Should you work more to make more money or spend more time with family and loved ones?

This post applies to people who have a job and have enough money to spend a little extra. If you don’t have a job or don’t have enough money to make ends meet, you don’t have a choice; you have to do everything you can to provide food and shelter for your family. If you aren’t in that situation, read on.

Money has no value in and of itself. It is what you do with it. It can buy food and shelter. It can buy things you don’t need and things you do need. It can buy experiences, or it can buy more tangible things. For many people, having more money gives a sense of security. This is often the justification used for working into old age rather than retiring. However, if it sits in an account and grows, and you never use it, you may die with a lot of money that never had a chance to turn into something more valuable. See this post on the idea of Dying with Zero.

If that is what you want, then go for it. You may want your children to inherit it. Some would prefer to spend the money with their loved ones while they are alive. Money spent on experiences is converted into memories. My wife and I made a choice to buy experiences with our hard-earned money rather than things we may not need or appreciate later. Most people don’t think about these choices carefully. They just keep plodding along, making more money to spend on things or saving it for nothing in particular.

There are two times when you have a stark choice between spending time with your loved ones (spouse, children, and friends) and working to make more money: 1. When you are young, you choose between working longer hours and spending time with your family. 2. When you are older, you choose between working into old age and early retirement to be with your loved ones.

There is no question that no matter how much you love your family, you will need to take some time away from them and make some money. If you are in the prime of your working years, you will need to work hard to make enough money to live. You may need to work very long hours if you want to save to buy a house or take a vacation. Later in your career, you may feel you have to work several more years to save enough to retire. Where you draw the line on how hard to work and how many years to work before you retire is what I am talking about in this post.

During the working years and after you retire, how you spend your money plays a part in the equation. You will decide how much money to spend so you can enjoy quality time with your loved ones. Do you spend more on a vacation with your kids or use that money to buy a new car? After you retire, will you visit your loved ones once a year or every other month? Will you take them on a trip that they couldn’t pay for themselves?

Another question may arise when you retire—when to start taking Social Security. You get the maximum amount of money at 70. Full retirement age is 67, but you can get more if you wait an additional three years. You can start taking Social Security at 62, but you will make substantially less if you do so. This comes down to the same question: make more money or spend time with family. If you take the money early, you can spend it on experiences with your loved ones.

Suze Orman and most financial advisors recommend waiting until 67 or 70 to start claiming Social Security. They talk about the lifetime financial benefits of waiting. It’s a complicated question, and there is no right answer for most people. If you take the money at 62, you give up about 30%, but you start collecting five to eight years earlier than you would have if you had waited. If you can’t live on that 30% reduction, then the decision is obvious. But for those who could swing it with the reduction, the answer may not be obvious. Take the money when you are younger, or save it for when you are older.

Think of what you can do with the extra money if you take it early. You can regularly take your family to dinner. You can take your grandchildren to the zoo, or maybe even to Disney World. If you do that, you will have less money in your 70s and 80s than you would have had you waited. If you wait on the money, you will have more money in your 70s and 80s, but you may not have enough to spend the extra time with your family in your 60s.

In my experience, most people don’t examine this question closely. They decide they want to make more money and don’t truly examine the choice. I am fortunate that our grown son lives nearby. We live in Minnesota and could save a lot of money by retiring elsewhere. Florida has no income tax. The cost of living is much lower in the Dakotas and the South. The weather is warmer in most of the country. We stay in Minnesota because of our son and his future family. We also have other family in Minnesota whom we love. Should we save the money and go south, or spend time with our loved ones in the cold north?

If you are fortunate enough to have these choices, I have a thought experiment to help you decide. Let’s first talk about when you are in your working life. I could have worked more hours and made more money when our son was young. Instead, I never worked weekends, I was home every day by 3:00 p.m., and I took every possible day off. I spent countless more hours with our son than I would have had I worked more.

I was fortunate to have enough money without working additional hours. Still, I made the choice to give up making even more. What about retirement, now that he is grown? I retired at 55. Several of my colleagues whom I left behind are working past 70. Now, I have time to meet our son for coffee during the week, to go on more trips with my wife, our son, and his girlfriend, and to spend time with friends and extended family.

So, here is the thought experiment. How much of your money would you give to save the life of a loved one? It is a harsh question, I know. Most of you would give a huge chunk of your money, perhaps all of it. If I would give everything to protect my wife and son, why would I not give up earnings so I could spend more time with them? Why would I work longer hours for more pay unless I absolutely had to? Why would I work a few more years to have more of a nest egg when I could spend that time and money now to have meaningful experiences with them?

Don’t forget, you may decide that you will work a few more years to build up that nest egg and die or become disabled in those years. I am 57. In five years, if all is well, I will take Social Security. I will not wait. I can spend that extra money on trips with my wife and son’s family. If I wait, I may be gone or have a medical condition preventing me from using that little bit of extra Social Security I would have.

I have mentioned this thought experiment to others, and they say it’s unfair. It is not. It is not at all uncommon for people to die or become disabled while waiting for their Social Security checks to start. Why would I purposely give up the chance to be with my wife and son by trying to build a larger nest egg?

Are Vaccines Still Important?

Early in 2025, I wrote a post about vaccines, stressing how important many vaccines are. Recently, I’ve had discussions with friends and family about vaccines and was surprised by how many people were against vaccines in general and objected to specific vaccines that are uncontroversial in the scientific community. I listened and tried to understand their concerns. It can be unnerving to have foreign material injected into our bodies. People feel different about an injection than they do about consuming something orally or inhaling it. Some of the same people who avoid all vaccines are perfectly willing to consume hallucinogens, tobacco products, and alcohol, which are more dangerous than any vaccine. They can eat bad carbs without concern, yet refuse to get a vaccine, which is proven to save lives with minimal risk of harm.

It can be even scarier to allow our children to get shots. Knowing the history of the vaccines might alleviate some of the concerns. Before vaccines, parents lived in fear that their children would get measles, diphtheria, polio, and other infections. Every year, thousands of adults and children died of diseases that vaccines now prevent. During the frequent outbreaks, parents were afraid to let their children leave the home.

Vaccines changed everything. I was an Infectious Diseases specialist and internist, and I saw one case of measles, a few cases of rubella (German measles), and no cases of smallpox, diphtheria, or acute polio. If you lived before the measles vaccine came out, virtually everyone got measles, and you likely knew someone who had polio.

We don’t see the infections much at all now and haven’t for years. People who didn’t live during those times don’t understand what it took to eliminate smallpox and virtually eliminate the other infections I just mentioned. They don’t know that all of these infections (except smallpox) are still common in parts of the world. Globally, there are over 60,000 rabies cases per year, all fatal. Over 99% of these are caused by dog bites. What would happen if we stopped vaccinating dogs? We would see cases again. Now, we have very few cases in the United States, nearly all from exposure to bats or raccoons, and virtually all in people who didn’t get the vaccine after exposure.

If you study the history of these infections, you can’t fail to understand that we no longer have them because of the vaccines. Vaccines have risks. Everything does. That is not the point. The point is whether the benefits outweigh the risks.

One argument some people have against vaccines is that the person in question is not likely to benefit much because they aren’t likely to become ill with the disease, anyway. That is true enough, but that is the whole point of all safety measures. Do something that will protect you in the uncommon but serious event that it happens. That is why we buy smoke alarms. Most people will never experience a fire in their home, but I don’t want to die from one. Same with homeowners’ insurance, seatbelts, car seats for babies, bicycle helmets, carbon monoxide detectors, life jackets, and back-up parachutes. The list goes on forever. I am 57 and have never been in a serious car accident. I probably never will, but if I do, I want to minimize my odds of dying. I take 15 seconds a few times a day to put on a seatbelt, knowing that it is unlikely ever to help me. I take a smoke alarm and a carbon monoxide detector on every trip. In the slight chance the hotel or rental home owner doesn’t maintain working alarms, my family and I are protected.

In addition to the individual, vaccines clearly benefit society. Here are links to individual data on Human Papillomavirus (New England Journal, Cochrane Review), Smallpox, TDaP (tetanus, diphtheria, and pertussis), and MMR (measles, mumps, rubella). Special note to pregnant women and those who may become pregnant. The MMR article I just linked discusses the horrible birth defects associated with rubella in pregnant women. This is called the congenital rubella syndrome. In the 1964 and 1965 epidemic, over 20,000 babies contracted this syndrome. These articles discuss the overwhelming benefits of the vaccines, and most of the articles also discuss their safety.

Below is from UpToDate. It is a chart of the Effectiveness of routine childhood vaccines.

As with everything, vaccines have risks. The benefits of vaccines significantly outweigh these risks, and serious adverse effects from vaccines are uncommon. The most common side effects are pain at the injection site, fatigue, and fever. Neurologic reactions such as Guillain-Barré Syndrome are much, much less common. People often talk about severe reactions they had to a vaccine. Some of the stories are real, but many are coincidental and not related to the shot itself. Remember, people who have bad reactions to vaccines, real or not, often talk about it, but the millions who get vaccines with minimal or no difficulty don’t.

Johns Hopkins has an excellent site on vaccine safety. Among many other topics, it outlines the data supporting vaccine use. Many people, including some in the government, complain that vaccines haven’t been adequately studied with regard to risks. This site should help assuage them. Also, here is an excellent article showing how much study goes into vaccines and their safety.

When our son was young, I sometimes worried about all the vaccinations he received. Was it safe to give him so many shots at the same time? The coadministration of vaccines has been studied extensively. There is a small added risk of fever and even febrile seizures if multiple vaccines are given together. As scary as that sounds, the risk is small, and fever-related seizures are usually benign. On the other hand, dividing up all the shots causes significant problems. It is difficult to take children to the doctor multiple times in the first two years, and many children would miss out on the vaccines that can save their lives.

When deciding whether to get a vaccine for yourself or your children, please keep in mind the benefits and the risks. It is easy to focus on one or the other. Doctors sometimes focus only on the benefits of vaccines, and if you haven’t personally seen the dangers of the infections themselves, it is easy to focus on the risks. In recent days, we have seen a resurgence in vaccine-preventable infections, most notably measles. If we are not careful, it could soon get much worse.

What do I mean by Thanksgiving perspective? As everyone knows, Thanksgiving is a day when we show gratitude and thanks for what we have, especially family and friends, though it was originally a religious holiday.

However, even on Thanksgiving Day, we sometimes spend much of our time feeling rushed and stressed. For several days leading up to Thanksgiving, I often see people complaining and worrying about all they have to do for the big party. I admit that I have sometimes been one of the complainers. I’ve gone to Costco twice this week and my beloved Lunds and Byerlys grocery store three times. At both stores, people were stressed and upset. A man in front of me at the Costco liquor store complained about how long the lines were at Costco. He had a cart full of food and was buying several bottles of wine, yet he couldn’t wait a few minutes longer than usual to buy them without complaining.

I overheard several other people complaining about the cost of food. Yes, I know that we have had an increase in some food prices. The cost of beef, coffee, soda, and other items has gone up dramatically in the last year or two. But Costco had a fresh turkey for $1.09. I just checked online, and Target has fresh turkeys for $0.79 a pound. A spiral ham is $1.49, and green beans are about $3 a pound. And if you spend $50, you get ten dollars back. You could feed ten people for under fifty dollars. I don’t think the cost of food was something worth complaining about. Yes, the price of a standing rib roast was over a hundred dollars, so we’re having turkey.

Rather than complaining about the hassles around the holiday dinner, we should be thankful that we live in this country, where we have easy access to food. In fact, few Americans need to worry about finding food. One look around will tell you that the majority of people have more food than they need.

In America, we have much to be thankful for. In addition to access to food, we have clean water, shelter, cars, television, streaming services, mobile phones, computers, and many other things our grandparents didn’t even dream of.

More important than anything I’ve mentioned is that we should be thankful for being alive.

Being born was not your only good fortune. You had to survive until today. We all know how many times our lives could have ended before now. And it was much worse a hundred years ago. In 1925, our life expectancy was about 58, and it was even lower in 1900. Now, we consider someone young when they die at 70. That’s in the United States. In several countries in Africa, the life expectancy is under 60.

It took extremely good fortune for any of us to be alive right now. My parents had to get together at the perfect time for me to be born. The same had to happen with their parents, their parents’ parents, and so on for millions, literally millions of generations. Had any of my ancestors died without children, I wouldn’t be here at all, and no one would have known the difference. The same is true for everyone in the world today.

One of the things that bothered me in my practice was when a patient in their 80s or even 90s complained about getting old. Really? There are only two things that can happen to a person: get old or die young. Which would you prefer? Yet, many people don’t do much to try to live into old age. Read about my book, The Six Rules for a Longer, Healthier Life, if you want to increase your chances. Just a few days ago, I complained about pain in my arthritic left thumb while I was playing piano. How silly. First, I should be thankful I have a piano. More importantly, I should be thankful I have lived long enough to develop age-related arthritis. That is one of countless things I’ve complained about that I shouldn’t have. Enough complaining.

Now, the most important thing.

If you have a single person in your life whom you love, be thankful. I am fortunate to have several such people. How my wife puts up with me is beyond my comprehension. Yet, as much as I love them and am thankful to have them, I have not always shown my gratitude. I have sometimes been short-tempered and have complained when they’ve done something that wasn’t ideal for me.

That is what I mean by Thanksgiving Perspective, showing your gratitude for what you have, especially your loved ones, on Thanksgiving and every day. Try to be thankful for all the good things, and accept that we will have things that don’t seem good when they are happening. In retrospect, what bothers us in the moment is usually not a big deal. (Keep a copy of Don’t Sweat the Small Stuff on your desk.)

I hereby make a Thanksgiving resolution.

I will work as hard as I can to keep the Thanksgiving Perspective, showing my gratitude for everything good in my life, and avoiding complaining about anything that is not perfect. Please consider joining me in a resolution to keep the Thanksgiving Perspective.

I hope that most people want to improve some aspect of their lives. If your life is already perfect, I am happy for you, and you have no reason to read the rest of this post. If there is something in your life you want to improve, there are three tools I find effective. I will discuss the first, “Do What’s Important First,” in this post. People I know say that I have willpower and discipline. Maybe so, but I use a lot of tools and tricks. This is one of my favorites.

The tool, Do What’s Important First, applies to anything you want to accomplish. I use it for habits I want to develop, getting in shape, and choosing which trip to take next. It also works well for less important choices, such as which hike to take on a trip in the mountains. The concept sounds obvious, but most people don’t do the important thing first. They procrastinate. Kids work on their pencil drawer and the text’s font before they start writing the term paper. Many people plan to start a diet and exercise program on January 1, rather than today. Write the paper first, and start eating better right now. This concept is critical in starting habits because they are so difficult to develop.

Years ago, I read several studies showing how good pushups are for your health. This study in JAMA shows the link between the capacity to do pushups and the risk of a future heart attack. (This is not one of the studies that got me started on this habit, but it is impressive.) I do pushups virtually every day. I have only missed days when I was ill or getting a colonoscopy.

People often can’t believe that I have done pushups every morning for years, but it’s true. This morning, I did three sets of 55 pushups about 30 minutes apart. How do I do it? It is important to me to do pushups daily, so I do it first. I get up, I do a set, then another, then another. That’s it. It took me years to build up to this level—I could only do a few when I started, and my form was terrible.

If I didn’t do pushups first thing every morning, or if I waited until later in the day, something would have always come up. I could be tired, hungry, busy—whatever. By 6:00 a.m., I have already done one of the things that is important to me. Other things are important, and I do them early also. Since I don’t enjoy doing pushups, it is especially important that I do them first. Ryan Holiday talks about doing the hardest thing first. It’s called swallowing the toad. I feel that way about pushups. On the other hand, I want to write something, anything, every day, but I enjoy it much more than pushups, so I can do my writing second, and so on. I talk more about wasting time here.

I wanted to get in shape in general, so I work out almost every day. Read about the benefits of exercise in my book, The Six Rules For a Healthier, Longer Life. I have trouble exercising before eating, so I exercise first thing after eating, usually when my wife leaves for work. If she’s home, we try to work out together. I will talk about spending time with others when I discuss another tool I use.

How does “Do What’s Important First” apply to choosing trips to take? Several years ago, my wonderful wife and I were debating what trip to take. We hadn’t been to Michigan for many years, so that was on our list. There were five or six other trips we had planned, including Yosemite and Oregon, where we had never been together. We chose Michigan because our dear friends, Jack and Suzanne, lived there. I have known them since I was about two, longer than any other non-relative. You never know what is going to happen, so we chose to go to Michigan. We had a wonderful trip, seeing the Upper Peninsula, Mackinac Island, and spending time with our friends. Less than two years later, Jack passed away. Had we gone somewhere else, we may never have seen him again.

This tool, to do what’s important first, helps when choosing less important things, like which hike to take. My wife and I love trips where we can hike all day long. I do the legwork—booking flights, arranging a rental car, and finding a hotel or VRBO, while she considers the hikes and chooses which ones we should do. Most of the time, I agree with her choices. In fact, I have never once been disappointed in her plan. In Oregon last month, we went on beautiful trails in places that didn’t sound all that great to me, but her choices were gold. For example, I was blown away by Smith Rock State Park near Bend.

My wife always asks me whether I agree with her plan for a day of hiking. My usual question is “What is the best hike here?” Whatever she answers, I respond with, “Let’s do that hike first.” If we save the best hike for later, we could be disappointed. It could storm, they could close the trail for a bear sighting, or I could sprain an ankle and not be able to hike. (If she sprains an ankle or even breaks a toe, it doesn’t stop her.)

If you want to make sure you get it done, then do it first. This also holds true in life’s big choices. If you really want to have kids, try early in your marriage. If you wait, you could become unable to have kids later. It happens more often than you may think. If you want a particular career, get started right away. Most kids who drop out, even those who say they plan to go back, don’t get a degree within eight years. So, if you want a career that requires a college degree, start early and work hard. Finish the degree first. Gap years may not have the same negative effect on attaining a college degree. Still, the ones who succeed after a gap year usually do something during that year to further their career and gain clarity about their career path.

Doing the important thing first is intuitive. Of course, you shouldn’t put off homework until you get home from a party. You shouldn’t go for a beer after work, planning on going to the gym right after. Still, it helps to actually focus on the concept. Many people never take the time to think it through. They believe they will have the time and motivation to go to the gym after a drink with friends. They believe they will feel like doing pushups and yoga after a big breakfast. More often than not, they won’t feel up to it. They will have completed the less important tasks (which may even be harmful) and ignore the important ones.

Many people miss out on life by working too hard. Sometimes, they are trying to make more money, and sometimes they simply don’t know how to live otherwise. They work 60 hours a week, and work until they are too old to enjoy the things they should have done when they were younger. They miss the great experiences they could have had with their loved ones. Doctors are especially prone to this error, and I know many physicians who are still working into their seventies. Hard work is important and necessary, but too much can make you miss out on life. Aleksandr Solzhenitsyn, in his book One Day in the Life of Ivan Denisovich, wrote, “Work is what horses die of. Everybody should know that.”

There are other ways we can miss out on life, and I am at risk of one of them. I am a retired physician and spent more than thirty years working to improve people’s health and prolong their lives. I am also obsessive, maybe not reaching the level of obsessive-compulsive disorder, but obsessive enough. At times, I have been lax about my health, gaining and losing hundreds of pounds, 25 pounds at a time. I have often gone months or even years without any regular exercise. Now, I am the opposite. I eat very healthily and work out nearly every day. On vacations, my wife and I (and our son when he joins us) stay active. We hike, bike, or go to a gym. I do these things to live longer, but when I am too strict, I miss out on life.

Eating right and exercising can help you live longer. See The Six Rules for a Longer, Healthier Life. It makes sense to be active and eat healthy foods, but taken to an extreme, you can miss out on life. On vacation, I’ve gone to the gym instead of going to breakfast with my wife, son, and his girlfriend. I’ve chosen to eat the healthiest dinner possible at home and missed out on a dinner at a nice restaurant with friends. I have declined invitations and wonder now if it was sometimes because I didn’t want to eat unhealthy food at someone’s home or at a restaurant. I am certain I could have had a better balance between health and my enjoyment of life.

The only things that truly matter in a person’s life are their experiences. See the superb book, Die with Zero, if you want to know how to experience life in your later years. Hopefully, you have loved ones to share in these experiences. I look back with pleasure on vacations with my family as a kid and as an adult. I don’t care what type of car I owned, how fancy my house was, or whether my cholesterol was high in the summer of 2012, when I was watching our son and nephew sled on Sperry Glacier on garbage bags. If you focus on the things you can buy rather than the experiences you can have, you will miss out on life. You can also miss out on life by worrying too much about health and safety. A longer life is good, but only if it is filled with meaningful experiences.

I still intend to eat healthy and exercise to feel better and to live longer, but I am working to avoid focusing too much on diet and exercise. Because I am so addicted to bad carbs, I will still avoid them. See my book, The Three Rules to Lose Weight and Keep It Off Forever. I am not as strict as I used to be with foods that can increase the risk of heart disease and cancer, such as processed or red meat. Tonight, my wife and I are having steak, and last month, our son and his girlfriend made me the most decadent burger I’ve ever eaten. The “buns” were crisped cheese, and there was another ton and a half of cheese on the burger. If I had eaten a can of tuna while everyone else had burgers, I would have missed out on life.

Following every exercise and dietary recommendation in order to live longer makes sense, but taken to the extreme, what are you living for? Recently, my wife and I met our wonderful friend Suzanne for breakfast. I have known her since I was about two, longer than anyone else outside the family. We ate at the superb RH in Montecito, near where she lives. I knew ahead of time that there was nothing on the menu that was within the Three Rules except an egg dish. (Eggs dramatically raise my cholesterol.) We went to RH and had a wonderful time. Had I not gone or had I ordered nothing, it would have cost me, or at least diminished, an experience I will never forget. It seems crazy to some people that I even considered not eating the eggs, but think of how many people stopped seeing loved ones to avoid the risk of getting Covid. Government shutdowns cost children a year of school, leading to increased mental illness and inadequate education. Shutdowns also increased loneliness and depression in older adults.

Who can blame anyone who wants to live longer? I hope that I live as long as my mind is sharp, but we can’t be so fearful of dying that we miss out on life. There is a balance. You can eat healthy most of the time, exercise regularly, and maintain a normal weight without sacrificing meaningful experiences. You can lower your risk of getting an infection, and still see your loved ones. During outbreaks of infection, we can keep schools open and minimize the risks to teachers and children.

Work hard, be healthy, and don’t miss out on life.

You are what you do

One of my favorite scenes in Total Recall with Arnold Schwarzenegger was with Kuato, the weird creature growing out of some guy’s abdomen. Kuato said to Arnold’s character, “You are what you do. A man is defined by his actions, not his memory.” I was only 21, and I thought that the writer of the movie first wrote that line. Now, I know that many philosophers and writers said it. Aristotle said that you are what you repeatedly do. But that is not what Kuato meant. He meant that what you do now is what defines you.

Carl Jung said, “You are what you do, not what you say you’ll do.” That is my favorite non-movie interpretation of the sentiment. Ryan Holiday, the modern-day philosopher who changed my life, says it many times in many ways, and I learn something every time I read it. But I still prefer what Kuato said.

You are what you do.  You make errors and recover by acting today. Starting now, you can be a good person. You can stuff your face on Thanksgiving and eat healthy the next day. In medical school, when someone said they had quit drinking, we asked when. If they said, “Today,” we scoffed, thinking they were joking. We thought it was funny or that they didn’t mean it. Yet, that is all it takes. Do it today. Start now. Be a good person now.

You are what you do also means that promises don’t mean anything unless they are kept. You can say you care about something, but if you don’t make the effort or pay the price for it, then you don’t care enough. I can say I care about my son, but if I don’t make an effort to be with him and support him, then I don’t care enough. Patients say they care more about their health than anything else, but they don’t quit smoking, drinking, or eating junk food. They won’t pay for a medication or procedure that can help them, but they go on an expensive vacation.

You are what you do. If you visit friends and treat them well, you are a good friend. If you don’t, then you aren’t a good friend. If you exercise, eat well, and avoid alcohol and smoking, then you are a person who cares about your health. Saying you care about your health is nothing. Do something about it. I have been an unhealthy person. For years, I didn’t exercise, and I ate fast food several days a week. That is what I did, not what I do. Now, I eat healthy, I exercise, and I avoid drinking and smoking. I am a healthy person. 

You may not be able to entirely recover from your past unhealthy habits. But you can be healthy now. You may not be forgiven for everything you have done wrong, but you can be a good person now. Ryan Holiday quotes Marcus Aurelius. “Waste no more time arguing what a good man should be. Be one.” 

Words are nothing. You are what you do.