Perspective at 2:15 A.M.: Grateful for Modern Medicine
It's 2:15 a.m. EDT, and apparently I'm still not tired.
After writing about Nextdoor, I found myself doing what many of us do far too late at night—doom scrolling. A Facebook Reel stopped me in my tracks. It was about anesthesia, and it gave me a whole new perspective.
If you'd like to watch it, here's the Reel that inspired this post:
https://www.facebook.com/share/v/1TT4xxcoQT/
Before I get to that, I want to say something that I don't think I say often enough.
I'm incredibly grateful for where science and medicine are today.
Because of medical advancements, I have a prosthetic leg that allows me to walk and continues to improve with every generation. Because of dialysis, I'm not days away from dying from the toxins that my kidneys can no longer remove. Because of modern eye surgery, I can once again see clearly after having my cataracts removed.
Then I watched the video.
It explained what surgery was like before anesthesia became common. Imagine undergoing an amputation while fully awake. Patients would bite down on a piece of wood or leather, assistants would hold down each limb, and the surgeon would work as quickly as possible. People would feel the pain, pass out from it, wake back up, and endure it again until the operation was finished.
I can't imagine it.
One thing we often overlook is that anesthesia doesn't just put us to sleep. It also helps prevent us from remembering the experience. That's an incredible gift.
As I thought about it, I realized how many surgeries I've had over my lifetime. It started with an appendectomy at Mount Sinai Hospital on the Upper East Side of New York City, when I was 19 or 20 years old. Since then, there have been many more procedures.
I'm thankful that I don't remember them.
It's easy to focus on what medicine can't do yet. But now and then it's worth stopping to appreciate what it already has done. Millions of people—including me—are living longer, healthier, and more fulfilling lives because of generations of scientists, physicians, nurses, engineers, researchers, and innovators who kept pushing forward.
Sometimes all it takes is a late-night video to remind us just how fortunate we are.
Why the Silence? Reflections on Day 36
It's very late at night...or very early in the morning, depending on your perspective.
A thought crossed my mind as I reflected on the past 36 days of waiting for a response to a simple request.
Why the silence?
To be transparent, there have been a few responses along the way. Nextdoor Support initially communicated with me until I asked follow-up questions. @John T. Williams from Investor Relations responded after I mentioned filing complaints with the Federal Trade Commission and U.S. Securities and Exchange Commission, although I believe he is no longer with the company following an unrelated email mistake. NextDoor Service has also interacted through comments on LinkedIn.
But from others, including Jacob Chavis, the press team, and CEO Nirav Tolia, there has been no direct response.
That led me to ask myself a question—not because I know the answer, but because it's one possible explanation among many.
Do they see someone like me as simply not worth responding to?
Or is it something else?
Perhaps they're following company policy.
Perhaps they've been advised not to engage.
Perhaps they're overwhelmed with other priorities.
Perhaps they don't believe a response would change anything.
Perhaps they view me as a disruptor.
Or perhaps they simply don't know how to respond.
I don't know.
What I do know is the lesson I learned early in my career:
Treat the environmental engineer with the same respect you would give the Chief Executive Officer.
Titles change. Job descriptions change. Companies come and go. Respect shouldn't.
One of the best leaders I ever worked with told me that every interaction is an opportunity to reinforce a culture—or weaken it. Sometimes, a simple acknowledgment is all someone is looking for.
This post isn't about assuming motives. It's about asking whether responsiveness and respect should be part of a company's culture, regardless of who asks.
What do you think? When someone reaches out professionally, does every inquiry deserve at least an acknowledgment?
Join the discussion on NielFlamm.com.
Proof It Was Time for a New Dialysis Backpack 🎒
Yesterday I purchased a new backpack for dialysis, and today was its first trip to the clinic.
Could I have used my old backpack a little longer? Maybe. But after looking at it, the answer became pretty clear. The seams were ripping, and it was only a matter of time before it failed. It wasn't a case of wanting a new backpack—it was a case of needing one.
My dialysis backpack carries my blanket, pillow, and other essentials three mornings a week. The last thing I want is for the seams to split while I'm walking into or out of the clinic, leaving everything on the ground in the middle of the swampy Lowcountry heat and humidity.
The old backpack served me well, but this is proof that replacing it wasn't an impulse purchase. Sometimes the smartest time to replace something is before it completely falls apart.
Recovery, Flow State, and the Present
One of the blogs on A Godd3ss3s Cr3ation really resonated with me.
The idea of living in a Flow State reminds me of recovery. Early on, I spent too much time replaying yesterday or worrying about tomorrow. Recovery taught me to focus on today.
It also reminds me of one of my favorite quotes from Kung Fu Panda:
"Yesterday is history, tomorrow is a mystery, but today is a gift. That is why it's called the present."
Whether it's recovery, dialysis, or everyday life, I can't change yesterday or control tomorrow. All I can do is make the best of today.
Read the original Flow State blog at https://agodd3ss3scr3ation.com/blog.
Remember This Infographic About My Last Labs?
Remember the infographic I shared about my latest dialysis lab results? I was excited because my pre-dialysis BUN had fallen into the normal range for the first time since I started tracking it in October 2025.
On Mondays, either my nephrologist or a Physician Assistant from the nephrology practice stops by the dialysis clinic to check in on patients. I had a feeling the conversation I had with Clark was coming.
He reviewed my labs—not just the BUN, but the entire panel—and simply said:
"We're going to run them again."
As encouraging as the BUN result was, a few other values were out of whack. My phosphorus was very, very low, along with a couple of other numbers that deserved another look.
By the time Clark reviewed everything, I was already well into my dialysis treatment. That meant it was too late to draw a true pre-dialysis sample and then compare it with a post-dialysis sample.
So, we may repeat the labs on Wednesday to see whether last week's results were an anomaly or the beginning of a new trend.
I'm as curious as you are.
Stay tuned!
Join the discussion on NielFlamm.com.