Sleep Disturbance

From time to time I go through substantial stretches of not sleeping well, falling asleep before the usual sleep time, awakening when the only things on TV are infomercials peddling things that other insomniacs might purchase to make them slimmer or cast an illusion of future savings, and even my Californian friends have put Facebook away for the night.  Sometimes I get back to sleep, sometimes spend the rest of the night tossing or staring until the clock says I can no longer do that.  Somehow I manage to acquire my second wind by the time the patients arrive but on arrival home I am in no position to remain awake until the usual sleep time, one of the core principles of regulatory sleep hygiene.  I have sampled some chemical regulation including some Ambien CR samples that a drug rep left at the office.  This worked rather well on the four tries.  I dozed off, stayed asleep, awoke at a reasonable time and felt OK the next morning.  For a Saturday night this would be fine.  Risking disorientation during the week when I have a long drive to work and many daytime responsibilities is hardly worth the potential downside.  So I never pursued this, other than a brief comment to my doctor at the last visit.  Benadryl, or more accurately Dollar Store sleeping aid capsules which contain diphenhydramine, also works well at getting me to sleep which has not been a problem and minimizing early awakening.  At the usual wake time I rarely feel rested.  Hot Toddy also has had inconsistent results, doing much better at putting me to sleep than keeping me that way until the next morning.  I've not tried this at 3AM to return to sleep, though I probably could on a Friday or Saturday night.

Having attended enough Grand Rounds on this subject and occasionally guiding patients, I have reasonable familiarity with principles of sleep hygiene that I routinely violate or make excuse to justify non-compliance.  My sleep times are generally not maintained since I often doze off early due to deprivation the night before.  Getting up at the pre-determined time seems to go well, with little variation between work days and off days.  Where I probably go astray is use of the bed for a variety of activities for which it was not intended, from reading to TV to iPod, as my comfortable sanctuary with a warm down comforter that serves me well in all seasons.  We have opaque shades, always closed, so that the room has artificial light all the time.  This tends to be a bigger problem with getting up than with staying asleep, but I overcome this by going downstairs at 5:30 most mornings where curtains are kept open allowing plentiful daylight.

For the most part, the purpose of sleep should be to enable activity the next day, so in that sense I am not particularly incapacitated by this, though I sometimes wish I felt a little more energetic by the time I get home most evenings.  Will definitely have to be more firm with myself in adhering to the modifications that may leave me more rested most mornings.

Incomplete Tasks

This weekend I had devoted to catch-up on a very long list.   I managed to get my overdue lab results from my doctor and acted on it.  Mercy Philadelphia Hospital has its first week of Computerized Physician Order Entry, known as CPOE, which occupied much of my work week to the neglect of anything else.  I had a few deadline items such as doing shacharit at AKSE and learning the third aliyah of next week's Torah portion, which I got done.  There was a semi-deadline for a blog contract with Medscape that I pretty much did as well.  And then we have the many things that have to get done or should get done but do not really have deadlines and sometimes not even end points.  This week I will have to update the hospital billing and change the system around to make the billing more timely.  The Department of Labor has sending me notices for a year even though I have not had employees during that time.  I finally took my fifty year old Schwinn out of the garage, put air in the tires and took it to Sports Authority for a safety and function inspection with the intent of riding it for exercise.  I can sit at my desk.  My new briefcase has sufficient content to transport things that I need to keep in my possession.  There is a menu for Mother's Day and I even got a card.  So it wasn't a total non-productive week or even weekend.

Just shy of two months remain in my semiannual intentions.  I may still be able to bring a cleaning crew in next month if I get the Family Room more accessible.  My monthly outings remain on schedule and I have some growth to the culinary herbs outside the front door and in the aerogarden.  I've done nothing of note financially. I've written nothing even close to submission for public consumption.  My research project remains largely neglected.  I'll try to plod along with these in the coming week.

shabbaton

We have a guest scholar coming to AKSE in a few weeks to enhance the shabbat experience which recently has a lot of opportunity for enhancing.  As one of the Torah readers I will need to attend, though most of these have been significant disappointments for the yield relative to effort.  With only a few weeks to go, there has been very little publicity.  I assume there will be a Friday night dinner with a talk, Shabbos morning with a luncheon and seudah shlishit with a talk.  I know nothing of the speaker other than somebody who I admire greatly admires him greatly and that he is a rabbi.  There is a financial investment that rarely gets recouped.  There are logistical problems for which people rise to the occasion.  That may be the congregation's  most significant benefit.  But for the most part these weekends are rather passive.  People come together but they do not have to put forth the effort to prepare their dinner or any other element of shabbat other than personal scheduling.  They listen to the speaker, maybe ask some questions, acquire an opinion of how the weekend went, give feedback if asked but are rarely moved significantly ahead from the experience.  An unexpected plus, the Cantor will be away so the congregants need to rise to the occasion to conduct services, something that will happen though not always easily.

Maybe the lack of enthusiasm for this reflects on me and what I aspire to Jewishly more than it does on the congregation and what its leadership aspires to for the advancement of the people.

Hakaras HaTov

While I work rather hard, I still enjoy the vigor to pursue what the hospital expects of me, and probably a little beyond that.  People younger age than me come to the exam rooms incapacitated in some way.  Yet despite feeling tired at times I am able to get up each day and find the energy to do what I am expected to do.

My lifestyle is simple and reasonably sedate.  There is a house, not at all ostentatious but paid for and in need of some upkeep but not beyond my capacity to complete.  My transportation is comfortable and stable.  I've been married going on 35 years and see a challenging effort of raising kids paying off.  My parents have passed on but I inherited and passed along enough character to allow the generations to turn over one to another.

Tal Ben-Shahar in his PBS special advocated keeping a log of five items worthy of thanks that occurred each day.  there are usually more than five, though sometimes it is a struggle to come up with five.  The Seder has a similar section of Dayenu with a somewhat longer than daily perspective.  The value of Hakaras HaTov, gratitude for the good, can and should be both daily and long-term.

On to a new personal year for me with its optimism and challenges begins today.

Baalebatim

AKSE accepted the report  of its nominating committee.  While the Rabbi has never taken a position on human cloning he may not have to since the President's relatively hand-picked governance assembly comes pretty close.  There has been negligible turnover in officers since a By-laws amendment a few years ago did away with term limits for all officers but the President.  Diversity of thought, or even creativity of uniform thought, has not been there in a while.  Membership reports, the lifeblood of the congregation not only financially but for future vibrancy, have become lists of who came and who departed when they should be opportunities to develop the people they have and plan expansion to the people they might like to have.  Financial reports again come across as lists rather than analysis of where to put the resources that we have and reallocate them for a purpose.  My lab sheets are also aggregates of numbers but they generated decisions.  The financial reports do not.  This is a variant of human cloning where everyone looks and thinks alike, where recessive genes or organizational incest take form as the norm.  I do not think a person or an organization can pursue excellence with that manner of uniformity.

Lest I be too harsh, AKSE is not the only place that defaults to mediocrity due to inability to engage the most capable baalebatim.  yutorah.org presented a wonderful symposium recently on this reality that has pervaded many synagogues.

http://www.yutorah.org/lectures/lecture.cfm/773422/Dr_David_Pelcovitz/Leadership_Influence_and_Professionalism__

There are entrepreneurs and there are corporate system managers.  There are people who work with what is there and there are people whose talent is to pursue what might be.  All four are not only needed for a place to thrive but all four need to be valued to for what they bring to the composite.  That has not been the case at AKSE for some time.  There are only two entrepreneurial visionaries which may be what is needed but the most capable third got lopped off.  There is no outreach to legitimate talent that would prefer to stand outside the tent and pee in.  As annoying as they sometimes are, or maybe more accurately as we sometimes are, they protect you from a course of mediocrity misrepresented as pseudoexcellence.  Increasingly AKSE has not been a place that justifies the benefits of laytzanos.  Its results reflect that.  Nobody puts themselves out to read more than a shlish of Torah or a haftarah that was not their Bar Mitzvah portion.  It is dominated by functionaries who fill slots in schedules.  They get filled but nobody gets the satisfaction inherent in meeting a new challenge.

A dearth of baalebatim may have infused much of the Jewish world, one in which people increasingly seem rewarded more for their loyalty than their ability.  There really are people of ability around pursuing the things that challenge and satisfy them.  The Jewish organizational world, AKSE among them, has just accepted less than it could have had.  Unfortunately projects like the Nominating Committee functioning as a Telephone Tree for the President when it should be an analytical body assessing what different people can do to make AKSE a more attractive place reinforce the impression that other forums value talent, energy, and diversity more.

Pesach Prep

Pesach this year largely spans the weekend for Yom Tovim.  Sedarim are Friday and Saturday nights, the concluding days are Friday and Saturday.  Moreover, Good Friday precedes Seder to allow a more leisurely entry than most years.  I will still need to sneak in an afternoon of patient care somewhere during the three days. Friday before Seder may work best for me as I have my own Seder to arrange Saturday night but little to do in advance of the first Seder.

In my preference for Jewish Holidays, Pesach usually comes first.  I find it a form of separatism, some preparation that seems arduous in the process but satisfying as a form of accomplishment once the festival has begun.  It has been a time for a family to assemble in one place, at one time the gantza mishpacha on my mother's side going so far as to rent a space for cousins and second cousins to gather.  I've been to large Sedarim in college and some so limited in attendance to my wife and me.  I try to sneak in a little learning before the holiday and some during the holiday.  For an entire work week I do not have to go to the doctors lounge for coffee, yet I never feel deprived of not having any.

Services for the Yom Tovim have been a mixed bag.  As a Bachor, or first-born, I am expected to fast the day of the Seder but there is an exit strategy by attending minyan then finishing a section of Talmud.  On work days I usually just fast, but this year with the day off I will more likely attend the tziyum.  Among my fondest memories of this were the tziyumim at the JCC Spring Valley during my teen years where there was a real discussion of a real tractate followed by breakfast with authentic local bagels and a good deal of camaraderie among first-born friends and their first-born fathers.  That has not been duplicated in Wilmington though the occasion probably stands on its own.

Usually Daylight Savings Time has begun before Pesach arrives so the sedarim can be quite late, particularly the second which cannot begin until after the first day yom tov concludes.  Not having to go to work the next day helps but there are a lot of groggy looking folks in shul.

Dietary restrictions add to the sense of separation and for myself and generations before reflect a challenge in creating treats amid limited availability of raw materials.  there are classics like matzoh brei and cremslach and macaroons.  There are matzoh kugels that would be wonderful anytime but special this season.  And there are new recipes to try out.  Most years shabbos Pesach coincides with Good Friday which remains a semi-secular holiday for the local companies and medical enterprises and schools.  With a day off and Pesach usually under way, I try to have dinner guests that evening and make something special.  Even though this year is a little out of sync, I will try to do the same.

Pesach is food and people and pageantry and effort, all worth it.

Two Days Off

Two vacation days to try out retirement.  That was not the initial purpose, which really included neglected chores like my finances, taxes, dental work, auto service, and drivers license renewal, all of which got done.  Most of it got done the first day, leaving me with some open ended time the second day.  I do not expect to last a whole lot longer at Mercy Philadelphia Hospital.  As much as I like being with the patients and meeting the residency program challenges, the time and effort involved have taken its toll on me personally.  I work at higher volume than what the people who run the place are used to and try not to be too demanding.  While I keep up with the work, the interest in removing the impediments which would enable me to do things that cannot be done when people are just tossed at you with little notice or planning just isn't there.  They are happy with having me as a Golden Goose and don 't realize that they will eventually slaughter it.

For me the question has been what would I do instead if I did not have to schlep off to work each day.  Might it drive me nuts?  So far it hasn't because I have other things that I might like to do instead.  I'd certainly like to get my house up to speed and have the funds to do it now.  My finances also need to be brought up to speed.  In both cases the rigors of my job have been real impediments.  I listened to a full lecture on yutorah.org for the first time in a while.  I used to listen to this a lot but I come home from a long day wanting nothing better than to be left alone while I see who posted what on Facebook.  I travel once a month as an escape.  I'd much prefer to travel as a destination without a clear deadline for getting back.  While getting my car serviced, I decided to write an essay that I've neglected for some time.  For an hour I had no place to go and no distractions.  I jotted down the thoughts though not having done this for a long time, I struggled with the actual composition.

A Facebook Friend recently allowed me to get reacquainted.  I knew he became an attorney and has what seems to be a solo practice, on only his name as the identity of his firm.  I also learned from his postings that he has become a ski enthusiast and a cycling enthusiast, spending a fair sum on each to say nothing of prioritizing them into his personal schedule.  Myra has her dogs.  Irene has Torah Portion Humor and Choral Music.  I never really developed an insatiable interest in anything, even though there are many things I like doing.  One probably does not really need that to retire successfully but there has to be some type of activity agenda.  I learned from my two days for myself that I can occupy my time in a productive way, both accomplishing a doable list of well-defined chores and absorbing time in a suitable way when it comes in a more amorphous fashion.