James Sabin


Re-Designing Medicare

Under the headline “Greedy Geezers,” the cover of the March 28, 1988 issue of the New Republic shows a phalanx of angry over 65ers surging forward, toting golf clubs and fishing rods. The accompanying article by Henry Fairlie, 64 at the time, excoriated over 65ers as being out for themselves and ready to bankrupt the […]

Why I Hope Not to Die at 75

I feel uniquely qualified to comment on Zeke Emanuel’s much-discussed article “Why I Hope to Die at 75.” I’m smack in the middle of the year he hopes will be his last. In addition, many years ago I wrote a book about health care organizational ethics with him (and Steven Pearson). I loved working with […]

Living in the Land of Limbo

This is not an impartial review. I’m a great admirer of Carol Levine’s work on family caregiving. Though we’ve never met in person, Carol has written seven terrific posts for Over 65. But despite my conflict of interest, I guarantee that if you read Living in the Land of Limbo: Fiction and Poetry about Family […]

Seventy-five Year Old Doctors Talk about Death

Here’s what George Eliot wrote in Silas Marner about how the elderly contemplate the prospect of death: “…it is often observable, that the older a man gets, the more difficult it is for him to retain a believing conception of his own death.” I observed the opposite at my fiftieth medical school reunion in June. […]

Robert Frost and the Decline of the Medical Profession

The title of this post is deliberately mysterious, but you’ll understand it at the end. At my 50th medical school reunion in June, my classmates agreed that while the goals of medicine are as valid as ever, the profession itself is in decline. Here’s a quote from the Preface to our reunion book: “A frequent […]

Overtreatment of elderly diabetics

The last time I was directly responsible for treating diabetes was fifty years ago, when I was an intern in medicine at UCLA. In my subsequent career as a psychiatrist I was not directly responsible for diabetes care, and as an individual, I don’t have the condition. As a result, I haven’t kept up on […]

Arnold Relman: 1923 – 2014

Dr. Arnold (“Bud”) Relman died yesterday at 91. He was the most esteemed leader among those who have been dismayed by the commercialization, fragmentation, excessive cost, and relatively poor quality of the U.S. health “system.” In 1980, as editor of the New England Journal of Medicine, Bud sounded the alarm about a danger he fought […]

Why I won’t test myself for the Alzheimer’s gene

A recent survey of 1200 adults found that Alzheimer ’s disease (AD) is the most feared disease among older Americans, with 44% identifying it as their biggest worry. Cancer was second, with 33% fearing it most. Over 65ers will not be surprised by these findings. Given the high level of fear, it’s natural and inevitable […]

Albert Schweitzer’s Advice about Aging

A friend recently quoted a saying from Albert Schweitzer that was especially meaningful to him as he approached his 70th birthday: The meaning of maturity which we should develop in ourselves is that we should strive always to become simpler, kinder, more honest, more truthful, more peace-loving, more gentle and more compassionate.  This advice captured my […]

A Caregiver’s Near-Suicide

An article on “caregiver burden” in the March 12 issue of JAMA (Journal of the American Medical Association) opens by describing a painful, nearly fatal, situation: Mrs. D, at 84 years of age, was the primary caregiver for her functionally impaired 86-year-old husband and shot herself 3 times in a suicide attempt. Mrs. D’s family […]