Decision Diagnosis

“Be aware.

Aware of who you are.

Aware of your surroundings.

Aware so that you may understand how to act.”

TASK AT HAND: This week I’m thinking about awareness. What does it mean to be aware?

Take the simple picture above of an animal and their surroundings. Is there awareness of self, of season, of a hunter in the distance? Or is awareness less complicated and a function of assuming the emotion of the moment?

From my vantage point, awareness is “situational knowledge”; i.e., insight into an instance in time.

“Awareness is situational knowledge.”

 

There are 3 types of awareness needed for self-realization, understanding and the application of successful strategy.

1.     AWARE OF SELF

First and foremost, you must be aware of yourself. What are your core beliefs? What are you in pursuit of? What mores and values do you ascribe to?

This is a non-negotiable aspect of awareness. You absolutely need to know this because this will function as the compass of your life. It will guide your actions through conflict, it will instruct your decisions when pondering questions, it will be your strategic Virgil as you navigate the circles of life.

 

2.     AWARE OF ENVIRONMENT

Second, you must be aware of your surroundings. Without knowledge of the space you occupy, you risk disconnection from your environment. Your environment includes everything from physical objects, to geography, to people. Proper awareness of your surroundings will allow you to be considerate and conscientious of how you move through space. Your impact on relationships are very much a part of your environment. Lacking awareness of this fragments our bonds and hinders our ability to mature our contact with the world around us.

 

3.     AWARE OF CONCEPT

Finally, aware of concept relates to how we apply knowledge. For example, understanding a concept or piece of information and successfully applying it are two very different items. Many times, you will see examples of individuals having correct conceptual understanding but failing in application. These examples occur in personal relationships, business strategies, and political undertakings.

In my opinion, to take a concept, and then successfully apply it requires awareness. You need to be aware of yourself, your environment, and how the knowledge in questions must be applied. This is analogous to working “in context”. If you are out-of-tune or lack situational knowledge – if you lack awareness – I doubt you will be able to successfully apply a concept through application.

 

So, the call to action on today’s Sunday Surgical Scrub is seek awareness. Constantly evaluate the multi-dimensional matrix of awareness in the spheres of self, environment, and concept to best guide your actions and strategy.

 

MEDICINE & MACULA: Many thanks to Michael Brun for showcasing me in the Woodbury Bulletin. You can check out the article entitled, A cure for procrastination: Surgeon combines diverse background in decision-making framework, here.

 

GRATIS: “That’s the biggest gift I can give anybody: Wake up, be aware of who you are, what you’re doing and what you can do to prevent yourself from becoming ill.” -Maya Angelou

 

My best to you,

David Almeida

david@davidalmeidamd.com

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Think about the last thing you did that made you feel really good?

What was special about it?

Most people I ask this question answer with the resultant accomplishment or achievement related to whatever event they are thinking about. Let’s take a fictitious example; someone might say, “I enjoyed my last run. It was special because I completed 10 miles.”

There is nothing wrong with this answer and I believe it’s important to celebrate accomplishment. However, now, go back to that event or action, and describe it without using some sort of productivity or accomplishment associated with it. You cannot use an outcome as a means of ascribing value to it.

Get’s difficult right?

What am I getting at? We tend to value productivity over presence. We want to extract takeaways from actions and events like: “I had…”, “I did…”, “I got…”. Instead of the desire to immerse in moments and experiences, we are all too ready to define our life in basic terms.

To continue with our example from above, maybe the significance of that last run was it allowed connection with nature or moments of mental clarity. Only if you are present, can you catch these wonderful experiences.
 

TASK AT HAND: This week I’m thinking about presence. One of my favorite quotes is from Walt Whitman: “We convince by our presence.” The ability to be present and engaged with the turbulent twists of life – rather than a mere passenger of happenstance – is not trivial!

The title of this blog, the Sunday Surgical Scrub, is dedicated to a ceremonious time of clarity. From the blog introduction above, “Before each and every case, a surgeon scrubs and disinfects his hands. At the same time, he or she becomes solely focused on the task at hand – preparing to navigate a complex surgical path – and ready to confront any difficulties that lie ahead.” The scrub is a moment of reflection to remind the surgeon to be present in the moments that lie ahead.

Unfortunately, too many times, we lose the connection to presence. A common example I see is simple conversations. You will notice that people will speak and, as soon as they stop speaking, they focus on what they will say next rather than listening. The other person does it as well. Is the point of the conversation to conduct some sort of business (productivity) or an opportunity for engagement (presence)?

Look out for all too easy trap of productivity. Efficiency and productivity are cornerstones of success but make sure you are producing relevant outcomes. Pause and ask yourself what it is that you want out of an action or interaction. More often than not, you will find that presence in a simple conversation, a parenting action, a commitment to a cause has great worth and impact than a trivial takeaway.

 

MEDICINE & MACULA: Thank you Tina and The Morning Blend for having me as a guest this past week! I had a wonderful time on the show and continue to be humbled and excited about all the interest in Decision Diagnosis.

You can watch the interview here.

 

GRATIS: Happy Mother’s Day! Resiliency I learned from my grandmother. Kindness and unyielding support I absorbed from my mother. Every day, I am lucky to witness the virtues of patience and grace in the mother of my children

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“The cure for the calamity of inaction?

A pact to make a decision with passion and purpose!”

TASK AT HAND: This week I’m thinking about decisions and indecision. Over the last few weeks, I have been repeatedly asked, “why did you write a book about decisions?” I pontificate, and answer, there is a major difference between pondering and procrastinating…

We have become accustomed to endless information, right there at our fingertips, to supplant the need for critical thinking. Through the endless notifications, messages and distractions, the data deluge has reduced our attention span and, with it, reduced our capacity for effective decision making. We procrastinate and put off for tomorrow what we should be doing today. The resultant is an overwhelming vector of negativity on our ability to solve the problems we face. Whether we like it or not, we must all make decisions. Through fear and faction, we must decide or risk time, opportunity, and fulfillment.

So, how do you come up with a strategy that will help you make better decisions? That’s the impetus of why I wrote, Decision Diagnosis: Seven Antidotes to Decision Procrastination (both paperback and Kindle versions available here). In it, I present an efficient and expedited strategy for successful outcomes regardless of the decision in question.

What’s the main takeaway?

If you are struggling making decisions, it’s time for you to make a PACT. Here is a quick summary of PACT:

1.     PRACTICE: Practice makes permanence. Practice, with purpose and passion, transforms.

2.    ASSESSMENT: Assess the problem: Identify the character of the conflict. Ask open-ended questions, “who”, “what”, “when”, “where” and “why” to uncover the character of the decision.

3.     COLLECT: Collect information on who are the people, what are the places and things, relevant to your decision. Think like a physician and collect the pertinent positives and negatives that describe your question.

4.     TIMING: Define how much time you must make the decision in question. Immediately triage your decision – do I need to resolve this right now, or can I do it later?

By applying this PACT framework, you will dramatically improve your decision making ability and the ability to seek the answers that resonate with your goals and objectives.

 

MEDICINE & MACULA: Thank you RETINA TODAY for showcasing our novel technique on retinal embolectomy in the current issue, entitled: Retinal Embolectomy: Why, When, How? (David R.P. Almeida, Eric K. Chin & Vinit B. Mahajan).

We describe surgical embolectomy as a viable technique for patients with acute fovea-threatening arterial occlusions without a patent cilioretinal artery. Our goal, with this technique, is to push forward the potential for innovation in vitreoretinal surgery. We are thankful for the interest and discussion this has generated.

You can find the article here.

 

GRATIS: “No compromise with the main purpose, no peace till victory, no pact with unrepentant wrong.” -Winston Churchill

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Panic causes tunnel vision. Calm acceptance of danger allows us to more easily assess the situation and see the options.” -Simon Sinek

 

TASK AT HAND: This week I’m thinking about the pitfall of cognitive tunneling. Cognitive tunneling, also known as cognitive capture, is an inattentional blindness phenomenon where one becomes hyper-focused on some variable other than the present environment. When this occurs, as the old axiom states, you “can’t see the forest for the trees”; or in other words, you become obsessed in some sentence that you lose perspective of the story.

“Cognitive tunneling is an inattentional blindness phenomenon where one can’t see the forest for the trees.”

When cognitive tunneling occurs, the individual may become lost in internal thought or instrumentation and lose focus on the present action or environment. An example would be a pilot focused on an altimeter rather than the runway ahead. More commonly, we tend to become entrenched in inner negative thought rather than executing effective strategies for the conflicts we face in our lives.

Inattentional blindness is primarily caused by our unconscious minds, particularly when we are overwhelmed with information or options, fatigued, inebriated or panicked (Caroline Beaton, Millennial Cognitive Tunnel Syndrome: Why We Miss The Solutions To Our Career Crises, Forbes July 2016). Realizing that our unconscious minds aren’t always the best at determining what’s important, cognitive tunneling helps explains why we tend to react to failures in counterproductive ways. Instead of remaining focused on the conflict, we lose awareness and move farther away from resolving the issue.

As mentioned above, under stress, this cognitive capture is exacerbated into the error of tunnel vision where the range of cue utilization is reduced (Dirkin GR, Cognitive tunneling: use of visual information under stress, Percept Mot Skills 1983;56(1):191-8). Simply put, tunnel vision limits our ability to process peripheral information because we are over-committed to some central issue.

“Under stress, this cognitive capture is exacerbated into the error of tunnel vision.”

Why is this important?

The crux here is awareness! You are at your best with maximal awareness for the task at hand, but also by being cognizant of the variables that influence it. Awareness is akin to context and, minimizing cognitive tunneling, aids you in the processing of relevant information. One step further, improved contextual awareness allows you to filter out the relevant from the irrelevant which minimizes your chances of becoming trapped by unimportant details.

“Awareness is akin to context and, minimizing cognitive tunneling, aids you in the processing of relevant information.”

 

MEDICINE & MACULA: Thanks again for all the interest in my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination, and for making it an Amazon best seller in multiple categories and countries!

Both paperback and Kindle versions are now available here.

GRATIS: “Stress makes us prone to tunnel vision, less likely to take in the information we need. Anxiety makes us more risk-averse than we would be regularly and more deferential.” -Noreena Hertz

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Man is the only kind of varmint who sets his own trap, baits it, then steps in it.”

-John Steinbeck

TASK AT HAND: This week I’m thinking about the confirmation trap. Confirmation bias, also known as the confirmation trap, occurs when we procure data and information that aligns with our beliefs and ignore that which runs counter to our arguments.

“The confirmation trap occurs when we procure data and information that aligns with our beliefs and ignore that which runs counter to our arguments.”

The ability to recognize bias is essential for survival. To be cognizant that we are strongly attracted to our own beliefs and that these biases, left unchecked, increase our vulnerability for errors needs to be constantly addressed. Bias in opinion is easier to detect and correct; however, confirmation bias – when we actively seek out information to back our preconceived beliefs is dangerous!

“The ability to recognize bias is essential for survival.”

 

How do you avoid the confirmation trap?

How do you escape the fallacy of searching for information that propagates an erroneous echo chamber?

There are three strategies you can employ that are effective at liberating you from this trap.

1. Be a cynic. Act like a doubter. Question as a skeptic. Question both the quality of the data and the validity of the source. Those that know me, come to recognize that engagement by means of doubt is something I value dearly. I believe that the ability to question is essential for the overall health of the individual and the common collective. Worthwhile societal contributions are commonly created by this process of questioning and conflict.

“The ability to question is essential for the overall health of the individual and the common collective.”

2. Plan how you acquire your data or information. This strategy tends to apply more towards your professional tasks but I recommend you plan your data gathering ahead of time. In the medical and scientific literature, we describe this as a priori endpoints and outcome measures. The act of specifying analytical methodology before you start looking at the results minimizes haphazard and scattered conclusions.

3. Two sources are better than one. When in doubt, have multiple sources. Few strategies are as simple, yet as effective, as having multiple trusted sources to ascertain the validity of the information you are analyzing. As I have mentioned here on the Sunday Surgical Scrub before, never rely on just one source for any meaning analysis.

 

MEDICINE & MACULA: My new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination, is now available on both Kindle and as a paperback.

My sincere thanks for making it an Amazon best seller in multiple categories and countries!

 You can find it here.

 

GRATIS: Whenever I’m lucky enough to get the opportunity to drive my kids to school, I always remind them to ask one good new question each day. Then, I ask them to look for holes, fallacies and inconsistencies in the answer they get back. Always be on guard for the confirmation trap!

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Think outside the box, collapse the box, and take a sharp knife to it.”

–Banksy (Wall & Piece)

TASK AT HAND: This week I’m thinking about the axiom, “think outside the box”. I don’t particularly like clichés but they sometimes are exemplary to illustrate a concept. For example, what does it mean, “think outside the box”? This is one you hear constantly, irrespective of field or expertise.

When I hear, “think outside the box”, I interpret this as the pursuit of original thought, creative discourse, or innovative strategy. These are all worthwhile goals! In fact, I believe these to be crucial to personal growth. As we previously discussed here on the Sunday Surgical Scrub with Constant Change (August 2016) and Agents of Change (January 2017), one must change or pay the heavy price for staying the same.

Banksy, the infamous social artist articulates and extends this concept one step further with our introductory quote. He feels that thinking outside the box is not enough; you need to shred and destroy the box – thereby eliminating boundaries – to appreciate your full creative potential. I like this!

 

But how do we go about getting outside the boxes that constraint our deliberations and decisions? There are two strategies that are central to getting outside the box.

1. Grow your capacity for self-awareness. Pursue self-enquiry and probe the degree of self-awareness you currently occupy. Do you constantly revisit your ability to look inward? This is challenging and difficult but, your ability to get out of the box and escape its boundaries, relies on your ability to be self-aware. Only when you recognize your comforts and conveniences can you eclipse them. The knife you need to cut this box into pieces is your degree of self-awareness. Sharpen it often!

2. Invite conflict. Akin to your degree of self-awareness is your desire to invite conflict in your life. Note, I do not mean to invite melodrama or perfunctory argument. Invite genuine conflict into your ideas. Invite conflict so as to challenge your strategies. You will find the resultant solutions are wonderful elaborations rather than products of simple linear thinking. Having conflict need not create a discordant song but rather allows for a symphony with rich notes and rhythms.

So, next time you are faced with dilemma or decision, get out of the box, stomp on the box, cut up the box, and realize that you need not be confined to its boundaries. Instead, use self-enquiry and self-awareness to invite conflict as a means for the creative expression of innovative solutions and strategies.

 

MEDICINE & MACULA: Thanks to everyone for all the support and interest in my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination.

It is a now an Amazon best seller in multiple categories and countries!

My sincere thanks!

You can find the book here. 

 

GRATIS: “Instead of thinking outside the box, get rid of the box.” -Deepak Chopra

 

My best to you,

David Almeida

david@davidalmeidamd.com

 

 

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“Gambling: The sure way of getting nothing for something.”

-Wilson Mizner

 

TASK AT HAND: This week I’m thinking about the gambler’s fallacy. When you flip a coin, the outcome (assuming a fair coin) is independent of the previous result. The gambler’s fallacy is the mistaken belief that, what happens more frequently in one time period, will happen less frequently in another time period.

“The gambler’s fallacy is the mistaken belief that, what happens more frequently in one time period, will happen less frequently in another time period.”

For example, someone flips a coin and it lands on heads five times in a row. What do you expect the next result to be? It’s still a 50% chance of heads or tails because, in situations where what is being observed is truly random, the previous result has no effect on the next result. The fallacy to think that the next coin flip will reveal tails, because the last five were heads, occurs by the appeal of this fallacy to the human mind which surmises that the next result “should” be different than the previous ones.

“In situations where what is being observed is truly random, the previous result has no effect on the next result.”

Why are we talking about this on today’s Sunday Surgical Scrub? The reason is this fallacy arises in varied situations and needs to be differentiated from the principle that, the best indicator of future performance is past performance. The significant difference between this key principle and the gambler’s fallacy is that the latter applies to random events while the former is best applied to the complex personal and professional strategies we employ.

For example, let’s take the situation of a job application. Let us take someone who has been turned down for five straight positions and has a sixth interview scheduled. He or she can take the approach that, “I’m bound to get one of these jobs sooner or later since I’ve been rejected so many times”. This is the gambler’s fallacy at work. Don’t see this as a random event in the same way a roulette spin is a random event. Our choices involve a multitude of inputs that we must process and then synthesize a coherent strategy from. The preferred adaptive approach would be to ask for feedback at the five rejections and look for common themes. Why are you not getting these jobs? Are there more qualified applicants? Is there a problem with your skill set? Do you have a bad reference? If you don’t seek this crucial information out, it will be difficult to break through and change the result. Contrast this with someone who pays attention to detail and seeks out positions that best suit his or her skill set. They may only get two or three interviews but, the chance of successful conversion, will be higher.

“Our choices involve a multitude of inputs that we must process and then synthesize a coherent strategy from. They are not random events in the same way a roulette spin is a random event.”

“Casino gambling is colorful and dramatic and theatrical” (Steve Wynn). Leave gambling to the theatrics of the casino. Don’t gamble with the decisions we ponder and pontificate on. Avoid the gambler’s fallacy in random events and, when it comes to choices and crossroads, use the power of analysis to maximize your performance and achieve the objectives you seek. Don’t ever leave these to chance.

 

MEDICINE & MACULA: Many thanks for the interest and support for my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination. Since its release, it has held a top spot on Amazon in multiple categories and in multiple countries.

It is currently listed as:

#1 in Decision-Making & Problem Solving (USA)
#1 in Management & Leadership (USA)
#2 in Business & Money (USA)
#3 in Management & Leadership (UK)
#2 in Decision-Making & Problem Solving (Germany)
#1 in Self-Help & Success (Canada)
#1 in Decision-Making & Problem Solving (Canada)
#1 in Management & Leadership, Decision-Making & Problem Solving (Canada)
#1 in Decision-Making & Problem Solving (Australia)

My sincere thanks for the support!

The paperback will be released in the next few days and you find it here.

 

GRATIS: “In a bet, there is always a fool and a thief.” -Unknown
 

My best to you,

David Almeida

david@davidalmeidamd.com

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“Passion is about living days immersed in the strength of a barely controllable emotion.”

 

TASK AT HAND: First, I want to say thanks to everyone for their interest and support in my new book, Decision Diagnosis: Seven Antidotes to Decision Procrastination. As I mentioned last week, I am going to do one more excerpt from the book here on today’s Sunday Surgical Scrub.

As part of my initial launch, I have reduced the price to 99 cents for one more week. If you feel inclined, kindly take a moment to leave a review. You can find it on Amazon here. If you are having any trouble with the link, you can copy and paste this address into your web browser: https://www.amazon.com/dp/B01NCRPPVL

 

Here is a portion from Chapter 6: Alleviating Factors, on the concept of passion in decision-making, personal relationships, and how to regularly reacquaint yourself with passion in your life. If there is one part of the book that feeds all others, yet stands alone, it is the one that follows.

 

Passion
To practice with passion, we need to define the concept of passion. We need to identify why passion is so important to successful strategic development. Passion is about living days immersed in the strength of a barely controllable emotion. Passion, as a source of energy, can be oppressed by the many tasks and distractions that endlessly intrude into our lives. However, I have found that reacquainting yourself with your passion is a revitalizing elixir of energy, focus, and determination that you can’t neglect.

“Passion, as a source of energy, can be oppressed by the many tasks and distractions that endlessly intrude into our lives.”

Consequently, I have found three strategies to ensure that passion is a tenet not lost and neglected. Using these three strategies, you can routinely and commonly implement your passion into your decision-making.

Passion and decision-making. When you are formulating decisions and employing strategies in your business or professional life, don’t neglect to acquaint yourself with your drives and desires. Some aspects are best decided dispassionately, but core fundamentals require a degree of enthusiasm, self-expression, and identity to fulfill the full potential of the decision in question. Many times, when you have options without major distinctions, choosing the one best aligned with your passion will provide you opportunities you did not foresee.

“A personal relationship without some element of passion is a mere acquaintance.”

Passion in your personal relationships. A personal relationship without some element of passion is a mere acquaintance. Strive to consistently surround yourself with people who stroke the fires of vitality: those who challenge you, those who ask you to grow, and those who allow you to change. Finding passion in your personal relationships will allow you to achieve better decisions, implement better strategies, and be more content in the relationships you have and care for.

Passion in your daily life. Finally, regardless of your professional and personal endeavors, do something you are passionate about each day. There is no need for it to be for more than a few minutes, but stay connected to that drive daily. Don’t lose this connection because it is a defining part of who you are.

The aim is that when you look back on your life, you can recall a life lived with passion—days filled with this barely controllable emotion that allows you to create and touch the lives of others in fantastical and wonderful ways.

 

GRATIS: “Let us live so that when we come to die even the undertaker will be sorry.” -Mark Twain

 

My best to you,

David Almeida

david@davidalmeidamd.com

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“What makes a strategy successful?

If it works, it’s successful!”

 

TASK AT HAND: This week, as you have probably noticed, I’m going off script here on the Sunday Surgical Scrub. Earlier this week, I published my first book entitled, Decision Diagnosis: Seven Antidotes to Decision Procrastination.

 

As part of the initial launch, I have reduced the price to 99 cents for a limited time. In return for this reduced price, I ask that, if you choose to download the book, you kindly take a moment to leave a review. My book will only be at this reduced price for the next two weeks and you can find it on Amazon here.
If you are having any trouble with the link above, you can copy and paste this link into your web browser: https://www.amazon.com/dp/B01NCRPPVL

 

With sincere thanks for your interest and support, I leave you here with the Introduction:

Are you struggling with decision-making? Are you having difficulty with the efficient application of strategies, whether in life or work? Is your life negatively affected by feelings of mediocrity, a sense of being stuck or glued to a lack of progress, or a lack of ability to move to the next phase in life?

If you are overwhelmed with decisions or struggling to find the best way to succeed and move forward, there is a solution.

“You can’t make successful decisions if you don’t know what those decisions are asking of you.”

You can’t make successful decisions if you don’t know what those decisions are asking of you. But when you uncover all the parts you need to consider, you can make fruitful and focused decisions. In this book, via the brokering of economics theories, the scientific method, and a surgical approach to medical problems, you will find innovative methods to diagnosing decisions and tools for improving your clarity in personal and professional decision-making.

My years as a physician and surgeon have given me insight into the diagnosis of complex diseases. I have learned that they can appear in many ways. Sometimes, a patient’s disease presents itself in a textbook way, making the diagnosis and treatment straightforward. However, most of the time, diseases present in convoluted manners, leaving doctors confused, with the possibility of complications with catastrophic implications.

Similarly, one day, life may flow predictably and idly, and the other, it may thrust you into violent storms that require sharp strategy, thoughtful decision-making, and excellent execution. So why not equip yourself to react and apply the correct techniques and maneuvers to prevent this pathology from taking a permanent hold?

Physicians and surgeons routinely go through seven attributes of a medical problem to tease out the pertinent positives and negatives from a patient, so as to arrive at the right diagnosis and manage the patient with the correct treatment. Here I have hybridized this medical technique normally used for complex diagnoses with my work in research and business leadership to create seven antidotes to decision procrastination—a framework, entitled Decision Diagnosis, which we can apply to decision-making.

I believe that when you apply this framework, it will provide useful insights. Most importantly of all, it will help you achieve a greater understanding, clarity, and focus in your strategy and decision-making. Whether it is for personal or professional decisions, I believe this construct will help you succeed and improve your strategic and executive function.

The seven antidotes are all about uncovering the relevant factors of your decisions so that you can be successful in your decision-making process. There are seven characteristics that you need to evaluate and judge to enhance your ability to be efficient and successful in decision-making: character, setting, timing, quality, quantity, aggravating factors, and alleviating factors.

Over the next chapters, I will show you how to apply this framework effectively, and I will break down complex decisions to give you the best possible understanding as you navigate through the difficult storms of life.

 

GRATIS: I’ll post one more portion of the book here next week as part of the initial launch.

 

My best to you,

David Almeida

david@davidalmeidamd.com

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