Disclaimer

This newsletter contains my thoughts are my thoughts alone; and do not necessarily reflect my employer or any other organizations with which I am affiliated.

Walking with Questions

Peripatetic, from the Greek peripatein, means “to walk about.” Aristotle taught while walking, and this Substack walks too — around the edges of clinical reasoning, decision science, human cognition, professional practice, and sometimes through the fields of philosophy and theology.

This space reflects my ongoing exploration of how clinicians think, how we act under uncertainty, and how we make decisions when evidence, values, and reality intersect. My writing wanders into, around, and occasionally through physical therapy — but it is not confined by it. This is a place for inquiry about clinical practice as a human, cognitive, philosophical, and epistemological endeavor.

Cognitive Engineering / Industrial / Organizational Psychology & Clinical Decision Science

My academic background is in Work Environment, where my dissertation focused on job strain and psychosocial ergonomics — a foundation that fits within engineering psychology (also referred to as human factors), and also Industrial/Organizational Psychology (I/O Psych).1 For years, I worked to contribute research in physical therapy, but my perspective increasingly led me to realize I was asking questions on clinical practice itself: questions about cognition, decision-making, and human performance in complex environments.

Today, I recognize myself as an I/O psychologist studying clinical reasoning. My work brings together:

• Clinical Decision Science: How clinicians reason, act, and adapt in real-world uncertainty

• Causal Modeling: Using Critical Realist Graphical Causal Models (CR-GCMs) to map decisions and causal structures

• Critical Realism: Exploring Bhaskar’s empirical, actual, and real domains in healthcare

• Cognitive and Behavioral Psychology: Applying principles of expert decision-making to clinical practice

• Psychosocial Ergonomics: Understanding how social and cognitive environments shape clinical performance

What This Substack Is (and Is Not)

This Substack is:

• A space for reflective scholarship at the intersection of psychology, philosophy, and clinical practice;

• A home for causal modeling, bias recognition, and the pursuit of epistemic responsibility in healthcare;

• A conversation about how clinicians know, decide, and become in the face of complexity.

It is not a traditional clinical education site, nor is it a professional advocacy platform. It is a walking inquiry — committed to complexity, nuance, and the disciplined imagination needed to rethink how clinical practice happens.

Why I Write

I came of age as a Gen X’er—raised in the long shadow of institutional idealism, trained to be skeptical of authority but still longing for meaning. That context taught me to listen for the quiet truths beneath the noise, and to question the systems that shape how we think, work, and care. I’ve come to believe in what I’d call conducive rationality—not just logic or expertise, but a way of thinking that leads us toward presence, clarity, and shared understanding. My writing is one way I try to hold space for that kind of thought. It’s not always tidy or conclusive, but I hope it’s useful.

A Bit of Faith and Formation

My journey in faith has been… peripatetic too. I started as an uncritical Catholic kid (unfaithful in the truest sense: no critical thought, no personal engagement). I became an antagonistic agnostic in college, a militant atheist in grad school (especially when I felt like pushing buttons), and by 2003, post-dissertation, I hit an existential wall that flirted with nihilism. Pancakes saved me. (Yes, I’ll tell you the story.)

In 2004 I started reading very broadly—philosophy, theology, science, politics. That’s when I began moving from indoctrination to education, from mere training to genuine inquiry. That was also when I began integrating faith and reason more honestly—through the lens of grace, pancakes, and eventually the person and work of Jesus.

Life Outside the Professional

I met the love of my life in 1990. We married in 1995. We had our sons in 1996 and 1998. I won’t say more here because I haven’t asked their permission—but their stories are inextricable from mine.

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