Thirteen Years

Thirteen years is a long time. When I first came to New York, I never imagined that I would still be there, thirteen years later, married to a beautiful, amazing soul who is inexorably changing the world in her own quiet, loving way.

Thirteen years ago, I met you. I didn’t know then that we’d have thirteen years together. I just knew that I wanted to be with you. You made me see life differently, and you taught me to see the best in people, instead of only the worst. You taught me to give people a chance. You taught me how live with kindness and love in my heart in a world that often feels cruel and harsh and unforgiving.

Thirteen years is a lot of time for two people to grow up together, to build a home together, and to find a place in this world together. Thirteen years adds up to a lot of days learning from each other and loving each other. Each day is a treasure - and thirteen years is so much time that sometimes it’s easy to forget that.

Thirteen years is enough time for two people to walk the same path together and learn who they each really are. When you both want the same things - especially if they're big things like justice and peace and love - it feels easy to walk the same path. But a day comes when you realize that those big things aren’t everything, and maybe they're not enough. And maybe this scary truth was always in our hearts, but love was enough to carry us down the path together for thirteen years. Until one day we looked down and realized that we're no longer walking the same path.

Now, our thirteen years are over. We're travelling separate paths now, because sometimes love isn’t enough anymore. But thirteen years is a lot of time - more than many ever have. Thirteen years is a lot of happy memories and challenges endured; it's a lifetime full of love, with no regrets.

In thirteen years, we’ll look back on this moment and know that this was right. All of it - even this ending and new beginning. And we’ll know that we started down our separate paths with our hearts still brimming with love for each other, and that we were blessed to have walked together, hand-in-hand, for thirteen years.

Broken-hearted: Boston

There's really nothing more to say.

How to Transform a Conservative Brick-and-Mortar Service Delivery Industry

How to Transform a Brick-and-Mortar Service Delivery Industry

Get a license to practice
Move to Wiliamsburg, become hipster (in that order)
Turn nose up at traditional career, wallow in ennui
Start a Tumblr blog, post cheeky picture of self, offer services online, in bars and in coffee shops
Get mocked on Gawker
Get book/TV deals
Start consultancy, let license lapse, throw parties
Rent loft space, start start-up.
Cater to technocrati.
Success.

The Doctor is In (Well, Logged In)

The Dark Side of ADD Meds

My three weeks of travel (Dallas to Jacksonville to Miami to Houston to NYC to Syracuse to Poughkeepsie) which included climate changes from balmy and humid to driving through a snowstorm in frigid 20-degree temperatures in a car with no working heat has finally caught up with me. I lost my voice completely after my last training on Friday, have been in bed since Friday evening, and I don't think I'll be able to write my planned reflection this week.

The NY Times published a heart-breaking piece on the tragic suicide of a young man who became addicted to ADD meds. The article suggests - and his poor parents believe - that he was misdiagnosed after he faked his way through the diagnostic test, and the doctors failed to conduct the full life-history evaluation that many practitioners recommend. He, like an alarming number of college students, started abusing ADD meds in college to boost concentration to enhance school performance.

The article paints a really tragic picture of a bright, promising life that went off the rails because of a drug that's meant to help those with who struggle with distraction and inability to control their attention. What the article doesn't do is question why people who actually don't have the kind if brain chemistry the meds were intended for feel the need to use them. What is it about our society, our education system, and our modern world that would cause someone who is "normal" to turn to drugs to be successful? More importantly, what does it say about the way our society has evolved that a significant percentage of our child and adult population are now being prescribed medications so they can be "normal"?

I've been planning to write something on an alternative way of framing ADD - not as a disorder, but rather as identification of individuals who have traits that were important and useful to society historically, but who increasingly have a hard time fitting into the fast-paced, regimented and demanding modern world we now live in.

Until I get to writing that piece, I really think anyone who has any interest in ADD, medication, and mental healthcare issues should read the Times article. And if you're someone who uses stimulants to boost performance in school or work, whether you have a diagnosis or not, think for a minute about what it says about our world that some people are medicating - and in some cases abusing medication - just to do what they think is expected of them.

Sticking Together

While on this last business trip, I had the opportunity to meet up with an old family friend. His fourteen year-old son was also recently diagnosed with ADHD, and he and his wife have really been struggling with how to support him. Their son - let's call him Jeff - has had a rough time the last couple of years in school. The diagnosis, instead of being a relief and a moment of rebirth as it was for me, hit him pretty hard. I offered to hang out with Jeff to see if maybe I could help. At the very least, he'd finally have a chance to talk to someone else with the same kind of brain wiring.

I can't imagine how hard it must be to be fourteen, just starting high school and just wanting to fit in, and be told that you have a "disorder". Freshman year of high school was tough enough as it is. Jeff has focused a lot of his energy on football - not surprising, considering exercise and sports are a common form of self-treatment that undiagnosed ADDers gravitate towards. He has insomnia, which causes a lot of stress, because he's tired a lot of the time, is late to school a lot, and because - in his quest to get bigger and stronger for football - Jeff has done the research and knows that he needs a lot of sleep at this stage in is life as he goes through puberty. He's worried that his inability to sleep (also a common trait) is going to doom him to being too scrawny to be a good football player.

Over huge Texas-sized steaks, I told Jeff about my own experience in high school (it may surprise you to know that I played football my Freshman year. I wasn't any good - not aggressive enough, apparently.) I talked about a bunch of the tricks I had developed over the years to deal with life, both pre- and post-diagnosis. When I told him I often feel at the end of the day thay I didn't accomplish anything, or how I have a lot of trouble remembering how I spent my time or how long it took me to do something, he told me he feels that way all the time, too. I talked to him about my lifelong struggle with procrastination, and I knew immediately that he understood what it was like. And while I only occasionally have trouble falling asleep, I've gone through pretty intense insomnia before, and I know how debilitating it can be.

I'd like to think that steak dinner was a turning point for Jeff as he grapples with this new reality. Only time will tell, I guess. If someone had sat me down at fourteen and started to rattle off a list of things that almost perfectly described things that were causing me a lot of inner turmoil, and then told me that it wasn't my fault, and that there were things I could do to make dealing with school and life a little more manageable, I'd probably be a very different person today. I think I'd at least be a little less insecure and experience less anxiety.

During our conversation, I suggested to Jeff that he try a white noise generator or some other kind of sleep sound device or app. In addition to masking the annoying random sounds that can really tug at an overactive brain, I've found that those kooky new-age nature soundtracks can often help relax my mind (I'm partial to waves crashing on the beach). The next day, Jeff texted me to say that he had tried a white noise app and that it had really helped him to fall asleep. It was pretty gratifying. As I told Jeff, we ADDers are a speciai tribe (about fifteen per cent of the population) and we gotta stick together of we're going to make it in this crazy world.

Flying with Focus

One of the more interesting and destabilizing parts of the past six months is that I'm learning a lot about myself since I was diagnosed with ADD. I have read a lot of the books out there on adult ADD, and it's extremely disconcerting to pick up a book and have a complete stranger identify in print so many of the fears, uncertainties, and traits I've struggled with all of my life.

I've learned enough about myself by now that I better understand why I find air travel to be so challenging. I'm in the middle of a four-city, two-week road trip for work, so now is as good a time as any to write about what it's like for me to travel with ADD.

Booking Air Travel

Trying to book an itinerary feels like walking into an open bazaar, with vendors everywhere shouting different prices at me for goods that are all slightly different. If it weren’t for travel search sites like Travelocity, Orbitz, Kayak and Hipmunk, I'd be a complete wreck trying to figure out timing for connections, finding the best prices, comparing itineraries and focusing on one airline rewards program. As it is, even with all the powerful search sites at my disposal, I find it incredibly time consuming and exhausting to book anything but the simplest itinerary. It took me more than half a day to book my current trip - between the complexities of a 4-city flight itinerary, hotels, car rentals and airport shuttles, all of which had to be within the per-city travel budget. It's a good thing I'm such a geek and have gotten pretty good at using the filters built into those search sites, otherwise I'd never get anywhere.

Packing

I hate packing. I’ve developed a ridiculous ritual every time I travel: the night before any trip, I usually end up pulling an all-nighter to do laundry and pack my bags. I used to attribute it solely to trying to do too much with too little time (which is true, but more on that in a future post), leaving no time to pack during regular waking hours like a responsible grown-up. I now recognize that there’s another factor: packing for a trip is exactly the kind of activity that taxes my ability to stay focused simultaneously on a number of small sub-tasks.

The process usually starts out well enough. I grab the appropriate luggage, and start gathering my clothes and other stuff. Then, I'll be unable to find a shirt I want to bring, and when I find it in the hamper, I think, "I'll just put in a load of laundry while I pack." That's usually the beginning of the end for my good start. What follows is... well, remember those Benny Hill cutaway scenes that were played back at high speed with crazy saxophone music, showing Benny and a whole gang of characters running around, bumping into one another helter-skelter? It's kind of like a one-man version of that, without any of Benny's scantily clad co-stars. I usually end up with things I didn't really need, like the book I've been meaning to read for four years, and missing things that I do need, like the charger for my phone.

The real problem is, because I'm at home with all of my stuff, I have a lot of trouble filtering out the universe of things I might need (umbrella, poncho, first aid kit, emergency zombie apocalypse supply bag) from all the things I actually do need (socks, toothbrush, glasses).

You might ask why, knowing full-well now that I'm not good at holding so many unrelated small tasks in my active working memory, I don't just create a list of things to pack. I've tried. Maybe I need to work on my list-making, but I start packing using the list, and inevitably I start thinking of things that aren't on my list and my trust in my past-self disappears because I see how unreliable I was in creating the list.

Anyway, I've gotten a little better at this. At least now I'm better at forgiving myself for forgetting things, and reminding myself that buying a tube of toothpaste or a bottle of contact lens solution at my destination is not the end of the world.

Flight

I'm blessed with the ability to sleep on planes. I sleep through takeoff, through landings, and often through most of the flight. If I couldn't do this, I'd probably go crazy. Flights are full of the kinds of distractions that rip my attention away from anything I try to do that requires focus, such as reading or writing. Put me anywhere within seven rows of a loud talker, and I want to rip my hair out in frustration (if I had hair to rip out), because I can't tune out the conversation, and I'm trapped for several hours. The constant drone of jet engines also, for some reason, pulls at me in a way that random noise in an office or in a car does not. And when the flight crew uses the overly-loud PA to sell their special credit card program, it takes a great deal of willpower not to scream in rage, especially if I've just barely managed to get into a groove and actually read my book.

I started using ear plugs recently, and it has completely changed my relationship to flying. I haven't found any that can block out as much sound as I would like, but the ear plugs I use now dampen noise so much that it really helps quiet my mind. I also use headphones - and I'm thinking very seriously about investing in a pair of good noise-canceling headphones - but I also worry about trying to block out noise with other noise and what that might do to my hearing. When I don't have ear plugs with me, I use in-ear earbuds with an app on my phone that generates white noise.

I'm happy to say that using ear-plugs and headphones, combined with better mindfulness about, well, my mind, have drastically improved my ability to concentrate while flying. I used to shift from reading a few sentences of a book, to flipping through a magazine, to glaring at the obnoxiously loud person three rows away to perusing the Sky Mall catalog, to playing a game on my phone, all within about three minutes, on a repeating cycle for the entire flight. I used to also try to actually do something productive on flights, but inevitably, I would take out my laptop and just stare at it in quiet frustration, unable to muster enough concentration to do more than write a few sentences.

Things haven't completely changed. I'm still very likely to wish a bad case of laryngitis upon fellow travelers who, like Austin Powers coming out of his cryogenic state, can't CONTROL THE VOLUME OF THEIR VOICE. But I'm a much happier and productive traveller now. I know this, because this post was written entirely in-flight, within earshot of two people who must be related to Sam Kinison.

Trail-Running Through the Fog

I Don't Understand Why You Can't...

In June of 2012, I was diagnosed with ADD. My path to diagnosis was pretty common for someone who was never diagnosed as a child. The stress and anxiety that has always simmered under the surface boiled over. Again. This time it was particularly bad, and I realized if I didn't finally do something about it, I was likely going to find out what rock-bottom really felt like.

I received the diagnosis, and started learning about brain chemistry and neurotransmitters. And for the first time in my life, at the age of 36, I felt there was a possibility that I wasn’t actually a complete mess who had somehow fooled everyone through dumb luck and because of a surprising ability to do well on standardized tests.

Undiagnosed ADD in adults can be extremely pernicious because the traits that many ADD'ers have are usually perceived as moral failings. For example, our working memory (being able to hold multiple pieces of information in our heads while working on a task) and our prospective memory (being able to remember to remember to do something like "Put that bill payment in the mailbox when you get to work.") - these functions don't work particularly well for an ADD'er. It's hard for people who don't have ADD to understand why the ADD'er can't just take care of simple tasks - and it's impossible for the undiagnosed to know that it's not their fault that they can't remember, or that they can't control their focus. But trust me, we know that we’re not taking care of things well, and that we’re not getting things done. We know when we’re falling short and falling behind. We're acutely aware that things are slipping through the cracks. We find names for ourselves, because this is the only way we can make any sense of it. Lazy. Stupid. Spaz. Irresponsible. Flake. Undisciplined. Procrastinator. Unreliable.

And that's just the inner dialogue. Imagine what it must be like to go through life - through school, through work, through relationships - having those labels placed on us by others as well. It doesn’t even have to be a vitriolic verbal assault to be devastating. Hearing “I don’t understand why you can’t...” can feel like a cold, quiet dagger of dissapointment in the gut.

Just Try Harder

Telling someone with ADD to just try harder to concentrate doesn't work. You might as well tell someone who is nearsighted to try harder to focus their eyes. Or why not tell someone who is colorblind that if they would just apply themselves and appreciate the value of hard work, they could distinguish between red and green? We don't question the colorblind, because we accept that they're not pretending that they can't distinguish between red and green. We believe them. But for some reason it's hard to accept that someone with ADD can't easily distinguish between something they really should be doing and something that happens to have their attention at the moment.

And so what do ADD'ers do? Well for one thing, we constantly tell ourselves to stop being so stupid, so lazy, so unorganized, so forgetful, so irresponsible. We tell ourselves to grow the-fuck up. We don't need anyone with a whip to drive us forward, because no one can come close to inflicting the kind of punishment that we visit upon on ourselves every day.

Some of us self-medicate. Addiction is common. I was fortunate that my addiction (video games) was relatively benign. Addiction to drugs, gambling, adrenaline and anything else highly stimulating are common. Chasing a high can sometimes be the only time our dopamine- and seratonin-deprived brains allow us to feel “normal”.

We also develop coping mechanisms. We rely on procrastination, because the stress of an impending deadline (and fear of the consequences of failing) is often the only thing that allows us to focus our attention. We try to find jobs where our paradoxical ability to hyper-focus is actually useful. We (try to) live obsessively by calendars and to do lists, because we know we’ll forget what it is we're supposed to be doing the moment the next shiny object (or email, or tweet, or phone call) appears. We develop hundreds of little tricks, like our dyslexic brethren who often unconsciously develop tricks to read well enough to get by.

But at the end of the day, these are just tricks. They're just coping strategies to help us in a modern world that demands skills that we don't naturally have. Sometimes, all of these tricks combined still aren't enough, or some of the tricks stop working, and suddenly the whole rickety scaffolding holding us together collapses.

Keep Up

We're not victims, though. This article might seem like a self-indulgent pity piece, but it's not. It's an attempt to describe why some of the people in your life might always seem to be one small crisis away from a complete meltdown. It's also reminder to myself to show more forgiveness - to myself and others. And it's a call for greater understanding of the entire range of neuro-chemical differences that causes a lot of people in this world to feel out of place. It's easy to dismiss ADD and a range of other conditions as paltry excuses for moral failings. It doesn't matter, though. Those of us with "deficiencies" in our brain chemistry - whether it's ADD, dyslexia, anxiety, or depression - have had to work pretty hard every day just to seem normal. We're so good at it, a lot of us don't even realize that we're doing it. We’ve been dealing with disappointment - from ourselves and others - our entire lives. A little disbelief isn’t going to make a difference.

But if you think there might be something to it, and if you want to know what it feels like to have ADD, imagine your're running through thick fog along a hilly trail covered with large rocks and tree roots. You have to keep running, because everyone else is running, and they don’t seem to have any trouble seeing the trail at all. But you can only see a few feet in front of you. You have two choices: slow down and pay attention to every blurry shape on the trail and get left behind; or charge blindly ahead, make what adjustments you can, hope that you won’t miss something, and pray that somehow you'll make it through in one piece. Imagine yourself in this position, and then tell me that you woudn’t be exhausted by the constant fear and anxiety. Or that you wouldn’t ever just fall flat on your face.

Think about that the next time you're wondering why someone always seems to be falling behind, because there are probably a lot of things you can say that are much more constructive than, "Keep up."

"One thing you who had secure or happy childhoods should understand about those of us who did not. We who control our feelings, who avoid conflicts at all costs or seem to seek them, who are hypersensitive, self-critical, compulsive, workaholic and, above all, survivors; we’re not that way from perversity and cannot just let it go. We’ve learned to cope in ways you never had to."

Piers Anthony - Author's Note from Fractal Mode