Cozy room with Christmas tree and decorations

This Christmas, I received a surprise gift, one that I definitely wasn’t expecting. No, it was not in a neatly wrapped box beneath the tree, nor did it arrive in a colorful envelope in my mailbox. Moreover, the person who gave it to me remains anonymous. What is this mystery present? Well, I got COVID for Christmas. I was also kind enough to pass it along to my older son.

I am so thankful that our symptoms have been mild. My experience has been fever, body aches, sore throat, cough and congestion. I am very fortunate that I was not affected more severely, and I pray for those that have suffered worse symptoms.

It seems as though the worse part of this is being isolated in our spare bedroom. My son feels the same way, as he is isolated in another room. I now know what I am sentencing all my patients to when I tell them that they must self quarantine. On the bright side, though, I had lots of time on my hands (a rarity) and thus had ample opportunity to catch up on things that I had been meaning to do.

I am most definitely blessed to have my wife, Mayra, by my side (not literally next to me). She has been taking care of everyone in the house—the humans, the dogs, the fish and the plants. She brings all of us our meals and ensures that our needs are met. Besides mother and wife, she is also doctor, making sure that my son and I have obtained a near full set of vital signs for ourselves everyday.

A few days into quarantine, it seems as though I was getting a bit moody. Out of concern and love, Mayra was telling me about many of the things she had been reading about COVID. She was doing a lot of research and informing me of items that I should be cautious about. For whatever reason, I decided not to listen. I figured that I knew enough about this horrible virus from working in the Emergency Department and I did not not need any additional information.

Mayra, always perceptive and astute, inquired as to why I was distancing myself. I initially resisted continuing the conversation (yes, I can be stubborn). But I quickly decided to do the right thing and open up (I also eventually figure out when I am not being my best self).

We spoke and I listened to everything that she wanted to say. I apologized for being inflexible and agreed that she had indeed learned many intriguing and important facts in her research. I felt much better after that conversation.

I enjoy being friends with Mayra. As a bonus, I also have a wonderful teacher. She keeps me open and honest with myself. Furthermore, in this instance she taught me that I was not practicing humility. I am grateful that she helped me to see myself as I truly was, and how I needed to make myself better.

Yes, it was an atypical Christmas with an unexpected gift. However, I did receive something else, something that is actually present in my life everyday—the love and friendship of a wonderful woman. 🧡🎁


White Printer Paper With Be Kind Text on Plants

We are often assaulted by negative news stories. Although factual, stories of murders, terrorism, political scandals and natural disasters saturate the airwaves. While there are anecdotes detailing acts of kindness, in my humble opinion, it seems as though the stories recounting acts of malice are much more ubiquitous than those describing deeds of goodwill.

            Despite this overwhelming amount of pessimistic narrative that enters our lives through newspapers, radio, television and our phones, I sincerely believe that there are more acts of benevolence than there are gestures of hostility. Kind acts occur every day around the globe, and when I learn about things that people do to add something positive to the lives of others, it motivates me even more to do the same.

            While in the middle of a busy shift in the Emergency Department last year, I witnessed such an act. We were busy to the point that we ran out of rooms, so there were many patients on stretchers in the hall. I had cared for a middle-aged woman, and after some testing, deemed that she was safe to be discharged home. I cannot recall all the details, but apparently she lived about an hour away from the hospital and she had no way of getting home. The clerk in the department had offered to call a cab, and it turned out that the fare was going to be $100. My patient said that she could not afford to pay such a large fare and she stated that she had no other way of getting home.

            After a short conversation at the desk with the clerk, the woman appeared despondent. Only a few minutes had passed when the man approached. He was an older gentleman, probably in his early seventies. He was a family member of another patient who had overheard the difficulties that my patient was experiencing. He took $100 dollars out of his wallet, handed it to my patient and told her that he wanted her to have it.

            My patient responded by saying something like, “I can’t accept this money from you,” and then, “Why are you being so nice to me?”

            I still remember the gentleman’s response. He said, “You’ve got it backwards. You’re actually doing something nice for me by allowing me to help you.”

Giving away $100 seemingly without thought to a total stranger appeared to be an effortless thing for this man to do. I believe that showing love and compassion is quite easy most of the time. Admittedly, it can sometimes be a challenge. However, the more you do it, the easier it becomes. Moreover, kindness can be quite infectious, and it will be paid forward over and over again.

A Backwards Society

Sliced Avocado Fruit and Green Vegetable on White Chopping Board

While at work in the Emergency Department a few weeks ago, I saw a young man in his early forties who had come to the hospital because of neck pain. It turns out that he was concerned because he had just suffered a heart attack the prior week for which he had a cardiac catheterization and a stent placed in his heart to open up a blocked blood vessel. A few months ago, I took care of a woman in her fifties that was admitted to the hospital and ended up needing open heart surgery due to extensive heart disease. 

I realize that the above is not the most uplifting opening paragraph for a blog post. However, it is factual nonetheless. My intention is not to be discouraging, but rather to create awareness and inspire change. Diabetes, high blood pressure, obesity, high cholesterol, cancer, heart disease and stroke are chronic diseases that are very often related to lifestyle choices—especially diet and exercise. These horrible conditions are frequently preventable. When they do occur, many are often reversible. Moreover, these maladies are oftentimes created by the afflicted individual. 

Although I could be mistaken, I believe that I have a fairly unique perspective on the healthcare system in this country. I would like to preface my thoughts by stating that our healthcare system is miraculous. We have an armamentarium of pharmaceuticals, procedures and surgeries that are life saving. I know this because I’ve seen it first hand. Amazing things happen in hospitals every day. 

Having said that, I believe that our society has it all backwards. We eat an abundance of processed foods containing sugar, white flour, salt, oils and artificial chemicals. These lifestyle choices unquestionably cause people to become sick with one or more of the aforementioned chronic diseases. How do we currently fix this? We turn to doctors, pharmaceuticals and medical device companies. We use pills to control the symptoms of diseases that we ourselves have often created. This. Is. Backwards. We need a paradigm shift. Why eat poorly, become ill and then take pills to put a band-aid on your diseases?  Instead, why not eat a nutritious diet and greatly decrease the risk of sickness in the first place? Do this and you can feel vibrant, focussed and well.

Which option sounds better? The choice belongs to you. Have a conversation with your doctor. It is my sincere hope that we can have a paradigm shift. I know that we can be better. Are you with me?

The Joy of Presence

Red Leaf Trees Near the Road

Today is a beautiful day. I sat on my porch as the sun bathed my face with a gentle warmth. It was quiet. The only sound was the melodious song of birds as they chatted with each other. My beautiful Japanese Maple, with its deep red leaves, stood to my right. The air was light and fresh. I let my eyelids close and meditated for twenty minutes. Upon opening my eyes, I felt refreshed and calm. I also felt present.

There is really a lot to be said about being present. Just being in the moment. Wherever you are and whatever you’re doing. Right here and right now. It seems like such a simple thing. Well, it actually is a simple thing. Yet, its effects can be profound and permeate into all aspects of your life.

The joy of presence. Lying on a beach. Hiking along a mountain trail. Having a hectic day at work. Being stuck in traffic. Petting your dog. Eating a crisp, juicy apple. Cuddling with your spouse or children. Trying to bring awareness to the moment you are in, rather than the future or the past, can be a wonderful undertaking. It doesn’t have to be an official meditation session.

I am tying to be more cognizant of this. There are many times when my body is in this moment while my mind is in some other time and place. Of course, sometimes daydreaming can be a wonderful way to generate ideas and spark creativity. I do enjoy letting my mind wander at times. However, I want to get better at being where I am right now. I know that, over time, it will help to bring more clarity and tranquility into my life.

Tsunami Aid?

Ocean Wave at Blue Hour

In the April 2020 issue of Scientific American, there was an excellent article entitled “The Aid Tsunami,” authored by Ajay Saini and Simron J. Singh on pages 59-65.

They discuss the catastrophic tsunami that that hit the Nicobar Islands (off the coast of Thailand) on December 26, 2004.

They discuss the devastation that affected the indigenous people and their villages.  They spoke about the massive humanitarian effort that ensued, with more that $14 billion dollars donated by both private and governmental benefactors. The relief effort seemed like an amazing pouring out of kindness by people.

However, it turns out that there would end up being a darker side to this.  The authors of this article were trying to convey several key ideas to the reader. One of these ideas centered around health. As the authors point out, “…benefactors inundated an essentially isolated society with packaged foods, a wide range of electronic and consumer goods, and enormous cash handouts.” Years later, with regards to the natives of the island, “…many of its members were beset by alcoholism, diabetes and other formerly alien ailments.”

They go on to state, “…over the years prolonged stress, sedentary lifestyles and a taste for processed foods had taken a toll. Previously unknown ailments such as hypertension appeared. The islands lack modern medical facilities, and most of the traditional healers — with their extensive knowledge of plant-based medicines — had perished during the tsunami. The Nicobarese began to die of heart attacks, diabetes, injuries, respiratory diseases, pneumonia, malaria and other diseases. Alcohol became a scourge as well.”

One of my take aways from this article reinforces ideas that I already feel strongly about. Specifically, that physical inactivity and poor diets will greatly increase the risks of developing many chronic degenerative diseases, such as diabetes, hypertension and heart attacks.

However, there is very good news here. Similar to the tragic outcomes suffered by the Nicobarerse when their lifestyles were changed, the converse is also true. When unhealthy lifestyles are transformed into healthy ones, many of their associated disease conditions can be improved and even reversed. This is incredibly powerful information.

Not only is there power in this information, there is power in you. You have choices everyday.  Over time, the choices you make will determine your life.

In school I learned that one of the reasons it is important to study history is so that present day people can learn from the mistakes that were made by others in the past. I believe that we can all learn a valuable lesson from the Nicobarese.

Be Kind to You




Be kind to yourself.

Treat your body well.

In general, it is always best to take great care of yourself. Eat right, move your body, get adequate rest and take some time every day to be in silence. These are healthy habits to cultivate and maintain.

Although some of us, such as healthcare providers and other first responders may be much busier during the current pandemic, we must not forget to care for ourselves. Especially now, we should keep our bodies fit and our minds clear.

If it does seem difficult, then perhaps focusing on doing a single thing daily to care for ourselves is a good place to start.

Taking baby steps and being consistent is a great way to be healthy.

Humanity United



I love to be inspired.

And I can tell you that I have felt so much love over the past few weeks.

I am not surprised, yet still amazed by the number of people that have stepped up to help each other.

Local restaurants have donated food everyday, even twice a day, to the Emergency Department.

A friend of mine delivered food on a church bus to people’s homes.

Healthcare workers, hospital employees, first responders and employees of essential businesses are putting themselves in harm’s way each day they show up for a shift-to help and serve others.

People have been staying indoors and have put their lives on hold to protect each other.

This gives me hope for humanity. Although so much of what is broadcast by the media is violence, terrorism, greed and scandals, I know that we can be so much more. This pandemic has proven that. We are all one people-a global community. We stand together and care for each other. God bless!

Helping to Create a Better Version of Myself

pexels helicopterMistakes. Failures.  In the past, I hated to make mistakes. I despised failure even more.   Years ago, I would become quite upset over mistakes and failures. It wasn’t until several years ago that I learned that mistakes and failures are important.  They are essential in that they are necessary for growth. If mistakes lead to learning and improvement, they are invaluable.

I find it curious that although I understand a concept, sometimes that comprehension does not translate into actual thoughts and feelings.  I had this experience recently during a flying lesson.  For a while, I had been interested in learning how to fly a helicopter.  I guess it was my fear of heights that held me back, but one day I decided to inquire.  I took an introductory flight and loved it.  I was scared up in the air, but I loved it and decided to continue.

One thing we practice is hovering.  It is challenging to coordinate brain, hands and feet to keep the aircraft in a hover in one place a few feet above the ground. I had been showing some improvement over the course of a few lessons. However, during my most recent lesson my flight instructor gave me greater reign over the controls and I did much worse than I had in the past. In the moment I felt disappointed with my performance. It wasn’t until the drive home that I realized that my mistakes were vital for my learning and growth.

Later that day, my son Joey was on his pogo-stick.  I watched him with amazement.  He was good!  I remember when he first got it. He couldn’t even do a single jump without falling off. He practiced.  Over time, all his mistakes and little failures created quite a talent for using a pogo-stick.

In the future, I am going to try to make a conscious effort to truly understand the importance of my mistakes in the moment. After all, if I learn from them, they are helping to create a better version of myself.

This is Steve Piriano ready for departure.  Until next time…


Clean Lenses

I can remember working a shift that ended at 11:00PM.  One of my last patients was a young lady in her thirties. Per the nurse’s notes in the chart, she had come to the ER secondary to complaints of chronic abdominal pain and constipation. After reading that, a barrage of thoughts flooded my brain.  “Did this patient come here just to receive narcotic pain medications?” “Is she lying about her pain?” “It’s almost the end of my shift, why did she come here so late at night with a complaint of constipation?”

Almost immediately, my perception of her was distorted. I already had thoughts about the type of person she was when I had not yet exchanged a single word with her. I was seeing her through cloudy lenses.

However, I decided to approach her as I do every patient–with kindness and an open mind. I spoke with her at length and learned a bit about her.  It turned out that she was a genuinely warmhearted individual who was going through some difficult times.  I tried to figure out what would be the best way to help her. She actually declined any offer of pain medications.  All of my initial perceptions were incorrect.

We all encounter people in a host of different locations and situations. So often it is easy to prejudge other individuals without ever giving them an opportunity to express who they are, what they are feeling or what kind of day they are having.  Have you ever had the experience of interacting with an unpleasant and impatient cashier at the checkout counter of your local supermarket?  I would propose that instead of acting in a similar fashion, you look at that individual through clean lenses.  After all, perhaps he has a sick child at home, maybe his car just broke down, or perhaps he doesn’t have enough money to buy dinner for his family. Or perhaps he is just grumpy all the time.  In either case, a little kindness on your part can go a long way to brighten that person’s day.

Thus, before you venture out into the world each day, please be sure to clean off your lenses.



We typically make decisions and take action based upon the things that we know-upon how we understand the circumstances that surround us.  Many times our conclusions are correct and our behaviors are appropriate. However, I’m fairly certain that on numerous occasions our assumptions are mistaken and thus our conduct will reflect this. I can definitely say that this is true of myself.

The manner in which we see a situation is our perspective. The eye of a hurricane looks and feels quite a bit different than other parts of the storm. Perspective. As a practitioner of medicine, I have an entirely different perspective than a layperson. A person who suddenly has the onset of severe abdominal pain will likely have a different meaning for me than for, let’s say-an astrophysicist. It would be like I am on an entirely different level of understanding with regards to the situation.  Similarly, if there was some enormous cosmic event that was going to impact our Earth, the converse would hold true. The astrophysicist would have an understanding that I could probably not even fathom.

I have two dogs- a yellow Labrador and a miniature poodle. Until a few months ago, I thought that I knew a lot about owning and raising dogs. Not so. Our Labrador was beginning to display behavioral issues that we were concerned about. I didn’t know what to do. Around that time, I happened to come across a copy of “Cesar’s way”, by Cesar Millan. Mr. Millan taught me an entirely different way to view canine behavior.  I learned how dogs see the world, and it is a lot different than I had once thought. I gained a new perspective, and it has helped immensely. (As an aside-prior to the behavioral issues, my wife had watched some episodes of Cesar’s television show and had mentioned some of his ideas to me. Of course, I didn’t listen at the time. She was right 🙂 – I should have listened.

Thus, proper perspective is essential.  It can help in all life situations. It can be especially valuable in difficult circumstances. When these circumstances arise, take a step back and ask yourself if there is any other way to look at things. Seek advice.  Read an article or book. Many times the perspective of others can be a wonderful gift, helping to provide the enlightenment needed to assist us in solving many of life’s most challenging quandaries.