4/2/2026

Thursday, April 2, 2026

1968 Senator Eugene McCarthy won the Democratic primary in Wisconsin

1975 Vietnam War: Thousands of civilian refugees fled from the Quang Ngai Province in front of advancing North Vietnamese troops.

2025  Donald Trump announced a universal 10% tariff,  a 20% tariff on goods from the European Union, and a 34% tariff on all imports from China, effective April 5.

In bed at 9:30, awake at 3:50, up at 4:30.  132/62//61 101 205.4.  35/18/60/33 Rain all day.

Morning meds at 8 a.m.  Ranolazine at 5:10 a.m. and 6:25 p.m.

Further to yesterday's Zeke Emanuel and me.  What's the big difference between Zeke's willing acceptance of voluntary, natural death after age 75 and suicide, a passive suicide?  Or is "passive suicide" an oxymoron, like "cruel kindness" or "kind cruelty"?  Euthanasia is illegal everywhere, whereas physician-assisted suicide is legal in a number of jurisdictions, and VSED (voluntarily stopping eating and drinking) is probably legal in all jurisdictions.  Unlike euthansia, physician-assisted suicide and VSED involve the voluntary hastening of death, but so does a DNR, or Do Not Resuscitate instruction in an advanced directive.  Might not Zeke's voluntary eschewing of all life-prolonging do the same thing?  I thought of this most recently yesterday when I declined a referral to General Surgery to correct an intrustion of my bladder into an abdominal hernia and was scheduled to have a cardiac monitor applied to my chest to provide more information on my bradycardia, premature ventricular contractions, and congestive heart failure.  I accepted the cardiac monitor and rejected the referral to surgery for the bladder/hernia problem.  Why not forego all medical attention except that addressing pain or discomfort?  Why have regular vaccinations for Covid-19, shingles, pneumonia, and influenza?  From Zeke's article:

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 off 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.”

Why not let nature take its course and "escape those 'cold gradations of decay' that are so distressing to me?

A main reason is that I have a life partner, Geri, and choosing to die when death could be medically/surgically prevented is choosing to leave her alone in her old age.  I don't presume to think of myself as such a great life partner, certainly not in my senectitude and decrepitude.  I'm of tremendously less help to her around the house than I once was and I'm not great company in my current condition, but I am company, companionship, and at least some help around the house.  We don't do very much together during our daytime hours, but it's comforting, to me at least, just being near her, sharing her presence, sharing our home, helping each other out in small and not so small ways.  I have no doubt but that sharing life with a loving partner is infinitely better than living alone, perhaps not for all, but certainly for me, and I think, for her.  Thus, choosing to let nature take its course, when the course is death, in order to avoid the hardships and deteriorations of old age, seems pretty cruel and selfish when one is in a loving partnership.  The same considerations as apply to a loving and mutually supportive spousal relationship don't apply generally to parent-adult child and friend relationships.

This having been said, I wonder about the ease with which I told the VA medical and surgical staff before my last surgery and upon my admission as an inpatient in the hospital that I did not waive the DNR instruction in my Health Care POA.  Geri and I have discussed the matter pretty recently and are generally on the same page regarding not wanting our lives to be artifically extended or maintained.  I can't imagine a satisfactory life without her, but I think she will have a much better chance of a still-worthwhile life without me.  She is closer to her children and both their spouses, and she has a good many good friends, some of very long duration, with whom she has maintained good contact.  It comforts me that she is better equipped than I am to live as a widow(er), but I suspect that the next time (if there is one) that I am asked whether I waive my DNR, I will not be as cavalier in my response as I have been recently.  And I wonder whether and how Dr. Zeke would re-analize his "Why I Wish to Die at 75" article to deal with the complications of marriage.  The problem is complicated by the issue of how disabled and needing care the post-75 individual is.  There may come a time when I get so disabled by the 'complications' of old age (especially the cardiac ones) that I am a big care-giving burden for Geri, in which case my survival is more a burden on her than a blessing.  In those circumstances, the DNR issue becomes simpler, but what about the stopping all medical tests, vaccinations, interventions, etc.  In those circumstances, Dr. Zeke's proposals still are moe complicated for the married than for the unmarried.  I used to tell our law clerks at our law firm, "Nothing's simple, nothing's cheap."  Same here.