“The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.” ―George Bernard Shaw

I was at a party once and I picked up a cola bottle and a cap and looked at group of people and asked, “How would you get this cap in the bottle?” The first person I looked at simply looked back at me dumbstruck. In fairness, she was an incredibly beautiful woman, but I suspect she’ll ever make any investment in herself beyond the most superficial outer level.

In my experience, ask anyone this simple question and you’re likely to witness the human version of the proverbial “deer in the headlights” look. A large segment of the population isn’t interested in taking the time to learn how to think; they live lives dictated by marketing companies. They wear what they’re told is hot at the moment, watch shows on television that are mind numbing, and buy coffee that cost $7.50 a cup.

Maybe one out of every nine or ten people I ask will say, “Bend the cap…” without skipping a beat. It’s actually a rather rudimentary response. At least these folks are able to step back a bit, use some basic logic, and come up with a reasonable solution to the problem in front of them. That’s where most people stop. Fold the cap, drop it in, and that’s you done.

But I submit to you there’s other ways of looking at this problem.

How do you get a ship in the bottle? Through the mouth of course. That’s how everyone has done it for centuries. Well, except a handful of artists who started cutting off the bottom of the bottle, shoving an already made model into the bottle, then gluing the base back on and adding some kind of decretive item like a piece of rope around the cut. And there you have it. An alternative way to look at the problem.

Is that it though?

In a previous post about a deck of cards in a bottle, the problem seems stranger. The deck, after all, is fully wrapped and sealed in its plastic wrap. It’s a head scratcher to be sure. The idea here is to look around you and expand your way of thinking. Don’t go into auto-pilot. Don’t zone out. Don’t let others dictate to you the solution to the problem. Thomas Edison held thousands of patents. He invented things that changed the world. Consider just the light bulb. As he put it, he learned thousands of ways how not to make the lightbulb before he got it right.

Watch the video again. Notice the cap goes through the top of the bottle. Notice the cap comes out into my hand. Notice it then penetrates the bottle from the bottom right in front of your eyes. Learn to think outside the box, or, in this case—the bottle. Life is just like this.

There’s always a different way. There’s always something ready to be invented, discovered, or changed for the better.

The key to being someone that changes the world is to first realize you don’t like the current situation or think it could be improved. Once you know you want something different, you have to accept that it can be different. The rest, well, that’s trial and error. The stuff a great life is made of.

I don’t actually think success can be fully attributed to positive thinking, but I do think your thinking plays a dynamic and powerful role in your success. One of my friends created “Possible Bottles”, which contain a complete pack of cards sealed in their wrapper.

Jamie is really is one of those “get more bears with honey” kind of chaps; always positive, always nice, always Canadian. Or is it get more bees? Heck, I don’t know. At any rate, I really respect people like that. Being nice, being kind, and always trying to do what you can to keep the peace is a great way to live. Life really is too short to get all mixed up and angry over things that simply, in the scope of life, don’t matter.

And I love his bottles almost as much as I love him. His “Send Wonder” campaign was a nice mix of great marketing and genuine interest in sharing his views and his personality in the form of art with the world around him. The bottle also sends out a subtle message that if someone can get a sealed deck of playing cards into a milk bottle without altering the bottle in any way, it gives you hope that you can do things that, on the surface may seem impossible―but really aren’t.

I’ll follow up more on this in another post.

Those of us who like to style ourselves as independent and self reliant, often charge through life and forget to settle down, take a step back, and spend time with the people they love. I’m certainly guilty of that. Even as I write this, I have more projects on my plate than a good friend of mine who has a doctorate in performance psychology says I should.

I was recently reminded (and as I get older and start to contemplate my own mortality a bit more this becomes all the more important) that friends matter. More than we might often think.

Many years ago I attended university in Scotland, where I earned my MBA. It was an amazing time and one I will always think fondly of. Ever the entrepreneur, I decided to replicate the martial arts teaching model I’d developed with other students and instructors in the USA, and import it into my new environment. I sat down at the computer and put together flyers that essentially states, “Martial Arts Instructors Wanted — NO EXPERIENCE REQUIRED”, which is rather strange if you think about it. But that’s the hook; I like to recruit people who don’t already have experience, because they often come to the mat with baggage. The first guy that knocked on the door, so to speak, was Callum. Shortly thereafter came KJ and Barry. They became my students, then they earned their black belts and became instructors. The experiences we had over a three year period set in stone a friendships that I value to a degree that I can’t even properly articulate it.

Just a few short weeks ago I had the opportunity to visit Scotland again. Before hand, I reached out to all three on Facebook. That social medium really has revolutionized the way we stay in people’s lives; we get to see families grow up, careers start, flourish, and end, and enough photographs of cats to last forty lifetimes. Facebook is great, but it doesn’t beat just being in the presence of the people you love.

Callum, ever the outdoors guy, suggested we all go to a place called Go Ape in Aberfoyle, which is in the Trossachs. We all agreed, and after I landed in Aberdeen Barry picked me up. We went to KJs for a barbecue, and then drove south to meet up with Callum. From that point on, it was like “old times” for me — except we weren’t thrashing around on mats MMA style. Thank god, I’m just too old for that these days. At any rate, we spent the entire day flying down zip lines, walking between tree tops, and generally just having a blast.

I don’t know about you, but those kinds of experiences are the ones that truly bless me. Life is short. We only get one crack at it. And if you’re not having good craich (that’s Gaelic for fun), then you’re squandering the life you’ve been given. That’s a realization that I’ve started to take much more seriously. One day you blink and your kids are grown, you’re about to retire from a career that kept you working in a box for more than twenty years, and it hits you — I’m middle aged and have friends who’ve died who were born the same year I was.

The good news is, I’m finally doing something about it. It’s only too late if you’re lying in a hospital bed regretting all the things you’ve not been able to do.

Why wait?

The program is designed to provide PAs with the knowledge, skills and attitudes to enable them to practice medicine in many different clinical settings as part of multidisciplinary healthcare teams. The 24 month program, which is composed of 90 weeks of study combines the theoretical and scientific basis of medicine with clinical experience to meet the competency frameworks for Physician Associates. As the course progresses towards the end of the first year and through the second year there are a series of clinical rotations (e.g. surgery, general medicine, emergency medicine, reproductive health, and pediatrics) where students learn about common diseases, meet patients and learn from a variety of methods including bedside teaching, seminars and tutorials, and working alongside a variety of multi-disciplinary health care professionals who are also in training.

Inset photo is of the first graduating class of PAs at Duke University.

The history of PAs (Physician Assistants or Physician Associates) is pretty remarkable. Here’s a timeline I found online that illustrates the development of the concept over the years. Though, some of these dates are not directly related, one can see the progression for mid-level practitioners.

(retrieved from: http://paprogram.siu.edu/pahistory%2010-08.html)

DATES OF INTEREST 

1650: Feldshers, originally medical assistants in German Military service, are introduced into the Russian Army by Peter the Great.

1778: The US Congress provides for a number of hospital mates modeled after the “loblolly boys” of the British Royal navy, to assist physicians in providing care.

1803: Officers de sante’ are introduced in France by Fourcroy to help alleviate health personnel shortages in the military and civilian sectors.

1891: The first US Military company to train medics is established in Ft Riley, Kansas.

1892: Officers de sante’ are abolished in France.

1940: Community Health aides are introduced in Alaska to improve the health status of Native Americans in villages.

1959: The US Surgeon General identifies a shortage of medically trained personnel.

1961: Charles Hudson, in an editorial in the Journal of American Medical Association, calls for a “midlevel” provider to be formed out of the ranks of former military corpsmen. The World Health Organization introduces and promotes health care workers in developing countries ( medecin African, dresser, assistant medical officer, rural health technician, and so on).

1965: Duke University enrolls the first class of the first PA Program.

1966: Barefoot doctors emerge in China in response to Chairman Mao’s purge of the elite and intellectual, which sent many physicians into the fields to work and left peasants without medical personnel.

1967: The first class of PA’s graduate from Duke University.

1968: The PA Program at Alderson-Broaddus College enrolls its first class. The Health Manpower Act funds the training of a variety of health providers. Volume 1 No.1 of the Physician Assistant is published. The journal later ceases publication. The American Association of Physician Assistants later becomes the American Academy of Physicians Assistants (AAPA) as it is founded.

1969: The first class enters the MEDEX Program at the University of Washington. Colorado becomes the first state to enact legislation enabling child health associations to work.

1970: Kaiser Permanente becomes the first health maintenance organization (HMO) to employ a PA.

1971: The American Medical Association (AMA) recognizes the PA Profession and begins work on a means of national certification and codification of PA practice characteristics. The Comprehensive Health Manpower Training Act contracts for PA education and employment.

1972: The Physician Assistant: Today and Tomorrow by Sadler, Sadler, and Bliss, the first book about the PA profession, is published. The Association of Physician Assistant Programs (APAP) is founded. The four year PA program at Alderson-Broaddus College graduates its first class. The Essentials, accreditation standards for PA Programs are adopted by the AMA; the Joint Review Committee on Educational Programs for Physicians Assistants is formed to evaluate compliance with standards. Federal support for PA education is authorized by the Health Resource Administration.

1973: The First Annual Physician Assistant Conference is held at Sheppard Air Force Base in Texas and draws 275 attendees. The AAPA and APAP establish a national office in Washington, DC. The National Commission on Certification of Physician Assistants is established. The National Board of Medical Examiners administers the first certifying examinations for primary care PAs. The American Association of Surgeon Assistants, later known as the American Association of Surgical Physician Assistants, is founded.

1974: The AAPA becomes an official collaborating organization on the Joint Review Committee on Educational Programs for Physician Assistants. The committee reviews physician and surgeon assistant programs and makes accreditation recommendations to the Committee on Allied Health Education and Accreditation. The American College of Surgeons becomes a sponsoring organization of the Joint Review Committee.

1975: The Physician Assistant, by Ford, is published.

1976: Federal support of PA education continues under grants from the Health Professions Educational Assistance Act.

1977: The Physician’s Assistant: A Baccalaureate Curriculum, by Myers, is published. The AAPA Educational and Research Foundation (later renamed Physician Assistant Foundation) is incorporated to recruit public and private contributions for student financial assistance and to support research on the profession. The Rural Health Clinic Services Act, passed by congress, provides Medicare reimbursement of PA and nurse practitioner services in rural clinics. The journal Health Practitioner (later renamed Physician Assistant) appears. Still later, the publication is distributed as the official publication of AAPA.

1978: The Physician Assistant: Innovation in the Division of Medical Labor, by Schneller, is published. The House of Delegates becomes the policy-making legislative body of the AAPA. The US Air Force first appoints PA’s as commissioned officers.

1979: The Graduate Medical Education National Advisory Committee predicts a surplus of physicians and non-physician providers in the near future.

1980: The AAPA Political Action Committee is established to support candidates for federal office who support the PA profession.

1981: Staffing Primary Care in 1990: Physician Replacement and Cost Savings, by Record, is published, documenting that PAs in HMOs provide 79% of the care provided by a primary care physician at 50% of the cost. The Art of Teaching Primary Care, by Golden and Hagor is published.

1982: Physician Assistants: Their Contribution to Health Care, by Perry and Breitner, is published.

1984: First Annual Report on Physician Assistant Education Programs in the United States, by Oliver and APAP, is issued. The Health Care Industry Advisory Council is established. Alternatives in Health Care, by Carter and Perry is published.

1985: The AAPA’s first Burroughs Wellcome Health Policy Fellowship fellow is named. AAPA membership surpasses 10,000; categories are expanded to include physicians, affiliates, and sustaining members. The AAPA and APAP begin a joint project, PA Job Find, to provide PA graduates with a national job-bank service.

1986: The AAPA succeeds in a legislative drive for coverage of PA services under Medicare Part B in hospitals and nursing homes and when assisting in surgery (Omnibus Budget Reconciliation Act). A videotape, A Dynamic Profession: Past-Present-Future, is produced by the AAPA. Physician Assistants: New Models of Utilization, by Zarbock and Harbert, is published.

1987: The Physician Assistant in a Changing Health Care Environment, by Schafft and Cawley is published. National PA Day (October 6) is established; the date is also the anniversary of the first graduating class of PAs from the Duke University program 20 years earlier. New AAPA headquarters in Alexandria, VA, open. The AAPA contracts to publish the Journal of the American Academy of Physician Assistants (JAAPA). The new editor is the first PA hired for the AAPA professional staff. Additional Medicare coverage of PA services (in rural, underserved areas) is approved by Congress.

1988: Volume1, No. 1 of JAAPA is published. The Duke University PA Program awards the first master’s degree for PA education.

1991: The AAPA assumes the administrative responsibility for the Accreditation Review Committee on Education for Physician Assistants (formerly the Joint Review Committee). US Navy PAs are commissioned.

1992: US Army and US Coast Guard PAs are commissioned.

1993: The Roles of Physician Assistants and Nurse Practitioners in Primary Care, edited by Clawson and Osterweis, is published. 24,600 PAs are recognized for practice in all but one of the 50 states, all US territories and the District of Columbia.

1994: Physician Assistant: A Guide to Clinical Practice, edited by Ballweg, Stolberg, and Sullivan, is published.

1995: The Physician Assistant Medical Handbook, edited by Labus, is published

1996: The AAPA is granted observer status in the House of Delegates of the AMA

1997: The number of PA Programs approaches 100. Approximately 30,000 practicing PAs are in the American health workforce. Physician Assistants in American Medicine, by Hooker and Cawley, is published. JAAPA marks its 10th year of publication. SIUC admits first class.