A Memo to Pro-Lifers

Rather than take an adversarial position, those who are Pro-Life could adopt a more proactive approach, one that would advance their cause. Their understanding is that life begins at conception. Consequently, from their perspective any induced abortion constitutes murder and is illegal.

It follows that the first thing to do, is to do everything possible to prevent an unwanted pregnancy. Therefore, the first step in the Pro-Life agenda would be to promote the use of contraceptives. Make all forms of them available to those women who at this stage in their lives do not want to have a child.

One important way for Pro-Life advocates to accomplish that would be to set up and fund clinics to help women (and men) who do not want to have a child to get whatever form of contraceptive they prefer and to provide the funds necessary to accomplish that objective. In that way, Pro-Lifers would significantly help. Fewer women would be placed in a position where they would choose abortion as their best option.

Since that would not prevent all unwanted pregnancies, the next step would be to provide counseling at the clinics. It would inform pregnant woman about the costs and benefits of various procedures, including one which the clinic provides: to assist her through all stages of the pregnancy and the birth and to make arrangements for the infant’s adoption once it has been successful delivered. All costs, including the support of the woman during the pregnancy, would be covered by the Pro-Life group.

The group’s objective would have been met. Once the child is born it would be placed in a family that wanted it. An induced abortion would not have happened. This Pro-Life approach would have prevented that from happening. Moreover, the pregnant woman would be less likely to be placed in a position where she would consider an abortion as her best option and she would be fully supported during her pregnancy. Along with that she would know that the child would be well taken care of. It has the additional advantage that a family that wanted and would otherwise not have a child, has one. In addition, the Pro-Life advocates were instrumental in making that happen.

It will lead to fewer women who consider abortion as their best option. Moreover, whatever time, energy, resources and funds (TERF) that the anti-abortion advocates commit to the program will further their primary objective. Furthermore, they are less likely to cause resentment and hostility and to alienate others in the process.

Aging is Isolating

If These Old Hands Could SpeakAging is isolating. Friends move away, effectively disappear, or die off. Others drift out of the relationship. We spend less time together. The younger ones appropriately have their own agenda. It is their time to take care of themselves. Furthermore, they may have already learned what we have to offer. It’s time for them to move on and build their own life experience. Moreover, things have changed since you and I were their age, in some ways drastically. Consequently, some of the things we have to offer them are less relevant.

So what can we do? How can we address aging? One thing is certain, our time here on Mother Earth is limited. Since that is part of our reality, one thing each of us can do is do our best to take care of ourselves. By doing that we will be less of a burden on others and less of a drain on society’s resources. Another is to pay attention to our limitations. We can’t do everything and certainly not as much as we used to. I can certainly vouch for that.

We can start by admitting to ourselves that we have a finite time left here on earth. Each of us has skills and experience. We can use them to the best of our ability to take care of ourselves and to continue to make a contribution. It is a good time to decide what is important, to figure out what we really want to accomplish in the relatively brief time we have left, and what we would like to be remembered for.

Think seriously about your relationships with others. Do you have any issues with those who are still alive, where by doing or saying something now could make a difference? We can all start by acknowledging our errors. And perhaps saying, “I’m sorry. What I did was inappropriate. I certainly didn’t intend to cause you any pain or harm.” Those are some of the things each of us might consider doing while we are still alive. This is not just good advice for the old, really none of us knows how long we will live.

In that way, when we leave, and trust me we will, our departure will make things easier for those who we leave behind. 8033522652_97090eabda_oAging is part of a larger process called life. If we go through it, we are the lucky ones.

Aging brings along with it some other things. We are less mobile, feebler, more likely to forget and less able to take care of ourselves. That makes us more of a drain on others, on their time and energy. It also makes it harder for us to take care of ourselves. If others choose to devote some of their time and energy to support us, the least we can do is say, “Thank you.” It is important to remember that the care provided in our declining years also places a greater drain on society’s limited resources. For example, it leads to fewer resources being available for children’s education, for developing new ideas, or for anything else. Hopefully, each of us has put enough funds aside to reimburse those for the services they provide.

I find myself sleeping longer, taking more time to do things, and making more errors. How about you? All that takes time away from our limited time — the 24 hours in a day. That includes the time involved in maintaining contact and communicating with others, in maintaining relationships. I realize there may be a time when I can no longer drive. In order to get together, friends must come to see me. That will further limit contact and contributes to the isolation.

It is harder to make new friends. There are simply fewer people around with common experiences. My friend Jeanne is five years older than I. In our phone conversations we treasure the fact we can discuss the “good old times,” including the songs we share. Younger folk often have no recollection of them.

Often us older folks are not familiar with today’s ways of doing things — including the new ways of staying in touch, of communicating. When we grew up we did not have computers, cell phones, iPhones or smartphones. They simply did not exist. When you called someone, either the phone rang and rang; or you got a busy signal; or they answered and you spoke to them saying who you are. You talked to a real person. Today, more than likely, you are talking to a computer. It pretends to be listening and has its own preprogrammed way of doing things. How frustrating and time-consuming that is. It takes away from your limited time and energy, often without successfully accomplishing what you intended, leaving the problem unresolved. Boy, is that frustrating.

Here’s another example. You decide you want to give someone a call. You can’t remember their phone number. The old way of looking it up in the phone book doesn’t work anymore. They’ve moved and kept the old number. The area code tells you they are living in Richmond and you know they live around the corner. Oh, you forgot, they now carry their phone with them. Unlike the old days. Now you know who I am without my saying anything. You know where I am, but I have no idea where you are. Or, the only way some people communicate is by e-mail. That’s no help. You don’t have, or can’t use a computer, an iPhone or a smartphone. Perhaps you call and all you get is their answering service. Apparently they never check it. In any case they never get back to you. Even if you’ve heard about texting, you don’t have the equipment or the know how. It’s all so complicated, so frustrating. From your perspective it is a waste of your time, draining and unproductive. It contributes to the feeling of isolation.alone

Those are just some of the hassles of being an older person living in today’s world. They create obstacles even when you have no infirmities or disabilities. As we get older, as with any other complex machine, the system is likely to breakdown. The longer we hang around, the more likely that becomes. Add that to the mix, and things become even more complicated. It is harder to achieve our objectives or even to take care of one’s self. In fact, that may even become impossible.

All that, as well as the realization of it, leads to one conclusion, “Aging is isolating.”

Stepping back, however, there is a bigger picture. The fewer relationships we have — that is what isolation is all about — the less of an impact our dying will have on others. By pulling back in the relationship with us now, others are effectively going through part of their grieving process. That is only true, however, when they have already dealt with any “issues” that they have in their relation with us older folks who are still around.

Think Before You Say “Yes”

Last August I talked about the Cost of War and how taking it into consideration beforehand improves our understanding and choices. In this post I would like to show how those deliberations help in our day to day decisions as well.

When someone asks you to do something — anything — think before you say, “Yes”. As adults our primary responsibility is to take care of ourselves first. That involves providing the basic inputs required to survive. It also includes fulfilling any commitments and obligations that we have taken on including the tasks involved in every day living. Either we perform the required tasks ourselves, provide goods and services to others in exchange for the ones they provide us, or earn the income necessary to purchase them.

Regardless of how we get those goods and services, what we use up is our own time, energy, resources and funds. Let’s call it our TERF. Since there are only twenty four hours in a day, the amount of TERF each of us has available is limited. Survival requires that certain things be done first including making sure we have enough of the basic inputs — clean air, fresh water, food, rest, clothing and shelter. Providing for them is our primary priority. That always requires a certain amount of our TERF. Another priority is allocating the TERF required to fulfill any commitments and obligations we have taken on. They include those involving our spouses or partners, having and raising children, taking care of sick or aging parents, friends or animals, etc. Here again, each of them requires more of our limited TERF.

Continue reading “Think Before You Say “Yes””

Should I Enter a Clinical Trial–Part Four

What to Consider Before Deciding

choiceIntervention is frequently based on the medical and public perception and assumption that doing something is better than doing nothing. That is not always the case. There are times when the net benefits of all interventions are negative — that is, anything you do will make you worse off.  Rather than starting with the underlying philosophy, “You/We should be able to do something that will fix it” begin by asking what are the likely benefits and costs of each of the alternatives. Then chose the one where the net benefits — the benefits minus the costs — are likely to be the greatest. Take no action when that provides the best results.

When the patient/consumer is not paying for the service, he/she is placed in the position of not having to consider what they are giving up when having the procedure. When that happens they are more likely to elect to have more services than they would if they had to pay for them. Historically, that goes under the name “Moral hazard”. Moreover, the prescribing practitioner and the PhysicianFirm almost always benefit from the additional revenue they receive from providing those services. Often it is someone else, like an insurance company or the government, who ends up paying the bill. Continue reading “Should I Enter a Clinical Trial–Part Four”

Should I Enter a Clinical Trial–Part Three

An Example of What Happened

We would like to provide a concrete example about the consequences of participating in a clinical trial. It is based on Amanda Bennett’s The Cost of Hope. She is a fine journalist and currently Executive Editor of Projects and Investigations at Bloomberg News. The book documents her husband, Terence Foley’s, seven year bout with kidney cancer. Initially, Foley was diagnosed with an atypical and aggressive form — collecting duct kidney cancer. It was spotted in December 2000 during the operation to remove his intestines to treat his ulcerative colitis. There were only 50 known cases of it worldwide at the time. This alone makes questionable whether his participation in the clinical trial contributes to our understanding of the potential benefits for future patients. In January 2001 when it was diagnosed, the prognosis was that he had a few months to live. [Bennett, p. 66] He died of it seven years later in December 2007. Continue reading “Should I Enter a Clinical Trial–Part Three”

Should I Enter a Clinical Trial–Part Two–The Beneficiaries

The Beneficiaries

It is at best uncertain whether you or anyone else currently in your condition will benefit from your participation in a clinical trial. If the trial is successful — and as we have mentioned earlier not all of them are — and the drug or appliance is cleared for marketing, some of those who get a similar condition in the future may benefit from it. Your participation is your legacy to them. But the important question is, “Who benefits now?” That is particularly relevant since large amounts of time, effort and money go into clinical trials. Someone must believe the investment is worthwhile. Let’s take a look at each of the stakeholders.

The stakeholders

Those conducting trials are stakeholders in it. They benefit from it. They include:

  • The doctors and other practitioners involved.
  • The organizations and institutions they are a part of and represent– the Medical Centers, Hospitals, Universities and PhysicianFirms.
  • The pharmaceutical and medical equipment companies whose products are being tested and who sponsor the trial whose self-interest is definitely connected to the success of the project.

The principal investigators — a.k.a., the lead doctors — have their reputation on the line. The study is based on their hypothesis. If the clinical trial turns out favorably, they can say, “See I was right!“ Not only is that a boost to their ego, it enhances their reputation and all that goes along with it. If successful, they get to publish the results and present the findings at national meetings. Moreover, it enables them to test out their ideas, to get funds for their projects and it increases their income as well. Those personal benefits contribute to their wanting you to participate and, perhaps, inadvertently encourage you to do so. That is particularly true when the number of possible candidates for the clinical trial is limited, and the lack of participants threatens the validity of the results or even makes it impossible to conduct the trial. In fact, the possibility of being pressured to enroll has led to the requirement that in order to participate in a clinical trial you must sign a form indicating that you are giving your informed consent. Continue reading “Should I Enter a Clinical Trial–Part Two–The Beneficiaries”

Aging

george-booth-i-would-embrace-the-aging-process-if-i-could-lift-my-arms-new-yorker-cartoonMy Mom, when she was 80, said to me, “Bernie, I wish I was 20 and knew then what I know now.” My response was, “Mom, That’s a contradiction in terms.” Perhaps by sharing my experiences and what I have learned from the time I was 20 until now can help others. Just to prove I’m keeping up with the technology, from time to time I post my experiences on this blog. Trust me, when I was growing up we didn’t have blogs! In the following series of posts on aging, I’ll tell you about some of the issues I’ve faced and how I’ve dealt with them. My hope is that this series will help you, no matter what your age, to understand some of the challenges older folks, like me, have.

Aging is isolating. It’s harder to get around. Friends die off or disappear. Your energy level ain’t what it used to be. You can’t do what you used to. Much of the new technology leaves you behind. Even though I use a computer and even have a blog, I never learned to text or twitter. I-Phones with their Apps are too difficult to deal with, even if I could afford one on my limited budget. People don’t talk to one another now, not the way we used to. Instead of picking up the phone they e-mail or text, and I don’t use a cell phone except for emergencies. Moreover, younger people have their own lives and appropriately, their own agenda. Continue reading “Aging”

The House I Grew up in

bernie's houseAbout a month ago Grace Camblos, a biographer, photographer, and author, invited me to participate in a four week memoir writing class.  One of the “prompts” she gave to us was to write about, “The house I grew up in.”

I remember it well. The address was 144-15 33rd Ave., Flushing, Long Island, NY. We moved there in about 1938. It was a two-story house with a finished attic and basement and was the third of three houses on the block. They were the first of many, built by Abraham Levitt, who went on to develop Levittown on Long Island and in Pennsylvania.

I was 14 in September of 1942 and I just got back from eight weeks at Camp Man, the Queens County summer Boy Scout camp, at Ten Mile River in upstate New York. It was a Monday morning and the High Holidays had just begun.  My grandmother’s room was just next to mine at the head of the stairs. I got dressed and was heading off to school — to Fieldston. As I passed my Mema’s room, her full-time nurse came out and said, “I can’t revive her.” We went into her room and turned her over so she was face down with her head to the side. I climbed on top of her and rhythmically pressed down on her rib cage administering artificial respiration 1940’s style, that I learned how to do as a Boy Scout.There was no resistance, no push back. Her body did not respond to the pressure. I could not revive her. Reality struck. I felt the difference between life and death. I felt it in my hands.

Continue reading “The House I Grew up in”

Thinking About How You Spend Your Time

Enshi-girl-with-teaTime is a limited resource. There are just 24 hours in a day. No more, no less. All mammals must consume the basic survival inputs — clean air, fresh water and food, resting and using clothing and shelter. Time must be spent gathering, preparing or producing the food and other inputs, in making them ready for consumption, and in cleaning up afterward. Whatever time is not spent on those activities is available for other things.

If you are not directly involved in making any of those inputs, someone else must do that. In order to compensate them for the time, effort and other resources they spent in the production of inputs and making them ready for your consumption, you must use some of your left over time to create an income — either as physical outputs or their monetary equivalent — to pay for the goods and services they provide. That enables you to compensate them. Otherwise, you are expecting or getting a gift from them.

You’ve heard of discretionary spending. It is buying things after you have taken care of the necessities. The same thing goes for time. Once you’ve utilized your time to take care of providing the basic inputs, you have the opportunity to allocate the balance of it to those other things you want to do most. But the available time is limited. Every hour you spend on anything, you are giving up the possibility of using it for something else. Typically you have a number of alternative ways to spend the next hour. Some are more important than others. Clearly, spending time on the basic necessities comes first. After that, then what? Continue reading “Thinking About How You Spend Your Time”