Transitions OMG

Photo courtesy of J. Stahlhut, September 7, 2026, near Georgetown, Colorado

What changes move you today?

It’s leaf peeping season in the Rockies; I will go eagerly back to Summit County, CO next weekend for aspens and friends–can’t wait! Hoping to get lots of photos to use here in the coming weeks. This is my 799th post–let’s see what I can capture for #800!

This made me laugh while scrolling Facebook today:

Baaahahahahaaaa TRUTH ;P

Summer to fall, youth to maturity. The Fourth Turning. Everything changes. How do we meet it all? What choices do we make?

Hubs decided this summer that we will replace the carpet in the whole house. The kids dutifully cleared their rooms before going back to school–it looks so sad, like they’ve moved out. My mental load increases the closer we get to installation, as 90% of the stuff in the rest of the place is mine and I must now clear 20 years of living off the floor and out of the closets–big lift for packrat me. I know I will be happy when it’s over and the process has already illuminated so much, for better or worse. I am who I am, have been so forever, with remarkable consistency, o.m.g. But after this project I may likely reorganize and reset, decluttered and refocused. Looking forward to it (but I’ll complain about it in the meantime). Makes me think about other things that are the same and also changing–my favorite paradox.

What have you noticed about menopause lately? I bet you hear or see something about it a lot more often now than ever. I wrote my most focused piece on it two years ago this week, which I still share with patients, but I really need to update it, as the landscape around this life transition has itself shifted significantly even since then. It’s still great that women’s health gets so much more attention and discussion now, no question. We have also swung well into pathologizing the normal in a lot of spaces, where unqualified influencers make money by sowing fear and mistrust of legitimate medical science and doctors in women of all ages. It’s all part of a larger societal transition, no? Social media has given everyone equal access to express and sell anything on various public platforms with little if any accountability. Menopause is a vastly different social experience now compared to even five years ago, let alone a generation.

Speaking of which, how is Gen X menopause different from that of our mothers? For many of us it hits when our kids are about a decade younger than we were when our moms went through it. We had much better access to birth control, and many of us delayed childbirth while getting our careers off the ground. So while our moms’ menopause happened after we were off at college or beyond, we’re going through it with teens and kids still at home–a very different, and I would argue more difficult, scenario. We are also the largest generation of working moms, primary breadwinner moms, and executive moms. We will or have hit our professional pinnacle around middle age, many in male-dominated fields, right when our adolescent kids’ brains and behavior devolve into chaos and our own bodies stage the second most significant physiologic revolution of our lifetime. Oh and don’t forget that our parents are also in their seventh or eighth decades of life, another pivotal transition that we also attend.

So to my fellow perimenopausal sisters: Holy moly, we are HEROES! Not only are we living every day in our own involuntary bodily transitions, but we’re doing it in a period of social and generational transition that is more complex than any timeframe to date. If you’re reading this and you have a woman leader anywhere in your life (and believe me, you do, even if she doesn’t have a formal title or designation), just thank her now. She’s holding all kinds of shit together and probably making it look easy.

What other monumental transitions do you observe now? What transformations? As we move from summer to fall in the Northern Hemisphere, entering the season of harvest and impending equinox, how do we feel and what do we need?

Multiple coincident and intersecting transitions can feel like a maelstrom. Can we find a quiet and stable center within it? Can we cultivate that dynamic balance that allows us to move more fluidly, with less friction and drag through it? What serves as our rudder, that which reliably stabilizes us on our life course, despite the inevitable weather changes? I know what mine are, and writing this post helps me reidentify and reinforce them.

Everything changes. Some things remain the same. May we always maintain clarity about the paradox of both, and exercise our agency to transition ever toward our most aspirational selves in each phase of life.

A Five Year Plan

The Lodge at Whitefish Lake, Whitefish, MT September 2025

It’s been a dense few weeks, friends! Or a dense year, maybe, as these blog posts appear late more often now than in a while. Life! I’m okay with it; eleven years is a long time to maintain a project that was only meant to last one. I’m just happy to be here! Family came in last weekend, and I’m about to fly myself tonight, so this post will serve for two weeks. Hope everybody is well and happy!

Daughter and I signed up for a pottery class back in June, 12 weeks ago, I realize today. It took a food twelve hours to call forth the muscle memory from 26 years ago when I made over 400 pots, and now I’m making progress again. The first batch yielded 27 pieces, teaching me how the glazes behave when layered. By the end, barring catastrophe, I will have over 50 creations to use and share this time. See below for photos!

I recently saw a patient who will retire in the coming year. Their annual exams brought us both warm connection over the years, and we agreed that they are as healthy as they could be on the threshold of this life transition. At the end of the day they asked me to include some parting advice for the next five years, a new request for me. How fun! Now I wonder what I’d write for any patient when I see them (potentially) for the last time. What would I write for myself? For the kids? My parents?

What advice would you write to yourself and your loved ones for the next some years? For your leaders? For our legislators and judiciary? How do you already think and communicate in these terms?

I listened to Simon Sinek’s The Infinite Game again yesterday and today. He writes in terms of business and professional leadership, but his premise of an infinite mindset applies to how any of us may choose to live. Inspiring. One of the reasons I get behind on the blog is that I’m writing Love Letters to Patients (LLTP) every week. Every time I think I will address their medical concerns, I end up writing about their life, their relationships, and their impact on me… and my aspirations for them–for us all. I intend to edit and organize after one full year; that will be Book. Can’t wait to share it with you all. Meanwhile, I think this extemporaneous ‘five year plan’ may give you a taste of what that bigger project may feel like. What think you? πŸ™‚


OK so in case I don’t see you next year (or ever again! 😦 ), you asked for my advice for the next five years.Β  AWESOME, this will be my first time writing something like this, let’s see what emerges ! πŸ˜€

  1. Continue to prioritize the most important things to you–the people and activities that give your life meaning.Β  I think you are already very good at this, and after retirement you will have time, energy, and resources to engage and invest even more, no?Β  How fulfilling!
  2. Physical fitness will be important. I love John’s advice of using gym time to fill in the small gaps in lower body strength that you may not get from your usual activities.Β  We discussed the ways you can tell if you’re still fit–getting up and down from the floor or low chairs/stools, feeling confident that you can embark on any new physical activity without limitation (hiking, skating, playing a new sport), etc.Β  Functional movements in the gym are key for this: forward lunges approximate going down the stairs.Β  Squats are getting up from a low chair.Β  Deadlifts are bending over and picking up something from the floor.Β  It’s the eccentric movement–the controlled deceleration–that is key for fall prevention:Β Think walking downhill quickly without hyperextending, torquing, or losing balance in your ankles and knees.Β Β 
  3. Stay open to learningΒ anything.Β  Hang out with curious people who know different things from you and are generous with sharing.Β  Say yes to trying new things.Β  Spend time with folks from all generations.Β  I really think this keeps us young–openness, curiosity, exposure to and engagement with novelty, and just growing our neural networks in any possible way–visual, auditory, tactile, intellectual, emotional, and in movement!
  4. Assemble your medical pit crew, if needed.Β  You have a primary care doctor, and you have us at Exec Health for exercise and nutrition advice once a year.Β  Events may lead you to need medical specialists in the future, eg physical therapy, personal training, talk therapy–who knows?Β  But finding *your people* in each of these domains, and connecting them whenever possible so they may compare notes and coordinate care, will give you all more connection and improve outcomes, in my opinion.
  5. Vet medical and health information in the public domain with a very critical mind.  Sadly right now, that includes information coming from the federal government.  Avoid influencers and even medical professionals who are selling products or services for very high prices.  Look at financial relationships between public figures and the products they recommend.  The number of non-evidence based, fear-mongering, capitalist health and wellness businesses increases every year, and I have yet to vet one that I recommend.  Review things with your doctor before you pay for anything she did not recommend herself.
  • I think that’s pretty good general advice–not just for you but for us all…Β  Thank you for stimulating the thoughts!Β  Please tell me what you think and if you want me to add/address anything else.
First pottery haul in 26 years. Not all beautiful; every one gratifying.
My best vessel and handle yet!
Accidental finger dents turned into a cute flower, which may be my signature hereafter
Waxy white over blue; two intended for the Ethos kitchen
The upside down ones are mine. Can’t wait to glaze them all!
Practicing for more mugs–learning how much clay and how to make a good cylinder first.
Also hoping to get at least a few ramen bowls out of the lot.

Whatcha Doin’ Lately?

Summer officially began today, around 4am Eastern Time. It’s Father’s Day.
The days get shorter in the Northern Hemisphere starting now and for the next six months.
Nature’s cycles march onward.
Have I appreciated and reveled in this season so far? I think yes. How ’bout you?

No burning questions or popping epiphanies tonight, friends. Just a wonderful sense of gratitude and contentment at life. Looking, listening, and feeling around me, it’s no wonder.

The family is well overall. No acute or severe health crises, relationships are stable–what more do we need, really? Surviving major challenges and threats in both of these realms makes one appreciate when things are quiet, stable, and well.

Daughter is home, which means I’m spending more time in the ‘woods’ by the house. That means more photos for the blog, more bug bites, and learning about thrips–tiny, kiwi hair-sized bugs that live on the mulberries that grow in the neighborhood.

I posted about it on Insta the other day. πŸ™‚

Daughter and I are also taking a pottery class together–tomorrow will be the third of five classes. I shake my head at the contrast: I last touched clay 26 years ago, before I had kids, over half my life ago. I can’t remember how long I did it, but I was there at all hours of the day and night and produced over 400 pieces. I have about four pots to show for it so far this time, and it’s been harder than I anticipated to recall the skills. Maybe I’ll just have to keep going! We still use many of the bowls I made back in 2000; hoping I can add some nice ones to the collection in 2026.

I’m very proud of the progress I’m making in the gym. 285# barbell hip thrust, 195# trap bar dead lift, and 145# barbell back squat, each for at least four reps, are my favorite accomplishments so far this year. I’m still working toward that one, good, unassisted pull up by Christmas–we shall see! And if not by Christmas or not ever, it’s okay! I can still continue to show up and practice. I finally felt worthy of adding another sticker to my water bottle:

Water bottle sticker: “Shhh… I’m doing math” next to a pile of barbell weight plates

Book writing enters the sixth month of consistent work, wow. What a labor of love, oh my gosh. It’s very much tied to my time at Ethos; my mind is clear and my mood elevated after a challenging workout surrounded by friends. The co-working space is open, bright, and also full of people I love. It’s the perfect setting to do my best reflecting and writing, and insights occur to me on each page that I don’t think would emerge any other way. I wonder if this is why I feel less driven to journal, although jar smile and snail mail writing continue at a regular, rewarding, and joyous pace. There is just something about writing that frees my soul… I wish for everybody to find something in life that feels this great!

What’s got your attention this season, friends? How does the chaos and uncertainty in our world affect you? I reflect on my privilege a lot lately, but don’t feel moved to write deeply about it here… yet. Our perspectives determine our perceptions, which influence or determine our beliefs, and thus our actions and thus our relationships, and thus our lives. So if we wish to live magnanimously, empathetically, generously, informedly, and understandingly, we must broaden our perspectives. Easier said than done, and almost always better with kind and direct guidance from others. Maybe more on this another day.

Life feels smooth and calm at the moment. I know it will not always be this way. So I pay attention and store up the positive energy. When harder times hit later, I will look back and know that I knew it and appreciated it when things were good, and that will hold me up until things are good again. Peace, friends. It’s what I wish for us all.