General Topics

“Begin the work. Forget the phantom of failure. Just start!”

 

TASK AT HAND: This week I’m thinking about the power of starting something. For those that visit here often, you know of my contempt for procrastination. My distaste for the paralysis of inaction. The inability to overcome inertia limits positive movement and meaningful strategy.

How do you keep this from holding you or your firm back?

Start!

Begin the work. Forget the phantom of failure. Simply start. Don’t worry about how hard you will have to strive. Don’t catalogue the reasons why it won’t work. Don’t fret over details and dire straits. Don’t ingratiate with impotence and ineptitude. Be it a moment or movement, start something. Whether a decision or an affirmation, by simply starting, you have overcome dread, delay and procrastination.

“By simply starting, you have overcome dread, delay and procrastination.”

When success finds you, the wave is easy to ride. When strategic moves are clicking, the puzzle fills in an orderly fashion and it seems all too easy. But, when you hit walls, when the pieces don’t fit, when your plans fail to crystallize; this when the ability to start something must be called upon.

Pandora, the online music streaming site, was rejected by over 300 venture capitalists and spent over two years of its early life broke, without cash. Nonetheless, Pandora utilized the resources available to create a basic platform. It started a tangible access point towards the goal of its creators. Online music streaming, like other competitive spaces, ensures multitudes of roadblocks and challenges and it will require the continual call of this skill.

Let’s take a job seeker as another example. How many rejections will you take? How many “No” and “I’ll pass” will you accept before you give up? How many times will you fail before you will do not risk failure again?

There is no number to contemplate, just start! Not in the fashion of Sisyphus, where the task was stereotyped and repeated in an endless loop. Instead, start anew, be willing, be flexible to learn from previous examples. This willingness to start anew, to pivot, to find a path of positive movement serves individuals and companies alike with the vector of acceleration where many seem content to circle at some average speed. The only requirement is that you start.

 

MEDICINE & MACULA: Fantastic to be part of the faculty at the Vit-Buckle Society V meeting in Las Vegas this past weekend (6-8 April 2017). Grateful for the discussion, learning new techniques that can best help our patients, and catching up with friends and colleagues!

I presented a talk on proliferative vitreoretinopathy (PVR), including pearls and techniques, for this challenging group of patients. Patients who are current or former smokers are significantly more likely to have PVR formation after retinal detachment repair.

 

GRATIS: Go ahead, start something!

 

My best to you,

David Almeida

david@davidalmeidamd.com

Read more

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).

cjo-power-study

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

Read more

 

mnfl final

Task at hand: This week I’m once again thinking about decision making; specifically, decision analysis and how to achieve success in your decision making process. As you know, I like to borrow from the spheres of medicine, science and business when constructing my models and frameworks. When diagnosing a patient, physicians will investigate “associated factors” –  what are the related symptoms, history, or other issues that may be contributing to the suspected underlying diagnosis? Similarly, when looking at the decision or conflict at hand, spend some time deciphering the associated factors. These are always pertinent to the outcome you are trying to achieve.

 

Let me use a simplified example for you here. With spring in full swing, let’s say you are trying to decide on a particular plant for your garden. Our simplified desired successful outcome of this decision is to pick a plant that will not only grow – but thrive – through the seasons. Consequently, we can quickly deduce that the “associated factors” will include environment (weather, rain, soil quality), resource availability (how much time do you have to tend to the plant, what is your budget for seed), and appearance (do you want a pretty flower or a unique plant).

 

The best method I have found to uncover the associated factors of a particular decision is through visualization. The concept of “visualization” is common ranging from sports to cognitive-behavioral therapy. Here, I am ascribing visualization as an act to appreciate all the forces acting on your decision. I’m always surprised at how much I uncover through this process and realize that our decisions are heavily indebted to a lot of extraneous influences: it is usually not possible to remove these factors so one would be wise to figure them out!

 

I actually use a lot of visualization in surgery as well – many times, the surgeon’s view is compromised secondary to many possible factors. In these challenging instances, my visualization of the problem at hand and the role of my immediate environment allow me to continue without being deviated in a negative manner. So, next time you are pondering a difficult conflict – visualize the relevant associated factors – and give yourself some clarity on your way to success!

 

Medicine & Macula: The first US universal newborn ocular screening initiative was recently published in the journal Ophthalmology. It showed that fundus hemorrhages are common in healthy newborns, especially in those born by vaginal delivery (9 times more likely) and in forceps assisted delivery. While the long-term consequences of retinal hemorrhages on visual development remain unknown, it is important to have empirical knowledge that these are common. The issue of child abuse and shaken baby syndrome are a natural extension of this topic, and key points of differentiation (vitreous hemorrhage, retinal hemorrhages in multiple layers, traumatic retinoschisis) in the latter need to be emphasized.

Check out the study here

 

Gratis: Thanks to American Journal of Ophthalmology Case Reports for recently publishing our study on Delayed fungal endophthalmitis secondary to Curvularia.

Curvularia

Check out the paper here

 

 

Happy Memorial Day!

My best to you,

David Almeida

Read more

Task at hand: This week I’m thinking about actions and experiences after being reminded of the Oscar Wilde words: “Experience is the name everyone gives to their mistakes”. In living one’s life, there is perhaps no better barometer of engagement than the merriment of the experiences one amasses over time. Fear of mistakes or failure are never an adequate reason to shy away from an experience that may allow us to learn and grow. In fact – seek out experiences that are outside of your comfort zone regularly – and you will be rewarded multiple fold. I have come to appreciate that, fear of mistakes is nonsensical, and instead, I urge myself to ask questions and then to test them in the many spheres of life. An empirical life allows the days to become a series of experiments and life a collection of experiences. Continue reading Sunday Surgical Scrub: May 8, 2016

Read more

“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. Here, on the Sunday Surgical Scrub, I bring you what I’m pondering for the week ahead.”

David Almeida MD MBA PhD

Task at hand: This week I’m thinking about how we, as humans, interact with our environment. A large study of over 2000 participants found that the average human has an attention span of 8 seconds; contrastingly, this was 12 seconds in 2000 before the smartphone revolution. For comparison, goldfish are believed to have an attention span of 9 seconds. Many will argue that our ability to multitask has improved so these 4 seconds lost may not be as significant. Continue reading Sunday Surgical Scrub: May 1, 2016

Read more