Hey Dr. Emanuel: you might not want to die when you’re 75!

I have been observing some wonderful physicians and nurses and others at the VA facility at Fort Miley in San Francisco.  The VA’s commitment to appropriate, non-torturous end-of-life care and its efforts to educate clinicians about how to deal with patients with serious illnesses is impressive.    I have, for example, observed physician Eric Widera and his geriatric and palliative care team at the VA in San Francisco.  They have a blog called GeriPal, which has wonderful information and posts about geriatric and palliative care.  They did this post on Ezekiel Emmanuel’s article in the Atlantic “Why I Hope to Die at 75.”  Since I also wrote about this in a recent post, I thought people would like to see this post by  Alex Smith.

Friday, September 19, 2014

Hey Dr. Emanuel: you might not want to die when you’re 75!

by: Alex Smith, @alexsmithMD

You may have heard of a new article in the Atlantic by Dr. Ezekiel Emanuel provocatively titled, “Why I Hope to Die at 75“.

Please take a moment to read it.

If you haven’t read it, and are … Continue reading

VA System Unfairly Maligned

Just did this oped on one of the biggest stories of 2014 and why it is so unbalanced.  It has run in a number of newspapers across the country.  This is from the Charlotte Observer, which picked it up.

VA system unfairly maligned

By Suzanne Gordon
Tribune News Service
Posted: Wednesday, Dec. 10, 2014

One of the biggest – and most misunderstood – stories of 2014 was about the nation’s largest health care system, the Veterans Health Administration.

Revelations that managers at the VA were concealing long wait times led to the resignation of VA Secretary Eric Shinseki and has left the lasting impression that the VA does not deliver high-quality care.

The drumbeat of negative coverage has also made it difficult for the new VA secretary, Robert A. McDonald, to recruit more physicians, nurse practitioners and physicians’ assistants to ease the staffing shortage that caused the waits in the first place.

And this negative coverage also obscured the basic fact that the VA delivers some of the best – indeed, some of the only – coordinated health care in the entire country.

While many health systems and hospitals in the private sector talk about patient safety … Continue reading

An Open Letter to Ezekiel Emanuel on Life and Death

3be28e23eIn the October issue of The Atlantic, physician and medical ethicist Ezekiel (Zeke) Emanuel, brother of Rahm Emanuel (former official in the Clinton White House, then Congressman, then Chief of Staff for President Barack Obama, now Mayor of Chicago) published an article why he thinks we should all forgo advanced age and die at 75. As a 69-year-old moving toward 75, my response to that article is this blog post requesting a stay of execution from our newly appointed Czar of American longevity.

An Open Letter to Ezekiel Emmanuel.

Dear Ezekiel Emmanuel:

Please forgive me for taking so long to comment on your article in The Atlantic arguing that we should declare our lives to have reached their productive limit at age 75 and therefore gracefully exit this world before we move into an inexorable decline. Your article – “Why I Hope to Die at 75″ -- appeared in The Atlantic in October and here it is December and I have not joined the 3000 plus people who commented on it earlier. First, I confess, I did not read it until almost a month ago, and then, I had … Continue reading

Alternative Models of Policing: Ferguson Should Learn from This

My husband Steve Early just wrote this great article about the city we live in — a city that has learned some hard lessons about policing.


Police Violence is Not Inevitable: Four Ways a California Police Chief Connected Cops with Communities


In the wake of Missouri’s grand jury decision, a model for better policing and relationships with the community is needed. Richmond, California is an example other cities can learn from.

Published: November 29, 2014 | Authors: | YES! Magazine | News Analysis

In the wake of a Missouri grand jury’s decision not to indict Darren Wilson, the police officer who shot and killed Michael Brown, it can be difficult to imagine a place where law enforcement and a racially diverse population work together productively in the United States.

But it’s happening in Richmond, California, a gritty town in the San Francisco Bay Area best known for its massive Chevron refinery and, in previous years, for its high crime rate. While the situation in Richmond isn’t perfect, it is an example other cities can learn from.

Today, violent crime in Richmond is down. In 2013, … Continue reading

Another Story of Silencing in Medicine

rounds.600Another dispatch from the front lines of patient safety. Several weeks ago, I spoke at a teaching hospital about the difficulties that medical staff encounter when they try to protect patients. I encouraged medical staff to speak up to protect patients, while acknowledging that the environment in which they practice does not – in spite of all protestations to the contrary –encourage such action. After the lecture was over, a striking young woman in her mid-twenties approached me. She asked if she could talk to me to tell me a story about which, she confessed, she feels totally ashamed. Of course, I said. (She asked me not to identify her, or her school, or even the region of the country where she is studying. For the purposes of this blog post, I am going to call her “Carla,” although that is not her name.)

“Carla” explained that she is a fourth year medical student and was, at the time of this incident, a third year student. She was going into her first clinical rotation, which just happened to be in surgery. She and a team of interns, a resident and senior resident … Continue reading