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AGING ISSUES

There is no evidence that biomedical science can deliver on its promise of “compression of morbidity,” enabling us to live out our allotted span in good health (“New Age Thinking,” July/August). And there is no compelling practical or ethical reason why those with past contributions to society should be valued above present or future contributions by younger adults and children.

Chronic disability is the nub of the problem, and it affects young and old alike. Our present health care funding arrangements are designed for acute illnesses. They cannot deal effectively with long-term illness and disability. In the United States, chronic illness can quickly lead to personal financial ruin. 

Our academic medical centers hold the key to change because they train our future doctors. There is a broad agreement among medical educators in favor of a more balanced approach, and how it should be achieved. The academic centers need to temper their obsession with cures and breakthroughs and move part of their caring activities outside the hospital, not just into nursing homes, but into the community where most people with long-term disabilities live. They must help develop systems that integrate the delivery of health care and personal social services. And they must promote a team approach that befits the multiple needs of the chronically disabled.

The arguments for a coherent national health policy that can rise to the unmet challenge of long-term care will be more likely heeded by politicians if that policy is seen to benefit all members of society, not just the powerful elderly.

Spyros Andreopoulos
Stanford, California

The writer is director emeritus of the office of communication and public affairs at the Medical Center.

Your article is full of cogent observations, but refuses to face up to the costs that are likely to be incurred even if we are able to keep our old people healthy enough to work.

Laura Carstensen insists that to keep the elderly at work we must increase the health of every older person, not just the affluent and best-educated. Are we expected to believe this can be done at less than the rate of health spending currently projected, based on the U.S. health care system as it exists today? 

The only recommendation on financing is Dr. Garber’s judgment that it isn’t politically viable to suggest restricting benefits or raising the age of eligibility. But without major reform to reduce either payouts or recipients, Medicare won’t succeed. Yet Professor Fries sensibly wants to broaden, not reduce, Medicare benefits, to include prevention. Absent is any suggestion that preventive health coverage of those under 65, extending down to children, is also required to insure healthy aging. Yet care for that age group is deteriorating, as health insurance coverage is chipped away year after year.

Isn’t there a Stanford professor bold enough to say that the whole health financing system is broken; that if we follow the recommendations of the current administration, we will wind up with a two-class medical system, where only the healthy and wealthy get quality preventive care while the emergency rooms are left to care for the rest; that health dollars are wasted on insurance company administrative costs, including the costs of trying to avoid covering the persons who need coverage the most; that today’s pharmaceutical prices feed monopoly profits and not productive research; and that the best bet for the long-term control of health care costs is universal womb-to-tomb coverage, which precludes tax cuts and may well require new taxes?

Cornelia Little Strawser, ’53
Washington, D.C.

I wanted to make you aware of the multidisciplinary Stanford Prevention Research Center in the department of medicine. Among their goals: to develop and evaluate successful programs and interventions to promote health, function and quality of life as people age. Three research projects currently offered to older adults in the Mid-Peninsula and greater Bay Area are the TEAM project, telephone-based programs to promote regular moderate-intensity physical activity and healthful diets among English- and Spanish-speaking adults 55 and older; the LIFE study, which aims to prevent disability and promote independence among adults aged 70 to 85; and the Teaching Healthy Lifestyles to Caregivers (TLC) project aimed at people 50 and over who are currently caring regularly for loved ones with aging-related impairments or chronic conditions. The TLC project seeks to determine the best ways of helping such family caregivers improve their lifestyle patterns to promote their own health and quality of life.

Abby King
Professor, Health Research & Policy and Medicine
Stanford University School of Medicine

In reading your July/August First Impressions, I could not help but think of my grandfather. Less than two years ago, he came to my wedding walking by his own means. Now, he is 89. He sits in a wheelchair, has nursing care at home 24/7 and barely speaks. As you well put it, he is alive, not living.

Born very poor in a small Romanian village and able to escape before WW II, he moved to Peru where he and Grandma built a life. Then, because of the political turmoil, in 1974 he moved to Venezuela to start again. All this gave him a strong will to live adorned by a cynical sense of humor, even after burying a second wife.

As he started suffering from old age, you would ask him, “Zeide, how are you doing?” and the answer invariably would be: “Aging sucks, but the alternative is far worse.”

Benjamin Wainberg, MS ’94
Caracas, Venezuela

SHOP TALK

The Stanford Shopping Center is unique because it was developed by and, until recently, managed by the University (“Bloomingdale’s Across the Street . . . Priceless,” July/August). I fear that its recent sale to the nation’s largest publicly held shopping-center company will result in its becoming simply another regional shopping mall, and that it will lose the uniqueness and charm that have been its principal attraction. The delightful street market with its European murals, the fanciful sculptures such as the frog fountain and the little men, and the lovely flower plantings were the inspirations of Stanford’s management team. Stanford’s management has also avoided installing such annoyances as walkway-cluttering individual vendor kiosks and has been responsible for the center’s meticulous housekeeping and landscaping. An ominous signal of changes to come was the recent placing of for-sale autos, SUVs, and pickup trucks along the full length of the central mall. I feel sure that would not have happened under Stanford management.

Cassius L. Kirk Jr., ’51
Menlo Park, California

In the mid-1930s, Joseph Magnin opened a store in downtown Palo Alto to serve
the Stanford community. It moved to the Stanford Shopping Center concurrent with its opening. The JM store abutted the Roos Bros. store; it, too, occupied 25,000 square feet and its sales per square foot exceeded those of Roos Bros. and I. Magnin, which was located adjacent to the JM store. Of the 35 stores in the Joseph Magnin group, the Stanford store was its most successful, so successful that additional space was acquired and occupied in another part of the center.

Donald Magnin, ’49
Executive vice-president and director, Joseph Magnin Co. Inc.
San Francisco, California

A historic strength of Stanford has been that its land is sacrosanct and its architecture fine. No amount of flowers can change the facts of Stanford mall. In 2003, a year when the University had to tighten its belt to soften the cyclical low of its investment returns, Stanford land was in effect sold for a function irrelevant to students and faculty. Worse still, it is a function housed in less than mediocre architecture with negative externalities of traffic congestion, increased local real estate prices and the exclusion of the type of inexpensive, useful and vibrant retail found adjacent to almost every other university campus on the planet. What will be sold off during the next low of the business cycle?

Ann Godfrey, ’06
Stanford, California

Wolff's old school

Cynthia Haven’s description, “the tony Hill School,” evokes for me the surreal image of wired, elegantly trendy souls sipping Starbucks in Purgatory (“Life as Invention,” Showcase, July/August).

When I was there, all-boys Hill wasn’t student-friendly. Boys were highly original sinners to be watched and reformed by pressure and heavy rules. We studied seven days a week; and Sunday church and daily chapel lectures were required, except for Wednesday, when we could go off-campus for three hours. Every several weeks someone was expelled for something minor, and he became an example in the headmaster’s chapel message. Diversions included lectures by famous people, like William (Original Sin) Golding.

I met Toby Wolff in 1962 across one of those dining tables pictured on the cover of his Old School. I liked him because he was unreformed. Ironic Hill, which emphasized English as first among equals, failed the one student who became an acclaimed writer. Today, he’s Hill’s bright son. Purgatory expelled him, but higher education delivered him from Hill to haven at Stanford, its toniest of theme parks.“O God, as Heaven is higher than earth, so Your fun with us is higher than our fun with You.”

Peter Pansing, ’67
Culver City, California

wedding bell blues

In “Gay Marriage in Context” (Farm Report, July/August), Marilyn Yalom acknowledges the 2,000 or 3,000 years of written history in which marriage was restricted to a man and a woman (or plural forms); but she compares this with previous restrictions [against] marriage between differing races or slaves. While she undoubtedly is more learned than I on this subject, I think these latter restrictions were far more limited in duration and less widespread.

I also think she too quickly dismisses the argument that marriage is about children. That is a little like saying Stanford is not about education and research because there are students who manage to avoid an education and professors who do no research.

The love argument is often a trump in our romanticized culture. But would we extend it indefinitely? What about the love between a 60-year-old man and a 12-year-old girl? Must love be validated in a public way?

Ronald G. Bailey, ’66
Dilsen-Stokkem, Belgium

There is a highly negative spirit taking hold of Stanford as seen in the July/August articles on gay marriage and biotechnology (“Frozen Fertility,” Class Notes).

Homosexual marriage subverts all that God ordains for creation, as does putting eggs on ice to give a career woman more “options.” It is selfish, deceptive and ludicrous. Concepts of family will be redefined and twisted, confusion will reign, and God’s wrath will certainly be provoked. To suggest that same-sex marriage is natural and to teach young people this in places of “higher” learning and to advertise it in the magazine is a disgrace.

What biotechnologists and other adherents of this fertility “market” need is a regeneration of spiritual thinking by studying Genesis and understanding what a little shop of horrors biotechnology is creating. If a woman dies, for instance, and her eggs are still frozen, who is entitled to them?

Did Jane Stanford, an ardent Christian, toil to leave a legacy like this—a university
I formerly cherished that endorses ideas, research, politics that throw into tumult
the most divine and central human activity, reproduction in heterosexual marriage? We have no idea what we are unleashing.

Jennifer L. Cullins, ’92
Chicago, Illinois

The marriages performed in San Francisco were acts of civil disobedience, not acts authorized by the state of California (“A Splendored Thing Unfolds at City Hall,” Red All Over, May/June). I recognize that some feel this authority should be granted, but I, along with the majority of California voters, do not. And until the law books read differently, people should not take it upon themselves to go ahead with such marriages. Those who do (whether mayor or court appointee) should face the legal consequences.

Historically, civil disobedience has had its place. Will these marriages be wholly
dismissed (as the law says they should be) or will they eventually be recognized? Whatever the result, it will be determined through the legislative process. I encourage those with an opinion in either direction to make their voices heard. The strength of our nation relies upon our active participation in determining its direction.

Jamison Moessing, ’99, MA ’00
Lafayette, California

By publishing in the May/June issue a “splendored” report on the bogus homosexual unions performed in San Francisco, a glowing feature on the “research” of a transgendered professor (“On the Originality of Species”) and a first-person story by a liberated lesbian mother in your staff (“Family Outing,” End Note), you have saddened and shamed this Stanford alumnus.

I am saddened as I see my alma mater aligning itself with the misguided Lesbian-Gay-Bisexual-Transgendered agenda. And shamed by being forced to hide the journal from young members of my family.

To what extent are these topics relevant to the life of a renowned university and
of interest to its alumni, who are regularly asked to support it? Please spare us further embarrassment.

Humberto M. Rasi, PhD ’71
Loma Linda, California

Nowhere in the civil, legal or religious definitions of marriage is there reference to two members of the same sex. There is no way these adoring couples can procreate their race, which was the basic reason for marriage in the first place. There is no question of equal rights here. There is no such thing as same-sex marriage.

The present federal administration wants to pass legislation to bar same-sex marriages. How can legislation be passed to bar something that does not exist?

William Burns, ’40, MD ’44
Aurora, Colorado

Thanks for the window on what passes for “science” on the Farm (“On the Originality of Species,” May/June). Roughgarden crafts a novel theory on sexuality, but freely admits, “This is a book of advocacy. I see myself in here as a lawyer advocating a case for diversity.” Darwin’s view of homosexuality “has promoted social injustice... We’d be better off both scientifically and ethically
if we jettisoned it.” Heartfelt maybe, but where is the objective science?

Mixing biology with engineering might puzzle the average Joe Blows out there, but it’s no problem for the Stanford professor’s colleagues. Roughgarden’s fellow biologists “know that whenever you do science, there’s an agenda—a subjectivity to what questions you’re asking.” Wink, wink, nudge, nudge.

While I was at Stanford, [theologian] Francis Schaeffer predicted that by the turn of the millennium we’d see “non-objective, sociological science” where conclusions are determined by the way the scientist wants the results to impact society. “Science” would be a tool to manipulate society by cleverly arranging selected pieces of data. Isaac Newton, meet Johnnie Cochran.

Joe Pool, ’72
Calabasas, California

writ larger

I’m a much younger alum than David DeLancey (“Too Small,” Letters to the Editor, July/August). I graduated only 50 years ago. However, I too would appreciate more readable type. Any chance?

Brigitte Wallerstein Dickinson, ’54
Prescott, Arizona

Editor's note: We heard you, and made a change. The type size throughout the magazine is bigger, beginning with this issue. In addition, we switched from a light-faced font to a darker one, and we think you'll notice a marked improvement in readability.

encouraging Segregation?

Camille Ricketts’s very personal story provides a counterexample to the belief that segregation in our society is almost entirely due to exclusion created by Americans of European descent (“What’s Race Got to Do with It?”, Student Voice, May/June). In my experience, self-segregation in America is as prevalent among minority groups. I am aware of a desire to segregate in order to preserve culture and avoid injustices, both perceived and real. Unfortunately, I think our society is swinging too far. “Assimilation” has become a dirty word. It is often more socially desirable to identify yourself as part of an ethnic subgroup than as just an American.

In the name of diversity, I think universities such as Stanford promote this. Note the myriad clubs based on ethnic or religious affiliation that often form a large part of a student’s social life. My experience is that these foster social segregation by young adults who were much more integrated in high school. I want to walk down the street feeling I have an equal chance of friendliness, closeness and socialization with someone regardless of their ethnicity. This may be a naive fantasy. But I think Stanford encourages the opposite.

Michael B. Mackaplow, MS ’91, PhD ’96
Chicago, Illinois

Letters to the Editor
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