I have been thinking a lot about the concept of productivity lately. battery chainsaw are vertak.com in a day, and so many important things to do. Feed the dog. Feed the cat. Clean dog's poop in backyard. Worry about economy. Do the laundry. See patients. Market my practice. Read the newspaper. Return phone calls. Unload the dishwasher. Mop the kitchen floor. Pay the bills. Stay in touch with friends and family. Stop the dog from tormenting the cat. Stop the cat from scratching the dog's eyes out. Clean the cat's litter box. Check email. Quite frankly, it all can seem rather overwhelming at times. I sometimes feel like an imposter in my own life and wonder how I have managed to avoid an ultimate collapse of this proverbial house of cards, landing myself on a park bench with my personal belongings stuffed inside an old shopping bag.

Speaking of bag ladies, I remember vividly my annual visits to see my grandmother in Miami Beach during early childhood, where a homeless woman lived on a bench in front of the public library on Collins Avenue. She dressed in heavy layers of bright colored winter clothing despite the Florida heat, and there she sat faithfully year after year, surrounded by a collection of plastic bags. Each year I returned to find the homeless lady dressed in the same peculiar attire, and I fought the urge to ask her why she did not remove the excess layers of clothing and place them in one of her many plastic bags. Her existence appeared so magnificently simple with her tangible world reduced to no more than several plastic bags and a park bench. She defied social conventions and lived on the fringes by remaining still and watching the world pass by. Here was a concept that I found to be perversely intriguing- a life reduced to pure simplicity, free of daily commitments and social obligations.

I often wonder, how do ordinary people of average intelligence manage to sleep, eat, exercise, care for pets and children, earn a living, keep abreast of current events, run errands, pay bills, procreate and clean the laundry without going stark raving mad and dropping out of society? Further, why do some folks juggle life's many dimensions seemingly effortlessly, always seeking a new pet cause or project while others amble along shrouded in a cloud of mental turmoil, drop out of society or perish under the weight of life's unforgiving demands?

During graduate school I paid the rent for a while by teaching preschool. In my class of three year-olds there was a child named Ariel; a tiny redhead who wet her pants regularly and cried much of the time. The demands of school presented a difficult challenge for Ariel and she required a lot of comfort and reassurance. Then there was Raina- a feisty child with a fiercely independent and confident personality. Raina refused to participate in mindless play and staged a daily revolt against the monotony of finger paints, circle time and morning naps. One could hardly blame her, as Raina craved a sense of productivity. I tried to imagine what Raina might be like as an adult and visualized her as a tall, sultry woman in stiletto heals and a red power suit, her long red nails tapping the lacquered surface of a conference table as she dictates the terms of a corporate merger to a group of skeptical businessmen slurping stale coffee. Such individual differences in temperament are striking and become evident very early in life. While some travel through life blessed with bright sunshine and calm waters, others thrash about in heavy rip tides, struggling to survive. Where does the explanation for such drastic difference lie- in the battery lawn mower of nature, nurture, or a complex interaction between the two?