His book, “Being Mortal” will be discussed at next Monday’s Book Club at Skyline.
His book, “Being Mortal” will be discussed at next Monday’s Book Club at Skyline.
Should one be a stoic or be an epicurean – or are the philosophies of the “dead white guys” still relevant. Professor Massimo Pigliucci has written about his take on finding a happy life – How to Be a Stoic: Using Ancient Philosophy to Live a Modern Life (2017). He uses Seneca as an example. (Marcus Aurelius is my favorite stoic.)
Pigliucci writes in Aeon: “Lucius Annaeus Seneca is a towering and controversial figure of antiquity. He lived from 4 BCE to 65 CE, was a Roman senator and political adviser to the emperor Nero, and experienced exile but came back to Rome to become one of the wealthiest citizens of the Empire. He tried to steer Nero toward good governance, but in the process became his indirect accomplice in murderous deeds. In the end, he was ‘invited’ to commit suicide by the emperor, and did so with dignity, in the presence of his friends.
Seneca wrote a number of tragedies that directly inspired William Shakespeare, but was also one of the main exponents of the Stoic school of philosophy, which has made a surprising comeback in recent years. Stoicism teaches us that the highest good in life is the pursuit of the four cardinal virtues of practical wisdom, temperance, justice and courage – because they are the only things that always do us good and can never be used for ill. It also tells us that the key to a serene life is the realisation that some things are under our control and others are not: under our control are our values, our judgments, and the actions we choose to perform. Everything else lies outside of our control, and we should focus our attention and efforts only on the first category.
Seneca wrote a series of philosophical letters to his friend Lucilius when he was nearing the end of his life. The letters were clearly meant for publication, and represent a sort of philosophical testament for posterity. I chose letter 92, ‘On the Happy Life’, because it encapsulates both the basic tenets of Stoic philosophy and some really good advice that is still valid today.” Click here for the full article.
From Cabby Tennis

Cold Spring Harbor Labs on Long Island is primarily about research, only secondarily about grad students. Most of these people are post-docs, selected from a worldwide pool of applicants without nationality restrictions; getting in for a few years is quite competitive. The non-US are under-represented because of all the highly qualified ones who fail to get visa and work permits. The US citizens are underrepresented because the culture of US high schools, thanks to local control by school boards, undervalues science and other hard work.
The 20th century will be remembered in many ways – one of which is the epidemic of lung cancer, emphysema, and cardiovascular disease related to tobacco abuse. Remember when cigarettes were less than a quarter a pack and the cheapest prices were at the VA Hospital canteen? Remember Bob Hope, Arthur Godfrey, doctors, and Joe Camel praising the cool aspects of smoking? Also to women, “You’ve come along way, baby.” What a way to equate women’s lib to smoking, and it worked!
We’ve got lots of problems in the 21st century, but there is some progress in the decline of smoking, but not enough. According to Wikipedia “As of 2002, about twenty percent of young teens (13–15) smoke worldwide. 80,000 to 100,000 children begin smoking every day. Half of those who begin smoking in adolescent years are projected to go on to smoke for 15 to 20 years.[9]“
There are a variety of smoking control programs and some medications which can help the smokers, but it proves to be one of the most difficult additions. A thoracic surgeon, friend, and patient of mine would be operating on a lung cancer – but then break in the middle to smoke in order to handle the jitters of nicotine withdrawal. Group Health, where I worked, became the first large health care organization in the country to become “non-smoking.” This was done in the early 80’s so we’ve indeed come a long way. Our respiratory therapists, doctors, and ICU nurses gradually become non-smokers.
Have you noticed the prices of cigarettes are rising. New York City has proposed raising the price to $13 a pack – or about 65 cents a cigarette. This might work, or might drive the poor to cheaper substances. Let’s see how it plays out. The “newest kid on the block” is the e-cigarette, the latest method to become nicotine addicted.
The letter below to President Trump was signed by America’s Health Insurance Plans, the American Academy of Family Physicians, the American Benefits Council, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association, the Federation of American Hospitals, and the U.S. Chamber of Commerce.
This was occasioned by the President’s threat to cut cost sharing funding which is vital to Obamacare.
Dear Mr. President:
As providers of healthcare and coverage to hundreds of millions of Americans, we share many core principles and common priorities. We believe that every American deserves affordable coverage and high-quality care. We stand ready to work with the Administration and all members of Congress to keep this commitment.
A critical priority is to stabilize the individual health insurance market. The window is quickly closing to properly price individual insurance products for 2018.
The most critical action to help stabilize the individual market for 2017 and 2018 is to remove uncertainty about continued funding for cost sharing reductions (CSRs). Nearly 60 percent of all individuals who purchase coverage via the marketplace – 7 million people – receive assistance to reduce deductibles, co-payments, and/or out-of-pocket limits through CSR payments. This funding helps those who need it the most access quality care: low- and modest-income consumers earning less than 250 percent of the federal poverty level. If CSRs are not funded, Americans will be dramatically impacted:
• Choices for consumers will be more limited. If reliable funding for CSRs is not provided, it may impact plan participation, which would leave individuals without coverage options.
• Premiums for 2018 and beyond will be higher. Analysts estimate that loss of CSR funding alone would increase premiums for all consumers – both on and off the exchange – by at least 15 percent. Higher premium rates could drive out of the market those middle-income individuals who are not eligible for tax credits.
• If more people are uninsured, providers will experience more uncompensated care which will further strain their ability to meet the needs of their communities and will raise costs for everyone, including employers who sponsor group health plans for their employees.
• Hardworking taxpayers will pay more, as premiums grow and tax credits for low-income families increase, than if CSRs are funded.
We urge the Administration and Congress to take quick action to ensure CSRs are funded. We are committed to working with you to deliver the short-term stability we all want and the affordable coverage and high-quality care that every American deserves. But time is short and action is needed. By working together, we can create effective, market-based solutions that best serve the American people.

From the San Diego Tribune: By Joshua Emerson Smith
Will Americans start seeing more lab coats at political rallies like the upcoming March for Science in the nation’s capital, San Diego and hundreds of other locations?
While many scientists have shied away from explicitly political actions in recent decades, the community throughout history has spoken publicly on a wide variety of social, technological and ideological issues. That has included everything from opposing fascism, nuclear proliferation and the Vietnam War to sitting on government panels that advise elected leaders on stem-cell research involving human embryos.
Sometimes history has proven the scientific majority to be correct, such as with the overall benefits of vaccination. At other times, history has shown that scientists are vulnerable to an assortment of biases, such as with eugenics research and the long-held view of sexual orientation as a lifestyle choice.
Several years ago, we went to an Easter service at the Bellevue First Presbyterian Church. The pastor shared a story as follows: Two neighbor ladies were quite friendly. One owned a pet rabbit, the other a golden retriever. One day, to her owner’s horror, the golden retriever arrived home with the neighbor’s prized rabbit, dead, in its mouth. Totally flustered, the kind but embarrassed woman decided on a plan to solve her dilemma. She brought dead rabbit in, bathed it and used a hair drier to fluff up the fur. Then surreptitiously she stole into the neighbor’s yard and placed the poor dead bunny back in its hutch. Several hours later, she received a somewhat frantic call from her neighbor, “You’re not going to believe this. My rabbit died two days ago, we buried him, and I just can’t believe it. He’s back!
It seemed odd to me to tell this “resurrection” story in this Holy Season, but at least it does remind us of one of those lessons to be learned in kindergarten, “honesty is the best policy.” Also noted, “we tend at times to create our own crisis.” Perhaps the woman should have asked the eternal Christian question, “What would Jesus have done?”
Update from : Aging & Disability Services; Seattle King County Area Agency on Aging
Thanks to effective advocacy from the Advisory Council and aging network partners, there has been a number of wins this legislative session, including:
As for budgets, the Senate budget includes several “age-friendly” increases, including:
Budget negotiations are underway, which may mean no news for a while. Given the gap between McCleary obligations and revenue, it is unlikely that we’ll have a budget compromise by the end of the session on April 23. We’ll keep you informed as we learn more.
In the meantime, please consider reaching out to your representatives to thank them for their attention to these issues and funding vital community services.
Link to proposed budgets: http://leap.leg.wa.gov/leap/archives/index_budgetsp.asp

We still know far too little about sleep. It’s surprising because if we live to be 75 and sleep 8 hours a day, we’ve slept for 25 years. Why? What’s going on? The restorative aspects of sleep are widely appreciated but little is understood just why sleep is so important.
I met Dr. Bill Dement several years ago at a sleep medicine conference where he was discussing his pioneering efforts in understanding sleep. Years earlier in the sleep lab at Stanford, he noted that during sleep he would see periodic rhythmic eye rolling, which would later be described as REM (rapid eye movement) sleep. He left an EEG monitor running when studying the sleep patterns of his wife, and noted that a unique “awake” pattern was present during these REM episodes (in which the muscles are basically paralyzed). Dement grew up in Walla Walla. The sleep lab there is named after his mother, the Kathryn Severens Dement Sleep Center. They’ve probably diagnosed more sleep apnea in Walla Walla than any other similar sized community.
When beginning to study sleep apnea, a whole new area of understanding began. Sleep apnea is unfortunately very common in persons with obesity and a large neck. It has now become a problem of epidemic proportions. I also met Colin Sullivan at a sleep conference. He invented the first CPAP device and published this breakthrough in 1989 in the Lancet. This device no doubt has saved countless lives. And a major “sleep industry” has grown like Topsy.
But what about sleep in general – insomnia, stress, drugs, etc. The sleep specialists deal with this in consultation, but there is abounding lay literature, sleep apps, and a great deal of pseudoscience. Read this article in the NYT for an update.
Where are you from – really?? Here’s a humorous video that helps to demonstrate the problems of this question. (This was shown to me by my granddaughter who is multiracial – Caucasian, Asian, and Latin American/Spanish.)
Paula Span in the NYT has an interesting and challenging essay about unwanted CPR. Others have also commented on this issue. There are legal, medical, and moral issues involved. I think at Skyline we are more aware of this issue than in many venues. Storing our advance directives and POLST forms in a hanging file under the kitchen sink at least gives a helpful start for medical responders. Some residents have acquired DNR bracelets or medallions, a more direct signal to try to prevent bystanders from initiating CPR.
Society’s general default is “to do everything to save a life” then clarify and ask questions. But many argue that their right to die peacefully is violated by CPR heroics. There’s even an attempt in Maine to legalize the use of DNR tattoos. The moral of the story – think hospice not hospital at the end; have a strong personal advocate; and consider a DNR bracelet when you have a POLST form.
I love reading David Brooks. His editorials and books give a reasoned perspective on character, ethics, and morality. He has Republican leanings yet is a severe critic of the new administration. I was surprised to read his most recent and very popular op-ed piece in the NYT entitled The Coming Incompetence Crisis.
It starts off as follows: “I just read that the Trump administration has filled only 22 of the 553 key positions that require Senate confirmation. This makes me worry that the administration will not have enough manpower to produce the same volume and standard of incompetence that we’ve come to expect so far.
Granted, in its first few months the administration has produced an impressive amount of ineptitude with very few people.”
This article digs deeply into a sarcastic place where Brooks hasn’t seemed to venture in the past. I get it. He’s very frustrated, as are many of us. And I admit, that I personally have a tendency to stoop to sarcasm when faced with incompetence. Although zingers might feel good and do release some bitter humor, is such writing by a renowned pundit useful or constructive? My own hope is that we can focus in front of us finding something that we can realistically act on. Let’s not become Don Quixote tilting windmills with sarcastic commentary. Brooks can do better. Continue to point out the dismal facts of the administration – minus the sarcasm however tempting.
Clipped from Nature:
Taking advantage of [Amazon and Barnes/Noble] ‘customers who bought this item also bought’ feature of online commerce, the researchers constructed a co-purchase network of political books and science books. And they found a clear division, which they label “partisan differences in the consumption of science”.
Both groups bought science books — more than 400,000 between them. But it was relatively unusual to find books that appealed to both liberals and conservatives. Members of each group — and their good friends — had different ideas about what made a good book. Buyers of “blue books” (the liberals) tended to pick from basic science topics, including physics, astronomy and zoology. “Red” customers preferred books that discussed applied and commercial science, such as medicine, criminology and geophysics. And whereas liberal choices tended to reflect mainstream thinking, “red books” tended to be co-purchased with a narrower subset of science books on the fringes of each subject….
…Sport, for example, sees liberals associate with brands that are connected to outdoor adventurous pursuits such as hiking and mountaineering, whereas the conservative right is more at home with companies that make golf clubs.
Who would have guessed.
Enter BP-CHECK, a new KPWHRI study that launched recently thanks to a $2.8 million award from the Patient-Centered Outcomes Research Institute (PCORI). Led by Dr. Green—a nationally recognized leader in hypertension research—the BP-CHECK study has set out to find the easiest, most accurate way to diagnose high blood pressure.
Later this month the study will begin enrolling more than 500 patients from Kaiser Permanente Washington in a randomized trial comparing three different methods of measuring blood pressure:
The study will also compare each method to a 24-hour blood pressure test that the U.S. Preventive Services Task Force (USPSTF) recently named the new “gold standard” for diagnosing hypertension. That test takes repeated measurements while patients are at home, wearing a portable blood pressure monitor and arm cuff that inflates every half-hour during the day and every hour at night.”