May 19, 2022

Dear Donald,

Thank you for your letter, which I answer once more by return e-mail for reasons which I explained last time.

Ask me how I am, and my answer is, "I don't know."  I'm suspicious of the presumption of being be able to calibrate the quantity and quality of what remains of my existence, since my accounting would reflect my mood, which fluctuates between my mother's lamentation "Ich kann nicht mehr!" (or awkwardly, in a language foreign to her, "I can no more!") and my father's pseudo-military exhortation: "Keine Müdigkeit vorgeschützt!" (Don't pretend you're tired) or more colloquially: "Stell dich nicht so an." (Don't make such a fuss.)

I'm impressed by way of contrast, with the fortitude with which you confront the perplexities of getting old. I'm aware it's not only what a physician does to his patient, not only what a physician prescribes for his patient, but also a physician's description of the illness and his anticipation of its future course that can make a big difference, for better or worse, in the remaining years, months or weeks of a patient's life.

As I may have confessed to you, for years now, my motto has been DIY, do it yourself, and as I get older, I want to serve as my own physician. The lawyers are fond of saying that a lawyer who represents himself in court has a fool for a client. I'm no lawyer, and I admit, the fact that for 61 years, I've appeared in court representing myself defines what I am. Of course I want to be my own physician.

My relationship to physicians must reflect the circumstance that not only am I a physician, but so was my father, and so is my son and my daughter-in-law. I'm casting aspersions only on myself, when I write that the older I get the more I'm impressed by what physicians don't know and can't know; and that their advice has reality only as a reflection of what society expects of them. 

Between June 19 and June 26, I expect to be locked in this huge building all by myself, while my family is vacationing in the house that I built on Nantucket. I will ask them to hide a key outside so that a stranger whom I might summon if I needed help, could get in without breaking a door. Their question, did I want to come along, I counter by asking them how they would get me down the stairs here and up the stairs there, how they would get me onto the ferry and off the ferry. Since they have no answers, all questions evaporate and I stay here.

Even more to the point is the issue of what would happen if I, or for that matter, if one of them got sick on the Island? How would they get me back into my second floor eyrie, and where would I be, where would I go, if they didn't? It's for similar reasons that I've resisted my urge, after my wife's death in October 2015, to revisit Germany. I spent some time on Internet research about which airline if need be, would bring me back in a wheelchair or on a stretcher.  It's not an inviting prospect. Besides, so far as I know, my Medicare programs wouldn't cover me in Germany. I also understand that, whatever their politics, German society is still authoritarian. There, it's the doctor, not the patient, who decides whether you're healthy or diseased, whether you're well enough to go home or whether you have to stay - where, and at what expense? -, and doctors' orders might just as well be given by the police.  But these may just be black midnight thoughts to veil my own longings and disappointments.  

I wish you and Jan a healthy and enjoyable trip; and when your river boat rounds the bend in the Rhine at Sankt Goarshausen and you see the cliffs and hear the siren songs of Loreley, don't listen to her, but give her my address and tell her that I am waiting for her.

Best wishes to you and Jan. Jochen