My 23 and Me Experience

you are already brilliant (it's in your DNA!) My husband recently decided to order a genetic screening kit from 23 and Me.  He’s a physician and does a lot of medical research, looking for ways to prevent preterm birth and other illness in women.  Since they do more and more genetic screening on patients, he decided to do some on himself.

When his results came in, we found out really important information about his health, as well as his potential longevity, which makes a big difference in some of the day to day decisions we are making as a family.  For example, based on his DNA, he has long telomeres, which means his chance for living to age 95 or older is greater than average, which means we better not skimp on retirement planning now.

Understanding DNA and Your “Destiny”

It’s probably important at this point to say a thing or two about DNA.  I was at a lecture this week given by Dr. George Saade of the University of Texas.  Dr. Saade looks at the influence of women’s health on the health of their offspring.  Dr Saade explains DNA and health this way- DNA is like the textbook, but your environment and your diet, exercise, actions, etc. are like the notes in the margin.  The main text is what it is, but the commentary, questions, and notes made can make a substantial difference in personalizing and understanding the deeper meaning of the text itself.  For example, we’re starting to learn more and more that what genes are active or not can be determined by the environment, leading to more rapid change in traits and expression than we would expect solely due to evolution.  (This is the nascent field of Epigenetics, and Time Magazine has written some really fascinating articles about it.)  Your genes may show you have a higher than average risk for some diseases, but how you manage your health has a huge impact on these various issues.

As a result of my husband’s tests, I’ve had my own DNA analyzed and I am about to do it for my sons as well.  My results are just coming in right now, and I’m relieved I have a decreased risk for Alzheimer’s and Parkinson’s.   I know I also have long telomeres, leading to an above average chance of living to 100, so time to start truly taking care of the body and joints- I can’t really assume they will have replaceable parts by then that are good and will last forever.  Playing wheelchair bumper cars in the nursing home may not be nearly as much fun as walking hand in hand with my husband on the beach when we’re 95.

The ancestry information is interesting as well.  My husband is a distant cousin of one of my favorite authors, Malcolm Gladwell.  All those family stories I heard from my Grandmother about her grandfather being a Prussian general might actually be true.  When you look at different genetic markers, you can see the spread of genes along trade routes going back to the Roman and Ottoman Empires, with other people with those markers currently living in India, Iran, Kurdistan, Germany, Russia, Italy, Spain or having relatives from that part of the world.

All of this has been fascinating and useful.  My son’s learning disability may be due to a gene identified that gives my side of the family a slightly increased risk for developmental dyslexia, balanced off with genes for increased episodic memory and higher than average intelligence.  I can look at these results and “blame” the genes for some of it, but how we work around those issues in daily life is really much more important, and that I have learned already.

What genes can tell us not only about our ancestors, but our potential response to drugs, potential for various disease, and even longevity can make a difference now.  There is, of course, potential scary news lying in wait in our genes for some people.  Some families may have a higher risk for some particularly nasty cancers, or for things like Alzheimer’s. But knowing might help those people make different and hopefully helpful choices on seeking early treatment for disease, or making life plans and choices that take this information into account.  (ie. Don’t avoid taking that trip  or putting off something you’ve always wanted to do, because you might not have infinite chances to do so- but that’s generally good advice anyway.)

There’s been fun and silly results, too.  I love Tab and Diet Coke as well as coffee, and so it was not a surprise to find out I am a fast metabolizer of caffeine.  I have higher odds than normal for feeling nauseous after surgery.    I’ve never smoked, but my genes say that if I did, I’d be more likely to smoke more than average, giving me yet another reason never to pick up that habit.  My husband’s naturally resistant to norovirus, but I’m not, meaning if we go on a cruise, I have to be extra careful with handwashing, where he can be a little more lax. (ie. make sure to bring Imodium on a cruise).  I also have a genetic predisposition to a higher than average episodic memory, so when I tell my kids “I know I told you to do that chore” – they should believe me- my genes say it’s so.

This has been a really positive experience for us, and one of the best $99 I’ve spent in a long time.  I know looking into what’s already been written in our genes can seem daunting, but at least for us, it’s been both reassuring and motivating to do things like tackle the weight issues once and for all- I’m going to have this body for a long time, so time to whip it into shape for real.

What do you think?  Is genetic testing a good thing or a bad thing?  What would you do with your results?

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Fear of Success and 5 Steps to Help

Everyone talks about the fear of failure, and how to look it in the eye.  (See this post by Seth Godin.)  Not as many people talk about the equally real fear of success that undermines and self-sabotages just as many.

Here are just a few examples of fear of success:

-The person who finishes every requirement to graduate and get a degree except for one course, maybe even an elective they could have taken pass/fail.

-The person who spends hours, weeks, even months on a project, but can’t quite seem to over close it out, publish the book or paper, or otherwise complete the damn thing.

-The person who looks at a project and all of its upsides, everything looks like a go, it’s obvious to everyone this is a winner… and then they change their minds at the last minute and decide to do something else instead.

-The person who always puts a roadblock or reason/excuse in their own way, such as waiting for someone else to do something before acting themselves.

-The person who always seems to be on the fence about any decision, ranging from where to have dinner, to what color to paint the bathroom, to what purchase to make. (The Hamlet Syndrome)

I’ve been this person from time to time- I think we all have.  What’s really behind this inability to finish, or what seems like lack of ambition?  It’s not really fear of failing- it’s a fear of succeeding, and what that might mean for your life. What goes into this fear?

-You might have more responsibilities.

-People will expect more from you.

-People might criticize you if you are in the spotlight.  They might snipe and be jealous.

-Your success might outstrip a parent, friend, or spouse- and that causes anxiety and/or competition.

-You aren’t sure what you’ll feel like after that moment of success, or how long it will last, and you’ll have to find something else to do or worry about.

-Anxiety and being the perpetual underdog may feel more normal and natural than being on top.

-You might have to make decisions and take control instead of letting others do it for you.

-You might not know what you want to do next, but you’ll be forced to decide if you finish.

-You might push yourself down a road you’re just not sure you want to commit to forever.

-Making a decision and taking action might foreclose other options, and you’re afraid to commit in one direction or another.

-You might have to take control and stand up for yourself, which means giving up the role as spectator or victim in your own life.

Objectively, we can see that failing to make decisions and to commit to a direction leaves us floundering and drifting.  Many smart and intelligent people, often over-achievers, flounder because the options are many and picking just one “mission” seems scarier than leaving options open.

The trick to all of this, of course, is to recognize the fear when it starts taking hold.  Here are five things you can do to help get out of your own way:

1.  Recognize procrastination as anxiety and fear.  If you are avoiding something, try to figure out why you “just can’t seem to get that thing done.”  If you find the root of the problem, you can address it.

2.   Write down your feelings, even if it starts out “I’m not sure why I’m avoiding this thing….”  Hand write two or three pages, longhand, free form, just thinking about the issue and what you might be thinking about.  Usually, you’ll start to find what’s really bothering you by the end of the pages.

3.  Try short programs like The Artist’s Way to identify where you might be blocking your own success and happiness.  Sometimes it might be things from your past getting in your way.  The Artist’s Way is a great pathway towards uncovering your own self-sabotage, whether you consider yourself an artist or not.  This is one of the best things I’ve ever done, and it’s often great to do with a friend you trust, to keep you both on track.

4.  While trite phrases like “If you don’t try, you can’t succeed” seem, well, nauseating, remember that we all learn from failure and stumbling along the way.  We need failure to learn, and we need at least a little success to keep going.  Be kinder to yourself and allow small successes- even crossing off tasks on your daily to do list, to help build comfort with accomplishment.

5.  Draw a roadmap to what you want.  Make a list of dreams and aspirations.  Pick one or two.  Then write down all the things that need to happen to make that dream a reality.  Seriously- every step.  If you can, break down those steps into smaller steps. Be specific.  For example, even if you write something like:  “Wait to be discovered by a talented director;” Break down  that “goal” into things you would need to do to get a Director’s attention, such as putting samples on Youtube, starting a blog, etc.  Then get started, put deadlines on the calendar and hold yourself accountable.  Once you make the dream a tangible reality, it’s much more likely you can find a pathway to the end.

Fear of success is painful to watch from the outside.  Watching people sell themselves short and not reach their potential seems like such a waste of talent and energy.  If you think you have an awful inner critic, or what Arianna Huffington calls “The obnoxious room mate in our head who always tells us how terrible we are,” remember the real world is often much more kind and only sees or assumes your good qualities, so try to live up to those standards instead.

If you need something to fear, fear the sad shake of the head from people who say “She had so much potential and seemed to have it all together, but it never lived up to its promise.”  That’s tragedy.  Going for broke and failing or stumbling along the way is natural and normal.  You’re probably already there.  Don’t fear finishing.  Don’t leave things only “mostly done”.  Finish it, close it out, and look back with pride as small successes start making you more comfortable with bigger ones.

I’ll be here working on these things right beside you.


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Those Transitional Moments

Today I sent my first son off to college. Everyone talks about how hard this is.  Michael Gerson summed it up well in his recent column in the Washington Post when he said:

This was the general drift of my thoughts as my wife and I dropped off my eldest son as a freshman at college. I put on my best face. But it is the worst thing that time has done to me so far. That moment at the dorm is implied at the kindergarten door, at the gates of summer camp, at every ritual of parting and independence. But it comes as surprising as a thief, taking what you value most.

We know it’s coming.  We try to be prepared.  But our kids grow up and become their own people over time, whether we’re ready or not.  My son is a warm and special guy.  He’s honest, and loving, and thoughtful.  He has two terrific room mates, including a young man from Egypt I hope will come home with us at Thanksgiving.  He’s at a great school, and he’s going to have a great year, I know it.  All of that is cause for joy.  The bittersweet part of lies elsewhere.

Part of this separation is about remembering how much fun college was and how much I miss that time of exploring new ideas and that being about my only real responsibility for a few years.  I wish I had explored even more.  Of course, I can do much of this on my own now, but getting all your friends to talk about the book you just read or the geeky idea you just had is a bit different from sharing this same experience with a group of peers as you discover the world as proto-adults together. Part of the separation pain is realizing that your kids are grown and need you less than before.  Even when he got his driver’s license, it took time and was  a gradual process towards being independent.  It took time before we were willing to toss him the car keys to go run errands and do his own thing.  By contrast, this one day separation and moving him out of our house and into his dorm feels more like a surgical amputation of the apron strings.  It’s something that needs to happen, and we know had to happen, but it seems abrupt.

To be honest- I’m not sure I would ever have felt ready to do this without tears.  As I fell asleep last night, I cried as I thought of the curly red haired toddler who is now a grown man and on his own.  He can handle it- I have every confidence in him-I’m just not sure I’m really ready for it. That’s the push-pull of parenthood, of course.  You get to raise new people, and help shape them into people you love and want to hang out with- people you love sharing holidays with, picking out special surprises and gifts for, just to see the look of joy on their face- people you feel lucky to know for all their excellent qualities, even if you probably spent too much time criticizing the silly things like laundry on the floor or failure to put their shoes away when they were in the house.  (I defend my actions in the name of making him a better room mate, but the guys in his dorm will be the final arbiters of my success or failure on that front.) But then you have to let go and let them live their lives, make their own mistakes, and enjoy their own successes, while becoming more background characters in their narratives rather than the central characters they have been in ours.

I have absolutely loved every second of being a mom.  I wish I could rewind time and do it all again.  With all the amazing times come a bit of bittersweet pain, like this.  It will be okay, with time making it slightly less painful.  But I will always treasure every moment- from that funny, adorable young baby and boy to the man he is now, and be forever grateful to have had a part to play at all on his stage.

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Fixing Traditional Retail

Over the course of my lifetime, I’ve seen traditional retail transform.  In Rochester NY, where I grew up, there were several local department stores, started by local businessmen who became legends in the community.  Over time, these stores struggled as their downtown “flagship” stores (long before that term came into vogue) had to compete with suburban malls.  The loss of these grand stores, as they were bought out by national companies like the May Company and left downtown for the malls, also left gaping holes in the downtown real estate and in the culture of the center of the City itself.   Commerce and entertainment migrated into the suburbs and smaller trendy neighborhoods.  Downtown appears poised for a comeback, but the loss of many manufacturing jobs at Xerox, Kodak, and even Gannett makes this a challenge as well.

Beyond nostalgia for going to Sibley’s with my Grandmother and having lunch served on tables with cloths and silver, or going to the traditional Breakfast with Santa Claus each year, we’ve lost something else as retail and department stores in particular have consolidated over time and become national- we’ve lost a local connection, a personal touch, and a sense of pride of being part of the larger organization.  This may sound silly, but I think this lack of investment in a business as part of a community, and instead  treated as a warehouse of fungible jobs that could be fast food or sales or anything for that matter, has meant a loss of loyalty from the customer base as well.

Let’s take Sears for example.  The New York Times is reporting that Sears (which also encompasses Kmart and Land’s End now as well) is struggling for the second quarter in a row with weak sales.  I am not surprised in the slightest, based on my experiences with them this summer.

I was in the market for a small dorm sized refrigerator to send with my son to college.  I looked at the local appliance store, but they didn’t have quite what I wanted, so I went to our local Sears.  Sears has always stood for quality appliances, and their Kenmore brand is always highly rated by Consumer Reports.  Whenever we have been in the market for appliances, we almost always buy them from Sears, so I was expecting this to be an easy transaction.  I found a fridge that looked perfect and was on sale near the 4th of July weekend.  When we showed up in the store, it took about 10 minutes to find someone to help us, who was looking up items on his iPad, something I could from home, thanks, and had already.  It turned out the store only had one of the items in stock, and it had just been purchased by someone ahead of us, but there was one available, said the computer, at a local store, about a 15 minute drive away.  We went ahead and bought the appliance at Store A and went to pick it up at Store B.  When we got to Store B, they told us they didn’t have any, and we needed to go inside and talk to the person on duty.  I had to wait 25 minutes before I could talk to a sales person, and an additional 20 before I could talk to a manager- apparently no one else other than someone in that Department could help me, which seems ironic since everyone was carrying around iPads.  (Side note: During this time, I began to tweet about my difficulties and got a prompt response from Sears on Twitter, and later from their customer service department, that was excellent and resolved our issues completely.)  When I did get to talk to a manager, her first response was “The person from Store A should have called here first since the computer is often wrong.”  Fine, but clearly not my problem- I had bought an item and they could not deliver!  So I asked for them to ship it to my house and cover the shipping, or have it delivered to the store and I could pick it up.  They couldn’t do that since it was discontinued.   We had to CALL web sales and order the fridge from the Web Store while I sat in the physical store, and the physical store had to refund my original purchase since and Sears the Store are not the same thing, apparently.  I also had to pay for shipping, (which ultimately was compensated through a gift card to the store through Customer Service) which made the waste of three hours of my life absolutely pointless.  It would have been faster, easier and less frustrating for everyone if I had merely bought the appliance online and had it shipped rather than go to their store.

The process of buying a microwave (with the giftcard from the above debacle) at the store, including an issue with incorrect shelf pricing and their new membership model) meant that this process, about two weeks after the first debacle, took about 45 minutes, when I could have done the same purchase at Target in about 5 minutes flat.

Sears has great tools and appliances.  Land’s End clothes are well made.  The quality of their stuff is fine.  Their staff is either poorly trained or simply don’t care at all unless they work on commission, based on our recent experience.  Even buying a small set of tools for the College freshman involved a salesperson first trying to use their iPad and eventually having to use a register to complete the transaction, making even the simplest purchase transaction more of a headache than it should ever be.

I was left with the impression after my recent experience that if I ever want anything from Sears, I should buy it online and pick it up in the store, only after verifying it is actually there by phone, but under no circumstances, should I actually try to purchase something in the store itself unless I had time to burn.  In fact, based on the fridge experience, I think they are sending me the message they would prefer I didn’t go to the store, either, as it seems just to annoy the managers and sales help. Given that much of their merchandise besides tools and appliances can be purchased at places like Kohl’s or Target with less hassle, I don’t know why I would ever go into a Sears store again except for tools or appliances.

If Sears, or any other store wants traditional retail to work, you have to make it pleasant.  You have to have sales people who know their products and actually think about helping the folks wandering around the department, help them narrow choices or consider options.  You have to make it something better than buying the same thing online.  When your sales help is using the same device I have at home to check inventory and still gets it wrong,  there is absolutely no benefit to either of us if I darken your doorway for which I am sure you are paying plenty of rent.

Traditional retail has to give us something beyond “Get it today”.  Once we have all gotten used to purchasing things online, you need to make going into the store more like going into a showroom.  Let me touch the items, talk to me about them, understand my needs and steer me towards a good solution.  Without that sort of help, your sales associates are of little use except for trying to sell added insurance on items.  They could just as easily be replaced by the self-checkouts I use at Home Depot, while minimizing frustration.

While I ended up with a satisfactory experience from Sears, the satisfaction came through Social Media and Twitter and national customer service, not from my community members and neighbors who worked in the store itself.  There was no sense of pride or investment in the store or product, just people punching a clock for the most part, and looking demoralized in the process.  No one needs that kind of environment- the workers or the shoppers.

Based on my recent experience, I totally understand why Sears has flat or declining sales.  This same experience of employee indifference is not atypical from my recent experiences at Best Buy, Macy’s, or a number of other national retailers.  What retail needs is what the department stores of yore knew- customer service, kindness, and solving small problems led to loyalty and then profits.  Indifference leads to bankruptcy.  Culture matters- not just for employees but for consumers.  If you forget this, you might as well consider closing your doors, because it may only be a matter of time until people find somewhere else to get what they need,faster and with less ennui.

(And in case Sears customer service does read this blog post, I do want to thank you again for your prompt attention to this matter and for far outshining your local employees.  However, until Sears helps make our local employees better and more engaged in their jobs, you may be fighting a losing, uphill battle.)



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Seeking Perfection

Seth Godin had an interesting post today talking about delight and mentioning six sigma.  It caught my attention, because some folks I know have been taking six sigma classes who work in health care.

Health care, and all of the caretakers in the system- doctors, nurses, technicians, lab folks, pharmacists- everyone- needs to walk a line between perfection and amazement every day.  Looking for perfection in performing tasks like surgery or making sure medical errors are as minimal as errors in manufacturing on an assembly line is worthwhile, to be sure.  But health care is also filled with individuals needing specialized and bespoke care, taking into account many factors that make them unique, as well as routine.  For example, treating someone for an infection may look routine, until you realize they are allergic to the common medications that are most likely to kill the infection, but instead would kill the patient if given.

I’ve heard stories from our local hospital about weird, one of a kind things happening- like a guy who took hospital transportation between medical centers to visit his girlfriend, and then went to her room and got into a fight, and sought to escape also using Hospital transportation.  While this guy doesn’t win any awards for criminal genius, how much time should the hospital spend on security, or rethinking the transportation system or more, for one guy with a bad temper and bad judgment?  While it certainly deserves notice and something to watch out for, this sort of incident is an anomaly based of dealing with the vast variety of humans, and is not something even six sigma can control.

Perfection and Six Sigma assumes you can control the parameters of a process.  In manufacturing, this is much more likely than in other venues, like social media or health care.  People may be predictably irrational*  but they still can often surprise us with the sheer variety of good and bad decisions they choose to make.

The skills we need as much as perfection are those of improvisation.  We need people to be resilient, to work with what they have on hand and solve problems, rather than search for perfection at the cost of functional.  I get the need for perfection, and pushing to be better than “good enough”- and I hold myself frequently to these standards, but I’ve also learned that there are some areas where good enough is all that matters.

In health care, I worry that if they begin to focus too much on systematization and perfection, a reliance on the “system” will hold people back from questioning and improvising when necessary.  By making too many things fool proof, we forget that fools teach us a lot, and there is always another smarter fool waiting to break the new system anyway.

The persistent problem we all face is that teaching innovation, out of the box thinking and improv is not as easy to systemize as rote learning.  Rote learning  is puzzle pieces, while improv and problem solving is putting the pieces together in more than one “right” way.

Give me the improv folks and the entrepreneurs every day.  The folks who actually like constraints because they make the problem solving more creative.  These are the folks I love to work with and for.  Blue sky thinking is great, but thinking inside and outside the box at the same time is where the magic lies.




*A great book by Dan Ariely, and he even has an app now that I’m eager to give a whirl.

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