It’s three am and I’m wide awake. I’ve been napping on and off since first awakening at midnight.  I just watched the end of a movie about a comedy writer who has Creutzfeldt-Jakob disease and is slowly losing his memory.  Billie Crystal’s performance is outstanding.  It’s sad when you live a full and happy life, only to lose your memory of that lifetime at the end.

I am dying a little at a time.  Currently, there is more of me that is gone than there is of me that still exists.  There is very little I can do about it.  Most days consist of napping in my lift chair until it’s time to eat, then repeat.   I can’t remember the last time I made Renee laugh or saw her smile. Her day is spent picking up after me since I drop things and can’t bend over to pick them up.

I work at maintaining a good attitude but fail often. I’ve got a long list of “used to” and it gets longer every day.  I’m fighting to lose some weight yet eating is now one of the few pleasures my body allows me to partake of.  There’s even a drawback to eating.  I bite my lip on at regular intervals.

I’ve become that “train wreck” of a patient that I hated to see because I couldn’t fix him/her.  I see a specialist for every part of my body knowing that there is not much they can do.  I remember the patient who was awake all night and slept all day and the advice I gave him about nocturnal binge eating.  Well now, that’s me.

I remember the counseling I gave the patient about depression and chronic illness.  Now that’s me.  I remember the patient who was bored because he spent almost the entire day in a chair.  Now, that’s me.  I remember all the patients I worked with over the years and all the good advice I handed out, and what bullshit that advice turned out to be.

I’m not giving up but it’s getting harder to be positive. I’m going on a cruise ship for a five-day trip to the Bahamas.  Rather than walk the deck at sun-up and sun-down, I’ll ride a scooter.  Rather than run down the beach and dive into the water, I’ll sit on the beach and look at the water.   The one thing I will do well is eat, being careful not to regain the weight I’ve lost.  Did I tell you I’m massive?  It seems the only thing I excel at is gaining weight.

This blog is coming to an end.  As I no longer practice medicine, there’s not much to write about.  I certainly do not want to publish dark and depressing articles like this one.  There are over 1500 articles on this site, many worth reading over and over again. 

I plan to shut this site down in December so feel free to print copies of any of the articles you’ve found helpful if you want them.  It has been my privilege to have shared my knowledge and thoughts with you through this site.  I wish you all health and wellth.

Here’s your joke for the day:


At 3 am, I wrote my last blog.  Actually, I thought it was my last blog but I just got sick listening to the news and I’m going to break one of my cardinal rules and comment on politics.  I’ve always thought that my political beliefs should be kept to myself so as not to interfere with my medical judgment and care.  As I’ve stated in earlier articles, times have changed.

The reporter on CNN was reviewing the DOJ’s decision to appeal the recent ruling regarding the appointment of a “Master.”   He showed a chart that broke down the judges the DOJ would be appealing to, Republicans and Democrats, and stated that not only did Republican judges outnumber Democratic judges, but that the majority of the Republican judges were appointed by Trump. He implied that an appeal was jeopardized by the judges appointed by Trump.  It’s as if they had been bought and now would pay off the cost of appointing them.

Now imagine that medical care was delivered by a system similar to the appointing of judges.  Might the doc decide that your condition is hopeless and let you die?   Might he decide that you deserved to live but, because you supported pharma, he would give you obscenely expensive medication.  Or, as a parallel to today’s issues, might he ignore your immediate risk and call for a “Master” to decide whether to resuscitate you, knowing that the “Master” is days or weeks away and likely to arrive too late.

I’m glad I’m on the downside of life.  Our democracy is crumbling. There are fewer Americans, fewer fair judges or politicians.  There are Republicans and Democrats; there are extremists, conspiracy believers, MAGA, LGB …, ETC. Certainly, you can’t trust anybody.  At a time when you can claim innocence and that your accuser is lying (despite being captured on film committing the crime), you can get away with anything.

There has never been a better time for orgies.  Shit, I’m too old for an orgy!


The medical world has changed to the extent that I no longer recognize it!  What I used to take for granted, I now question. Did doctors really respond to patient needs after hours?  I remember pulling off the road and putting quarters in a pay phone, returning patient’s or the hospital’s call.  Did I really do that or was I hallucinating?

I remember awakening to the phone ringing, taking a message from the answering service and then calling my patient or the hospital, responding to my patient’s need.  Did I really do that?  Yep, I took call seven days a week for years.

I had an exam room at home and, on weekends, would have patients come to my house to be examined.  During the summer, their doc was often in a wet bathing suit.  And yes, I made house calls when appropriate.  My memories of these events are so complete, it must have been real; yet today’s docs look at me like I’m nuts when I talk about the old days.

I started my day doing hospital rounds.  On occasion, I assisted in surgery and even delivered babies. I did a long list of procedures in my office, negating the need to send my patients to the ER.  Now a shoulder surgeon claims he is not trained in elbows or wrist.  Now a message may go unanswered for over a week if the doc is on vacation.  As many of you know, I spent a few weeks in Mexico every year.  Dr Bell covered my practice and supervised my PAs.  What you didn’t know is that, while on vacation, I woke up at 6 am and reviewed every chart note on every patient seen in my absence.

The world I worked in was certainly different than the world I’m currently living in.  In retrospect, I was so dedicated to my patients’ care that I must have been nuts. Of course, most of the family docs and internists I trained with and called colleagues did the same thing.  The closest I’ve come to finding an old fashioned doc is my Gerontologist.  While she does not go to the hospital or make house calls, she does some procedures in her office and is available on short notice.

There are a few dinosaurs still making hospital rounds in the morning before going to the office.  I check in on Dr Bianchi from time to time.  He still practices as I did 40 years ago.  God bless Dr Bianchi.  Lake Zurich is lucky to have an old fashioned family doc.

The next version of medical care is taking root now.  Telemedicine is here to stay, and, in my opinion, TV driven telemed is horrible.  There are commercials for erectile problems, depression, baldness, birth control and others.  The commercial informs you that you will be assessed by a licensed medical “provider.” A licensed medical “provider” is probably not a medical doc!  When you respond to one of these commercials, you are trusting a stranger who will never meet you with your medical care.  You have no idea what the provider’s training is or what degree he/she holds.  That should scare you!

It certainly scares me!!!

Here is today’s joke:  You don’t appreciate a lot of stuff in school until you get older. Little things like being spanked every day by a middle-aged woman: Stuff you pay good money for in later life.

– Emo Philips

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