“We should always be asking ourselves: Is this something that is, or is not, in my control?”– Epictetus (Enchiridion)


TASK AT HAND: This week I’m thinking about the illusion of control. This powerful mirage commonly creates a façade we believe to be actually present. While the desire for control may be real, in actuality, control is an illusion that can impair our judgement and create anguish and anxiety that does not exist.

How can we give up on the illusion of control?

The first step is to realize – you are not in control! You are not in control of the weather. You are not in control of what others think of you. You are not control of any external events. So, as the Stoics accepted long ago, you too must accept this as a means to fulfillment. All you can control is your reaction. Be honest, caring and genuine in the acts you put forth into the world but, beyond that, realize you do not have control.

The second step, which follows logically from the point above is, if you are not in control, then to worry is pointless. That flight delay, the toddler screaming from the next table, the insult from a disgruntled coworker – all inconsequential. By choosing to not worry about it, and to rather embrace that all you can control is your reaction to events, will liberate you from most of life’s torments.

The final step, in the process of letting go of this desire for control, is to come to terms that this process is not an apathetic one. Quite contrary – events may cut deep and personally injury you. This is ok. However, they need not consume you with resentment, fear and regret. The call to action is to be compassionate and honest in what you curate and create; however, beyond this, there is no need for control.


MEDICINE & MACULA: Thanks to everyone who regularly emails and contacts this forum with opinions, suggestions and criticisms. In response to recent comments, I will continue with regular postings of interesting patients similar to the images last week of Vogt-Koyanagi-Harada (VKH) disease.

Here is a color fundus photograph of a severely immunocompromised patient with viral retinitis. This shows the condition known as Progressive Outer Retinal Necrosis (PORN) secondary to herpetic virus infection.


GRATIS: “I can control my destiny, but not my fate. Destiny means there are opportunities to turn right or left, but fate is a one-way street. I believe we all have the choice as to whether we fulfil our destiny, but our fate is sealed.” -Paulo Coelho


My best to you,

David Almeida

2 Comments, RSS

  1. ana sanka October 30, 2017 @ 9:25 am

    My consciousness tells me, the more I read the more I learn and this article is, surely, one of my favorite. It is so true, nobody is in control of anything. Everything is so subjective …

    My big thanks to Dr. David Almeida.
    Regards. Ana

    • David Almeida November 3, 2017 @ 6:55 am

      Thanks Ana, and fully agree with you! Better to focus on how we act than all the other factors outside of our control. Best wishes! David

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