As We Think

Directing our emotions, our thoughts, our words, and our actions…to be who we were created to be.

The Economist is no fan of Donald Trump. The October 27 to November 2, 2018 issue featured a column by the editor Lexington describing the foreign policy failures and successes of the President. It was accompanied by the picture noted here, which shows Trump as an archer rejoicing over a single bulls-eye while quivers of arrows are far off the mark. He seems to be ignoring his many failures and raising his arms in triumph over one, perhaps random, success. Maybe Lexington sees Trump as an incompetent egomaniac who sometimes gets lucky. Certainly, other people do. While catchy, this illustration is a snowflake in an avalanche of political cartoons criticizing the US leader.

In my primary care medical practice, I encounter dozens of patients every week who, if they were featured in the same picture, would be sad. The context wouldn’t be foreign policy, but might be success at work, a loving family, new hobbies, losing weight, quitting smoking, or any of a hundred other things.  Rather than looking out of the illustration at the reader with upraised arms and a self-satisfied smile, their eyes would be downcast. Their brows would be furrowed and the corners of their mouths drooping. Instead of more than 30 arrows there may only be 10, or 5, or 1, because the person would have given up. He or she might tell a bystander “this is a stupid sport anyway. I have better things to do.” Just below their level of consciousness, they might get a queasy feeling – “why show my failures to the public, and to myself? How much better would it be to stay home alone with my screens, my games, and my programs? That way I cannot fail.”

There is danger in an excessive focus on our successes, but likewise danger in an excessive focus on our failings. The best focus is outside ourselves – at the problem to be solved or the grace to be enjoyed.

A focus on failures is not only a problem for patients, but for all of us. How do we regard each moment of our lives? Do we ruminate on our regrets? Do we marinate in our missteps? Do we refuse to forgive those who hurt us? Do we choose to take offense at the clumsy words and actions of others? Do we reject others for what they are, and reject ourselves for what we are? Do we put ourselves and others in the worst possible light? Do we cut others out of our lives when they don’t consistently meet our expectations and fulfill our wishes? Do we withdraw into a cave of confusion, sit down in den of darkness, and finally lie in a coffin of loneliness?

Conversely, do we bounce back after our blunders? Do we stand up after we fall? When faced with a seemingly impossible task, do we act as the inventors did in The Roses of Success, from Ian Fleming’s children’s musical Chitty Chitty Bang Bang:

Every bursted bubble has a glory!
Each abysmal failure makes a point!
Every glowing path that goes astray,
Shows you how to find a better way.
So every time you stumble never grumble.
Next time you’ll bumble even less!
For up from the ashes, up from the ashes, grow the roses of success!
Grow the roses!
Grow the roses!
Grow the roses of success!
Oh yes!
Grow the roses!
Those rosy roses!
From the ashes of disaster grow the roses of success!
(spoken) Yes I know but he wants it to float. It will!
For every big mistake you make be grateful!
Here, here!
That mistake you’ll never make again!
No sir!
Every shiny dream that fades and dies,
Generates the steam for two more tries!
(Oh) There’s magic in the wake of a fiasco!
It gives you that chance to second guess!
Oh yes!
Then up from the ashes, up from the ashes grow the roses of success!
Grow the roses!
Grow the roses!
Grow the roses of success!
Grow the roses!
Those rosy roses!
From the ashes of disaster grow the roses of success!
Disaster didn’t stymie Louis Pasteur!
No sir!
Edison took years to see the light!
Alexander Graham knew failure well; he took a lot of knocks to ring that
So when it gets distressing it’s a blessing!
Onward and upward you must press!
Yes, Yes!
Till up from the ashes, up from the ashes grow the roses of success.
Grow the ro… (continue)

To succeed after failure, we must control our emotions. Years ago a young woman told me of a time when she felt awkward. I replied, “Awkwardness is a choice. If you chose to not feel awkward, you will not feel it.” She paused, a look of realization crept over her face, and she smiled.

Offense, discouragement, and every other emotion is also a choice. We cannot control the initial flush of feeling that we get from any situation, but we can control what we do with that flush of feelings. Emotions roll over us like a wave for the first few seconds, but then we must decide whether and how to redirect the waters.  We can nurture resentment over an injury or to forgive it. We can see any circumstance as a defeat or a victory. We can dwell in the prison of our fears or dance in the pastures of our joys. We can consider that both compliments and criticisms say more about the giver than the receiver.

The Bible tells us again and again to control our thoughts and our emotions and channel them toward success. We are to “Fear not!” (Isaiah 41:10) and “Not let our hearts be troubled (John 14:1).” Day by day success is performing the tasks which He has given to us with all our might (Ecclesiastes 9:10, Colossians 3:23). Ultimately, success for the Christian is loving, glorifying, and enjoying God.

The Economist probably did not mean to make Donald Trump look good in this illustration. I do not know Trump’s thoughts or his character. However, insofar as the Trump in the picture is rejoicing despite many, many failures, the British newsmagazine may be revealing a secret of his success.  

Communication Conflicts

Assumptions, Emotions, Perceptions, Conditions, and Facts color our communication with ourselves and others. We must learn to manage them.

A wise man once said that the hardest thing about communication is the illusion that it has occurred. I have been involved in hundreds of medical, military, and public safety operations, and the after-action reviews of each one cite communication as a problem. Whether in business, relationships, or anywhere else, avalanches of academic papers and mountains of media articles bemoan our inability to effectively talk to each other, and propose ways of fixing it.

Several factors are present in every communication event, including assumptions, emotions, perceptions, conditions, and facts. They change the communication, often without the participants realizing it.


Assumptions are believed true but without proof. Each person, whether he considers himself religious, spiritual, philosophical, materialistic, or something else, makes metaphysical assumptions, assumptions about the fundamental questions of life. Suppose three college students, Mike, Sienna, and Jorge, are talking about their planned vacations. Mike, a Christian, believes that God created everything, that He is the center of existence, and that the purpose of every created thing, including people, is to glorify God and enjoy Him forever. Sienna, a secularist, believes that the universe is just one of many universes in a “multiverse”, that the human community is the center of existence, and that making oneself happy is the purpose of existence.  Jorge, a philosophical naturalist, agrees with Sienna on the origin of things, believes that each individual is the center of existence for that individual, and claims that the universe has no meaning or end at all. Mike plans to do a mission trip to Brazil for his spring break, Sienna is scheduled to take an eco- and poverty-tourist trip to Belize, and Jorge is going to the Caribbean for alcohol, parties, and women. Each is acting in accordance with their fundamental assumptions about life, but their discussion will probably be no deeper than “whatever works for you.”

Most people do not recognize their own assumptions, but have a smorgasbord mishmash drawn from religions, the media, popular culture, and those around them. Nonetheless, these assumptions color everything that we do – from who we marry to how we work and vote. When two people talk, the further apart their assumptions are, the harder it will be for them to communicate, and the less likely it will be for the conversation to go well. Keep in mind that we are talking about fundamental, important assumptions; beliefs about life, the nature of good and evil, and purpose.

Imagine that Asherah, an ancient Sumerian woman, were listening to the conversation between Mike, Sienna, and Jorge. Unfamiliar with any idea of universal religion, she would puzzle over why Mike was sailing over the ocean (she couldn’t conceive of flying) to bring his religion to another people, who already had their own gods. Scoffing at the idea that all people are created equal, she would be scandalized that Sienna was going anywhere without her father or brother, and that she should be care about poor at all. Even if our Sumerian maiden secretly admired Sienna’s independence, she would not admire her egalitarian leanings. Asherah would understand Jorge’s plans the best, and if Jorge were wealthy, might approve.

Lesser assumptions also impact communication. If a woman believes that black men are threatening, or that men in general are oppressive, she will have trouble understanding anything that a male is trying to say, no matter how he says it. If a man considers women little more than sexual prey, he will be equally impotent in understanding women. The same is true for other prejudices, no matter their basis (religion, culture, nation, etc.). That is why such attitudes are so toxic.


I know the look. When I am talking with my oldest daughter, I am in trouble when she squints, tilts her head, and furrows her brow. At that point, I better start apologizing, because we have moved from (usually) rational discourse to emotional damage control. It is not that she is unusually irrational but that she, like all people, is a complex mix of intellect and emotion. Often the emotion leads. My daughter is helpful in that she signals when the switch has occurred – with others you may never know.

Emotions powerfully affect communication, sometimes blocking it entirely. When doctors give a patient a terminal diagnosis, the patient hears nothing else during that conversation, no matter how the doctor says it. When a judge announces a contest winner, the same thing happens. Excessive anger or fear can also stop the ears and close the mind. Stress hormones like epinephrine and cortisol surge in the body, and all the person can do is react.

Emotions color conversations. All else being equal, speaking with someone you love will always be better than speaking with someone that you do not like, or are neutral towards, even if the words are as tame as “Please pass the butter.” Newlyweds eating by candlelight might see that request with the rose hue of love, while feuding co-workers at a mandatory company dinner might see it with the red fire of anger or the blue ice of bitterness.

Talking with someone new may be exciting, but it also generates fear. The same is true of talking to a person of a different age, sex, religion, culture, nationality, race, or political persuasion. Discourse with those who are different from ourselves is imperative, but the emotions involved often make it more difficult.

Emotions amplify or deaden the importance of communication. When a rigorous teacher in an important class says, “the test is tomorrow”, students will color and amplify the statement based on their perceived readiness. Prepared students will feel satisfied in their work and a readiness to get the exam over with, and unprepared students will feel dread about their anticipated grade and shame for not working harder. The words “the test is tomorrow” will pound in the unready student’s head all day long, while the ready student will hardly give them a second thought.


I was standing near a military medical tent in Washington DC during Barak Obama’s second inauguration in 2013. The Presidential motorcade was approaching, and several black women were chattering wildly in anticipation of seeing America’s first black president. Their emotions were high, and from the tenor and text of their conversation, had been for days. It was hard to know which black limousine the President was in, and hard to see anyone inside the vehicles due to their dark, tinted windows. Nonetheless, everyone found him and in the few seconds that he passed by, studied his every move. One woman shouted, “he looked at me!” while another exclaimed “he smiled at me!” Watching the same scene, I could not be sure that the President had done either. He could have scowled, or more likely not noticed them at all given the tens of thousands of people on the parade route, but it didn’t matter. Those women will stick to their stories and tell them to their friends and family all of their lives.

Perceptions are mental impressions or intuitive insight. In day to day life, what we perceive is often more important to our understanding and our actions than the truth. A look, body position, or tone of voice perceived as threatening, unkind, or even uncaring will undo the best of words. Similarly, favorable perceptions can make the communicating parties feel better about themselves and each other. Regardless of what Barak Obama actually did, the perceptions of these women at the Inauguration made them like him more.


Everyone who communicates does so to gain something:

  1. Money
  2. Self-esteem
  3. Esteem in the eyes of others
  4. A chance to do good, whether by advancing their business or some other cause
  5. Specific, personal goals

While everyone more or less shares general goals, communicators are not likely to share specific goals. A boss might want to get his employee to do a task, while the employee might want to shift that work to someone else. A politician may want each person in the audience to vote for her, while listeners might want free food, a good time, and a chance to have an interesting experience with an important person that they can share with their friends. A man may want a date, but the woman he is talking to may simply want to escape from a “creepy” situation.

Real communication will be much harder to achieve if the parties don’t know what motivates others. If they know what the other person is thinking, the boss might emphasize the benefits of doing this particular job, the politician might design a rally to provide an exciting experience, and the suitor might learn more about the object of his affection to avoid making her uncomfortable. If the boss knows that nothing he can do will make the employee do the work, if the politician has no chance of getting certain votes, and if the man’s amorous advances are dead in the water, each would drastically change their tactics, or give up communicating all together.


People generally believe that they are communicating in facts, those objective truths upon which life is based. Because each party feels that he is dealing only in irrefutable facts, he may have trouble understanding how anyone could disagree. When we are not careful, this opinion leads to dismissing other opinions as stupid, or even evil. We demonize those with whom we disagree, and they demonize us. Our assumptions, emotions, and perceptions align against our opponents, and our desired outcome is no longer understanding or compromise, it is victory. Crushing the hated enemy, not understanding each other and accomplishing mutual objectives, becomes the goal.

Actually, facts can be challenged, debated, and seen from different perspectives. Truths are still objective – a person with colon cancer has colon cancer regardless of what they, their friends, or all the doctors in the world think. But finding the objective truth can be extremely difficult – much harder than we assume. No one has a monopoly on truth, but some do understand reality better than others – at least in certain fields. By comparing facts, acknowledging other opinions, being humble enough to learn, and keeping all participants’ best interests at heart, we all can get closer to the truth, and closer to solving the problems that vex our world.


It is hard to communicate effectively. If communication is an iceberg, facts are the visible part above the waterline, and assumptions, emotions, perceptions, and conditions are the barely visible parts below the surface. Just as the Titanic never would have foundered if it had hit only the top of the iceberg, so communication rarely founders on the facts. Rather, it founders because the parties don’t understand and sometimes don’t trust each other. Anyone who wants to communicate will take the time to ponder the assumptions, emotions, perceptions, conditions, and facts of others. These people will communicate better and have success.

How was your day?

My wife Nancy and I celebrated our 26th wedding anniversary last week, and I have been reflecting on our years together. She works from home, raising our five children, and caring for her high-maintenance husband. She is utterly precious, and I value her more than diamonds or rubies. Almost every day throughout these years, Nancy has greeted me at the door when I get home from work. Her smile is warm and her embrace warmer. She is genuinely glad to see me, and always follows a hug with “how was your day?”

For years I thought little about this question, answering “good”, “fair”, and “rough” depending upon a mix of factors – what happened to me, how my drive home was, and how tired I felt. If something big or bad happened, the perceived quality of my day was based on just a few minutes of real time. For example, although a fight with a co-worker or a rebuke from a boss may have lasted only a few minutes, the whole day might be ruined.

Eventually I realized the foolishness of judging my day by what happened in a few minutes. I trained myself to mentally cut the day into segments, and to notice how long pleasant and unpleasant events actually lasted. Once during my morning commute I was rear-ended by an inattentive driver on the I-395, south of Washington DC. The damage was minimal, but my schedule was thrown totally out of whack. That night when Nancy asked her inevitable question I said “my day was good, but this morning I had a rotten 45 minutes.”

My answer, though, was still passive. The quality of my day was based on what happened to me rather than on what I had done. Other people had the power to control my perception of how good or bad my day was. Since weeks, months, and years are ultimately only collections of days, others had tremendous control over how I perceived my life. I pondered the question “how was your day”, and considered several possible ways to answer it.

  1. The perfunctory “fine”. The asker is left to wonder if you are too tired to give a better answer, if you are trying to hide something, or if you care so little about them and your relationship that you don’t bother to reveal more.
  2. Based on what happened to you? This is probably how most people do it. A man who wins a sweepstakes probably feels like his day was great, even if his 20-year-old, 200,000-mile pickup truck was also stolen. However, “big” events, whether happy or unhappy, are rare. Our days are filled with “little” occurrences, and we tend to remember the unpleasant ones more than the pleasant ones.  Thus the passive answer to “how was your day” tends to give us a lot of slightly bad days.
  3. Based on how you feel at the moment? The evaluation of the day is skewed by the events that occurred just before the question was asked. Heavy traffic and “the guy that cut you off” on the way home can ruin the perception of an otherwise good day.
  4. Based on what you did? Judging a day based on what you accomplished is more active than judging the day based on what happened to you or how you feel at the moment. It also gives you more control – days that you accomplish a lot will seem better than days in which you accomplish little. “I took care of 18 patients” is a better answer than “So and so bad-mouthed me to the boss.” However, this answer still allows others a lot of control over how you perceive your life. If John, Muhammad, or Fernando prevented you from accomplishing all that you wanted, he can make your day worse, intentionally or unintentionally.
  5. Based on how you handled what the Lord brought into your life? God is sovereign over our world and our lives. He uses people and events to shape us and us to shape people and events. When the Lord says “work”, we work. When He says “rest”, we rest. When He brings someone into our lives who we perceive as a “bother” or a “waste of time”, we try to discover His purpose. The most irritating person may be teaching us compassion, or may provide a good occasion to practice control over the time that He has given us. God knows what we need far better than we do. Days that we trust, obey, and enjoy Him are the best days of all.

We have no record of how Jesus answered the question “how was your day”, or even that he ever got it. Nevertheless, His example is useful. Jesus was never passive, and likewise His followers are to be active in every area of life. We cannot let others control us, for we serve God alone. Seemingly little things, like the answer to the question “how was your day” slowly but inevitably shape us over the years. The summation of how you answer this question over time affects how you remember your life. It also affects how others think of you. 

One last note. While it is important to judge your day by how well you handled what the Lord brings into your life, there remains the danger of too much self-focus. Be sure that you spend more time thinking about God’s faithfulness than thinking about your own.

How was your day?  

Your Permanent Record

A little boy couldn’t resist the urge to pull the hair of the girl sitting in front of him. Across the room, a little girl couldn’t help chatting with her friend while the teacher was talking. These incidents happen every day in thousands of classrooms across the United States. Modern teachers have a variety of new techniques for dealing with such infractions, but in bygone days teachers would often respond with the same threat: “if you do that again, I will write that in your permanent record.” The children would immediately stop, at least for the moment, because everyone feared bad reports in their permanent record.

As children grew and went to school to school, perceptive ones realized that these transgressions never actually appeared on their report cards. The few who were able to see their school records found that only the most egregious sins were documented. Parents didn’t seem to have a “permanent record”, unless it was a criminal one. By the time that school ended and the working world beckoned, the secret was out; there was no “permanent record.” Teachers had known it all along, and their pupils had taken 20 years to figure it out.

Over the years several of my children have told me that a school teacher had mentioned a child’s permanent record. I felt the familiar egoism of experience, the smug sense of skepticism, gained in decades of American schooling, and told my children – there is no permanent record.

Your Permanent Record – Body and Mind

Recently in my clinical practice I cared for a 14 year old girl with a torn anterior cruciate (knee) ligament from a soccer game. Several months earlier I counseled a 26 year old whose life had been overturned by rape. Years before I treated a 23 year old for cervical cancer; she had started sex at age 13. Some patients, especially boys, have been hooked on tobacco before they started high school.  One young boy had a head injury from a bicycle accident, putting him far behind his peers. In all of these cases, the decisions that these people made as children, or decisions that were imposed upon them, changed their lives forever. My experience as a physician belies my skepticism. There really is a permanent record, and it is found in our bodies and minds.

Another obvious example of your permanent record is memory. While we usually overcome the pain of past mistakes and experiences, we usually can’t erase the memory of them. Few people reach adulthood without carrying a bag of regret, and before middle age that bag grows into a knapsack. Over the years our knees buckle and backs stoop with the growing weight of the past. As we enter the winter of our lives, many people can think of little but summers past. Much of the psychological illness that I treat every day comes from my patients’ memories of what they did, didn’t do, or what someone else did to them.

Your Permanent Record – Habits and Emotions

One of the key concepts of physiology and psychology is that of practice; what we do becomes easier to do again. If we throw a ball, we can through the ball more easily the next time. If we think a thought, we can think that thought more easily the next time. Champions in sports and music are made because the body improves through practice. Neophytes in a field make two common mistakes. First, they expect practice to make huge improvements, then become disappointed and quit when it does not. Second, they believe that practice makes perfect. In truth, practice makes permanent; only perfect practice makes perfect.

When a person thinks, neurons fire and hormones flow in certain patterns. When someone moves, neurons fire, hormones flow, and muscles contract in certain patterns. Repeating those patterns thousands and even millions of times develops habits and skills in certain areas.  This is how champions are made.

It is also how people fail. Repeating the same negative thoughts, refusing to forgive and wallowing in bitterness will develop neural pathways and hormonal patterns just like more productive activities will. Lying makes it easier to lie just as kicking a ball makes it easier to kick. Using foul language makes it easier to use foul language just as smiling makes it easier to smile. There really is a permanent record, and it is found in our habits and emotions.

Your Permanent Record – How Others Perceive and Treat You

Just as people develop patterns within themselves, they develop patterns in their interactions with others. I was caring for one woman in clinic while her husband sat in the exam room berating her. They had only been married two years, but his habits were toxic to her, to him, and to their marriage. I asked him, “If you have committed yourself to this woman in marriage, why would you want to hurt her, and yourself, by chiding her so? You had better change your ways or she won’t be there when you need her.”

Our actions change how others treat us. If a child gets a reputation as a troublemaker early in the school year, others in the class will treat him as a troublemaker, even if he improves over the course of the year. Because others are not as interested in us as we are, they will take a long time to notice our actions and change their opinions of us. Sometimes they will not change their opinions no matter what we do, because changing an opinion is harder than keeping the same opinion.

Benedict Arnold has a terrible reputation in American history because he tried to betray his country. Few will change their opinion of him, even if they learn that he was one of very few successful admirals (Battle of Valcour Island) and generals (Battle of Saratoga) in world history. Arnold fought with wisdom and courage for the colonies, only succumbing to pride and ambition at the end of a noble career. Richard Nixon was another character whose decades of admirable service have been forgotten and only his late mistakes remembered. People refuse to change their opinions of others because they gain something by keeping the opinions that they have.   That is one reason that it is so hard to make changes in life. A person does something good, no one notices, and others will treat them the same way as before. There really is a permanent record, and it is found in how others perceive and treat us.


Thoughts, words and actions are self-reinforcing spirals, and the summation of all of those spirals makes a life.  There really is a permanent record, and that record is you. Nothing good or bad is ever lost, and every moment makes a lifetime. Use them well.