The Philosophy of Wisdom and the Wisdom of Philosophy

 

Recently I had the pleasure of reading Daniel Klein’s little wisdom book, Travels with Epicurus (2012), a writerly account of his month on the Greek island of Hydra in search of a philosophy of old age.  Klein opens with a story about being faced with the question of whether to pay for expensive dental implants or lives “with an old man’s goofy smile.”  He decides to forego the implants and uses the money instead for his journey to Greece. Continue reading…

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Mental Health Care for the “Silver Tsunami”

On January 23 the New England Journal of Medicine published “The Underside of the Silver Tsunami – Older Adults and Mental Health Care.” The article draws on an Institute of Medicine report on the mental health workforce for older adults that Peter Brown, executive director of the Institute for Behavioral Healthcare Improvement, discussed here on Over 65 four months ago. Continue reading…

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Are You Still Working?

Though a newcomer to the blogosphere, Over 65 has already attracted media attention.  A few weeks ago, a network news staffer contacted The Hastings Center trying to find a woman over 65 who is still working for an interview the following day. Susan Gilbert, Hastings public affairs and communications manager, contacted me that night and I agreed, somewhat perplexed by what could possibly make my date of birth rather than the work I do newsworthy. Continue reading…

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Living Will, Dying Well

I glanced at the chart. New patient, female, age 72.

I have adopted the practice with new patients of quickly scanning the medication list before opening the door to greet them. In the old days patients hand wrote their medications on a paper intake form prior to the office visit. Now I click the “medications” tab in the electronic health record to review the data already entered. Continue reading…

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Avoiding Unneeded Tests

In my previous post, I talked about medical tests and how “normal” and “abnormal” results do not always correlate to healthy or sick.  The bottom line from that discussion is that while tests are essential to diagnosing illness, they are fallible. Put another way, if you do enough testing on anyone, some tests are bound to turn up “abnormal” regardless of whether the person has a real abnormality.  So, what does it mean when we have an abnormal test result?  Continue reading…

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What Patients Should Know About Medical Testing

The next two posts are about medical testing, something to which we are more and more subject as we get older.  It seems rare these days to visit a doctor’s office and not come away with a handful of requisitions for some kind of medical test. This is especially true as we get older. Continue reading…

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Does Self-Deceit Increase Happiness in Old Age?

Do old people have a “positivity bias” so that they self-deceptively ignore negative information?  Yes, says evolutionary biologist Robert Trivers in his provocative book, The Folly of Fools: The Logic of Deceit and Self-Deception in Human Life. Trivers tells us that preliminary experiments show older adults preferring positive faces, ignoring negative stimuli and generally focusing on emotionally positive stimuli. Continue reading…

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Retiring and Rechilding

“You’re not a psychiatrist anymore,” my wife has told me over and over since I retired from clinical practice on June 30, 2012, our  44th wedding anniversary. For a while, I kept protesting that conclusion. Wasn’t I writing as a psychiatrist more and more? Still presenting papers? Still serving on professional boards? Surely, not seeing patients was not the only criteria for being a psychiatrist, right? Didn’t people still ask me psychiatric questions, maybe even more than they used to? I could still focus on psychiatric ethics, even branching out into general ethical and moral theory and behavior, that most serious of topics. Continue reading…

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