1. As you get older, stay away from people your age if you don’t want to get older. (There are exceptions, you know who you are)
2. It is so much easier to judge people than to understand them.
3. Do we appreciate memories after they pass? Can’t we learn to enjoy the present right now?
4. I have accepted my many imperfections; one is that, until my last breath, I never engage when I hear the phrase, “it’s just not fair”. My inner voice is saying, “Who in your life waterboarded you into believing that life is fair?” If life were fair for me, every time I had a good outcome with my patients, an administrator would hand me a soft-serve ice cream cone.
5. Life experiences can be so intense. Yes, my sense of humor can be a bit off. I don’t comment to be mean; I comment because I find humor in the ridiculous.
6. Let’s pretend you like your local or national politician.
7. Surrounding yourself with people who struggle, have visions, and aim to be better in life promotes success. Surrounding yourself with people who don’t ask the best of you means you live in a cage.
8. Birkenstocks are an unusual form of birth control (think about this a while)
9. I have had times in my life when I had no luck, such that if I sold candles, the sun would never set.
10. At this time of my life, I am tired of complainers. I know and understand their brand. I choose to focus and express gratitude. This has helped me to see the good qualities of those in my inner circles. There is freedom in accepting how blessed one can be, especially when life gets difficult.

1) I saw this sign at work: “The beatings will continue until morale improves.

2) Unfortunately, in life, doing really great work frequently goes unnoticed

3) I still struggle with this. I hardly ever celebrate what I have accomplished; I am always looking forward to what needs to be completed

4) Important life lesson: “I don’t know, but I will find out”.

5) For every mistake you have made in life, forgive yourself

6) apparently as it relates to leadership, I am an easy person to read but a difficult person to get to know

(I just don’t like to talk about myself)

7) When a person shows you who they are, you have to believe them

8) You know what’s great about this time of my life? Being unapologetically myself

9) A day without overcoming obstacles is a day filled with regret

10) Every day of my life, I have seen patients be courageous in the face of their greatest fears

1) It takes tremendous inner strength and courage to face our emotional fears

2) Humor is derived in the face of pain

3) I know I have grown when I was asked the other day, What is the most valuable to you?

I answered, “Self-knowledge “

4) I lost my desire to care what people think of me early in my adult life. When I was in college my capacity to think that it is really none of my business what people think about me and to stay laser focused on being the best version of myself consumed my psyche

5) When I am doing a heart procedure, I can make it appear effortless, simple, and very natural in my hands, until the fellow attempts it and it seems awkward, like a teenage girl trying to walk in stilettos. What few appreciate are the millions of times I rehearsed every motion, every step in my mind while shaving, in the shower, or when I let my mind daydream, and the thousands of heart procedures I have performed over my career. It reminds me of the ignorance of our society that fails to understand the many gifted musicians, songstresses, artists who perfected their craft from thousands of hours and many years of work

6) I learned and validated early in life that problems left unresolved become crises later in life

7) Crises in our lives are an emotional stress test; they expose the small, vulnerable spaces in our foundation and our resilience. These help to fill in our weaknesses in our emotional foundation and make us better prepared for future challenges.

8) What is it about humanity that we believe in the ideology of overnight success? Successful people, when fully transparent, will tell you it’s not overnight, it’s “over your whole life”!!!

9) When I thought I was at the end of an experience, I was already at the beginning of another

10) Your life is a canvas; you are in complete control of what you produce

1. Everyone has a right to success, but not everyone is entitled to success.
2. Sometimes in your work life you will more likely get a stick than a carrot.
3. My views about the world around me is continuously changing, as my experiences in life changes my values remain intact.
4. I have had to work very hard throughout my life to approach life with no fear and no ego, I have had to do this because in my career, those with egos and fear have always tried to hijack my life.
5. You cannot have a healthy functional relationship in your future if you are still held hostage to your past emotional pains.
6. Healing from previous emotional pains is a life long process, sometimes it requires leaving the environment that hurt you in the first place
7. Physical injuries all heal in time and leaves a well healed scar, emotional pains can never heal, unless courageously confronted and conquered
8. Your most important super hero power is to decide how you choose to cherish your emotional gardens, both rain and sunshine makes flowers grow
9. Listen to people, really listen to your inner voice, then watch their behavior your inner voice will always tell you something is just not right
10. In this season of my life I have met many people whom have accumulated a lifetime of minor pains, a ton of feathers is still a ton.

1) As we age, we learn that life’s journey is one we get to write, our journey is only about the choices we make and the responsibility we take for making them.

2) it takes far more courage to confront your inner demons than to run from them.

3) Truth does not become more true by virtue of the fact that the entire world agrees with it, nor less so even if the whole world disagrees with it.”

4) Is just me or does joe Biden appear to be a few candles short of a Menorah?

5) Society spends far too much time focusing on strengths and refuse to look at weakness, I have been acknowledging my strengths but spend more time and effort working on my weaknesses, I can always do better and be a better person.

6) I am the person I was meant to be, and I am all right with this.

7) Sometimes in my life I had to get burned more than once  to learn not to touch a hot stove

9) Get to know me real well because you will not meet a man like me twice in your life.

10) The purpose of life is to live, to experience love, pain, heartache, to name a few, to deny these experiences is to only exist.

23) I get it, life is not binary.

24) failure can be success.

25) I have become comfortable with the daily grind and not seeing much progress.

26) we live in a culture that we scream out failures and whisper accomplishments, is that humility? or insecurity?

27) From hardship comes enlightenment

28) if you dont love yourself, you cannot love me.

29) Fear and faith cannot exist together

30) if you are depressed you live in the past, if you are anxious you live in the future

31) I have lost many times in life to appreciate the times I have won.

32) Don’t worry about Karma, it is always waiting for you outside your door.

33) there are times when people speak to me and I cannot tell if its a compliment or an insult.

34) Some mornings I wake up and think I might have a striking resemblance to Tommy Lee Jones.?, I would have said Morgan Freeman but I am not attracted to my grand daughter.

35) Sometimes your life needs to be unplugged and plugged back in, what IT calls “reboot”

36) I have come to embrace the ideology that I may have a vision that on one sees but me, I am ok with that

37) throughout my life I have always felt that I was pushing the outer boundaries of my physical/emotional capacity

38) Do you feel pushed in life? I have never felt this, I always felt I was being pulled by a force I cannot resist.

39) My experiences with people is that some individuals learned that you can be mentally beaten at any time for anything, and also learned that there is no point in making any effort to avoid the beatings.

40) its not about what people call you, Its about what you answer to.

41) I dont fear failure, I am terrified of regret.

42) Adversity doesnt build character, it reveals it.

43) Do what you have to do, so that you can do what you want to do.

44) sometimes I find myself making SWAG (scientific wild ass guess)

1. There will be some time in your career, that you become tired of the doors of opportunity closing on you and will need to “Kick the door down”!!!!!

2) I can honestly state that I am overweight and need to lose ten pounds, but I self-identify as skinny.

3) I am at a point in my life that I find myself continuously asking, “Which battles of my associates do I want to fight today? Which of their demons do I want to avoid engaging?”

4) There are a lot of very talented people out there who will never reach their level of success because their inner demons or external demons constantly prey on their success.

5) You are in trouble if you give me the “silent treatment,” and I enjoy it.

6) Outside of the hospital, I am not the guy who feels a need to validate my adulthood by fixing everything. I am ok with that. Now, get help, own, and fix your own dysfunctions.

7) My life’s work outside of the hospital is not to validate you, I will listen to you, support you, and love you, deal with your own shit, or let that shit go!!

8) We continuously run from our inner demons, never understanding that our inner demons are ever present, lurk in the shadows, and find unfortunate, untimely, and painful ways to confront us.

9) Living your life to fit into a tribe is overrated.

10) Most of the unfinished business in your life can always be found in a cemetery.

11) There is no shortage of people who want to take credit for your great work, and a far greater number of people who want to discredit your work.

12) Arrogance and self-awareness rarely go together.

13) There have been times in my career when I had to take action and “let me show these fuckers what they are missing”.

14) The work of a heart specialist doesn’t change you, it makes you more of who you are.

15) with a college education, I learned how to learn and realized I knew little, with life experiences, I learned how to apply what I learned and gained wisdom.

16) I have traveled over 1.5 million miles, the world has become small to me.

17) I can function and work well because I apparently have a very high tolerance for ambiguity.

18) We all have our battles, one with the person sitting across from you, the second is the person inside of you. Once you conquer the one inside of you, the one across from you really doesn’t matter.

19) I have had many times in my life and career when I had to work harder than an ugly stripper.

(20) Working and operating on the heart has a very, very small margin of error.

(21) I have never heard someone wake up one morning and say, Working on the heart looks like fun, I think I will make a living working in conditions where a patient is at continuous risk of imminent death

22) Failure does not make you a loser; it makes you human.

23) Denial and fear are humans’ greatest inner demons.

24) In life, we perseverate on the negative things, despite wanting to relive the positive things.

 Autumn is in the air, and it was a typical fall day in Washington DC, the last day of an international meeting.  This meeting introduced many new medical and surgical therapies to lower mortality in patients with heart failure. The Willard Hotel was 50 yards from the back gate of the white house. While packing to leave for Regan Airport, I turned on the news and watched a replay of a commercial airline flying into the south tower of the world trade center. Quite frankly, I thought it was a trailer for a Steven Spielberg movie. As the news continued, a second commercial airline struck the north tower of the world trade center. Is this real? Am I in an alternate reality?

As I sat on the edge of the bed in my birthday suit, a heaviness fell over my heart. The intercom system of the hotel summoned all guests to the lobby. My survival instincts kicked in. I dumped all contents of my backpack on the bed and proceeded to fill it with all health bars and bottled water. What would motivate me to do something like this? As we all gathered in the hotel’s atrium, the doors open, and many tall men dressed in black suits and white shirts with black ties start to file in patterns speaking into their sleeves? Patrons rushed to the front of the hotel under the canopy. As we stand at attention, still not sure what is happening, a sudden dark smoke emanates from the distance, the Pentagon? The smell of Kerosene is in the air, ( our fighter jets are fueled by kerosene) jet fighters were scrambled, but it is too late. To our right, the back gates of the White House are open, and the white house staff is being evacuated. All guests are corralled in the hotel basement. Tuesday morning, kerosene-filled air was the last time I would be outside until Friday afternoon.

When we arrived in the basement, I found a payphone and called my eldest sister and the hospital. Cell phones were not that ordinary in 2001. “I am ok,” as we talked, several large screen TV showed the news and burning north and south towers of the World Trade Center. Shortly after, cell phones are no longer functional, and the system is overwhelmed.  We were allowed to go back to our rooms if we left the hotel, we could not come back. So this will be home until US intelligence can figure out the next steps. While walking back to my room, I looked out the lobby window; yes, it was a war zone. Humvees had hijacked the DC political streets, and military personnel was walking the streets with AR rifles. The hum of life in DC became a void, the absence of a joggers footsteps, no dogs barking, the void of clanking of dishes in restaurants, all were gone. The only sound in the background was the sound of change in lights at intersections. The president had grounded all flights in the US . While looking toward the White House, the presidents’ helicopter had descended out of the clouds, and I watched as President Bush rushed to the oval office; he will be speaking to us this evening.

Life had never been as uncertain as it was this moment in time, no flights home, streets were militarized, and after the first plane struck the world trade center, America had just joined the war on terror. Being sequestered and secluded for nearly one week makes one wonder about life and loss of life. The over 3000 people who died a violent death was disturbing. As a physician, I have been in a room with the grim reaper far too many times. As much as I travel, I could have easily been on one of those planes. My attention was about those who perished, the families they left behind. My raw emotions were darkness, sadness, and anger. What little innocence I had in 2001 was ripped from my soul.

We finally were given the news that there would be limited travel on that Friday. I booked my flight to head back to Texas. The flight home was quite sad; every time the plane banked, we could not help but wonder, “who is in the cockpit” I also made a significant change in my life. I would always take an aisle seat when I travel, always. I don’t have a hero complex. I want one shot at any asshole that attempts to take the cockpit.

The downstream results of 911 were my emersion into the study of terrorism. I read all books and CIA reports released and looked at documentaries on terrorism, including the 911 commission report, twice. I studied with the same ferocity I did medicine. The most important lesson from the book?  From the mouth of the mastermind of 911 regarding terrorism? ” our will to die is greater than Americans will live.” This quote resonated as to how you can win a war when you love the comforts of the US and the hatred of terrorists in the comfort of death. Osama Bin Laden had been on the radar of CIA intelligence for quite some time. His first exposure was during the Afghan/ Soviet war, and he was a leader in helping to get the Soviets out of Afghanistan. He built his brand as a warrior. Despite his heroics, he was not welcomed in Iraq, kicked out of Saudi, and eventually ended up in Afghanistan, where we nearly had him in Tora Bora. He settled in Abbottabad, Pakistan, until his death. CIA had been on the hunt, and he evaded every time. CIA operatives captured Khalid Shaik Mohammed (KSM). He was the mastermind that presented the initial idea to Bin Laden that since they could not fund a war, they could turn a hijacked plane into a missile to destroy the financial infrastructure of the US. Terrorists reasoned that if they could cripple our infrastructure, they could bring down the US. Bin Laden did not immediately agree to the plan and argued that it was dangerous and would never work. The American culture and CIA intelligence did not see this bearded man from the middle east as a threat to our national security. They even argued how he could run a global terrorist organization from a cave? KSM capture was vital. That was the first time CIA analysts concluded that they were looking in the wrong places. Since Bin Laden was not on the internet and was off the grid, he used a series of couriers who sent messages, financing, and plans to cell networks. CIA identified a courier in Abbottabad, Pakistan and the intelligence race was on. Bin Laden’s compound was only one mile from Pakistan naval School (our Westpoint). Admiral McCraven, whom I have had the honor to meet on several occasions, crafted a plan to send in Navy Seals to kill Bin Laden on a dark starry night; there was no capture. The movie zero dark thirty is a depiction of the actual mission. Yes, I have seen it at least a dozen times.

I have friends in Washington that this is a reasonably close representation of what happened in the events leading up to that fateful evening.

My mood the last several days has been somber. My darkness returned for the lives and families lost on that painful day in American history. Life was never the same for me, nor my innocence.

Our country is at a crossroads of domestic terrorists. How did we get here? When the national anthem is a point of questionable patriotism, are we no longer Americans? Why is it when I hear the national anthem, I am  brought to tears each time?

1. Corporate culture paradox: “If you see something, say something”, yet if you identify a problem, you become the problem.
2. Leadership can be more about becoming something you aren’t than becoming something you are.
3. Sometimes my heart hurts too much to be angry.
4. The corporate circle has a unique underbelly: “live inside the circle and know everything and to survive you feel nothing, or live outside the circle and know nothing and to survive you feel everything.
5. In God we trust; everything else, we need data.
6. Just because you can do it doesn’t mean you should do it.
7. I’d rather live one day as a lion than 1000 days as a lamb.
8. Is it just me, or does Ben Carson speak like he is one scalpel short of an operation?
9. The voice of ten angry people is far more influential than the voice of the 1000 silent majority.
10. Someone once said, “Imagine a world in which we are all enlightened by objective truths rather than offended by them.
11. Heart procedures have a margin of error that is very, very small
12. In your home, you want to be loved; in your work, you want to be believed.
13. My retirement comes when my best effort is no longer good enough.
14. Sometimes when I look at someone or something, I don’t always see it as it is, but for what it can be.
15. Have you ever gone to a wedding and you’re like, “So that’s your best”?
16. The journey should be cherished and the destination ignored.
17. When a man loses his dreams, he ceases to live and merely exists.
18. Just because you can, it doesn’t mean you should.
19. Don’t ever let another person tell your history
20. Even a broken watch is right twice per day.

1. The one thing that will lead a team to never reach its fullest potential would be “Meetings”.
2. Do not confuse your practice with you life.
3. No one cares about you as much as you think they do.
4. Never, ever, say anything to a woman that suggests that you think she may be pregnant unless you happen to be in the operating room assisting with her vaginal or C-section delivery.
5. A person who is pleasant to you, but an ass to a waiter or waitress, is not a nice person. (you should make this observation and remember time and time again)
6. There is no right way to do something wrong.
7. To rely on others is to be disappointed
8. We all see life though the filters of our previous experiences.
9. Never is no longer in my vocabulary, except this: I will never have the ability to express the depth of my love for my children.
10. The very old saying, “sticks and stones may hurt my bones, but words will never hurt me”. My life experiences have taught me that, ” The pain of a stick will always go away and heal, but words are divisive, painful and are eternal.
11. What we say and what we do can be very different from what we believe, true authentic growth comes from saying, believing and doing the same.
12. I must always close the current chapter in my life before I open a new one.
13. Everyone you meet in life is fighting a battle you know nothing about.
14. The truth does not set you free, the ugly truth does.
15. Eagles don’t fly with chickens
16. Eagles don’t flock, you have to find them one at a time
17. Sometimes if you go back far enough in your past, you can see you future.
18. You have no limitations, society sets those limitations and it is up to you to accept or refute those limitations.
19. Amateurs practice until they get it right, professionals practice until they can’t get it wrong.
20. We are tremendously biased by the last thing we saw.
21. If there is anything I would like to give my children, is the ability to see them through my eyes.