The short version Most communication problems between partners are a mismatch, not a deficit. One person wants to be heard and the other shows up with a solution. The research on support says the unrequested solution often makes things worse, even when it's correct. Your partner is the one person who gets no benefit of the doubt. We over-trust experts and under-trust the person across the kitchen table, because we know every one of their flaws. Being right is not enough to be

Part II of the Risks series. Part I covered cardiovascular disease. Cancer is the second leading cause of death in this country, behind heart disease. For the age group I take care of — call it 38 to 58 — it is the one people are actually afraid of. Nobody lies awake worried about their LDL. Plenty of people lie awake after a friend their age gets a diagnosis. That fear is not irrational. Roughly one in two men and one in three women will get a cancer diagnosis at some point.

The 5/2 Matrix: What Do I Want, and What Do I Do? Goal setting and health go well together. The whole practice of medicine is more or less goal setting: we see something we're trying to accomplish or change, and we run an experiment. Humans are complex and things come up, so we're never running a clean experiment where only one variable changes. That's why medicine is a practice and not a classically controlled experiment. Goal setting is a lot like coaching in that both star

There's a concept in personal finance called paying yourself first. Retirement contributions and tithing come out before the money ever lands in your checking account. The reason is simple and a little unflattering: money in the checking account gets spent. Not maliciously, not stupidly — it just evaporates against a hundred small, reasonable demands. So you take it off the top, before the demands get a vote. Your days work exactly the same way. The moment you interact with a

When I ask people what they want their life to look like five years from now, the most common answer is some version of "I want to be healthy and happy." It's usually said without much thought. But I'd push back on the phrasing, not the sentiment: I'm not sure how someone could be truly healthy and completely discontent at the same time. If health is understood correctly, "healthy" is a good enough answer on its own. This idea isn't new. Aristotle called it eudaimonia — liter

Automate Your Health the Way You'd Automate Your Money Health and wealth are highly correlated, and I'm a fan of automating both. The people who build real wealth aren't the ones making heroic financial decisions every morning. They set up the system once and let it run. Health works the same way. At some point you want a set-it-and-forget-it posture toward the major decisions. You work out because it's on the schedule, not because you negotiated with yourself about it. You e

Health Is a Set of Ratios — Not a Series of Extremes A long time ago Martin Rooney wrote something I copied onto my medical school desktop and kept as a note. The advice was simple. Read twenty-five pages a day. Go to two conferences a year. Talk to an expert in your field once a month. Do that for seven years and you'll be an expert in almost anything. But the line that actually stuck wasn't about expertise. It was about your entertainment-to-education ratio — how much of yo

Right now everyone wants to know their biological age. The wearables sell it, the clinics sell it, the supplement companies sell it. People walk in genuinely rattled that an app told them their "true age" is seven years north of their driver's license. I understand the appeal. It's a more interesting question than how many times you've circled the sun. But you don't have one age. You have at least four — chronological, biological, functional, and emotional — and the inconveni

I love birthdays. For the past decade I've done a review twice a year and set goals for the year ahead. One lands in December. The other lands around my birthday, July 18, and I start it about two weeks out. Last December the reflection stretched across the whole month, which tells you something about the year I was having. Most of life is swimming. Head down, arms turning over, working hard just to stay afloat. That's not a complaint — it's the job. But you can swim for year

The People in Your Life Are Keeping You Alive Human beings are wired for connection. Underneath most of our frustrations, our political tribalism, our late-night arguments with people we barely know on the internet — there's a more basic craving. We want to feel heard. We want someone to understand our perspective. The trouble is that's an unreasonable expectation. No one will ever fully understand your personal narrative because they haven't lived it. I write more than most

The Solution to Complexity Is Simplicity — Decide What You Want Life is complexity. Science likes to pretend it can isolate one variable, but I've never seen a single-variable experiment in real life. People are different — genetically, phenotypically, contextually — and yet most of us still want the lazy answer: what's going to work for me? Modern evidence-based medicine responds by comparing you to the average. The problem is the average doesn't exist. One of the biggest di

Everything Is a Tool — The Question Is Whether It's Worth Using Almost everything in life traces back to health. Your career, your relationships, your ability to show up for the people you love — none of it works if you're not functional. So when I think about health interventions, I think about them the way you'd think about a toolbox. The more tools you have, and the better you know how to use them, the more efficiently you can get through this project called life. That rai

Medicine Is a Best Guess. Act Accordingly. The honest answer to most clinical questions is: it depends. That's not a cop-out. That's medicine. "Evidence-based medicine" sounds reassuring until you realize what it actually means — it's the intersection of available data, a provider's clinical experience, and the patient's own preferences. The consensus answer might be correct on average and still be wrong for you specifically. The Evidence Problem Nobody Talks About Only about

Incentives Drive Outcomes — In Health Too Charlie Munger famously said: "Show me the incentive and I'll show you the outcome." That principle applies just as much to your health as it does to business or investing. Most people don't struggle with knowledge. They struggle with alignment. Their daily incentives aren't structured to support the behaviors they claim to value. If you want better health, you don't need more information — you need a better incentive system. The Pro

Risk Tolerance vs. Reality in Health A financial advisor told me something recently that stuck with me: "Everyone says they have a moderate risk profile. Their behavior says otherwise." The same thing is true in healthcare. Most people say they want to be healthy, functional, and independent as they age. They say they want low-risk, sustainable solutions. But their daily behavior doesn't match that goal — and that gap is where most health problems are born. The Gap Between Wh

Just Try to Be Less Stupid Warren Buffett and Charlie Munger are two of the most celebrated figures in American business — not because they were born brilliant, but because they spent a lifetime trying to do things the right way. As the architects of Berkshire Hathaway, their advice was refreshingly simple: Don't be stupid. You only need to make a few good decisions per year. It turns out this is equally wise counsel for your health. Stupid Health Behaviors Are Everywhere We

In the first article in this series we discussed a simple framework borrowed from Morgan Housel’s work in The Psychology of Money : Happiness = Expectations – Reality This equation applies to almost every area of life, including health. When expectations are reasonable, people tend to feel satisfied with progress. When expectations are unrealistic, even objectively good outcomes feel like failure. One of the biggest drivers of unrealistic expectations in modern health culture

In The Psychology of Money , Morgan Housel does an excellent job articulating a simple idea: Happiness ≈ Expectations – Reality The gap between what we expect and what actually happens determines a large portion of how satisfied we feel with our lives. The same concept applies to health and the healthcare system. Over the next few articles, I want to explore how expectations vs reality shapes how people perceive their health, their fitness, and ultimately their well-being. T

Walking With People Through Loss There are very few constants in our existence: birth, change, taxes, and death. Everything else is variable. Death is the one appointment none of us can cancel. The finish line looks different for each person, but it is certain for all of us. In that way, death may be the most honest teacher we have. It reminds us that our time is limited. And because it is limited, it matters. Yet in modern society, death is largely removed from daily life or

Parenting is one of the strangest callings in life. It is exhausting, frustrating, ego-crushing…and at the same time, it is one of the greatest privileges you will ever experience. Both things are true. People are a lot like dogs. We are wired differently. Some kids are calm and compliant. Some are intense and explosive. Some are natural pleasers. Others are relentless negotiators. Some require very little guidance. Others require enormous energy, structure, and patience. The