A Modest Proposal To End The Terror

The liberal world is looking for a leader, or a new group of leaders. The sclerotic leadership of Schumer et al. is a dead world of marginal players and marginal thought. The younger group of Democratic politicians has much to offer, many smart and dynamic personalities with some more populist, some more security-minded, but so many fresh and vibrant. They are kept bottled up by seniority and mediocrity and money-raising and cries for moderation in chasing the sliver of middle voters who will deliver margins of ten in the House and two in the Senate.

Meanwhile, true fascism has come out of the shadows with a shallow and cruel and malignant and acquisitive Trump and Trump-like formerly shadowy figures prompted to show themselves in daylight and flaunt their cruelty and racism and sexism while cashing in. Ordinary citizens are being terrorized by concentrated bands of thugs with hidden badges and hidden faces and hidden motives and obvious cruelty and there have even been public murders. Public Murders!

It is time to uncork the righteous. Young Turks must become the new leaders by seizing power in the Democratic party; it won't be given to them, because power never is. Seize upon events, risk being called opportunistic and inflammatory. As if roving bands of ICE are not inflammatory. It's the resistance that inflames, those who protest their own victimhood? Really? That's always the way. The extreme perpetrators cry, “It's the time for unity, and for calm!” But on their terms. It's always on their terms. It is the righteous citizens who are to bottle up their fear and grievances, to be polite and to give way, not the perpetrators, so as to avoid civil war and weakness to external threats. Such self-serving bullshit.

What I suggest is that the righteous officials, the younger (except Bernie, who is eternally young in spirit, God bless him) vibrant officials organize themselves right now. Don't say “it's up to the people now.” The people are doing their job, in sub-zero weather and in snowstorms, they are doing their job. The Amy Klobuchars of the Democratic world can't say the same; they are safe indoors demanding answers and writing sharp letters and calling the White House to say “stop.” What bullshit.

The younger righteous officials, the Eric Swalwells and Robert Garcias and Jamie Raskins and Ruben Gallegos and Abigail Spanbergers and Elise Slotkins, and Chris Murphys and Jason Crows – and so many others – they should be manning up. Fly to Minnesota in your snow and cold gear, and lead marches as the people shut the town down in general strikes. Lead marches of solidarity in other areas all over America, from Lahaina to Portland, Maine, calling to shut ICE off. Stop the Murder! Stop the Brownshirts! Stop the Terror! Shut down town after town in general limited strikes until the terror stops.

Picket the White House 24/7, all led by officials, with all the willing citizens following. Teach-in – let the orators who can do it, the antitheses of Schumer, make the case. Take it to them. Let the terrorizers worry about civil war. We won't stop until the terror stops. No More Murders! Impeach Christy Noem.

It's time to cut the Gordian Knot.

Budd Shenkin

Notes on Aging, by Carol S. Wolman, MD

My classmate, friend, and first year med school anatomy partner, Carol Wolman, read my last post and called our attention (mine and our other classmates) to this wonderful handout that she passes on to her patients.  She gave me permission to reprint it here.

NOTES ON AGING    
by  Carol S. Wolman, MD

Many people in my psychiatric practice are concerned about aging.  It may because of a milestone birthday-  50, 60, 70.   It may because of an injury or new physical weakness, or because of memory loss.

Since I am older than most of my patients (83 in June 2024), I have already experienced much of what you are concerned about.  I’m a pioneer in the unknown territory of aging, a guide to those embarking on this adventurous journey.  

 
I’ve put together a set of observations that some may find helpfu    l.  Please email me with any questions, or additions to this list.   
 

Here we go:
“Consider the alternative.”  This is a cliché, meant to console.  For people suffering from depression, it may be encouraging.  But in my experience, it is easier for people to talk about death, which is an a fantasy outside of life experience, than about aging, which is ongoing reality for all of us.

Congratulations, you’ve made it this far.  You’re a survivor.  You must be doing something right.   Celebrate your birthdays.

Attitude is everything.  If you resent aging, it adds to wear and tear.  If you become depressed, you can easily slide downhill.  

Survival, of both acute and chronic illness, is heavily dependent on the will to live.   What keeps you going?   Loved ones, an activity, a sense of purpose, meaningful work, your faith?  Hold on to it; it will see you through crises of all sorts.  Your life matters.  

If you get sick, don’t assume that this is the end.  You can recover from most infections and many cancers, with proper treatment.  

Do what you need to do to stay healthy- get enough sleep, eat healthy, exercise as you can.  If your ability to exercise is limited, try yoga, t’ai chi, or swimming.  Simple walking is available to almost everyone.   

Accept the disabilities and pain that go along with aging.  Resenting them, ignoring them, becoming anxious or depressed about them only adds a layer of psychic pain.  One cannot weather “the slings and arrows of outrageous fortune” for all these years without something going wrong.  Just as the warriors of old were proud of their battle scars, so be proud that you have won the battles that have come your way, and lived to tell about them.

You are a survivor.   As you age, friends and relatives will die around you.  Perhaps you are lucky; more likely, you have taken good care of yourself, and the people close to you have also taken care of you.  Cherish your own good sense and the love of those dear to you.  Grieve for those who have died, but embrace your own life.

When someone close to you dies, especially your life partner or a child, you are vulnerable for a while.   Often, if one spouse dies, the other follows within a year.   It’s as if you are being called from the grave, and life is no longer worth living.  You may need grief counseling.  Memorial services are helpful by putting a closure on the loved one’s life.  Concentrate on your will to live, and the activities that make your life worthwhile.   

Don’t hesitate to talk about your health problems with other old people.  With time, most of us have surgeries, hospitalizations, doctor visits and medications.  It’s normal to share these experiences with others who are going through similar ones.  Younger people don’t necessarily want to hear your stories- save them for your peers.

Experience leads to wisdom.  You’ve been there, done that.  You needn’t fear complications, you’ve dealt with them before.  You know your strengths and weaknesses.  You are much more likely to put things in proper perspective, make wise choices.  You understand and apply the serenity prayer:  God, grant me the serenity to accept the things I. cannot change, courage to change the things I can, and wisdom to know the difference.

Take each new difficulty as a challenge, a puzzle to be solved.  

Are you going deaf?  There are cheap hearing aids now.  Are you forgetful?  Write things down, repeat things you want to remember to yourself several times, place objects in obvious places to remind yourself- eg, your purse or backpack by the door.  There are lots of workarounds.

Do you have aches and pains?  Ibuprofen with food works miracles and won’t hurt your stomach.  See an MD if something is seriously wrong, but take responsibility for understanding the illness and doing whatever is necessary to overcome or manage it.

Live until you die.  As we age, we have less time ahead of us.  When we are young, the future stretches out endlessly.  Now we know to value every day, finish unfinished projects, do the things we never got around to doing.

Computers appeared during our lifetimes.  We were not weaned on them, given them to learn and amuse ourselves, as is true of younger people.  Learn what you can, but don’t agonize if you get stuck.  Find a friendly tech person- eg, a younger family member, to help.

Give up pride and vanity.  If you need a cane, use it.  Be yourself, warts and all.  At this point in your life, you don’t need to apologize for who you are.

It’s normal to do a life review as you age.  Looking back, you’ll have remorse, regrets, pride, happiness and sadness, love and enmity.  If you have unfinished business with someone, take care of it.   If you need to make amends, do it.  If you have unfinished projects, complete them as best you can.  You probably have some regrets- most people do.  Nobody is perfect; accept yourself, past and present.   

Stay in touch with young people and children if you can.  Enjoy your grandchildren- they help you stay youthful.  Try to understand the difficult world they are facing.  Tell them stories about your life.  Don’t talk about your medical problems unless they are helping you with them.

You are only as old as you feel.  Your body is aging, slowly wearing out, but your mind and spirit are ageless.  Keep your mind active and sharp.  Stay current with current events.  Play games that challenge you.  Learn a new skill.

Stay in touch with friends and family.  The internet makes it easy to find long-lost friends, and renew the tie.  Old people can become isolated; your social network is important.

Allow yourself to depend on others when you need to.  As we age, we have less energy.  We may need help with getting places, shopping, cleaning.  Don’t be too proud or ashamed, ask for what you need from the people you are close to.  

Don’t worry about ageism.  There are people who shun the elderly or look down on them.  These are people who categorize by race, sex, age- they are not worth worrying about.  

Enjoy life- it is a priceless gift.  


 

My Friend David And I Have Gotten Old

I called my stepdaughter Sara on my way down to the Peninsula to see David. She asked me if I had any feelings, any hesitations about going down to see him, as I started over the Dumbarton Bridge. It was a clear day after all the days of rain coming from the “atmospheric river” from Alaska, I guess. Clear, but cold. No, I said, no feelings, but you know I don't anticipate feelings much, I just get them when I get there. I'm really good at denial, and really bad at planning.

Yes, she agreed.

Denial is what gets us through life, I said. People shouldn't knock it.

It was yesterday that David and I walked down in the evening from my freshman dorm at Harvard, the newly converted apartment house called Pennypacker, over Mass Ave and down to Elsie's for a roast beef sandwich. We sang as we crossed the street. It was still September, I think, maybe early October. We hadn't known each other until about a day or two before we left Philadelphia for Cambridge. David had been at Episcopal Academy right on City Line, the very same institution that years later would spring John Yu upon the world, but these days it's pretty clear that you can't blame institutions for the dreck they produce – look at Tom Cotton, for instance.

David was a little taller than I was, with the most open, even wide-eyed open and welcoming face you could imagine on a WASP, which he most certainly was, and that wasn't helped by Episcopal, from the stories he told fondly, but which I received with hesitancy. He prized the faux-English-isms of his teachers. “I dread the day they raise teachers' salaries,” said one, “then every damn fool in Christiandom will want to be one!” Imagine, “every damn fool in Christiandom.” Episcopal was miles away from Lower Merion High, my alma mater, but at Harvard, we were both Philadelphians, who established a “Philadelphia table” in the freshman commons where we ate, long sturdy wooden tables where Lower Merion and Episcopal ate together, and brought others in our orbit there regularly. “Where do you eat, Al” they would ask a new friend of ours from Cedar Rapids, whom I would visit the next summer for a night as my friend DiGi and I crossed the country and stopped there – imagine the excitement of the families as their new friends from Harvard – well, Digi was from U Michigan but still, it was the new friends from the East – as we rolled in and Al set us up with some of the girls from his class, for the one night we were there. Al, after all, was a denizen of the Philadelphia table.

That night we walked across Mass Ave and we sang. David had a good voice and some musical ability, which formed a great contrast to me, who couldn't and can't carry a tune, much to my chagrin. But, observed David, that's a shame, because he told me that I had a musical soul. I don't know about that. I grew to like jazz, but my roommate John and the guy from the next room over, Lowell Davidson, taught me the names of the current great ones, Miles and Coltrane and Milt Jackson and the rest, basically so I could impress girls.

I had been to Elsie's a few days before and the guy behind the counter, Smitty, was a toothy black guy who was a genius at making sandwiches with his cleaver in nothing flat while a crowd of students vied for his attention. I said to David, I kinda know Smitty, he's from Philadelphia, actually. Imagine Smitty's excitement and interest as the new freshman class appeared. 17 year old, 18 years old, so wet behind the ears, we must have been something to behold. Well, said David, I guess I know him, too, dismissing my claim. We got there and they weren't too crowded and we got close to the counter and I saw Smitty and said hi and he recognized me and gave me a big grin and said, How are you? How's it going? And David said to an unseen audience, He does know him! His admiration for me was immense – he knows Smitty!

I never stopped loving David. The most open, naive in the best way, sweetest guy you could ever meet, always admiring others, never angling for anything, but a wonderful English student and Shakespeare student and eventually he even had a named professorship at Stanford, where he has lived for probably 45 years or so. I think he went there straight from Harvard and just never left. I can't believe he was anything but loved.

I stayed in touch with David, even when I was in med school and he was in grad school. He looked at me then and said, Learning your craft! I hadn't thought of things that way, but I guess that was true. He had met and married Sue when he was in England, probably Oxford I guess, I'll have to ask her, and he lived in Adams House as Assistant House Master or whatever they were called and he told me, We're into coffee as he poured hot water into the paper cone to drip it into the carafe. I thought, that's not a lot to be into, coffee as your passion?

When he was down at Stanford, he and Sue and Ann and I got together a few times to go to plays, but then we gave it up. We all got along well, but the plays weren't great and I guess it usually takes the women to arrange stuff like that, and David and I weren't quite up to it. Women are supposed to run the social show, right? We did our best, and it was fun when we managed to arrange it.

I started a non-profit effort in medicine and I needed two other guys to be on the board. My friend Bob was one and David was the other. It was just a minor league effort but David thought it was a big deal so he insisted on making the drive to Berkeley to sign the papers and go out to dinner – I guess I should be doing the driving for this, he said. The Center for Responsive Health Policy. It was only a vigorous effort at the beginning, but we did manage to have at least one annual board of directors meeting with emphasis on the dinner. David said, Let's see who's responsible for raising money for this! Mocking the stuffy board member that he pretended to be. That was yesterday, too.

After I got off the Dumbarton Bridge I found the building fine, in Redwood City, a hospice converted from some other building. Nice, clean, painted well, attractive and subtle colors. Sue met me there. She is old and frail, too, very thin, quite deaf, using the app on the phone to present in print what her interlocutors are saying, walking with a cane, but vivacious, and so attentive to David. She has done volunteer church work – Church of England, I presume – all her life. So attentive. Brings mango juice from Trader Joe's. I remembered that was their favorite from when I visited the rehab center in the spring, when he was recovering from a fall. Late in the visit she poured some into his mouth and there was a significant amount that dripped down his beard from the corner of his mouth which I wiped away. It doesn't matter, Sue said. David was sleeping for my whole visit. I think he was zonked on Fentanyl. He gets a new patch every few days, Sue said, you can tell from his groaning that he needs it, and he's much better when he gets it. At the end of the visit I asked the aide how he was eating, and she said he has a good appetite. So I guess he still has some time to go. Sue had warned me that she didn't think he would be with us much longer, is how she put it, when I was arranging my visit by texting with her.

His two kids, both divorced, have wound up living back home with David and Sue, and even though they recognize the tragedy of that, David has loved having them back. They visit all the time, Sue told me.

So this is where he's going to die. It did hit me, as Sara knew it would but as I insisted in not anticipating. When Ann died four years ago, it was at home, and she had me and all the wonderful aides who came 24 hours for the last few months. She was in her own room where she had slept for fifty years, although now in a hospital bed, which was necessary. That's where she would die. It was the best option available. I imagine that David's is OK, too – lots of professional care, and I'm not sure if he minds that he's in an institution, I don't think so. He's in the memory care unit, and a brief glance at the common room ascertained that, with one lady with her head on a table that she was sitting at when I came and when I left, the young staff at a table in the center as though they were at lunch. Maybe they were, although I didn't notice a lot of food, maybe some.

We could never have imagined this as we crossed Mass Ave going down to see Smitty at Elsie's. Elsie's is gone, of course – I checked last time I was there. I guess David isn't into coffee much anymore – mango juice, now. Plus some other tidbits that Sue thinks are delicious. They obviously have gotten a lot out of sharing little things. I'm in a different world. I'm up and at'em most of the time. I drive out to the Lafayette Reservoir and walk the three miles around it in about an hour, and I'm at the gym several times a week, and today I walked 12,972 steps. I drive two cars, mine and Ann's, Ann's more now because it's lower mileage. I live alone. I don't know how I'll die, but my med school classmates, some of them, are making a big deal about how they are handling their transition to institutional living. They speak about it clinically, Karl encourages others that it can really work, but the hesitancies of others remain mostly unstated. So many people are staying where they are, the hesitancies don't need to be said, maybe.

It looks like I'm choosing to die at home, but that's not reasonable. Ann could do it because she had me. I could and maybe will get the same caregivers Ann had to help me, but then that's not really enough. When David and I were in Phllly we planned our move to Cambridge, but that was different. We were on the upswing. I didn't plan then what I would feel and what I would do when I was in Cambridge, and I didn't plan on what I would feel when I came down to Redwood City to see David, and I'm not planning now. The best I can do is clean up everything so the kids have as little to do as possible. Digitalize all the pictures on computer. None of them will be in a position to help me, and I wouldn't want to disturb their lives, that would be unreasonable. What I'm planning is to stay vigorous. I gifted myself a home theater for Christmas, and that has to tell you something. I'm thinking of trips to take – last year's trips were great, and I think I'm due a few more. I made a great friend last year, who has been a lot of fun.

I'm not planning, and I wonder if I'm even preparing. What's the difference between denying and preparing? I think they can work together. I sure don't over-prepare. I don't what to be in a place where when I come in I lower the average age. I keep myself in shape. David is going. My friend Lou is going – I can't even get in touch with him now, something has happened, he has Alzheimer's and is not well cared for. Neither my undergraduate roommate Arthur nor my first boss in the Public Health Service Don can walk. My lifelong friend and undergraduate roommate John has seen his treasured daughter finally die from her brain tumor, finally, of a brain tumor, and John seems to be recovering from it. Classmates die regularly. Thoughtful alumni associations want to help us plan our wills. I'm lucky I have kids and younger friends. Fucking time doesn't stop.

But last week I settled on a motto, two mottos really. “It's never over until it's over.” That's number one. Number two is, “accelerate into the tape.”

Are they mottos to be proud of, or are they denial?

Fuck it. They're both.

Just because I'm an atheist doesn't mean I shouldn't be able to say, I don't need to plan excessively, God will provide. That even has a public policy equivalent: I'll just muddle through. (Lindblom, professor at Yale, 1959.) I'll muddle through, I'll keep my energy up as best I can, I'll keep up studying because it seems that's what I like to do, I'll keep up talking to friends from all times in my life, from those I knew in kindergarten through those I met last year, and I'll keep trying to come up with good and interesting stuff. I'll keep helping others. I'll have fun! Sports! Walk and work out! Writing! Even travel! Keep posting on social media and emailing with friends! My precious family! Projects to help others and be politically active! Really, I've been so lucky, and still am.

And all through it, I'll also prepare to die. I figure the last months of decline I'll just have to wing it, as Ann used to say, one of her favorite expressions, but before that, I'll get as much stuff taken care of as I can, so that the kids are faced with as little busy work, throwing out work, figuring out what to keep work, disposing work, divving up work, all that horseshit you have to go through when somebody dies especially when you have to sell the house. All that stuff I'll try to do what I can, better take care of it sooner or later, because no matter how much I love to deny and just carry on, I really know that it's just a tactic what I'm doing, and I've been lucky so far, but don't push your luck, as Ann would say, don't push it.

Budd Shenkin