PROLONGING LIFE, NOT DEATH

The 3.8 million United States seniors who celebrated their 85^th birthday before the year 2000 constituted the fastest growing segment of the population. By 2030, this group will number 9 million, and will swell to 19 million by 2050. The new focus on aging must go beyond extending the life span. Rather than delaying death, medical science must work toward prolonging a fully lived life.

Metaphor in the Wizard of OZ According to 1964 High School History Teacher, Henry Littlefield

Oz = oz., an abbreviation for ounce

Kansas = the hardships of life

Cyclone = the financial panic of 1893

Silver slippers = silver as a monetary standard

Yellow brick road = gold as a monetary standard

Emerald City = the fraudulent world of greenback paper money that only pretends to have value

Dorothy = the naive and simple American people

Tin Woodman = the dehumanized industrial worker

The Scarecrow = the farmer

The Munchkins = the ineffectual ordinary citizens who are controlled by politicians and big money

PONTIFICATING PEOPLE: A short play in two acts.

Act one, scene one: in heaven.

GOD (adjusting the HD TV): Hey, boys, come in here that sitcom from earth, Pontificating People, is about to start.

JOHN THE APOSTLE: Great, I’ll make some popcorn. How about some wine?

MATTHEW: Cool it, John. What a party guy. You’ve never been the same since that wedding in Cana.

LUKE: I left that miracle out of my book. Sorry John, but compared to the other miracles I didn’t consider the water-into-wine miracle worth mentioning.

 JOHN THE APOSTLE (entering carrying a huge bowl of popcorn): Hey, where’s Peter? He loves this show.

GOD: He’s over at the Sea of Faith practicing the water-walking thing.

MARK: And Paul? It would do him some good to laugh a little.

GOD: At the library writing a letter to the Martians. Shh. It’s starting.

Act 2, scene one: on earth at a home Bible study.

JIM: Because I’m an engineer, believing in this spiritual stuff gives me a little trouble at times.

BILL: It’s a heart thing not a mind thing.

LARRY: No. Jim’s predestined to think that way.

ANITA: Stop talking about predestination. If we didn’t have free will, we’d be like puppets.

PHYLLIS: I think you might want to consider a third option. As it says in the Bible, “Don’t put all your eggs in one basket.”

A FIRST TIME GUEST AT THE BIBLE STUDY: I didn’t know that was in the Bible, but I haven’t read it that much. As Shakespeare said, “Much study is a weariness to the flesh.”

KAREN: That’s in Ecclesiastes, not Shakespeare.

JOHN W. (interrupting): Phyllis is right. You can have predestination and free will at the same time. Its called antinomy.

GOD: That guy’s such a know-it-all. He makes me laugh.

JOHN W. (droning on): It’s sort of, like Plato wrote in The Republic. There are two horses in the sky pulling a chariot. One horse is named Passion; the other is named Reason. They’re pulling against each other. That’s a metaphor for predestination and free will.

GOD: That guy’s a hoot.

PETER (entering while toweling off): To me he’s just a big bore.

KATHERINE (back at the Bible study): I think it’s all free will. Like the Weegie Board thing. We thought we had set the evil spirits free.

PAULA: I’m kind of leaning toward predestination, because when we got Coach Fran, we weren’t given a choice.

JOHN W. (interrupting again): Dante wrote about free will and predestination too. In The Divine Comedy, he used Rebecca and Rachel to represent faith and reason.

PAUL (entering carrying a huge scroll): That’s a non sequitur. He’s showing off again. He’s so arrogant, he’s funny.

PETER: Yes, but in Heaven he’ll get a little tiresome. Where am I going to put that guy when he comes through the pearly gates?

JESUS: As I said, “My house has many mansions.” You’ll find a place for him.

PETER: I think I’ll have him bunk with Erasmus. They’ll put each other asleep with their pontifications and we won’t have to listen to them.

GOD: All those guys down there think they know all the answers. Haven’t they read Job? Who are they to question me?

THE HOLY SPIRIT: I enjoy trying to influence their thinking…. and their heart.

JESUS: When you are around them a lot you begin to really love them.

GOD: I’m glad you like them boys. It took quite a bit of dust to get them started.

LEON (back at the Bible study): It’s time to stop. We can have it at our house next week.

JOHN THE APOSTLE: They are so funny. I can’t wait until next week’s show. I’ll bring the wine in the new skins.

Sonnet 116

Let me not to the marriage of true minds

Admit impediments. Love is not love

Which alters when it alteration finds,

Or bends with the remover to remove:

O no! it is an ever-fixed mark

That looks on tempests and is never shaken;

It is the star to every wandering bark,

Whose worth's unknown, although his height be taken

Love's not Time's fool, though rosy lips and cheeks

Within his bending sickle's compass come:

Love alters not with his brief hours and weeks,

But bears it out even to the edge of doom.

If this be error and upon me proved,

I never writ, nor no man ever loved

Thank God For Hurricaine Katrina--The Storm Gave Me Hope

The Lower Ninth Ward in New Orleans experienced calamitous flooding from Hurricane Katrina in 2005. The storm surge came from the east via flooded Saint Bernard Parish and from the west through two large breaches in the Industrial Canal flood protection system, creating violent currents that smashed homes and tore them from their foundations. The storm became the costliest natural disaster in U.S. history. At least 1,836 people lost their lives in Hurricane Katrina and many more thousands were rendered homeless.

            A College Station resident commiserated with one of the Hurricane evacuees temporarily housed in a local church:

            “That must have been the most terrible thing that ever happened to you. You lost your home. You lost your clothes and all of possessions. You have no money. You can’t get in touch with your relatives. Your friends have been displaced. What a tragedy. How will you ever recover?”

            The evacuee replied:

            “Surely that storm was a terrible thing. I was scared and pretty well knew for certain I was going to die. Then a boat came and they took us to the Superdome, and it was like the devil himself had come down and was torturing us. We were all crowded together and squashed-up. People were yelling and crying. It was hot and dirty. And we all got thirsty and hungry. It smelled bad and it seemed there was no hope for any of us. But somehow, we got rescued and took care of. And now here I am in this nice church. We have food. And water. And air conditioning. And good people are helping us and looking after us.

            Yes, that Hurricane was a horrible thing and I never want to go through nothing like that again. But, you know, that Hurricane—no matter all the bad things that happened—was the best thing that ever happened to me and I am thankful for it.

            I’m not discounting the bad things that happened to so many people and all the dead people and people who never will find their families, but for me that hurricane was good. If it hadn’t been for Katrina, I would have been trapped in the lower ninth ward for life. Before the hurricane, I had nowhere to go. I had no idea how to go. I had no money to go. I was just there and that was my life. But the big wind came and blew me to a better way of looking at things. And now I have a new life, a new start on life. I’ve got possibilities. Yes, thank God for Hurricane Katrina. I’ve got hope.” 

THE TRAGIC FAILURE TO CHANGE

            Some people have difficulty changing because they are caught in financial or geographical traps. Let us consider those people, however, who have every opportunity to change, but, nonetheless, continue to engage in self-defeating behavior despite ongoing negative consequences:

v    Smoking, obesity, and alcohol abuse can lead to chronic illnesses and premature death. Despite ominous health warnings that are more certain than storm alerts from the National Hurricane Center, surveys by the Centers for Disease Control and Prevention show that very few people are willing to stop their self-destructive unhealthy habits.

o      20% of American adults smoke

o      More than 30% of Americans are overweight

o      15% of Americans are binge drinkers

v    People are often noncompliant to medical treatments

o      50-65% of Americans fail to follow their doctors’ treatment recommendations

o      10% of hospital admissions among older adults result from failure to follow doctors’ directions

o      Almost one-third of patients visiting a physician fail to get their prescriptions filled

o      A Case Western Reserve University survey showed that 54% of glaucoma patients failed to use their eye drops as directed even though these patients knew they would go blind unless they complied with their doctors’ instructions.

o      70% of patients receiving treatment at a community mental health center dropped out of treatment before the third visit.

v    Most serious attempts to maintain behavior change are unsuccessful. A University of Scranton study found that only 19% of those who had made a significant change in a problem behavior maintained the change when surveyed two years later.

v    People continue to engage in patterns of behavior—anger, violence, nagging, dependency, and jealousy—that are destructive to their relationships and their well-being.

A Reason to Resist Change

v    EMOTIONAL AMBIVALENCE. A woman complained vociferously about her husband who controlled her. He wouldn’t let her out of the house alone. He wouldn’t let her drive a car. He wouldn’t let her visit friends. When asked why she didn’t leave her husband, the woman replied, “I love him so much.” When the woman was seen two years later. She had the same complaints about her husband. She remained married.

REASONS FOR LACK OF CHANGE

v    CIRCULAR EXCUSES. Common explanations for lack of change become circular arguments. People may blame their resistance to change on stubbornness, an addictive personality, or self-destructiveness. An explanation for refusing to improve a situation may go this way, “Because my situation is hopeless, I can’t change.” The behavior is then used to support the explanation, “I can’t change because my situation is hopeless.”

v    REBELLION. Telling someone to change often exacerbates the situation. A highly directive approach causes a person to adamantly resist change. One study showed that the more alcoholics were directed to change the more they drank.

v    INERTIA. Systems resist change. Physicists call this resistance to change “inertia.” The first law of motion indicates that people, like objects, tend to keep on moving if they are moving and remain standing still if they are still.

v    BLAMING. It is easier to make excuses for our problems than it is to assume responsibility for our own behavior. The statement “If she didn’t nag me so much, I wouldn’t drink,” is an example of blaming others.

v    LEARNED HELPLESSNESS. Put an animal in a cage. Apply a mild electrical shock all over the floor of the cage. When the animal discovers that escape is impossible, the animal lies down and passively in the corner of the cage and accepts the shock. Then the electrical shock is applied only to the corner where the animal is lying. The other areas of the cage are shock free. The animal continues to stay in the corner. Humans that are constantly exposed to conditions from which there appear to be no escape will eventually give-up and surrender to the situation. 

FORCES THAT IMPEDE CHANGE

Psychological Forces	Thoughts and Habits that Limit Change
Pain versus Pleasure	The immediate pleasure of the habit (gambling) is more powerful than the delayed pain (financial ruin).
Fear of failure	“If I don’t change, I will feel even worse than I do now.”
All or nothing thinking	“I must lose 50 pounds; losing 10 pounds is unacceptable”
Unconscious conflicts—unaware of problems	We may repeat maladaptive behavior because we fail to recognize the destructiveness of our acts.
Change is unpredictable	The discomfort of the status quo may be preferred over the anxiety produced by change.
Resisting authority	“I don’t like anyone telling me what to do.”
An undesirable habit may provide unmet needs.	Drinking relieves stress. Physical abuse provides attention. Eating fills a psychological void.

UNDERSTANDING BORDERLINE PERSONALITY DISORDER

I HATE YOU, DON’T LEAVE ME

            Borderline personality disorder (BPD) is a misnomer. The term "borderline" originated in the 1930s when psychiatrists thought that emotionally unstable patients dwelt on the border between neurosis and psychosis. The classification, Emotional Instability Disorder, better describes those individuals who demonstrate the following:

Ø    Ambivalent feelings about others—an “I hate you, don’t leave me” attitude. The borderline has intense love-hate relationships—thinking that a person is angel or a devil with no realization that all of us have “good” and “bad” traits. A few minutes or hours later, the borderline might idealize an individual and the next hour (or minute) the borderline will consider the individual worthless or evil.

Ø    Chaotic relationships

Ø      Frantic efforts to avoid real or imagined abandonment

Ø     An unstable self-image

Ø     Self damaging impulsivity such as overspending, sexual indiscretion, substance abuse, reckless driving, binge eating

Ø     Recurrent suicidal behavior, gestures, or threats

Ø     Self-mutilating behavior—cutting or burning self

Ø     Rapid onset of intense and profound depression

Ø     Rejection sensitivity—considered the slightest inattention of an individual as a totally rejecting attitude

Ø     Chronic feelings of emptiness

Ø     Inappropriate, intense anger—screaming, yelling, throwing things

Ø     Transient paranoid thinking, self-image, and behavior.

Ø     Emotional instability that disrupts family and work life

            People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). They may form an immediate attachment and idealize the other person, but when a slight separation or conflict occurs, they switch unexpectedly to the other extreme and angrily accuse the other person of not caring for them at all. Individuals with BPD are highly sensitive to rejection, reacting with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. Suicide threats and attempts occur as a maladaptive attempt to prevent abandonment. Intense anger develops when the borderline feels rejected. Self-mutilation results from an attempt to reduce emotional stress. For the borderline, physical pain is preferred over emotional distress. People with BPD exhibit other impulsive behaviors, such as excessive spending and risky sexual activity.

ORIGIN OF BORDERLINE BEHAVIOR

            Anyone who has a child knows that around 18-months of age the youngster toddles out of the room plays alone for a few minutes and then toddles back in the room looking for mother. With a wide-eyed smile, mama picks up her toddler, gives a warm hug, and coos encouragement. Consistent maternal and paternal affection enables the child to develop a stable sense of self and, with dependable parental behavior, the child develops the ability to sooth the self—the ability to tolerate the vicissitudes of life.  

            When the-soon-to-become borderline toddles back into the room, mama has disappeared or is drunk or is verbally, emotionally, physically, or sexually abusive. Inconsistent, negligent, and abusive parental behavior generates a fear of abandonment and retards the toddler’s emotional development. The toddler feels alone, lost, and worthless.

            As the years pass, feelings of worthlessness, and a poor sense of self cause frequent changes in careers, jobs, friendships, and values. Borderlines view themselves as fundamentally bad or unworthy. They feel unfairly misunderstood or mistreated, bored, and empty. These feelings result in frantic efforts to avoid being alone. The emotional clinging behavior exhibited by borderlines repulses others. The fear of abandonment felt by the borderline generates hostile behavior that results in the very rejection that the borderline fears.

NATURE VERSUS NURTURE— A GENETIC OR A PSYCHOSOCIAL ORIGIN?

            Although no gene has been identified as a precursor to borderline personality disorder, neuroimaging studies are intriguing. PET scanning and fMRI studies demonstrate enhanced amygdala and prefrontal activation in subjects with BPD. Excess activity in the cingulate gyrus is associated with borderline personality disorder. These findings are nonspecific indicators of intense emotional activity.

            Common sense indicates that some children are more sensitive than others. Just as some geneticists believe they have isolated a gene for shyness, a gene that serves as a biological marker for BPD may be identified. Remember—a gene must be activated before an illness occurs. That is, many of us may have a genetic marker for schizophrenia, but a stable emotional life prevents the gene from becoming activated.

NEUROCHEMICAL MARKERS

            The chemical messenger serotonin helps regulate emotions, including sadness, anger, anxiety, and irritability. Drugs that enhance brain serotonin function may improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs that are known to enhance the activity of GABA, the brain's major inhibitory neurotransmitter, may help people who experience BPD-like mood swings. An imbalance of dopamine, the so-called pleasure neurotransmitter, may contribute to impulsivity and anger. Antipsychotic medications can help regulate dopamine balance.

Illnesses ASSOCIATED WITH BORDERLINE PERSONALITY DISORDER

            BPD often occurs together with other psychiatric problems, particularly bipolar disorder and depression. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger and depression that may last only hours, or at most a day.

            BPD is one of four related personality disorders associated with dramatic-erratic behavior, poor impulse control, and emotional instability. Narcissistic, histrionic, and antisocial personality disorders are also distinguished by dramatic-erratic behavior. While almost 75% of borderlines are female, the vast majority of sociopaths (antisocial personality disorder) are male.

            Bulimia and other eating disorders, dissociate states, and anxiety syndromes are commonly associated with BPD. Substance abuse is a common problem in BPD. 50% to 70% of psychiatric inpatients with BPD are drug or alcohol dependent.

 

DIALECTIC BEHAVIOR THERAPY

            Dialectic behavior therapy is based on the Socratic method of discovering the truth. The therapist asks a series of questions exploring the what, where, when, why, and how of conflict and stress. Asking questions helps the patient learn appropriate responses for managing stress and conflict.

three elements of dialectic behavior therapy

1. The therapist communicates verbally and nonverbally to the patient that the therapist cares enough to be involved in helping the patient learn self-disciple. The therapist sets limits. He/she does not give into the excessive demands of the patient. At the same time, the therapist is reliable and steady. The therapist avoids rescuing the patient when the patient gets into difficulties in his/her daily activities of living while remaining kind and understanding. 
2. The patient keeps a daily journal that records events and feelings and thoughts generated by daily events. The therapist asks a series of questions to enable the patient to learn better ways of handling conflict.
3. Therapy allows the borderline to learn specific skills in dealing with stress and interpersonal conflict:

v    Evaluation of distorted thinking—the patient is helped to see different viewpoints in a conflict and to focus on present issues instead feelings from the past.

v    Dealing with stress—the patient learns to manage emotions that are triggered by distressing events, including those that cannot be immediately resolved.

v    Dealing with conflict with others—the patient is assisted in maintaining good relationships with others. Through a series of questions the therapist helps the patient learn that certain rules of society must be followed to get along in the world, and that to break social, ethical, and moral rules leads to self-destruction. Using the Socratic method the therapist helps the patient find ways to fulfill his or her needs in a way that allows others to fulfill their needs.

v    Developing emotional stability—the patient learns self-soothing behavior by changing distorted beliefs and inappropriate actions. For example, a series of questions can help improve the patient’s response to perceived rejection:

ü     What are you thinking (or doing) right now?

ü     Is what you are thinking (or doing) helping you?

ü     What thoughts (or actions) can help you feel better about yourself? (Several options may be formulated until the best solution is discovered.)

ü     Will you commit to changing your thoughts (or actions)?

ü     How will you demonstrate that you have committed to change?

FAMILY/MARITAL THERAPY

            The crux of family therapy involves educating family members regarding BPD. Improving communication will help resolve the two poles of inappropriate family response: over involvement (rescuing) and neglect. 

ELEMENTS OF CHANGE

v    Because ambivalence to change maintains the disease process, books, tapes, and didactic lectures help reveal unconscious psychological conflicts that retard progress.

v    Cognitive behavior therapy teaches more appropriate ways of thinking about conflicts.

v    Fellowship—developing friends who model appropriate behavior helps generate change.

v    Spiritual transformation provides love, joy, peace, patience, kindness, generosity, faithfulness, gentleness, and self-control.

TWO REASONS PEOPLE CHANGE

1.    Pleasure—realizing that new behavior patterns will produce more pleasure than maladaptive behavior patterns brings change. Believing that we can have a better life engenders different approaches. The power to visualize a successful outcome gives the courage to try new ways of doing things.

2.    Pain—understanding that maladaptive behavior causes intolerable distress stimulates an alternative lifestyle. Drastic environmental consequences may be required before inertia can be overcome. Imprisonment, financial ruin, homelessness, or the treat of death may be necessary before transformation occurs. Allowing a person to suffer may be the best way to generate change. 

VALENTINE CHOCOLATES

            He sits there for a while, looking at her. She is still beautiful. Her freckles have faded with the years, but her skin radiates warmth, moonlight bathing the contours of her face. Her hair, silver now, softly falls all around the pillowcase. Her emerald eyes, magnetic as always, pulls him to the first time he had seen her—in college, in Professor Mangum’s Freshman English class. He remembers her eyes and her voice, resonant as she recited Shakespeare:

 

As you were when first, your eye I eyed,

Such seems your beauty still.

 

            She was a young girl, filled with excitement and wonder. Her laughter filled the gloomiest day with sunshine. Her radiant smile warmed his life. He had never seen a face so expression filled, ever changing like ocean waves.

            Her body athletic, firm and well proportioned, stomach flat, legs tanned, reflected health and feminine strength. When he wrapped his arms around her body, she seemed to melt into his, summoning sensations of soft snow falling. Her kisses opened the door to heaven.  

            A bird starts to sing outside the window, and he turns his head. Outside the rolling lawns shaded by towering oaks, make life seem secure somehow. He sits there quietly, enjoying nature’s beauty with her.           

            He marvels at the privilege of being married to her for 43-years. He is grateful for the steadiness of her love and her support, even when his mistakes were unsupportable.

            He remembers her hugely pregnant; her long and difficult labor that had him worried, and the doctor too. The sudden x-rays “just to check if her pelvis is big enough.” The pain she experienced standing and twisting to the instructions of the technician as the contractions intensified.

            After the delivery and she was tucked in warm and safe, he walked back to their apartment numb from the ordeal, crying softly for her and her suffering. He was trying to study for the Medical Board exam scheduled that afternoon when a call came from the hospital. She was bleeding. He ran back to find her pale and clammy. He felt guilty—Why did he leave so soon? He knelt beside her bed, praying. Emergency surgery was scheduled. A small section of placenta extracted. The danger had passed.

            Now the menace is different, a slow, progressive slide into oblivion. An aide enters the room to take vital signs and fluff the pillow, interrupting his thoughts. As she leaves, he recalls his flight surgeon days, the vertical power of the F-4 Phantom, over the top, negative Gs. The thrill of riding the helicopter hoist to help those below. The daily adrenalin rush. He had ignored her needs then and she began to pull away, becoming more independent. Sadly, she placed second during the years of medical specialization, the pleasures of academia, and the demands of medical practice. Worldly things made him less considerate to her needs, never knowing how much she needed his attention, and he, hers.

 

The world is too much with us; late and soon,

Getting and spending, we lay waste our powers…

We have given our hearts away.

 

            Making money and buying things. Ambition. Competition. Wanting it all. More recognition. Bigger cars. Larger homes. The best schools. Trying to beat everybody else at everything.  All these things get into the way of what is most important—loving those we care about.

            A crisis. Then a coming together with a better understanding of needs they each had. As was his bent, he remembers other ways that he had let her down and had disappointed her.

            He looks at her. She smiles peacefully. He asks if she remembers walking in the Angelina County rain, drive-in movies Friday night, country summer evenings, the first time he told her he loved her, sitting together after Caribbean lunches, sunset sails, walks along Carolina Beach. She doesn’t.

            He tells her about their trips to tennis tournaments with the kids; reading out loud together; kneeling for nighttime prayers, mountain cabin excursions, board games with the family, card games together—how she always seemed to edge him out in the end.

            He reminds her of riding the jeep on mountain road switchbacks and campfire ghost stories—the Battery Beast, Chug Houndlicker, the Ditch-dog Killer, Gunner Shellachumm. She smiles at his enthusiasm, but the stories fail to register.

            He tells how she laughed when on a canoe portage she fell, the backpack pressing her, turtle-like, into the mud before he ran to help her. He laughs about their first fight when he couldn’t get the wet wood to light. As a last resort, he tore their hiking map throwing it on the kindling. Finally, the fire started, but she refused to let him grill the hamburger patties because “they had been out too long.” She remembers none of it.

            He told her about the basketball games. She would yell loudly for their team, but when it got to crunch time and the game was close, she would hide her eyes with every shot, asking, “What happened?” Ditto for movies. In the scary parts, she always hid her eyes. He would kid her and suggest that they request a ticket rebate because she only saw half the movie.                       

            She shivers slightly. He stands and pulls the covers over her shoulders. Returning to the bedside chair he remembers the mornings when he would make the coffee, and bring it to her in bed where they would talk of prayers and promises, their family and friends, their children and their hopes.

            Gradually, they learned the value of putting God first in their lives, and, paradoxically, when they did so, they became closer. When their children left the state for prospects elsewhere, they became almost inseparable. Friendships became more abundant and more intimate.           

            He considers her biggest fault—one of her few faults. The fault that bothered him the most was this: She never told him what she wanted. She never asked him to do something for her. Because he got the most joy out of giving her joy, he would have given her anything she wanted. But she never told him what she wanted. “You should know,” she said.

            He remembered her father’s funeral when he learned something about her that he had never known before. At the wake she had said:

            My father was such a wonderful man. He had integrity. He was loyal. A good provider. Understanding. He allowed me to make small mistakes that taught me life lessons, while standing firm on rules and regulations that kept me out of real trouble.

            It seems strange, but one thing he did keeps returning to my mind. Every Valentine’s Day he gave me a box of chocolates. That gift of chocolates came every year, as certain as the sun rising.

            Chocolate? He didn’t understand what made her father’s gift so special. In contrast to his father-in-law who gave chocolates, he was a “candy-is-dandy-but-liquor-is-quicker” man, a fast track guy. Run for a gift at last minute, charming the clerk to wrap it. What’s the big deal about chocolate? He was clueless.

            Months later at a party, the discussion turned to chocolate—the flavors—dark chocolate, milk chocolate—chocolate with names he had never heard discussed, chocolate imported from Europe and Asia! My goodness!           

            From then on every Valentine’s Day, he bought her big boxes of chocolates, lots of boxes. He overdid it, she said. Finally, he learned the chocolates that were special to her. Thereafter she got her special chocolates, the ones she liked the most “in the whole wide world.” Her happiness warmed his heart.            

            A rain taps tiny drops gently on the windowpane, bringing his thoughts back to the present. He reaches down. He takes a red package out of a gift bag. He places the package on the nightstand.

            She looks at it.

            “What is it?” she asks.

            “Chocolates.”

            “Chocolates. I love chocolates, don’t I?

            “Yes,” he says.

            “David?” she says. “David. You’re David aren’t you.”

            “Yes,” he says.

            “I’m sorry,” she says. “I didn’t know who you were and I was afraid to ask. I was afraid I would hurt you. You were so kind to me, but I couldn’t remember who you were. David… David…I’m afraid I will forget who you are again.”

            “You remember who I am now,” he says.

            Slowly he gets out of his chair. He goes to her bed. He lowers the bedrails and lies beside her. He wraps his arms around her body. She seems to melt into his, summoning sensations of soft snow falling.

           

 

The Power of Visualization

Imagination powerfully influences successful outcomes. When imagination and will-power compete, the imagination always wins.

Force of will never keeps you striving for success, but proper visualization will. Visualization will make you a winner on the golf course or tennis court and it will enable you to be more successful in business and your daily life.

All peak performers visualize success. Before shooting a free throw, skilled basketball players see the ball ripping through the net. Before great golfers hit each ball, they vividly picture where they want the ball to go.

Likewise, when we visualize a pleasant and contented family life, we will most likely have a happy home. And visualizing business success enhances a good outcome.

A relaxed mind enforces the effectiveness of visualization. Practice this exercise:

Assume a relaxed position. Close your eyes. Silently repeat these words, "Breathe in relaxation; breathe out tension." When you feel relaxed, visualize what you want to happen. Focus on this positive visual image for a few seconds. Hit the golf ball 250 yards straight down the middle of the fairway or the tennis serve deep into the backhand corner…or successfully complete that sales call…or peacefully persuade your truculent child to go to his room.

Broadcast Good News

No one ever made a friend or accomplished anything worthwhile by transmitting bad news. Good news, on the other hand, promotes good will and spreads enthusiasm. The message, "I've got good news" gets the attention of everyone. Take sunshine to work. Talk about the positive things your company is doing. Compliment people you work with. Let them know you have faith in them. Always aim to make the person you talk to feel better than he otherwise would.

Talk to your family about the amusing, pleasant things you experienced during the day and let the disagreeable stay concealed. Bring rainbows home. If you can't say anything good about your physical health say nothing at all. No one wants to hear about your aches' and problems. Instead, glorify in your good health and the good things that are happening.

Choose Enthusiasm

Enthusiasm. Corporate presidents voted it the most valuable personality trait. It's the biggest single factor in successful selling. It wins ball games. Inspires audiences. Enhances learning. Builds team spirit. Propels careers. Makes dull days bright.

Choose enthusiasm by seeing your dreams come true. Think enthusiastically. Talk enthusiastically. Become enthusiastic by acting enthusiastic. Your thoughts and actions determine your level of enthusiasm.

Add Zip to Everything You Do.

Walk fast.

Put a bounce in your step.

A vigorous, hearty handshake indicates you are glad to be alive and happy to be with the other person.

A robust smile radiates enthusiasm.

Reply to the mundane, "How do you do?" with an attention getting, "Fantastic...and I'm going to get better!"

Put spirit into your speech by varying the pace, raising and lowering the pitch, changing the tone and modulation.

Talk with more than your mouth-use wide sweeping gestures. Don't hold back. Turn it on.

Force yourself to act with enthusiasm, and soon you will feel enthusiastic.

This is the era of dramatization. Simply stating the facts isn't enough. The truth must be made vibrant, arresting, theatrical. If you want to keep and hold someone's attention, you must use showmanship.

Strawberry Solutions

A psychologist stood in the produce department of a grocery store. As each customer passed him, the psychol¬ogist tested their reaction to verbal influence. He declared to one group, "You don't like strawberries do you?" 90% of the customers agreed with his statement.

He offered the next group a basket of strawberries with this assertive query, "You want some strawberries, don't you?!" Half of them accepted his strawberries.

He asked the third group, "Do you want one or two baskets of strawberries?" 40% of these customers took two baskets; 50% took one basket; and only 10% took no strawberries.

Attitude Platitudes

Whether we are running hot, running cold, or sim¬ply running on overload, we can take charge of our atti¬tude by remembering these aphorisms:

Success has more to do with our emotional disposition than with our social position.

Kites rise against the wind, not with it.

A rubber band becomes effective only when it's stretched.

More opportunities exist than there are people willing to seize them.


What matters is what happens in us not to us.

You can tell when you are on the road to success. It's uphill all the way.

When Goliath appeared, David said, "He's so big, I can't miss."

Wait until the lows pass and you will feel on top of things.

Choices, not circumstances, determine how we think.

Because action cures misery change your motion to create positive emotion.

Where there is no faith in the future, there is no power in the present.

To accept failure as final is to be finally a failure.

Failure is the line of least persistence.

Others can stop us temporarily, but we are the only ones who can stop ourselves permanently.

Our lips program our brain for success or failure.

Act "as if" we are successful and we will be.

Attitude determines whether our failures make us or break us.

Life is one percent what happens to us and 99 percent how we react to what happens.

Gratitude adjusts our attitude.

Attitude is Everything

Two shoe salesmen were given a new territory on a Pacific island. Immediately upon arrival, the first sales¬man placed an urgent call to the home office: "Get me out of here. No one on this island wears shoes."

The second salesman sent an e-mail request to the factory, "Please put everybody on overtime. Will need as many shoes as you can manufacture. No one on this island has any shoes."

Attitude determines the difference between shoed or shoeless. Attitude is more critical than events. It's more significant than what's happened or what's hap¬pening. Attitude is more consequential than the past, than genetics, than education, than money. Attitude is more important than what other people think...or say...or do. It is more important than appearance or tal¬ent. Attitude will make or break an individual, a home, a company, or a country.

Because attitude determines whether we are happy or unhappy, fulfilled or empty, the positive perspective assures us that we can never fail. A hopeful attitude guarantees internal success. Attitude-the altitude adjuster-determines whether we fly high or low, crash or soar, glide or slide.

A couple of days ago I had a pity party. I became upset with everything and everybody. Suddenly I felt ashamed. I wasn't any better than a spoilsport. I rebuked myself: "Anybody can have a positive attitude when things are going well. It's how you act when things are going badly that determines the strength of your character. An appropriate attitude means feeling hopeful in challenging times. Stop feeling sorry for yourself. Count your blessings. Look for the good."

I shared my insight with a friend who, later that day, gave me a adhesive label to place on my bathroom mirror. Now whenever I shave, brush my teeth, or comb my hair, I see the message: Attitude is Everything. This little reminder helps me tidy up my point of view.

VALENTINE CHOCOLATES

 

            He sits there for a while, looking at her. She is still beautiful. Her freckles have faded with the years, but her skin radiates warmth, moonlight bathing the contours of her face. Her hair, silver now, softly falls all around the pillowcase. Her emerald eyes, magnetic as always, pulls him to the first time he had seen her—in college, in Professor Mangum’s Freshman English class. He remembers her eyes and her voice, resonant as she recited Shakespeare:

 

As you were when first, your eye I eyed,

Such seems your beauty still.

 

            She was a young girl, filled with excitement and wonder. Her laughter filled the gloomiest day with sunshine. Her radiant smile warmed his life. He had never seen a face so expression filled, ever changing like ocean waves.

            Her body athletic, firm and well proportioned, stomach flat, legs tanned, reflected health and feminine strength. When he wrapped his arms around her body, she seemed to melt into his, summoning sensations of soft snow falling. Her kisses opened the door to heaven.  

            A bird starts to sing outside the window, and he turns his head. Outside the rolling lawns shaded by towering oaks, make life seem secure somehow. He sits there quietly, enjoying nature’s beauty with her.           

            He marvels at the privilege of being married to her for 43-years. He is grateful for the steadiness of her love and her support, even when his mistakes were unsupportable.

            He remembers her hugely pregnant; her long and difficult labor that had him worried, and the doctor too. The sudden x-rays “just to check if her pelvis is big enough.” The pain she experienced standing and twisting to the instructions of the technician as the contractions intensified.

            After the delivery and she was tucked in warm and safe, he walked back to their apartment numb from the ordeal, crying softly for her and her suffering. He was trying to study for the Medical Board exam scheduled that afternoon when a call came from the hospital. She was bleeding. He ran back to find her pale and clammy. He felt guilty—Why did he leave so soon? He knelt beside her bed, praying. Emergency surgery was scheduled. A small section of placenta extracted. The danger had passed.

            Now the menace is different, a slow, progressive slide into oblivion. An aide enters the room to take vital signs and fluff the pillow, interrupting his thoughts. As she leaves, he recalls his flight surgeon days, the vertical power of the F-4 Phantom, over the top, negative Gs. The thrill of riding the helicopter hoist to help those below. The daily adrenalin rush. He had ignored her needs then and she began to pull away, becoming more independent. Sadly, she placed second during the years of medical specialization, the pleasures of academia, and the demands of medical practice. Worldly things made him less considerate to her needs, never knowing how much she needed his attention, and he, hers.

 

The world is too much with us; late and soon,

Getting and spending, we lay waste our powers…

We have given our hearts away.

 

            Making money and buying things. Ambition. Competition. Wanting it all. More recognition. Bigger cars. Larger homes. The best schools. Trying to beat everybody else at everything.  All these things get into the way of what is most important—loving those we care about.

            A crisis. Then a coming together with a better understanding of needs they each had. As was his bent, he remembers other ways that he had let her down and had disappointed her.

            He looks at her. She smiles peacefully. He asks if she remembers walking in the Angelina County rain, drive-in movies Friday night, country summer evenings, the first time he told her he loved her, sitting together after Caribbean lunches, sunset sails, walks along Carolina Beach. She doesn’t.

            He tells her about their trips to tennis tournaments with the kids; reading out loud together; kneeling for nighttime prayers, mountain cabin excursions, board games with the family, card games together—how she always seemed to edge him out in the end.

            He reminds her of riding the jeep on mountain road switchbacks and campfire ghost stories—the Battery Beast, Chug Houndlicker, the Ditch-dog Killer, Gunner Shellachumm. She smiles at his enthusiasm, but the stories fail to register.

            He tells how she laughed when on a canoe portage she fell, the backpack pressing her, turtle-like, into the mud before he ran to help her. He laughs about their first fight when he couldn’t get the wet wood to light. As a last resort, he tore their hiking map throwing it on the kindling. Finally, the fire started, but she refused to let him grill the hamburger patties because “they had been out too long.” She remembers none of it.

            He told her about the basketball games. She would yell loudly for their team, but when it got to crunch time and the game was close, she would hide her eyes with every shot, asking, “What happened?” Ditto for movies. In the scary parts, she always hid her eyes. He would kid her and suggest that they request a ticket rebate because she only saw half the movie.                       

            She shivers slightly. He stands and pulls the covers over her shoulders. Returning to the bedside chair he remembers the mornings when he would make the coffee, and bring it to her in bed where they would talk of prayers and promises, their family and friends, their children and their hopes.

            Gradually, they learned the value of putting God first in their lives, and, paradoxically, when they did so, they became closer. When their children left the state for prospects elsewhere, they became almost inseparable. Friendships became more abundant and more intimate.           

            He considers her biggest fault—one of her few faults. The fault that bothered him the most was this: She never told him what she wanted. She never asked him to do something for her. Because he got the most joy out of giving her joy, he would have given her anything she wanted. But she never told him what she wanted. “You should know,” she said.

            He remembered her father’s funeral when he learned something about her that he had never known before. At the wake she had said:

            My father was such a wonderful man. He had integrity. He was loyal. A good provider. Understanding. He allowed me to make small mistakes that taught me life lessons, while standing firm on rules and regulations that kept me out of real trouble.

            It seems strange, but one thing he did keeps returning to my mind. Every Valentine’s Day he gave me a box of chocolates. That gift of chocolates came every year, as certain as the sun rising.

            Chocolate? He didn’t understand what made her father’s gift so special. In contrast to his father-in-law who gave chocolates, he was a “candy-is-dandy-but-liquor-is-quicker” man, a fast track guy. Run for a gift at last minute, charming the clerk to wrap it. What’s the big deal about chocolate? He was clueless.

            Months later at a party, the discussion turned to chocolate—the flavors—dark chocolate, milk chocolate—chocolate with names he had never heard discussed, chocolate imported from Europe and Asia! My goodness!           

            From then on every Valentine’s Day, he bought her big boxes of chocolates, lots of boxes. He overdid it, she said. Finally, he learned the chocolates that were special to her. Thereafter she got her special chocolates, the ones she liked the most “in the whole wide world.” Her happiness warmed his heart.            

            A rain taps tiny drops gently on the windowpane, bringing his thoughts back to the present. He reaches down. He takes a red package out of a gift bag. He places the package on the nightstand.

            She looks at it.

            “What is it?” she asks.

            “Chocolates.”

            “Chocolates. I love chocolates, don’t I?

            “Yes,” he says.

            “David?” she says. “David. You’re David aren’t you.”

            “Yes,” he says.

            “I’m sorry,” she says. “I didn’t know who you were and I was afraid to ask. I was afraid I would hurt you. You were so kind to me, but I couldn’t remember who you were. David… David…I’m afraid I will forget who you are again.”

            “You remember who I am now,” he says.

            Slowly he gets out of his chair. He goes to her bed. He lowers the bedrails and lies beside her. He wraps his arms around her body. She seems to melt into his, summoning sensations of soft snow falling.