Use Your Signals: It Matters

A car stopped on the street in front of me yesterday. Then its hazard lights came on. I was so grateful, because then I knew what to expect and do! HALLELUJAH, THANK YOU!

Brake. Turn. Reverse. Hazard. High beam. Our cars are designed with signals to make our intentions and actions on the road efficiently and effectively communicable.

Car going straight goes before car turning at a stop sign. If both cars are going straight then the one on the right goes first. No changing lanes in an intersection. DO NOT ENTER AN INTERSECTION YOU CANNOT CLEAR. Our traffic laws are designed to make vehicular interactions uniform and safe.

And yet, much like passengers during air flight, drivers seem to disregard any and all conventions of safety and courtesy more and more every year. We disregard one another.

“Always make eye contact.”

The most important safety lesson I learned from the Susan G Komen Breast Cancer 3-day in 2002 was to always make eye contact with drivers at intersections, before crossing the street. I had never thought discreetly about it before, and suddenly it made total sense; I adopted the practice immediately and fully.

20+ years later now, I see this as yet another practice in relationship (of course!). It’s not just about safety, though that is the primary goal, for both pedestrian and driver. Nobody wants an accident. When we make eye contact, we see each other and negotiate our interaction–our relationship–if only nonverbally and in a second or two.

All of these practices–using car signals, following traffic law, and acknowledging one another while out and about–connect us as fellow humans. By offering other drivers and pedestrians the courtesy of a signal, a gesture of invitation to cross, or God forbid a wave and a smile of gratitude when someone lets us pass or merge, we make the world a little less cold, a little more personal, and a lot better, one small and significant interaction at a time.

Imagine if we all treated one another like someone we care about while out on the road? Imagine if we all actually cared for one another, just because we are all here, fellow humans, doing our best to get through this crazy, chaotic life with a little more dignity and a little less suffering?

Imagine if we all used our readily available, efficient, direct, and effective communication tools to signal our intentions, needs, and caring for one another off the road, too?

Wow, what an amazing world this might be.

New on HTC: The Bit Post; Choices

Captured from Facebook

Friends, every once in a while I have moments of relative wisdom and avid connection. Often it comes while responding to patient questions, sometimes on the phone, sometimes on email or portal messaging, and very often over text. So many posts on this blog started as these little, ‘bit’ insights. I marinate them, stir them around, turn them like a Rubik’s cube, until they’re so convoluted that it takes another, longer period to unravel them again to be ‘worthy’ to post.

So tonight I’m trying something new: the Bit Post. When moved, after brief and thoughtful enough consideration, I give myself permission to post these small notes, as is and with just enough background, just to share, in case they resonate with anyone. I feel an urge to engage here on the blog more frequently and lightheartedly, with less perfectionism and self-doubt. So we will see how this goes!

I sent the message below after a dear patient apologized for some behaviors that appear to have led to suboptimal blood test results. They made a self-judgmental comment about their life. I could feel their guilt and maybe some shame. So I replied honestly, as I wrestle with many of the same challenges. The example I give happened just last night.

So we go together, my patients and I. We are all here doing our best!!

Onward, my friends—ODOMOBaaT!

“Your life is what it is. Your choices are what they are, influenced by many circumstantial factors that vary day to day, moment to moment. No need to apologize to me—I’m not you!
“I have a rapidly evolving perspective recently on how I counsel people on habit and behavior change anymore.
“I’m here to inform and advise, not to judge. All of our choices are trade offs made in real time. I overeat tonight because I’m with friends and enjoying the food and that is more important to me in this moment than losing weight. I may regret it later and I’m not consistent at slowing down and asking myself when the weight later becomes equally important to me as dessert now. You see?
“We just have to own both our choices and their consequences.
“My goal is to have the fewest possible regrets when I die. I wish that for you too, but only you can know what choices will get you there.
“Makes sense?”

The Prosperous Heartbeat Bank

Okay friends, this is a fun post with some lighthearted existential philosophy. It also talks about sex, so consider yourself warned.

I really do wish everybody peace, love, and health (usually joy, also). People who receive emails, texts, and snail mail from me will all tell you. I also love a cheeky, irreverent expression sometimes, and this one showed up before the New Year:

From The Fuckit List page on Facebook

I shared it immediately with all my friends who would appreciate it, including a brilliant and pragmatic cardiologist. I added ‘etOH [ethanol] and weed in moderation, and the rest–yeah!’

The ensuing email thread between us:

Friend: 😂😆 no orgasms in moderation?!?!

Me: Some things you just cannot get too much of.  No risk.  😉😆

Friend: i’ve never heard a physician say “no risk” – only “low” “moderate” “high” risk. so i’m happy to go with no risk!!!!

Me: Teeheehee / It just occurred to me—YOU are the cardiologist!! IS there a risk?? 😱 / I cannot lead people astray here… / I suppose MI [myocardial infarction–heart attack] during sex does occur, right? / So shit, there is a risk! 😣

Friend: i suppose as a cardiologist, it’s always a risk-benefit ratio. risk is very very low. benefit is likely there every time. plus there’s the added cardiac benefit of ischemic pre-conditioning [training the heart with exercise] in those with significant CAD [coronary artery disesae] wherein you can develop angiogenesis [growth of new blood vessels] and collateral formation [bypass blood flow around blocked arteries] in the context of regular sexual/exercise activity. so it’s a big yes to orgasms!!!!

Me: Omg YYYAAAAAAAYYYYY!!! 💃🏻🎉🥳❤️ / And ENDORPHINS, yes? 😄

Friend: ah, yes, sympathetics. you know there is a hypothesis (totally unproven) that you are born with a certain # of heartbeats and once you use them, your life is over. if that is the case, endorphins, sympathetics and (eek) orgasms are probably no good for us. but again, that hypothesis is totally unproven and the more “exercise” you do, the slower the resting heart rate and the longer (observationally) the life. so probably, all in all, better to stick with the orgasms than to avoid them!!!

Me: Ooooo, fascinating!!  I bet there is some vague, partial and flexible truth to that theory?  Like yes, any given heart has a finite number of future beats left at any given time.  

AND, there are likely many things we can do throughout our lives that give it more or fewer remaining beats—like a bank account that we deposit to and withdraw from… 😜 OH I just LOVE this idea!!


Diet: fiber, healthy fats, lean protein, moderate naturally occurring sugars (Food Rules by Michael Pollan: Eat food, not too much, mostly plants)

Movement: full body, cardio/strength/mobility


Stress: wise mind, radical acceptance, inner peace; and FUN!!

Relationships (I would bet anything this is proportionally the DENSEST, highest value heartbeat reserve elevator): love, meaning, connection… 

Of course withdrawls are the opposites of these… I wonder whether bad sleep or toxic relationships are the greatest heartbeat extinguishers?  My money’s on relationships—maybe not even toxic ones—rather the lack of them altogether.  It makes total and complete sense to me that loneliness is a better predictor of mortality than smoking (I think it’s actually phrased that it’s a bigger mortality risk than smoking but I bet it’s a better predictor, too—if you look at the data a certain way?)…

OMG this totally aligns with my framework of the 5 reciprocal domains of health!! 😄 ❤️ ❤️

Ok so my mom told me that her dad told her that we are each born with a finite amount of prosperity in life.  So the idea is to be frugal with spending, consumption, partying etc in your youth, so you have enough to spread out over a longer lifetime.  I do like that idea.  It feels akin to humility and generosity to me…  So I wonder if there can be a pooling effect among one’s tribe—that we all spend/consume/share over a lifetime and extend/improve all of our lives?? 

OH thank you for telling me about this, I will think more (and possibly write) on it!! 😄 xo …And maybe my gong-gong’s theory is also flexible like a bank account, too. 

I think we get to invent it, since it’s all made up to help us feel better about how we choose to live life anyway! 😄

THANK YOU for stimulating such fun thinking tonight! 😄

Ok more soon, big hugs!!! xo


All of these thoughts and ideas poured out between us from 4:44 to 7:22pm on 12/28/2022. I’m not sure more writing is required at this point? I thought about doing the math–for each episode of exercise, how many more beats, and does it even out with a resulting lower resting heart rate over a lifetime…? Nah. It was a fun and thought-provoking conversation between two friends which, for me at least, tightened connection and elevated joy. I am definitely heart-healthier for it.

Hope 2023 is off to a peaceful, loving, and healthy start for you all, my friends, if not a moderately buzzed and high, frequently orgasmic, and suddenly wealthy one. 😉