Reflections on The Emperor of All Maladies

I’ve been listening to Siddhartha Mukherjee’s The Emperor of All Maladies [public library] on audiobook for the past few days.  The book is a history of cancer and the medical community’s various efforts to fight the disease.

What I have learned thus far:

#1.  If I were dropped back in the 1800s or prior without access to modern medicine, practicing proper sanitation/hygiene, using carbolic acid on cuts to prevent infection, and staying the fuck away from “doctors” will expand my lifespan considerably.  In fact, seeing a “doctor” (aka butcher/quack) is most likely to result in a very painful death (e.g. by infection, blood loss, traumatic surgery, poisoning, etc.)

#2.  Preventative care for the win, because it sounds like cancer is mostly incurable and all the treatments sound extremely painful.  Basically, cut sugar, do keto, and start intermittent fasting to clean out the useless cellular detritus in your body and signal to your body that now is NOT the time to go on an uncontrolled growth binge because resources are tight.

#3.  Just because someone is a doctor doesn’t mean they automatically know the right answers.  You need to do your own research and come to your own conclusions.  Some doctors don’t know jack shit.  And/or their egos are so inflated that they can’t even see that they don’t know jack shit.  Which results in poor patient care and outcomes.  Basically, no one cares about your life more than you.  So take what they tell you with a grain of salt.

#4.  Sometimes you gotta make a decision about whether you want to die a dignified controlled low-pain death, or eke out a few more extra days/months in extreme pain in the hospital.  Is it worth it to try those experimental trials?  Is it worth it to go through radical untested surgeries?  Sometimes irrational hope leads to a painful and ignoble way to die.  To the extent that you have the choice in how you die, you should make a reasoned choice.  Personally, if I catch an incurable disease, I’d rather not put myself through that extra misery, and I’d rather spare my family the hardship/burden (emotionally, financially, temporally) of going through a long expensive complicated and painful treatment process.  (But then, maybe I have an obligation to the rest of society/future patients to be a good little data point in that experimental trial so that my death can contribute to the medical corpus and maybe help with the search for a cure.)

#5.  Whenever I read history, I am reminded of how lucky I am to have been born in the 20th century.  To be able to live in a first world country (in what some might argue, is the best country in the world).  To have access to public sanitation, clean water, relatively unpolluted living environs, healthy(ish) food, civil rights, and of course, medical care that is usually more likely to make you feel better rather than worse.  I have been hospitalized twice in my life, and I am grateful that I had good experiences and came out fully recovered.  I had a life-threatening disease that would have killed me in any other prior era, but instead I was cured and got to live.  So thank you, all the people who have gone before me, who have died to make the world what it is today.  All of you heroes, experimenters, mad scientists, human guinea pigs, activists, politicians, donors, biochemists, and everyone else who quietly worked to make the world a better place.  I will do my best to pay it forward so that the next generation is also able to feel this sense of awe and gratitude.

The Virtues of Documentation

Recently I’ve been transitioning roles across teams.  The easy transitions have happened when the new team has been organized, and when they have good documentation (e.g. process docs, product requirement docs, design docs, training docs, etc.).  When there are no such docs, transitioning is a long and confusing slog bouncing from one person to the next, trying to collect important information but realizing that each person has a slightly different understanding of what the state of affairs is, and that you might be the one responsible for piecing together what the actual source of truth looks like.

So.  Let me extol the virtues of writing documentation!

#1.  Documentation forces you to clarify your thinking, lay out all assumptions, and make sure that everyone is on the same page.

When you write something down, you distill nebulous ideas into concrete form.  You open up for comments.  You share commitments and make sure that everyone shares the same view of the world.  You find out if the definition for a piece of jargon you’ve used for the past 3 months is actually wrong.  You confirm that you and other people on the team are talking about the same thing when you talk about X or Y process.  You check and confirm that every action item committed to has been completed.  You collect all future plans in the same place and make sure everyone understands what they are supposed to do next, and what they are working towards.


#2. Documentation allows you to identify weak points and areas for improvement.

Writing down how something works forces you to understand where things could go wrong.  It makes very clear when there are extra steps, or steps that don’t logically follow from previous ones.  You have the opportunity to track and record historical discussions of why this feature was chosen over this set of available options.  You get the opportunity to think about whether the current way of doing things is the best way.  When describing an existing process to a new team member, you may get more insight on whether legacy systems don’t actually make sense.  When you understand deeply and clearly how something works, you may see parallels in unrelated fields that help you improve your work.


#3.  Documentation is more enduring, shareable, and scalable than human memory.

If you have something written down in a document, you don’t need to spend brain space remembering all of its details.  It doesn’t matter if the project gets stalled for a quarter and then comes back to life the next quarter–you can just refer back to the documentation and know exactly where you left off.  If you have something written down in a document, you don’t need to personally respond to every question about it–just point them to the document.  Similarly, if you need to ramp up a new team member on the subject, you don’t need to spend hours 1:1 with them doing a brain dump of ideas and history, you can just refer them to the documentation and spend 30 minutes for Q&A (which can be made into another document, if you have to ramp up lots of new people).  This saves you a lot of time and mental anguish, and means that you can delegate more effectively.


Just remember to keep your documentation up to date.  Your team and future self will thank you.

A Field Guide to Getting Lost Book Notes

A Field Guide to Getting Lost [public library], by Rebecca Solnit, is a series of essays exploring what it means to get lost, the benefits thereof, its role in personal transformation, and a retelling of stories about her past and her life.  Some of this is like therapy for herself, coming to terms with family/friend issues.  Other essays deal with pieces of history, cultural differences, art history, movie/former writing, nature, etc.

The language is a bit annoying (she is too wordy).  People who like obscure literary/art references, flowery language, and artsy (what I associate with high brow New Yorker hoity toityness) would like this book.  I can understand why Brain Pickings LOVED this book (it’s very geared for that kind of audience).  It feels fluffy even though it addresses some deep topics (e.g. abandonment, child abuse, suicide).  Unfortunately the fluffiness doesn’t allow for a full exploration of that depth, although the book is not completely shallow.  Perhaps it’s that she sneaks up on touchy/deep subjects, sidles alongside, pokes it a few times, and then is away before you even really realized anything happened.  The obliqueness is annoying though, at least for me.  And perhaps this entire book was better for the writer (as therapy) than for the reader (who is just confused).


“Leave the door open for the unknown, the door into the dark.  That’s where the most important things come from, where you yourself came from, and where you will go.”


Meno: “How will you go about finding that thing the nature of which is totally known to you?”

“The things we want are transformative, and we don’t know or only think we know what is on the other side of that transformation.  Love, wisdom, grace, inspiration–how do you go about finding these things that are in some ways about extending the boundaries of the self into unknown territory, about becoming someone else?”


On literal getting lost:

It usually happens b/c ppl are (1) not paying attn, (2) don’t know how to get back, or (3) don’t admit they don’t know

“Children…are good at getting lost, because ‘the key in survival is knowing you’re lost’: they don’t stray far, they curl up in some sheltered place at night, they know they need help.”


There’s one art to reading the landscape of things and knowing your way around (domain knowledge), but another art to remain calm in the face of the unknown (which is a general skill that one can develop and then apply across multiple domains)–if you remain calm in the face of the unknown and know how to get yourself unlost, you’re never truly lost per se, just not fully aware of specifically where you are at a particular point in time

“‘I never was lost in the woods in my whole life, said Daniel Boone, ‘though once I was confused for three days.’”


Historian Aaron Sachs: “[Explorers] were always lost, because they’d never been to these places before.  They never expected to know exactly where they were.  Yet at the same time, many of them knew their instruments pretty well and understood their trajectories within a reasonable degree of accuracy.  In my opinion, their most important skill was simply a sense of optimism about surviving and finding their way.”


Cultures who value wandering:

  • Crisis happens in your life, perhaps some kind of unbearable loss or shaking of the foundations of your identity/narrative
  • You must lose yourself and divorce yourself from all the normal triggers of your life that bring about uncomfortable reminders
  • You go wandering into the wild places, alone, or with little company, to outposts and small villages, places where you can lose yourself
  • Rinse and repeat until you die, or until you find some measure of wisdom/acceptance on this journey and then return as a shaman/wisewoman/man

Some people need to destroy their old identities and find new ones.  Or life deals them some radical shift such that by the time they acclimate to their new situation they find that they’ve changed themselves to a person who would no longer be comfortable in their old life (even if they originally wanted to return to the old life).


Interesting tidbit about tarot card for Justice:

“Justice, a book on classical lore asserted, stood at the gates of Hades deciding who would go in, and to go in was to be chosen for refinement through suffering, adventure, transformation, a punishing route to the reward that is the transformed self.”


Regarding desire: instead of always focusing on how to get what you desire, maybe you should change your perspective and just enjoy the sensation of desiring something.  To “look across the distance without wanting to close it up”.


“Beauty is often spoken of as though it only stirs lust or admiration, but the most beautiful people are so in a way that makes them look like destiny or fate or meaning, the heroes of a remarkable story.  Desire for them is in part a desire for a noble destiny, and beauty can seem like a door to meaning as well as to pleasure.”


Interesting take on Persephone myth:

“Maybe Persephone was glad to run off with the king of death to his underground realm, maybe it was the only way she could break away from her mother, maybe Demeter was a bad parent the way that Lear was a bad parent, denying nature, including the nature of children to leave their parents.  Maybe Persephone thought Hades was the infinitely cool older man who held the knowledge she sought, maybe she loved the darkness, the six months of winter, the sharp taste of pomegranates, the freedom from her mother, maybe she knew that to be truly alive death must be part of the picture just as winter must.  It was as the queen of hell that she became an adult and came into power.”


On people who do reckless things:

“I wonder now about Marine’s abandon.  In a way it seems brave to me, this charging into adventure without fear of consequences.  Or was it a desperation in which there were more terrible things than death, a desire so urgent for the anesthesia, distraction, and sense of destiny drugs seem to offer, even a desire for death?  Was I cowardly not to want to explore the farther reaches of consciousness, afraid of getting lost, of being unable to return?”


“Adulthood is made up of a prudent anticipation and a philosophical memory that make you navigate more slowly and steadily.  But fear of making mistakes can itself become a huge mistake, one that prevents you from living, for life is risky and anything less is already loss.”


Awareness per a Zen teacher:

Seeing how you balance between fear and complacency when approaching a new situation

“…human beings have asked themselves, Hmmm, how do I engage this process in a way that I don’t become too frightened by what it might unfold or too complacent by avoiding it?  This is the delicate work of awareness.”

“We see someone and make up a story about who they are, and sometimes we get ourselves into a lot of trouble with the stories we make up as we weave our world.  And the practice of awareness doesn’t say don’t weave your world.  That’s what we’re hardwired to do…The practice of awareness says don’t grasp it too tightly, don’t be too convinced.  And in that simpler way of being…it’s okay to sometimes experience not knowing what to do next, to run into a barrier.  It’s okay to realize that life has a mysterious quality to it, it has an element of uncertainty, it’s okay to realize that we do need help, that calling out for help is a very generous act because it allows others to help us and it allows us to be helped.”

Absolutely on Music Book Notes

Every once in a while, I will finish a book I should have stopped reading 20 pages in.  Usually this is due to some bullheadedness on my part: I should like this book, damn it, so maybe if I just read a few more pages I’ll get into it?  And then a few hundred pages later, I close the book and realize it was a lost cause.

That being said, this book, Absolutely on Music [public library] was just too outside of my realm of knowledge to be engaging.  It’s one of Murakami’s nonfiction books.  And since I loved his What I Talk About When I Talk About Running [public library] so much, I kept trying to give this book more chances (which alas is what I tend to do to his fiction books, which I tend regret spending time to read after the fact).  Anyways, this book is a conversation between Murakami and Seiji Ozawa, one of the most famous conductors of classical music in the world, and the first famous Japanese conductor in that world.  Their conversations range from classical music and different interpretations of the same songs by different conductors/orchestras, how writing is like conducting, and various interesting stories from Ozawa’s life and work.  There are some vignettes from Ozawa’s early work history under Lenny Bernstein and Karajan (famous conductors?), later career and recordings, foray into opera, his impromptu/once-a-year orchestra in Japan, and involvement in music education in the string quartet camps he created.

Honestly, if I was a bigger classical music buff, I’m sure I would have gotten so much more out of this.  Or, maybe, if I had listened to this book on audio and they included soundtracks of the different songs they discussed, I would have more context to put their conversations in.  As it stood, it made me feel very ignorant of a deep world of music, as if they were talking about things I had no experience of, despite playing violin in an orchestra for 7 years.  Then again, I was at best an indifferent violinist…Anyways.  If you are a classical music buff and get the song references below, you’ll get a kick out of this book, and perhaps will understand the nuances of musical interpretation that various conductors and symphonies have.

More general non-music related takeaways:

  • It helps if you have the talent and if you start practicing early, but nothing replaces hard work ethic.
  • In art, possibly there is some inescapable innate talent required.  But this might also be a function of life experience.
  • Stay the fuck away from politics.  Assume the best of everyone, work hard, help people out, be passionate about things, always try to do the best for your particular tribe, and generally you’ll be treated well.
  • The more you take on, the more voracious you are about learning, the faster you will learn–if you’re willing the price in time and outwork your peers, that will all pay off.
  • Every master has their own unique style.  You should focus on thinking about what unique thing YOU want to bring into the world is, what your world view is.  Technical mastery is one thing, but without vision you’re only good as a tool for someone else to direct.
  • If you are passionate about something and pay attention to the details, you don’t need a degree or advanced study to pick up on fascinating patterns and variations.  You just need to pay very close attention.
  • Again, do what you love and it won’t feel like work.  Or at least, it will feel meaningful enough that even when it feels like work you’ll still be motivated to stick with it.
  • Ozawa’s early career success sounds like an example of Ryan Holiday’s idea of the canvas strategy–he took on extra work to make his bosses’ lives easier, and since they were famous conductors, he got to learn their techniques and build relationships which resulted in them recommending him for prestigious conductorships around the world.


Book Notes:


Murakami–musical layman, no technical training, just knows that he likes good music

“Basically, I believe that music exists to make people happy.”


Things Ozawa and Murakami have in common–a sense of craftsmanship, flow, and purpose in work:

“…what I mean here is that I can feel a sense of identity in the way we live our lives.

First of all, both of us seem to take the same simple joy in our work. …both of us are happiest when absorbed in our work.  And the very fact that we are able to become so totally engrossed in it gives us the deepest satisfaction.  What we end up producing as a result of that work may well be important, but aside from that, our ability to work with utter concentration and to devote ourselves to it so completely that we forget the passage of time is its own irreplaceable reward.

Secondly, we both maintain the same ‘hungry heart’ we possessed in our youth, that persistent feeling that ‘this is not good enough,’ that we must dig deeper, forge farther ahead.  This is the major motif of our work and our lives. …

The third of our shared traits is stubbornness.  We’re patient, tough, and, finally, just plain stubborn.  Once we’ve decided to do something in a certain way, it doesn’t matter what anybody says, that’s how we’re going to do it.  And even if, as a result, we find ourselves in dire straits, possibly even hated, we will take responsibility for our actions without making excuses. …”


On the self-centeredness of creative pursuits:

“Creative people have to be fundamentally egoistic, this may sound pompous, but it happens to be the truth.  People who live their lives watching what goes on around them, trying not to make waves, and looking for the easy compromise are not going to be able to do creative work, whatever their field.”


On habits of working:

“Like Ozawa, I also get up at four in the morning and concentrate on my work, alone.  In winter, it’s still pitch dark, with no hint of sunrise and no sound of birds singing.  I spend five or six hours at my desk, sipping hot coffee and single-mindedly tapping away at the keyboard.  I’ve been living like this for more than a quarter of a century. …It often occurs to me that this life of mine would not exist if I lacked the ability to concentrate.”


On work as life:

“As I watched him in action, however, one thing dawned on me: He can’t help himself; he has to do this.  His doctor, his gym trainer, his friends, and his family could all try to stop him (and of course they did try, to a greater or lesser degree), but this was something he had to do.  For Seiji Ozawa, music was the indispensable fuel that kept him moving through life. …There was only one way in this world for him to feel truly alive, and that was for him to create music with his own hands and to thrust it as a living, throbbing thing into the faces of an audience: ‘Here!’  Who could possibly tell him to stop?”

“To put it simply, this man was living in a world that transcended reasonable ways of thinking, just as a wolf can only live deep in the forest.”



Beethoven Third Piano Concerto in C minor

Beethoven’s 9th

Beethoven’s Fidelio opera

Beethoven’s String quartet no. 16, no6, no13

Brahms’s Piano Concerto No. 1 (in D minor)

Brahms First Symphony

Berlioz (who is apparently crazy) Benvenuto Cellini; Symphonie fantastique; Grandes Messes des Morts, The Damnation of Faust

Mahler Ninth

Mahler Second Symphony

Mahler Fifth Symphony

Mahler First Symphony

Mahler’s Das Lied von der Erde

Mahler Eighth Symphony

Bruckner Ninth

Mozart’s string quartet no. 15 in D minor (K. 421)

Mozart’s Divertimento K 136

Mozart’s Haffner Symphony

Bartok’s Concerto for Orchestra

Bartok Piano Concerto No 1

Bartok Piano Concerto No 3

Bartok Divertimento for String Orchestra

Toru Takemitsu’s November Steps

Tchaikovsky’s Serenade for Strings

Tchaikovsky Piano Concerto no1

Tchaikovsky’s Eugene Onegin

Tchaikovsky’s Fifth Symphony

Tchaikovsky’s Fourth Symphony

Tchaikovsky’s Queen of Spades

Handel’s Concerti Grossi

Bach Brandenburg concerto

Bach Well-Tempered Clavier

Schoenberg’s Verklarte Nacht

Poulenc opera

Honegger opera

Sibelius Fifth Symphony

Richard Strauss’s Elektra opera

Richard Strauss Burleske

Richard Strauss Metamorphosen

Schumann Piano Concerto

Messiaen’s Turangalila Symphony, Oiseaux exotiques, Saint Francois d’Assise

Stravinsky’s Rite of Spring

Stravinsky’s Firebird and Petrushka

Mussorgsky’s Pictures at an Exhibition

Mussorgsky’s Boris Godunov

Orff’s Carmina Burana

Debussy’s La Mer

Debussy’s Pelleas et Melisande

Britten’s War Requiem

Ravel’s L’Enfant et les sortileges

Ravel String Quartet in F Major

Rigoletto opera

Don Giovanni opera

Cosi fan tutte opera





La Boheme

Madam Butterfly

Manon Lescaut



Ginastera’s Estancia op. 8

Weber’s Oberon

Haydn’s String Quartet No 75, op 76, no1

Smetana’s String Quartet no1

Janacek String Quartet no1

Schubert String Quartet no13

Mendelssohn String Octet in E flat major

Grieg’s Holberg Suite

Dvorak’s Serenade for Strings

Hugo Wolf Italian Serenade


On empty spaces:

“In Japan we talk about ma in Asian music–the importance of those pauses or empty spaces–but it’s there in Western music, too.  …Not everybody can do it–certainly no ordinary musician. …Or if they do, the spaces don’t fit in as naturally as this. [in Glenn Gould’s Beethoven Concerto]  It doesn’t grab you–you don’t get drawn in as you do here.  That’s what putting in these empty spaces, or ma, is all about, isn’t it?  You grab your audience and pull them in.”


On the similarity between music and writing to Murakami:

“No one ever taught me how to write, and I’ve never made a study of writing techniques.  So how did I learn to write?  From listening to music.  And what’s the most important thing in writing?  It’s rhythm.  No one’s going to read what you write unless it’s got rhythm.  It has to have an inner rhythmic feel that propels the reader forward.”

“…the rhythm comes from the combination of words, the combination of the sentences and paragraphs, the pairings of hard and soft, light and heavy, balance and imbalance, the punctuation, the combination of different tones.  ‘Polyrhythm’ might be the right word for it, as in music.  You need a good ear to do it.  You either can do it or you can’t.  You either get it or you don’t.  Of course, it is possible to extend one’s talent for rhythm through hard work and study.. …I write as if I’m making music.”


Ozawa’s 10K hours:

As a young conductor, he acted as the assistant conductor to Lenny Bernstein, conductor for the NY Phil.  B/c Ozawa was poor and obsessed with music, he ended up spending almost all of his time at the rehearsal hall, poring over scores, reading scores, watching rehearsals, watching the conductor, sounding things out on the piano, etc.  Altho there were 3 assistant conductors and they were supposed to divide up scores evenly to cover in case Lenny got sick, in practice Ozawa learned everyone’s scores b/c the other 2 assistants had other jobs and occasionally also couldn’t make it.  So his sense of responsibility meant that he learned 3x as fast and worked 3x as hard.


Interesting: the same songs sound different when played by different symphonies (even if same conductor).  The same conductor may choose to express the music differently at different points in his life: enthusiastically when young, more nuanced/nurtured/mature when older


On Ozawa’s technique (he seems to think it was innate, or learned early on in college w/Prof Saito, but then it turns out he had been conducting orchestras since middle school):

“So then, when I got to observe Lenny or Maestro Karajan conducting close-up, I pretty much understood what they were doing.  I could see what they were trying to do.  I could look at them analytically.  So it never occurred to me to mimic their techniques.  By contrast, someone who doesn’t have his own technique in place ends up imitating someone else’s outward form, just superficially copying another person’s movements.  That didn’t happen with me.”


On how vision is necessary before one can usefully apply technique:

“MURAKAMI: Yes, but even before that–you have to have a clear image in your own mind of exactly what you want to do and how you want to do it.  If you’re writing fiction, say, it’s important to be able to write, of course, but before that you have to have a strong sense in mind of something you are determined to write about.  As far as I can tell from your records, at least, you always had a strong self-image from the time you were young.”

“It seems to me that the world is full of musicians who…while they have a high overall level of technical mastery and can perform music that may be technically flawless, they rarely communicate a distinct worldview.  They don’t seem to have a strong determination to create their own unique worlds and convey them to people with raw immediacy.”


On Ozawa and the canvas strategy (part 2):

When Lenny (Bernstein) went on sabbatical, Ozawa “house-sat” the orchestra for him, which meant doing chores for the orchestra, inviting guest conductors, making the arrangements for the guests, etc.  He became friends with these famous guest conductors, who later recommended him to lead other famous symphonies around the country.


On connections between music and art:

“And when I first saw the work of Klimt and Egon Schiele, they came as a real shock to me.  Since then, I’ve made it a point to go to art museums.  When you look at the art of the time, you understand something about the music.”

“There’s something about it [Klimt’s art], I don’t know, that tells you about the importance of madness, or that transcends things like morality.  And in fact, at the time, morality was breaking down, and there was a lot of sickness going around.”


What is special about Ozawa (ability to deep dive into music and see it high level all at once):

“Maybe it’s a bit too much to be talking about ‘special powers,’ but there are these people who have the ability to simultaneously take in all parts of some complex object or some convoluted idea all at once, like taking a high-resolution photograph of it.  Maybe you have something like that going on with music rather than understanding it through logical analysis.”


Ozawa insulates himself from politics by being bad at the language and purposefully distancing himself from it.  Also he seems rather oblivious to ppl being mean to him, and tends to assume the best of ppl, which perhaps causes them to treat him better.

Gratitude (graceful essays on death) Book Notes

Gratitude [public library] is a collection of 4 essays written by Oliver Sacks, the famous neurologist/writer, shortly before he dies of cancer.  These essays include reflections on how he feels as an 80 yr old, vignettes from his life, things he appreciates, his hobbies, finally coming to terms with some of his wobbly bits (i.e. publicly coming out), how he came to be who he is, what his interpretation of the meaning of life is, etc.  It’s a very short but charming read (pair with Insomniac City), and reminds me a bit of When Breath Becomes Air [public library] in its approach to death.


  • Everything in life should be appreciated because it has an upside and a lesson, including death (bringing clarity/urgency on what’s important in life) and old age (wisdom, perspective)
  • One should take a Stoic approach to death, no hysterics, just accept the facts and do the best with what is within your control
  • In the end, what is important is your tribe (family, friends, work peers, and in this case book readers) and your relationships, and the sense that you have given back to the world with your work
  • Recognize how you cope with loss, what your brand of escapism is, and embrace it (turn it into a strength–addictive personalities can achieve six sigma results if passionate about the right things; relatedly, find things to obsess about)
  • Think about your death, the transience of life, and the immensity of the universe (and your small place in it); this will prompt you to appreciate the beauty of fleeting moments, to put your troubles in perspective, to allow you to focus on the bigger picture, and to lend more urgency and willpower to your actions
  • Consider introducing a rest day into your life where you focus on meditation, no media/electronics, long walks in nature, introspection, thinking/reading/writing, and napping


Book notes:

On gratitude to be alive:

“At nearly eighty, with a scattering of medical and surgical problems, none disabling, I feel glad to be alive–’I’m glad I’m not dead!’ sometimes bursts out of me when the weather is perfect. …I am grateful that I have experienced many things–some wonderful, some horrible–and that I have been able to write a dozen books, to receive innumerable letters from friends, colleagues, and readers, and to enjoy what Nathaniel Hawthorne called ‘an intercourse with the world.’”

[meaning and significance from writing and correspondence with his tribe about his work]


When he was 41, he broke his leg mountaineering alone and thought he would die, had these memories: “Most were in a mode of gratitude–gratitude for what I had been given by others, gratitude too that I had been able to give something back.  Awakenings, my second book, had been published the previous year.”


Old age does not cure all of our foibles and insecurities and shortcomings:

“I am sorry I have wasted (and still waste) so much time; I am sorry to be as agonizingly shy at eighty as I was at twenty; I am sorry that I speak no languages but my mother tongue and that I have not traveled or experienced other cultures as widely as I should have done.”


But old age does have some benefits:

“My father, who lived to ninety-four, often said that the eighties had been one of the most enjoyable decades of his life.  He felt, as I begin to feel, not a shrinking but an enlargement of mental life and perspective.  One has had a long experience of life, not only one’s own life, but others’ too.  One has seen triumphs and tragedies, booms and busts, revolutions and wars, great achievements and deep ambiguities.  One has seen grand theories rise, only to be toppled by stubborn facts.  One is more conscious of transience and, perhaps, of beauty.  At eighty, one can take a long view and have a vivid, lived sense of history not possible at an earlier age.  I can imagine, feel in my bones, what a century is like, which I could not do when I was forty or sixty.  I do not think of old age as an ever grimmer time that one must somehow endure and make the best of, but as a time of leisure and freedom, freed from the factitious urgencies of earlier days, free to explore whatever I wish, and to bind the thoughts and feelings of a lifetime together.”


On the things that matter most to him/what gives meaning and significance to life:

“Perhaps, with luck, I will make it, more or less intact, for another few years and be granted the liberty to continue to love and work, the two most important things, Freud insisted, in life.”


“…I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight.

This will involve audacity, clarity, and plain speaking; trying to straighten my accounts with the world.  But there will be time, too, for some fun (and even some silliness, as well.”


“And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual but on what is meant by living a good and worthwhile life–achieving a sense of peace within oneself.”


On how to face death:

“When my time comes, I hope I can die in harness, as Francis Crick did.  When he was told that his colon cancer had returned, at first he said nothing; he simply looked into the distance for a minute and then resumed his previous train of thought.  When pressed about his diagnosis a few weeks later, he said, ‘Whatever has a beginning must have an ending.’  When he died, at eighty-eight, he was still fully engaged in his most creative work.”


After finding out his cancer had returned and that he had only a few months to live:

“It is up to me now to choose how to live out the months that remain to me.  I have to live in the richest, deepest, most productive way I can.”

[a very Stoic approach to things–just focus on what you can control and don’t bother worrying about the things you cannot change, such as impending death]


On the detachment/clarity of thought that knowing you are about to die gives you:

“Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts.  This does not mean I am finished with life.”

“I feel a sudden clear focus and perspective.  There is no time for anything inessential.  I must focus on myself, my work, and my friends.  I shall no longer look at the NewsHour every night.  I shall no longer pay any attention to politics or arguments about global warming.” [How can one get this sense of urgency without that known death sentence/limited life span of months hanging over your head?]


On Sacks’ personality (sounds like he is one of those obsessive addictive personalities, so it was good that he found a passion/obsession in his work instead of stg less healthy):

“…I am a man of vehement disposition, with violent enthusiasms, and extreme immoderation in all my passions.”

“When I moved to Los Angeles, I found a sort of community among the weight lifters on Muscle Beach, and with my fellow neurology residents at U.C.L.A., but I craved some deeper connection– ‘meaning’–in my life, and it was the absence of this, I think, that drew me into near-suicidal addiction to amphetamines in the 1960s.

Recovery started, slowly, as I found meaningful work in New York, in a chronic care hospital in the Bronx…I was fascinated by my patients there, cared for them deeply, and felt something of a mission to tell their stories…I had discovered my vocation, and this I pursued doggedly, single-mindedly, with little encouragement from my colleagues.”


He deals with emotional loss/stress by escaping to science/#s (similar to Alan Turing):

“I have tended since early boyhood to deal with loss–losing people dear to me–by turning to the nonhuman.  When I was sent away to a boarding school as a child of six, at the outset of the Second World War, numbers became my friends; when I returned to London at ten, the elements and the periodic table became my companions.  Times of stress throughout my life have led me to turn, or return, to the physical sciences, a world where there is no life, but also no death.  

And now, at this juncture, when death is no longer an abstract concept, but a presence–an all-too-close, not-to-be-denied presence–I am again surrounding myself, as I did when I was a boy, with metals and minerals, little emblems of eternity.”

Sacks has a little coffee table that has a collection of metals and minerals that are the periodic table of elements (every birthday, he gets himself the relevant element)–Thallium is for 81st bday, lead for 82nd bday


Thoughts on death:

“There will be no one like us when we are gone, but then there is no one like anyone else, ever.  When people die, they cannot be replaced.  They leave holes that cannot be filled, for it is the fate–the genetic and neural fate–of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.”

[If deaths leave holes, then perhaps a solution is to fill your life up with so many new people that your world keeps expanding, and there is always more warmth than holes.  You can’t replace people, but you can replace relationships to some extent.]


Looking at the stars in the countryside:

“It was this celestial splendor that suddenly made me realize how little time, how little life, I had left.  My sense of the heavens’ beauty, of eternity, was inseparably mixed for me with a sense of transience–and death.”

[Reminds me of Japanese haikus and their appreciation for the beauty of transience.]

Random aside–Sacks was friends with Auden!  And Crick of Watson and Crick fame!  I guess they were alive during the same era and were part of the British intelligensia set, but I am still charmed by the unexpected connections.

“Auden used to say that one should always celebrate one’s birthday, no matter how one felt.”


Final essay in the book is a lot more personal–about his family, coming to terms with and healing separations and divides.

Sabbath: holy day when you are not to work, drive, use the telephone, turn on the light, or turn on the stove

Ritual starts on Friday–evening meal is 1st meal of Sabbath, you wear special clothes, say prayers, light candels, etc.

On Sabbath/Saturday, you go to synagogue and then do family visits with tea since all the extended family lives close by

“‘The observance of the Sabbath is extremely beautiful…and is impossible without being religious.  It is not even a question of improving society–it is about improving one’s own quality of life.’”


Formative event in his life:

When he was 18, his father made him admit he was gay, and then told his mother against Oliver’s wishes.  Mother “came down with a look of horror on her face, and shrieked at me: ‘You are an abomination.  I wish you had never been born.’”

“…her harsh words made me hate religion’s capacity for bigotry and cruelty.”  Then once he qualified as a doctor, he immediately left England and all the life/family he had there, and went to LA where he knew no one.


Later, in his 80s, he goes back to visit family in Israel for a cousin’s 100th bday and brings his lover Billy, where they are invited to a Sabbath meal–his reconciliation with his Orthodox Jewish past:

“The peace of the Sabbath, of a stopped world, a time outside time, was palpable, infused everything, and I found myself drenched with wistfulness, something akin to nostalgia, wondering what if: What if A and B and C had been different?  What sort of person might I have been?  What sort of a life might I have lived?”


Reading recs:

Hume’s autobiography ‘My Own Life’

Sacks’ other books about his patients: Awakenings, The Man Who Mistook His Wife for a Hat, Musicophilia, Hallucinations

Sacks’ memoir: On the Move

There is no right time, so stop waffling and just do it now

There is no right time, so stop waffling and just do it now.

You might not be ready yet, but what’s the worst that could happen?  Barring some life/limb-threatening consequence, better to jump now and deal with the fallout as it comes.  Fortune favors the bold.

What if you look stupid?  Then accept that you look stupid and do it.  If you worry about this, you need to learn more lessons in humility.  Hence more reason to act even when unsure.

What if people are offended?  If you care too much about social approval and the opinions of others, you’ll never be able to achieve peace of mind, much less happiness.  Perhaps if you care too much about social approval you should purposefully do things to stand out and offend people.  Be different on purpose.  Step over the damn line.  Self-expression and freedom to pursue the things you deem important (not society, not your friends, not your parents, not your social media followers, but YOU) is what you should really care about.  Don’t wait for permission.  You give yourself permission.  Just do it.  Yesterday is better than today, and now is better than later (or never).

Need more motivation?  Think back to all of those times when you hesitated and the opportunity passed.  Think of the bitterness your regret.  Think of the promises you made to yourself (never again!).  Think of the jealousy or envy or admiration and fire and competitive spirit for those who DID take action.  Now do it.

Yeats “He Wishes For the Cloths of Heaven”

Romantic poetry confuses me.  On the one hand, I am touched by the depth of feeling the author feels/evokes, and by the beauty of her/his word choice.  On the other hand, I am disgusted by the overly sentimental irrationality reflected in them–the content reflects minds that are insecure, disturbed, juvenile, immature, unstable, etc. etc. etc.  Perhaps this is because the “love” written about in romantic poetry tends to be that passionate immature love that burns brightly and then flares out (and tends to leave a path of destruction in its wake).

In any case, today I was reminded of this Yeats poem:

Had I the heavens’ embroidered cloths,
Enwrought with golden and silver light,
The blue and the dim and the dark cloths
Of night and light and the half light,
I would spread the cloths under your feet:
But I, being poor, have only my dreams;
I have spread my dreams under your feet;
Tread softly because you tread on my dreams.

I suppose (being an uncultured sort) I shall just resign myself to irrationally loving these verses: “But I, being poor, have only my dreams; I have spread my dreams under your feet; Tread softly because you tread on my dreams.”

The danger of local optima

A lot of the time things get worse before they get better.  That does not excuse you from making progress.

The most dangerous moment is when you reach a local optimum and get complacent.  The global optimum is out there, but to get there you will have to get through some sub-optimal points.  Don’t be so attached to your comfortable local optimum that you stop moving forward to the long term better thing.

Yes, life is good and you should appreciate what you have.  But at the same time, never forget that if you are taking the circuitous route, this rest stop, this scenic vista, is not the end of the line.  There is more to go.  You must go on.  To dally, to stand still, is dangerous, is death.

The danger lies in getting complacent and so comfortable (in eating the lotus) that you forget what you originally came here for.  You forget the dream, the beautiful impossible thing that lit a fire in your soul and made your heart sing.  Life is not meant to be a gray plod, and it’s also not meant to be this bland mediocrity.  You must keep taking risks and adding color.  You must not lose sight of the most important thing.  You must not allow yourself to be led astray, nor to be cosseted to sleep.  Keep moving, and seize those moments of extreme lucidity (in fact, introduce hardship and hard conversations into your life to elicit those doses of harsh reality).  The aim is to have lived a full and meaningful life, and not to regret what you didn’t do when you lie at death’s door.  Don’t forget, and step out of that local optimum.