The downturn in the economy has done us a favor in a strange and back-handed fashion. As many of us boomers watched our retirement accounts and 401Ks lose half of their value during 2008 and 2009, we begin to rethink retirement. I don’t want to sugarcoat it too much because many of us must reconsider staying on the job for longer than we had hoped or planned as our investments no longer suffice to provide sustainable revenue streams. But the instability in the investment markets has now made it apparent that this boomer generation of ours may never be able to simply withdraw from life and quietly retire. That we will need not only a plan to keep busy but also one that calls for us to continue working in some capacity. And that’s a good thing.
Maybe swinging golf clubs or casting a fly rod sounds like a happier vision of retirement than swinging a hammer or crunching numbers but there is also truth to the expression: “to retire is to expire.” Epidemiologic studies have shown that individuals who opted for early retirement (age 55-60) experienced mortality rates twice as high those retired more than five years later. Furthermore, brain imaging studies suggest that those individuals who continue to work—even into their eighties and nineties—continue to demonstrate enhanced brain activity and growing interconnectivity between different functional areas of their brains than those who do not stay intellectually active and engaged. In other words, it’s not just a matter of use it or lose it. It is also, thankfully, a matter that as we use what we know, our brains continue to grow.

As Tennyson wrote in his poem Ulysses:

How dull it is to pause, to make an end,
To rust unburnished, not to shine in use!
As though to breathe were life. Life piled on life
Were all too little, and of one to me
Little remains: but every hour is saved
From that eternal silence, something more,
A bringer of new things….
So at least we can rest assured we will not have to put our swords away.

Sarah Lawrence-Lightfoot, in her mesmerizing and inspirational book,
The Third Chapter—Passion, Risk, and Adventure in the 25 years after 50, makes the point that the transition from middle age to old age is no longer being as the starting point of inescapable decline but rather as a gateway to further development. As we enter old age, not only do we have a new chapter to look forward to writing for ourselves but, for many of us, it may also be a new livelihood. One in which we are less restricted than we were in the second chapter of our middle age when we had families to support and college funds to fill. Now, we have the opportunity to enter that stage in life that psychologist  Erik Erickson referred to as “generativity versus stagnation.” This is the chance to do that job we dreamt about but just couldn’t take because the money wasn’t as good, the situation didn’t have long-term potential for advancement, or it was just taking too much risk. Yes, we downsize as we get older but that leaves us more able to mobilize, meaning as we simplify our needs we can amplify our possibilities. Maybe becoming a chef isn’t so outlandish or applying to be the photographer for the local paper isn’t impractical any longer. The economy will improve and when it does, let’s promise ourselves that whatever positions we take or hold, we will fulfill them with renewed dedication because we understand the vital importance of being active and useful. The next jobs we take we will fill with passion because we know there is much more life to be lived and more growing to be done. Because, finally, as Tennyson wrote:

I am a part of all that I have met;
Yet all experience is an arch wherethrough
Gleams that untravelled world….

And those unexplored realms still beckon long after we have passed out of middle age.

Originally posted by Dr. Hamilton on  Boomer-Living.com

When I was younger, I could remember anything, whether it had happened or not; but my faculties are decaying now and soon I shall be so I cannot remember any but the things that never happened.
– Mark Twain’s Autobiography

As baby boomers, some of us have already lost our parents. But, for the fortunate rest of us (those who still have surviving ones), we have to worry that, healthy as they may be, they can still start to lose their marbles.

If and when they do, then, as their children, we will have to ford that most treacherous of maturational currents: the river of forgetfulness. Wading through those waters, we metamophisize. Instead of just being the children of our parents, we become the parents of our parents. We become caregivers, or get labeled as providers.

We can give it whatever dissimulating titles we want. But clever names do not take away from the fact that there comes a poignant moment in our lives when our parents no longer are taking care of us, but we are now responsible for looking after them. It is hard to know the exact instant when this transformation can begin but I will give you one vital clue to recognizing it – you’ll laugh, at least the first time it happens.

I recently crossed this Rubicon at the front gate of my own property. My mom had been complaining about some problems getting the gate to open when she would come over to visit me. That was bad enough. But, Mom had made matters worse. After three or four consecutive attempts at punching entry codes, the system is programmed to go into a protective, digital hibernation to prevent people from trying to break in. Great. Mom, frustrated that the system had become unresponsive, would resort to getting herself buzzed in. By me? Fine. But if my response was not instantaneous, then anyone was fair game. She contacted, it would seem (and current estimates vary) anywhere from half to all of the folks listed as residents at the complex.

I felt a corrective effort was needed to quell a growing and coalescing constituency of irate neighbors. I use the term “neighbors” loosely because I did not want them to think it was my mother who was the culprit. So many conversations went like this: “Yeah! You too? Yeah, some old lady calling to get buzzed in at six o’clock in the morning. Weird. Can you believe it?

To fend off a burgeoning vigilante militia movement or some other kind of organized response, Mom and I decided to check that her entry code was still working properly. An added wrinkle: I had recently had surgery for a broken leg so I was on crutches and couldn’t drive. Mom had given me a lift to the doctor’s office and as we drove back home and pulled up to the gate, we thought we might use the occasion to check out her entry code.

Since my initial working hypothesis was that Mom must have been pushing the keys in the wrong order or sequence, I clumsily clambered out of the passenger side, without my crutches, and hopped over to the keypad and tried her code out. The iron gates squeaked open in instant obedience. Okay, so her code worked! My theory was right. I turned to begin making my rabbit-like, hippety-hoppety way back to the passenger side when, to my utter surprise, my mom simply drove off, passing through the now open wrought-iron entry gates. And then she just kept going! She never looked back and never stopped.

Eventually, she drove to the parking lot in front of our family’s residence, about a quarter of a mile down the main drive. The car pulled into an empty parking space. I waited. Surely, she’ll come back. Reverse out. Make a U-turn and come around to pick me up. I stared at the car for quite a while. It remained still. The vehicle was too far off for me to yell and, as luck would have it, I’d left my cell phone in the pocket of my jacket lying across the back seat of Mom’s car. I was sure she would come back for me. But she didn’t!

And so I began a very long, slow, and arduous hop for more than a quarter of a mile. A kind of leporine Bataan Death March. About fifteen minutes later, exhausted, dripping with sweat, my good leg quivering from the effort, I pulled up to where my mom’s car was parked and leaned in over the open window.

The engine was running. Mom was sitting calmly behind the steering wheel, still strapped in with her seat belt, staring out ahead through the windshield.

“Mom? What are you doing?” I gasped.

“Oh, there you are! I wondered where you went.”

“Where I went? Yeah,” I joked (told you your first instinct would be to laugh), “I would have gotten here a lot earlier if I hadn’t had to get all the way down here from the entry gate without crutches.”

“Oh, no, honey. You should use your crutches. Of course, it would take you forever to get from the gate to here. That would take you some time–at least a quarter of an hour.” She glanced at her wristwatch as if to corroborate the estimate.

“Well, when I got out at the gate to check out your code, I thought maybe you’d stop and give me a ride. You know, after you pulled through the gate?”

Mom looked over me with genuine alarm. “Funny,” she murmured, “it simply never occurred to me.”

I chortled. “Well, maybe you figured out I need more physical therapy.” Mom just had a very puzzled look on her face.

“Oh, come on, Mom. No harm done.”

But we both knew it was a real slip…a chink in her armor.

There’s a part of me that was amused. It would make a good story to chuckle over with my brother. But I also felt a hint of embarrassment for her and for me. I wanted to see it as humor. To have it just be a joke—my Mom ribbing me, driving off as a prank.

But I wasn’t smiling when I made my way down the driveway. I shook my head instead. I knew Mom had somehow forgotten. Slipped up. Just lost track of me and what we were doing. I knew she had parked there in front of my building because she was waiting for me to come out. She had forgotten we had already come and gone and had been headed back home.

I also knew my Mom would never have left me there to struggle on my own back down the driveway. It just shocked me because I’d never seen Mom forget a thing. It was totally out of character in every way; to forget, to just let me struggle and not come to my aid, and to just wait there blankly…patiently…absent mindedly. It was so not my mom.

Later that evening, Mom called me to apologize. I joked with her. I told her that if she was going to make a habit of dropping me off at random spots to fend for myself and struggle home, I could save some money on gym memberships and some physical therapy visits as well.

I told her to forget it. It was just a slip up. “I feel so stupid,” she confessed. “I’ve no idea what happened.”

I didn’t say much. A couple more jokes to try to get her distracted, to get her laughing at it rather than dwelling on it. But I knew I had seen the mark of something terrible, an irrevocable change taking place in my mom’s memory. Because, it’s not the forgetting that I regret, it’s the remembering that I mourn. In Luis Bunuel’s words: “You have to begin to lose your memory, if only in bits and pieces, to realize that memory is what makes our lives.”

Originally posted on Boomer-Living.com by Allan J. Hamilton, MD, FACS

The debate over healthcare has loomed large on the national stage this year. Naturally, few topics draw as much political attention (or zeal) as this one among our generation of baby boomers. For good reason. No single group of consumers is going to have a greater need or place greater demands on the medical delivery system of the near future than ours will. It is a matter of self-interest: we have an enormous stake in the outcome of this legislative slug-fest.

But make no mistake about it: This is not a debate about health care! It is simply an attempt to reform, to massage, our insurance coverage. What we call medical care in the United States is an outgrowth of a profit and market-driven disease management process. It is based upon paying physicians and hospitals for treating disease and carrying out procedures.

The equation is transparently simple: the more diseases diagnosed, the more frequently these diseases are treated, and the more invasively they are addressed, the higher the reimbursement (and hence the greater the profits). There’s an old saying: “The behaviors you incentivize are the ones you see.” And this is why our healthcare system is a disease care system. It is not concerned with health because it is only incentivized to compete in treating illness.

Think about this: As a physician, if I work with my patients and get them to adopt a healthier diet and exercise regularly, I will receive no compensation for having helped make those patients become healthier nor will the system reimburse me for having contributed to reducing the overall health care costs for these patients. There is simply no incentive for—nor value placed upon—prevention.

If on the other hand, I simply go on testing patients’ blood sugars and charting their lipid profiles and prescribing more insulin to lower blood sugar and more statins to restrain cholesterol levels, then the system continues to gurgle with profitable contentment. In fact, if a few of my patients then go on to need cardiac surgery from the sustained, unrelenting impact of these diseases, then the system hits the multiple hundreds of thousands of dollars per capita jackpot!

If I give them gym memberships to get on the treadmill, an opportunity to work with nutritionists, or a regimen supervised by trainers—nada. Nothing. I’ve actually removed lucrative potential customers out of the system. I’ve stolen patients by helping them to prevent disease.

It may seem paradoxical, but a good healthcare system puts medical insurance companies out of business. Period. Ideally, a great healthcare system aims to maximally maintain the health of its citizens. It ensures that the utmost effort and zeal are exerted to prevent disease and intervening early to return the patient to a state of wellness before they even succumb to illness.

In short, the better a healthcare system works, the less disease there is to treat, the less surgery required, the less hospital stays….You get it. The gigantic, global, medical-industrial complex begins to wind down, slowly rumbling to a halt. And if you think such a gigantic set of industries is going to go quietly into that good night, you’re dead wrong. The medical industry—the hospitals, the physicians, the equipment suppliers, the pharmaceutical industries—make the Big 3 auto makers in Detroit look like a little kids’ lemonade stand in terms of size and dollars.

As laudable as President Obama’s and Congress’s intentions may be (and have my doubts about some of them), no one seems ready to assert that the only way we can turn this disease-treatment system into one of prevention is by having a sole-payer, government-run healthcare delivery system that is not based on profit and but is truly motivated to hold down medical costs by focusing on preventing disease.

Only the government could subsidize healthier eating. Only the government could lead a program at developing a healthier food supply. Only the government could insist on a mandate for better nutrition and extensive physical education of our school-aged children. Only the government could use tax rebates to encourage and incentivize citizens to obtain and regularly use gym memberships, to exercise daily. Only the government has the clout to put an end to the economic ruin and devastation that insurance companies have imposed on our country.

We pay nearly twice as much for healthcare as any other developed country. We’re ranked thirty-seventh in the world in terms of the quality of the healthcare of our people-behind Cuba, a country that had made exemplary strides aimed at prevention and spends less than ten percent of what the US does on medical care.

I don’t know where this whole healthcare debacle will end. Unfortunately, my best guess is that it is unlikely to go where it should—towards a truly healthier citizenry. No one seems to want to go there. Like global warming, like ecological conservation, like military imperialism, like nuclear proliferation, like regulating Wall Street and big banks, like immigration reform, like civil rights…we always seem to wait too long, to cling to the status quo for too long.

Originally posted

written by Allan J. Hamilton, MD, FACS on Boomer-Living.com

As baby-boomers, we must face the possibility that our generation may go down as the most despised in history. Why? Because, despite being the wealthiest and most politically powerful generation on earth, our legacy may be a ruined planet. That bequest would be ironic since, just a few decades ago, baby-boomers were synonymous with ecological awareness and the conservation movement.

We baby boomers, after all, were the prototypes for tree-huggers. Baby boomers celebrated the first Earth Day, launched Green Peace, enacted the Endangered Species Act, enforced the Clean Air Act, and created more national parks, monuments, and wilderness areas than at any other time since the Great Depression.

It was we baby-boomers who saved the whales and brought the wolves back. Who invented communes and organic vegetables. Well, maybe not actually invented them (there may have been a Biblical precedent here or there) but, at least, we gave them product recognition and market share. At one time, it looked like baby-boomers might be the generation destined to save the Earth. But not any more.

Now, as we preside over the greatest environmental debacle in history, as we stagger under the weight of three decades of scientific data about fossil fuel emissions, holes in the ozone, disappearing rain forests and the vanishing polar ice caps, we might face the prospect of being remembered for what we failed to do rather than what we accomplished.

Our generation may be accused of smug complacency and even criminal negligence because we have so much convincing evidence in front of us. Nero was infamous for fiddling while Rome burned but what if our generation serves an entire string section while the planet is consumed?

All the dire trends are graphed. The satellite photos in hand. The polar ice specimens evaluated. Baby boomers may be condemned because no other generation has had the benefit of so many warnings. We simply cannot claim we didn’t know. The impact of rising carbon dioxide levels has been documented across all ecosystems. It is affecting flora and fauna all over the planet. And yet, so far, we have failed to stop it.

As scientists come forward to warn us that we are fast approaching the “tipping point”–beyond which we can no longer reverse the damage done by greenhouse effect–I wonder how shall we answer our grandchildren when they ask us: “Grandma and Grandpa, why did this happen on your watch?” Remember our parents’ generation was asked: “If you knew about the concentration camps and the holocaust, why didn’t you act?” Our children and grand children will similarly wonder: “If you knew this was happening to our planet–to the only place we could live–why didn’t you take action in Kyoto? Or Copenhagen?” I don’t have an answer.

It strikes me as doubly regrettable that so many of our leaders (and, by proxy, us) hide behind the premise that we cannot stand up and resist global warming because countries like China and India will not guarantee verifiable reductions of carbon emissions. Can’t we set an example instead of condemning other nations? Can’t we agree the economies of these nations, struggling out of the agrarian third world into the first industrial, might be allowed the luxury of “sinning” even as we change our own evil ways first? And since when has America justified its actions based on whether other nations do the right things?

As a baby boomer, I may nominally be a member of the generation that gave birth to the green revolution but I have not yet earned my rightful place in that ecological heritage. We can only stand out as a generation when we have stood up. So now it’s time to take up in earnest an old familiar chant: “Earth first! Earth first!” The reversal of global warming is the greatest test the human race has ever faced. It is a challenge that can define this baby boomer generation or condemn it. And it’s not a fight that any of us can afford to lose. I finally understand now that it’s personal: because this is my kids’ planet. And if I do something—enough—it might even be a better planet for their children.

So here are ten things, as individuals, as baby boomers, that I (and hopefully you) can start doing today to help:

1. Carpool or drive a car that gets thirty miles or better to the gallon.
2. Better yet, walk or bike.Set up a complete recycling program for your household.
3. Start a vegetable garden. Even if you only have a few pots, it’s a start.
4. Think local, buy local.
5. Make sure every bulb in your house is energy efficient.
6. Plant a tree or volunteer to help on a “green belt” project in your area.
7. Make your voice heard; let your representatives know this is a pivotal issue for you as a voter.
8. Don’t buy bottled water.
9. Get a permanent, dishwasher-safe, reusable water bottle and a water filter.
10. Eat only grass-fed beef.

Margaret Mead’s famous quote keeps echoing in my head: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” I imagine then that an entire generation of thoughtful, committed citizens could save it.

Originally published on Boomer-Living.com Allan J. Hamilton, MD, FACS

Every morning, we wake up to a choice: status quo or something better? We must decide if we are content to live as we have been doing or do we, can we, change? Wayne Dyer has summed the challenge like this: “If you change the way you look at things, the things you look at change.” But we’re also hopelessly caught in a kind of Catch-22: How can we change the way we see life if it is largely determined by our genetic and experiential history–something we have no control over? The answer lies in our ability to transform our personal story.

Let’s start off by confessing that each of us is just the main character in his or her own story. And that story—like all good ones—is made up. It bears no resemblance to any truth because it is simply our version of the truth. So it is fantasy, mostly lies. Not that we’re liars (we are that too, but that’s a different story). Some of us see ourselves as victims – or patients – or martyrs. Some have chosen to cast ourselves as heroes – or providers – or saviors. And, we could just claim that all of these scripts are the result of mere chance; or we can take ownership of them by admitting that our personal vision of the truth is nothing more than story we choose to believe in with the most energy.
But that admission also opens a vital option for us too. We can exercise the author’s ultimate prerogative – a rewrite. We can turn the page and start a beautiful new chapter about the story of how we began to transform ourselves to become well, to be healthy, and to be at peace. We can grant ourselves the power to declare this day – this moment – different from all the others we have experienced so far. Wellness is a script where renewal is central to the plot. It’s sets up the development of sustained inspiration, fueled by faith that every moment lying ahead can hold as much joy and beauty as we choose to put into our story.

The truth is that we just need to throw the switch in our heads. Turn disbelief into wonder. Maybe it’s nothing more than walking the dog two extra blocks (for the dog’s sake) – or heading to the gym for the first ten minutes of your life – or maybe, it’s canceling fast food tonight and deciding to cook a fresh, wholesome meal – or maybe, it’s listening. Maybe it’s asking a question, instead of giving an answer, so there’s a space created for another person’s voice to fill – or maybe it is just watching stuff instead of doing stuff.

The changes may be small changes but they are the bricks with which we build the path of rejuvenation. Two blocks becomes four. Ten minutes in the gym leads to fifteen. One good meal takes you to the organic produce aisle. And one conversation of active listening leads to a deeper friendship. That’s how renewal begins.

The best part of renewal is creating a context for dreams. My daughter taught me the power of context. One day, when she was about ten, she went through a stage where she had a fantasy that she would go diving for buried treasure off the Great Barrier Reef of Australia. Don’t ask me where or how this notion came. Let’s just assume she wrote it that way. But, as part of her chapter, she decided one afternoon she should lead me by the hand to the swimming pool in our backyard.

Here, she took a step down into the water and then settled her diving mask on her face. Then she looked up at me expectantly as if to say: “Well, we’re not going to find any gold standing here on the edge—out of the water.” So I put on my mask, flippers, and snorkel to play along and off we glided into the deep—the deep end, at least. The next evening the ritual repeated itself only we swam about longer. Somehow the game got more elaborate with each dive. Soon, on my way home, I would stop off at the pet store and purchase a handful of small plastic sharks and rubber whales, designed for decoration in aquariums, and bring them to populate the imaginary reef in our pool. We would swim after them and race to see who could get them first. We would hold our breath and dive to the bottom to retrieve them. Our play sessions in the pool stretched into hours.

I also began to mysteriously develop a terrible French accent – a bad imitation of Jacques Cousteau – with which I would narrate each of our dives. “As we pree-pair to leeva da safetee of da Calypso, my diving part-nair and I sink een-too dee deep when we suddenly see dee vague but ohm-meenous sha-dough of what could only be aah great white shark.” Then I’d start shaking a handful of my sharks back and forth, wrestling with them in a miniaturized feeding frenzy, and left me sinking helplessly to the bottom. Only my daughter could save me. And for that, well, she had to decide to change the story. Forsake her quest for the gold or save me instead? The great whites would then slowly sink into the depths. As she swam to rescue me, I could see my daughter smile so widely that tiny little bubbles would escape from the corners of her mouth. I am sure Monsieur Cousteau could not have written it better.

Renewal means today will be different because we are willing to entertain new, different stories which all begin by allowing ourselves the freedom to play the characters we want to be.

(originally posted on www.boomer-living.com)

Often we undertake bringing about healthful, positive changes in our lives, but we always seem to find ourselves falling short of our expectations. Our resolution just seems to eventually fizzle out. We have the best of intentions. We start off well with lots of enthusiasm and determination. And then, life just starts to get back in our way. We tell ourselves that it’s just a momentary hiatus, nothing more and that we get right back on track; but, we don’t. Instead, we find ourselves on a slippery slope and our determination eventually evaporates.

Every one of us can tell a similar story whether it’s weight loss, exercise, or spending quality time with our kids. As one of my acquaintances put it, “I’ve been losing the same twenty pounds my whole adult life.”

So why do we all find ourselves falling short? The answer: We all exhibit a lack of mindfulness. We deal with our expectations–with what we should bedoing–what the future was supposed to be. Or, we kick ourselves in the rear with frustration or guilt about the past–what we should have done. In both the past and the future, we’ve locked ourselves out of the present (the now–the moment) where the real engine of change and transformation lies.

So let’s say I’ve resolved to finally lose that twenty pounds of extra weight my doctor has told me I need to shed. I get out my healthful dietary plan and recipes. For a few days, I’m all pumped up, psyched. I’m the fervent convert.

The first week goes well.

But then there’s the night when I’m stuck at the office. I get home late. I take some paperwork home to finish that night. I tell myself I can’t afford the extra minutes to cook something so I stop off at McDonald’s. I grab my bag and drive home. Plop my work on the dining room table and start reaching in for a few fries. I turn on CNN to catch up on the news and the stock market.

So where am I in all this? I’m all over the place! I’m bouncing off the walls and my attention is ricocheting like a bullet. I’m not even enjoying the burgers. I’m not giving my attention to the paperwork. And the market dropped a hundred and fifty points, so I’m worried about how my portfolio is going to do tomorrow.

What was I really feeling through out all of this? Resistance. I was not mindful enough to stop, feel it, and recognize when it was happening. I was angry and frustrated that my boss made me stay late. I could have made a healthy meal out of the fridge. It actually would have taken less time and money than the stop at McD’s but, in truth, the burgers were the consolation prize I gave myself for what I perceived as having been treated unfairly and made to stay late against my wishes. So I felt I deserved “a break today”, as the commercials say.

I reacted to my resentment. I did not stop to ask myself what I was really feeling at that moment as I watched the clock ticking away in the office. Nor did I ask myself what I wanted to do about it. I just reacted. And how did I react? Returning to old familiar habits which is what we all do when we react viscerally. As John Shukwit, a behavioral health therapist, put it, “Habit, by definition, is not mindfulness”. Habit is autopilot. We’re not flying the plane. We’re being carried by it. We’re passengers.

After I’m done gulping down the burgers (I ate them so fast while watching the news I was hardly aware of what I ate), I hate myself for it. Oh, I should have just come home and grabbed something. I chide myself that I should be eating healthier. And there are those magic words again–should have (the past)–should be (the future). Guilt in the past. Expectations in the future. Me? Where do I find myself? Nowhere close to being mindful, in the present.

What is the moment? I hate my boss right now. I’m anxious about reading all those files. Right now: I’m bloated; I’m nauseous; I’m taking an Alka Seltzer. Right now: I am feeling better about my diet when I plan out my breakfast because it helps me feel like I’m correcting myself. Right now: Here’s the orange I’m picking for tomorrow’s breakfast. I love the smell. The feel. The organic label makes me feel safe. The whole-wheat toast feels rough and grainy. The egg whites are put in their container and I’m chopping up some neat looking vegetables to add to the omelet. I acknowledge what I’m feeling. Resistance lies in the past and the future. I cannot focus on what I wanted myself to do or what I hope I will do tomorrow if I declare what sensations I have in this instant.

The question that keeps us anchored in the present is: What am I feeling now? And now? And now? There’s no resistance because I’m acknowledging it. There may be anger and frustration over quitting my diet but that’s what I’m feeling and I want to discern that because when I stick to my diet plan I feel healthier.

So asking the right question can keep us returning to the moment. And that’s where our ability to carry out transformational change is to be found. Right now. No regrets. No wishes. Just doing or not doing. Even if it takes a whole lifetime to do it.

originally posted in Boomer-Living.com by Dr. Hamilton

In what was to prove her penultimate visit with me, she described a trip that she and her husband had taken to the top of the nearby Santa Catalina mountain range. They had chosen Mt. Lemmon, overlooking the city of Tucson, as their destination as it was accessible by a well-paved road that could carry them all the way to the summit. By this time, her tumor had robbed her of almost all ability to ambulate and she was no longer able to navigate any treacherous terrain, let alone a mountain trail.

Upon arriving at the clearing on the summit, her husband had opened the trunk of his car and, from within its depths, produced a picnic basket, complete with traditional red-and-white checkered tablecloth that he laid out on the ground with painstaking care. The wicker basket, he confessed to his wife, was full of nothing but sin. It contained paté de foie gras. A rich, runny Camembert cheese. And fresh baguette bread and pastries aplenty. He also produced a bottle of vintage red wine.

There, on top of the mountain, he admitted: “I have always been holding onto this bottle. I’ve had it for several years, hoping some great occasion would come along and then I could open it. A chance to celebrate something, to commemorate…something. But a couple of days ago, I came to my senses and decided there is only one thing worth celebrating: today.”

“So what, exactly, are we celebrating?” she asked. “There’s not much to celebrate. I’m dying.”

“No. That’s not exactly true,” he replied. “We’re going to celebrate that you’re alive. You’ll only be dying in that last minute when you actually expire. But, for the rest of the time–up until then–you’re alive. That’s what I want—what we can choose–to celebrate.” His wife looked at him for a second.

“You know, that the doctor told us that I shouldn’t drink. Alcohol could trigger another…event.” The husband didn’t seem to even be listening.

He popped the cork out. “Don’t bother,” she said, “I’m not going to have a drink.”

“Watch this,” the husband said. He slowly decanted the wine into an elegantly stemmed glass of cut crystal. He poured the wine until the glass three quarters full.

“If you drink too much of that,” his wife admonished him, “you won’t be able to drive us back down the mountain. And you know I can’t drive because of my seizures.”

He held the wine glass high up in front of him against the sun where it stood like a gigantic, luminescent ruby. As the light danced through it, he turned the glass by its stem round and round between his fingertips. With each revolution, blood-red shafts of light shimmered.

“Oh, my,” she exclaimed, “it looks like it’s practically alive.”

“It is. The sun is dancing with the grapes right now. There is nothing in this glass that can hurt you.” He held the glass in her direction.

“Think so?”

“I know so. I promise. Nothing this beautiful can hurt.” With that, she took the glass, full of light and wine and love, and held it to her lips. She took a sip and then a full swallow.
“That is a great glass of wine, isn’t it?”

“The best,” he smiled.

The wife finished her first glass. She looked at her husband inquisitively. “You think I dare have another glass?”

“Well, what’s the worst that can happen?” he asked.

She smiled, grabbed the bottle herself and poured another glass, fuller than the first. She then held the glass up high for a toast. “I suppose the worst is that I get a good buzz on and could just go on and die happy. Right now. Then you’d have to drive my corpse back down the mountain.”

“Well, I’d have to drive you down either. Dead or alive. It’s the same amount of gas.”

My patient never did have a seizure. Not on that day, or any of the remaining forty-three she had left to live on this earth. All of us, the doctors, were wrong. The wine was right. As a physician, I can’t help but wonder how many patients we restrain with our conservative advice, how many moments of joy we have inadvertently extinguished with sage, restrained medical advice. It is a part of our frail intellectual tradition of medicine that we play it safe and teach our patients to avoid unnecessary risks. But so often the moments of greatest happiness and abandon lie in the direction of the greatest chance.

previously published by Dr. Hamilton on Boomer-Living.com

President Obama will address the nation on how he proposes to fix healthcare. Unfortunately, neither the President nor Congress have the courage, will, or strength to put forth a proposal that would support a government-backed single payor plan—the one and only long-term solution to the crisis in American healthcare.
That’s because such a plan would mean the end of excessive profiteering by both the health insurance and the pharmaceutical industries. Together, these two industrial sectors represent the most powerful lobbying groups the Congress has ever seen. Their combined revenue last year was in excess of a trillion dollars and that buys the attention and compliance of a lot of members of both the House and the Senate. And those elected officials who do not go along with the agenda of these lobbyists will find their more willing opponents well funded in the next upcoming election.
A single payor universal healthcare plan would mean no private insurance company (what’s referred to as third party payors) could survive if they charged more than the government. That would be equivalent to a congressional mandate requiring that private health insurance not seek reimbursement greater than what is provided by Medicare—a non-profit, government-run healthcare program. An insurance company cannot comply with such a requirement and still skim off thirty percent of its insurance premiums to funnel back to shareholders and top executives (many of whom received bonuses in excess of $4 million last year while millions of Americans lost their jobs and healthcare coverage). Most third party payors currently seek reimbursement rates as high as 115-200% of Medicare reimbursement.
Unfortunately, the situation is even more despairing when it comes to the pharmaceutical companies. The last thing they want to see is a federal single payor system that can basically demand that negotiated prices on drugs carried in the government’s formulary be reasonable, fair, and subject to periodic review. That would be a pity for many of the pharmaceutical companies that see as much as three thousand percent mark-up on the medications they sell. To put this excessive profiteering into perspective, American patients spend as much as eighty percent more for exactly the same medications that their European counterparts are purchasing. Why? Because American healthcare is as ripe for plundering and profiteering as Wall Street found the real estate market to be.

Many critics (and now the ubiquitous “carpet bombing” of television ads produced by the insurance and pharmaceutical companies) claim that a government-run single payor system is tantamount to the s word—socialism.  So what. Such socialistic healthcare systems have worked well in more than twenty countries in Europe. In fact, every nation listed in the top twenty of the World Health Organizations ranking of health care systems provides its citizens with universal health care.  The United States, incidentally, is ranked thirty-seventh, just behind Costa Rica and just in front of Slovenia. Ask how many Americans want to seek their healthcare in Slovenia? Interestingly, Medicare could be fairly described as a socialist institution. No one has objected to the fact that currently more than fifty percent of all American healthcare is funded and overseen by the US government and that it used as the standard by which the private payors measure the coverage in their own healthcare plans (not the cost, just the coverage).

Finally, sooner or later, America must have a single payor system. It is inevitable that something must be done to control the upward spiraling costs of healthcare. We are just beginning to learn that we must tackle global warming or we will all perish with our planet. For healthcare, the end is much closer than for carbon emissions. Medicare funds will be completely depleted by 2015. If Medicare and Social Security costs continue at the current rate of growth then, by 2050, the entire budget of the federal government will be reduced to just these two items. No DOD. No EPA. No Department of Justice, Homeland Security, or Department of the Interior. It will mean the end of government as we now know it. So, like it or not, we have got to control healthcare costs (and, yes, to some extent, probably ration it too). The only solution lies in a universal, single payor, healthcare program for the United States.

But, in the next few months of debate and hearings about healthcare reform, the only mention of a national single payor system will be denouncements by naysayers. Not supporters. It will be discussed as untenable, unnecessary, and un-American—largely by the individuals bullied or paid to say it. As the American people, we have recently been witness to the un-American qualities with which the top executives have been leading this country’s largest, most powerful corporations. And you will see the idea of a national, single payor healthcare conveniently smothered at the hands of hundreds of our elected representatives—again. And we will wait for American healthcare to collapse–as we did for the auto industry, the mortgage funds, and the stock brokerage houses–before we can find the courage to do what’s right and to do what’s needed.

But that admission also opens a vital option for us too. We can exercise the author’s ultimate prerogative - a rewrite. We can turn the page and start a beautiful new chapter about the story of how we began to transform ourselves to become well, to be healthy, and to be at peace. We can grant ourselves the power to declare this day - this moment - different from all the others we have experienced so far. Wellness is a script where renewal is central to the plot. It’s sets up the development of sustained inspiration, fueled by faith that every moment lying ahead can hold as much joy and beauty as we choose to put into our story.

The truth is that we just need to throw the switch in our heads. Turn disbelief into wonder. Maybe it’s nothing more than walking the dog two extra blocks (for the dog’s sake) - or heading to the gym for the first ten minutes of your life - or maybe, it’s canceling fast food tonight and deciding to cook a fresh, wholesome meal - or maybe, it’s listening. Maybe it’s asking a question, instead of giving an answer, so there’s a space created for another person’s voice to fill - or maybe it is just watching stuff instead of doing stuff.

The changes may be small changes but they are the bricks with which we build the path of rejuvenation. Two blocks becomes four. Ten minutes in the gym leads to fifteen. One good meal takes you to the organic produce aisle. And one conversation of active listening leads to a deeper friendship. That’s how renewal begins.

The best part of renewal is creating a context for dreams. My daughter taught me the power of context. One day, when she was about ten, she went through a stage where she had a fantasy that she would go diving for buried treasure off the Great Barrier Reef of Australia. Don’t ask me where or how this notion came. Let’s just assume she wrote it that way. But, as part of her chapter, she decided one afternoon she should lead me by the hand to the swimming pool in our backyard.

Here, she took a step down into the water and then settled her diving mask on her face. Then she looked up at me expectantly as if to say: “Well, we’re not going to find any gold standing here on the edge—out of the water.” So I put on my mask, flippers, and snorkel to play along and off we glided into the deep—the deep end, at least. The next evening the ritual repeated itself only we swam about longer. Somehow the game got more elaborate with each dive. Soon, on my way home, I would stop off at the pet store and purchase a handful of small plastic sharks and rubber whales, designed for decoration in aquariums, and bring them to populate the imaginary reef in our pool. We would swim after them and race to see who could get them first. We would hold our breath and dive to the bottom to retrieve them. Our play sessions in the pool stretched into hours.

I also began to mysteriously develop a terrible French accent - a bad imitation of Jacques Cousteau - with which I would narrate each of our dives. “As we pree-pair to leeva da safetee of da Calypso, my diving part-nair and I sink een-too dee deep when we suddenly see dee vague but ohm-meenous sha-dough of what could only be aah great white shark.” Then I’d start shaking a handful of my sharks back and forth, wrestling with them in a miniaturized feeding frenzy, and left me sinking helplessly to the bottom. Only my daughter could save me. And for that, well, she had to decide to change the story. Forsake her quest for the gold or save me instead? The great whites would then slowly sink into the depths. As she swam to rescue me, I could see my daughter smile so widely that tiny little bubbles would escape from the corners of her mouth. I am sure Monsieur Cousteau could not have written it better.

Renewal means today will be different because we are willing to entertain new, different stories which all begin by allowing ourselves the freedom to play the characters we want to be.

This article originally appeared in Dr. Hamilton’s Well-Beings column on boomer-living.com