous myth! As the opening quote states, if you are the smartest person in the room, turn around, exit the room, and run – as fast as possible – in the opposite direction!

I’m often asked if this advice should be applied to professional relationships, or personal ones as well. In my opinion, you should apply this advice in its most general form: find people that will challenge and encourage you to grow. Find groups that will contribute to your proficiency and petitions. Avoid the fallacy of superiority – which is seeded in insecurity – by denying the need to be the smartest in the group. Instead, look to develop yourself by surrounding yourself with thoughtful and creative characters.

smartest in room

When it comes to coworkers, Donny Deutsch surmised it best: “my philosophy is to always find the smartest people you can. Hire people smarter than you.” The idea here is simple – but of utmost importance – you must surround yourself with colleagues and coworkers of the highest caliber possible. Whether you are in a small business or a large organization, collaborations should always have you reaching up! The simplest path to this growth is by surrounding yourself with those that have varied vantage points and see problems differently than you.

Why is this so important? The answer: “the people that you have around you are your biggest influence” (RJ Mitte). Since you are a running average of the people you most interact with, you need to be cognizant of who these people and groups are. If “leadership is influence” (John C. Maxwell), seek to be influenced by the best, and you will find yourself in good company.

MEDICINE & MACULA: Check out one of our recent publications, Acanthamoeba endophthalmitis after recurrent keratitis and nodular scleritis. Acanthamoeba species are ubiquitous free-living protozoa and are usually responsible for corneal disease. We present the first case with confirmed involvement of Acanthamoeba in all ocular layers, including choroidal involvement.

acanthamoeba panuveitis

Thank you Retinal Cases & Brief Reports for publishing our case! Check out the study here.

GRATIS: “Follow those who are seeking the truth, but run away from those who have found it.” Goethe

My best to you,

David Almeida

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triage decision sss

“Don’t fight the problem, decide it.” -George C. Marshall

 

TASK AT HAND: This week I’m thinking about triage. In medicine, triage is the process of assigning degrees of urgency. In any hospital Emergency Department, you will find a Triage desk that functions to grade the severity of your ailment. Triage decides if your problem is an emergency (must be assessed and resuscitated right away), emergent (needs assessment very soon), urgent (important but can usually wait some amount of time), or nonurgent (can wait). An emergency has the potential to kill or seriously harm your patient and needs to be addressed right now. An emergent condition has the potential to inflict significant morbidity and cannot be delayed any significant amount of time. An urgent state needs to be assessed but usually lacks immediate temporal gravity.

Over the years, I have found that you can apply this same triage process to decision making. One can formulate strategy by triaging decisions and prioritizing subsequent actions. Whether you are taking inventory of personal sentiments, deciding on a strategy for an ambitious project, or developing a new idea, the ability to triage allows you to set priorities, execute strategy, and engage in effective delegation. The goal of decision triage is to emerge from the deluge of questions with a set of priorities aligned with your strategy. Clarity for success by means of deciding how to tackle multiple problems.

now

I triage decisions using these same emergency principles: an emergency requires an answer or decision right now – no exceptions! I reply to all emergent decisions within 12-24 hours. For urgent decisions, I reassess later. Nonurgent matters tend to be delegated elsewhere. Try this next time you are asked to solve a problem or your input is required. If the issue has immediate consequences, deal with it straightaway. Don’t procrastinate and don’t delay. Is it emergent? If so, you have some time. Relatively urgent? Maybe you can delegate this task or move it down your prioritized to-do list.

In triaging decisions, will almost always find conflict and disagreement because, what to one is an emergency, to another is only urgent. What do you do when this occurs? Make sure you communicate clearly so that trust is built in your assessment skills. Lead by example and never trivialize the conflicts of others. When in doubt, have the best interests of others in mind. Selfish behavior is based out of insecurity. Act selfless and create value for others in your triage. This is a key principle of successful decision making.

“Nothing is more difficult, and therefore more precious, than to be able to decide.” –Napoleon Bonaparte

As the quote above emphasizes, the ability to decide deserves your judicial attentiveness. Decision making and strategy are topics we revisit frequently here on the Sunday Surgical Scrub and you can think of decision triage at the top of the algorithm. Once you decide on the priority of the decision, you can use the many tools presented here to resolve the crux of your conflict and put forward the best decision.

 

Caregiver burden fig

MEDICINE & MACULA: Check out our new systematic review pertaining to depression and burden among caregivers of patients with visual impairment. While caregiving allows those with vision problems to better adapt, it has been shown to take a toll on the caregiver on various levels, such as invoking depression and burden. Recognition of this is key for awareness, prevention and management.

burden study paper

Thank you International Ophthalmology for publishing our study! Check out the study here.

GRATIS: One last note on the decision triage system above. By frequently using this method of triage for decision making, I have found a wonderful unexpected side effect: I gain perspective by realizing that few things are a true emergency that require destabilization to correct. This calming vantage point will allow you to appreciate that many decisions – whether we like or not – are just not that important. Find those that are, prioritize them, and then successfully attend to them.

My best to you,

David Almeida

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constant change

“There is nothing permanent except change.” -Heraclitus

 

TASK AT HAND: This week, after reading the recent Fortune 500 review, I’m thinking about change. The Fortune 500 survey found that 97% of CEOs say their companies will change more in the next five years than in the past 5 years (Fortune.com, 15 June 2016). Fortune 500 CEOs, which lead benchmark business successes representing revenues equal to two-thirds of US gross domestic product, in majority “strongly agree” with this statement of emphasis on change.

The ability to change, at an organizational level, means adapting to growing market demands and is essential for survival. As a biological species, our ability to evolve granted us survival via constant differentiation. What happens now? At a personal level, the ability to change is paramount to fulfillment. I agree that, “To improve is to change; to be perfect is to change often” (Winston Churchill). This quote implores our need to constantly seek improvement. To seek constant change.

 

agentofchange

How do we seek change? First, realize “different” is not “change”. Different may be an avenue for change and may offer one the potential to change, but in of itself, does not permeate change. A clear example is traveling. One may travel to exotic places, see novel vistas and villagers, yet return to a baseline state soon thereafter. Actual change requires a loss of original identity. Simply recognizing that we are not permanent – that all our hang-ups and hiccups – are not perpetual opens us to the possibility of letting go of these old happenstances that prevent positive personal change.

 

“Only the wisest and stupidest of men never change.” Confucius

I have yet to meet the wisest man or woman, and myself feel a fool compared to the sages and stoics I am lucky enough to collide with. Approach change constantly. Let go of preset conditions. Change. Grow. Fulfill.

PS If you liked this Task At Hand, check out my post from last week on Anticipation vs Expectation; disregard expectations and find the purity of the challenge. You can find it here.

 

 

asrs 2016

MEDICINE & MACULA: This week I’m attending the American Society of Retina Specialists (ASRS) Annual Meeting in San Francisco, California. I wanted to thank everyone who reached out in interest of the work we presented. Also, a kind thanks to all my collaborators!

 

Here is a brief summary of the work we presented:

Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis. David RP Almeida, Eric K Chin, Benjamin Bakall & Vinit B. Mahajan

 

Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis. David RP Almeida, Eric K Chin & Vinit B Mahajan

 

Ocular hypertension after intravitreal dexamethasone (Ozurdex) sustained-release implant. Eric K Chin, David RP Almeida, Gabriel Velez, Kunyong Xu, Maria Peraire, Maria Corbella, Yasser M Elshatory, Young H Kwon, Karen M Gehrs, H. Culver Boldt, Elliott H Sohn, Stephen R Russell, James C Folk & Vinit Mahajan

 

Bimanual pars plana vitrectomy for removal of a dislocated descemet stripping automated endothelial keratoplasty graft from the vitreous cavity. Kunyong Xu, Eric K Chin, Emmett Carpel & David RP Almeida

 

Intravitreal foscarnet with concurrent silicone oil tamponade for rhegmatogenous retinal detachment secondary to viral retinitis. Kunyong Xu, Eric K Chin, Vinit Mahajan, & David RP Almeida

 

GRATIS:

Yes, there are two paths you can go by, but in the long run


There’s still time to change the road you’re on


And it makes me wonder.

“Stairway to Heaven” by Led Zeppelin

 

My best to you,

David Almeida

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