Friday, February 19, 2010


Just got through watching Tiger’s public apology. Tough duty.

As a lifelong avid golfer, I have been a Tiger Woods fan. He seemed to personify all the positive things about the game. When his dalliances became known, I was, along with millions of folks all around the world, deeply disappointed and saddened.

Unfortunately for him, his promiscuous adultery is more than a matter between him and his wife.

Here is a man who has become the living symbol of a game which is all about integrity.

In football, baseball and basketball, the players are more or less expected to break the rules. There is the attitude that if the referee didn’t see it, it didn’t happen.

Not so in golf. A golfer, alone in the forest, who accidentally moves his ball a quarter of an inch, is expected to report the fact, and penalize himself one stroke.

The man who cheats at golf is drummed out of the foursome, banned from the club, regarded as a pariah.

It should be rather obvious that cheating on one’s spouse is a more serious offense than cheating on the golf course. Unhappily, many people don’t see it that way in the age of Hugh Hefner and Larry Flynt.

Still, in Tiger’s case the philandering led to lying, and urging others to lie. Once the ramparts of truth have been breached, the fortress of integrity falls.

The USGA, the PGA of America and the PGA Tour have invested millions of dollars in the First Tee Program, which introduces intercity kids to the game of golf as a means of encouraging them to play the game of life by the rules.

These leaders insist that golf teaches integrity, personal responsibility and good character. It is a game, they say, that helps young people develop their moral compass.

Tiger Woods has only begun to experience the punishment that an unsympathetic society will extract from him.

With his truthfulness impuned, he will face myriad rumors and vicious gossip. Not only will his numerous trysts be exaggerated, and supplemented with outright fabrications, but insinuations about his business ethics, allegations of steroid use and who knows what other calumny will fill the check out counter magazines for years to come.

As sincere and wrenching as was his appearance on TV this morning, Tiger will not escape the penance that follows naturally from his conduct.

Eventually he will have to answer questions. Hard questions. Uncomfortable questions. Unfair questions. Hurtful questions. What is at issue in the public mind is his veracity. And veracity cannot be bolstered by stonewalling. It will only be reestablished in the heat of cross examination.

The good news is that the bad guys will wear out their welcome. To the extent that Tiger is perceived as being pilloried unjustly, he will earn the sympathy of the public.

To the extent that he stands up courageously and forthrightly responds to the concerns and doubts of his many admirers, he will win back the respect of golfers who, like me, want so very much to have their hero back on the first tee.

Sunday, February 7, 2010


A couple years ago, I received an email with a video of Randy Pausch’s last lecture. Randy Pausch was a professor at Carnegie Mellon University in Pittsburgh.

Apparently someone at the University came up with the idea of presenting a series of “Last Lectures.” The idea was to have faculty members prepare and deliver the lecture they would give if they knew it was to be their last. An interesting enough exercise for most of the faculty.

But for Randy Pausch, it was the real thing. He had just been informed that he had incurable pancreatic cancer. So he made a video of his last lecture. It took the Internet by storm, and inspired a book which was published shortly after his death in July of 2008.

Oddly enough, Professor Pausch appeared on the video to be in excellent general health. He began his lecture by doing a series of vigorous push ups, just to show that he was in great shape.

Randy called his lecture “Really Achieving Your Childhood Dreams.” It’s an incredibly moving and inspirational message. I recommend that you Google Randy Pausch and view his video. You won’t be disappointed.

Preparing to give a talk at Cooley Law School a while back, the idea of a last lecture kept sort of cropping up. Mayo Clinic tells me I’m good for several thousand more miles, but the fact is that in May I will be 81 years old. I remember when my mother was 81. I gotta say, she was old.

When you get to be my age, you think a lot about death, but not the way you think about it when you’re forty or fifty. There’s no panic, no fear. We all know, and we always knew, that death is a part of life. It’s natural. It’s certain. It’s universal. When you get old, your friends die. People treat you differently. Younger golfing buddies rake your sand traps and fix your divots.

And people listen to you; as though you have somehow gotten smarter just by living longer. I wonder about that. I always prayed for wisdom; always wanted to be a wise person. Now I read opinions I wrote forty years ago as a Supreme Court Justice and I marvel at how smart I was back then. I certainly don’t feel any wiser now. I sure wouldn’t want to take a bar examination this summer.

But I suppose there are some things that begin to sink in as the years go by. Some things you always knew become even more certain.

For example, there’s my mantra about perseverance, progress and personal responsibility. It goes like this:

If you drop it, pick it up. If you spill it, wipe it up. If you forget it, go back and get it. If you break it, fix it. If you destroy it, replace it. If you owe it, pay it. If you did it, admit it.

Why? Because most of the forward progress we make in the game of life is just getting back to the line of scrimmage.

They say that Irish Altzheimer’s is when you forget everything but the grudge. Despite my Celtic heritage, I have had no room in my life for ill will toward anyone. Besides, I think that hatred eats the hater.

If you have a friend, it’s like having a relative. It never changes. Your friend is your friend. Period.

Forgiving feels good; forgetting feels better. Every hour, every minute spent seething over hurt feelings is an absolute waste of time. You can’t control the thoughtless, cruel, or mean spirited things that other people do or say. You can control how you react to them. You can control your feelings. You are the only one who can make you feel good.

I’m a dreamer; always have been. I put myself to sleep at night thinking about my dreams. And I think about them in the morning to get myself up and started. Many times, I dream about my dreams. Come up with new ideas, new solutions, new strategies while I’m asleep.

And your dreams demand attention. They demand action. You can’t just dream about a dream. You’ve gotta do something about it. Often just doing something – anything – will make the dream go away. If it doesn’t actually pan out –and many don’t – at least if you gave it your best shot, you will have earned some credits in the college of hard knocks.

Randy Pausch said that the brick walls we encounter in life are good. They’re put in our way so that we can prove how much we want to achieve our dreams. Nothing in life worth having or doing will come to you unless you want it. Really want it.

That’s because valuable things demand a high price. Whether it’s an education, a career, a marriage, a reputation, or anything else you set as a goal or let yourself dream about having or doing, it will not come to you unless you are willing to pay the price.

That price isn’t always money. Indeed it rarely is. Usually the price is paid in sacrifice, in waiting, in patience, in perseverance, in starting over again and again, in believing and preparing and in holding on when everyone tells you to let go.

I have often told my children and grandchildren that success is getting back up again. And so it is. But there is another dimension to success that is so axiomatic it rarely gets mentioned.

My father put it this way, “You know what’s right and you know what’s wrong. Do what’s right.”

The inmates who dug a tunnel under the prison industries building in Stillwater Minnesota recently certainly had a lot of perseverance. But they were on the wrong road. They were not doing what’s right.

Success comes by achieving or working tirelessly toward good, honorable, positive goals.

Those are the dreams worth having, worth fighting for.

My son Tom and his family came to Florida to visit over New Years. One night at dinner, Tom suggested we all tell our New Year’s resolutions. When it came my turn, without any particular forethought, I said that in the new year I was going to be happy.

Not lose weight to be happy. Or save money to be happy. Or take a trip, go on a cruise, buy a car, or do anything else to be happy. No, I just decided that next year, I am going to be happy.

And you know something? It works. If you just decide to be happy, you can be happy. Nobody else can make you happy. Nothing you do, nothing you acquire, nothing you learn, or see, or experience will make you happy. Happiness comes from the inside. It is self generated.

A happy person is happy. An unhappy person is unhappy. It’s as simple as that.

I have a dozen things on my plate. Things I want to do. Spend time with my darling wife, and hear her laugh. Improve my golf game. Write a book or two. Promote golf as a team sport. Advocate for a convention to propose amendments to the United States Constitution. Travel. Visit my grandchildren and my new great granddaughter.

But these things don’t make me, won’t make me, can’t make me happy. I bring my happiness with me. I take it with me wherever I go. To the dentist’s office. To the movies. To a wake or a funeral. Happiness is a state of mind.

I sincerely hope to be happy on my death bed. The good Lord has blessed me with a long and healthy life, filled with love, achievement, friends, and beautiful moments. I thank God for the life He has given me.

At the end of it, I only hope it will be said of me that I finished the race, that I kept the faith, that I did my best and went out with courage and grace.

And that would be my last lecture. Thanks for listening.

Wednesday, February 3, 2010


Trying to get to sleep last night, I turned on CSPAN, the reliable electronic sedative, there to stumble upon Senator Carl Levin and his minions of the Senate Armed Services Committee grilling the Secretary of Defense, Robert Gates, and other military mucky-mucks on the titilating subject of gays in the military.

Triggered by President Obama's State of the Union call for the abolition of the so-called "Don't Ask. Don't Tell" policy, the Senators waxed poetic about gay rights, gay patriotism and gay heroism on the battlefield.

Got me to thinking.

The third edition of Roget's Thesaurus, published in 1995, calls the word "gay" an adjective and provides four classifications of synonyms:
1) jolly, jovial, merry
2) bright, colorful
3) homosexual, oriented toward one's own sex
4) licentious, dissapated, wanton

Since 1995, our dynamic English language has invented a noun, "gay," which generally means a homosexual or homophile, but carries the additional connotation of openness.

The distinction between the adjective and the noun is critical to the political issue, although none of the distinguished talking heads on CSPAN seemed aware of it.

If one is gay (adjective) he or she is oriented toward his or her own sex, but if one is a gay (noun) he or she is not only homosexual, he or she is out of the closet, overt, known, and acknowledged to be oriented toward his or her own sex.

The present "Don't Ask, Don't Tell" policy allows gay people to serve in the armed forces, and the witnesses testified that there are many such persons currently serving quite honorably in all the branches of our armed forces.

But that policy is not enough for today's aggressive homosexual community and their political compatriots. They want their fellow soldiers and sailors to know that they are oriented toward persons of their own sex.


Why in the name of all that is fair, decent and honorable would any man or woman want his or her fellow service men and women to know that he or she has a disposition toward felatio or buggery?

Do they really intend, by demanding abolition of "Don't Ask" to empower or even require the military services to inquire into every recruit's sexual orientation, and label or classify them accordingly?

Do they really intend, by demanding abolition of "Don't Tell" to require every recruit to disclose his or her innermost, personal, sexual feelings and urges?

I would be quite surprised if the introduction of females into the ranks of foot soldiers has meant that male and female troops now bivouwac together, shower together, or deficate in community facilities.

Military discipline often trumps the right of privacy, but there are some core personal matters that touch upon basic human dignity. Sex is one of them.

Do Senator Levin and his votaries contemplate constructing of a third and a fourth latrine on every army base and naval station?

Or do they intend to indoctrinate every recruit with the willingness to strip down in the presence of colleagues who openly view them as objects of sexual arousal?

If so, I would be one American who would not want to see his son or grandson among the few, the proud and the brave.

Monday, February 1, 2010


Dear Dr. Gawande:

I am a former Chief Justice of Michigan, and founder of the nation's largest accredited school of law, The Thomas M. Cooley Law School with four campuses in Michigan.

After writing a blog about health care, [] I got a note from a friend referring me to your excellent article about McAllen, Texas in the June 1, 2009 issue of the New Yorker magazine.

One paragraph stood out, and prompted this email:

The third class of health-cost proposals, I explained, would push people to use medical savings accounts and hold high-deductible insurance policies: "They’d have more of their own money on the line, and that’d drive them to bargain with you and other surgeons, right?" He gave me a quizzical look. We tried to imagine the scenario. A cardiologist tells an elderly woman that she needs bypass surgery and has Dr. Dyke see her. They discuss the blockages in her heart, the operation, the risks. And now they’re supposed to haggle over the price as if he were selling a rug in a souk? "I’ll do three vessels for thirty thousand, but if you take four I’ll throw in an extra night in the I.C.U."—that sort of thing? Dyke shook his head. "Who comes up with this stuff?" he asked. "Any plan that relies on the sheep to negotiate with the wolves is doomed to failure."

Ridicule, of course is a powerful form of polemic, but the assumption that discussion about the cost of an operation would take the form of haggling only reveals the profit-making mind set of the doctor you were talking to.

A more reasonable and accurate assumption would be this: They discuss the blockages, operation, risks AND COST of the operation. The patient says she can't afford it. The doctor says he will send her a bill and if she can't pay it, he will sell the account to Medi-Fex, a government agency created to assure that all Americans have affordable health care. She asks him what the government will do to her and he hands her a brochure which describes the way Medi-Fex works.

If she has no money, obviously she won't go to debtor's prison. If she has some money and can afford to pay something, Medi-Fex would set up a payment plan. If she wins a lottery or inherits a fortune, it will ask for full payment of the bill.

Here's a reality check. The elderly woman has a $150,000 home, free and clear, and $95,000 in a savings account. She plans to leave it all to her daughter. If Medi-Fex will make a claim against her estate for the cost of the operation, she may decline the surgery. Her daughter may urge her to do so, or may insist that she have the operation. Or, as happens too often these days, she may transfer all her assets before the operation. There is no system which people will not seek to beat, if there is money involved.

The point is that 'affordable' is a subjective standard, which can only be determined on a case by case basis. What is important here is that the legal and moral obligation to pay for the medical service needs to rest with the recipient.

It doesn't take a degree in economics to realize that when you separate the duty to pay for a benefit from the right to receive the benefit, the demand and hence the cost will escalate.

Consumer reticence results in cost containment in a free market. We're not using it.

Thomas E. Brennan

NOTE: A surgeon and a writer, Atul Gawande is a staff member of Brigham and Women’s Hospital, the Dana Farber Cancer Institute, and the New Yorker magazine. He received his B.A.S. from Stanford University, M.A. (in politics, philosophy, and economics) from Oxford University, M.D. from Harvard Medical School, and M.P.H. from the Harvard School of Public Health. He served as a senior health policy advisor in the Clinton presidential campaign and White House from 1992 to 1993. Since 1998, he has been a staff writer for the New Yorker magazine. In 2003, he completed his surgical residency at Brigham and Women’s Hospital, Boston, and joined the faculty as a general and endocrine surgeon.

He is also Associate Professor of Surgery at Harvard Medical School, Associate Professor in the Department of Health Policy and Management at the Harvard School of Public Health, and Research Director for the BWH Center for Surgery and Public Health. He has published research studies in areas ranging from surgical technique, to US military care for the wounded, to error and performance in medicine. He is the director of the World Health Organization’s Global Challenge for Safer Surgical Care.