Tag Archives for Ph.D.

Prominent Oncologist’s Death Wish at Age 75

Published in Pawtucket Times, December 12, 2014

Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer.  While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list.  We would be doing both society and our loved ones a favor by agreeing with this belief, he says.

When I am 75…

Why not age 80 or even 85?  Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.

The renowned 57-year old breast oncologist is at the top of his professional game.  Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.

Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews.  .

The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare).  At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.

With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.

But Emanuel claims that these charges are not true.  Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.

Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.”  Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life.  For him, he doesn’t buy it and most definitely, seventy is not the new 50.

Sharing a Death Wish on the Air Ways

On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.”  His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.

Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”

“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”

“It is really about what you are doing to contributing and enriching the world.  I want people to stop focusing on just more years, focusing on quality,” he says.

Emanuel says that you need to be realistic on living forever, your body and mind doesn’t  go on forever.  You should just be satisfied with living a complete life, he says.

By age 75, people will have gone through all stages of life, says Emanuel.  As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.

During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide.   As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington.  His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.

In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life.  He notes that his last colonoscopy will be at 65, to screen for cancer.  No more colonoscopies after 75.  And, he’ll only accept palliative care after that milestone age, too.

“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.

How Others See it

Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.

“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.

As Emanuel says, there is a downside to aging.  My 88-year-old mother died after a 14 year battle with Alzheimer’s disease.  At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.

For me, 89 is the year I choose to meet my maker, hanging up my spurs.  Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure.  I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.

I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.”   There is no alternatives, you can only hope for nature to ultimately take its course, and it will.  And so, we all are inclined to pick our own magic number.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.

Gubernatorial Candidates Go Negative to Get Votes

Published in Pawtucket Times, August 22, 2014

With less than three weeks before the September 9th Democratic primary, gubernatorial candidates are working overtime to get their political message out by mailed campaign literature and bombarding the airways with their 30 second commercials and at debates.

As primary day quickly approaches, political new comer Clay Pell is staying on message in his campaign literature and television ads, claiming he has a “real plan” to fix Rhode Island’s problems, even claiming that he will bring a “real plan” and a “fresh perspective” to the Governor’s Office if he is elected. On the other hand, Mayor Angel Taveras and General Treasurer Gina Raimondo duke it out to take the lead. Taveras even takes pop shots at Pell as more voters begin to support him.

From the start, Businessman Ken Block and Cranston Mayor Allan Fung took off their gloves and began negatively blasting teach other in their campaign literature, TV ads and even at debates. Block was not a real Republican who had voted for Democratic President Barack Obama, he even supported his new ObamaCare program. On the other hand, Block went after Fung’s handling of Cranston’s ticketgate, calling him a political insider.

Yes, as my good friend long-time Pawtucket resident Jon Anderson says, “it’s the silly season of politics.” Like it or not, negative campaigns are here to stay and they do work, say political pundits

Poll Numbers Shifting

Just as summer began, Democratic and Republican gubernatorial candidates began to get negative and the numbers began to shift.

According to an exclusive WPRI 12/Providence Journal poll, released two days ago, of 503 likely Rhode Island Democratic primary voters, Raimondo takes the lead at 32%, Taveras drops to 27%. Pell is closing in at 26%, the poll shows, conducted by Joe Fleming, of Fleming & Associates of Cumberland, Rhode Island. One percent of the voters give Todd Giroux their support. Only 13% of the respondents remain undecided.

Last May, a previous WPRI 12/Providence Journal poll showed a politically-unknown Pell had support of 12% of those polled. Huge infusions of his personal wealth on TV ad purchase and campaign outreach has ratcheted up his visibility. At that time, Taveras was in the lead with 33%, Raimondo at 29%. With a larger campaign war chest than the Mayor, she was able to chip away at his lead by focusing the voters on his City’s economic woes and spike in crime.

As to the Republican primary race, the universe of Republican voters is so small there are no public polls, says Chairman Mark Smiley, Rhode Island Republican Party. He notes that the Fung and Block campaigns are doing their own internal polling.

Negative Campaigning Works…

Negative campaigning works, says Wendy Schiller, Associate Professor of Political Science and Public Policy at Brown University. In his book, Defense of Negativity, Vanderbilt Professor John Greer found that “not only do negative ads work to undermine the opponent, they also convey information about candidates,” notes Schiller.

“Even when an ad is completely negative, it almost always contains some element of truth to it about the opponent’s record or positions, adds Schiller, a frequent guest of Rhode Island PBS’s “A Lively Experiment.”

Schiller gives her assessment of the Block-Fung race. “Because Ken Block was formerly a moderate, he has the most pressure to jump into his race with energy and aggression and undermine the perceived front runner Mayor Allan Fung,” she says, noting that he may have well been successful in doing that at a time when the police scandal in Cranston was unfolding and now more recently, with the filming of an expensive ad in Ohio instead of being created in Rhode Island

“Fung has fought back by criticizing Blocks proposal’s and his lack of elected experience, but his first negative ad on Blockheads was perceived to insult Block supporters more than Block himself, so they pulled it, notes Schiller.

As to the Taveras-Raimondo contest, Schiller believes the Mayor had to go negative against his opponent because she was criticizing him for higher taxes and the rising crime rate in Providence, noting that of these candidates went negative on Pell’s inexperience. It was a mistake because they did not want to give him status as a contender but it allowed him to shape his own reputation among voters with unchallenged TV ads, she says.

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Schiller says that negative TV ads can backfire. “I think overly negative – or too much distortion of a record – can backfire more in Rhode Island because we are such a small state that most folks can spot an exaggeration when they see it,” she observes.

“We are already seeing Taveras go more negative on both Raimondo and Pell so expect to continue [in the upcoming weeks before the primary], adds Schiller. She predicts that the General Treasurer will “likely stay positive in effort to pull a few more voters from the undecided camps into her vote column. She says that Pell has responded to Taveras negative ads in a limited way, and expects him to stay above the negative fray in hopes of pulling votes from the other two Democratic candidates.

Can a political candidate win an election by not going negative? It depends on where you are in your campaign, says Schiller. For instance, a while back Raimondo went negative on Taveras, but only continues to do so in debates, not so much on TV ads. Pell thinks a positive strategy is also a winning strategy while Taveras is now on the attack. “We will just have to wait and see on primary night who wins,” she says.

Watching the Political Tumble from the Side Lines

From inside the Beltway, Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, watches his former state’s gubernatorial races and gives this columnist his observations.

“The Ocean State’s GOP primary turned negative early in the campaign because it is only a two-person race. In this situation, once one candidate goes negative, the other person has to defend himself and go on the attack too,” says West, a former Brown University professor and a prominent Rhode Island political commentator, noting the complexity of negative advertising in three-person races. “If two candidates go negative, that sometimes benefits the third candidate who has stuck with a positive message,” he says.

West speculates as to Taveras’ use of negative TV ads. “Taveras has a problem on both flanks. Raimondo is more moderate while Pell is more progressive. So the Mayor went negative to prevent vote erosion on both sides of the political spectrum. His strategy hasn’t bought him much support and he has lost ground to Pell in the most recent poll, he says.

West agrees with Schiller that negative ads can backfire. “Negative ads can backfire if the candidate is seen as mean-spirited and overly negative. That can redound to the benefit of the candidate who has stayed positive,” he adds.

Look for more nasty TV ads in the upcoming weeks, says West. You often see more negativity as you get closer to election day. With the margin of victory very close among the Democratic candidates, that primary runs the risk of turning into a slugfest in its closing days,” he says.

Finally, West says that positive ads might push a political candidate to victory. “Candidates can win by staying positive in a three-way race. Lack of negativity becomes a distinguishing factor with the other two candidates, he notes.

Your Vote Counts

Historically, older voters from across the country have played a major role in electing political candidates because they consistently-voted in larger percentages than other age groups. The political fate of Rhode Island’s statewide and congressional elections and ballot initiatives may well rest on the shoulders of aging baby boomers and senior voters.

By now, the Ocean State’s political candidates have mailed campaign literature, debated, attended debates and gatherings, hoping to effectively deliver their political messages and ultimately influence their vote.

While negative ads may sway voters, take control of who you will vote for at the upcoming primary. Spend the next three weeks to read between the lines of campaign literature and negative ads, learning more about a candidate’s background and issues. You must separate political rhetoric and negative innuendoes from the substance of issues. Put time into determining who can best represent your interests.

If political candidates do not know the power of the educated voters, hopefully they will after the polls close at 8:00 p.m. on September 9th.

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com

Comic Robin Williams’ Death Puts Spotlight on Depression, Suicide

Published in Pawtucket Times, August 15, 2014

Last Monday evening, millions of Americans were shocked to hear that 63-year- old Robin Williams died from an apparent suicide. While it was well-known that he had a history of severe depression and years of alcohol and drug addiction, we were stunned by the unexpected tragic news. publically, Williams had it all, fame, fortune, loyal friends, and fans in every corner of the globe. But like millions of Americans he suffered in silence trying to slay his personal demons when he went into substance abuse treatment.

The sudden death of this Oscar-winning actor, recognized as America’s comic genius, squarely puts the spotlight on depression, a mental illness that commonly afflicts tens of millions of Americans.

DDepression Becomes a Public Conversation

Within the first 48 hours of Williams’ suicide The Samaritans of Rhode Island saw an increase in calls from people concerned about loved ones and friends, says Executive Director Denise Panichas, who expects to also see an increase in visits to her Pawtucket-based nonprofit’s website. Last year, its website received more than 50,000 visitors.

Panichas says, “William’s death reinforces the fact that suicide knows no boundaries, it being a relentless demon afflicting both rich or poor, and those having access to therapy or medical care and those not having it.

According to the Woonsocket resident, William’s suicide has raised the awareness of suicide prevention in a way that millions of dollars in public health announcements could never have done. “William’s movies as well as his dedication to community service resonate with multiple generations, says Panichas, stressing that his six plus decades had value “which will live on.”

Williams substance abuse problems also highlights the need for more awareness as to how addictions can be a risk factor for depression and suicide, states Panichas, who observes that throughout the country, in ever city and town, budgets for substance abuse treatment are being decimated, she adds.

“Promoting wellness and preventing addictions will always be a big challenge but we must do more if we want to see a decrease in suicides,” says Panichas.

Panichas expects the death of Williams, an internationally acclaimed movie star, will have an impact on fundraising for suicide prevention or addiction and depression prevention programs. She has seen an increase in donations from Rhode Islanders as well as from around the country. .

“One donor gave a donation in memory of “Mork”. The donations coming in may be small but every one counts toward keeping our programs available to the public,” says Panichas, noting that over the years public funding has “been drying up.” The Samaritans of RI is using more creative fundraising structures, like crowdfunding (www.crowdrise.com/samaritansri2014) and other social venture sites to create new revenue streams for her nonprofit, she adds.

An Illness That Can Affect Anyone

Lisa B. Shea, MD, Medical Director of Providence-based Butler Hospital, Providence, learned of William’s suicide by a CNN alert on her IPhone. To the board- certified psychiatrist who serves as a clinical associate professor at Brown University’s Alpbert Medical School, “it was tragic but preventable.”

Shea, a practicing psychiatrist for 20 years, notes that people who have suicidal thoughts, like Williams, are struggling with mental health disorders. “Their thinking can get very dark and narrow and they believe they have no options,” she says, oftentimes feeling like a burden to others. “It does not matter who you are mental illness can strike any one regardless of their wealth and fame,” she says.

According to Shea, the public’s interest in William’s tragic death sheds light on the fact that people can get help and it begins with taking a positive first step. “People with suicidal thoughts, who feel “intensely tortured and can not see any way out of their situation, can benefit from supportive therapeutic relationships, medications, and getting support from family and friends who can push them into getting professional help,” she says.

Shea calls on Congress and Rhode Island state lawmakers to positively respond to the William’s suicide by providing increased funding to create access to treatment and prevention programs and to support mental health research.

Finally, Shea says that there are a number of tell-tale signs of a person expressing hopelessness who may be thinking of ending their life. They include statements made by someone that others are better off if he or she were not around; excessive use of alcohol and/or drugs; not taking care of yourself; and giving away personal items. When these occur, talk to the person telling them that you care about them and are concerned for their well-being.

Adds Melinda Kulish, Ph.D., a Clinical Psychologist/Clinical Neuropsychologist and Instructor of Psychology at Harvard Medical School, “There are also times when depression is not easily recognizable. Some people who are depressed experience it most acutely when by themselves but can appear fine, even quite happy, when they are with other people.”

Kulish explains that, for various reasons, some people feel the need to make others happy. Cheering others up or making others laugh makes them also feel happy.

“But, if that person is suffering from depression, the happiness is fleeting – the laughter ends and they once again feel empty and sad. The cheering up of others is a fix that is OUTSIDE, not inside of them.

“And drugs and alcohol can make them feel better for a time. The high always ends, and when alone, they feel empty and even more depressed,” says Kulish. “There’s really good research to suggest that talking about traumatic and upsetting events leads to much healthier responses. The old idea, ‘I’m just not going to talk about it so it’ll go away’ doesn’t work.”

“It’s a myth that if you ask a person if they are suicidal you will put that idea in their heads,” says Shea.

Feeling Low, a Place to Call

When this happens, “feeling low with nowhere to turn” as noted singer songwriter Bill Withers once said in a public service announcement, there is a place to call – The Samaritans of Rhode Island – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to reducing the occurrence of suicide by befriending the desperate and lonely throughout the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 500,000 calls and trained more 1,380 volunteers to answer its confidential and anonymous Hotline/Listening Lines.

With the first Samaritan branch started in England in 1953, chapters can now be found in more than 40 countries of the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices,” notes its website.

Executive Director Panichas, notes that the communication-based program teaches volunteers to effectively listen to people who are in crisis. Conversations are free, confidential and, most importantly, anonymous.

A rigorous 21-hour training program teaches volunteers to listen to callers without expressing personal judgments or opinions. Panichas said that the listening techniques called “befriending,” calls for 90 percent listening and 10 percent talking. Panichas noted The Samaritans of Rhode Island Listening Line is also a much needed resources for caregivers and older Rhode Islanders.

Other services include a peer-to-peer grief Safe Place Support Group for those left behind by suicide as well as community education programs.

In 2014, The Samaritans of Rhode Island received more than 4,000 calls and hosted more than 50,000 visitors to its website.

The Samaritans of Rhode Island can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being lonely or just needing to talk, our volunteers are there to listen.”

For persons interested in more information about suicide emergencies, The Samaritans website,http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

For those seeking to financially support the programs of The Samaritans of Rhode Island, its Art Gallery and Education Center is available to rent for special events, meetings and other types of occasions. For information on gallery rental, call the Samaritans business line at 401-721-5220; or go tohttp://www.samaritansri.org.

Need to Talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll-free in RI (1-800) 365-4044.

For mental health resources, go to http://www.butler.org.

Herb Weiss, LRI ’12 is a Pawtucket-based freelance writer who covers health care, aging, and medical issues. He can be contacted at hweissri@aol.com.