About this Blog

I am on a quest to understand and grapple with the reality and meaning of aging. My professional career – over 30 years practicing general internal medicine – focused largely on helping people grow old more successfully and accepting death with grace.

I never felt successful in this role. My patients often expressed gratitude as we journeyed down the road together, but I never felt I was adequately discharging my responsibilities. In large measure, my doubts reflected my inability to truly grasp the fact I too was traveling down the path of aging. I was trying to ignore the reality that I too would come to an end.

Maybe my decision to become a general internist stemmed in part from my hope that my aging patients would help me better understand myself. In 1993, early in my career, I wrote an article giving voice to some of my musings about the aging process. I speculated on why it was taking me so long to learn the secrets of growing old from my patients.

After the piece appeared in a local newspaper, I received more than 100 letters over the next few weeks (this was before the widespread availability of email). People wrote to share their own doubts and questions. Some letters were brief. Some were long, describing personal fears and uncertainties about what it meant to grow old and die.

Over the next couple of years, I continued to receive an occasional letter from people who said they had cut out my article and kept re-reading it because it reflected their own anxieties about the aging process, and they needed reassurance they were not alone.

I was touched by these letters. They validated my worry. They helped dispel my concern that perhaps I was too immature to accept life and death as they are offered to us.

So, what transpired over the succeeding years of my career? I did learn some things from my patients about what it meant to live while aging. But the answers were incomplete. The problem was not my patients. It was me.

Six years ago, I retired. Since then I have continued to ponder the shortening path ahead. I am in good health, as far as I know, and hopefully have a couple of decades of life to go.

A little over a year ago, I celebrated my 70th birthday. In my 1993 article I set age 70 as the time I should have answers. While I have some inklings of understanding, I still have more questions than answers. It is in effort to sort through these questions that I decided to start this blog.

Two disclaimers:

(1) I will not be writing about what occurs after we reach our ultimate destination. People have different beliefs about what may happen when our journey in this life ends. I don’t plan on touching directly on that topic, but will limit myself to reflecting on what it means to mosey, stumble, and drift further down the road into old age, in this lifetime.

(2) I am not providing medical advice, and none of my posts should be interpreted as offering medical advice.

About Me

My name is Richard Fleming. I was born and raised in Kansas. After high school, I left the Great Plains to attend college in Chicago and Palo Alto. After graduating, I attended medical school in San Francisco, getting my degree in 1976. I completed an internship in internal medicine, then worked for a year for the U.S. Public Health Service, followed by three years as an emergency room physician in a small hospital. I subsequently completed an internal medicine residency and worked as a general internist in northern California for 30 years.

While I was in practice, I wrote a number of articles reflecting on my experiences as a general internist. These were published in Newsweek, Discover, Hippocrates, and various local newspapers. I also wrote articles about doctor-patient relationships which appeared in the professional staff newsletter of the medical center where I worked. These are available at notesfromthepractice.com.

I retired in 2016 after 33 years in clinical practice, though I continue to maintain my skills by teaching medical students as an adjunct faculty member.

I have been married to a wonderful woman for the past 31 years, and have two amazing step-children and three energetic and loving grandchildren, with a fourth on the way. We all live in northern California.

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