Farnam Street http://www.farnamstreetblog.com Thu, 23 Oct 2014 11:56:19 +0000 en-US hourly 1 http://wordpress.org/?v=4.0 What Matters Most http://www.farnamstreetblog.com/2014/10/what-matters-most/ http://www.farnamstreetblog.com/2014/10/what-matters-most/#respond Thu, 23 Oct 2014 11:56:19 +0000 http://www.farnamstreetblog.com/?p=19278
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The Holstree Manifesto

The Holstee Manifesto sits above my fireplace. A reminder to live a life of purpose and meaning.

This is your life. Do what you love, and do it often. If you don’t like something, change it. If you don’t like your job, quit. If you don’t have enough time, stop watching TV. If you are looking for the love of your life, stop; they will be waiting for you when you start doing things you love.


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Aphorisms for Thirsty Fish: The Lost Writings of Wu Hsin http://www.farnamstreetblog.com/2014/10/the-lost-writings-of-wu-hsin/ http://www.farnamstreetblog.com/2014/10/the-lost-writings-of-wu-hsin/#respond Wed, 22 Oct 2014 12:00:10 +0000 http://www.farnamstreetblog.com/?p=19262
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“Expectation is the grandfather of disappointment. The world can never own a man who wants nothing.”



One hundred years after Confucius, came Wu Hsin. His name literally means ‘no-mind.’ And there is almost no trace of this person available, which is probably how he would have liked it. What does remain of this nearly-erased character are some of his writings, some of which can be found in the excellent Aphorisms for Thirsty Fish (The Lost Writings of Wu Hsin).

First, let’s put him in context. Hsin grew up in a period

… during which the ruling house of Zhou had lost much of its authority and power, and there was increasing violence between states. This situation birthed “the hundred schools”, the flourishing of many schools of thought, each setting forth its own concepts of the prerequisites for a return to a state of harmony. The two most influential schools were that of Confucius and the followers of Mozi (“Master Mo “), the Mohists. The latter were critical of the elitist nature and extravagant behaviors of the traditional culture. The philosophical movement associated with the Daodejing also was emerging at this time. Wu Hsin’s style of Daoist philosophy developed within the context defined by these three schools and appears to be most heavily influenced by the latter. In addition, it most clearly contains the seeds of what would become Ch’an Buddhism in China or Zen in Japan.

Hsin, in stark contrast to his contemporaries who were writing lengthy tomes, was known for his brevity.

Wu Hsin’s style reflected his sense that words, too, were impediments to the attainment of Understanding; that they were only pointers and nothing more. He would use many of the same words over and over because he felt that people needed to hear words repeatedly, until the Understanding was louder than the words.

His writings are filled with paradoxes, which cause the mind to slow down and, at times, to even stop. Reading Wu Hsin, one must ponder. However, it is not an active pondering, but a passive one, much in the same way as one puts something in the oven and lets it bake for a while.

I’m a big fan of concentrated wisdom. The Art of Worldly Wisdom is one of my favorites. I’ve also found a lot of value in La Rochefoucauld and Nassim Taleb. So what then can we learn from Hsin? Here are a few of my highlights.

Our attachment to beliefs …

The attachment to beliefs is
The greatest shackle.
To be free is
To know that
One does not know.

Sleep …

It is understood that
Sleep is the desire for
A period of rest
For the body.
It is less understood that
Sleep is the desire for
A period of rest
Away from the body.

True peace cannot be disturbed…

What is called peace by many is
Merely the absence of disturbance.
True peace cannot be disturbed;
It resides beyond the reach of disturbance.

As if addressing our soundbite culture …

When one is enthralled with
The beauty on the surface of the ocean,
The immensity of its depths can
Never be discerned.

You can’t think your way to freedom.

Controlling the mind doesn’t
Take one to freedom.
Controlling the mind
Adds another link To one’s shackles.

Pain is physical, whereas suffering is mental.

Whereas pain is
A physical experience
Suffering is a mental one.
It is the sense that
Things should be
Other than they are.
Its antidote is Acceptance.

We can be in a crowd and still be alone.

Solitude is not
A condition of the body.
Instead, it is
A condition of the mind.
Solitude may be found
In the busy market or
May be elusive in the forest.

Feeling lost is the first step

For many,
The first step on
A spiritual journey is to
Become lost.
The final step is
Losing one’s self.

As if to explain why consumption does not make us any happier …

Chasing after the things
One yearns for is
Inferior to
Chasing after
The source of the yearning.

The search for happiness …

To search for happiness
Implies its absence.
This implication is a fundamental flaw.
Happiness is ever present.
It may become obscured,
Such obscuration being temporary.

How magicians fool us …

The preoccupation with
The foreground, the sights,
The smells,
The sounds,
Takes the attention away from
The background.
Yet, it is in this very background that
The Mystery resides.

The natural doesn’t need laws

What is natural
Follows no laws nor
Requires any.
Can there be a rule for
The beating of the heart or
The blackness of the raven?
There is a natural rhythm to
The workings of the world.
Some are discernable
While others cannot be discerned.
It is the dance
Between the two that
Creates action.

We cannot hide from ourself.

There is no forest,
There is no cave,
There is no mountaintop
Where one can hide From oneself.

Live in the moment …

The greatest enjoyment is experienced
When there is no concern for its duration.

Speaking of mindfulness, before it had a name, he writes:

The sum of a past is I was.
The sum of a future is
I will be.
The continuous crossing back and forth
Between the two
Obscures the present moment,
The I am, Being Itself.

On freedom …

A free man’s life is
A life that is free of
Demands,
Free of dependency.
With nothing to drag along
One goes where one will.

Anyone who has ever lived through a corporate reorganization …

Do not mistake
A mere rearranging of the furniture
For true change.

Being content is about dropping attachment and desire.

The man of contentment
Seeks nothing that
He doesn’t have and
Understands that
Whatever he has
Isn’t his to own.

In fact he later writes: “Chasing after more and more is futile. It is only less and less that lastingly satisfies.”

Building on this he incisively looks at our expectations

Expectation is the grandfather of
Disappointment.
The world can never
Own a man Who wants nothing.

Hsin writes on our desire to seek confirmation of what we already know.

You are not satisfied
With the answers
Given by others.
So you come to Wu Hsin.
But what you really seek
Are not answers
But confirmation
Of what you think
You already know.
If you were to admit
That you know nothing,
Then I will most gladly answer.

The greatest crime …

The greatest crime is
The overlooking of
Who you really are In favor of
The story of
Who you think you are.
This preoccupation with
Your personal drama is
The cloud that masks The sun.

On how to change the world …

To conquer the large,
Begin with the small.
To change your world,
Begin by changing yourself.
What needs to be changed?
Only the point of view.

Hsin, like me, sees failure as an opportunity.

Nothing succeeds like failure.
Failure is a natural
Call for attention,
Like pain.
To pay attention is to
Step out of your trance.

Sometimes you have to crack some eggs

To free the chick,
The shell must be broken.
To free what is inside
One must shatter
What is outside.

How we live …

What is known is familiar
Yet unsatisfying.
What is unknown is feared
Yet desired Life thrives in risks and
Dies in stasis.
Live.

On the delta between our expectations and reality …

The world changes profoundly
When demands on it cease.
The real world and one’s imagined world
Share little.

What’s better than the acquisition of knowledge? Invert. Getting rid of ignorance. This passage also reminds me of the Arab Scholar Ali Bin Abi-Taleb, who said: “keeping one’s distance from an ignorant person is equivalent to keeping company with a wise man.”

Ridding oneself of ignorance is
Worth more than the acquisition of knowledge.
With memory gone
The past is gone
Relinquishing hopes and fears
The future is gone.
The present is upon you.
In every moment.
You are free.

Not only is Hsin full of knowledge, he’s often beautiful in his writing. Consider this …

The Infinite has no preferences.
It kisses both the darkness and
The light equally.

Aphorisms for Thirsty Fish is a worthy read.


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The Keys to Happiness http://www.farnamstreetblog.com/2014/10/the-keys-to-happiness/ http://www.farnamstreetblog.com/2014/10/the-keys-to-happiness/#respond Tue, 21 Oct 2014 12:00:30 +0000 http://www.farnamstreetblog.com/?p=19252
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“The mental construction of our daily activities, more than the activity itself, defines our reality.”

What if the formula for success is backwards. We’re told that if we work hard, we’ll be successful. And of course, if we’re successful then we’ll be happy. It’s all about the next thing. The next step will make us happy. But it doesn’t really work this way. If we’re always focused on what’s next, we’re never in the present. The present, of course, is where we live.

In his eye-opening book, The Happiness Advantage, Shawn Achor, who spent over a decade living, researching, and lecturing at Harvard University, shows that the formula is backward: Happiness isn’t the result of success but rather it fuels it. “When we are positive, our brains become more engaged, creative, motivated, energetic, resilient, and productive at work.”

Here are some of Achor’s tips for becoming happier.

The first tip, echoing Dan Harris, is to meditate.

Take just five minutes each day to watch your breath go in and out. While you do so, try to remain patient. If you find your mind drifting, just slowly bring it back to focus. Meditation takes practice, but it’s one of the most powerful happiness interventions. Studies show that in the minutes right after meditating, we experience feelings of calm and contentment, as well as heightened awareness and empathy. And, research even shows that regular meditation can permanently rewire the brain to raise levels of happiness, lower stress, even improve immune function.

Do something nice for someone.

A long line of empirical research, including one study of over 2,000 people, has shown that acts of altruism—giving to friends and strangers alike—decrease stress and strongly contribute to enhanced mental health.

You really need to invest in your social relationships.
“Countless studies have found that social relationships are the best guarantee of heightened well-being and lowered stress, both an antidote for depression and a prescription for high performance.”

And you need to get outside. Not only is solitude an important part of the creative process, it improves memory and thinking.

Making time to go outside on a nice day also delivers a huge advantage; one study found that spending 20 minutes outside in good weather not only boosted positive mood, but broadened thinking and improved working memory … studies have shown that the less negative TV we watch, specifically violent media, the happier we are.

Cutting the cord also helps you read more.

It’s about people and relationships.

Turns out, there was one—and only one—characteristic that distinguished the happiest 10 percent from everybody else: the strength of their social relationships. My empirical study of well-being among 1,600 Harvard undergraduates found a similar result—social support was a far greater predictor of happiness than any other factor, more than GPA, family income, SAT scores, age, gender, or race. In fact, the correlation between social support and happiness was 0.7. This may not sound like a big number, but for researchers it’s huge—most psychology findings are considered significant when they hit 0.3. The point is, the more social support you have, the happier you are.

If you’re going to spend money, make sure it’s on experiences and not stuff. Unless it’s a Vitamix, because that’s just awesome.

[W]hen researchers interviewed more than 150 people about their recent purchases, they found that money spent on activities—such as concerts and group dinners out—brought far more pleasure than material purchases like shoes, televisions, or expensive watches.

Spend it on your friends and family or random strangers. “Spending money on other people, called ‘prosocial spending,’ also boosts happiness.”


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How to be 10% Happier http://www.farnamstreetblog.com/2014/10/dan-harris-10-percent-happier/ http://www.farnamstreetblog.com/2014/10/dan-harris-10-percent-happier/#respond Mon, 20 Oct 2014 12:00:45 +0000 http://www.farnamstreetblog.com/?p=19234
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Think you had a bad day?

Dan Harris had a panic attack on live TV in front of millions of people.

Something had to change. He knew it. Almost immediately after the panic attack on the air he was assigned to cover religion, which introduced him to meditation, which made him, as he puts it, 10% happier.

He wrote about his on-air panic attack in great detail in his fascinating book 10% Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Found Self-Help That Actually Works–A True Story.

Harris argues that meditation has a PR problem.

… largely because its most prominent proponents talk as if they have a perpetual pan flute accompaniment. If you can get past the cultural baggage, though, what you’ll find is that meditation is simply exercise for your brain. It’s a proven technique for preventing the voice in your head from leading you around by the nose. To be clear, it’s not a miracle cure. It won’t make you taller or better-looking, nor will it magically solve all of your problems. You should disregard the fancy books and the famous gurus promising immediate enlightenment. In my experience, meditation makes you 10% happier. That’s an absurdly unscientific estimate, of course. But still, not a bad return on investment.

Originally Dan wanted to call his book The Voice in My Head Is an Asshole. We all have that voice.

To be clear, I’m not talking about “hearing voices,” I’m talking about the internal narrator, the most intimate part of our lives. The voice comes braying in as soon as we open our eyes in the morning, and then heckles us all day long with an air horn. It’s a fever swamp of urges, desires, and judgments. It’s fixated on the past and the future, to the detriment of the here and now. It’s what has us reaching into the fridge when we’re not hungry, losing our temper when we know it’s not really in our best interest, and pruning our inboxes when we’re ostensibly engaged in conversation with other human beings. Our inner chatter isn’t all bad, of course. Sometimes it’s creative, generous, or funny. But if we don’t pay close attention —which very few of us are taught how to do— it can be a malevolent puppeteer.

The voice in your head is what takes you out of the present.

Consider Dan on day 9 of a 10-day meditation retreat. In the morning question-and-answer session, the instructor insists that the participants not tune out during the closing hours of the retreat.

As he presses his case, he says something that bugs me. He urges us not to spend too much time thinking about the stuff we have to do when the retreat is over. It’s a waste of time, he says; they’re just thoughts.

This provokes me to raise my hand for the first time. From the back of the echoey hall, in full-on reporter mode, with my overloud voice apparently not atrophied one bit from disuse, I ask, “How can you advise us not to worry about the things we have to do when we reenter the world? If I miss my plane, that’s a genuine problem. These are not just irrelevant thoughts.”

Fair enough, he concedes. “But when you find yourself running through your trip to the airport for the seventeenth time, perhaps ask yourself the following question: ‘Is this useful’?”

His answer is so smart I involuntarily jolt back in my chair and smile.

“Is this useful?” It’s a simple, elegant corrective to my “price of security” motto. It’s okay to worry, plot, and plan, he’s saying— but only until it’s not useful anymore. I’ve spent the better part of my life trying to balance my penchant for maniacal overthinking with the desire for peace of mind.

At some point, you just have to move on. Mediation helped him draw the line.

How do you stop thinking? How do you stop the voice in your head? Dan asked Eckhart Tolle, who simply replied that “You create little spaces in your daily life where you are aware but not thinking,” he said. “For example, you take one conscious breath.”

10-percent-happier-dan-harris

As for how to meditate, Dan’s instructions are simple. Simple but not easy.

1. Sit comfortably. You don’t have to be cross-legged. Plop yourself in a chair, on a cushion, on the floor —wherever. Just make sure your spine is reasonably straight.

2. Feel the sensations of your breath as it goes in and out. Pick a spot: nostrils, chest, or gut. Focus your attention there and really try to feel the breath. If it helps to direct your attention, you can use a soft mental note, like “in” and “out.”

3. This one, according to all of the books I’d read, was the biggie. Whenever your attention wanders, just forgive yourself and gently come back to the breath. You don’t need to clear the mind of all thinking; that’s pretty much impossible. (True, when you are focused on the feeling of the breath, the chatter will momentarily cease, but this won’t last too long.) The whole game is to catch your mind wandering and then come back to the breath, over and over again.

After a while of daily forced practice, Dan started to notice big changes.

Pretty quickly, my efforts began to bear fruit “off the cushion,” to use a Buddhist term of art. I started to be able to use the breath to jolt myself back to the present moment— in airport security lines, waiting for elevators, you name it. I found it to be a surprisingly satisfying exercise. Life became a little bit like walking into a familiar room where all the furniture had been rearranged. And I was much better at forgiving myself out in the real world than while actually meditating. …

Meditation was radically altering my relationship to boredom, something I’d spent my whole life scrambling to avoid. The only advice I ever got from my college adviser, a novelist of minor renown named James Boylan (who later had a sex change operation, changed his name to Jenny, wrote a bestselling book, and appeared on Oprah) was to never go anywhere without something to read. I diligently heeded that guidance, taking elaborate precautions to make sure every spare moment was filled with distraction. I scanned my BlackBerry at stoplights, brought reams of work research to read in the doctor’s waiting room, and watched videos on my iPhone while riding in taxicabs.

He started to see more of life.

The net effect of meditation, plus trying to stay present during my daily life, was striking. It was like anchoring myself to an underground aquifer of calm. It became a way to steel myself as I moved through the world.

This was great but it wasn’t the point. The point was mindfulness — the key to thinking like Sherlock Holmes. Mindfulness, as Harris discovered, is Buddhism’s secret sauce.

In a nutshell, mindfulness is the ability to recognize what is happening in your mind right now— anger, jealousy, sadness, the pain of a stubbed toe, whatever—without getting carried away by it. According to the Buddha, we have three habitual responses to everything we experience. We want it, reject it, or we zone out.

[...]

On the cushion, the best opportunities to learn mindfulness are when you experience itches or pain. Instead of scratching or shifting position, you’re supposed to just sit there and impartially witness the discomfort. The instruction is simply to employ what the teachers call “noting,” applying a soft mental label: itching, itching or throbbing, throbbing.

[...]

The idea is that, once you’ve mastered things like itches, eventually you’ll be able to apply mindfulness to thoughts and emotions. This nonjudgmental noting—Oh, that’s a blast of self-pity . . . Oh, that’s me ruminating about work—is supposed to sap much of the power, the emotional charge, out of the contents of consciousness.

[...]

Once I started thinking about how this whole system of seemingly spontaneous psychological combustion worked, I realized how blindly impelled—impaled, even— I was by my ego. I spent so much time, as one Buddhist writer put it, “drifting unaware on a surge of habitual impulses.” This is what led me on the misadventures of war, drugs, and panic. It’s what propelled me to eat when I wasn’t hungry or get snippy with (my wife) because I was stewing about something that happened in the office. Mindfulness represented an alternative to living reactively.

[...]

By way of example: you can be mindful of hunger pangs, but you think about where to get your next meal and whether it will involve pork products. You can be mindful of the pressure in your bladder telling you it’s time to pee, but you think about whether the frequency of your urination means you’re getting old and need a prostate exam. There’s a difference between the raw sensations we experience and the mental spinning we do in reaction to said stimuli.

The Buddhists had a helpful analogy here. Picture the mind like a waterfall, they said: the water is the torrent of thoughts and emotions; mindfulness is the space behind the waterfall. Again, elegant theory— but, easier said than done.

The book is a great read that just may make you happier. Complement with this short video of Dan on the science of meditation.


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Brené Brown on The Difference Between Guilt and Shame http://www.farnamstreetblog.com/2014/10/brene-brown-guilt-shame/ http://www.farnamstreetblog.com/2014/10/brene-brown-guilt-shame/#respond Sun, 19 Oct 2014 12:00:38 +0000 http://www.farnamstreetblog.com/?p=19116
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Brené Brown studies vulnerability, courage, authenticity, and shame. She’s a researcher-storyteller and author of Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead, a book that argues we should embrace vulnerability and imperfection, to live wholeheartedly, and engage in our lives.

In this TED talk, a follow-on to her one on vulnerability, she engagingly brings us into the “unspoken epidemic” of shame and explores what happens when people confront their shame head-on.

I think the main point of her two TED talks is to embrace our vulnerabilities and expose them to others so we can live a more meaningful life.

Shame is a focus on self, guilt is a focus on behavior. Shame is “I am bad.” Guilt is “I did something bad.” How many of you, if you did something that was hurtful to me, would be willing to say, “I’m sorry. I made a mistake?” How many of you would be willing to say that? Guilt: I’m sorry. I made a mistake. Shame: I’m sorry. I am a mistake.


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No Risky Chances: The Conversation That Matters Most http://www.farnamstreetblog.com/2014/10/atul-gawande-being-mortal/ http://www.farnamstreetblog.com/2014/10/atul-gawande-being-mortal/#respond Thu, 16 Oct 2014 12:00:39 +0000 http://www.farnamstreetblog.com/?p=19225
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Lacking a coherent view of how people might live successfully all the way to the very end, we have allowed our fates to be controlled by medicine, technology, and strangers.


Atul Gawande is one of my favorite writers. Aside from the amazing work he did getting us talking about the power of simple checklists, he’s also pointed out why most of us should have coaches. Now he’s out with a new book, Being Mortal: Medicine and What Matters in the End, which adds to our ongoing conversation on what it means to be mortal.

I learned about a lot of things in medical school, but mortality wasn’t one of them.

Although I was given a dry, leathery corpse to dissect in anatomy class in my first term, our textbooks contained almost nothing about aging or frailty or dying. The purpose of medical schooling was to teach how to save lives, not how to tend to their demise.

I had never seen anyone die before I became a doctor, and when I did, it came as a shock. I’d seen multiple family members—my wife, my parents, and my children—go through serious, life-threatening illnesses, but medicine had always pulled them through. I knew theoretically that my patients could die, of course, but every actual instance seemed like a violation, as if the rules I thought we were playing by were broken.

Dying and death confront every new doctor and nurse. The first times, some cry. Some shut down. Some hardly notice. When I saw my first deaths, I was too guarded to weep. But I had recurring nightmares in which I’d find my patients’ corpses in my house—even in my bed.

I felt as if I’d failed. But death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things. I knew these truths abstractly, but I didn’t know them concretely—that they could be truths not just for everyone but also for this person right in front of me, for this person I was responsible for.

You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. These days are spent in institutions—nursing homes and intensive-care units—where regimented, anonymous routines cut us off from all the things that matter to us in life.

As recently as 1945, most deaths occurred in the home. By the 1980s, just 17 percent did. Lacking a coherent view of how people might live successfully all the way to the very end, we have allowed our fates to be controlled by medicine, technology, and strangers.

But not all of us have. That takes, however, at least two kinds of courage. The first is the courage to confront the reality of mortality—the courage to seek out the truth of what is to be feared and what is to be hoped when one is seriously ill. Such courage is difficult enough, but even more daunting is the second kind of courage—the courage to act on the truth we find.

A few years ago, I got a late night page: Jewel Douglass, a 72-year-old patient of mine receiving chemotherapy for metastatic ovarian cancer, was back in the hospital, unable to hold food down. For a week, her symptoms had mounted: They started with bloating, became waves of crampy abdominal pain, then nausea and vomiting.

Her oncologist sent her to the hospital. A scan showed that, despite treatment, her ovarian cancer had multiplied, grown, and partly obstructed her intestine. Her abdomen had also filled with fluid. The deposits of tumor had stuffed up her lymphatic system, which serves as a kind of storm drain for the lubricating fluids that the body’s internal linings secrete. When the system is blocked, the fluid has nowhere to go. The belly fills up like a rubber ball until you feel as if you will burst.

But walking into Douglass’ hospital room, I’d never have known she was so sick if I hadn’t seen the scan. “Well, look who’s here!” she said, as if I’d just arrived at a cocktail party. “How are you, doctor?”

“I think I’m supposed to ask you that,” I said.

She smiled brightly and pointed around the room. “This is my husband, Arthur, whom you know, and my son, Brett.” She got me grinning. Here it was, 11 at night, she couldn’t hold down an ounce of water, and she still had her lipstick on, her silver hair was brushed straight, and she was insisting on making introductions.

Her oncologist and I had a menu of options. A range of alternative chemotherapy regimens could be tried to shrink the tumor burden, and I had a few surgical options too. I wouldn’t be able to remove the intestinal blockage, but I might be able to bypass it, I told her. Or I could give her an ileostomy, disconnecting the bowel above the blockage and bringing it through the skin to empty into a bag. I would also put in a couple of drainage catheters—permanent spigots that could be opened to release the fluids from her blocked-up drainage ducts or intestines when necessary. Surgery risked serious complications—wound breakdown, leakage of bowel into her abdomen, infections—but it was the only way she might regain her ability to eat.

I also told her that we did not have to do either chemo or surgery. We could provide medications to control her pain and nausea and arrange for hospice care at home.

This is the moment when I would normally have reviewed the pros and cons. But we are only gradually learning in the medical profession that this is not what we need to do. The options overwhelmed her. They all sounded terrifying. So I stepped back and asked her a few questions I learned from hospice and palliative care physicians, hoping to better help both of us know what to do: What were her biggest fears and concerns? What goals were most important to her? What trade-offs was she willing to make?

Not all can answer such questions, but she did. She said she wanted to be without pain, nausea, or vomiting. She wanted to eat. Most of all, she wanted to get back on her feet. Her biggest fear was that she wouldn’t be able to return home and be with the people she loved.

I asked what sacrifices she was willing to endure now for the possibility of more time later. “Not a lot,” she said. Uppermost in her mind was a wedding that weekend that she was desperate not to miss. “Arthur’s brother is marrying my best friend,” she said. She’d set them up on their first date. The wedding was just two days away. She was supposed to be a bridesmaid. She was willing to do anything to make it, she said.

Suddenly, with just a few simple questions, I had some guidance about her priorities. So we made a plan to see if we could meet them. With a long needle, we tapped a liter of tea-colored fluid from her abdomen, which made her feel at least temporarily better. We gave her medication to control her nausea. We discharged her with instructions to drink nothing thicker than apple juice and to return to see me after the wedding.

She didn’t make it. She came back to the hospital that same night. Just the car ride, with its swaying and bumps, made her vomit, and things only got worse at home.

We agreed that surgery was the best course now and scheduled it for the next day. I would focus on restoring her ability to eat and putting drainage tubes in. Afterward, she could decide if she wanted more chemotherapy or to go on hospice.

She was as clear as I’ve seen anyone be about her goals, but she was still in doubt. The following morning, she canceled the operation. “I’m afraid,” she said. She’d tossed all night, imagining the pain, the tubes, the horrors of possible complications. “I don’t want to take risky chances,” she said.

Her difficulty wasn’t lack of courage to act in the face of risks; it was sorting out how to think about them. Her greatest fear was of suffering, she said. Couldn’t the operation make it worse rather than better?

It could, I said. Surgery offered her the possibility of being able to eat again and a very good likelihood of controlling her nausea, but it carried substantial risk of giving her only pain without improvement or adding new miseries. She had, I estimated, a 75 percent chance that surgery would make her future better, at least for a little while, and a 25 percent chance it’d make it worse.

The brain gives us two ways to evaluate experiences like suffering—how we apprehend such experiences in the moment and how we look at them afterward. People seem to have two different selves—an experiencing self who endures every moment equally and a remembering self who, as the Nobel Prize–winning researcher Daniel Kahneman has shown, gives almost all the weight of judgment afterward to just two points in time: the worst moment of an ordeal and the last moment of it. The remembering self and the experiencing self can come to radically different opinions about the same experience—so which one should we listen to?

This, at bottom, was Jewel Douglass’ torment. Should she heed her remembering self—or, in this case, anticipating self—which was focused on the worst things she might endure? Or should she listen to her experiencing self, which would likely endure a lower average amount of suffering in the days to come if she underwent surgery rather than just going home—and might even get to eat again for a while?

In the end, a person doesn’t view his life as merely the average of its moments—which, after all, is mostly nothing much, plus some sleep. Life is meaningful because it is a story, and a story’s arc is determined by the moments when something happens. Unlike your experiencing self, which is absorbed in the moment, your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole. That is profoundly affected by how things ultimately turn out. Football fans will let a few flubbed minutes at the end of a game ruin three hours of bliss—because a football game is a story, and in stories, endings matter.

Jewel Douglass didn’t know if she was willing to face the suffering that surgery might inflict and feared being left worse off. “I don’t want to take risky chances,” she said. She didn’t want to take a high-stakes gamble on how her story would end. Suddenly I realized, she was telling me everything I needed to know.

We should go to surgery, I told her, but with the directions she’d just spelled out—to do what I could to enable her to return home to her family while not taking “risky chances.” I’d put in a small laparoscope. I’d look around. And I’d attempt to unblock her intestine only if I saw that I could do it fairly easily. If it looked risky, I’d just put in tubes to drain her backed-up pipes. I’d aim for what might sound like a contradiction in terms: a palliative operation—an operation whose overriding priority was to do only what was likely to make her feel immediately better.

Being Mortal

She remained quiet, thinking.

Her daughter took her hand. “We should do this, Mom,” she said.

“OK,” Douglass said. “But no risky chances.”

When she was under anesthesia, I made a half-inch incision above her belly button. I slipped my gloved finger inside to feel for space to insert the fiberoptic scope. But a hard loop of tumor-caked bowel blocked entry. I wasn’t even going to be able to put in a camera.

I had the resident take the knife and extend the incision upward until it was large enough to see in directly and get a hand inside. There were too many tumors to do anything to help her eat again, and now we were risking creating holes we’d never be able to repair. Leakage inside the abdomen would be a calamity. So we stopped.

No risky chances. We shifted focus and put in two long, plastic drainage tubes. One we inserted directly into her stomach to empty the contents backed up there; the other we laid in the open abdominal cavity to empty the fluid outside her gut. Then we closed up, and we were done.

I told her family we hadn’t been able to help her eat again, and when Douglass woke up, I told her too. Her daughter wept. Her husband thanked us for trying. Douglass tried to put a brave face on it. “I was never obsessed with food anyway,” she said.

The tubes relieved her nausea and abdominal pain greatly—“90 percent,” she said. The nurses taught her how to open the gastric tube into a bag when she felt sick and the abdominal tube when her belly felt too tight. We told her she could drink whatever she wanted and even eat soft food for the taste. Three days after surgery, she went home with hospice care to look after her.

Before she left, her oncologist and oncology nurse practitioner saw her. Douglass asked them how long they thought she had. “They both filled up with tears,” she told me. “It was kind of my answer.”

A few days later, she and her family allowed me to stop by her home after work. She answered the door, wearing a robe because of the tubes, for which she apologized. We sat in her living room, and I asked how she was doing.

OK, she said. “I think I have a measure that I’m slip, slip, slipping,” but she had been seeing old friends and relatives all day, and she loved it. She was taking just Tylenol for pain. Narcotics made her drowsy and weak, and that interfered with seeing people.

She said she didn’t like all the contraptions sticking out of her. But the first time she found that just opening a tube could take away her nausea, she said, “I looked at the tube and said, ‘Thank you for being there.’ ”

Mostly, we talked about good memories. She was at peace with God, she said. I left feeling that, at least this once, we had done it right. Douglass’ story was not ending the way she ever envisioned, but it was nonetheless ending with her being able to make the choices that meant the most to her.

Two weeks later, her daughter Susan sent me a note. “Mom died on Friday morning. She drifted quietly to sleep and took her last breath. It was very peaceful. My dad was alone by her side with the rest of us in the living room. This was such a perfect ending and in keeping with the relationship they shared.”

I am leery of suggesting that endings are controllable. No one ever really has control; physics and biology and accident ultimately have their way in our lives. But as Jewel Douglass taught me, we are not helpless either—and courage is the strength to recognize both of those realities. We have room to act and shape our stories—although as we get older, we do so within narrower and narrower confines.

That makes a few conclusions clear: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; and that we have the opportunity to refashion our institutions, culture, and conversations to transform the possibilities for the last chapters of all of our lives.

Being Mortal: Medicine and What Matters in the End


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To Give or Take? The Surprising Science Behind Success http://www.farnamstreetblog.com/2014/10/adam-grant-give-and-take/ http://www.farnamstreetblog.com/2014/10/adam-grant-give-and-take/#respond Wed, 15 Oct 2014 12:00:58 +0000 http://www.farnamstreetblog.com/?p=19215
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Adam Grant - Give and Take

​​“The principle of give and take; that is diplomacy—give one and take ten” — Mark Twain

Was Twain right? It certainly seems so. The world is full of people who operate with that fuel. For them it’s all about taking. Lest you lose your faith in humanity, the world is also full of people who believe that on some level, karma or otherwise, it pays to be nice. The question arises as to which is the better strategy. Is it better to take or to give?

So much of life depends on how we interact with others. We all want to be friends with givers. We have a way of eliminating takers from our social circles and generally filtering them out of our life. Yet when it comes to the workplace, things change. We can’t rid ourselves of the takers and they often seem to get ahead at the expense of the givers. Even givers often behave differently in the workplace, argues Adam Grant in Give and Take: A Revolutionary Approach to Success.

According to conventional wisdom, highly successful people have three things in common: motivation, ability, and opportunity. If we want to succeed, we need a combination of hard work, talent, and luck. [Yet there is] a fourth ingredient, one that’s critical but often neglected: success depends heavily on how we approach our interactions with other people. Every time we interact with another person at work, we have a choice to make: do we try to claim as much value as we can, or contribute value without worrying about what we receive in return?

And part of how we approach our interactions with others has to do with our preference for reciprocity — our desired mix of taking and giving.

Grant introduces us to two kinds of people that fall at opposite ends of the reciprocity spectrum: givers and takers.

Takers have a distinctive signature: they like to get more than they give. They tilt reciprocity in their own favor, putting their own interests ahead of others’ needs. Takers believe that the world is a competitive, dog-eat-dog place. They feel that to succeed, they need to be better than others. To prove their competence, they self-promote and make sure they get plenty of credit for their efforts. Garden-variety takers aren’t cruel or cutthroat; they’re just cautious and self-protective. “If I don’t look out for myself first,” takers think, “no one will.”

[...]

In the workplace, givers are a relatively rare breed. They tilt reciprocity in the other direction, preferring to give more than they get. Whereas takers tend to be self-focused, evaluating what other people can offer them, givers are other-focused, paying more attention to what other people need from them. These preferences aren’t about money: givers and takers aren’t distinguished by how much they donate to charity or the compensation that they command from their employers. Rather, givers and takers differ in their attitudes and actions toward other people. If you’re a taker, you help others strategically, when the benefits to you outweigh the personal costs. If you’re a giver, you might use a different cost-benefit analysis: you help whenever the benefits to others exceed the personal costs. Alternatively, you might not think about the personal costs at all, helping others without expecting anything in return. If you’re a giver at work, you simply strive to be generous in sharing your time, energy, knowledge, skills, ideas, and connections with other people who can benefit from them.

… being a giver doesn’t require extraordinary acts of sacrifice. It just involves a focus on acting in the interests of others, such as by giving help, providing mentoring, sharing credit, or making connections for others. Outside the workplace, this type of behavior is quite common. According to research led by Yale psychologist Margaret Clark, most people act like givers in close relationships. In marriages and friendships, we contribute whenever we can without keeping score.

In the workplace things change. Things get more complicated. Subconsciously employing game theory, we become matchers.

Professionally, few of us act purely like givers or takers, adopting a third style instead. We become matchers, striving to preserve an equal balance of giving and getting. Matchers operate on the principle of fairness: when they help others, they protect themselves by seeking reciprocity. If you’re a matcher, you believe in tit for tat, and your relationships are governed by even exchanges of favors.

Despite that, we develop a “primary reciprocity style” at work, which “captures how (we) approach most of the people most of the time. And that style can play as much a role in our success as hard work, talent, and luck.”

If you were to guess who was to end up at the bottom of the success ladder, what would you say? Givers? Takers? Matchers?

Research demonstrates that givers sink to the bottom of the success ladder. Across a wide range of important occupations, givers are at a disadvantage: they make others better off but sacrifice their own success in the process.

But if givers are at the bottom, who is at the top? It’s the givers.

This pattern holds up across the board. The Belgian medical students with the lowest grades have unusually high giver scores, but so do the students with the highest grades. Over the course of medical school, being a giver accounts for 11 percent higher grades. Even in sales, I found that the least productive salespeople had 25 percent higher giver scores than average performers—but so did the most productive salespeople. The top performers were givers, and they averaged 50 percent more annual revenue than the takers and matchers. Givers dominate the bottom and the top of the success ladder. Across occupations, if you examine the link between reciprocity styles and success, the givers are more likely to become champs—not chumps.

A lot of life strategies that work in the hundred-yard dash fail in the marathon. Grant convincingly argues that we underestimate the success of givers. We stereotype them as “chumps and doormats,” yet they also turn out to be some of the most successful people. So what separates the champs from the chumps?

The answer is less about raw talent or aptitude, and more about the strategies givers use and the choices they make. … We all have goals for our own individual achievements, and it turns out that successful givers are every bit as ambitious as takers and matchers. They simply have a different way of pursuing their goals.

Givers are the win-win people. When takers win, someone loses. As the venture capitalist Randy Komisar remarks, “It’s easier to win if everybody wants you to win. If you don’t make enemies out there, it’s easier to succeed.” Or as Charlie Munger says, “The best way to get success is to deserve success.”

Givers are non-linear.

[g]ivers, takers, and matchers all can—and do—achieve success. But there’s something distinctive that happens when givers succeed: it spreads and cascades. When takers win, there’s usually someone else who loses. Research shows that people tend to envy successful takers and look for ways to knock them down a notch. In contrast, when [givers] win, people are rooting for them and supporting them, rather than gunning for them. Givers succeed in a way that creates a ripple effect, enhancing the success of people around them. You’ll see that the difference lies in how giver success creates value, instead of just claiming it.

And, Grant argues that we live in a world where giving matters more than ever.

The fact that the long run is getting shorter isn’t the only force that makes giving more professionally productive today. We live in an era when massive changes in the structure of work—and the technology that shapes it have further amplified the advantages of being a giver.

Givers thrive in teams, takers as the lone wolf. As the structure of success changes—as we move out of school and into the workplace—a new sense of teamwork emerges that favors the givers. Takers focus on wealth, power, pleasure, and winning. Values that are constantly getting attention from the media. Givers are interested in helping, being dependable, social justice, and compassion (notably things that get much less attention in today’s sensationalist page-view world.)

In the first part of Give and Take, Grant shows us what makes giving “both powerful and dangerous.” The second part shows us the benefits and costs of giving and how they can be managed. Before you put the book down, you’ll be rethinking your assumptions about success.


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What Book has the Most Page-for-Page Wisdom? http://www.farnamstreetblog.com/2014/10/the-most-page-for-page-wisdom/ http://www.farnamstreetblog.com/2014/10/the-most-page-for-page-wisdom/#respond Tue, 14 Oct 2014 12:00:35 +0000 http://www.farnamstreetblog.com/?p=19196
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Here is what happened when I asked twenty-seven thousand people “What is page for page the book with the most wisdom you’ve ever read?”

My thinking was, and still is, that you need to filter what you read. Reading, I mean really reading, is not simple. It’s time consuming. So aside from finding time and remembering what you read, you want to make sure you’re reading the right things. There are a few approaches to this filtering. One is to employ the Lindy Effect. But another approach that I use personally is, and this is really going to sound simple, to ask smart people what they’re reading, what they learned from, or, in this case, what book has the most page-per-page wisdom.

The results are often surprising and I usually find one or two books that I’ve never heard of that offer a lot of value.

In no particular order, here is what twitter had to say:

Seeking Wisdom, by Peter Bevelin
This is number 8 on the list of books that changed my life. It is also the book I give away most often, sending innumerable copies around the globe.

Cosmos, by Carl Sagan
This is one of the best-selling science books of all time. I’ve never read it, so I ordered it after reading the blurb: “retraces the fourteen billion years of cosmic evolution that have transformed matter into consciousness, exploring such topics as the origin of life, the human brain, Egyptian hieroglyphics, spacecraft missions, the death of the Sun, the evolution of galaxies, and the forces and individuals who helped to shape modern science.”

To Kill a Mockingbird, by Harper Lee
A book that a lot of people, myself included, talk about but have never read. It’s time to change that.

Do the Work!, by Steven Pressfield
I liked Pressfield’s, The War of Art enough to pick this manifesto arguing that ideas are not enough, you actually have to do the work.

Zen and the Art of Motorcycle Maintenance by Robert Pirsig
I’ve picked this book up at least 3 different times in my life and stopped reading it for one reason or another. Considered a cult classic by many, I haven’t found the right time to read it … yet.

The Conquest of Happiness, Bertrand Russell
First published in 1930, this book attempts to “diagnose the myriad causes of unhappiness in modern life and chart a path out of the seemingly inescapable malaise.” The book remains as relevant today as ever, and in this edition Daniel Dennett, who showed us how to how to criticize with kindness, re-introduces Russell’s wisdom to a new generation of readers and thinkers calling the work “a prototype of the flood of self-help books that have more recently been published, few of them as well worth reading today as Russell’s little book.”

This is Water by David Foster Wallace
This is one of the best things you will ever read (and hopefully periodically re-read). I wholeheartedly agree with this selection.

Meditations, by Marcus Aurelius
Another of the books that changed my life and also one of the books that I gave away at the Re:Think Innovation workshop. Translation matters enormously with this book, get this one.

Letters from a Stoic, Seneca
Love love love. As relevant today as it was when it was written.

Influence: The Psychology of Persuasion by Robert Cialdini
The person who recommended this book said “you can’t throw away any one page of this book.” You can read a quick overview of the book, but I’d recommend digging in.

Dr Seuss, Oh, The Places You’ll Go!
I agree. Don’t write it off because it’s a kids’ book. I love this book.

An Intimate History of Humanity, by Theodore Zeldin
I’d never heard of this work exploring the evolution of emotions before. Time magazine called it “An intellectually dazzling view of our past and future.”

The Road Less Traveled, M. Scott Peck
I’d never heard of this book (seriously) either and it’s sold 7 million copies. A book to “help us explore the very nature of loving relationships and lead us toward a new serenity and fullness of life.”

The Hitchhiker’s Guide to the Galaxy, by Douglas Adams
“For all the answers, stick your thumb to the stars!”


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Google and Combinatorial Innovation http://www.farnamstreetblog.com/2014/10/google-and-combinatorial-innovation/ http://www.farnamstreetblog.com/2014/10/google-and-combinatorial-innovation/#respond Mon, 13 Oct 2014 12:00:35 +0000 http://www.farnamstreetblog.com/?p=19192
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Innovaiton
In his new book, How Google Works, Eric Schmidt argues that “we are entering … a new period of combinatorial innovation.” This happens, he says, when “there is a great availability of different component parts that can be combined or recombined to create new inventions.”

For example, in the 1800s, the standardization of design of mechanical devices such as gears, pulleys, chains, and cams led to a manufacturing boom. In the 1900s, the gasoline engine led to innovations in automobiles, motorcycles, and airplanes. By the 1950s, it was the integrated circuit proliferating in numerous applications. In each of these cases, the development of complementary components led to a wave of inventions.

Today’s components are often about information, technology, and computing.

Would-be inventors have all the world’s information, global reach, and practically infinite computing power. They have open-source software and abundant APIs that allow them to build easily on each other’s work. They can use standard protocols and languages. They can access information platforms with data about things ranging from traffic to weather to economic transactions to human genetics to who is socially connected with whom, either on an aggregate or (with permission) individual basis. So one way of developing technical insights is to use some of these accessible technologies and data and apply them in an industry to solve an existing problem in a new way.

Regardless of your business there is a core of knowledge and conventional wisdom that your industry is based upon. Maybe it’s logistics, maybe it’s biology, chemistry or storytelling. Whatever that core is, “that’s your technology. Find the geeks, find the stuff, and that’s where you’ll find the technical insights you need to drive success.”

That’s also the area to look for — where conventional wisdom might be wrong. What was once common sense becomes common practice. When everyone agrees on some fundamental assumption about how the industry works, the opposite point of view can lead toward disruption.

Another possible source of innovation is to start with a solution to one problem and then look at ways to use the same solution on other problems.

New technologies tend to come into the world in a very primitive condition, often designed for very specific problems. The steam engine was used as a nifty way to pump water out of mines long before it found its calling powering locomotives. Marconi sold radio as a means of ship-to-shore communications, not as a place to hear phrases like “Baba Booey!” and “all the children are above average.” Bell labs was so underwhelmed by the commercial potential of the laser when it was invented in the ‘60s that it initially put off patenting it. Even the Internet was initially conceived as a way for scientists and academics to share research. As smart as its creators were, they could never have imagined its future functionality as a place to share pictures and videos, stay in touch with friends, learn anything about anything, or do the other amazing things we use it for today.

Schmidt gives his favorite example of building upon a solution developed for a narrow problem.

When Google search started to ramp up, some of our most popular queries were related to adult-oriented topics. Porn filters at the time were notoriously ineffective, so we put a small team of engineers on the problem of algorithmically capturing Supreme Court Justice Potter Stewart’s definition of porn, “I know it when I see it.” They were successful by combining a couple of technical insights: They got very good at understanding the content of an image (aka skin), and could judge its context by seeing how users interacted with it. (When someone searches for a pornography-related term and the image is from a medical textbook, they are unlikely to click on it, and if they do they won’t stay on the site for long.) Soon we had a filter called SafeSearch that was far more effective in blocking inappropriate images than anything else on the web—a solution (SafeSearch) to a narrow problem (filtering adult content).

But why stop there? Over the next couple of years we took the technology that had been developed to address the porn problem and used it to serve broader purposes. We improved our ability to rate the relevance of images (any images, not just porn) to search queries by using the millions of content-based models (the models of how users react to different images) that we had developed for SafeSearch. Then we added features that let users search for images similar to the ones they find in their search results (“I like that shot of Yosemite-go find more that look just like that”). Finally, we developed the ability to start a search not with a written query (“half dome, yosemite”), but a photograph (that snapshot you took of Half Dome when you visited Yosemite). All of these features evolved from technology that had initially developed for the SafeSearch porn filter. So when you are looking at screen upon screen of Yosemite photos that are nearly identical to the ones you took, you can thank the adult entertainment industry for helping launch the technology that is bringing them to you.

How Google Works is full of interesting insights into the inner workings of a company we’re all fascinated with.


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Chimamanda Adichie: The Danger of a Single Story http://www.farnamstreetblog.com/2014/10/chimamanda-adichie-the-danger-of-a-single-story/ http://www.farnamstreetblog.com/2014/10/chimamanda-adichie-the-danger-of-a-single-story/#respond Sun, 12 Oct 2014 12:00:26 +0000 http://www.farnamstreetblog.com/?p=19104
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Our lives, our cultures, are composed of many overlapping stories. Novelist Chimamanda Adichie, author of Americanah, one of The New York Times’s ten best books of the year, tells the story of how she found her authentic cultural voice — and warns that if we hear only a single story about another person or country, we risk a critical misunderstanding.

I was 19. My American roommate was shocked by me. She asked where I had learned to speak English so well, and was confused when I said that Nigeria happened to have English as its official language. She asked if she could listen to what she called my “tribal music,” and was consequently very disappointed when I produced my tape of Mariah Carey. … She assumed that I did not know how to use a stove.

What struck me was this: She had felt sorry for me even before she saw me. Her default position toward me, as an African, was a kind of patronizing, well-meaning, pity. My roommate had a single story of Africa. A single story of catastrophe. In this single story there was no possibility of Africans being similar to her, in any way. No possibility of feelings more complex than pity. No possibility of a connection as human equals.

I must say that before I went to the U.S. I didn’t consciously identify as African. But in the U.S. whenever Africa came up people turned to me. Never mind that I knew nothing about places like Namibia. But I did come to embrace this new identity. And in many ways I think of myself now as African. Although I still get quite irritable when Africa is referred to as a country. The most recent example being my otherwise wonderful flight from Lagos two days ago, in which there was an announcement on the Virgin flight about the charity work in “India, Africa and other countries.”

So after I had spent some years in the U.S. as an African, I began to understand my roommate’s response to me. If I had not grown up in Nigeria, and if all I knew about Africa were from popular images, I too would think that Africa was a place of beautiful landscapes, beautiful animals, and incomprehensible people, fighting senseless wars, dying of poverty and AIDS, unable to speak for themselves, and waiting to be saved, by a kind, white foreigner. I would see Africans in the same way that I, as a child, had seen Fide’s family.

This single story of Africa ultimately comes, I think, from Western literature.


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