I’ve been intrigued by the recent presidential debates and interviews and analyses and pundit commentary.

One of the issues that has come up has been how the candidates handle adversity, even at this very early time in the 2016 race.

They say that Donald Trump is in it for the thrill and the fun and sheer ego-boosting ride that is pre-caucus and pre-primary politics, when the love of the American people can be, all at once, embracing, supportive, petty and fickle. When it is no longer fun, the story goes, he will be gone too.

Ben Carson is too quiet, too low-energy, too easy-going to be the Chief Executive, his detractors say. The man is a trained neurosurgeon, but he is still portrayed by some as soft and weak and not presidential.

Jeb Bush has come across as hurt, frustrated, angry, and apathetic, a candidate whose temperament might have been better suited to 1950s politics than today’s fast-paced, multi-tiered, multi-threat politic landscape. “I have better things to do than…” he said.

The Democrats are not immune from this kind of talk either. Hillary has come out on the  other side of fifteen days of talks, hearings, attacks and smears designed to knock her down and keep her down for the count. She has not ceased to bounce back up and arguably has the Democratic nomination locked up even before the first snowy caucus is held in Iowa.

Adversity comes in many forms for the presidential hopeful. If he or she cannot handle the heat of the pre-primary kitchen, how in the world can they ever be expected to stand the blazing heat of the world stage after victory is won? This part of the process is by design a winnowing, a series of tests to see who has it, and who doesn’t.

I have had some adversity in my own life of late. I’m sure you have too. I sometimes think that I finally have it all figured out, that I have my ducks in a row, that my plans are sound and that my path to success and victory in life is clear and obstacle free.

Then, something happens.

Someone does something that I am not prepared for, pulling the rug out from under me.

Someone says something that makes me wonder about their allegiance, their resolve, their loyalty.

Someone does something that makes me doubt the goodness of man as a whole, frustrating me and making me angry.

It is at these times that I must sit myself down and give myself a pep talk, a gentle chiding.

Sure, I could always take the easy way out, and many times I have been tempted to do so. Stop trying, stop caring, stop being flexible, stop coming up with innovative solutions and new answers.

I could quit because sometimes life is just not fun any more. I could abdicate my responsibility to my coworkers, friends, family, or others who look up to me or count on me to be strong.

Sometimes I simply do not feel that strong.

No matter.

Life goes on, with all its wonderful surprises and deep emotions and withering assaults and twisting, turning, enigmatic shifts of perspective and vision. If we want to live life, really live it, we can’t bow out at the first sign of heartache or trouble or difficulty. Not in the arenas that we hold dear.

We must be steadfast in the face of adversity.

Adversity builds character.

Character holds us up, buoys us in times of great stress and trouble. Without it, we drift and are tossed about like so much chaff on the wind.

Adversity, whether for presidential hopefuls or for you and me, is the crucible in which the ore of resilience is refined.

Embrace it, face it head on, and you will be stronger.

Things Pondered Whilst Drinking Korbel Brandy

My lady friend and I have just finished an eight day,  212 mile biking trip across five valleys in northern California: Napa, Sonoma, Dry Creek, Alexander, and Russian River. We saw many things including acre upon acre of beautiful autumn-tinged grapevines, shady country lanes and active geysers. We ate food at Michelin-starred restaurants, sampled some of the best wines we’d ever tasted, talked with new friends and learned the value of time spent in a local country store.

I thought I would share just a few of my insights, gleaned while pedaling, napping, eating, and drinking on this very active, always-moving vacation. Indulge me, if you would be so kind.

First of all, flying standby is just what it says. You show up at the airport, boarding pass in hand, but it says STANDBY on it. You get through security, TSA-Precheck if you’re very lucky, and you STANDBY some more until your name turns blue on the little board. Sometime the evil gatekeepers make you STANDBY until the very last minute, as the boarding doors are closing, even though there are clearly thirty open seats on the plane. Am I complaining about this? Of course not. I did make it out to San Francisco and back, after all. (Thanks, Scooter)

San Francisco is a very neat city. It has clam chowder; sourdough bread; vocal, nine foot, aggressive, hungry sea lions; and hills. Lots of hills. You get the hill street blues in San Francisco, especially if you decide to get off the cablecar and walk. (I would not recommend this).

This Just In! The Golden Gate Bridge is not golden. It is a rusty orange. It had no visible gates that I could see. I had Trina take my picture standing on it, for my birthday, anyway. You never can tell when the painters  might actually get the color right on the next coat, or when the whole thing might be closed off by a piece of swinging wood with a Master lock on it. it could happen. I guess The Rusty Ungated Bridge would not attract as many tourists.

Alcatraz would make a nice place for a game of hide and seek.

If anyone tells you, “Hey, it’s easy! Just like riding a bicycle!”, don’t believe them. If the last bicycle you rode was red, had a big padded tush toter and had one gear, beware of the hybrid bike with twenty seven gears and a skinny-ass unpadded (read HARD) seat being fitted to your middle-aged body. It is about to be your home for five or six hours a day for the next week.

Day One: wine is your friend.

Goats are funny. Some of them bleat. Some of them butt their offspring. Some goats faint. I kid you not. Look it up.

Geysers are playful and cantankerous. They tease. Even when the nice lady up front says that the Old Faithful Geyser of California should treat us to a show every thirty minutes, and that she expects the next eruption in twenty minutes (just enough time to resuscitate a goat that just fainted), she then offers us some wine while we wait. It is ten in the morning, This is not a good sign.

The geyser does its geyser thing, but after nine, count ’em (Trina did, and videoed them all too) nine false starts. Ten times was the charm. It was underwhelming, but hey, we could have flown STANDBY to Yellowstone, yes?

Grapes picked off the vine surreptitiously are the sweetest, juiciest, best in the whole world. (No, I did not have to bail her out, thank God.)

You can have chocolate, really, really good chocolate, and coffee, and more chocolate on your birthday and nobody can stop you.

The tall white hats that chefs wear used to have 101 pleats in them to signify the 101 uses that the egg could be put to by a well trained chef. You’re welcome.

There is a characteristic smell, pungent and grape-y and musty and fertile, that one experiences when riding a bicycle through the wine country. I would bet that no one riding in a car ever experiences this wonderful smell in quite the same way that the cyclist does.

French oak barrels are works of art.

Porch sitting with your companion, reading a newspaper, planning the next day’s ride, eating cheese and drinking wine, stretching your tired legs and petting the cat are as close to heaven as you need to be on this earth.

Watching olives being harvested is too cool for words.

Standing next to the actual desk that was used in the filming of The Godfather is surreal.

Finding that there is a hill, a winery driveway to be exact, that is so steep that you can barely get off your bike and push it up to the top with all your might and determination is quite humbling.

I never knew that sitting in the sun, having lunch and good conversation, and drinking excellent champagne could bring such midday joy.

Entering a redwood grove is like entering a cathedral. Cool, misty, mysterious, and so quiet that you hardly want to break the silence by whispering your awe. Can you just imagine the stories a 1400 year old redwood tree could tell?

The Pacific Ocean has more hues of blue and green than can be described in words.

A boat on the bay. A kayak. A mailbox. A flower. “It’s that spot of red…” (Trina Watters, the painter, paraphrased)

Finally, why do they insist on calling it the shoulder of the road, anyway?

“You will have a much narrower shoulder for the next three miles”, or “You will enjoy a much wider, smoother shoulder on tomorrow’s ride”.

I suppose they could have called it the “butt” of the road.

But then, the Kardashians would not have been pleased at all at the prospect of “wider butts” in California, now would they?

After all, the shoulder is the first thing that might likely hit the ground if a logging truck crowded you and pushed you off to the right, just short of the Pacific cliffs.

No. luckily, that never happened.

This was the best vacation ever.

No ifs, ands, or butts.


There are thousands and thousands of applications, or apps, on the Apple App Store for iPhone and iPad. Many are free or very low-cost. Some cost tens or even hundreds of dollars.

I have purchased or downloaded three hundred ninety-seven apps from Apple in the last eight years. Probably more than that, but that’s what I still see on the store when I check it out today.

Of those almost four hundred apps, I currently have eighty installed on my iPhone 6.

Of those eighty, eighteen are on my home screen, which to me means that I use those eighteen apps multiple times every single day.

Now I wager that some of you have many more apps than I do, and most of you likely have less.

One thing I have noticed about myself and  my use of the iPhone, which I dearly love, since 2007 is that I am never quite satisfied with what I have.

The basic apps provided by Apple, for the most part, do a very good job at helping me keep track of my appointments, my to do lists, the weather and my social networks. Even so, I am always searching for something just a little bit better, a little more cutting edge, a little flashier or more colorful or with more animation. I’m not entirely sure why this is so, but I know that I have repeated the cycle of download-use-enjoy-tire of-delete-download-try something new more often than I can remember over the last eight years.

What is it about novelty, newness and difference that attracts us? What is it that makes us always think that what we have is not good enough, fast enough, slick enough or sufficient enough to get the job done, and well?

I know that when I have tried the latest podcast app or calendar or writing tool that most of the time I return to the apps that have served me well over many years, electing to use what I know works and is reliable over what might give me a few more thrills the first few days after I install it.

Sometimes, the tried and true is better for us, and serves us better, than the flashy, the novel and the new.

The safe, comfortable, in-control feeling I get from using tools that work and that I know won’t let me down more often than not offsets the transient thrills of promises made and glittering bells and whistles that I don’t really need anyway.

Sometimes, we think we can’t get satisfaction until we go to the ends of the earth, or the app store, to find the best.

In fact, what is best for us, and will serve us best in the long run, has been right in front of us all along.“>http://

The Dash

Okay, so news flash.

We will all die.

Some sooner; some later.

This is always brought home to me when someone famous or notorious or personally connected to me or my family passes on.

But wait! This is not a sad post.

What do we do in the meantime? What do we do “with the dash”, the time allotted to us between the birthday and the date of death that will one day be inscribed on a headstone or crypt plaque or other signage for each and every one of us.

  1. Embrace every single day. Get up in the morning ready to live. Physically grab the twenty four hours ahead of you. Look at them as a palette of new paints, a dictionary full of words not yet used, a long list of notes that only need organization to make a symphony.
  2. Do something fun. Life is hard, it’s messy, it’s tricky, but there is a lot of joy out there. So many of us have lost the capacity to go after it, find it, search for it, feel it. Paint a picture. Ride a bike. Eat an ice cream cone.
  3. Simplify. Cut out the unnecessary, the trivial, the time wasters and the attention grabbers. Put the phone down and kiss your sweetheart like you mean it. Talk, Learn. Relate. Experience. Do one thing at a time.
  4. Make a difference in someone else’s life. Give money. Bake a cake. Give your time. Listen. No, you cannot change the whole world, but you can damn sure change the life of the person sitting right there in front of you, begging for your undivided attention.
  5. Stop worrying! Go back to sentence number two of this blog post. Things will happen when they happen. Some of them will be bad. The truth? You can’t make a single thing happen by worrying about it. It’s wasted effort, it’s wasted energy, and it’s just not productive. Clear your heart and your head for Number 1-4 above.

Have a great day!

Tipping Points

When one lives alone for a period of time, certain equilibria are reached. There is just enough of something or just the right combination of things or just the correct state of disarray, but not quite enough disturbance in the Force to precipitate action.

Yes, the single man (or woman, I suppose) comes to appreciate that fine line that separates good enough from not enough, clean from needing attention, a small pile of dirty clothes versus a load of laundry.

Mark my words, you know it and I know it. This line of demarcation exists, even if no one else is there to see it. If a tree falls in the woods…

This line, this state of being, this rallying or staging area in the single person’s world, is the tipping point.

That point when inaction will lead to hunger, sadness, disappointment, or madness.

What are some of my personal favorite tipping points, things that push me to my limits and help me to understand just how much I can tolerate before I start to embarrass myself, even though no one else lives with me?

A classic is the almost empty gas tank. We’ve all been there. Cars used to have needles that showed how much  $0.75 petrol was left in the tank, riding lower and lower until the little metal or plastic stick lay irresolutely against the little plastic spindle that meant EMPTY, not wanting to finally rest there with finality but knowing that it was inevitable. In recent years cars have had digital and visual gas gauges that often times make use of little blocks of light called pips, each little square standing in for a gallon or two of $3.50 (or later, $1.85) gas. Less pips, more anxiety about not making it to the next station.

And less you folks who drive Prii or other hybrid electric cars gloat too much, believe me, a Prius can run out of pips, and gas, just like my father’s Ford Falcon could. Yes, my friends, that story of adversity on the road from Myrtle Beach to Augusta, Georgia is one for another day and another post. Trust me. Lose your pips, and you will not have a gladus night.

Another single man’s tipping point is the amount of food in the refrigerator (substitute pantry or cupboard or other if you like) that it takes to sustain life. Now, I like to eat. Hell, I have even been known to cook a meal or two that tasted pretty good. Like any self respecting guy, though, I hate to go to the grocery store. Hate it. Hate it. Tonight, my refrigerator happens to be stocked with fruit, some veggies, milk, some good cheese, a few brews, and a wonderful Irish lamb stew that I cooked up two nights ago. My freezer is full of venison and chicken and frozen vegetables.

There have been times, however, when I peeked into the abyss and saw exactly one lemon, a shriveled up Roma tomato, a single Fat Tire and half an onion. Could barely make Stone Soup with that. Now, to be clear, this was not because I had no money, and it was not due to lack of time to go to the grocery store. It was due to a combination of laziness and curiosity about how long I could actually survive without replenishing the home stocks. How many Zaxby salads and Chick-fi-A fruit cups does it take to drive one over the edge and propel one’s car (with only two pips left on the gas gauge, no less) towards Publix and the wide aisles of plenty?

One last tipping point, although I could go on.

How many times have you realized that there is not enough coffee, ground or whole bean or even instant, if you can stand that stuff, to make a pot first thing in the morning? And it’s 11:45 PM. At night.

Your dilemma: get dressed in something other than skivvies and athletic socks and drive (now with only one pip left on your gas gauge, this is getting interesting) to find a bag of Dunkin Donuts House Blend (because America really does run on Dunkin, my northern friends tell me), or risk getting up and being in such a state of caffeine withdrawal that you cut yourself shaving three times and go out of the house with mismatched socks, cutting off every hapless driver who gets in your way going to Starbucks.

Coffee, you see, is worth more than gas and food combined. Coffee makes the world go round. Without coffee, we are no better than the apes (who are smart enough not to drink coffee but stick to bananas, which they wisely peel sideways, thank you very much) Without coffee and caffeine, social discourse stops, commerce grinds to a halt, and continuing resolutions in the House of Representatives are never voted on. The government shuts down and we all move to Nicaragua, where they have coffee plantations.

Tipping points.

American men love their cars, and the way to a man’s heart may be though his stomach, but for those of us who love the ripe red bean, you will have to pry our worn, weathered coffee mugs from our cold, dead, recently caffeinated hands.

The Starbucks at the University opens at seven. There’s a gas station on the way.

Good night and have a pleasant tomorrow.


We began a three day accreditation survey visit at the Aiken-Barnwell Mental Health Center today. The two surveyors, one who will look at administrative issues and one who will focus more on clinical programming and outcomes, came as representatives of the Commission on Accreditation of Rehabilitation Facilities, or CARF.

Our initial contact with the surveyors was a morning meeting where the executive team and other managers introduced themselves and then heard a brief presentation about the survey process and what was to come.

As things moved around the room and it became my turn, I introduced myself as “Greg Smith, Medical Director”. Comments were made about having the doctor in the room and the like, and I thought little of it. I chatted with the surveyors briefly before going on to start my day and to let them get to their work.

Later in the morning I returned to the Board Room at my scheduled time for a brief meeting with the clinical surveyor. She and her coworker had not yet returned from their tour of the facility. Moments later, I heard them coming down the hall, accompanied by one of our staff.

They apologized for making me wait, not being on time for the doctor and the like. Again, I took note of this but thought little of it until later. I assured them that my morning had been kept open for them, that I was available to speak with them and to answer questions at any time they wished, and that I wanted t make myself easily accessible as part of the site visit. “See,” the staffer said, “I told you he would be okay. He’s okay.” Everyone smiled.

It struck me that the two surveyors, very nice and very interested, engaged ladies, were wanting to make sure that we were not inconvenienced or that our schedules were not compromised by their being there to do their survey of our organization. They seemed to be almost embarrassed and were very apologetic about being a few minutes late for an appointment that was certainly not set in stone.

I thought about my own feelings about the survey, and those of the staff I work with. We were all appropriately nervous, anticipating telling our stories and sharing the successes of our organization with someone new to it, and having a good outcome on Friday at the exit conference. I for one was very cognizant of the fact that I could be called back to answer other questions later in the day (I was, twice), to provide further clarification about policies, procedures or other issues that the surveyors might focus on. In essence, they were in the driver’s seat, and we were at their beck and call, not the other way around.

Perception can be a funny thing. Sometimes you can see things one way and have them be completely different. Sometimes you have expectations and the real situation is nothing like the one you were afraid of or nervous about of unsure of. This works both ways in relationships.

My takeaway, after interacting with these ladies on the first day of our CARF survey?

Be yourself, be genuine, be open, and be friendly.

Provide timely, succinct, and valid information.

Express what you feel to be true, focus on the positives, and brag about what the organization does well.

An open, honest exchange that disregards artificial trappings, titles and jargon is usually the best for all parties involved.

Now, we’re ready for days two and three.


“How far did you go in school?”

This is a question that I ask every new patient as a matter of course.

Granted, I have gotten some very odd answers, including hearing from a very successful businessman who only finished the seventh grade, or a very psychotic person who has a double master’s degree. Not implausible, but certainly not expected or the mainstream answer from the majority of my patients.

Now, leaving the children aside, most of whom are of course still actively engaged in academic pursuits, what is one of the most common answers to that question that I hear day in and day out?

I’ll give you a minute. Discuss, select a spokesperson for your group, and be prepared to show your work.

The answer is, “I finished.”

Now, if you were me, and you heard that, what would you think?

Depends on your frame of reference, personal experience, your own educational level and your expectations or preconceived notions about the person sitting in front of you. Yes? Do you agree?

The majority of folk who give me that answer, “I finished”, mean that they graduated high school. We could even split that hair further and talk about who got a regular academic diploma, who was on a technical track, or got a certificate of attendance, but that’s not important for this particular post. Fodder for another day.

“I finished.”

Often said with pride, sometimes with hesitation, and sometimes even with a little fear and trepidation.

We often read in our news outlets or see on television, especially in an election year, those who say that the common core is the ticket, others that say we are not setting the bar high enough, and still others who want to abolish the Department of Education all together. I think we all know in our hearts and heads, and can agree, that education, REAL education that can be put to good use in REAL life, is key to longterm success. Many of us know this. We have lived it, studying for years if not decades to learn a trade or skill or profession that will allow us to provide for ourselves, our families, and be active, vibrant members of our communities.

It bothers me, a lot, that many of my patients look towards the age of eighteen and the high school diploma that may come with it as being the pinnacle of their educational experience. Once they are emancipated from their home, and once they walk across that stage and flip their tassel from one side to the other, they really do believe that their education is over. They are not obligated to learn another thing. I believe that they believe that.

How sad to think that before you are even old enough to drink alcohol that you have essentially been taught that you do not have to be taught anymore. That you feel that there is nothing more that really entices you to read, listen, explore, or get your hands dirty in that way that helps you learn something  real that sticks with you far beyond a standardized test.

Life is all about learning. Learning something new every single day that we live. Trying new ideas on for size to see if they fit, and tossing them for others if they don’t. Visiting new places, having new adventures, reading new books, listening to new music, learning a new language, meeting new people who disagree with us, thinking outside the box that we have put the lid on, taped securely shut and put up on the shelf to (not so proudly) display the rest of our lives.

Life is about living, not just existing.

If we convince ourselves otherwise, we are shortchanged and hamstrung, limited and hobbled.

The second you finish learning and experiencing and growing should be the second that you draw your last breath. Who knows, we may even go on learning and experiencing past that point too.

The second you finish learning is the second that you become stagnant.

The second you stop learning, the day you say you have finished, is the day you will die.

There will be time for dying. That time will come for all of us.

For now, living, really living, is the thing that we should strive for.

(Feel free to comment on this post and share your feelings with me and others by visiting me on Facebook (Gregory Smith) or Twitter (@GregSmithMD). I look forward to your thoughts.)