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#22 — On Being Tested: “But I shouldn’t have to do this!”

February 9, 2014 Leave a comment

In 1963 a 20-year-old pitcher named Thomas Edward John, Jr. was signed by the Cleveland Indians. The young left-hander showed some early promise, but not enough to keep from being traded, and in 1965 he went to the Chicago White Sox. There he spent seven respectable seasons, using his sinkerball to induce batters to hit grounders and start double-plays. Yet in 1972, John was traded again, this time to the Los Angeles Dodgers, where he finally came into his own. As a regular part of the starting rotation, he proved to be a consistent winner, and midway through the 1974 season his record was 13 wins and only 3 losses, and he had accumulated 124 career victories.

Then, without warning, there was a misstep and a strain, causing permanent damage to the ulnar collateral ligament in John’s pitching arm. No one had ever come back from this type of injury, and as far as anyone knew, his playing career was over. But then an orthopedic surgeon named Dr. Frank Jobe proposed a new form of reconstructive surgery in which the damaged ligament in John’s elbow would be replaced with a tendon transplanted from somewhere else in his body. Even then, Jobe put the chances of the surgery being successful at only about 1 in 100. Nevertheless, John agreed, and the surgery was performed in September 1974. While it seemed unlikely that he would ever pitch again, John spent all of 1975 in recovery, working at his own form of rehab. Throughout that year, he had daily workouts to strengthen his arm, and he developed a style of pitching that would not strain his arm or the repaired elbow.

By the start of the season in 1976, John was ready to pitch again, and if anything, he was even better than before. His 10 and 10 record that year was considered “a miracle,” yet it was only the beginning. He won twenty or more games in three seasons after that, one with the Dodgers and two more later with the New York Yankees. By the end of his career, he had posted 288 wins, 164 of them coming after his surgery. At the time of his retirement, John had established himself as the seventh most successful left-handed pitcher in major league history. Yet beyond all the victories, he has been consistently credited for his courage, his fortitude, and his daily persistence in overcoming a seemingly impossible hardship. He did not complain. He did not seek redress for the unfairness of what life had handed him. Instead, he simply focused on what he had to do next and then doggedly went about doing it.

It is often said that the true test of our character is not in how we deal with success but in how we deal with adversity, and it is through the unexpected that life tests our character. Not surprisingly, it is often life’s unexpected hardships that bring people into my office for therapy. These people may have experienced an accident or illness, a betrayal, a loss of some kind, or any number of other possible intrusions into the lives they had been planning or had started to live. In many cases it is necessary for therapy to begin by addressing the trauma they have experienced and to help these people through the immediate process of healing. Sooner or later, however, the focus of therapy moves to the adjustments they must make. Life can no longer be viewed or lived as it had been before. The issue then becomes less about the changes that have impacted these people and more about the changes they must make in themselves in order to move on with their lives. For many, this is where the real challenge begins.

Presented with this challenge, people often resist because, after all, discomfort is the price of change. Some people simply refuse to accept that change is necessary, often demanding some justification for what life has dealt them. They may ask, “Why did this happen?” or “Why do I have to change?” Of course, such questions can never be answered to their satisfaction, since life offers no explanations; it just is what it is. At the same time, others may have the opposite view; they want change to be immediate, without all the time and effort that might be necessary — as if all that was required was the pressing of an Enter key or a swipe on a touch screen. Yet, whether it is impatience and the demand that things be “fixed” or the dogged insistence that change should not happen at all, both viewpoints result in utter futility. Life simply doesn’t care.

What’s more, people often think of changes that impact their lives as some sort of aberration interrupting whatever situation they consider to be “normal.” And yet adapting to change is an ongoing process that literally lasts a lifetime, and while it may be imperceptible in the moment, change is happening constantly. This means that dealing with change, uncomfortable though it may be, is an inevitable part of daily life, demanding both acceptance and patience. Moreover, no one is likely to achieve or sustain any substantive change without making a commitment to the process of change itself. This starts by first accepting that life permits us only limited control, and often the things we really want to change are beyond the scope of that control. We must also accept that a lot of patience may be required because the needed changes cannot be forced. Like growth in a garden, life’s changes proceed in their own time.

My own experience with open-heart surgery offered me compelling opportunities to appreciate what it really takes to be accepting and patient (See #3.). In preparing for and entering surgery, I had to accept that, while I was in a very serious situation, I was ultimately helpless and I had to let go completely and trust the surgical team. Following the surgery, I was tired and weak and in pain; yet I was informed right away that it was important to be up and moving in order to keep the newly repaired heart active. Even as I wondered if I had the strength to do it, I began my own rehab, with my loving wife guiding, supporting, and encouraging me literally step by step. Patiently we both followed a program of exercise and walking, gradually increasing day by day. It took a great deal of patience as I slowly built up speed until I could easily walk an extended period at a brisk pace that my cardiologist deemed “therapeutic.” Even being back at work, I continue to follow that regimen of brisk walking.

Famed Los Angeles Dodger manager Tommy Lasorda once noted, “The difference between the impossible and the possible lies in a person’s determination.” In working through life’s hardships with acceptance and patience, we each have the opportunity to demonstrate for ourselves the truth in Lasorda’s comment. The irony to all this is that in many cases no one else will understand or appreciate fully what we accomplish. Still, you never know. No one expected much from that young left-handed pitcher. Yet thanks to his willingness to accept what life put in front of him and the patience to keep working day by day, that procedure which is medically termed ulnar collateral ligament reconstruction will forever be known as “Tommy John Surgery.”

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#21 — On Playing Each Game: “But that’s not supposed to happen!”

November 24, 2013 Leave a comment

Statistics play an important role in baseball. Many fans and even some sportscasters enjoy tracking and quoting such measures as batting averages, runs batted in, earned run averages, won-lost percentages, and so on. This is all interesting information, and for many it makes the game more enjoyable. But for the players, coaches, managers, and front office staff, these simple statistics are not nearly enough. Much greater detail is needed to support what goes on in the dugouts and on the field as each manager and coaching staff tries to outthink or outguess the other. Every major league team has at least one full-time statistician to track the patterns and performance of their own players and those of other teams. The work of these specialists is so thorough that by mid-season they know what a particular opposing pitcher is likely to throw to their clean-up hitter in a late inning with a tie score, a two-strike count, and runners in scoring position. This kind of information helps managers and coaches make tactical decisions during a game, and baseball strategists have a maxim: always go with the percentage!

There is a long-held belief among players and coaches that over the course of a season, the breaks tend to even out. To be sure, they also know that nothing is guaranteed, that despite all their analysis, bad hops still happen, bad calls still get made, good players still have slumps, mediocre players still have hot streaks, and the weather is still uncertain. In other words, during any given game a lot can happen that cannot be predicted by statistics. Everyone who is part of baseball understands and accepts that uncertainty is part of the game, just as it is part of life. When it comes to life outside the ballpark, however, understanding and acceptance are not so common.

In my therapy practice I occasionally see people who simply refuse to acknowledge that the only certainty in their daily lives is the lack of certainty. Raised and ruled by the idea of “supposed to,” these people stubbornly resist the idea of adopting the attitude of a ballplayer. They just cannot conceive of dealing with life by giving it their best and taking their chances. Instead, they view life as a strictly black and white, right or wrong proposition, with rules for everyone to follow and assured outcomes for those who do and for those who do not. The mindset is reminiscent of the stereotypical perception of 1950s western movies in which the good guys wore white hats, the bad guys wore black hats, and in the end the good guys always came out ahead. Naturally, these people see themselves as the good guys, and they usually come to my office because in spite of doing everything they are supposed to do, they are not coming out ahead.

One of these was Chet, a late middle-aged man who had been diagnosed as clinically depressed, prescribed an antidepressant, and referred to me for therapy. While I understood the basis for this diagnosis, as I got to know him I found Chet frequently more angry and resentful than depressed. He had come from “a good family” and attended “good schools,” and he had done everything he was encouraged to do by his parents, his teachers, his friends’ parents, and every other influential adult in his life. He scrupulously followed a regimen of “clean living,” kept in shape and performed well in sports, while also maintaining honor grades in his studies. After college and graduate school, Chet married his high school girlfriend and went to work for a major accounting firm, where he performed steadily, if unspectacularly, in his job over the next 15 years. During that time, the couple had the expected two children, a boy and a girl, and Chet came to see himself as on his way to the success he had been raised to expect. He was unaware that gradually, imperceptibly things were shifting toward the unexpected.

In a surprise move, the firm where he worked was taken over by a larger one, and Chet found himself reporting to someone younger and less qualified than he. Soon there were internal power struggles, and Chet was drawn into a morass of organizational politics for which he was ill prepared. Unable to cope with the almost constantly shifting alliances and expectations, Chet was finally let go. Thoroughly bewildered, he spent over two years vainly trying to obtain another position. He received several offers, but none that matched what he felt he deserved to have. After all, he had followed the rules, done the work, and made the sacrifices, so where was his reward? It finally came in the form of a bank foreclosure and notice from his wife that she was leaving, taking the children, and filing for divorce. After several months of often bitter recriminations, Chet had finally succumbed to the depression that led him to my office. It took many months after that for him to acknowledge that perhaps life didn’t really owe him anything except the chance to go out and do his best every day and deal with what comes.

Too often we forget that life is like a baseball season, requiring all the same kinds of changes and adjustments and shifts in our thinking. And while we can follow the percentages and formulate strategies, we must also be prepared to set these aside and regroup when things don’t go our way. After all, during the course of a season, each game must be played in its turn, and it is not played on paper or with a computer; it is played on the field.

In the 1960 World Series between the New York Yankees and the Pittsburgh Pirates, the percentages clearly favored the Yankees. After all, they had won the Series seven times in the previous eleven years, including five of those years in a row. Still, the Pirates proved surprisingly competitive, and after six games the Series was tied. The seventh and final game was played at Forbes Field in Pittsburgh. The Pirates started quickly, scoring four runs in the first two innings, but then the Yankees answered, and going into the bottom of the eighth, the Pirates trailed 7 to 4. With a runner on first and Pirate fans hoping for a rally, outfielder Bill Virdon hit a routine ground ball to the Yankees’ sure-handed shortstop Tony Kubek for what looked like a certain double-play. But at the last moment the ball took a fiercely bad hop and hit Kubek in the throat, knocking him out of the game and preserving the rally. The Pirates scored five runs in the eighth, which the Yankees answered with two runs in the top of the ninth. Then in the bottom of the ninth, with the score tied 9 to 9 and a count of one ball and no strikes, Pirates’ second baseman Bill Mazeroski hit his historic home run over the left field wall to win the game and the Series for Pittsburgh.

The odds makers and statisticians could not have predicted that a seemingly routine ground ball and a bad hop would determine the outcome of a game, a series, and a season. Yet that’s the way it goes in baseball and in life; despite our plans and preparations, we are promised nothing except life itself and what we are able to make of it. If we can accept that reality, then we can free ourselves from the burden of expectations and continue to pursue what makes life meaningful for us. And we can also remember that no matter how things go today, even if plans fail and things seem unfair, tomorrow is a whole new ballgame.

#3 — On Life, Experience, and Change: Free baseball!

October 8, 2011 Leave a comment

It’s called “open-heart surgery,” and somehow the term doesn’t do justice to the experience.  There are many ways to describe spending 4-5 hours having your chest cut open, your heart stopped, and one of your giblets taken apart.  What comes to mind for me is memorable.  In my case, my defective aortic valve was removed and replaced with donor tissue described as “porcine.”  My doctor said later that he had installed a “large valve.”  That makes the porcine citizen probably male, and my intuitive sense sees him as British and going by the name Barnaby.  Even now, I find myself developing an interest in tea in the late afternoons. 

Naturally, the impact of such an experience is profound and not to be taken in all at once.  Yet what is most memorable to me is not the occasion itself but many of the details involved.  What struck me first was how routinely I was greeted at the hospital.  There was a group of us, all scheduled for surgery early that morning.  We were all cordially yet unceremoniously greeted and then ushered into a series of preparation rooms.  Then there were questions, followed by a lot of poking, sticking, and “prepping,” followed by more of the same questions.  I was struck by the contradictory nature of this experience, a bizarre mixture of the monumental and the mundane.  So much was treated as simply routine that it was difficult to connect it all with the idea that I was about to face my own mortality, with my life and future quite literally in my surgeon’s hands.  But then another voice from the back of my mind chided, “What did you expect — a brass band, fanfare, some kind of ceremony?”  I recognized this as the part of me that seeks to keep me grounded and that lets me know if I start to take myself too seriously.  I have come to value this part of myself very much.  After all, the only thing I really needed to know was that I was about to go through a major transition — change. 

So much of how we deal with change is determined by how we view experience, whether we see it as happening to us or from us.  Do we have active control of our lives, or are we merely victims of them?  This is, of course, a classic yin-yang debate: subjective or objective, proactive or reactive, right brain or left brain.  There is benefit in understanding and appreciating both sides of this debate, yet there is great danger in actually choosing a side.  The reason is that we are not truly faced with an either-or question.  The answer, ultimately, is both.  Just as we seek to change our experience, our experience changes us; that’s what it is supposed to do!  That is the way life works!  There are many important lessons we all must learn that only experience can teach us, which means that being an active participant in life is not an option but a requirement.  You can’t learn about love or pain or inebriation, for example, from books or in a classroom.  Sure, you can get an intellectual grasp of what those things are like, but until you’ve actually experienced them for yourself, you can’t really know. 

 If we make the mistake of choosing a side in this yin-yang debate, say opting for objective over subjective, we first experience a gradual devaluing of the other side, the other point of view, and an inevitable loss of perspective.  I remember working with a couple years ago who always ran into conflict in making joint decisions.  He would start by asserting they should choose A because it “made sense.”  She would respond that A didn’t “feel right” and B did.  He would then accuse her of being “illogical and emotional.”  She would respond that he was “insensitive.”  I would point out that they had both painted themselves into a corner by insisting on seeing and interpreting all their experience from just one point of view.  Such decisions cannot be made in the corners; they must be made in the middle.

 An even greater danger, however, in adopting a fixed viewpoint is that it makes you vulnerable to that dreaded bugaboo, expectation.  There is much wisdom in the saying: The man who has no expectations cannot be disappointed.  Yet having no expectations is a tall order.  Despite all our practices of mindfulness, presence, acceptance, and so on, we still inevitably develop expectations even without knowing it.  And expectations love to play off ego.  Without even being aware of it, we can easily become wedded to those expectations and start to feel entitled.  Then, when an expectation isn’t met, we’re not just left disappointed, we become resentful.

 My recent major surgery was not my first.  Having gone through coronary bypass surgery nine years ago, I looked forward to this latest experience with the confident air of a veteran.  I knew the territory.  I knew what to expect.  I knew how to handle it.  I was ready.  And, of course, what I expected is not what happened.  I awoke in the ICU, not with focused attention or relaxed acceptance, but in a kind of anesthetic never-never land.  Rather than the quiet calm and constant attention I had received previously, I was surrounded by chaos and cacophony and a caring but harried nurse who had to deal with me and three other people.  To make matters worse, I suffered a bad reaction to a pain-suppressing drug I had been given, which took several days to identify and eliminate.  In all, my arrival on the other side of this surgery defied all my expectations and left me feeling somewhat chagrinned.  Nevertheless, while I didn’t exactly breeze through the way I had expected, I did get through.

 And there is a bright side.  Before and after both my surgeries a lot of people made a point to discuss post-operative depression with me and how it is prevalent among “older men.”  I am forced to confess that of all the aspects of this surgery with which people struggle, this is the one I relate to the least.  I still vividly remember what it was like being in those cheap seats at Fenway, when the game would end tied and then have to go into extra innings.  Every pitch, every hit, every play became a potential game winner for one side or the other.  The players, coaches, umpires, and fans were never more engaged, and all this was after we had already completed nine innings.  The game was still going, and being there was never more fun.  We used to call it free baseball.  For me, this is what it was like waking up after surgery.  Once I became oriented and understood where I was and that the surgery was past, I realized that the game was still going.  I could still be engaged and make every part of every moment of every day count.  Rather that post-operative depression, I experienced post-operative euphoria.

 I think there are two things to take from all this.  First, if you’re having surgery, leave your modesty at home and take your sense of humor with you.  Second, in approaching experience, it’s importance to seek a balance.  Life is rarely all one thing or all another; rather it is an ambiguous mixed bag in which we get to choose some things but not others.  And sometimes life makes choices for us, even when we prefer that it wouldn’t.  Nevertheless, if we can resist choosing the yin or the yang, if we can keep seeking our own balance, accepting its personal and elusive nature, then we can be truly free to engage fully in life’s ballpark.  We can keep the game going and enjoy personal enrichment.  Free baseball!

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