General


Struggling With One’s Age

I see now the problems I experience confronting old age. Of all things, the words of literary critics, and more generally, the function of literary criticism, clarify the struggle I face practically every morning in one manner or another, as I feel the culture slipping away from me like a dock finally unleashed from its […]

Forgiveness and Aging

I’ve been thinking lately about the act of forgiving. When I was about 10 years old, my father was in business in San Francisco. Like many immigrants at the time, he was not an educated man, having left school after the sixth grade, but he worked hard, and he accumulated a little money running an […]

Medicare and the Physician Shortage

Still vivid in my mind is a visit I paid to the director of Center for Medicare and Medicaid Services in Washington, D.C. in 1990 in the company of the president and second vice president of the American Academy of Orthopaedic Surgeons. I was then its first vice president. The president spoke on behalf of […]

On Turning 65

The first thing I learned about my new Medicare card is that it’s hard to fit in my wallet. Made of paper, not laminated, it’s a tad bigger than the slots perfectly-sized for a credit card, a driver’s license, or my Blue Cross-Blue Shield card, which until Sept. 1, the start of the month of […]

Job Loss and Mortality

In my clinical practice some years back I saw “Mr. A,” a man in his early 50’s who had become profoundly depressed after losing his job. We had a good relationship and he was very cooperative in his treatment, which involved medications, different forms of psychotherapy, and environmental manipulations. Despite all our efforts, nothing worked. […]

Becoming the “It’s Not All About Me” Generation

Some months ago my colleague, dear friend, and mentor, Gordon Moore, showed me the draft of a proposal he had written for Medicare reform. Gordon and I have worked together and exchanged ideas regularly for more than 30 years, so it’s not surprising that we agree that we in the over 65 generation are key for […]

Suing Your Children

During a recent teaching trip to Singapore I learned about the country’s fascinating Maintenance of Parents Act, which went into effect in 1996.  The law allows Singapore residents over 60 who are unable to maintain themselves adequately to claim maintenance from their children, either in a lump-sum payment or in the form of monthly allowances. […]

Amour or Love Among the Ruins

Nominated for five Academy Awards, Amour is a film about love and death. (Read no further if you haven’t seen the film and don’t want to know who dies and how.) The setting is Paris, the language French, but any resemblance to a conventional French film about light-hearted romance or a ménage a trois ends […]

The Philosophy of Wisdom and the Wisdom of Philosophy

  Recently I had the pleasure of reading Daniel Klein’s little wisdom book, Travels with Epicurus (2012), a writerly account of his month on the Greek island of Hydra in search of a philosophy of old age.  Klein opens with a story about being faced with the question of whether to pay for expensive dental […]

Mental Health Care for the “Silver Tsunami”

On January 23 the New England Journal of Medicine published “The Underside of the Silver Tsunami – Older Adults and Mental Health Care.” The article draws on an Institute of Medicine report on the mental health workforce for older adults that Peter Brown, executive director of the Institute for Behavioral Healthcare Improvement, discussed here on […]