General


No Sense, Lots of Dollars

Twenty-five years ago, discussions of medical futility were the rage in bioethics circles. The discussions petered out when it became clear that futility was in the eye of the beholder: physicians and patients often had very different ideas about what futility meant, depending on what they hoped medical treatment would accomplish.     In one […]

How Patients Can Assess the Quality of Their Outpatient Care

Even before I launched my geriatric consultation practice, I found myself often poring over another doctor’s outpatient notes, trying to explain to a patient what the other doctor was doing. Not every patient had questions and concerns about what their other healthcare providers were saying, and doing, but a fair number of them did. And […]

Too Old to Drive?

On February 25, 1983, my mother drove out of the parking area behind the apartment building in Florida where she and my father lived. She suffered from gradual cognitive decline and should not have been driving. She didn’t notice an oncoming car and pulled in front of it. There was no initial sign of injury, […]

A Proposal That Just Might Solve the Primary Care Crisis: Meet the 35 Hour Work Week

In March, The Health Care Blog published a truly outstanding commentary by Jeff Goldsmith, on why practice redesign isn’t going to solve the primary care shortage. In the post, Goldsmith explains why a proposed model of high-volume primary care practice — having docs see even more patients per day, and grouping them in pods — […]

Seamus Heaney

Learning, today, of the death of Seamus Heaney, I first thought of his magnificent essay  contrasting two views of dying, “Joy or Night: Last Things in the Poetry of W. B. Yeats and Philip Larkin,” in his 1995 volume The Redress of Poetry.  Heaney speaks of Larkin’s stark poem “Aubade” as “treating as mystification any […]

Learning from Our Elders

A recent phone call led me to reflect on how over 65ers can help younger folks learn about aging. Three months ago I received a call from Langley Danowitz, daughter of Emily Lublin, a long time patient of mine, who had died in 2000 at age 84. (Langley had seen me quoted in a New York […]

Making a Human Community

My wife Sidney and I spend our summers on a small island off the coast of Maine, Little Cranberry, well down east. The island has many charms, but I am most impressed by the wonderful integration of all age groups in the life of the island, from babies and young children to those in their […]

Irony, Resilience, and Late-Life Depression

I recently read two fascinating articles by Bill Randall, professor of gerontology at St. Thomas University in New Brunswick, Canada: “Aging, Irony, and Wisdom: On the Narrative Psychology of Later Life” and “The Importance of Being Ironic: Narrative Openness and Personal  Resilience in Later Life.” Two quotes convey the core perspectives I took from Randall’s […]

Music for the Aging Mind

“Music is the healing force of the universe” -Albert Ayler, the late jazz saxophonist Coincidentally or not, on the day after my last post, “Two Zorbas on Aging“, was published, I happened upon a column by Zorba Paster in the Lacrosse, Wisconsin Tribune titled “Patients need help with noisy hospitals,” that discusses a recent study […]

Old Age and Autobiographical Memory

Encountering new research on autobiographical memory is always unsettling. Even if you avoid the frightening findings on Alzheimer’s and other pathological conditions, the unreliability and difficulty of aging memory are humbling. All of the errors of recall that beset the young become more pronounced in the old. A well written and authoritative description of the […]