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How Much Life is Enough?

May 15, 2017 Leave a comment

Editor’s note: Amitai Etzioni is a sociologist and professor of international relations at George Washington University and the author of several books, including “Security First” and “New Common Ground.” He was a senior adviser to the Carter administration and has taught at Columbia and Harvard universities and the University of California, Berkeley.

(CNN) — No one has come out yet and explicitly suggested that old folks like me (I am about to turn 83) should be treated the way the Eskimos, as folklore has it, used to treat theirs: put on an ice floe and left to float away into the sunset. We are, however, coming dangerously close.

A recent study by Dr. Alvin C. Kwok and his colleagues finds that surgery is common in the last year, month and week of life. Eighty-year-olds had a 35% chance of going under the knife in the last year of their lives; nearly one out of five Medicare recipients had surgery in their last month and one in 10 in their last week.

Nobody doubts that some of these surgeries were necessary. But major medical and ethical figures argue that they reflect our reluctance to accept death or let go, the surgeons’ activist interventionist orientation and the way the incentives are aligned.

As the surgeon Atul Gawande put it in The New Yorker: “Our medical system is excellent at trying to stave off death with eight-thousand-dollar-a-month chemotherapy, three-thousand-dollar-a-day intensive care, five-thousand-dollar-an-hour surgery. But, ultimately, death comes, and no one is good at knowing when to stop.”

It remained for Daniel Callahan, an influential bioethicist and co-founder of the prestigious Hastings Center, a nonpartisan bioethics research institute in New York, to take the next step. In a May article in The New Republic, Callahan (with co-author Sherwin B. Nuland) argues for a cease-fire in America’s “war against death,” calling on us to surrender gracefully; Americans thus “may die earlier than [is now common], but they will die better deaths.”

Focusing on care for the elderly, Callahan and Nuland warn that our present attitudes “doom most of us to an old age that will end badly: with our declining bodies falling apart as they always have but devilishly — and expensively — stretching out the suffering and decay.” They hence call on us to abandon the “traditional open-ended model” (which assumes medical advances will continue unabated) in favor of more realistic priorities, namely reducing early death and improving the quality of life for everyone. They further advocate age-based prioritization, giving the highest to children and “the lowest to those over 80.”

The journalist Beth Baker summed up this position: “After people have lived a reasonably full life of, say, 70 to 80 years, they should be offered high quality long-term care, home care, rehabilitation and income support, but not extraordinary and expensive medical procedures.”

Baker’s interview with Callahan reveals one reason this line of argument should be watched with great concern: Once we set an age after which we shall provide mainly palliative care, economic pressures may well push us to ratchet down the age. If 80 was a good number a few years ago, given the huge deficit and the pressure to cut Medicare expenditures, there seems no obvious reason not to lower the cut-off age to, say, 70. And nations that have weaker economies, the logic would follow, should cut off interventionist care at an even younger age. Say, 50 for Guatemala?

Above all, age is the wrong criterion. The capacity to recover and return to a meaningful life is the proper criterion.

Thus, if a person is young but has a terminal disease, say, advanced pancreatic cancer, and physicians determine that he has but a few months, maybe weeks, to live (a determination doctors often make), he may be spared aggressive interventions and be provided with mainly palliative care. In contrast, an 80-year-old with, say, pneumonia — who can return to his family and friends to be loved and give love, contribute to the community through his volunteering and enjoy his retirement he earned with decades of work — should be given all the treatments needed to return him to his life (which in my case includes a full-time job and some work on the side).

We should learn to accept death more readily; we should stop aggressive interventions when there is little hope; we should provide dying people with palliative care to make their passing less painful and less traumatic. Such a case may not just be that of an elderly person succumbing to a terminal illness — it can be that of a preemie born too early to survive, a youngster following a car wreck, a worker following a tragic accident. We should learn from the Eskimos — they long ago stopped abandoning their elderly just because they got “too” old.

Living on Chemicals

April 28, 2017 Leave a comment

The pharmaceutical companies encourage us to do things we ought not to do. If you get heartburn from spicy chicken wings, don’t worry. Just gulp Pepto or pop Zantac and indulge your addiction. Eat wings, eat pizza, eat salami… it doesn’t matter, because there’s a ‘medicine’ for that.

You like to jog, but your knees make you suffer. Pop a couple of Naproxen, and off you go. Just ignore the fact that whatever is going bad in your knees, it’s still going bad, but you’ve masked the reality.

My own organs are wearing out. They’ve served me well for 80 years, but the wear and tear begins to show. One’s prostate gland swells, interfering with the flow of urine. A series of pills helps somewhat, until finally, a colonoscopy fixes it, and creates another problem – one can’t quite turn it firmly off for the whole day.

The heart needs help, so there are pills for that. They do a great job on the heart, but the side effect is impotence. Along with that, there is some degree of depression. There’s a pill for that. There are pills for blood, pills for Thyroid, pills to sustain the function of almost every organ in your body.

I question myself, requiring so much maintenance. As Gloria Steinem said (she’s a year older than I am) “Most people my age are dead.”

The truth is, every day I see news of people 10 to 20 years younger than I am, passing away. Maybe I’m on borrowed time. The people I knew in high school are gone. Most of my cousins are gone. One of my brothers is gone. Meanwhile, I’m still having fun. I’ve never taken life, or death, very seriously anyway.

All My Friends But One Have Died

March 29, 2017 Leave a comment

It’s something one is unlikely to think about until one is very old. The people and pets that have occupied your life begin to die off. Several pets pass during our lives because their life span is about 15 to 25 years. Cats, dogs, horses, fish and birds live a full life in fewer years than do us primates. I admit that I enjoy being older than most people, and I love the phrase I stole from Gloria Steinem: “Most people my age are dead.”

I suppose my condition will decline before I pass away, but for now, on the cusp of 80, I’m okay. I walk, I drive, I played with my Doberman until last week, when she died of old age, at twelve. I guess I’m one of the lucky ones who inherited good genes. It’s true that I take 16 pills a day, but in my defence, I never felt the need. Each medication came into my routine when doctors had me tested during annual examinations. One of Canada’s true blessings is the health care system. They apparently realize it will cost a lot less to strengthen the age-weakened than to let them fall apart and then have expensive care to keep them going.

So Joey died first, leaving a troubled wife with three young children. He was extremely, morbidly obese, and it killed him. I believe his food addiction was because he was only about 5 feet 4 inches tall, and might have led him to take on size in the wrong direction. We’d sometimes meet for lunch in a favourite deli. My bill would come to six or seven dollars – his bill would be about ten or twelve dollars. He once told me that when he had business lunch appointments, he’d go early, eat first, then eat again when the associates arrived. That’s not all. After the lunch meetings broke up, he’d stay and eat again, alone. He was a witty, humorous friend, and I did my best to get him to control his diet, but it was impossible, and he died at 44.

Mitch died next, at seventy. He had lived a tough guy life, had been convicted and jailed when a young man, for robbery and again for marijuana marketing. He was a wonderful, colourful guy whom I completely trusted. He had much higher moral standards than do many police personnel. His wife had died from cancer decades before. One of his sons turned out to be gay, and voluntarily disappeared from Mitch’s life. Very sad. His other son, however, is a fine, handsome man, married with children that thankfully Mitch got to know before he died. The son is a successful television writer and producer.

Dave died most recently. He was never quite right, emotionally. Although very intelligent, remarkably articulate and good-looking, he could never have a typical relationship with a girl. He liked girls, and they certainly liked him, but somehow, he couldn’t ‘feel’ the mutual emotion. Frankly, he enjoyed prostitutes, and felt friendly toward them. Obviously, they represented sex without emotional stress. He declined as he aged, as I heard when I lived in a distant city. He spent 10 years like a vegetable on his aged mother’s sofa. He had been a late life child. His two older brothers and one older sister didn’t sympathize with him, which is something I never understood.

The oldest brother took over the family business, a successful retail store in a priceless location. Jack Nicholson once shopped there for things to wear in “The Last Detail.” The eldest was really just golfing while letting the business die.

The second brother was a successful pharmacist with a thriving store. Both brothers were, bright, humorous storytellers, as was Dave. The sister was just cold. She had married a foreign hustler, lived with him in Rome, in luxurious accommodations while driving around the ancient city in a Lincoln Continental convertible. The hustler husband eventually got nailed and was jailed. His wife, the sister, came back to Canada and existed as an obese welfare recipient.

I had a hobby farm in the mountains when in my sixties. I kept horses there. Dave had always been a riding fan, and had even owned a horse and beautiful tack, saddle and all. I heard he was living on his mother’s sofa, so I got in touch with him and brought him out to the farm. I gave him simple chores in horse care, in which he’d been educated, and set out to restore him to normalcy. I kept him there for six years, paid him, housed him, got him his drivers’ license back, paid income taxes to gain him pensions.

Dave declined even at the farm, doing the work he dreamed of. Finally, I gave up and took him back to his oldest brother. I drove away and have no idea what happened after that. Somebody sent me an obituary on Dave. I’d never seen one like it. There was a big photo of him, smiling, in a suit jacket and shirt and tie. I’d never seen Dave dressed like that in thirty years. I’m baffled by where the photo came from, and why. Why was he dressed like that, and why had an emotionally challenged failure gained this final notoriety? I’ll never know, and I’ll always regret that I was unable to re-light his life.

My dearest friend is still very much alive. We live about 350 miles apart, and speak on the phone two or three times a day, sometimes for more than an hour. He’s 8 years younger than I am, at 72, and we share a tenuous connection that stretches back fifty years. He and I are the survivors. I will likely go before he does. Although my mother lived to 94, his grandfather lived to 109. He’s also very active. He plays tennis almost daily, and in winter, is a successful competitive snowboarder.

I’m much more sedate. In our day, we were both amateur race car drivers, and I’ve done a lot of wilderness camping. I even lived in a wilderness cabin for four years, lacking telephone lines, cell towers or Internet. It’s a pleasurable, all day job just to survive out there. Now, in my home in this small farm village, I just draw pictures, sculpt clay, paint canvas, and most of all, write stuff like this to relax.

Treasure Lake – Hunters Hunting

March 16, 2017 Leave a comment

The air boat was cruising slowly down the shallow channel that passed in front of the blind of bulrushes. They listened to its approach, the big propeller spinning slowly – pukata-pukata-pukata – as the vessel drew adjacent to the hiding place where the four young people in their canoes hid behind the rushes.

Lilly Pads

Solly had his slingshot pulled back to maximum, planning to send a knockout hit with the only shot he was likely to have. He arranged for Phyllis and Caroline to part the rushes at the precise moment when he could let fly the stone. The driver of the air boat sat up high in front of the engine while the guy with the gun sat below him. Solly made the best judgement he could, shooting just ahead of the driver’s head to allow for the boat’s forward movement.

“Now,” Solly called. The two girls pulled bundles of rushes to the right and the left, and through the open space, Solly let fly the stone. Before the gunman or the driver could react to the parting of the rushes, the projectile struck the driver in the head, hard. He slumped forward, and knocked the speed control to full speed.  At the same time, he fell from his high seat onto the gunman below him.

They were in a tangle on the floor of the vessel unable to rise because the acceleration of the airboat when the driver’s fall pushed the speed to maximum. They shot forward several meters and struck a floating log.  The impact bounced the nose of the boat up into the air and the fast revolving propeller launched them up and over.  They fell back into the water upside down. The propeller kicked up a mess of froth, water and weeds until it sank back and the engine was choked out with water.

“Okay,” Caroline Rich said, “let’s get out of here.”

“Not so fast,” Rob Snitzer said. “I want to see if those guys are okay, or need help or something.”

“Are you crazy?” Phyllis Snitzer shouted at her brother in the other canoe. “They’re here to kill us!”

At that moment, both men broke the surface, sputtering and wiping their eyes with their hands. They saw Solly Cohen with his slingshot, and the other three, and started to come for them in the waist deep water and weeds.  Progress was slow and laborious.

“Okay,” Rob said.  “They’re okay, so let’s get out of here.” They paddled their canoes out from behind the natural blind of bulrushes and started to stroke briskly away.

“Hey, wait,” the boat owner called, “don’t leave us stuck here! How will we get out of here?” At the same time, the gunman fished his rifle out of the water, shook water out of the barrel and hastily prepared to shoot at the foursome.

The bullets blipped into the water on either side of the canoes. Clearly, the gun was not functioning ideally, and the gunman was soaked, sputtering, and clearly out of his element.

Stroking hard, both canoes moved out of range quite quickly and headed for the tributary that should lead them back to their cars and eventual escape. Within minutes, the drone of the single engine aircraft could be heard approaching. The canoes were guided under some overhanging willow branches where they waited until the aircraft landed or moved on.

10. Beryl O’Flies – Confidential Investigator

May 26, 2015 Leave a comment

I assumed Bianca’s inappropriate offer of sex for favours was because she was an illegal immigrant. She must be in this country without a visa or other documentation. I believe her when she says she was pretending to change a front tire as she was instructed by her employer, Kimberly Rashid-Monterrain. I don’t think she knew that it was a setup as Beryl and I now believe it was. Rashid-Monterrain was putting Bianca’s life in danger because it was a murder plot.

We spent a week looking for the truck as described by Bianca. Of course, it’s understandable that she would have only vague information to give us because it was night, and the truck’s headlights would have blinded her until it passed. She could only tell us it was white, the kind with the flat front and a frame on the back that would normally haul an eighteen wheeler type trailer. So we searched for a white cab-over tractor type in body shops. We assumed that the truck would require repairs after wiping out an Alpha Romeo and a man’s life.

We split up so we could cover more ground in less time. I didn’t find the rig in any of the twelve shops I checked out but Beryl spotted it parked among trees behind a rural body shop. I rushed to meet her when she called to tell me. She waited for me before going into the shop to ask questions because she feared a killer might be there. I question her wisdom. What did she think I could do about it? I have nothing but a camera. ”If I take his picture, it ain’t gonna help.”

The shop was labelled “Mighty Rite coachwork repairs” by a sign in cracked and faded red, white and blue paint. Looking at the broken stucco that covered the exterior, I thought the owner must have a sense of humour. He boasted an elegant phrase like ‘coachwork repairs’ on a dump called ‘Mighty Rite’. I gathered my guts and led Beryl through a dented metal pedestrian door beside the huge, truck-sized overhead doors.

The interior was like a gigantic, dark cavern. It was crude, with greasy work benches along a wall and the obligatory calendars presenting naked girls pinned above the benches. On the left was a crudely fashioned cubicle of unpainted, oil stained plywood. Inside the enclosure was meant to be an office of some kind. I peered over the edge of the cubicle and saw a young man in greasy coveralls, sleeping in an old office chair with his workboot-shod feet on an ancient oak desk.

“Excuse me,” I said rather loudly. His eyes popped open and his first act after taking his feet off the desk was to pop a greasy cap onto his head. Through the grease I could see the logo ‘Carruthers’ on the cap.

“What! What?” he stammered. Beryl pushed me aside.

“Who brought that white truck in?” she said.

“What white truck?” he said.

“The one hidden in the trees,” Beryl said.

“Oh, that’s the one that little lady brought in,” the kid said.

“Lady?” Beryl and I said in unison.

“Yeah,” he said.

“What’s her name?” I said.

“She didn’t leave no name. All she said was that if we can fix it, we can have it.”

“Isn’t that a little odd,” I said.

“Damn straight it’s odd, but the boss ain’t gonna sweat too much over getting’ a free rig like that.”

“Describe the lady,” Beryl said. The kid looks at the ceiling and muses.

“First off, she was a really lush piece, y’know. A bit older, but still, really hot,” said the kid. “I figure she’s rich, not just ‘cause she gave away a valuable truck, but she was wearing spotless suede pants, jacket and boots that all matched. I don’t usually notice that stuff, but this babe was really sweet.”

“Anything else?” I said.

“A Volvo was waiting out front for her when she left, and it looked like another dish was driving it.”

5. Beryl O’Flies – Confidential Investigator

May 15, 2015 Leave a comment

Rome’s Fiumicino “Leonardo da Vinci” Airport was relatively quiet when we landed in Italy. It was very early on Tuesday morning and the flight was almost uneventful. I say ‘almost’ because… well… you know how goofy Beryl O’Flies can be. We were out there over the middle of the Atlantic in a 747 when she woke me. She wanted us to make love at thirty-seven thousand feet and six hundred miles an hour. We quietly met in the washroom and made love. I sat on the toilet seat and she straddled me so we were face to face. I don’t really like doing ‘sex stunts’. I prefer a calm, peaceful, gentle night… or day… exploring each other, tasting each other for hours. Although it’s against the rules, we got away with making love in the washroom to join the ‘mile high club’.

As we left immigration there was a lovely young woman holding a sign that read ‘O’Flies’. We identified ourselves and she led us to the Mercedes limousine that was sent by Kimberly Rashid-Monterrain – our client – to meet us. I enjoyed following Bianca, the driver, because she had a pleasant walk and ‘culo’ in her chauffeuse uniform. It was form fitted soft, supple, grey leather. As she drove us, Bianca pointed out famous landmarks in the ancient Italian city. We soon were driven through a pair of huge wrought iron gates and up a long, long driveway surrounded by fruit trees. Eventually we emerged into a groomed garden area at the other side of which stood a splendid, although ancient, mansion.

We were driven around the central fountain and stopped at the front steps of the mansion. Bianca hurried around the car to open the door for Beryl and I. At the same time, a uniformed servant hurried down the steps to get luggage out of the trunk. Right behind him, a tall, stately, elegant woman with white hair piled majestically on top of her head descended the stairs with graceful movements. She presented a bejewelled hand to Beryl and then to me. Her dark eyes looked into mine as she welcomed us.

“Welcome to Monterrain,” she said. “I am Ariani Rashid, Kimberly’s mother. She is eager to greet you but is unfortunately occupied with a critical telephone call.”

The man who gathered our luggage was named Martin. He showed us to our quarters when he carried some of our luggage while Beryl and I carried some smaller pieces.

“When you feel refreshed,” said Martin, “simply descend to the main floor and you’ll be shown into Ms. Rashid-Monterain’s salon.”

Our quarters turned out to be a suite with a sitting room and two separate bedrooms with private bathrooms at opposite ends of the sitting room. Beryl and I agreed that until we get a better feeling of what’s going on here, we should take separate bedrooms.

Lured Into A Secretive Squad (continued 26)

May 7, 2015 Leave a comment

In the afternoon my cellphone buzzed. It was Aileen Schachter, sounding cold and indifferent. I was relieved at that. She said that I was to attend a meeting of N3 at a synagogue banquet room. I wanted to ask her if Naomi Cheslow was to come along, but I refrained for fear it might touch off a jealous tirade. I needn’t have done it, because Naomi’s phone buzzed before I’d rung off. She was also called to the meeting which was called for eight that evening, so Naomi and I had supper together before we proceeded to it.

The restaurant was called ‘Little Sicily’. We chose a table in a little alcove not visible from the entrance. I ordered fettuccini Alfredo and Naomi ordered Veal Marsala.

“I’m sorry I caused stress between you and Aileen,” Naomi said.

“It’s not your fault. Aileen feels she has a right to me, whether I agree or not,” I said.

We ate in silence. The food was wonderful. I love Italian food, and ‘Little Sicily’ knows how to make it properly.

We left the restaurant feeling satisfied. We arrived at the N3 meeting just before Aileen called it to order. There was a large, rough-hewn hardwood crate at the front of the room. On a sign from Aileen, two of the guys opened the top of the crate and began to unload firearms of various kinds.

“The time has come, friends, to establish our position in this society,” said Aileen. “We have been asked by the Jewish Defense League to ‘ride shotgun’, so to speak, for a peaceful protest. A group of orthodox and Hassidic Jewish people will assemble at nine o’clock Sunday morning.”

“Where?” said Naomi. Aileen glared at her.

“At the north end of Riva Goldstone Park near Eisenhower Avenue. The Aryans have sworn to crack every skull in the group, so all of us will be armed and ready to shoot on command if a desperate situation arrives. Please make your way to David and Sheldon to get your armaments.”

“I don’t like this,” I said to Naomi. “I don’t want to shoot anybody.”

“Nobody wants to shoot anybody, Sweetheart,” said Naomi. “I’m sure the show of force will dissuade the bikers from attacking.”

“I have a bad feeling about this,” I said.

There was nearly five hundred people gathered in the park when I got there with Naomi. More than half of them were Hassidic people, the men in long, black coats, white shirts and black vests with the tassels (tzitzis) hanging out. Their women wore heavy dresses and skirts to their ankles, with kerchiefs over their wigs. The other people were just ordinary people that you’d not notice were Jews. Except for orthodox people, where the men all wore yarmulkes on their heads, and some wore fedoras.

The mob had just begun to spread from the park onto Barnard Avenue and began the slow walk to city hall to bring recognition to the suffering of the Jewish citizens at the hands of the Aryans. The earth began to tremble as the Aryans on their Harley-Davidson motorcycles rumbled up the Avenue. They stopped half a block away and parked their bikes together, right across the road so no one could get by.

Little Aileen was carrying an Uzi as she strode out ahead of the marchers and saw Clark McCracken standing proudly in the line of ruffians.

“McCracken!” said Aileen, “are you crazy? Do you know what I’m going to do to you now?”

“You ain’t gonna do nuthin’ you piece of Jew shit!” said McCracken. He ran at Aileen brandishing a machete. Naomi raised her nine millimetre Luger and dropped Clark in his tracks. Suddenly, Aileen turned and shot Naomi. I was shocked and automatically raised my AK47. Before I could squeeze off a shot, Aileen nailed me with a burst from her Uzi. One went through my left eye and knocked a chunk of brain matter out through the large hole it made behind my ear. Another went through my heart and left lung and one in the groin an inch above the willy. I was dead before I hit the floor, and I have no idea how the protest went, what happened to Aileen, if anything. You know what? I don’t care. I realize that nothing really matters much, and my frustrations, my burdens and my concerns are all gone. This is heaven.