Aging Not So Gracefully

Some years ago on a trip to the Big Bend of Texas with My Lovely Bride (MLB), we went for dinner at a very nice restaurant in Alpine.  On the way out, I was helping MLB down the slate stairs leading to the parking lot when she lost her balance and began falling backward.  Not one to let her crash and burn without me, I proceeded to lose my balance as well, after which we both went down for the count. Looking back, the whole process seemed to have taken place in slow motion as we … in unison … dropped to a sitting position on the top stair and then … still in synch … collapsed all the way back until we were, side by side, lying on our backs in the restaurant entryway. 

I recall this event for two reasons … first, I am confident that we would have scored higher in the Olympic Team Tumbling competition if not for the fact that the Russian judge only gave us a score of 4.5.

The second reason I remember this event so vividly is that I know we dodged a bullet.  Though we both wound up laughing while struggling to get back on our feet, if that same scenario were to play out today, I am certain that someone would be dialing 911, and long-term rehab would be taking over our calendar.

All this is the long way around of saying … well … I’m starting to feel my age more and more of late.  That is not to say that I plan to spend my remaining time sitting on the porch yelling at kids to “get the hell off my lawn,” but I have to admit that the days of hanging on the rim in a pickup basketball game are behind me.  On the plus side, I meet regularly with my doctors, I try to stick to a healthy diet, and I engage in moderate exercise on a daily basis.  All of this, I am told, goes in the “plus” column.

At the same time, I have come to understand that while careful management of the physical dimensions of aging is essential, equal attention must be paid to emotional equilibrium and stress management.  In that vein, a recent Wall Street Journal article recommends the creation of a personal “F___ it Bucket” into which we can toss upsetting information that we can’t change.  An excellent suggestion … in fact, I have already put a few things in my bucket:

Family Drama  This one is not talking to that one.  The other one is still angry about something said twenty-five years ago.  Some blow off family events because … well, who knows?  This sort of thing used to make me anxious … now it just makes me tired.

Politics  Among the most volatile of areas, it seems few actually focus on listening or being respectful of differing opinions.  I will always vote, of course, but discussion of political views is off the table.

Media  Much like the political arena, limiting exposure to news media of every stripe is essential.  We subscribe to a range of news sources and it always entertaining to note how different media outlets report and editorialize on exactly the same event.

Sports  A life-long sports fan, I no longer pay attention to who wins any athletic contest, or the opinion of overpaid pro (and college) players.  This is especially so when their outrageous salaries are measured against the vast numbers of people in need of assistance.

Needless to say, there is ample room remaining in my “Bucket” for additional items and I am confident that, as time goes on, other nuisance issues will be added.

While expounding on the travails of aging in the midst of the holiday season, I can’t help but think of the classic Christmas poem “The Night Before Christmas.”  In particular, I can identify … up to a point … with the fellow who hears a clatter outside and “springs from his bed” to see what is going on.  The difference between that mythical fellow and me is that, first, I would slowly sit up on the side of the bed.  Then, I would take a moment to collect my thoughts.  Next, I would stand up carefully and after slowly limping to the window I would open the sash and yell:

Get the hell off my lawn!

Have a Hippie Holiday!

So, I’m sitting here trying to come up with some Christmas gift ideas for my bride, when my eyes fall upon an ad for something called “Instant Pot.” Whoa! Can this really be what the name suggests? Has some genius finally designed a system for creating weed without having to go through the whole planting, cultivating, and harvesting thing?

Alas, upon reading further, the full details of the “Instant Pot” became clear … it is nothing more than a kitchen appliance that can be used to cook a wide range of foods in a variety of ways. Sigh … well, I guess that is a pretty good idea as well.

In my defense, my initial thoughts about this product were likely driven by fond reminisces of my time working as a police officer at the 1969 Woodstock Festival, and the fact that we only recently celebrated the 50th Anniversary of that singular event.  But come to think of it, perhaps there is more to it than just that … maybe there is, as some have suggested, some sort of a magical connection between Hippies, marijuana and Christmas.

For example, what should we make of the fact that the words C-H-R-I-S-T-M-A-S and W-O-O-D-S-T-O-C-K have the same number of letters? Or that the names of S-A-I-N-T-N-I-C-K and W-A-V-Y-G-R-A-V-Y are identical in length? What about M-I-S-T-L-E-T-O-E and M-A-X-Y-A-S-G-U-R? Are these all mere coincidences? You be the judge.

There is even some speculation that Santa, himself, may be an occasional toker. Those who take that position cite, as evidence, several of his well known behaviors that are common to regular users of marijuana. For example:

Munchies It is a well known fact that smoking marijuana creates an appetite for copious amounts of tasty and binge-worthy food. Santa loves cookies … think of how many he eats in just one night!

Forgetfulness One notable side of effect of marijuana use is the way it is said to affect memory. Santa needs to keep a list for everything and, as we know, he has to check it twice. The guy can’t even remember who’s naughty and who’s nice!

Paranoia Like many marijuana users, Santa goes to great lengths to conceal his location and even his very existence!

Always Happy Stoners readily admit that, when high, it is difficult to suppress their giggles. Santa is always smiling, laughing and generally jolly. What does that tell you?

As we all cross our fingers wondering what we will find under the tree on Christmas morning, stoners can breathe easy. In North Pole, Alaska, a member of the city council by the name of Santa Claus (yes, his real name) took exception to a recent ordinance that prohibits a marijuana business in his city. He even went public with his objection noting: “Cannabis users will not be getting coal in their stockings unless they have done some other thing that might be considered egregious.”

Hippie Holidays!

Looking for Mr. Ames

Working as a police officer in the early 1970’s in upstate New York, I can recall being dispatched in the middle of the night to a remote dirt road to look for an elderly woman reported wandering aimlessly in her nightclothes.  Having been sent there previously, I knew that it would be Mrs. Ames, and that she was, once again, out searching for her husband and her son … both of whom who had passed away years before. 

Given our scant knowledge of dementia at that time, it was our understanding that Mrs. Ames was “senile.”  That being so, I did what we always did … I picked her up, took her back to her home, and sought a family member to take her into their care.

Over the many years since my paltry efforts to help a disoriented woman to safety, I have come to understand that Mrs. Ames suffered from dementia … an umbrella term encompassing a broad range of brain conditions that cause a progressive decline in a person’s ability to think and remember.  What’s more, the loss of these abilities makes it increasingly difficult for people to function or care for themselves.

Today, dementia in its many forms is far better understood and, in the law enforcement community, comprehensive training is readily available for police agencies nationwide.  The International Association of Chiefs of Police, for example, provides model policies   and training curricula to prepare officers for encounters with citizens suffering from dementia, as well as checklists to follow in mounting a search for someone who may have wandered away and gone missing.

My wife, Bonnie, and I, are fortunate to reside in a community where a number of resources are available to those suffering from dementia and to their caregivers.  Just a few of the very supportive entities upon which one can call in our area include Dementia Friendly Fort Worth (dffw.org), the James L. West Center for Dementia Care (jameslwest.org), and Musical Memory Singers (musicalmemorysingers.org).  

Given the fact that one in three seniors dies with Alzheimer’s or another form of dementia, having access to support and guidance of this nature is invaluable.

As I look back some fifty years to that rural road and my interaction with Mrs. Ames (not her real name), several thoughts come to mind.  First, I hope that I treated her with dignity and compassion as I picked her up, took her back to her home, and reached out to family to care for her.  Second, I am comforted in the knowledge that first responders, today, are far better prepared than I was, to identify and assist individuals suffering with dementia.

Finally, I have boundless gratitude for the efforts of those working to find a cure for Alzheimer’s, as well as for the many groups and volunteers who provide support and guidance to individuals struggling with that awful disease, and to their caregivers.

Gail Weatherill has been a practicing RN for more than 40 years, and is a board-certified Alzheimer’s Educator.   Her poignant words are an inspiration to anyone touched by this awful disease:

Dementia care … it’s not rocket science, it’s heart science.

You are right!

Every once in a while, a small gem of wisdom bubbles up from that vast morass of anger, despair and self-promotion known as the Internet.  One such nugget introduces us to two friends discussing how, best, to avoid getting drawn into an ugly debate when someone says something intended to provoke.  Their conversation goes like this:

Friend 1:  What do you do when someone says something to you that is clearly wrong or is intended to cause an argument?

Friend 2:  Simple.  I just say “You are right.”

Friend 1:  Well, that is the stupidest thing I ever heard.  You are a fool for responding that way!

Friend 2:  You are right.

And there it is!  A quick and painless way to deflect someone whose intent is to goad another into an argument … and if you are like me, political squabbles and fruitless consequent debates are the very last things in which I want to engage.  This is not to suggest that I have no interest in the many issues that confront us all, but engaging someone with a closed mind is, to my way of thinking, likely to yield only frustration, damaged friendships and, in some cases, family estrangement.

It is important to pause here, for a moment, and underline the fact that this “You are right” conversational strategy … obviously … is not suitable in every situation.  For example, in those cases where someone expresses views that are racist, sexist, anti-semitic or supportive of violence, the only appropriate response would be to object or simply walk away.  Sad to say, we have all seen examples of how perilous it can be to confront someone with deeply held fringe views and a loose rein on their emotions.

For the “run of the mill” flat-earth proponent or the football fan who declares that “The Dallas Cowboys Suck,” though, a simple “You are right” can save a lot of time and energy.  And there is, by the way, a kernel of truth in that observation about the Cowboys!

Anyone acquainted with a “dyed-in-the-wool” Cowboys devotee knows that should he come upon that last critical remark he would, no doubt, rise in protest.  And while labelling me a heretic for besmirching “America’s Team,” he would likely go on to attribute my irreverence to the fact that I am nothing more than a transplanted New Yorker with little respect for that storied franchise.  In the face of such vitriol, there can be only one satisfactory response:

You are right.

Lock ‘Em Up!

For those interested in the salacious juncture of politics, extraordinary wealth and sexual abuse of children known as the Epstein Files, this is your moment in the sun.  Consider, for example … bitter and competing legal actions to expose or conceal details in those files … subpoenas … political battles over release of information … open discussion of criminal acts.

At the epicenter of things is the late Jeffrey Epstein who, following his 2014 guilty plea to criminal offenses involving children, was named a “level three” sex offender in New York (a lifelong designation for someone at high risk to reoffend).  A pervert to the end, he was arrested, again, one month before his reported suicide in 2019, on federal charges of sex trafficking minors in Florida and New York.

Adding to the stench is Ghislaine Maxwell, a British socialite currently incarcerated for recruiting young girls for Epstein.  Though serving a twenty year sentence for sex trafficking (including the procurement of a 14-year-old for sex abuse and prostitution), her input in this miasma is apparently of such value that she has been moved from a federal penitentiary to a minimum-security prison camp … with some speculating that a Presidential pardon may be in the offing.

As we slog through this torrent of legal and political noise, it is essential that we remember to embrace and support that group so central to this discussion, but so often overlooked:

The victims.

Bluntly, victims of child sex abuse have suffered unimaginable damage, and treating them as mere objects in the midst of this debate serves only to traumatize them further.  The harm inflicted by a pedophile is more than just physical … those who have endured sexual abuse as a child suffer, among other maladies, life-long social/relationship difficulties and Post Traumatic Stress Disorder.

Fans of the award-winning animated series, South Park, have watched its new season be unmercifully critical of the current President and his administration.  In response, Secretary of Homeland Security, Kristi Noem, lashed out at this fictional television show declaring that the mission of DHS is to “… remove murderers, gang members, pedophiles, and other violent criminals from our country.”

Kudos to Ms. Noem for highlighting pedophiles as among those evil-doers deserving of deportation.  If she is true to her word, we can look forward to televised images of serial sex abusers being wrestled to the ground alongside taco vendors and migrant workers before being carted off to their new digs at Alligator Alcatraz..

Telling The Good Guys From The Bad

As a youngster, I would sit in front of our 12” black and white Zenith television watching the Lone Ranger perform heroic acts of derring-do to save another small town or damsel in distress in the West.  At the end of each of episode, I can recall various townspeople asking one another: “Who was that masked man?”

Today, news coverage of illegal aliens being taken into custody and carted away around the United States has me asking a similar question: “Who are those people in the masks?”  I assume they are Immigration and Customs Enforcement (ICE) officers, but since they wear no discernible uniform and cover their faces it is hard to say for certain.  Police officers generally wear blue uniforms … Border Patrol wear green … even the FBI will often don raid jackets when taking enforcement action … but who are these guys?

I doubt I am alone in wondering how I might react if accosted by a masked individual attired in randomly-assembled civilian clothes … should I obey their orders?  My instincts tell me to resist … should I?  If I were to comply, would I be putting myself at risk?  And more to the point, how, in this country, have societal norms disintegrated to the point where law-abiding citizens, like me, should have to weigh those sorts of questions?

As a retired police officer, I know that the important work being performed by ICE is complicated, difficult and dangerous, and I am steadfast in acknowledging the importance of officer safety.  In carrying out those duties, though, there is no rational reason for ICE officers to wear masks and, in fact, it could be argued that doing so makes their jobs even more hazardous.  In my view, when law enforcement officers conceal their identify while carrying out their lawful duties citizens and police, alike, are on perilous terrain.

Mike German, a former FBI agent and a fellow at the Brennan Center’s Liberty and National Security Program, puts it this way:

Masking symbolizes the drift of law enforcement away from democratic controls.  When it’s hard to tell who a masked individual is working for, it’s hard to accept that it is a legitimate use of authority.  

A Sign Of The Times

Though I have always taken seriously the right to vote, I have never aligned myself with one particular political party.  Instead, it has been my practice to remain informed on issues and on individuals running for office, and then to lend my support regardless of political affiliation.  Sometimes the outcome of an election has turned in favor of my choice, and sometimes it has not.  Regardless of the outcome, though, I always had faith in the system.

But as Bob Dylan put it: “… I was so much older then, I’m younger than that now.”  In other words, like Dylan, I have begun to doubt some of the things in which I once had inalterable faith.

Things, for example, like the orderly and civil conduct of government business, and strict adherence to the United States Constitution without regard to political affiliation … and … the guarantee of due process in criminal proceedings … and … the Posse Comitatus Act of 1878, prohibiting deployment of the military in American cities.  In this Orwellian environment, it is no surprise that a Florida Sheriff felt justified in announcing, recently, a return to law and order “Old West” style, declaring that stepping out of line at protests could “land ‘ya graveyard dead.”

For all these reasons, the June 14, 2025, “No Kings” rallies across the United States came just in time.  

In Fort Worth, Texas, the rally took place in a shaded park near downtown and, never having participated in an event of this sort, two octogenarians (Bonnie and me) approached the gathering crowd with some trepidation.  What could we expect?  Would we fit in?  Was there going to be violence?  Would extremists hijack the day?  And most important … would there be restrooms nearby?

I am pleased to report that our experience at the rally was both uplifting and confirming … especially since we found ourselves in the midst of so many folks our age.  Those in attendance spoke to a range of causes, with the central notion being that of a common striving for government accountability and adherence to the rule of law.  And while it was hot there in the park, event organizers provided water and made sure to pick up any trash and … thankfully … the line for the restrooms was relatively short!

Home-made signs were in abundance … many very creative … some obscene … but all connected in one way or another to the theme of the day.  One sign, in particular, stood out, for it captured … perfectly … the reason why we were there:

My Grandkids Know I Did Not Remain Silent!  No Kings!!

If there were something I would want our seven grandchildren to grasp from our attendance at this rally, it would be that each of them should take, seriously, what the sign suggests … do not remain silent!  They do not have to agree with us on issues … we know some of them do not … but we love them all, and we encourage them to be heard on matters of importance to them and to our nation.

Incidentally, John Spitzberg of Gainesville, FL, is my newest hero.  At a rally outside the Supreme Court, Spitzberg … age 87 and  a veteran … was arrested for crossing a police line.  Taken into custody after refusing attempts to get him to move back, he said he wanted to be with other veterans who had already been arrested.  Notably, it took two officers to move Spitzberg to a police van … one to zip tie his hands behind his back and lead him by the elbow, and the other to push his walker.  When asked how he felt about having been arrested, Spitzberg said: “I’m just beginning, my friend.  I’m gonna just get a little sleep, and I’m starting again.”

One of the most powerful moments at the Fort Worth rally occurred when 60 women in silent formation and dressed as Handmaids, marched into the park carrying with them a banner reading: We The People Were Not Meant to Kneel.  Their breathtaking appearance was a vivid reminder of the way in which Margaret Atwood, author of The Handmaid’s Tale, warns of the ease with which a democracy can fail:

That was when they suspended the Constitution.  They said it would be temporary.  There wasn’t even any rioting in the streets.  People stayed home at night, watching television, looking for some direction.  There wasn’t even an enemy you could put your finger on.

Driving Miss Bonnie

As a young kid with a brand new drivers license, the exhilaration of driving a beat-up ’51 Plymouth station wagon with “3-on-the- tree” was, to me, like being behind the wheel of a Lamborghini.  Oh, the places I would go … as long as I was home by dark, of course, because the old jalopy, among its many other ailments, did not have working headlights.

Now that I am in my 80’s, driving remains among my most enjoyable activities … especially when my lovely bride, Bonnie, is performing her navigator duties from the passenger seat.  And while that 16-year-old kid rattling around our little village in upstate New York could only imagine exploring places unknown, we are actually able to do that … and, oh my goodness, we do!

Though we reside in a city whose population just passed one million, we are located on its western fringe.  This gives us convenient access to the vast rural areas that bring us such enjoyment.  Avoiding Interstate highways we, instead, traverse state, county and “Ranch to Market” roads that introduce us to locales and scenery we would otherwise miss.

It doesn’t matter, by the way, that we may have driven a particular route previously, the change of seasons always presents us with a different version of what we saw the last time we passed.  The Bluebonnets … the Indian Paint Brush … the Cactus Flowers.  In one neighborhood, there is a herd of deer that seems almost domesticated as they stand by the roadside and watch us pass.

To the best of my recollection, that ’51 Plymouth mentioned above had a scratchy AM radio glued to WABC (Cousin Brucie!).  Our current ride is much more comfortable, and the Sirius radio allows us to alternate between soft rock, 60’s Gold and Country.  But regardless of the background music and even the scenery, after 60 years of marriage, it doesn’t get much better … talking … holding hands … and just looking at the world around us.

Is This Who We Are?

In the opening sequence of the 1942, film Casablanca, we follow a police officer searching for refugees in flight from the Nazis. Stopping a civilian for investigation, the officer … speaking in a carefully modulated German accent … demands: “May we see your papers, please?”  

It should come as no surprise that this heart-stopping sequence has become a cultural metaphor for life in a repressive state.  And, at the risk of putting too-fine-a-point on the issue, one is left to wonder whether the fictional event just described might not be a suitable analogy for the world around us today.

Like every American, I want to live in a safe and secure world.  And while I believe illegal immigrants have no place in our country, it is essential that the rule of law … and, especially, due process … be adhered to when it comes to deportations. I am, of course, fully aware that this view is not shared by some in positions of political authority. 

Needless to say, I am not personally acquainted with Kilmar Abrego Garcia, the Maryland resident who was deported, recently, to a “super max” prison in El Salvador.  The details of his status in the United States have been widely reported but, the most telling aspect of this matter has to be the government’s acknowledgment that his banishment was “a mistake.”  In other words, he should never have been sent to incarceration in a foreign country.

Most of us, when we make a mistake, take steps to make things right … but that is not what happened here.  Instead, we were witness to a press conference with President Trump and Nayib Bukele, the self-described “world’s coolest dictator” of El Salvador, both chuckling about Garcia’s plight and Bukele’s refusal to return him to the US.  It was at this event that Trump made the stunning suggestion that expulsions of this sort might be suitable for “home grown” criminals as well.

I do not know whether Garcia is a member of the violent MS-13 gang or not but, regardless, the US Constitution grants him the right to due process, and the highest court in the land … the US Supreme Court … has ordered that his return be “facilitated.”  As of this writing, though, the government has not complied with that ruling.

During a recent interview marking his first 100 days in office, President Trump described a photograph showing various tattoos on Garcia’s hand.  In that they included the letters and numbers M,S,1 and 3, the photo was offered as evidence of Garcia’s membership in that notorious group (and, therefore, justifying his deportation).  According to a variety of sources, though, those letters and numbers were “Photoshopped” onto the original image, a fact which Trump vehemently denied.

Sigh.

Among his many prescient observations, German philosopher Theodor Adorno (1903-1969) suggested that a nation’s descent into hell begins when all questions of truth are converted into questions of power.  Further, when a government attacks the distinction between true and false it does so, according to Adorno, in furtherance of its own version of reality.

Sound familiar?  Might Adorno have been ahead of his time in contemplating the sort of government that rejects criticism by using such phrases as “fake news” and “media hoax”?

Adding to the mix in this dystopian world, Senior White House Antiterrorism Advisor Sebastian Gorka has gone so far as to suggest that Americans should not question government decisions about deportations.  In Gorka’s universe, if you are not on the side of the government, you are in league with terrorists and illegal aliens, adding: “… you have to ask yourself: Are they technically aiding and abetting them? Because aiding and abetting criminals and terrorists is a crime in federal statute.”

For a reasoned response to Gorka’s view, we need look no further than the words of the 26th President of the United States, Theodore Roosevelt who, in 1918, wrote:  

To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.

To be clear, I am not suggesting that we are … or will soon become … a totalitarian state.  Neither do I believe that we should countenance criminals in our midst.  We would be well-advised, however, to care about the fate of Kilmar Abrego Garcia, for the way in which he is treated will say much about how we, as a nation, view and treat others … including those like you and me.

Paging Doctor Shafmeister

Growing up in a small village in upstate New York, I have fond memories of a family doctor who actually … wait for it … made house calls!  Yes, on those rare occasions when Mom’s home remedies were insufficient, Doc Shafmeister would show up at the door with his black bag and caring manner.  I don’t know how he got paid … scant resources and a lack of insurance defined our household … but, as I recall, his ministrations always helped me to get well.  

Fast forward to today’s environment of deeply-intertwined health care, insurance, the internet and big business, a world into which we were recently thrust via an ambulance ride to the Emergency Room and a subsequent hospital admission.  Gratefully, the quality of medical care received at the hospital, itself, and from the various doctors, specialists and staff we encountered was of superior quality.  Their work was impeccable and caring, and we are forever grateful for their skills and dedication.  

That said, arranging for continued care after discharge from the hospital was, well, a nightmare.  In our defense, we are fairly computer-literate, but the morass of web sites, “patient portals,” calendars, phone numbers, email addresses and assorted other “apps” to which we were obliged to respond left us feeling overwhelmed.  For example:

⚫️Each of four doctor’s offices, a lab, an imaging center and the hospital itself presented us with a bevy of electronic forms to complete, and …

⚫️Each of those forms asked basically … and at great length … for the same information, and …

⚫️If we had a question for a doctor, we could submit it through a “portal” promising a reply in up to 72 hours, and …

⚫️When one doctor prescribed a new drug, checking for possible contraindications with a different doctor could take, again, up to 72 hours, and …

⚫️We could forget about trying to actually speak to someone by phone.  Office staff, understandably, cannot provide medical information … the best they could do was promise to forward a message to medical staff.

Adding another layer of aggravation in the midst of this confusion, a suspicious email showed up in our inbox inviting us to “click here” to register with some other medical entity.  Though at first glance seeming legitimate, it was a Phishing attempt and we simply deleted it.  But give credit to the scoundrel who sent it … he could not have picked a better target than someone thoroughly fatigued and fed up with all forms of electronic media. In other words … me.

As mentioned above, we could not have been more pleased with the various medical professionals whose efforts contributed so fully to diagnosing and treating the condition that presented itself.  And while we know how lucky we are to have access to such high quality care, the bureaucracy and repetitive, overly-complicated requests for information woven through the process are exhausting.  In short, one is left to wonder …  don’t these entities talk to each other?  Isn’t there some master data base that each can access?  Is there not some mechanism for conversing with a human being about medical concerns?  Weren’t computerization and associated data technology supposed to make things easer for us? 

Despite how this may read we endeavored, throughout, to avoid becoming known around various medical offices as nuisances … you know, “that patient” who nobody wants to talk to.  On the other hand, we saw our part in this endeavor as being vigorous advocates for patient care, and we took that role seriously.

The days of Doctor Shafmeister’s form of family care are long gone.  In its stead we find ourselves, today, in an environment in dire need of an ombudsman or “voice” for patients who find themselves adrift in the digital world of medicine.  Put differently, the system needs someone equipped to help us … especially the elderly … better understand what is going on with our medical care, while managing and explaining the process in ways we can comprehend.  

Jason Wolf is President and CEO of the Beryl Institute, an  institution dedicated to supporting patient and human experience in healthcare.  He describes the focus of his organization this way:

To truly improve the patient experience, we must understand the patient journey from the patient’s perspective.

Well said, Dr. Wolf.  Well said.