Integrity vs. Despair

 

I've been pretty unconscious about it. Since I've passed 80, unimaginably and contrary to all expectations – mine, anyway – and since my wife has passed on – unexpectedly, despite her long illness, I never expected her to die on me – since I've passed 80 and I'm living alone, although I have friends and family I retire to our house where I am alone with my computer and my television and my refrigerator and several bathrooms, I now proceed through each day with some idea of where I'm going, what tasks to accomplish every day, because I do insist on accomplishing something everyday of either urgent or long-term implications, even if it's just putting some stuff in order that I've been wanting to do, and I don't plan a lot of the rest of what I do. It just kind of happens, in a way, although it all seems purposeful.

So it seems I'm seeking my past and in a way stitching it together, not respecting time very much at all. I'm reaching back to the different parts of my past, the people in my past, and some of my past activities. My past activities seem to be centered on my pursuit of learning and my school days. I take French, study it each day, read French books and love it, I lie in my bed and read and underline and I study French on my computer and I write little notes like this, and I write a chapter of my French novel each week – up to chapter 286 this week. I love my characters in the novel. Who would have thought that that's what I would do?

And now I take advantage of my own and my contemporaries' longevity and the abolition of long-distance charges, reminding me how much of a curse AT&T was, years of high charges and stagnation. It's actually amazing. My past is studded with friends who still exist and who will still talk to me or write to me. My oldest friend is my brother Bobby whom I have known since I was 2 years 8 months old, although I don't remember when we met; according to me, he was just always there, a little bit smaller than me. Then there's Bob Levin, from kindergarten, John Raezer from nursery school originally, and then he was my high school friend where he was a God and then roommates in college and friends ever since. My high school friends, a bunch of them, Lynn Sherr whom I love to introduce as my friend for the last 65 years, Jonny Fish who lives nearby and Jon Gross from fifth through 8^th grade and then high school, and my med school friends, lots of them now, and Tom Uridel and Jim Perrin from the Public Health Service, and so many more contemporary friends from practice from the neighborhood from book club from our new friends in Maui and so much more.

It's like jewels on a belt of time that you can lie out flat and see the periods, and rub whichever jewel you want, or roll it up and then the different times are right beside each other.

They say that you take stock of yourself at my age.

Integrity vs. Despair – According to Erikson, the last psychosocial stage is Integrity vs. Despair. This stage includes, “a retrospective accounting of one's life to date; how much one embraces life as having been well lived, as opposed to regretting missed opportunities,” (Erikson, 1982, p. 112).

So you do, or at least so I do, but it's not as serious as all that, and it's not mournful – well, maybe a little – it's more grateful than that. It would be even better if I could revisit the women in my life – I wonder what happened to those women friends in Sweden, when I was so desirable but so confused, but also very fulfilled. I'd love to see them again. I really should go back there and visit Annika, although I'm lacking an invitation.

But what I wanted to mention was the conversation that I had a few days a with John Wesley, a friend from Leverett House in college and from med school. I called him out of the blue – why not? I have his number in my contact list and, as I said, calls are free these days, amazingly, and we have the equivalent of Dick Tracy's wristwatch radio, called a cell phone. I talked to one of my college roommates, Arthur Freeman, last week, he just up and called me, on Raezer's urging. We talked for an hour and 45 minutes, picking up where we left off, although it's been about 60 years. We had to catch up.

But in talking to Wesley, he reminisced about being a resident in surgery at the Mass General and his fellow resident was John Erdman, another friend from college and med school both, who committed suicide as a young doctor. There are various theories, I guess, and I don't know the facts, really. I did hear he plugged himself into an IV and infused something fatal as he lay on a gurney. But the story John told, with a humorous lilt in his voice, strangely, was how their chief resident demeaned John in front of all the assembled residents for not knowing some basic data, the hematocrit, of one of his patients. He said something about “Sweet baby Jesus” having a task for everyone and if everyone doesn't do it then it doesn't get done. A public putdown. John thought it was charming and funny, somehow. But I can imagine the emotion Erdman must have had, and the fact that he later did himself in, and I can't help but connect them, and I can't help but think of the inhumanity of the hospital setting for trainees, just when the tension is so great and the relief and support so needed. I remember the small provocations I experienced. I think of what my med school friend Larry Kadish just related last week in our Humanistic Medicine Initiative discussion, when he was serving a medicine rotation as a resident and a new patient was admitted from the ER and turned up on the ward dead. Here's the way Larry put it:

Although I had a surgical internship, every surgeon in our program had 2 months of medical rotation. My rotation in medicine started July 1st.  My first patient had an MI and was sent to the medical floor from the ER.  I examined him as soon as he arrived, but he was dead.  After informing the family, I called the second year resident to inform him.  He said I was lucky to have a Q-C.  I should go to bed.  A Q-C was a quick cool.  So much for humanistic values.

I guess that qualifies as taking stock of myself, or ourselves. I figure that our HMI, seeking to help students appreciate and solidify humanistic medical values and activities, is part of reassessment, taking account, and then doing what parents do when they lose a child, try to prevent others from suffering our fate if it can be avoided. Look back and repair, if not for yourself (time's arrow takes care of that), then for others. In our case, help the current students to at least understand the pressures they will be under to lose their humanity as they become professionals.

But it's not all grim, unless I dwell on my failures and embarrassments, which are so many. But I do have my strengths, which might be overrated, but it's pretty amazing how time has continued, and how I can make a claim to a successful life, even in terms of helping others, which I suspect of conventionality. But there it is.

I guess it's no sin to be conventional.

Budd Shenkin

Newsom Could Sharpen His Defense Of Biden's Age

I caught the last part of last night's Newsom-Desantis10-rounder, a worthy undercard for what's perhaps to come. I don't like these face-offs much, dispute for dispute's sake, don't stick to the question, no premium on clarity, and Hannity is a disgrace – tilted questions that weren't even disguised. But given the form, Newsom is formidable, and Desantis was persistent in his execrable opportunistic right-wing lying points.

But as strong and prepared as Newsom was, he could have done better on the Biden-age thing. Hannity and Desantis both harped on the “obvious truth” that Biden isn't what he used to be. Newsom replied that he has been a terrific President, getting so many things right. Which is true, but it isn't quite direct enough, to my mind. It doesn't spell it out. I spell it out in my post here, but here's a shorter reply that Newsom could have adopted, and that other Dems should adopt as the campaign progresses.

The best answer to that is this: right! Of course he isn't! We all change, for the good and for the bad, all the time, as long as we're alive.

But it's a balance. You get better at some things and worse at some things. As you get older, your numerical calculation skills decline – it's hard to divide and multiply in your head. But, you also get smarter with experience, you gain in wisdom, you've seen a lot more. When you're young you might have more energy – although Biden is still tremendously full of energy, just look at this schedule, what he's done around the world as well as at home! But when you're young, you don't know as much, you haven't been around the track as much, you are more impulsive, less patient, you have gained less wisdom.

Reagan was right in his debate with Mondale – he vowed not to make an issue of how untried and inexperienced Mondale was.

Who knows more about government and getting things done than Biden? Desantis? GMAFB. Who knows more world leaders over more years – an indispensable advantage in foreign affairs – than Biden? For that matter, who knows people all over the country, and understands them?

Yes, Biden's walk has become stiff; there is some arthritis, no doubt. He sometimes has trouble with words – but that's not new, and in the end, it doesn't matter. He's still sharp as a tack, he's still solid in his values, he knows how to be patient and go one step at a time, but he also knows how to act at the right moment, to be decisive, to be sharp and on point and seize the day. He still knows how to relate to people in and outside of the governing process, and that is indispensible.

On balance, he's better than he's ever been, and we're so lucky to have him.

Budd Shenkin