The Big R²: A Compass for What Matters Most

We were wrestlers who talked statistics and everything else, from fighter jets to philosophy. We shared a drive for challenge and a search for meaning.

Dennis was the kind of mentor who did not just help you solve problems. He helped you believe they were worth solving. Over two decades, he became a touchstone in my life. A steady voice.

I still smile when I remember him gleefully commandeering my computer to tweak an Excel formula. His quiet joy made every problem feel solvable.

What I would give to hear him say, “Hey Brian,” one more time.

When he became sick, I walked with him through the long arc of decline and his final weeks. His voice became a whisper, but he never stopped teaching.

I grew as a person by being his friend. I was not a clinician charting his decline. I was someone sitting beside a man who had always lifted others, trying to support him as time grew short.

We wrestled with a different kind of weight then: shrinking time.

In that space between data and dying, numbers and meaning, I learned something I now carry into every hospice room I enter.

Years ago, while we were jogging, Dennis taught me about R² (“R-squared”), a statistical measure of how much variation in an outcome is accounted for by a model (NIST/SEMATECH). From that conversation came a practical lesson I never forgot:

“You don’t need to solve everything. Just find the variable that matters most.”

I carried the idea with me, although for years I referred to it simply as “the Big R.”

Then hospice gave the concept a deeper meaning. In the midst of illness, uncertainty, and limited time, the most important question is often not “What else can we do?” but “What matters most now?”

Today, I call that guiding idea the Big R².

The Big R² asks:

What is the one thing that brings the greatest peace or value in this moment?

The Big R² is not always another treatment. More often, it is personal: a long-awaited goodbye, a pain-free moment, or hearing a granddaughter laugh on the porch.

This is not just philosophy. It is a strategy that sharpens our focus.

When time is short, precision matters. Not everything can be fixed. The sacred can still be honored.

Every bedside encounter gives us another chance to refocus and ask:

What is the Big R² today?

We may ask it aloud. We may carry it silently as we enter the room.

In hospice, that question is more than a courtesy. It is a compass.

It helps us avoid wasted motion. It centers the care plan, realigns overwhelmed families, and reminds the team why we are there.

I once thought hospice work required encyclopedic knowledge. Now I know it demands something harder:

Precision with presence.

The Big R² is not only a metaphor. It is a mindset shaped by three forces:

The square is intentional: leadership and leverage multiply rather than merely add. Legacy is the result.

Leadership is the clarity to act.

Leverage is using the smallest meaningful action to create the greatest peace or value.

Legacy is what we leave behind.

We do not need to fix everything.

We need to identify what matters most for this moment, this visit, and this person.

That is the power of the Big R².

It points true north.

Before the visit ends, ask:

“What would bring the most peace today?”

Then translate the answer into:

one action

one owner

one next step

A meaningful answer without follow-through remains only a good conversation.

The Big R² turns clarity into care.

It may lead to a medication adjustment, a family conversation, a phone call, a final visit, a change in the care plan, or the decision to stop an intervention that no longer serves the patient’s goals.

The action may appear small.

Its effect may not be.

Hospice is the practice of presence.

The Big R² does not live in formulas. It lives in moments.

It surfaces in a pause, a quiet question, or a gentle truth finally spoken.

For patients, it may be the decision to stop a burdensome treatment and reclaim comfort.

For families, it may be an honest conversation that names uncertainty and brings priorities into the open.

For clinicians, it may mean standing steady while others sway and calmly naming what no one else wants to say.

When time is short, clarity matters more than complexity.

Sometimes the most important thing we offer is steady presence. We earn the trust to remain when nothing can be fixed.

These are not merely tasks. They are acts of leadership rooted in intention.

That is how we honor the work of hospice.

We find the Big R² in small moments.

Dennis lived this mindset long before I carried it into hospice. He did not just teach me how to solve problems. He taught me how to search for what mattered most.

That is legacy.

We carry it forward each day.

When time is limited, precision matters. Find the one thing that brings the most peace, then lead with it.