My gastroenterology team really thinks I need a colonoscopy now that three years has elapsed since they removed three benign polyps. Now in my mid-70s, I've accumulated multiple conditions, none an immediate threat, all competing with each other to see which escapes indolent first. My medical team now expands well beyond GI, which began innocently with normal surveillance colonoscopies at age 50 and 60, an inadequate cleansing at age 70 requiring a do-over, and now concern that something invasive may arise before either my actuarial table catches up with me or some other lingering process needs more than semi-annual lab assessment. The NP answered all my questions. The procedure got scheduled far more promptly than the last two times. And I've been treated better by the office, which I suspect is a regional private equity enterprise that pays the lawyers who compose all their forms to sign more than they pay their endoscopists. Or they have taken patient feedback more seriously than I remember.
Tuesday, July 7, 2026
GI Prep
My gastroenterology team really thinks I need a colonoscopy now that three years has elapsed since they removed three benign polyps. Now in my mid-70s, I've accumulated multiple conditions, none an immediate threat, all competing with each other to see which escapes indolent first. My medical team now expands well beyond GI, which began innocently with normal surveillance colonoscopies at age 50 and 60, an inadequate cleansing at age 70 requiring a do-over, and now concern that something invasive may arise before either my actuarial table catches up with me or some other lingering process needs more than semi-annual lab assessment. The NP answered all my questions. The procedure got scheduled far more promptly than the last two times. And I've been treated better by the office, which I suspect is a regional private equity enterprise that pays the lawyers who compose all their forms to sign more than they pay their endoscopists. Or they have taken patient feedback more seriously than I remember.
Monday, July 6, 2026
Pocket Notebook
My alumni rep assigned to my region contacted me about a year ago. Though my donations over the years would barely qualify for having my name engraved on a flush handle, I had referred the previous representative to a more accomplished classmate in the same city who chaired a medical school department. He made a huge gift. The referral got me an online invitation to a small-group meeting with the University President. More recently, the new alumni rep arranged for us to chat over a beer.
Wednesday, July 1, 2026
Commenting
In another era, though well within my lifetime, celebrities used to get cards and letters. President Kennedy asked his staff to pull every 50th for his personal reading. Betty Smith, author of A Tree Grows in Brooklyn, noted that about a quarter of her fan mail was addressed to Francie Nolan, her book's main character, instead of to her. People took the time to form opinions and express them. Unlike Letters to the Editor that got selected for print, correspondence to public officials and celebrities remained private communications. Responses were few, but people still selected stationery from doodle pads to Crane's, pens from Bic to Mt. Blanc or typewriter, reserved time to express on paper, and applied postage.
Our electronics have transformed how we express our opinions to people of fame and influence. Pen and paper have given way to screen and keyboard. Though not exactly. Thoughts often organize better for later expression when outlined in a person's recognizable handwriting before composing sentences and paragraphs. Admirers and critics alike still target public figures, but what we tell them no longer gets shared exclusively with them or staff hired to deal with correspondence. A comment on Twitter intended as feedback for a VIP gets read by anyone. Responses are more likely to come from random strangers than from the influencer to whom the writer directed the feedback.
Because of the ease of submission, volume has increased. A censorship of cultural norms has yielded to bluntness, though that may have also been true when cards and letters came through verbal provocation of an Influencer on TV.
Mechanisms of contact have changed. Pre-computer, we did not know where celebrities lived. Actors got mail addressed to their studios, authors to the publishers. Our Congressional Delegation had published office addresses and an allocation to hire somebody to respond to constituent needs, if not opinions. In the early email era, people had accessible email addresses. their name or variant @ company or university . com org or edu. Major publications solicited feedback at the end of news stories. These could go into the thousands, created an expense to hire screeners to determine if standards of reader comments were violated, and largely disappeared. Individual journalists and authors now often have their own websites which invariably include a contact option.
Who is worthy of a response has also shifted. We never expect a movie star to write back, beyond maybe having a studio agent send a stock autographed photo. Academics and think tank representatives used to respond to me much more than they do now. Maybe volume, maybe pressure on time, maybe delegation of the response task. Perhaps my most interesting sorting comes from my own Jewish biome. As online educational sites became available, a lecture could be accessed, a question sent to the speaker, and a brief response suggesting that the query was read and understood would appear in a few days. The Orthodox and Reform officials invariably acknowledged my approaching them. The Conservatives screened me out or deflected me to my own Rabbi. They seemed to have some fear of undermining the hierarchy and authority of intermediaries.
Much of these dialogues of cyberspace have transformed again. We now have Substack. Subscribers can pay a monthly fee, which includes both wisdom of the writer and access. The Atlantic, one of my paid subscriptions, now has a comment section at the end of each article. Responses number in the hundreds. While a substantial fraction conveys impressions of the article, far more of these create a conversation with what the original poster began. Nearly all with a nom de plume of some type to preserve anonymity.
The role of correspondence seems in transition. In the written era, the cards and letters served as a vote up or down. The early days of email created more of a private conversation. Modern forums using platforms or feedback boxes at the end of journal articles seem to bifurcate. Some, like FB and Twitter, have become arenas for verbal combat requiring no expertise. Others like Reddit and Substack function more like communities. People of common interest exposed to identical material express to each other their views of what they read or what they had been asked. Those are invariably more civil than the arenas. Responders do their best to use their knowledge to guide a person with less familiarity or a valid but opposing view. Private communication has expanded to public engagement among strangers. Expectations have changed. In the paper era, I expected no response, in the early electronic era targeted responses, now more of a melee or gathering of minds, depending on the platform. Of the models, I have found the community of shared interest most appealing and most engaging. It has its limitations, but for me, when I have something to enhance another person's perspective or their expertise advances mine, we each do better.
Sunday, June 28, 2026
Best Deal
My wife and I have a disparity of vacation preferences. She seems perfectly content at home, willing to go to our kids' homes hours away when somebody else gets her there, and mostly stays inside their places when there. I have more of a preference to escape to the new, willing to burden myself a bit to do this. When at the kids, I zip around SF's Muni System, walk the neighborhoods, occasionally book a tour that I go on myself. At my son's, I walk the blocks near his inner city house and drive around to different places. Hop-on Hop-off buses get a ticket, even though few stops see me exit to explore up close. I seek the window seat on planes and buses. New places interest me, even if they are daily stops to those who live there.
Tuesday, June 23, 2026
Living Spaces
My children and their friends live differently from me. As much as I enjoy going to a big city periodically, and have lived in a few, my upbringing took place in a free standing suburban house designed from an architectural template. My adult life had its base in an even larger home, ample bedrooms, basement, garage, attic. And it filled with stuff that will eventurally find its way to some blend of dumpster and estate sale. A small city sits a few minutes drive, accessed primarily for synagogue and OLLI. A major city, where I can travel for free with my Senior Transit Pass makes for a periodic but random visit, usually to visit a museum or historical site. The city has things that my town does not, but not alluring enough to want to be in proximity. Even in my time in three major cities, my focus always remained school or work, never trendy places to eat. Even for shopping, when I had a car, I drove to a suburban mall.
Wednesday, June 17, 2026
Every Contingency
Overnight trip upcoming. By car. With wallet and credit card and enough cash. To a major city with retail options exceeding what I have at home. I should be able to put my worldly goods in something more compact than my airline carry-on. Clothing for the next day. Grooming needs for the morning. PJs. Even my laptop with its charging cord.
Sunday, June 14, 2026
Learning a VLog
My two grandchildren, each not quite a year old had scheduled visits. With a $50 Amazon gift card as an honorarium for serving as a university research subject, I spent the majority of it on a VLog kit, anticipating not only my grandchildren's encounters but some other summer travel.