Okay, here we go, brace yourselves for the obvious. You must drink and you must eat. These are the only two "musts" in life. Now, for the not so obvious:  Everything else is a choice. Allow me to be a bit patronizing, everything else is a choice. From the moment you subconsciously understand the concept of consequence your actions become deliberate and self-serving. Are your choices getting in the way of a healthy, functional life? Are you making the right choices to enrich your life and the lives of those around you?

As we move through life we are constantly asked to make choices. Some are of a grave nature requiring us to draw on every emotional fiber. These may be dreaded moral and ethical dilemmas for which we may or may not choose “the road less traveled.” Others are of no consequence, in fact, we relish the thought of these choices. For example, a glass of Dahl Winnie single malt Scotch whiskey born of the freshest Highland spring waters of Lochan-Doire-Uaine to round off a Michelin-star meal or a fried Mars bar after greasy fish and chips--both the high road and the low road lead you to such yumminess. Hmmm, I'll take both! 

We never have the luxury of avoiding a decision by turning off our brains, crossing our arms, and stamping our feet in protest. No decision, after all, is a decision. Whether you're presented with a life changing scenario or a trivial option, the subsequent consequence of your choice(s) is yours alone to bear. Thankfully, decision-making doesn't have to be done alone.

For my 11-month-old precocious daughter, with a gentle and loving redirection she is quickly distanced from the danger of the cords and cables. For my 40-year-old clients who should know better, my approach is a swift kick in the ass to untangle them from the mess they’ve woven.

I am an occupational therapist. I am fascinated by the "why" of decision-making. My entire practice, save one, is made up of adults who can't figure out why life hasn't turned out as they expected. They have convinced themselves that it is easier to give up than it is to try again. They are sure that if it weren't for different circumstances, things would be just fine. They claim they have always made the right choices but things just didn't work out. It is my commitment to these clients to help them live the fullest lives possible.

I am also my own patient. The day after my eleven-month-old daughter was born I woke up with a terrible headache. Over the course of three weeks I systematically lost the use of my arms and legs. My wife was asked to live up to the promise of our marriage vows, even though “… or worse” was supposed to be a good 40 or 50 years away. I couldn’t embrace my wife on our anniversary, I couldn't rock my baby to sleep at night, or work and provide for my family. I demanded, from the doctors, to know what was wrong and never settled for, "we don't know."  I found the leading specialists and begged for consultations. Seemingly countless visits to doctors, blood tests, MRIs, nerve conduction studies and spinal taps resulted in a death sentence of a diagnosis: Lou Gehrig's disease. I made a very important choice at that moment to not accept the diagnosis. There was no way that my baby was not going to remember her father.

The choice to not accept the diagnosis was important, but more important was the "why” behind my decision. The majority of my patients can never answer why they make their bad choices in life. They can never accept that their morbid obesity is due in large part to an inability to keep that extra Twinkie out oftheir mouths, or that they are foreclosing on their home because, you shouldn’t own a $400,000 house on a $15 an hour salary. I did nothing to bring on my condition, but I was sure as all hell not going to let anything get in my way of getting better. 

I was eventually, correctly, diagnosed with an aggressive form of a rare neurological condition that is not life threatening. I undergo weekly infusions and chemo every four months. It sucks, it’s inconvenient, it hurts and I’m eternally grateful. Will I ever be able to hike the Rocky Mountains again? I don't know. But I will be around to put the fear of God into my daughter's first boyfriend. I can now stand without falling and I can feed myself. If it weren't for my daughter, I would have accepted my diagnosis with grace and hoped for the best.

As an occupational therapist, I help my clients find meaningful and purposeful activities for the future and identify the harmful actions and choices from their past. As part of my commitment to them, I make a deliberate choice to speak candidly and mince no words. I agree with them that it is easier to give up, and if that is the choice they make then they are cowards. I also remind them that no one has the power or foresight to guarantee anything. If they are upset because everything has gone wrong, then that implies that everything should have gone right--the epitome of arrogance and narcissism. Not surprisingly, most of my clients are quite critical of others. I submit to those "adults" that the more time they spend judging others the greater the stone that should be hurled back at them. I remind them that they now belong to a not-so-special cadre of people who are quick to give advice to friends, family and even strangers, but rarely ever follow that advice themselves. A group that is quick to judge but slow to embrace and forgive. The litany of excuses that they hold on to would be more useful to them as sheets of toilet paper. Most importantly, I remind them that they are missing out on everything that is beautiful and wonderful in this world.

The experience with my condition, coupled with the hundreds of conversations with perfectly healthy individuals led me to write a book: For the Love of God, Wake Up! A Much Needed Slap in the Face for Idiots Who Have Managed to Make it Into Adulthood Despite the Laws of Natural Selection. The individuals I highlight are the embodiment of bad choices. They represent the masses who defiantly choke-hold the notion that it is their inalienable right, whether granted by God or the Constitution, to smoke and die from lung cancer, drive drunk and risk killing innocent people, eat like pigs and complain about indigestion, spend like rock stars on stagehand wages and beat a crying baby when the baby cries louder. These individuals have taught me that we are all just a few bad decisions away from an unfulfilled and miserable existence. Conversely, we have the power to choose a meaningful and purposeful life. 

I said earlier that from the moment you subconsciously understand the concept of consequence your actions become deliberate and self-serving. Are your choices getting in the way of a healthy functioning life?  Are you making the right choices to enrich your life and the lives of those around you? My life doesn’t suck and neither does yours.

If you are interested in purchasing copies of Mr. Garcia’s aforementioned book, utilizing his Occupational Therapy services or commenting on his article please contact him at: This e-mail address is being protected from spambots. You need JavaScript enabled to view it