Strategy

“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

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“Fight the need to judge. Become a celebrator rather than a critic.”

 

TASK AT HAND: This week I’m thinking about critics. As we all know, everyone is a critic! Everyone has opinions and biases that they feel the need to impart on others. The need to judge has two facets. On the one hand, you need to judge effectively to survive the physicality of life. You need to judge which food to eat and avoid the rotten fruit. You need to judge whether to drive given the forecast for a snowstorm. You need to judge the offers, opportunities, and obligations present in your life.

However, on the other hand, there is a point when the need to judge degrades our relationships and experiences. Constantly criticizing the possible or perceived negative aspects of our station causes us to lose the ability to fully partake in it. In this stressful state, we become defensive and detached. It is difficult to acknowledge that by criticizing, we are retracting from meaningful communication. By judging, we are choosing to turn away from the rapport and recognition that may help us grow and develop.

“By judging, we are choosing to turn away from the rapport and recognition that may help us grow and develop.”

So, what do you do? How do you become a celebrator rather than a critic? There are two strategies to embrace your inner celebrator. First, accept that “Time is the fairest and toughest judge” (Edgar Quinet). You don’t need to judge anyone. You don’t need to criticize every interaction. Time will hand down its judgment on all. You can free yourself from this need to judge by seeing yourself as an insignificant microcosm on time’s rather lengthy record. This liberating action helps you detach from negative encounters without becoming consumed by them.

“You don’t need to judge anyone. You don’t need to criticize every interaction. Time will hand down its judgment on all.”

Second, celebrate with gratitude! Whether it be relationships or duties, find some aspect to be grateful for. Then celebrate it! Although simple, this is not intuitive, because of our overwhelming need to find negative attributes to correct. Next time you want to judge someone or something, try this. Find some aspect that you are grateful for and celebrate it. Before you know it, instead of criticizing you will be celebrating even losses and hardship.

“Rather than criticizing, find some aspect that you are grateful for and celebrate it!”

 

MEDICINE & MACULA: Check out our latest publication, Deer Tick Masquerading as Pigmented Conjunctival Lesion (Robin K Kuriakose, Lorna W Grant, Eric K Chin & David RP Almeida) published in the American Journal of Ophthalmology Case Reports.

In it, we report a unique case of tick penetration of a black-legged deer tick (Ixodes scapularis) into the conjunctiva. Despite the low risk for Lyme disease, doxycycline was prescribed for prophylaxis. In any case of suspected tick penetration to the ocular surface, immediate ophthalmologic consultation and prompt removal as well as attention paid to the Infectious Diseases Society of America guidelines regarding prophylaxis.

You can find the study here.

 

GRATIS: “Let you look sometimes for the goodness in me, and judge me not.” -Arthur Miller

 

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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sss-unexpected-opportunities

“Opportunity dances with those already on the dance floor.” -H. Jackson Brown, Jr.

 

TASK AT HAND: This week I’m thinking about opportunities and how to catch unexpected prospects. I believe that unexpected opportunities are events that need to be created. Expecting the unexpected, when it comes to opportunity and progress, rarely works. One is best guided by a proactive nature to facilitate and cultivate these opportunities. “If opportunity doesn’t knock, build a door” (Milton Berle). As this fitting quote so nicely summarizes, opportunities require active participation. You need to build a bridge to get to the opportunity you seek.

“Expecting the unexpected rarely works.

Opportunities require active participation.”

But how do you create opportunities or uncover unexpected ones? There are three strategies you can consistently use to increase your yield on opportunities. First, change something. “Change brings opportunity” (Nido Qubein). Change a habit, change a routine, change a relationship, change the way you go about completing some task. Change is a powerful conduit for opportunities and can greatly help your ability to improve processes and pain points. At the very least, committing to changing a routine or practice allows for reflection on subtleties and nuances you may not have been previously aware of.

“Change is a powerful conduit for opportunities.”

Second, don’t be afraid to fail. “Failure is simply the opportunity to begin again, this time more intelligently” (Henry Ford). On a previous Sunday Surgical Scrub, I averred the need to fail and the benefits inherent is this necessary stage of growth (you can find the post here). Failure is the most common missed opportunity I see. Whether it is a failed drug trial or a contract not landed, these “failure” events usually possess unexpected opportunities but, as stated above, they require active consideration and proactive pursuit to materialize any merit or substance.

“Failures usually possess unexpected opportunities but require active consideration and proactive pursuit.”

Third, prepare for all possible outcomes. Pilots routinely use situational analysis to algorithmically assess all possible outcomes in flight scenarios. This allows pilots to be prepared for all situations. We can extrapolate this situational awareness to our personal and professional lives. Be prepared for the ideal outcome, the worst-case scenario, and all possible eventualities and the unexpected becomes opportunity.

“Be prepared for the ideal outcome, the worst-case scenario, and all possible eventualities and the unexpected becomes opportunity.”

MEDICINE & MACULA: One of our surgical techniques for endophthalmitis was published earlier this week. The study entitled, Five-Port Combined Limbal and Pars Plana Vitrectomy for Infectious Endophthalmitis, was published in Case Reports in Ophthalmology (2016;7:289–291) and centers on how acute infectious endophthalmitis can be challenging due to severe inflammation. In it, we describe a surgical technique combining limbal based vitrectomy and pars plana vitrectomy to manage acute infectious endophthalmitis. You can find the study here.

case-rep-opthalmol-2016-5-port-endophthalmitis

 

GRATIS: “There is no security on this earth; there is only opportunity.” -Douglas MacArthur

 

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-bias-opinion

“Every piece of data is biased. Every argument has opinion.”

 

TASK AT HAND: This week I’m thinking about the effects of bias and opinion. Analysis after the US election show that “fake news” – stories that are false but presented in a truthful manner (e.g., newspaper article format) so as meant to deceive – outperformed legitimate news stories on social media. We now occupy the post-truth economy of thought. In this state, opinion and argument are given the same credence as fact and truth.

Recently, the Oxford Dictionary announced that “post-truth” is its 2016 word of the year. It defined it as ‘relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.’ Simply put, If you believe something strongly enough, talk loudly enough about it, and can connect with someone emotionally with your argument, then it impacts others like truth or fact.

As a scientist, I am vehemently against this idea that opinion can be substantiated for fact. Truth requires evidence and logic. Truth should be void of bias and opinion.

“Truth requires evidence and logic. Truth should be void of bias and opinion.”

I have heard many times, “what’s the problem with voicing your opinion?” There is nothing wrong with expressing your opinion – I encourage this! However, please don’t confuse the expression of worthy words versus baseless chatter. Your argument should still be based on truth and constructed in a logical manner.

The problem of repeating nonsense over and over is related to how our brains form memories. Studies show that the more often a message is repeated, the more likely we are to remember it. This effect is called fluent retrieval. However, our brains then erroneously extrapolate that, what we can remember easily, must be true (Inferring facts from fiction: reading correct and incorrect information affects memory for related information. Memory 2012 Jul;20(5):487-98; you can find the full study here). The effect is that if you repeat a lie often enough, it starts to feel like truth.

But how to uncover bias and opinion? First, assume every piece of data is biased and every argument, whether it be in a newspaper article, social media post or formal communication, has opinion. You are a detective and must identify the bias and opinion in everything you consume.

“You must identify the bias and opinion in everything you consume.”

You can minimize bias and opinion by sticking to trusted reporting. However, this is not enough. In science and medicine, we have peer-reviewed literature which is considered the benchmark for bias-free communication. Peer-reviewed studies have experts and thought leaders review the work in question to ensure it is scientifically sound before being published. Having personally published over 100 papers, I can tell you that even this process can have bias. Reviewers have personal and professional biases and humans operate poorly in recognizing their own biases.

Second, when developing an argument, use multiple sources. Never stick to one reference and never rely solely on one authority. Attempt to survey as many respectable sources as possible when trying to come to a conclusion. This synthesis of thought is the crux of thinking for yourself because it forces you to take multiple vantage points and create a unique one for yourself. This is hard work and the main hurdle to overcoming herd mentality.

Finally, refute and reject frequently.Blind belief in authority is the greatest enemy of truth” (Albert Einstein). This is not a call for anarchy but a reprisal for individual thought. Authority, or that which is accepted as truth, needs to be questioned. Force yourself to formulate independent thoughts as often as possible. This is not your brain’s default mode so you have to work at it. The goal is to have a society of independent thinkers that question truisms and myths alike. A culture that challenges arguments without fact and calls out opinions lacking logic.

How to uncover bias and opinion:

1.    Assume every piece of data is biased and every argument has opinion.

2.    Never stick to only one reference. Use multiple sources.

3.    Refute and reject regularly.

 

“The goal is to have a society of independent thinkers that question truisms and myths alike. A culture that challenges arguments without fact and calls out opinions lacking logic.”

 

MEDICINE & MACULA: One of our recently featured publications on the ongoing debate of auto-antibodies.

osli-auto-ab

Check out the paper, Positive Auto-Antibody Activity With Retina and Optic Nerve in Smokers and Non-Smokers: The Controversy Continues, published in Ophthalmic Surgery, Lasers and Imaging Retina (OSLI Retina). You can find the study here.

osli-retina

 

GRATIS: “If you tell the truth, you don’t have to remember anything.” ―Mark Twain

 

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-no-time-no-rush

“It’s when you realize that you are out of time that you must focus on not rushing.”

 

TASK AT HAND: This week I’m thinking about the last minute, the eleventh hour, time as it expires. We are constantly rushed and hurried in our professional commitments and personal relationships. In these pressured moments, we tend to rush when, in fact, we should be deliberate and purposeful with our strategy. As time slips away, we can succumb to bad decisions but there are strategies you can use to avoid errors in these situations.

“As time expires, each second is worth more.”

First, realize that, as time expires, each second is worth more. I like to think of the eleventh hour in terms of relativity. Although one second is one second, in the closing moments of an assignment or instances where a quick decision is required, I like to think of those seconds as “more valuable” than previous ones. When you only have minutes to act, each second is crucial. When you have days to decide, deliberation can be consummate with a longer time window, and seconds seem to matter less.

Previously, on the Decision Triage post of the Sunday Surgical Scrub (you can find it here), I emphasized that, in the last minute, every decision must be made right away and that all triages become urgent in this context. For example, in surgery, I imagine expanding each second to feel like minutes so that I can carefully execute the maneuvers that will bring the outcomes that are required. If there is an unforeseen complication or adverse event – where there is a very small amount of time to correct the error – it is here, I cannot rush! Realizing each second here is worth more than at any other time during the surgery, I can focus solely on these intense junctures. This approach allows speed and efficiency, without ever being rushed or forced into shortcuts.

“Quiet your mind, then plan and execute!”

The feeling of “running out of time” is an external force. It comes from outside you and is then transferred onto your inner self. This creates needless self-inflicted pressure. Quiet your mind, then plan and execute! When you are left with what seems as no time and limited options, still your mind and see beyond the time frame. Find the character of the decision  and align yourself with the basic principles of what you want to achieve.

 

MEDICINE & MACULA: I was in Toronto this weekend for the 56th Annual Walter Wright Symposium, Retina 2016: A Practical Approach to Navigating the Future.

walter-wright-2016

On Saturday, I presented a talk on my approach and techniques for infectious endophthalmitis. The evolving paradigm calls for early surgery and aggressive treatment to salvage vision from this devastating infectious condition.

044_rs0916_North_RK.indd

 

GRATIS: “Why do they call it rush hour when nothing moves?” -Robin Williams

 

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-disclosure

“Men often hate each other because they fear each other; they fear each other because they don’t know each other; they don’t know each other because they can not communicate; they can not communicate because they are separated.” -Martin Luther King, Jr.

 

TASK AT HAND: This week I’m thinking about truth and lies. All humans lie. There are numerous research reports and published studies that show that we all lie. Whether a pastor or prisoner, black or white, we all lie. From rationalized half-truths to orchestrated cons, lies hurt our unique ability to communicate. They, as the MLK quote states above, separate us and break down real discourse with each other. This has serious consequences that negatively impair our personal and professional relationships.

However – in knowing we all lie – what is the best strategy to free us from lies and liars? Disclosure is a forgotten tool that helps us navigate the byways of truth and lies. Disclosure, loosely defined as the action of making new information known, is a powerful weapon against the tendency to blur reality and fiction.

“Disclosure is a powerful weapon against the tendency to blur reality and fiction.”

As a surgeon and scientist, I disclose all possible positive and negative outcomes of a treatment or surgery to my patients. Before I say anything else, I disclose to the patient. I disclose all the good and all the bad. My hope is that the patient then reciprocates and starts an honest conversation with me about their questions, fears and anxieties. From here, we can cement a trustful rapport that will allow us to share in decision making and achieve what is in the best interests of the patient.

One can build on this concept of disclosure. Whether you are discussing with a friend or negotiating with a competitor, start by disclosing up front. Leslie K John’s book, How To Negotiate With A Liar, shows that humans have a strong reaction to reciprocate and return disclosure with truth. This disclosure is a surprise tactic when you encounter a liar. When you are facing a deceptive strategist, start with disclosure and they will find it difficult to avoid the honest road.

“When you are facing a deceptive strategist,

start with disclosure and

they will find it difficult to avoid the honest road.”

MEDICINE & MACULA: Check out one of our recent publications, Chronic Recurrent Pseudophakic Endophthalmitis, published in JAMA Ophthalmology (JAMA Ophthalmol. 2016;134(4):455-456. doi:10.1001/jamaophthalmol.2015.3638).

This study details a case of an immunosuppressed patient with active chorioretinitis and chronic endophthalmitis after cataract surgery.

jama-endophth-2016

Thanks to everyone for their interest in our growing body of endophthalmitis literature. This is a significant interest of mine and we have more studies planned.

Check out the publication here.

GRATIS: “No man has a good enough memory to be a successful liar.” -Abraham Lincoln

My best to you,

David Almeida

david@davidalmeidamd.com

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sss-survival-bias

“Hi, I’m Bill. I’m a birth survivor.” -Bill Maher

 

TASK AT HAND: This week I’m thinking about survival bias, also known as survivorship bias. Survival bias is a logic error that produces false conclusions by looking at a person who achieved an outcome and overlooking those that did not, despite both having similar characteristics. Simply put, the “survivor” is used as a model to extrapolate from, only because they survived the event, despite the fact that many similar individuals exist for comparison that did not survive the event.

Let me use a couple of examples to illustrate the point. Usain Bolt, the Jamaican sprinter, is heralded as the fastest human ever timed. He is the first man to hold both the 100 and 200 meter records. He is an amazing sprinter, a charismatic character, and a fantastic entertainer. Many have tried to ascertain how he is able to run so fast. Bolt usually states common athletic creeds such as “belief in yourself” and “training hard”. Survival bias enters here because Usain Bolt is the fastest human in the history of mankind not because he trains hard and believes in himself, but despite this.

How many athletes believe in themselves and train hard? How many fall short? Too many to count. Many times athletes are asked how they achieve greatness and they usually provide the same predictable answers. The reason is, because they don’t know. They trained hard like everyone else but they, for some reason, were able to produce superlative results. Now, in no way do I diminish these feats. I celebrate them! But, you have to be careful in their extrapolation to your life.

Another example. Many want to be the next Steve Jobs and create a behemoth success like Apple. Steve Jobs dropped out of college and started a business. Do you think this was the reason? How many others have dropped out of school and started business that failed? Too many too count. Steve Jobs was the “survivor” of this event and succeeded not because he dropped out of school, but in spite of this.

There are numerous examples of survival bias in a myriad of disciplines so one needs to be aware of this erroneous process of reasoning. Survivorship bias leads to overly optimistic and simplified beliefs because only successful survivors are used while the many similar failures are ignored. Most of the time, the failures have very similar attributes and no significant relationship is evident.

This important because one needs to understand that successful groups – most of the time – do not have any special property. This does not diminish or lessen their achievement. But, when you are trying to reproduce some of these behaviors, consider both successful and failed examples. The role of timing, coincidence, and serendipity will become apparent.

How does this help you? Personally, it serves to balance my emotional reaction to events. I know I’m never as good as my best day. But, I’m also not as terrible as my worse day – and I don’t beat myself up over it. I survive each day, despite how factors beyond my control play out, and I remain focused on what I have defined as important.

MEDICINE & MACULA: A couple of weeks ago I described our technique for retinal embolectomy. This technique was recently published in Retinal Cases & Brief Reports. Retinal embolectomy involves the removal of emobli from the retinal vasculature in selective cases of arterial occlusions.

embolectomy1-copy

embolectomy2-copy

Check out the publication here.

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GRATIS: “Science is the search for truth, that is the effort to understand the world: it involves the rejection of bias, of dogma, of revelation, but not the rejection of morality.” -Linus Pauling

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.

044_rs0916_North_RK.indd

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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