Rapid Rise in Syphilis Hits Native Americans Hardest

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From her base in Gallup, New Mexico, Melissa Wyaco supervises about two dozen public health nurses who crisscross the sprawling Navajo Nation searching for patients who have tested positive for or been exposed to a disease once nearly eradicated in the U.S.: syphilis.

Infection rates in this region of the Southwest — the 27,000-square-mile reservation encompasses parts of Arizona, New Mexico, and Utah — are among the nation’s highest. And they’re far worse than anything Wyaco, who is from Zuni Pueblo (about 40 miles south of Gallup) and is the nurse consultant for the Navajo Area Indian Health Service, has seen in her 30-year nursing career.

Syphilis infections nationwide have climbed rapidly in recent years, reaching a 70-year high in 2022, according to the most recent data from the Centers for Disease Control and Prevention. That rise comes amid a shortage of penicillin, the most effective treatment. Simultaneously, congenital syphilis — syphilis passed from a pregnant person to a baby — has similarly spun out of control. Untreated, congenital syphilis can cause bone deformities, severe anemia, jaundice, meningitis, and even death. In 2022, the CDC recorded 231 stillbirths and 51 infant deaths caused by syphilis, out of 3,761 congenital syphilis cases reported that year.

And while infections have risen across the U.S., no demographic has been hit harder than Native Americans. The CDC data released in January shows that the rate of congenital syphilis among American Indians and Alaska Natives was triple the rate for African Americans and nearly 12 times the rate for white babies in 2022.

“This is a disease we thought we were going to eradicate not that long ago, because we have a treatment that works really well,” said Meghan Curry O’Connell, a member of the Cherokee Nation and chief public health officer at the Great Plains Tribal Leaders’ Health Board, who is based in South Dakota.

Instead, the rate of congenital syphilis infections among Native Americans (644.7 cases per 100,000 people in 2022) is now comparable to the rate for the entire U.S. population in 1941 (651.1) — before doctors began using penicillin to cure syphilis. (The rate fell to 6.6 nationally in 1983.)

O’Connell said that’s why the Great Plains Tribal Leaders’ Health Board and tribal leaders from North Dakota, South Dakota, Nebraska, and Iowa have asked federal Health and Human Services Secretary Xavier Becerra to declare a public health emergency in their states. A declaration would expand staffing, funding, and access to contact tracing data across their region.

“Syphilis is deadly to babies. It’s highly infectious, and it causes very severe outcomes,” O’Connell said. “We need to have people doing boots-on-the-ground work” right now.

In 2022, New Mexico reported the highest rate of congenital syphilis among states. Primary and secondary syphilis infections, which are not passed to infants, were highest in South Dakota, which had the second-highest rate of congenital syphilis in 2022. In 2021, the most recent year for which demographic data is available, South Dakota had the second-worst rate nationwide (after the District of Columbia) — and numbers were highest among the state’s large Native population.

In an October news release, the New Mexico Department of Health noted that the state had “reported a 660% increase in cases of congenital syphilis over the past five years.” A year earlier, in 2017, New Mexico reported only one case — but by 2020, that number had risen to 43, then to 76 in 2022.

Starting in 2020, the covid-19 pandemic made things worse. “Public health across the country got almost 95% diverted to doing covid care,” said Jonathan Iralu, the Indian Health Service chief clinical consultant for infectious diseases, who is based at the Gallup Indian Medical Center. “This was a really hard-hit area.”

At one point early in the pandemic, the Navajo Nation reported the highest covid rate in the U.S. Iralu suspects patients with syphilis symptoms may have avoided seeing a doctor for fear of catching covid. That said, he doesn’t think it’s fair to blame the pandemic for the high rates of syphilis, or the high rates of women passing infections to their babies during pregnancy, that continue four years later.

Native Americans are more likely to live in rural areas, far from hospital obstetric units, than any other racial or ethnic group. As a result, many do not receive prenatal care until later in pregnancy, if at all. That often means providers cannot test and treat patients for syphilis before delivery.

In New Mexico, 23% of patients did not receive prenatal care until the fifth month of pregnancy or later, or received fewer than half the appropriate number of visits for the infant’s gestational age in 2023 (the national average is less than 16%).

Inadequate prenatal care is especially risky for Native Americans, who have a greater chance than other ethnic groups of passing on a syphilis infection if they become pregnant. That’s because, among Native communities, syphilis infections are just as common in women as in men. In every other ethnic group, men are at least twice as likely to contract syphilis, largely because men who have sex with men are more susceptible to infection. O’Connell said it’s not clear why women in Native communities are disproportionately affected by syphilis.

“The Navajo Nation is a maternal health desert,” said Amanda Singer, a Diné (Navajo) doula and lactation counselor in Arizona who is also executive director of the Navajo Breastfeeding Coalition/Diné Doula Collective. On some parts of the reservation, patients have to drive more than 100 miles to reach obstetric services. “There’s a really high number of pregnant women who don’t get prenatal care throughout the whole pregnancy.”

She said that’s due not only to a lack of services but also to a mistrust of health care providers who don’t understand Native culture. Some also worry that providers might report patients who use illicit substances during their pregnancies to the police or child welfare. But it’s also because of a shrinking network of facilities: Two of the Navajo area’s labor and delivery wards have closed in the past decade. According to a recent report, more than half of U.S. rural hospitals no longer offer labor and delivery services.

Singer and the other doulas in her network believe New Mexico and Arizona could combat the syphilis epidemic by expanding access to prenatal care in rural Indigenous communities. Singer imagines a system in which midwives, doulas, and lactation counselors are able to travel to families and offer prenatal care “in their own home.”

O’Connell added that data-sharing arrangements between tribes and state, federal, and IHS offices vary widely across the country, but have posed an additional challenge to tackling the epidemic in some Native communities, including her own. Her Tribal Epidemiology Center is fighting to access South Dakota’s state data.

In the Navajo Nation and surrounding area, Iralu said, IHS infectious disease doctors meet with tribal officials every month, and he recommends that all IHS service areas have regular meetings of state, tribal, and IHS providers and public health nurses to ensure every pregnant person in those areas has been tested and treated.

IHS now recommends all patients be tested for syphilis yearly, and tests pregnant patients three times. It also expanded rapid and express testing and started offering DoxyPEP, an antibiotic that transgender women and men who have sex with men can take up to 72 hours after sex and that has been shown to reduce syphilis transmission by 87%. But perhaps the most significant change IHS has made is offering testing and treatment in the field.

Today, the public health nurses Wyaco supervises can test and treat patients for syphilis at home — something she couldn’t do when she was one of them just three years ago.

“Why not bring the penicillin to the patient instead of trying to drag the patient in to the penicillin?” said Iralu.

It’s not a tactic IHS uses for every patient, but it’s been effective in treating those who might pass an infection on to a partner or baby.

Iralu expects to see an expansion in street medicine in urban areas and van outreach in rural areas, in coming years, bringing more testing to communities — as well as an effort to put tests in patients’ hands through vending machines and the mail.

“This is a radical departure from our past,” he said. “But I think that’s the wave of the future.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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  • The Well Plated Cookbook – by Erin Clarke

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Clarke’s focus here is on what she calls “stealthy healthy”, with the idea of dishes that feel indulgent while being great for the health.

    The recipes, of which there are well over 100, are indeed delicious and easy to make without being oversimplified, and since she encourages the use of in-season ingredients, many recipes come with a “market swaps” substitution guide, to make each recipe seasonal.

    The book is largely not vegetarian, let alone vegan, but the required substitutions will be second-nature to any seasoned vegetarian or vegan. Indeed, “skip the meat sometimes” is one of the advices she offers near the beginning of the book, in the category of tips to make things even healthier.

    Bottom line: if you want to add dishes to your repertoire that are great for entertaining and still super-healthy, this book will be a fine addition to your collection.

    Click here to check out The Well Plated Cookbook, and get cooking!

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  • Older Men’s Connections Often Wither When They’re on Their Own

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    At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition.

    “I didn’t know what I was going to do, where I was going to go,” he told me, describing a period of crisis that began in 2017.

    Seeking a change of venue, Rousseau moved to the mountains of North Carolina, the start of an extended period of wandering. Soon, a sense of emptiness enveloped him. He had no friends or hobbies — his work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out.

    His wife had passed away after a painful illness a decade earlier. Rousseau was estranged from one adult daughter and in only occasional contact with another. His isolation mounted as his three dogs, his most reliable companions, died.

    Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss.

    “I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.”

    In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.

    “Men have a harder time being connected and reaching out,” said Robert Waldinger, a psychiatrist who directs the Harvard Study of Adult Development, which has traced the arc of hundreds of men’s lives over a span of more than eight decades. The men in the study who fared the worst, Waldinger said, “didn’t have friendships and things they were interested in — and couldn’t find them.” He recommends that men invest in their “social fitness” in addition to their physical fitness to ensure they have satisfying social interactions.

    Slightly more than 1 in every 5 men ages 65 to 74 live alone, according to 2022 Census Bureau data. That rises to nearly 1 in 4 for those 75 or older. Nearly 40% of these men are divorced, 31% are widowed, and 21% never married.

    That’s a significant change from 2000, when only 1 in 6 older men lived by themselves. Longer life spans for men and rising divorce rates are contributing to the trend. It’s difficult to find information about this group — which is dwarfed by the number of women who live alone — because it hasn’t been studied in depth. But psychologists and psychiatrists say these older men can be quite vulnerable.

    When men are widowed, their health and well-being tend to decline more than women’s.

    “Older men have a tendency to ruminate, to get into our heads with worries and fears and to feel more lonely and isolated,” said Jed Diamond, 80, a therapist and the author of “Surviving Male Menopause” and “The Irritable Male Syndrome.”

    Add in the decline of civic institutions where men used to congregate — think of the Elks or the Shriners — and older men’s reduced ability to participate in athletic activities, and the result is a lack of stimulation and the loss of a sense of belonging.

    Depression can ensue, fueling excessive alcohol use, accidents, or, in the most extreme cases, suicide. Of all age groups in the United States, men over age 75 have the highest suicide rate, by far.

    For this column, I spoke at length to several older men who live alone. All but two (who’d been divorced) were widowed. Their experiences don’t represent all men who live alone. But still, they’re revealing.

    The first person I called was Art Koff, 88, of Chicago, a longtime marketing executive I’d known for several years. When I reached out in January, I learned that Koff’s wife, Norma, had died the year before, leaving him hobbled by grief. Uninterested in eating and beset by unremitting loneliness, Koff lost 45 pounds.

    “I’ve had a long and wonderful life, and I have lots of family and lots of friends who are terrific,” Koff told me. But now, he said, “nothing is of interest to me any longer.”

    “I’m not happy living this life,” he said.

    Nine days later, I learned that Koff had died. His nephew, Alexander Koff, said he had passed out and was gone within a day. The death certificate cited “end stage protein calorie malnutrition” as the cause.

    The transition from being coupled to being single can be profoundly disorienting for older men. Lodovico Balducci, 80, was married to his wife, Claudia, for 52 years before she died in October 2023. Balducci, a renowned physician known as the “patriarch of geriatric oncology,” wrote about his emotional reaction in the Journal of the American Geriatrics Society, likening Claudia’s death to an “amputation.”

    “I find myself talking to her all the time, most of the time in my head,” Balducci told me in a phone conversation. When I asked him whom he confides in, he admitted, “Maybe I don’t have any close friends.”

    Disoriented and disorganized since Claudia died, he said his “anxiety has exploded.”

    We spoke in late February. Two weeks later, Balducci moved from Tampa to New Orleans, to be near his son and daughter-in-law and their two teenagers.

    “I am planning to help as much as possible with my grandchildren,” he said. “Life has to go on.”

    Verne Ostrander, a carpenter in the small town of Willits, California, about 140 miles north of San Francisco, was reflective when I spoke with him, also in late February. His second wife, Cindy Morninglight, died four years ago after a long battle with cancer.

    “Here I am, almost 80 years old — alone,” Ostrander said. “Who would have guessed?”

    When Ostrander isn’t painting watercolors, composing music, or playing guitar, “I fall into this lonely state, and I cry quite a bit,” he told me. “I don’t ignore those feelings. I let myself feel them. It’s like therapy.”

    Ostrander has lived in Willits for nearly 50 years and belongs to a men’s group and a couples’ group that’s been meeting for 20 years. He’s in remarkably good health and in close touch with his three adult children, who live within easy driving distance.

    “The hard part of living alone is missing Cindy,” he told me. “The good part is the freedom to do whatever I want. My goal is to live another 20 to 30 years and become a better artist and get to know my kids when they get older.”

    The Rev. Johnny Walker, 76, lives in a low-income apartment building in a financially challenged neighborhood on Chicago’s West Side. Twice divorced, he’s been on his own for five years. He, too, has close family connections. At least one of his several children and grandchildren checks in on him every day.

    Walker says he had a life-changing religious conversion in 1993. Since then, he has depended on his faith and his church for a sense of meaning and community.

    “It’s not hard being alone,” Walker said when I asked whether he was lonely. “I accept Christ in my life, and he said that he would never leave us or forsake us. When I wake up in the morning, that’s a new blessing. I just thank God that he has brought me this far.”

    Waldinger recommended that men “make an effort every day to be in touch with people. Find what you love — golf, gardening, birdwatching, pickleball, working on a political campaign — and pursue it,” he said. “Put yourself in a situation where you’re going to see the same people over and over again. Because that’s the most natural way conversations get struck up and friendships start to develop.”

    Rousseau, the retired South Carolina doctor, said he doesn’t think about the future much. After feeling lost for several years, he moved across the country to Jackson, Wyoming, in the summer of 2023. He embraced solitude, choosing a remarkably isolated spot to live — a 150-square-foot cabin with no running water and no bathroom, surrounded by 25,000 undeveloped acres of public and privately owned land.

    “Yes, I’m still lonely, but the nature and the beauty here totally changed me and focused me on what’s really important,” he told me, describing a feeling of redemption in his solitude.

    Rousseau realizes that the death of his parents and a very close friend in his childhood left him with a sense of loss that he kept at bay for most of his life. Now, he said, rather than denying his vulnerability, he’s trying to live with it. “There’s only so long you can put off dealing with all the things you’re trying to escape from.”

    It’s not the life he envisioned, but it’s one that fits him, Rousseau said. He stays busy with volunteer activities — cleaning tanks and running tours at Jackson’s fish hatchery, serving as a part-time park ranger, and maintaining trails in nearby national forests. Those activities put him in touch with other people, mostly strangers, only intermittently.

    What will happen to him when this way of living is no longer possible?

    “I wish I had an answer, but I don’t,” Rousseau said. “I don’t see my daughters taking care of me. As far as someone else, I don’t think there’s anyone else who’s going to help me.”

    We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care, and advice you need in dealing with the health care system. Visit http://kffhealthnews.org/columnists to submit your requests or tips.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Keeping Your Kidneys Healthy (Especially After 60)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Keeping your kidneys happy: it’s more than just hydration!

    Your kidneys are very busy organs. They filter waste products, balance hydration, pH, salt, and potassium. They also make some of our hormones, and are responsible for regulating red blood cell production too. They also handle vitamin D in a way our bodies would not work without, making them essential for calcium absorption and the health of our bones, and even muscular function.

    So, how to keep them in good working order?

    Yes, hydrate

    This is obvious and may go without saying, but we try to not leave important things without saying. So yes, get plenty of water, spread out over the day (you can only usefully absorb so much at once!). If you feel thirsty, you’re probably already dehydrated, so have a little (hydrating!) drink.

    Don’t smoke

    It’s bad for everything, including your kidneys.

    Look after your blood

    Not just “try to keep it inside your body”, but also:

    Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.

    Watch your over-the-counter pill intake

    A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.

    Many people take ibuprofen (for example) constantly for chronic pain, especially the kind cause by chronic inflammation, including many autoimmune diseases.

    It is recommended to not take them for more than 10 days, nor more than 8 per day. Taking more than that, or taking them for longer, could damage your kidneys temporarily or permanently.

    Read more: National Kidney Foundation: Advice About Pain Medicines

    See also: Which Drugs Are Harmful To Your Kidneys?

    Get a regular kidney function checkup if you’re in a high risk group

    Who’s in a high risk group?

    • If you’re over 60
    • If you have diabetes
    • If you have cardiovascular disease
    • If you have high blood pressure
    • If you believe, or know, you have existing kidney damage

    The tests are very noninvasive, and will be a urine and/or blood test.

    For more information, see:

    Kidney Testing: Everything You Need to Know

    Take care!

    Share This Post

Related Posts

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  • When You “Can’t Complain”

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A Bone To Pick… Up And Then Put Back Where We Found It

    In today’s Psychology Sunday feature, we’re going to be flipping the narrative on gratitude, by tackling it from the other end.

    We have, by the way, written previously about gratitude, and what mistakes to avoid, in one of our pieces on positive psychology:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    “Can’t complain”

    Your mission, should you choose to accept it (and come on, who doesn’t like a challenge?) is to go 21 days without complaining (to anyone, including yourself, about anything). If you break your streak, that’s ok, just start again!

    Why?

    Complaining is (unsurprisingly) inversely correlated with happiness, in a self-perpetuating cycle:

    Pet Peeves and Happiness: How Do Happy People Complain?

    And if a stronger motivation is required, there’s a considerable inverse correlation between all-cause happiness and all-cause mortality, even when potential confounding factors (e.g., chronic health conditions, socioeconomic status, etc) are controlled for, and especially as we get older:

    Investing in Happiness: The Gerontological Perspective

    How?

    You may have already formulated some objections by this point, for example:

    • Am I supposed to tell my doctor/therapist “I’m fine thanks; how are you?”
    • Some things are worthy of complaint; should I be silent?

    But both of these issues (communication, and righteousness) have answers:

    On communication:

    There is a difference between complaining, and giving the necessary information in answer to a question—or even volunteering such information.

    For example, when our site went down yesterday, some of you wrote to us to let us know the links weren’t working. There is a substantive difference (semantic, ontological, and teleological) between:

    • The content was great but the links in “you may have missed” did not work.❞ ← a genuine piece of feedback we received (thank you!)
    • Wasted my time, couldn’t read your articles! Unsubscribing, and I hope your socks get wet tomorrow! ← nobody said this; our subscribers are lovely (thank you)
    • Note that the former wasn’t a complaint, it was genuinely helpful feedback, without which we might not have noticed the problem and fixed it.
    • The latter was a complaint, and also (like many complaints) didn’t even address the actual problem usefully.

    What makes it a complaint or not is not the information conveyed, but the tone and intention. So for example:

    “You’ve only done half the job I asked you to!” → “Thank you for doing the first half of this job, could you please do the other half now?”

    Writer’s anecdote: my washing machine needs a part replaced; the part was ordered two weeks ago and I was told it would take a week to arrive. It’s been two weeks, so tomorrow I will not complain, but I will politely ask whether they have any information about the delay, and a new estimated time of arrival. Because you know what? Whatever the delay is, complaining won’t make it arrive last week!

    On righteousness:

    Indeed, some things are very worthy of complaint. But are you able to effect a solution by complaining? If not, then it’s just hot air. And venting isn’t without its own merits (we touched on the benefits of emotional catharsis recently), but that should be a mindful choice when you choose to do that, not a matter of reactivity.

    Complaining is a subset of criticizing, and criticizing can be done without the feeling and intent of complaining. However, it too should definitely be measured and considered, responsive, not reactive. This itself could be the topic for another main feature, but for now, here’s a Psychology Today article that at least explains the distinction in more words than we have room for here:

    React vs Respond: What’s the difference?

    This, by the way, also goes the same for engaging in social and political discourse. It’s easy to get angry and reactive, but it’s good to take a moment to pick your battles, and by all means fight for what you believe in, and/but also do so responsively rather than reactively.

    Not only will your health thank you, but you’re also more likely to “win friends and influence people” and all that!

    What gets measured, gets done

    Find a way of tracking your streak. There are apps for that, like this one, or you could find a low-tech method you prefer.

    Bonus tip: if you do mess up and complain, and you realize as you’re doing it, take a moment to take a breath and correct yourself in the moment.

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Is Ant Oil Just “Snake Oil”?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We Tested Out “Ant Egg Oil”

    Did you know?! There’s a special protein found only in the eggs of a particular species of ant found in Turkey, that can painlessly and permanently stop (not just slow!) hair regrowth in places you’d rather not have hair.

    Neither did we, and when we heard about it, we did our usual research, and discovered a startling secret.

    …there probably isn’t.

    We decided to dig deeper, and the plot (unlike the hair in question) thickens:

    We could not find any science for or against (or even generally about) the use of ant egg oil to prevent hair regrowth. Not a peep. What we did find though was a cosmetic chemist who did an analysis of the oil as sold, and found its main ingredient appears to be furan-2-carbaldehyde, or Furfural, to its friends.

    Surprise! There’s also no science that we could find about the effect of Furfural (we love the name, though! Fur for all!) on hair, except that it’s bad for rodents (and their hair) if they eat a lot of it. So please don’t eat it. Especially if you’re a mouse.

    And yet, many ostensibly real reviews out in the wild claim it works wonders. So, we took the investigative reporting approach and tried it ourselves.

    That’s right, a plucky member of our team tried it, and she reports:

    ❝ At first glance, it seems like olive oil. There’s something else though, adding a darker colour and a slight bitterness to the smell.

    After waxing, I applied a little every few days. When the hair eventually regrew (and it did), it grew back thinner, and removing the new hairs was a strangely easy experience, like pulling hairs out of soft soap instead of out of skin. It didn’t hurt at all, either.

    I had more of the oil, so I kept going with the treatment, and twelve weeks later there are very few hairs regrowing at all; probably there will be none left soon. Whatever’s in this, be it from ant eggs or wheat bran or something else entirely, it worked for me!❞

    So in short: it remains a mystery for now! If you try it, let us know how it went for you.

    Here’s the “interesting” website that sells it, though you may find it for less on eBay or similar. (Note, we aren’t earning any commissions from these links. We just wanted to make it easier for you to dive deeper).

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Experience life lessons with the powerful message of "Make Your Bed" beyond the comfort of a picture.

    Beyond “Make Your Bed”—life lessons from experience

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Beyond “Make Your Bed”—life lessons from experience

    This is Admiral William H. McRaven, a former United States Navy four-star admiral who served as the ninth commander of the United States Special Operations Command.

    So, for those of us whose day-to-day lives don’t involve coordinating military operations, what does he have to offer?

    Quick note: 10almonds’ mission statement is “to make health and productivity crazy simple”.

    We tend to focus on the health side of this, and in the category of productivity, it’s often what most benefits our mental health.

    We’re writing less for career-driven technopreneurs in the 25–35 age bracket and more for people with a more holistic view of productivity and “a good life well-lived”.

    So today’s main feature is more in that vein!

    Start each day with an accomplishment

    McRaven famously gave a speech (and wrote a book) that began with the advice, “make your bed”. The idea here doesn’t have to be literal (if you’ll pardon the pun). Indeed, if you’re partnered, then depending on schedules and habits, it could be you can’t (sensibly) make your bed first thing because your partner is still in it. But! What you can do is start the day with an accomplishment—however small. A short exercise routine is a great example!

    Success in life requires teamwork

    We’re none of us an island (except in the bathtub). The point is… Nobody can do everything alone. Self-sufficiency is an illusion. You can make your own coffee, but could you have made the coffee machine, or even the cup? How about, grown the coffee? Transported it? So don’t be afraid to reach out for (and acknowledge!) help from others. Teamwork really does make the dream work.

    It’s what’s inside that counts

    It’s a common trap to fall into, getting caught up the outside appearance of success, rather than what actually matters the most. We need to remember this when it comes to our own choices, as well as assessing what others might bring to the table!

    A setback is only permanent if you let it be

    No, a positive attitude won’t reverse a lifelong degenerative illness, for example. But what we can do, is take life as comes, and press on with the reality, rather than getting caught up in the “should be”.

    Use failure to your advantage

    Learn. That’s all. Learn, and improve.

    Be daring in life

    To borrow from another military force, the SAS has the motto “Who dares, wins”. Caution has it place, but if we’ve made reasonable preparations*, sometimes being bold is the best (or only!) way forward.

    *Meanwhile the Parachute Regiment, from which come 80% of all SAS soldiers, has the motto “Utrinque paratus”, “prepared on all sides”.

    Keep courage close

    This is about not backing down when we know what’s right and we know what we need to do. Life can be scary! But if we don’t overcome our fears, they can become self-realizing.

    Writer’s note: a good example of this is an advice I sometimes gave during my much more exciting (military) life of some decades ago, and it pertains to getting into a knife-fight (top advice for civilians: don’t).

    But, if you’re in one, you need to not be afraid of getting cut.

    Because if you’re not afraid of getting cut, you will probably get cut.

    But if you are afraid of getting cut, you will definitely get cut.

    Hopefully your life doesn’t involve knives outside of the kitchen (mine doesn’t, these days, and I like it), but the lesson applies to other things too.

    Sometimes the only way out is through.

    Be your best at your worst

    Sometimes life is really, really hard. But if we allow those moments to drive us forwards, they’re also a place we can find more strength than we ever knew we had.

    Keep on swimming

    It’s said that the majority in life is about showing up—and often it is. But you have to keep showing up, day after day. So make what you’re doing sustainable for you, and keep on keeping on.

    Don’t Forget…

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