Not Today Summary and key ideas

Not Today, by Erica Schultz and Mike Schultz.

Mike and Erica Schultz’s account of productivity begins with a family whose time and attention were claimed by urgent needs. Before Ari’s diagnosis, they had built a family and were making a major pivot in their business toward sales training. At an eighteen-week ultrasound on September 28, 2011, they learned they were expecting a boy. Their joy shifted when doctors focused on his heart. They diagnosed critical aortic stenosis: a narrowed aortic valve was raising pressure and damaging the left ventricle. Clinicians later told them Ari had a 99 percent chance of hypoplastic left heart syndrome if he survived to term.

At Boston Children’s Hospital, Dr. Wayne Tworetzky offered an experimental fetal balloon procedure as a possible way to open the valve, preserve the ventricle, and prevent that outcome. The parents were told the procedure carried a risk that Ari would not survive it, and that its success could not be guaranteed. A first operation was technically successful: the team reached the valve, inflated the balloon, and withdrew. That did not show whether the valve would stay open. Weekly checks showed it beginning to close again, so the team tried a second procedure. It, too, was technically successful, but the family still faced uncertainty about Ari’s heart after birth.

Ari was born on February 16, 2012, and transferred to Boston Children’s for surgery within hours. In his first seven months, he had two major open-heart operations and spent barely five weeks at home. The surgeries replaced three of his four valves and saved his left ventricle, allowing circulation through a whole heart. But the ventricle remained damaged, and the hoped-for growth of healthy muscle did not happen.

Across the five and a half years after Ari’s birth, he spent about 430 nights in the hospital, his parents say. They were also raising their younger children, Lexi and Eli, and trying to keep their business going. They depended on the business for health insurance and felt they could not put it on hold. By Ari’s second birthday, his medical bills had topped three million dollars. These demands left the parents making decisions about care, work, and their other children while time and energy were already scarce.

One homecoming brought a particularly clear example of how they organized essential work. After Ari came home with a transplanted heart, his parents managed twenty-three medications. They arranged the medication bags with color-coded Post-it Notes alongside them and followed exact doses and schedules. They report making no mistakes. The system made a complicated set of daily responsibilities explicit, but it did not make the care simple or remove the need to stay alert. Its value lay in helping them carry out crucial tasks amid everything else they had to manage.

Work was another necessity, but the hospital made concentration difficult. The parents tried to work near Ari’s bedside and in places around the hospital, including hallways and common areas. Some days after surgery were expected to be quiet, yet the intensive care unit had constant staff and family traffic, alarms, phone activity, and nearby emergencies. Even when a crisis was not happening to Ari, it could shake them. When he was relatively quiet, they felt pressure to produce and deliver so another part of their lives would not collapse. The need to keep the business and its insurance in place was real; so were the limits on focus created by the ICU and their fear for their child.

Erica also describes how they searched for treatments and services, believing that enough learning and effort might give her control of the outcome. Ari died on July 21, 2017, at five years, five months, and five days old. Afterward, ordinary reminders at home made his absence concrete. The authors describe a dark period that lasted through the first year and beyond. Joy and peace seemed unimaginable. Erica recalls that at times she did not want to get through it if doing so meant letting Ari go.

Over time, they drew on the belief that Ari would want them to live fully and be happy. They name Lexi and Eli among their reasons to keep living, and describe family and friends as sources of support. Sharing their story and what they had learned gradually became a purpose for them. Their account gives purposeful action a limited but meaningful role: organization and effort helped them meet urgent responsibilities, but did not control Ari’s medical outcome. Their grief remained intense through the first year and beyond, and they eventually found purpose in sharing their story. They also needed help from others. That is the human context against which the book’s later methods should be understood.