I’ve been waiting. For days.

Getting along. Trudging through the mundane and kicking the mildly infuriating rocks of unreasonableness that gather underfoot.

I’ve been waiting. For it.

The lesson, the big idea, the spark that proves I learned something valuable. Something worth sharing.

That moment is like emotional rocket fuel. The jet stream is not the vapor of wisdom; it contains satisfaction and, if I’m being transparent, more than a little smugness. The moment has become too familiar. The spark releases the writer’s dopamine and the rocket launches. Off to deliver the next essay like Amazon Prime. “Ah yes, my next essay has arrived on my doorstep.”

The spark either arrives with a bang or it sneaks under the covers while I’m drifting off. But it always comes. Packed in its suitcase of inspiration are clear metaphors, elegant prose, tidy connections, (a few oxford commas) and a neat moral that turns my experience into publishable meaning.

The kind of meaning that a person who nearly died should be able to extract from every passing day.

Yesterday, there was no such lesson. Just a gigantic “should.”

In DBT (Dialectical Behavior Therapy), this is a thinking mistake called “shoulding on yourself.” It sounds even grosser when you say it out loud. But what it looks like is turning your life into a series of tests you can never pass.

My son Jack and I went to the gym together yesterday. I had fallen off my exercise routine and was dreading the workout. The mere decision to pack a bag and go there gave me enough of a jolt that I wanted to just call that a win and avoid working out for yet another day. I trudged forwards but we made it there with eagerness in the trough and resolve at the peak.

We walked side by side on the treadmills. Jack hopped on like the immortal 10-year-old he is while I stretched and warmed up. The stiffness did not dissipate, and the burn came on far earlier than I expected. Little shockwaves shot out from my scar and spread across my chest with each running stride. I did about 20 solid minutes of cross training before my lungs gave out. After recovering from the cardio, I did some chest presses while Jack worked with some dumbbells.

Today my body hurts. It may be that kind of hurt that reminds you of the good and honest work you just did, but damn it hurts.

Then we swam. We laughed. We splashed. We tried to dunk one another. It felt less like exercise and more like a laughing re-entry into my body. My skin tingled. My joints came alive and the chlorine stung my nose. I was in the moment. Present. Mindful.

New England is as New England does.

Snow came overnight. Just enough to have to deal with it.

In the morning Jack and I shoveled the driveway together. No speeches, no parenting lessons from Dad. Just two people doing a job on a bright morning.

He started a snowman and abandoned it halfway. I didn’t mind. The driveway was passable, not perfect. Neither were we.

We finished shoveling as the snow began to fall once again. We laughed at ourselves, kicked off our boots, and collapsed on the couch. Jack watched TV while I dozed. Drifting in the gentle-letting-go of someone who had done enough for the day even though it was barely noon.

Before we could head out to spend the evening with Cory and her son, the driveway needed yet another shovel. We ordered food to pick up and drove through falling snow like a small spaceship on hyperspeed.

The restaurant told us someone else had picked up the order – perhaps to deliver it. With stomachs growling, Jack and I headed on to Cory’s house on empty stomachs only to find no food. They apologized and offered to make us a fresh order. So, back in our spaceship and back down the hill to pick it up. Nobody panicked. Nobody blamed anyone. We laughed more than we complained, ate our food way too late, played way too long, and rolled home around 10:30 — a weekend indulgence that felt exactly right.

And then there I was: Jack asleep, quiet house, fire burning, and snow drifting past the window.

I felt steady and warm. As much as I tried, I did not feel grateful.

Fear had crept in.

Because after cheating death and a long reckoning with my mortality, shouldn’t I have developed the perspective to extract something profound from a day like this. Shouldn’t I be able to turn snow into a sermon, a couch nap into a meditation on life and death, a mixed-up takeout order into a parable about surrender?

Nope.

No big metaphor.
No lemonade to make.

Only a quiet evening after an ordinary day.

That’s when Fear invited its friend Doubt to join us on the couch:
“This is indulgent thinking that I have something valuable to offer.”
“I am probably not a unique voice among the legions who write about their trauma.”
“Maybe I should just keep my writing between me and my therapist.”

I don’t remember a lot from college but something came back to me that I think matters in this context: the Cycle of Experiential Learning.1

It moves in four steps:

1. You live something (Concrete Experience)

2. You notice and think about what happened (Reflective Observation)

3. You find meaning in the experience and reflection (Abstract Conceptualization)

4. You try something different next time (Active Experimentation)

Here’s how it looks in my story so far:

1. I experienced the widow maker heart attack, the surgery, and the hallucinations in the ICU.

2. I use therapy to reflect and describe my lived experience before, during, and after the moment that changed everything.

3. I find meaning when my experience and reflection forge into something stronger.

Meaning has only come for me in fits and starts. Some weeks are full of those moments. Others sputter. But the engine always tuned over. Until today.

What if, instead of arriving with a thunderclap and trumpets, the new understanding has been walking beside you unannounced?

What if it is time to stop mining every moment for a lesson and just live again?

After all, yesterday I played without performance. I handled an inconvenience without derailing. I rested without guilt. I parented alongside Jack instead of above him.

In DBT terms, I wasn’t “practicing” mindfulness, I just was mindful. It came to me as reflexively as my next breath. And I almost missed it.

There is a softer but steadier voice in me telling me to keep writing. Reminding me that someone might need to hear that growth and healing does not always look like it does on Instagram, or TikTok, or even, dare I say, Substack. There is someone today who is looking for a quick emotional fix. That person will find a thousand promises of lightbulbs and breakthroughs in exchange for a paid subscription. There is nothing new under the sun. Sometimes the message hits, sometimes it isn’t the right time.

Yesterday I shoveled my driveway twice, worked out, played in the water, and enjoyed the evening stillness on the couch with my son sleeping soundly upstairs.

Last January, I could barely hold ten pounds, let alone shovel a driveway. No way would I risk rough housing with Jack. Chest presses? Impossible. Hell, I couldn’t even be alone for very long.

My 2025 was full of struggle.
And, so far at least, my 2026 feels like evidence that the struggle was worth it: yesterday was just as mundane as it was filled with things I could not have done just 12 months earlier.

Maybe that is the learning: Lemons are great as they are. I can make the lemonade tomorrow.

I used to believe growth would arrive neatly packaged. Instead, it seems to be arriving like snow: soft, cumulative, and almost invisible. And at some point, you notice how much has settled so you shovel the driveway and start making a snowman with your kid.

My next step in the cycle is to lean into the present: to keep living days like this without expecting revelation and to apply my learning to today.

And maybe …to try writing from experience instead of trauma.

Because just being alive to notice this moment is not trivial. It is not small. It is, in its own way, a kind of miracle that arrived slowly and almost silently.

Before we begin anything heroic, maybe we begin here — with a fire, some falling snow, and the simple fact that we are alive to notice it.

And if it mattered to me, perhaps it will matter to someone else too.

That might be the whole point.

These notes are almost embarrassing in their simplicity.

This is a lovely chat
What is tube removal like
Kind of shitty but over fast?

All normal pains
I’ve always had a low resting heart rate

I had just come out of anesthesia after emergency quintuple bypass surgery. I didn’t know yet that I would crash into respiratory failure later that day, or that I’d spend the next two and a half days packed in ice to keep a fever from killing me.

They were written on sticky notes Cory and I passed back and forth while I was still on the ventilator waiting for news about when it would be removed from my throat (shout out to Postpartum Support International Connecticut). This would be the third, and thankfully, the last attempt to get me breathing on my own.

At the time, I was fixated on something smaller: whether what I was feeling was normal. “Normality,” whatever that is, hijacked my thinking. Was I “normal” after all this? Would I even survive? If I did survive, what would I look like? Sound like? Could I roughhouse with my kids? Could I be as strong as I was before?

Pain, as it turned out, I could tolerate. Confusion and unpredictability were far more difficult to manage. The terror came from not knowing whether what I was experiencing was expected—or a sign that something was going very wrong.

The question is this normal? Stuck with me long after the tubes came out.

When I first regained consciousness, my body felt like it had been poorly reassembled. My head felt hinged open at the neck, as if it might tip backward and not come back. My hands barely worked. Pink Floyd had it right: they felt like two balloons, floating uselessly at the end of my arms.

My parents tried to interpret my eye movements and gestures like a game of charades. Cory sat closer. When doctors attempted to extubate me the first time, I became violently agitated while still unconscious. Cory pushed back. Advocated. She asked for medication to calm me down when I couldn’t ask myself.

That advocacy probably saved my life.

The second attempt came overnight. I crashed. High fever. Respiratory failure. Then the ice. Then the coma.

I survived all of that.

Which makes what I’m about to say feel almost ungrateful.

Exercise was one of the best things I did in early recovery.

It wasn’t about fitness or weight or discipline. It was about orientation. The treadmill anchored me to mornings. It gave shape to the day ahead. It quieted my nervous system. It reminded my body that it knew how to move forward, one step at a time.

And it was the first thing to fall off.

Not fast food. Not sleep. Not boundaries around work. Not emotional grounding.

Just exercise.

That’s the part I couldn’t understand. Until recently.

Here’s what I think now.

Exercise wasn’t just a healthy habit. It was a symbol of survival.

In the earliest weeks, that symbol of survival fueled my desire to restore my physical health. Moving my body was proof that I not only hadn’t died, but that I had the capacity to regain full health. Every walk, every mile, every routine reinforced that narrative.

But as life normalized, exercise stopped being a victory lap and started being… ordinary.

And ordinary is where the real work begins.

Because ordinary no longer provides the emotional payoff of I lived. Ordinary asks a quieter, harder question:
How do I keep showing up when survival is no longer the headline?

Exercise stopped being an act of defiance and became an act of maintenance. And maintenance doesn’t come with adrenaline. It comes with boredom. Resistance. Excuses that sound reasonable because they are.

In other words: all normal pains.

I think this is true far beyond recovery.

We’re very good at rising to crises. We are less practiced at sustaining ourselves once the crisis passes. The habits that save us in emergencies don’t always translate cleanly into long-term care.

And sometimes the behaviors that fall away aren’t the unhealthy ones—but the ones that were holding our fear at bay.

Exercise didn’t fail me.

I stopped needing it to prove I was alive.

Now I need it for a different reason.

And relearning that without drama, without urgency, without a monitor beeping in the background?

Well, that turns out to be its own kind of work.

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“I can tell your future

Look what’s in your hand.”

-Robert Hunter, Bob Weir (Grateful Dead)

Smokers have their cigarettes. Musicians have their instruments. And children who were left to fend for themselves hold their independence like a shield.

Just as a dowsing rod moves in response to where the dowser already believes to be the location of the water, what we hold onto does not point the way to what is next, it shows us that tomorrow will likely be the same as today. The person who is “trying to quit smoking” is still a smoker until the cigarettes are let go.

Life isn’t that simple. We hold on to some intangible things for so long that we forget they are nothing but habits, adaptations, or coping skills we developed in response to the hurts and fears of our youth.

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For me, I’ve been holding onto an absurd idea: that I’m still the same as I ever was just because my medical outcome was so positive with no physical restrictions.

Or better yet, that for all the physical and mental work, I am not only healthier and happier today, but that I can continue to live in the way that brought me to the operating table for emergency quintuple bypass surgery.

Something to Prove

I have been trying to prove it all out in this first year of recovery.

That I actively exercise.

That I have achieved a new, healthier state of mind.

That I can lead my business to new growth.

That I can disconnect from work and be fully present with loved ones.

That this massive disruption has only changed me for the better.

While at the same time,

Prove that I can handle the same amount of stress.

Prove that I can drink like I used to.

Prove that I can still burn the candle at both ends.

Prove that the Lone Wolf inside me deserves to still live there.

It’s exhausting. And heavy.

For all of that effort, I proved only that I am not strong enough to hold on to both the life I was living and the healthier happier version of myself growing inside me. No one is either that strong or that big; our bodies are only big enough to contain one person.

And still, I’m holding on

To the worry that I am broken.

To fear of rejection.

To the walls I built around my vulnerability

To seeking validation from others more than intrinsic satisfaction.

And then this line found me:

Learning to Let Go

Recovery, I’m learning, isn’t about returning to who I was.

It begins with forgiving myself for the ways I’ve kept hurting myself along the way. For clinging on to damaging habits. For the grudges I’ve carried long past their usefulness. For the moments I let my fears make me act sharp, distant, or unkind to myself and others.

And for all the energy I spent maintaining a curated identity that changed with what I thought people wanted to see, and never felt fully honest on the inside.

That kind of forgiveness isn’t soft or weak. It is hard, strong, and necessary.

Forgiveness is freeing.

Because it’s the end of punishment.

And everywhere I have stopped punishing myself, my grip loosens and I feel the calloused hurts, the paralyzing anxiety, the simmering anger, the lingering doubts, slipping from my hands.

That’s where permission has made its beautiful entrance in my life.

Permission to let go of behaviors, patterns, and emotions disguised as personality traits.

Permission to open my now empty hands to replace resistance with willingness. Permission to feel the fear of change while embracing what is to come.

We are not Ebenezer Scrooge and we do not live in A Christmas Carol. For me, however, in many ways this year, the ghosts of my past, present and future showed up for a difficult self-reckoning that led me to this:

Positive change—growth—is freely available when we set down the hard loads (forgiveness) and give ourselves permission (acceptance) to pick up the perspectives, attitudes, and behaviors that lead us to greater health and happiness.

If you’re thinking about making a change in 2026, before you begin, look at your hands. Forgive yourself for what you’re holding, give yourself permission to let it go, and make space for growth.

Boxing Day in an Incomplete Nutshell

The term “Boxing Day” may come from medieval Britain, where churchgoers would fill alms boxes in the month leading up to Christmas, and churches would distribute that money to people in need on December 26, the Christian Feast of St. Stephen, a figure remembered for service to the poor. The term may also come from servants and tradespeople who collected “Christmas Boxes” of money and gifts from their employers on December 26 and were given the day off to spend with their families.

The point of this day is simple and far deeper than it looks at first glance:
There is more to this day than executing a social good and the moral imperative for those who have more to give to those who have less.

Boxing Day can and should teach us about recognition of service, respect for all people, and dignifying those who do the jobs most would never do and then suffer for it at the end of society’s cold hand. Boxing Day is also a day to give ourselves the same gifts. Because who among us does not know the feeling of being ignored, disrespected, or degraded?

That matters to me this year, because I feel unrecognized and disrespected by some people that are important to me. I feel like my service is undervalued, and this long scar running down my chest feels like a scarlet letter. I feel a constant rumbling fear that something could still go wrong with my heart.

I question whether I still have what it takes to succeed in business; whether I deserve to have career ambition is an active internal debate.

And I feel an aching sadness in the deepest part of my stitched-up heart that my family and my life look nothing like what I once imagined they would.

Happy Boxing Day? No, not for me right now.

Why should I feel this way when 2025 has been a year of survival, resurgence, and gratitude? I’m here. My heart is strong. I have new mental and emotional clarity. There are solid people in my life who offer me unconditional love, and I have opportunity. I didn’t know if I’d ever make it out of the hospital, let alone experience a full life once again. And still—this Boxing Day—I feel sick with all this.

I guess that’s the part we don’t talk about enough: how gratitude and fear, relief and grief, confidence and doubt can all occupy the same body at the same time. My cup this year isn’t as empty as it feels. The fact is that my cup is probably hovering somewhere around 40% full. And that feels terrible. It is coldly sorrowful in places, scorchingly angry in other, and swirling with worry.

And yet, Boxing Day reminds me that generosity does not require overflowing fullness.

We all carry different cups, filled to different levels. Our cups are both leaky and patched. Someone may feel financially secure and deeply lonely. Another may enjoy love and connection together with fear of future instability. The point is that others can be strong where I feel weak or they may feel empty where I am full.

Despite my personal and professional fears, my self-doubt, the longing for deeper connections, I still have something to give.

So do you.

It might be money, food, or clothing for the less fortunate. Perhaps it is your time or talent promoting social good.

It could also be giving your full attention, patience, and presence to your children.
Maybe a call to a long-lost friend, just to say hi.
Or drop a little surprise at your neighbor’s door, even if you don’t like that person.
A small act may just fill that person’s cup just enough to help them keep going.

Consider what else you have to give and whether it might be more valuable than your time, talent, or treasure.

Today, I’m trying to remember that these acts of generosity put another patch in my leaky cup. I do not need abundance—only awareness enough to notice where I have enough to give.

This Boxing Day, before we begin again, I hope you’ll notice where you have enough to give. And I ask you to share some of it. Fill someone else’s cup.

I believe—deeply—that those of us who choose that path will set ourselves up better for a happier 2026 than any New Year’s resolution.

Sometimes the most lasting gift isn’t what we receive. It’s what we offer even when our own hands are still shaky.

I’m trying to practice this today. If you are doing a similar practice, drop me a note. I know I’m not alone.

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When my heart attack moved me to the sidelines, I was forced into a duel with my fear, and only one of us was going to win.

Fortunately, fear has two weaknesses: exposure and witness. When I began naming my fears out loud, they shrank. When I shared them, they dissolved even faster.

Fear’s Origin Story

By the time I was nine, my family had already splintered — my father had left with another woman, my older brothers slipping into addiction, my mother rebuilding her life while trying to hold our family together. I adapted by becoming the easy one: competent, charming, agreeable, the kid who wouldn’t add to the chaos. That strategy worked so well that I rode it into adulthood, long enough that I didn’t even come out publicly until I was 51— not out of shame, but out of decades of practicing the safest version of myself.

Is it any wonder then that I am a fiercely independent adult who measures himself by an impossibly high standard and tends to gauge my self-worth through external approval? Our inner child curates our sense of self, adulthood teaches us to protect the image.

Fear, Courage, and Returning to Work

I chose to stay on the sidelines and dive deeper into recovery, even when my core fear of rejection and inadequacy beckoned me to return to work sooner. Had I relented, I could have returned three or even four months earlier. To what end? I would have come back weaker, less effective, and more beholden to the very insecurities I was learning to overcome.

Before the heart attack, I encouraged my team to take bold risks. I told them that it was better to try and fail than not to try at all. And even though I encouraged them to run, I never fully dropped the leash. I was too scared that the organization might go off the rails if I let them have too much independence. That contradiction stifled our individual and organizational growth. Today, I understand my role differently: My job is to create conditions where people can rise to the level of their ambition and their potential.

Connection and Unity

While my near-death experience crystalized this learning, I had the privilege of working for someone who embodied the sort of humble, fearless leadership that delighted in the success of others: Connecticut’s former Lieutenant Governor Nancy Wyman, for whom I served as General Counsel.

Nancy connected without calculation. With an easy smile and a quick wit, she built trust by giving hers away first. As a boss, she created opportunity and the space to seize it. Not surprisingly, Nancy Wyman was loved in the statehouse. Her bipartisan reputation for fairness and civility was well-earned over decades of public service— even in this contentious and divisive era. In short, Lieutenant Governor Wyman understood instinctively that the best leaders don’t grip control with a fist. They lift others up with open hands.

Her legacy is proof that generosity strengthens your impact and solidifies your leadership.

Connection Compounds in Ways Control Cannot

When we invest in people this way, the impact benefits everyone: everyone’s influence broadens, our networks expand, and opportunities multiply. The best part is that the people we lift will be the first to lift us back. The road to our own success runs through the successes we help others realize.

That means:

• Provide education; share your own wisdom

• Build internal unity within your all your groups

• Broker external connections; share your contacts

• Be a champion (Manager<Mentor<Champion)

• Open the door to the room where it happens

And one more thing:
Prioritize advancement over retention.
It may feel counterintuitive, but if my recovery has taught me anything, this is exactly right.

Fear is Greedy. Connection is Generous.

I learned that truth in the ICU.

Lying in that bed I was terrified of dying, or that I would have to live on a ventilator forever. I was scared of losing my familiar body and mind. Doctors moved around me, speaking about me, not to me. As much as I was locked in that bed, I was locked in the fear of being forever altered and losing the power and control I once had.

The spark of human connection had dimmed. Once the ventilator came out, everything changed. I talked to anyone I could about anything and everything. Rebuilding connection smoothed the way forward in my recovery.

The nurses talked to me.
The staff listened.
The world opened back up.

What began as teary confessions and a thousand questions, turned into sharing stories about our personal lives outside the hospital. A member of the housekeeping team told me of her passion for hiking and all the national parks she had visited. She confessed that almost no one at the hospital knew this about her. Then she thanked me for taking an interest.

She thanked me.

I cried. And I thanked her. For one precious moment, she lifted me out of the fluorescent drone of the ICU and showed me the beautiful world that was still out there, waiting for me to return to it.

Connection healed me in ways control never could have.

Here’s something I learned embarrassingly late: every day is “Bring Your Inner Child to Work Day.”

That kid always shows up, overflowing with adolescent certainty and gripping our decisions with adult strength.

But we are the parents of our inner child, and that gives us the right and an obligation to teach that scared kid how to navigate discomfort and regulate fear. We can, and should, take their hand off our decisions and hold it with love by teaching them a few things:

• Discomfort is not danger; it’s healthy and beneficial.

• Fear is a greedy idiot who will happily run your life into the ground if you let it.

• Safe harbors have their place, but ships are built to sail, and the purpose of life is to live.

• There is only one key to both happiness and success: the more we share, the more we have.

At its core, leadership is so much more than a professional concept that applies to groups. Leadership begins within ourselves and we can use it to gain the benefits of living a life in alignment. Personal leadership helps us to put fear in its place and unlock the key to happiness and success. We can lead ourselves to a place where our outsides match our insides. A place where we feel full enough to be able to give more of ourselves. Nancy Wyman is one of those people. The ICU set me on the fast track to get there. And I’ve taken another step forward with everything I’ve lived since then.

Fear wants us to tighten our grip. Connection asks us to open our hands. The more I loosened mine, the easier it was to let others in closer. The more I shared, the more I received back. Abundance doesn’t come from holding on. It comes from letting go and leaning in the right direction.

If there is one foundational practice in my life it is this: open your hands and live with a generous spirit. Extend the helping hand. Connect people. Share what you know. Trust others enough to let them grow to their full potential. That is how influence compounds. That is how unity begins.

And to do any of that well, we must stop letting fear choose our path. We have to have some words with the younger part of ourselves that clings to the hurts and scares. Teach them that they are safe with you.

That’s the work in front of me now, and maybe yours too.

Make friends with your inner child.

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Please let me know if my writing is speaking to you. It gets lonely out here!

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Stepdown — that’s the hospital unit you are transferred to after “graduating” from ICU. My final exam involved proving 1) that I had overcome respiratory failure, and 2) that I could stand up and walk on my own. This is a piece about how learning to study for and pass those physical exams provided the inspiration for the title of my Substack by opening my mind to a healthier way of approaching life.

Understanding Breath
The ICU pulmonologist told me that I would pass their part of the final exam when I was consistently able to use a device called an Incentive Spirometer to keep a little ball in the air at just the right height.

There was a procedure. After putting a small hose in my mouth, I was to push out all my air, and breathe in as slowly and deeply as possible while trying to keep the ball at the right height for as long as I could. As if that wasn’t hard enough, I was instructed to hold my breath for at least 5 seconds when the procedure was complete. Not only is actively thinking about what it takes to breathe exhausting, but using the Incentive Spirometer made everything hurt.

It is designed to make you cough, a task not so lightly undertaken with a freshly cracked sternum and the two tubes poked into your belly that rub against your diaphragm. At least they give you a heart-shaped pillow to cry into hold against your chest and keep your ribs together. I failed that painful exam so many times that I developed a habit of throwing the spirometer across the room. No incentive anywhere to be found — I cursed its stupid name!

Everything changed with that first successful breath. Both the pillow and the extra suction tube were in place, ready to help control the spasm and receive the resulting phlegm. I reluctantly emptied my lungs, resigned to the fact that the instinctive urge to inhale would once again overcome my best efforts to control the pace of the intake. My chest expanded painlessly. No rattles. No spasm. Only fresh, cold, clean air hitting my bloodstream, jolting me into clarity.

All the time I thought I was taking the test, I was only “studying” for it.

With the new confidence that I would pass the test came fresh determination to embrace the struggle and recognize that the “stupid” device was rather smart. It had surreptitiously exercised my chest muscles, opened my airways, and cleared the fluid from my lungs.

Each strengthening breath expanded my understanding along with my lungs. I had been throwing the spirometer across the room because I judged myself for failing a test I had not even taken yet. There is no failure in preparation, and there is no weakness in doing pre-work. The short painful breaths, the spasms, the spitting up – and even the sobbing – were the unseen work that had to happen before I could begin again. My body had been learning, slowly and stubbornly, how to breathe long before I ever passed the exam.

It took breaking down something as fundamentally instinctive as breathing for me to learn the first lesson of my second life:

The pre-work, what we do before we begin, often hides in plain sight. Focusing on the work of choosing, preparing, and allowing ourselves to begin makes:

· the beginning steadier,

· the work more efficient,

· and the completion more meaningful.

Regaining my breath revealed the usually unseen work of choosing and preparing to begin. Part two of my final exam—learning to stand—taught me how to approach each beginning with intention, and to let my actions follow that intention.

Standing Up

Passing the breath exam led me closer to ICU graduation and the transfer to the Stepdown Unit, which I found quite odd since I had taken only one timid walk with significant hands-on assistance from the occupational therapy staff and a rolling IV pole. I was not at all sure how I would even stand up, let alone put one foot in front of the other and walk unassisted.

In the hospital context, Stepdown describes a place that provides an incremental decrease in the level of care for patients who have recovered enough to move from critical to stable condition. I would soon learn that Stepdown was also the name of the instruction manual for getting discharged from the hospital: I would have to prove that I could stand, walk, and climb stairs. On the morning of my discharge, the occupational therapist stood in front of me and said, “OK Bruce, let’s get you standing up on your own so you can walk out of here.”

And she said something that ended up becoming the second lesson of my second life:

“Nose over toes.”

· Lean forward.

· Balance your weight.

· Trust your legs.

It sounded simple enough. After all, standing feels as instinctive as breathing—even though it isn’t. Standing is learned behavior. There is nothing automatic about standing.

I did what she said.

I put my hands on the arms of the chair,

And she put her hands on my shoulders.

“You don’t use a hammer to turn a screw; it’s the wrong tool for the job,” she warned. “Not only does it waste your precious energy, you could hurt yourself.” The strain of pushing yourself up with your arms spread to the arms of the chair could tear apart the bones that were newly knitting themselves back together.

That made immediate sense to me. After all, I made a wish with each cough that my heart would not fall out of my body after blowing apart my surgeons’ work. Once your ribs have been split open and wired shut, your chest feels like an old screen door that could fly open in a light breeze. In those early days, standing was never a thoughtless movement. Each attempt required a small moment of preparation, a big leap of faith, and the intentional commitment to see it through to completion.

And there I was: an adult toddler learning how to stand and wobble tentatively into someone else’s arms. But I did it with intention, preparation, and practice. And the parts of me that were only just starting to heal stayed intact.

Before beginning, I chose to stand, placed my feet flat on the floor, balanced nose over toes, dropped my hands to my sides and leaned into it. Standing wasn’t the start of a process, it was the conclusion.

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Before We Begin

We don’t see it, but so much happens before we begin. We tend to skip over the parts that feel hardwired or preprogrammed. We assume the things we’ve done a hundred thousand times—breathing, standing, speaking, choosing—feel like they require no preparation. We often treat our beginnings as well-defined moments rather than the jagged and fragile onramps they actually are.

Regaining my breath taught me how much unseen work precedes even the most hardwired beginnings. Learning to stand again taught me that beginnings require an intentional choice. Breath revealed the preparation; standing revealed the commitment to put all the steps together.

What surprised me most was the similarity of these two lessons:
I was ignoring the fact that my body needed time, awareness, and a chance to learn what strength felt like again before I could inhale without pain, and before I could rise without fear. The best beginnings aren’t built on effort; they are grounded on orientation.

Standing up made this undeniable. My legs shook, I held my breath, my heart beat sideways, and my mind went straight into fight-or-flight. Nothing about that moment resembled instinct. No part of me was on autopilot. I had to pause, feel the floor with my feet, make eye contact with the wall, lean forward, and trust my legs. And I stood. On my own.

That’s when it hit me:
You don’t begin by moving.
You begin with mindfulness, by locating yourself in the moment.

• ground yourself

• identify your limits

• trust your strengths

• name your fear

• set your goals

“Nose over toes” may sound like a physical instruction, but it is really a way of examining what needs to happen before you begin. It teaches that good beginnings are not heroic leaps; they are careful orientations. They are wise choices made with full awareness of what we bring into the moment—our history, our pain, our strength, our capacity, and our fear. And that is the stuff that transforms a wish into hope.

Most of us rush into beginnings. We brace. We push. We muscle through. But pushing with your arms is what you do when you don’t trust your legs. How many of us fall back into the emotional equivalent every day? I know I do.

Beginnings are defined not by the movement, but by the moment we choose to move.

That is why I named this Substack Before We Begin.
Because almost everything meaningful in life—loving, healing, returning, learning, and leading—starts not with action, but with orientation.
With breath.
With balance.
With nose over toes.

Before we begin, we find our ground.
And then, when we’re ready, we lean forward.

— Bruce

“Fear has no brains; it is an idiot.”

- Ambrose Bierce

Fear is a primal emotion that all animals experience—because it is an instinctive survival mechanism. It guides our response to threats, from encountering predators to assessing the safety of old milk. Fear also responds to more abstract or remote threats: financial insecurity, climate change, rejection, failure. Our nervous system is notoriously bad at determining whether danger is present or projected. It is all heart and no head.

To be human is to know fear.

Its desire to protect us is so strong that fear will create threats out of our experiences and observations. This is where fear can start taking too much control. These conjured threats do not just distort our thinking; they quietly damage our relationships, stifle our ambition, and cloud our decision making.

We know fear when it kicks down the front door, pounding our hearts, shaking our voices and trembling our hands. It is harder to recognize fear when it sneaks in like a cat burglar. We easily explain away hesitation, unease, or avoidance. No matter how it shows up, fear has one universal truth:

fear makes us hoard.

The power to make us hoard is superhuman. When our trust was broken, we start hoarding security by keeping others at arm’s length. When resources were scarce, we hold on to what we have and grab what we can. When we were passed over we start ducking under while we hoard our vulnerability. And when someone broke our young heart, fear teaches us to hoard validation while fortifying our most tender parts.

By adulthood, our fears have taken control without our consent. We say, “this is just who I am,” but fear began shaping our sense of self long before we had the words to name it. The truth is closer to: “this is what I have learned.”

One way to identify our fears is to figure out what we hoard:

• Reputation

• Praise

• Food or money

• Power

• Vulnerability

• Confidence or trust

What threat are you protecting against?

And if this rings true in your personal life, consider how your hoarding shows up at work. Because it does.

I’ve seen leaders — even good ones — hold back from developing people because they’re afraid of being outperformed.

Afraid the investment won’t “pay off.”
Afraid the investment will walk out the door.
Afraid of being seen as a bad leader.

“I can tell your future, just look what’s in your hand.”

- Grateful Dead

If fear teaches us to hoard, then the work of letting go begins by noticing what we’re gripping too tightly — our reputation, our certainty, our approval, our resources. We can’t let anything go until we know what we’re holding.

Sometimes our eyes play tricks on us, and sometimes it hides in plain view. It’s OK if you can’t quite see it yet, just close your eyes and listen. Fear doesn’t always send up a flare; it often it whispers to us in the quiet moments — in the drift between thoughts, in the stillness before sleep. If we listen to those whispers, fear will tell us about our blind spots.

When we finally loosen that grip, everything fear told us would keep us safe falls away.

We become free, once again, to do the work we were born to do — to put our hands to the useful work of planting seeds, working the soil, and creating abundance. You can’t hoard with open hands.

I know how to walk the lonely road — I’ve been doing it for years. But I won’t pretend that I don’t miss good company.

As Always…

If you had asked me in the summer of 2024 to start speaking out, I would have said that the internet highway is too littered with armchair psychologists and itinerant philosophers for reasonable people to find a healthy and safe community to share our experiences and explore them together. I do not have a psychology degree. I am not a social worker. Maybe I’m too private for this, idk. But life has a way of rearranging your mental furniture and making you stub your emotional toe. So here I am.

In October 2024, I had a heart attack — a really bad one. They call it a “widowmaker.” I was 51 years old. Emergency quintuple (5) bypass surgery. I should have died.

But I lived.

And I worked. Hard.

I recovered in body, mind, and spirit.

I was not left here on this earth to keep my mouth shut. So I started talking about it.

In the weeks that followed, I heard from people all over the country — colleagues, friends, strangers — responding to a Business Insider article, to a LinkedIn post, to a few things I’d written in moments of clarity during recovery. I heard messages of thanks, gratitude for authenticity, vulnerability, for making a safe place to explore the parts we usually keep out of sight.

I don’t know how or why but my early writings went from my little state in the Northeast USA to England, Australia, and all around the world. The response was aligned:

“Don’t stop. Keep talking. This matters.”

And I think that’s what finally brought me here.

I don’t want to perform or proclaim any wisdom from on high. I don’t have any. But I do have a desire to tell the truth and share my perspective— about fear, recovery, leadership, identity, and the places where all of those collide. Those are the places where most of us stop talking. And that kind of silence almost killed me.

Darrell Scott has a line in “The Day Before Thanksgiving” that says:

“It’s the day before Thanksgiving, and I’m not feeling much of thanks. Just a low grade desperation leaves me reeling in the ranks. Just when I think I’m getting somewhere, it’s somewhere further to fall. It’s the day before Thanksgiving. That is all.”

That is what honesty looks like — Pure and Raw.

There’s no performance in it. No forced optimism.

I’ve spent most of my life keeping my inner world inside.

I learned to believe that tucking the tender parts out of sight was the only way to stay safe. To succeed. Writing publicly helps me pull those parts out and show them some sunlight. It feels a little awkward — like stepping out from behind the curtain I’d been holding for decades.

But after living through the emergency, the devastating news, the surgery, the respiratory failure, the delirium, and the helplessness everything changed.

Staying quiet started to feel like a recipe for cooking up the heart attack that would finally complete the job.

This Substack is my attempt at charting a course to a new understanding of health and happiness.

I’ll write about fear — not in the abstract, but in the everyday ways it shapes us, hides from us, and drives us to hoard things that were never meant to be clutched so tightly.

I’ll write about leadership, not as a posture, but as a relationship with the world around us.

About generosity.

About the cost of control.

About the paradoxical grace of the immeasurable gifts we are given when we unite
and connect the people around us.

And I’ll write about recovery — not just the medical kind, but the recovery of self.

The recovery that comes from radical acceptance of the truth.

I don’t know exactly where this will go.

That’s part of the point.

After walking all these miles and crisscrossing the country more times than I can count, I have learned that our world is kinder, softer, and more navigable when we do not walk alone.

I’ve walked the lonely road for years.

But I will no longer pretend that I don’t appreciate good company when it shows up.

— Bruce