The View From The Top

Gaia.jpg

In Greek mythology Gaia was the Goddess of the Earth and the mother of all creation.

Imagine someone born on top of a mountain (let’s call these types “Bureaucrats”), unable to get down (possibly because they need to keep paying for the mortgage they can’t really afford or the car they shouldn’t have leased).

Their view from the top will be warped.  They can only look into the distance and contemplate abstract thoughts.

The ironic thing is that even if they wanted to, they wouldn’t be able to closely examine the very thing they’re stood (or sat) on top of.

The only way to closely examine reality is to hike the mountain itself.  You may fall and get bruised, but your bruises and pain will guide your learning.

You cannot attain real knowledge without contact to the ground

The Greeks called it pathemata mathemata.  Or, “things suffered, things learned”.  Something mothers of young children know all too well.

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Specifically Not Obvious

How do you figure out what advice to listen to?

Most of the advice that you come across from books, courses, teachers, articles etc is very general.

You know the type of advice intuitively as you’ve already heard the answers a million times.

For example, I recently came across an article where the interviewer was asking a successful entrepreneur; “what advice he would give to his twenty year old self”.  The answers he gave were general and obvious; “Work hard, stay close to family, be frugal….”.

The advice was so generalised as to not carry any meaning whatsoever.  It was literally the same as speaking without actually saying anything at all.  It seems that when advice is too generalised it’s too hard to extract any meaning and take any action from it.  This is probably the reason why the vast majority of “self-help” books and books on entrepreneurship are so bad.

The polar opposite of this type of advice is when you sit down with someone really close to you, who really knows you inside out and understands your situation exactly.

I remember when I was thinking about going to medical school.  The first people I went to get advice from was my father and brother.  The advice I got from close family members was certainly 10x better than the general and obvious advice I received from teachers or random doctors that I met.

The problem with family members and ultra close friends is that they give you specific and obvious advice.  Most of the time they say exactly what you thought they would say or give advice which may not be completely the truth, because they might be worried about hurting your feelings.

I think the holy grail of advice though is specific and not obvious.

Sometimes when you get lucky, you can get advice from someone who understands your position well, but is still removed enough to remain objective.  When you speak with someone like this it can lead you to re-examine things through a new lens which you hadn’t worn before.  It can help you re-assess your position and decide what the best way forward will be.

And isn’t this the reason we seek out advice in the first place?

What It’s Like To Start A Business

I received a letter from a fellow healthcare worker the other day.

She wrote to me regarding a patient of mine, demanding that I “do something”.  Her letter was, to be quite honest, rude and uncalled for.  She knew very well that I had already seen the patient, assessed the patient correctly and that the patient had the ability to make decisions regarding her own medical care.

This isn’t an uncommon occurrence.  I spend a significant part of my working day telling patients and other healthcare professionals that nothing needs to be done.  And that often doing nothing is more beneficial than doing something for the sake of doing it.

But why are patients and people in general like this?  Why, for example, does a patient with lower back pain for a grand total of two days turn up at my clinic demanding an urgent MRI scan, which would bring no benefit to the patient whatsoever?  Why do they get angry and upset when I explain that physiotherapy and lifestyle changes are the way forward?

I think there’s a simple answer:

The patient is worried that they are going to die*.

And who can blame them for having this outlook?  Most people from a young age have been conditioned to think that death is lurking right around the corner.

The thinking even in primary school was something along the lines of: “If you don’t do well in school, then you’ll end up without a job, then you’ll end up homeless and then you’ll die a sad and lonely death.”.

Of course for the people who made it through school and are not dead – which happens to be the majority of mankind – the above line of reasoning is clearly false.

Yet the same thinking often persists and manifests itself in absurd ways later on in other parts of  their life.

riskysport

This is not what it’s like to start a business

I think a lot of people avoid going into business for themselves due to this reason.  Even though it would be better for themselves, their family and those they serve to go it alone, they don’t.  Or worse, they say “someday”…

The fear of death manifests, in the form of being someone elses devoted employee for the whole of their healthy adult life.  “I’m not a risk taker”, they tell themselves.

Look, I get it.  It’s fine if you are truly happy as an employee.  What I can’t tolerate is when people make up BS excuses for not doing something with no logical reason.

So how to think about things?  How do you decide what is truly risky and what isn’t?

The Two Types of Risk

I believe that there are two types of risk.

  • Compound Risk

This is the type of risk which builds up over time and then ultimately does result in poor life outcomes such as bankruptcy and death.  Ironically people take these risks all the time without any consideration for their ultimate effect.

For example the decision to not exercise today, or the decision to just have that pizza instead of sticking to the diet.  These types of risk compound over time and then one day give you a heart attack or stroke.

  • Simple Risk

These are risks that can be calculated and taken with no hidden / compound effects.  If for example you decide to buy a car with cash you can easily calculate if you can afford it and what type of risk a reduction in your bank balance will lead to.

The problem is that these two types of risk often become conflated. 

People think that starting a business is a “compound risk” instead of a “simple risk”.  When in fact starting a business has a limited downside and a possible large upside.  It’s a calculated, simple risk.  

Or people think that “eating one more slice of pizza “is a “simple risk” and not a “compound risk”.  They think that one more slice of pizza or drinking one more alcoholic drink is no big deal.  They fail to realise how the risk compounds with time and that that “one more” may lead to an unpredictable heart attack somewhere in the future.

This conflation of the types of risk is what’s happening in the patients who have back pain demanding that “something has to be done”.  They don’t realise that when a doctor has competently assessed you and has ruled out “red flags”, which could indicate a serious underlying issue, that the risk will not compound.  It doesn’t matter if you’ve had the back pain for a day or a year.  If the clinical scenario has not changed then the risk is still a “simple risk” and will not “compound”.

Yes, physiotherapy and lifestyle change is still the way forward.

*Usually men and women alike tend to think that they have metastatic cancer if they have lower back pain.  They fail to realise that they have developed the pain because their body is trying to signal to them that they have poor muscle development (usually due to being overweight and inactive).

When It Feels Like You’re Pushing A Rock Uphill

There’s a running gag in “It’s Always Sunny In Philadelphia”.

One of the main characters keeps getting more and more fat in the name of “cultivating mass”.  He claims that he’s not obese, but muscular and strong.

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The reason the gag is funny is because there are so many people out there who claim they’re going to the gym, that they’re eating a healthy diet, that they’re fit.  But in reality they’re still their usual, unhealthy self.

This self-deception seems to come from adopting habits which superficially look like they should lead to a healthier self.  But whereas “Dry January” and grabbing a protein shake from time to time may seem like healthy habits, they often don’t lead to any significant changes in health and well-being.

When you try to reach a goal, whether that be in business or in life, it’s easy to fill your time up with actions which may seem helpful.  Many founders of companies are guilty of this.  They go to “conventions”, to “networking events”, they meet investors “just in case” they need to raise money.  It’s easy to fill your time up with stuff instead of doing the important work which will get s*%t done.

But how to decide what is worth your time and what isn’t?  I think it comes down to this:

Speed ≠ Velocity

The higher the speed, the more it may seem like you’re doing productive work.  But what happens if your speed is in the wrong direction?  What happens if you’re trying to get to London, but you end up in Leeds?

In physics, speed with a direction is called “Velocity”*.  

When you’re trying to get s*%t done, velocity and not mere speed is what counts!

The three points to remember when you’re trying to achieve something are:

  1. When you undertake a specific action you have to be able to measure the specific outputs you are hoping to see.  What specifically were you hoping to achieve by doing actions X, Y and Z?  If there isn’t a measurable, observable, repeatable outcome then it could be that you’re simply wasting your time.
  2. If you do a specific task, which leads to a measurable, observable, repeatable outcome then you’re not wasting your time.
  3. It then follows that if you modify or change your specific task, you will be able to achieve different outcomes if you wish.

So the questions of the day are; What are the tasks that fill up your day?  And what are the outcomes you are hoping to achieve with those tasks?

*Velocity is therefore considered a “Vector” in physics, i.e. movement with a direction.

Screw That! Do The Opposite!!

Apple it seems, is a bit greedy.  They want you to ditch your old iPhone for a shinier, new version.  They do this by pushing updates that reduce the battery life of older iPhone’s and make them run slower.

The other day I saw a classic Rolls Royce drive past me.

rolls

It was a thing of beauty.  As it drove by everyone was staring at this majestic work of art.

This made me think:

There are very few things which get better with time*.

I find it sad that so few things are built to last.  

In fact nowadays, “planned obsolescence” – where products are designed to break after a period of time – is part of the plan so that people will upgrade or buy more of the same products.

This sort of impatience and nearsightedness doesn’t do anyone any favours and yet it seems to be affecting people’s thinking when it comes to all sorts of things.

People even talk about “flipping businesses”!  As soon as they start a business they’re looking for an “exit” to literally get out.

Screw that!

Do the opposite!

Instead of looking for a way to get out, plant deep roots.

Instead of “flipping a business”, serve your customers for the long-term.

Instead of making sure your product breaks, make something that gets better with time.

If you as a freelancer, an artist, a writer an entrepreneur can lean in when others bow out, then there will always be people out there who would like to be served by you.

*Off the top of my head I can only think of a few things which get better with time; old recipes, certain watches, certain cars, fine wines, art, nature….

If It Looks & Swims & Quacks Like A Duck, It Might Not Be A Duck

I was shocked at what the pyramids looked like up close when I went to Egypt.  I always thought that they’d be smooth* on the outside.  But when I got up close to them they were made of very large stones.

Pyramids of Giza

Pyramids of Giza

More recently I found out that many of the Greek and Roman architects tilted columns and spread them out unevenly to give the appearance that the columns were actually spread out evenly and absolutely straight.

parthenon-feature

The Parthenon in Greece uses a technique called “entasis” to make it appear that the columns are absolutely straight when in fact they are slightly curved

The point is that when we observe something superficially, we may be fooled into thinking a certain way.  And sometimes it takes someone to point it out and say; “Hey, look at it this way”, before we ever even notice the truth.

It strikes me that when people talk about “success” and “failure” they are often described as the opposite of one another.  People make it sound like there’s a spectrum like height, where there’s a tallest person and where there’s a shortest person.

The reality is very different.

The reality is that when you set out to accomplish something “failure” and “success” often require the same amount of effort, the same actions, the same thought processes, the same sacrifices, but one has an outcome which we call “failure” and the other has an outcome we call “success”.  Failure and success it seems are just two sides of the same coin.

“Mediocrity” is in fact the real opposite of both “success” and “failure”.  Coming somewhere in the middle, not standing out and fitting in is the path that people who are trying to accomplish something avoid at all costs.

*I am aware that the pyramids in Egypt were in fact smooth on the outside many years ago, but nonetheless they definitely aren’t smooth today.

How To Measure Your Life

It is unusual how when you insist on measuring something, you often end up measuring what actually doesn’t matter.  Often the thing you end up measuring is a distant relative of something meaningful.

Modern medicine is pretty incredible.  We can stick a tube down your air pipe and artificially ventilate you, we can keep your heart pumping artificially to keep the blood flowing, we can introduce an IV line and keep you hydrated by giving you fluids, we can feed you with a tube into your stomach (a PEG feed) and we can catheterise you to make sure you’re peeing properly.

By all measurable metrics we can keep you “alive”.  But by doing all of this are we really keeping the patient “alive” in any meaningful way?

 

Measure

I have a feeling that we often end up measuring things due to the mere fact that they are easy to measure.  The things which actually matter are usually difficult or impossible to measure:

  • “Likes”, “Follows” and “Shares” instead of measuring impact and engagement.
  • Money instead of measuring purpose and fulfillment.
  • Short-term growth instead of “durability”.

So the question becomes; “Are you measuring your life in a meaningful way?”, or are you measuring out of convenience.  Maybe it’s time to buckle down and figure out what actually matters.