9/30/24

Monday, September 30, 2024

1938 Treaty of Munich forced Czechoslovakia to give territory to Germany. Chamberlain infamously declared "Peace for our time" upon his return to London.

1943 Pope Pius XII encyclical on Divine spirit

1946 Twenty-two Nazi leaders, including Hermann Goering, were found guilty of war crimes and sentenced to death or prison at the Nuremberg war trials

In bed at 9, awake at 3:40, and up at 4.  Lilly didn't show up until 6:35, after Katherine and Geri had left.  

Prednisone, day 139, 7.5 mg., day 18/28.    Prednisone at 4:50 a.m.,  morning meds at 6:30 with pumpkin bread.

Katherine departed for Alexandria at 6:15 this morning, Geri driving her to the airport.  Her visit was wonderful.

Way To Go: Thoughts on Dying.  These are some thoughts I wrote down in 2018 or 2018:

I don’t remember when I first started thinking about death and dying but I suspect it was one of the many gifts I received as a child from my Holy Mother Church.  It was HMC that opened my young mind to the idea of eternal punishment in the fires of Hell.  Yes, there was also the everlasting joy of the Beatific Vision (You’re so great God, you’re so good.  You’re so good God, you’re so great.  You’re so great … you get the idea)  But it was the torment of Hellfire that captured my imagination and created a fear of dying and death.  As long as I was alive, I was OK.  Once I kicked the bucket, I was in a binary game, either endless (if boring) bliss, or never-ending pain and suffering.  And you could never be sure whether you’d be a winner or a loser in this game, since, try as you might to be good, we were all born sinners prone to a lifetime of sin.  

Ever since those youthful days in the Reign of Error, I’ve been conscious of the inevitability of dying and death but never in an immediate sense until 1965 when I flew from California to Japan.  I was sure that my aircraft could not stay airborne for the 14 hours we were en route.  Dying in a plane crash at age 24 was hardly a way to go, and somehow I managed to evade dying and death.

Several days later I flew for several hours from Japan to Vietnam on an old C-130 “Hercules.” As we neared Chu Lai, the pilot made a steep nose-down ‘combat approach and landing’ to avoid ground fire from the hills surrounding the airstrip.  All the cargo in the belly of the aircraft surged forward to the front of the cargo bay.   Again I was sure I was going to die in a crash landing, again not a good way Io go, especially on my first day in Vietnam.

A few weeks later, I woke up in the middle of the night in the ’hardback’ tent I lived in at the airbase at Danang, aware of movement and creaking sounds in the tent.  I had read Andre Malraux’s Man’s Fate a year or so before I went to Vietnam.  The novel begins with a Chinese assassin in Shanghai plunging his dagger through mosquito netting into the heart of his sleeping target.  Half asleep and surrounded by my own mosquito netting, I was certain that an Asian assassin was in the tent, intent on killing me.  This was not a good way to go so I was relieved to discover the ‘assassin’ was just the Marine in the cot next to mine, tossing and turning in the subtropical heat.

On my last day in Vietnam, I was loaded onto a large Air Force transport on the taxiway on the Air Force side of the airbase only to sit on the tarmac forever while the aircraft mechanics tried to find and correct to cause of the “fire warning” light in the cockpit’s instrument panel.  The longer we sat there, a huge, shining, silver, immobile easy target for rocket and/or mortar fire from the surrounding hills, the more I thought of being incinerated in that aircraft with the bellyful of fuel on my last day in Vietnam, again not good way to go.

I was 25 when I left Vietnam and I wasn’t plagued by thoughts of death after that, at least not by thoughts of involuntary death.  I’m 77 now and my end-of-life thoughts have done a 180.  Now I fear involuntary living and how to avoid it.  I’m at higher than normal risk of strokes and heart attacks because of diabetes and related morbidities, ironically attributable perhaps to exposure to Agent Orange during my 8 months in Vietnam.  But I have no fear of a heart attack or cardiac arrest or even a stroke, thinking that’s a way to go that I could go for, so long as it does kill me.  Do not resuscitate!  Way to go!  On the other hand, with each passing year, I become more at risk for Alzheimer’s or some other form of long-term dementing or otherwise incapacitating disease.  Living with those diseases is not something I want to do, at least not in their most incapacitating forms.  And even though they inevitably lead to death, that is no way to go as far as I’m concerned.  

Long ago, a friend remarked how great it would be to live forever if you lived forever young and healthy, sort of a Mormon and I suppose Christian view of Heaven.  When I said I couldn’t imagine anything worse, he couldn’t understand how I could disagree, Living forever seems to me to be a version of Hell, not of Heaven, just another version of the “Do you know how long Eternity is, boys and girls” claptrap that we got from the nuns and priests in Catholic schools. The older I get, the more I believe it, so much so that I have long thought that perhaps the most basic human right is the right to stop living,  to call it quits, to say “I’ve had enough.”  I’m surer of this than I am of any doctrine or dogma of any religious faith.

“There is only one really serious philosophical problem,” Camus says, “and that is suicide. Deciding whether or not life is worth living is to answer the fundamental question in philosophy. All other questions follow from that”  One might object that suicide is neither a “problem” nor a “question,” but an act. A proper, philosophical question might rather be: “Under what conditions is suicide warranted?” A philosophical answer might explore the question, “What does it mean to ask whether life is worth living?” as William James did in The Will to Believe. For the Camus of The Myth of Sisyphus, however, “Should I kill myself?” is the essential philosophical question. For him, it seems clear that the primary result of philosophy is action, not comprehension. His concern about “the most urgent of questions” is less a theoretical one than it is the life-and-death problem of whether and how to live.”

Is life ever not worth living?  Even posing the question begs its affirmative answer.  One who doubts it, has not seen enough of life, or of human suffering.  Those who doubt it embrace cliches, pieties, and religious conventions like “God has a plan for me,” “Jesus loves me, this I know for the Bible tells me so,” and “Suffering is a Grace from God.”  The problem is, not all of us, and perhaps only a few of us, really believe those pieties.  Not only is there no realistic proof of them, there really is no evidence of them.  Their roots are not in experience, but in someone else’s Scripture or in what we were indoctrinated with as children.   In my own long life, I have come to prefer a benign atheism that attributes human suffering to Nature, or Random Chance, or evil deeds  by human actors rather than to an All Good, All-Powerful, All-Loving God who permits so much suffering as part of “His Plan.”

For me, then, the philosophical question posed by Camus is not hard.  Of course, there are circumstances in which life is not worth living.   We can all come up with our own lists, though we don’t like to think of such things.  The hard questions are how to determine when it’s the right or a good time to stop living and how to stop living in a way that doesn’t risk survival in worse circumstances than those that caused one to prefer death in the first place.

There is always a risk of course of ending life too early, too quickly, or in situations in which waiting might have led to circumstances much more ‘livable’ than those which prompted thoughts of suicide.  “If only he had waited . . .”   Or when a different set of personal values would lead to different choices.  But isn’t it presumptuous to think that we should be able to choose the time of death and the sufficient raison de mourir of another person?  Isn’t it arrogant to be so confident that another’s case of depression is only temporary or curable by antidepressant medications to conclude that the presumer is justified in usurping or appropriating the other’s right to autonomy?  Isn’t it presumptuous to think that because one is likely to live longer than X months or Y months, it is too soon to recognize her right to call it quits now?  Why is it anybody’s business but the sufferer’s whether we believe her pain is bearable or unbearable?  Beethoven started losing his hearing before the age of 30 and was totally deaf by  44 or so.  He continued to compose beautiful music but he couldn’t hear it as his audiences could.  If in these circumstances he had decided, for himself, that his life was no longer worth living, who had the moral right to second-guess him?  Ditto if Stephen Hawking had decided, for himself, that living for decades with ALS was not something he chose to do. itto if Claude Monet had given up the will to live after he lost his color vision late in life.   Our churches and, through them, our governments have effectively transformed the notion of “a right to life” into “a duty to live.”  Isn’t that a rather stunning “leap of faith”? 

And then there is the awful question of “how?”  And, more specifically, how safely, but safely in the sense of failsafe.  If there is something worse than living a life a person doesn’t want to live, it’s trying to end it unsuccessfully and winding up in a worse situation, unable to try again.  The poison you take doesn’t kill you but does put you in a nursing home, sitting in a hallway strapped into a wheelchair, incapacitated for years.  The bullet that was intended to strike a vital part of the brain or heart misses its target, leaving the shooter alive but more severely impaired than when he pulled the trigger.  The tranquilizers and/or other prescription meds you were secretly hoarding don’t kill you but leave you alive and comatose and racking up those huge medical bills you were specifically trying to avoid.  The door to the exhaust-fumed-filled garage is opened before you are a goner.

But Mousie, thou art no thy-lane, 

In proving foresight may be vain: 

The best laid schemes o’ Mice an’ Men 

          Gang aft agley, 

An’ lea’e us nought but grief an’ pain, 

          For promis’d joy! 

I can’t attempt to answer these questions.  I don’t know the answers.  But I am reasonably sure that it is no answer to prohibit suicide, to deny to each one of us the ultimate right of autonomy, of sovereignty over our own bodies and lives.  One reasonable way to recognize and protect this ultimate civil right and human right is to remove legal restrictions on suicide and assisted suicide.

*The photo above is of the headstone on the grave of my great-grandfather Jacob Clausen and his wife Martha in duncombe, Iowa.}

__________________________________________

Austria moves far right.  Austria has joined the list of countries moving toward the far right with the victory of its Freedom Party over the center-right Peoples Party and the center-left Social Democrats in the parliamentary elections.  The Freedom Party did 13% better than in the last elction and the People's Party did 11% worse.  The Freedom Party is Kremlin-riendly, opposes aid to Ukraine and opposes sanctins on Russia.  It is decidedly anti-immigrant urging "re-migration" or deportation of immigrants to their homelands.  Mene, mene, teckel upharsin.

New painting attempt.  The 54" X 32" canvas that Sarah stretchd for me when she was here developed a scalloped corner which I was able to stretch out by spraying some hot water on it and letting it dry out.  Yeterday I applied a coat of gesso primer to it further the stiffening and it seems to have worked.  Now the canvas seems reading for painting but I've had a very difficult time figuring out how to draw grid lines on it, converting the grid lines on my 5" X 9" print to the much larger sized canvas.  My addled old brain is having a very hard time with mathematics (among other things.)  This afternoon, I drew what I think will be workable grid lines but now I'm thinking I should have waited until I applied some background undercoats to the canvas.  My executive funcitoning continues to slip.

9/29/24

September 29, 2024

1916 American oil tycoon John D. Rockefeller became the world's first billionaire

923 The British Empire reached its geographical peak, covering a quarter of the globe's land (nearly fourteen million square miles), with the Palestine Mandate coming into force under British control

1941 Nazi massacre at Babi Yar ravine Ukraine began, 33,771 Jews were  murdered

1983 US Congress authorized President Reagan to keep 1,600 US Marines in Lebanon

1990 US Secretary of State James Baker met with Vietnam's foreign minister

In bed at 9 and up at 4:15.     

Prednisone, day 138, 7.5 mg., day 17/28.   Prednisone at 5:00 and morning meds at 5:50.  Pumpkin bread for breakfast.

Obituary, psychological assessment.  In this morning's NYTimes, there is an op-ed by Kelly McMasters, "Why I Write My Obituary Every Year."  She got into this unusual habit when her mother started working at a hospice and was required to write her own obituary as a part of her job, or rather as an imaginative exercise in preparation for work with terminally ill patients.  The column reminded me that I have composed my own obituary as part of my 'death dossier,' a collection of documents I keep in a three-ring binder on the credenza behind my desk in the basement.  The dossier contains important or not-so-important documents and information I gathered for Geri to be used when I die in an attempt to make my 'last arrangements' as unburdensome as possible.  This morning's op-ed is a reminder to bring the binder upstairs to my bedroom desk and to see what, if anything, needs updating.  In searching my laptop for the draft obituary, I came upon the VA report of my long neuropsychological examination on July 24, 2028.  How interesting, if somewhat spooky, to read about one's self as a "subject" which would seem more accurately phrased as an "object."  Excerpts:

DATE OF NOTE: JUL 24, 2018@10:29 AUTHOR: LARSON,ERIC READ 

Mr. Charles Clausen is a 76-year-old left-handed Caucasian man who was seen for evaluation of his cognitive and emotional status to assist with differential diagnosis and treatment planning. He was referred by his Primary Care Physician . . .Clinical interview by psychologist: 60 minutes . . .Neuropsychological testing by technician: 240 minutes.  Computerized neuropsychological testing by technician: 60 minutes Integration of findings with medical record by psychologist: 60 minutes

Behavioral observations: The veteran ambulated slowly and assisted by a walking stick. He was appropriately dressed and well groomed. He was pleasant and cooperative with the examiner. Speech was fluent and articulate, normal in tone and rhythm; however, rate was moderately slow. Thought content was logical and goal oriented, although he was somewhat verbose upon interview. No language errors were noted. Insight into his condition was adequate. His affect was mildly restricted and his mood appeared mildly depressed. He denied current suicidal ideation. There was no evidence for any symptoms of psychosis. Eye contact was somewhat low upon interview, but appeared to improve over time during testing. Vision appeared adequate for testing. Hearing difficulties reported by the veteran were evident upon testing, requiring occasional repetitions; however, hearing generally appeared adequate for testing. He exhibited long response latencies between items during list recall, and was frequently able to provide additional appropriate information with more time. . . . On a timed task requiring visual construction and problem solving, the veteran was able to compose the correct designs with additional time. A generally slow speed of processing was noticed throughout testing. 

Results: Performance on measures of verbal knowledge and concept formation was in the very superior range, while visuo-constructional problem solving abilities were average. Auditory learning and memory for stories and word lists was high average to superior, with no decline in performance apparent after a delay.  While visual memory for geometric designs after a delay was high average, learning over trials as well as ability to discriminate learned designs following a delay were average. Language measures including word reading, confrontational naming and comprehension of verbal commands were performed in the average to superior range. Visual scanning abilities were measured as average; however, the addition of set-shifting demands resulted in reduced performance in the low average range. Letter and category fluency were performedin the low average range. The veteran's ability to determine rules and flexibly shift mental set based on feedback was average to superior. Visuospatial perception for judgement of line orientation was high average. Ability to rapidly process visual symbol to number associations was low average for both written and oral modalities. The veteran endorsed mild symptoms of depression with suicidal ideation on self-report measures, as well as mild elevations on scales indicative of alcohol use concerns, post-traumatic stress, social withdrawal, and preoccupation with physical complaints. Of note, the veteran has endured significant health problems including chronic pain.

Summary and impression: Mr. Clausen is a 76-year-old left-handed Caucasian man with a history of suicidal ideation and plan without attempt; vascular risk factors such as diabetes and diabetic retinopathy, hypertension, obstructive sleep apnea; and chronic pain, referred for memory concerns. Results of testing indicated broadly intact learning and memory, language, executive functioning, and visual perception; however, subtle difficulties were evident on tests requiring efficient processing speed, such as on timed measures of mental flexibility and non-verbal problem solving. Mood was characterized as mildly depressed on self-report, consistent with the veteran's report upon interview.  Self-report measures were noteworthy for clinical elevations of suicidal ideation, and mild elevations of alcohol use concerns, post-traumatic stress, social withdrawal, and physical complaints. . . .

This is a mildly abnormal neuropsychological profile with mild difficulties on tests requiring efficient processing speed. These findings are consistent with mild subcortical dysfunction and likely represent the effects of cerebrovascular pathology, given his elevated risk factors, but mood symptoms might be playing a role as well. The most appropriate diagnosis is likely mild vascular neurocognitive disorder.

I have no idea where the reference to PTSD comes from.  My weight in the summer of 2018 was 239 so I have lost 40 pounds since then.  That was also the year I received steroid & lidocaine injections for bilateral hip pain.   The photo is a distortion giving me a big head; it seemed appropriate to accompany the text about my session with the headshrinker.

 

  

9/28/24

 Saturday, September 28, 2024

1978 Israeli Knesset endorsed the Camp David accord

1995 Israeli Prime Minister Yitzhak Rabin and PLO Chairman Yasser Arafat signed the Oslo 2 Accord to transfer the West Bank to the PLO (Taba, Egypt)

2000 Israeli opposition leader Ariel Sharon visited the Temple Mount in Jerusalem sparking the outbreak of violence known as the Second Intifada

In bed at 9, awake at 3, and half-slept till 4:15.  Lilly showed up at 6:15 to be let out into the windy morning, 15 mph with 25 mph gusts.  The whole day is windy but warm, sunny, and lovely.

Prednisone, day 137, 7.5 mg., day 16/28.   Prednisone at 4:50.  Morning meds at 5:30 with 2 slices of Dave's Bread, butter, and strawberry preserves.

Katherine's visit is a shot in the arm.  She is ebullient, as usual, and reminds me that happiness and unhappiness are contagious, something I first learned, in an explicit way, from Dennis Prager's book Happiness is a Serious Problem.  He introduced me to the idea of happiness as a duty to those around us, especially to those in our immediate orbit.  Remembering the book makes me think of my Dad of course and of how his PTSD after the war affected Kitty and me.  In any case, Katherine's ebullience also reminds me of it.    

LTMW at 9 a.m., a succession of chickadees, red-bellied nuthatches, and house finches enjoy a late breakfast of sunflower and safflower seeds at our feeders.  I put orange halves out this morning, hoping to attract some locals and migrators but so far no luck.  The sun is shining with an expected high of 72° today, a beautiful day kicking off what I hope will be our most enjoyable weather season, late September and October.

Maladaptive self-focus, male old age, and journaling.  Maladaptive self-focus is the psychological term for overthinking about one's self, self-absorption, or self-obsession.  Arthur C. Brooks has an article about it in the current The Atlantic titled "How to Stop Self-Obsessing and Be Happier" and subtitled "Some introspection is healthy and necessary, but too much can trap you in a cycle of misery."  The article caught my attention because I'm aware of how much time I spend thinking about myself, my history, and my regrets since I started writing in this daily journal (which I am increasingly coming to think of as simply my daily 'notes.')

Approaching the midpoint of one's ninth decade of life, there is a great deal of life to look back on and precious little to look forward to.  And much of what the future holds is scary, even terrifying: painful and debilitating illnesses, increasing cognitive decline and dementia, increasing decrepitude and immobility, helplessness and fear.  Keeping a journal or notebook at this stage of life is a mixed blessing.  The writing and even the mere act of typing and formatting provide mental stimulation and exercise and may (who knows?) help stave off cognitive loss and delay or soften dementia.  It also provides a daily opportunity to feel and express gratitude for what there is to be grateful for in daily life, everything from warm breezes, billowy clouds in cerulean skies, and the elegance and plenitude of trees to the sight of young parents caring for children (and of children caring for old parents).  I have become consciously grateful for the opportunity to shop for food at our local supermarkets and especially for the ability to take leisurely drives in the rural countryside.  On the other hand, journaling also invites reflection on one's long past life.  If one has a conscience, reflection inevitably leads to an examination of one's conscience.  For me, it has led to many regrets.  It has led to a recollection of a notion I read about or heard about years ago, that the Last Judgment is not as Jesus described it in Matthew 25: 31-33:

31 “When the Son of Man comes in his glory, and all the angels with him, he will sit on his glorious throne. 32 All the nations will be gathered before him, and he will separate the people one from another as a shepherd separates the sheep from the goats. 33 He will put the sheep on his right and the goats on his left

but rather standing in front of a mirror that reveals, inescapably, all one's deeds, good and bad, with no hiding from or sugar-coating the bad deeds, the wickednesses, the cowardices, the selfishnesses. 

Keeping a journal in old age easily leads to much looking in the mirror and seeing one's failings, one's sins, and God knows I've done a lot of it over the last few years and it takes a toll.  I need to practice some self-forgiveness.  By chance, I picked up a book I've had for many years, a collection of spiritual exercises by the Jesuit Anthony de Mello, titled Wellsprings.  One of the chapters is headed "The Redemption" and includes some mindfulness advice, such as

. . . I advert to the fact that I am living.  I imagine a fully alive plant or animal . . . I think of a person who is fully alive.  What qualities do I find in this person?  For me, what does it mean to be fully alive?

One thing is certain, to be fully alive involves the renunciation of one's past and of one/s future.  The past.  Yesterday.  I cannot be alive if I cling to yesterday for yesterday is a memory, a creation of the mind.  It is not real.  So to live in yesterday is to be dead.

I therefore let go of my yesterdays, my propensity for living in the past.  One way of living in the past is holding on to grievances.  As a first step toward being fully in the present I make a list of people I resent.  I offer each of them an amnesty, an absolution, and let them go.

, , , , If I mean to give up living in the past I must drop regrets as cleanly as I drop resentments.  What I tend to look upon as loss -- my failings, my mistakes, my handicaps, the lack of opportunities in y life, my so-called bad experiences -- I must learn to see them all a blessings.  For in the dance of life, all things cooperate to do us good. 

Having released myself from the future and the past, I come into the present to eperience life as it is now, for eternal life is now, eternal life is here.  I listen to the sounds around me . . . I become aware of my breathing in and out and of my body so as to be as fully present as I can. 

In another exercise, called "The Good News", he writes

One day, alone in my room I think of the things in my life I am especially thankful for, the things I am proud of.  Then I turn to the things I regret and wish had never happended, especially my sins.

While I am thus engaged, Jesus Christ walks in.  His presence brings the sweetest joy and peace.  I tell him some of the things in my life that I regret.  He stops me with the words, "That is all forgiven and forgotten.  Do you not know that love keeps no record of wrongs. (1 Cor. 13:5)  Then he goes on to say, "In fact, your wrongs have not just been forgiven, they have even been coverted into grace.  Have you never been told that where the sin was great, grace was greater still? (Rom. 5:21)

I don't know that de Mello's exercises will help me with my regrets.  It is much harder to forgive myself than forgive any other who may have hurt or harmed me.  Self-forgiveness seems too much like minimizing my wrongs, treating them as if they were not real wrongs, real failings with real consequences for others.  I need to think about this some more, or is that just more 'maladaptive self-focus'?

 BTW, how does Arthur C. Clark recommend dealing with the problem of self-obsession?  1. Bring happiness to others. 2. Serve the world, and 3. Be more mindful.  All good advice.

Anniversaries.  Israel has been nothing but trouble and warfare from the get-go with plenty of blame on both sides.  I'll be long gone by the time of its centennial in 2048, if it has a centennial.  I'm inclined to think that hope for Israel died with the assassination of Yitzhak Rabin in 1995.  I hope I am wrong but as I write these words the world holds its breath wondering whether we are on the verge of a regional conflagration.