My grandfather was a bit of a philosopher, and he loved to share quotes at the dinner table. One of his favorites was “Moderation in all things, except moderation.”
He often said this with a Manhattan in hand, or after a full meal, as he leaned back in his chair, hand rested on his belly. Together with my grandmother, he lived one of the happiest lives I know of–a full life that lasted almost 95 years. So, perhaps advice worth considering.
Moderation in all things, except moderation. Another way of saying this is a term from economics: marginal utility. Before we all fall asleep, marginal utility is the idea that the amount of “utility”—or usefulness, good, or benefit—that you get from something decreases as you get more of it. Meaning that for each additional unit of a thing (or service, or XYZ) you acquire, consume, or experience, you get less out of it.
This is a typical kind of chart used to show what this means. In the beginning, by having more of something, you are better off…but the benefit slows down and stops as you get more, and then eventually having more of it gives you no benefit whatsoever. And having too much of something can actually leave you off worse than where you started.

Whether or not we’ve been aware of it, we’re all familiar with marginal utility in our daily lives, and regularly experience these effects with the things we buy or consume.
Take ice cream, for example. You have one bite of ice cream and it is so tasty you realize you had somehow forgotten how delicious it is. Then you have another bite, and it is tasty. Then the next bite is good, and the next one is fine. Eventually you are simply focused on finishing the ice cream before it melts and drips through the bottom of the cone.
If someone gave you another ice cream cone, you would maybe be able to eat it, and it might taste okay. If you had any more you would be sick to your stomach. If you have too much over time, you are going to be sick in more serious ways.
The point is not that ice cream is a problem. Some of life’s happiest moments involve eating an ice cream cone, preferably by the shore of a lake. The point is that if you have too much, eventually it stops providing any benefit at all, and starts taking you in an undesirable direction.
As the aforementioned ice cream continuum demonstrates, if we keep adding more and more of something, we can actually end up in a worse place than when we started. This is true for just about anything, even water and other necessities.
Take pants, for instance. If you are the man in the Shel Silverstein illustration of “Something Missing,” then getting a pair of pants will be a blessing for you and those around you. If you get a second pair of pants, then you will be able to wear pants while your first pair are in the wash, thus avoiding potentially uncomfortable situations.
If you had dozens of pairs of pants, you wouldn’t even notice or wear some of them. If pairs of pants kept arriving at your home, it would soon be difficult to find a place to store them, and pants would be piled everywhere. Eventually you would risk drowning in the plethora of pants permeating your place [iii].

Marginal utility is economics answer to “moderation in all things.” Another related concept is what is called the diminishing marginal utility of wealth. If we are still awake after that phrase, this means that a given amount of money is worth more to a financially poor person than it is worth to a wealthy person. In the unlikely event that any economists are reading this, by “worth more,” I mean provides greater relative benefit, or usefulness.
For a person who is destitute, for example, one hundred dollars will buy food, some warm clothes from Goodwill, and maybe a place to stay for a little while. If you give a hundred dollar bill to a billionaire, on the other hand, they might absentmindedly put it in their pocket, lose it in the laundry, and never notice it is missing. Or it might just add another number into an account, where it will be lost in the noise of interest earnings and the ups and downs of the market.
Many years ago I joined my brother and some of his friends for Thanksgiving. At one point in the dinner conversation, the subject of poverty came up. A woman at the table said something to the effect of, “Well, either they are suffering, or we are suffering,” meaning that if we give to financially disadvantaged people, then we will have to suffer because of our loss.
Most of us have heard this type of argument, and at the surface it seems to make sense. One person’s gain is another person’s loss, and vice versa. But luckily it doesn’t exactly work that way.
I will note here that in an earlier conversation this same woman had said, “You just can’t get a handbag for less than fifteen hundred dollars these days.” I don’t intend to demonize or otherwise pick on this woman. It’s just that her comment is a pretty good indication of where she resides on the spectrum of diminishing marginal utility of wealth.
* * *
On the other side of that spectrum is much of Haiti. Right around the time of that same Thanksgiving meal, an organization called Haiti Outreach Pwoje Espwa, or H.O.P.E., was spending fifteen hundred dollars in an entirely different way.
H.O.P.E. works in in a region called Borgne in the northwest part of Haiti, where for the past twenty years they’ve run the only health clinic and hospital in the area. The hospital is located in the town center, but most people in Borgne live in outlying areas so rural and remote that there are no roads, let alone any other services or infrastructure.
In many developing areas, people are described as living on one or two dollars a day. In the town of Borgne, families may make $500-$1,000 per year or so, so this would be accurate. But in the outlying areas, many people don’t have any cash or currency at all—they grow food, harvest from trees, and raise animals, or they go without.
For many people in the rural areas the journey to the hospital involves a five to nine hour walk up and down steep mountain paths and across rivers—no matter the weather.
Since the walk to the hospital is so difficult, people in critical condition are commonly carried into the hospital on the back of a door. When people are too sick to make the journey to the hospital on their feet, family or neighbors take down a door, and set the sick or injured person (or woman in labor) on top of the door. They then carry them up and down those same mountain paths, across those same rivers, to get them to the hospital. After all of this, some people are too far along to survive.
So H.O.P.E. partnered with community leaders in Borgne to run Mobile Clinics, to bring medical services to the people in the remote areas, and to work to avoid this kind of fate.
A Mobile Clinic is the kind of thing you have to see to appreciate. It starts out with the team packing up a truck and heading out while it is still dark, picking up doctors and nurses and other staff on the way. Once the truck reaches the (literal) end of the road, it is time to unpack the truck. Local volunteers arrive to pick up boxes and coolers of medical supplies, and carry them to the Mobile Clinic site—a hike that can take up to hours.
When the team arrives at the site–which is often a community member’s home, school or other site, opened up for H.O.P.E. to use as the clinic for the day–staff and volunteers next set up, sorting medications and vitamins, bringing out blood testing equipment, and setting up a private room.
The Mobile Clinic officially begins with an educational session, where patients gather around to listen to staff share information and stories about health issues including tuberculosis, dental care, family planning and nutrition.
The clinic is held all day. Hundreds of people from the surrounding community come for counseling, testing, exams, and medication.
If anyone is in critical condition, they are transported to the hospital in town. The clinic does not close down until every last patient has been seen. Each clinic serves about two hundred people.
Women are also alerted of potentially serious problems, such as preeclampsia. If unchecked, preeclampsia can lead to complications in childbirth, and even the death of the mother and infant. With Mobile Clinics, women are aware of such problems ahead of time, and can go to the hospital in town to deliver.
Because so much of what they test for and treat at Mobile Clinics is preventable, people don’t get as sick. When Mobile Clinics are happening regularly, there are far fewer acute or critical visits to the main hospital. During a time when H.O.P.E. was running many Mobile Clinics, H.O.P.E.’s Medical Director, Dr. Thony Voltaire, asked, “When is the last time we saw someone get carried in on a door?”[iv]
Around the time of the Thanksgiving dinner I mentioned earlier, the cost of a Mobile Clinic was about seven dollars per patient, or fifteen hundred dollars total. For the price of a handbag in certain circles, H.O.P.E. can provide education and medical care for hundreds of people, some of whom might otherwise die on a door.
* * *
In this world we live in, we hear so many messages about how more of this or more of that will make our lives better. But at this point, lack isn’t really our problem. We are some of the most materially wealthy people in the world—in the history of the world—and yet somehow we don’t see it.
As a friend said, “We may not all have a fifteen-hundred-dollar handbag, but we all have our fifteen-hundred-dollar handbag.” We all have things we spend money on that aren’t really giving us much benefit, comparatively speaking.
Likewise, we all have our ice cream. We all have things we consume way past the point that they are doing us any good—whether we consume them with our mouths, or eyes, or minds. And we all have our piles, pants or otherwise.
In places like Borgne, more is more. But for so many of us, in so many ways, more is less, and less is more. Our diseases are not of scarcity and starvation, but of excess and stagnation.
The small part of us wants to tell us that it is a loss or a sacrifice to give. The deeper part of us knows better. The deeper part of us knows that giving is as good for us as it is for those to whom the gifts are given.
And science agrees. A body of scientific research has shown that giving, generosity and altruism are good for us, by nearly any measure you might imagine. People who give sleep better, are less stressed, are happier, and live longer[v]. Scientists have actually identified measurable beneficial changes in our genes in response to giving and other selfless behaviors [vi]. And spending our money on others and altruism actually makes us happier than if we had spent it on ourselves.

There are countless theories as to why giving may be so good for us, from the metaphysical to the biological and evolutionary. Darwin even wrote that altruism is necessary for a species to survive and thrive. We could argue as to what are the real reasons that giving is so good for us. But when we know it is good for us, and we know it is good for others, what else is there to know?
I came across this poem by Hafiz, posted on a park bench:
“Even
After
All this time
The Sun never says to the Earth,
“You owe me.”
Look
What happens
With a love like that,
It lights the whole sky.”
Imagine what the world would look like if none of us took more than we needed—or more than was good for us—and if we all shared what we have to share. Even if we aren’t able to give financially, we can share our time, or skills, or knowledge, or lend our hands.
Today is Giving Tuesday. H.O.P.E. is a cause close to my heart. If H.O.P.E.’s work resonates with you, I’d ask that you consider supporting the organization.
It has been a rough year in Borgne, as in the rest of the world. In an area already facing extremely limited resources, COVID required even more resources to be diverted to COVID prevention and treatment. Meanwhile, on top of the economic consequences of COVID, Haiti saw an artificial change in the currency exchange rate compared to the U.S. dollar, which means that the value of financial support from the U.S. to Haiti has effectively declined, and significantly.
For these reasons and many others, H.O.P.E. and the partners in Borgne are currently unable to run the Mobile Clinics. But with enough support, these could be up and running again. In many cases, a contribution can be lost in the noise of a large cause or organization. In this case, any help you can give could literally make the difference between life and death for someone.
This year has been a rough year for H.O.P.E., as well, with the loss of founder and Executive Director, Rose-Marie Chierici, after a long battle with cancer. A team of us are working together to fill her shoes, but they are mighty big shoes.


We could really use your help. If you’d like to donate, or learn more about helping in other ways, you can click here.
If H.O.P.E. is not your thing, that’s okay too. There are as many worthwhile causes as there are stars in the sky. Pick the ones that call to you.
* * *
Moderation in all things, my grandfather said. That is one of the first things my family members think of when we think of him. But it isn’t the first—the first is his generosity. Papa was one of the most generous people most of us have known, and that as much as anything might have been responsible for his health, happiness, and longevity.
Earlier I wrote that moderation in all things–and marginal utility–apply to nearly everything. But there are a couple of things where they do not apply. The things we can never have too much of are not things we can consume or compile. They aren’t things at all really, but rather love, and purpose, and connecting with people, however we might achieve that. Even if it that means simply sharing the sunniest little smile your corner of the world has seen.
Wishing you all the best,
E.
The original version of “In All Things, Except” was posted in November 2017. This is an updated and revised version, posted in honor of Rose-Marie Chierici’s life and legacy, and in the hopes that her work will continue.
Notes:
[i] This is a reference (and reverence) to my friend Jocelyn, who approximately 20 years ago said, completely off the top of her head, while picking out pumpkins, “There’s a plethora of pumpkins permeating the patch.”
[ii] The GloWorm substituting as Benjamin Franklin is not intended to be any sort of serious social commentary or political statement. The truth is that I can’t even explain how horrible the drawing of Benjamin Franklin turned out once I transferred it to ink. It was bad enough in pencil, and then it just turned into the chained up guy in The Goonies. I might have just kept it, but honestly it was distracting. Or someone might have thought that I was being unpatriotic, and I would have been arrested. It really doesn’t seem worth a hassle like that for one drawing. Further, if you caught the the “A”, “2”, and “d”, it is a reference to a movie from my childhood…my friend thinks it is Home Alone. That or Goonies. I will also note that there are way too many things wrong with this figure to count.
[iv] This is what would be called “anecdotal” in certain circles, meaning there isn’t scientific or measurable evidence of this. But in areas like Borgne, the baseline data literally doesn’t exist. Establishing a baseline is one of the many things H.O.P.E. would like to do, but sometimes when the choice is between measuring the extent of a problem, and helping the people who are doing something about that problem, you have to lean towards the latter.