Dear Cyndy,

Last evening I brought my sister home from the hospital.
Her discharge was delayed from 10 a.m. to 8 p.m., because
regulations require that she be discharged by a staff
physician, who happened to be the trauma surgeon on call
and was tied up with accident victims in the operating
room.  It turns out that subsequent to her operation
six days preceding, she had never been seen by a staff
physician, only by residents, interns, medical students,
nurses, nurses aides, orderlies, laboratory technicians,
cleaning ladies, social workers, discharge planners.
Come to think of it, her surgeon has never once talked
to her, has never faced her except when she was under
general anesthesia. All medical records, even those of
the nurses are now maintained by computer, with the
result that no human being kept count of episodes of
diarrhea the night before she was discharged. Margrit
herself couldn't remember, but the computer claimed there
had been 128 episodes of diarrhea, perhaps because that 
number expresses two to the seventh power. It's a brave 
new world that now confronts patients and their physicians.

Now that she's home, Margrit seems to be recovering nicely. 
She is is very resilient, and insists on ignoring, as she
always has, the diverse limitations of her existence. 
So far she hasn't fallen. She makes life interesting. 

I have been preparing my spirit and my mind, I think
rather successfully, to cope with the denial of my appeal
in the Nantucket case, which I have reason to expect.
It won't happen for another three or four months.
I don't know how much additional money we would be
prepared to invest in the project; I don't know what
physical resources, how much strength, how much energy
I have left; I dread even to contemplate the fading of
the mind.

With very few exceptions, my established patients are
staying with me, putting up with the informality of my
present office arrangements, - but there are fewer and
fewer of them; they are dying off, inexorably, one
by one, and new patients are disconcerted by the
unconventional arrangements. I'm toying with the idea,
that if I lose the lawsuit, I might convert the two
downstairs rooms with the adjoining bath, which you
saw at the time of your 90 minute visit, into an office
with an entrance separate from the living quarters.
I tell myself I could then invest in a white coat and
revive my practice even without hiring a secretary or
a receptionist. But at age 80, why would I want to do
that? Just to prove that I could? Wouldn't the effort
itself be evidence of poor judgment, of the failure of
mind, of senility?  We'll see.

Meanwhile, I have much writing that wants my attention,
and many improvements to this house that, if I chose to
make them, would absorb my attention and what energy I
have left.

Stay well, and give my regards to Ned.

Jochen