Wednesday, April 1, 2026
1939 US recognized Francisco Franco's government in Spain at the end of the Spanish civil war. Pope Pius XII congratulated Generalissimo Franco's victory in Spain
1945 US invaded Okinawa in the largest amphibious assault of the Pacific theatre
1976 Steve Wozniak and Steve Jobs founded Apple Computer in the garage of Jobs' parents' house in Cupertino, California
1982 US formally transferred the Canal Zone to Panama
2001 Slobodan Milošević surrendered to be tried on charges of war crimes.
2001 The Netherlands became the first country to make same-sex marriage legal
2002 The Netherlands legalized euthanasia, the first nation in the world to do so.
2004 Google introduced Gmail
2020 President Donald Trump said the Strategic National Stockpile was almost depleted amid widespread shortages of medical equipment to fight COVID-19
2025 1939 US recognized Francisco Franco's government in Spain at the end of the Spanish civil war. Pope Pius XII congratulated Generalissimo Franco's victory in Spain
2025 The U.S. announces it is sending a second aircraft carrier strike group, the USS Carl Vinson group, to the Middle East
2025 The Chinese Navy and Air Force conduct large-scale military exercises around Taiwan. At least 19 Chinese warships are deployed, including the aircraft carrier Shandong, marking its closest ever approach to the island.
In bed at 9:30, up at 5:20. 164/66/33 0537. 134/68/62 0545 115 205.0
Morning meds at 10:30 a.m. Ranolazine at 6:10 a.m. and 5:55 p.m.
Symptoms. My feet are numb/tingly each night when I go to bed. My watch tells me my heartbeat range today is 35-92. Also, I've been very tired each day, especially in the mornings, since leaving the hospital on the 23rd.
Zeke Emanuel and me. In the October 2014 issue of The Atlantic magazine, Dr. Ezekiel Emanuel has an article that he titled "Why I Hope to Dive at 75." I read back when it was published, and for some reason printed a copy of it, which I have kept ever since. Emanuel cites (with evidence) many reasons to avoid life after age 75, but they mainly come down to decriptude and the losses and suffering that decrepitude bring. I believe I have cited or written the article several times in this journal/blog. Today I am thinking about this part of his article:
Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either.
Today, when the doctor recommends a test or treatment, especially one that will extend our lives, it becomes incumbent upon us to give a good reason why we don’t want it. The momentum of medicine and family means we will almost invariably get it.
My attitude flips this default on its head. I take guidance from what Sir William Osler wrote in his classic turn-of-the-century medical textbook, The Principles and Practice of Medicine: “Pneumonia may well be called the friend of the aged. Taken of by it in an acute, short, not often painful illness, the. old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”
My Osler-inspired philosophy is this: At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. And that good reason is not “It will prolong your life.” I will stop getting any regular preventive tests, screenings, or interventions. I will accept only palliative—not curative—treatments if I am suffering pain or other disability. . . After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. . .
His argument makes a lot of sense but the problem is the execution. I am almost 10 past my 75th birthday and, not surprisingly, I'm seeing more doctors than ever, taking more prescription medications than ever, and under going more medical tests and procedures than ever. I've spent 12 days as an inpatient in the VA hospital in the last 6 months, plus a couple of outpatient surgeries. I have an "open account" in the Gold primary care clinic, the rheumatology clinic, the cardiac arrythmia clinic, the congestive heart failure clinic, the urology clinic, the infectious disease clinic, and even the mental health clinic. I take 15 or 16 pills and capsules every day, and have taken fistsfuls each day for many years. Despite all of that, I usually feel at least crappy, if not truly miserable. I'm suppposed to be on a low sodium, low sugar diet and to try to take in no more than 64 ounces of water each day. All this to extend my life so I can grow ever more dependent on doctors, therapists, and prescription drugs. Does this ake any sense? Zeke says "no", and I have to agree with him. This morning RN Kim Kitzke, NP Kali Kisro, my primary care provider's nurse, called to tell my that my bladder extends into a hernia and that that may be the cause of the recurring pain in my right flank, so she wants to refer me to the General Surgery clinic. I declined. I also wondered whether I should decline the wearing of a Holton monitor that was applied to my chest this afternoon. Should I start following Zeke's advice? Would I be doing Geri a favor, or the opposite? That's the issue that Zeke didn't address in his article. I supposed it's because he's been divorced since 2008 and never remarried. For us married types, it's the crucial issue. [Hopefully to be continued later.]
