May 2018

“The total entropy of any isolated system will increase over time, approaching a maximum value.” -The Second Law of Thermodynamics 

TASK AT HAND: This week I’m thinking about entropy. Entropy is the universal tendency towards disorder and disorganization. Newton’s Second Law of Thermodynamics surmises that the total entropy of an isolated system – the total degree of chaos – can never decrease over time.

Why are we talking about the laws of thermodynamics here early on a Sunday morning?

Now, there are extensive aspects of Newton’s second law that discuss usable energy and how, as energy is used, entropy increases. But, let’s put all that aside and simply think about this: over time, chaos will only increase. As time elapses, disintegration will grow. Over time, you will not be made whole, but rather, randomness will win out.

The second law of thermodynamics is not simply a physical principle, it’s a physical law that governs the world we inhabit. Consequently, we can use this principle and apply it to the randomness we encounter. Realizing that no matter what we do, there is an overwhelming tendency for chaos to increase, should liberate us from the anxiety of compulsion and control.

Consider entropy as a surrogate of randomness. No matter how good your strategy is, no matter how aligned objectives and techniques are – randomness and chaos will still increase. It is our responsibility to be cognizant of this eventuality and have the adaptive mindset to control our responses. In other words, when you become a victim of randomness, smile at the fact that this is simply a physical law of the world we live in. When circumstances consume you, don’t despair, it’s part of the physical world we live in.

“The law that entropy increases—the Second Law of Thermodynamics—holds, I think, the supreme position among the laws of Nature.” 

Sir Arthur Stanley Eddington, Gifford Lectures (1927) & The Nature of the Physical World (1928)

The call to action from today’s Sunday Surgical Scrub is to be aware of the Second Law of Thermodynamics and the fact that chaos will never decrease; over time, randomness will continue to increase. Be aware that the increasing chaos around us needs to be met with our ability to let go of control and appreciate these immutable forces. Don’t let the growing disorder and disorganization result in disappointment! Forego the reaction – the energy lost in trying to control this inevitable outcome – and let this incontrovertible thermodynamic law allow you to appreciate the radiance of randomness.

MEDICINE & MACULA: After 3 years at VitreoRetinal Surgery in Minnesota, the Almeida’s are moving to Charlotte, North Carolina!

These transitions are always complex because, as hard as it is to leave a place you like, the overwhelming excitement at the opportunities and challenges that lie ahead have the ability to conjure fantastic growth. I am grateful for my time in Minnesota and the privilege to have taken care of so many patients! Moreover, I am thankful to all the wonderful colleagues and friends we have made during our time in the Land of 10 000 Lakes.

In North Carolina, I will be joining Metrolina Eye Associates in Charlotte and I am elated at being part of a dynamic group and the prospect of caring for the patients of North Carolina and beyond.

Finally, I am thrilled at the upcoming adventure that I get to partake in with my wife, children and family! As always, I thank you for your kind support!


GRATIS: Happy Mother’s Day! To my beautiful wife Jasmine, to my caring mother Maria Fernanda, and to all those whom superlatives fall short in describing the courage of our mothers and role models.


My best to you,
David Almeida

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