July 2026
By Richard Fleming

In June I celebrated my 75th birthday. It was a warm, relaxing occasion at home, surrounded by family. Folks came from Colorado, southern California, and from around the Bay Area. It was an enjoyable evening with good food and much sharing of stories and love. Best of all, no one roasted me in their after-dinner toasts, all of which were kind and moving.
Originally I did not plan to write a post about this day, but I eventually had to acknowledge that turning 75 is kind of a big deal. It meets the definition of a milestone birthday. Though as I have noted previously, it can also be viewed as a millstone birthday.
Reaching age 75 is an appropriate occasion for contemplation, to look back, to look forward, and to consider the present. I want to briefly assess each of these three vistas. While my reflections may resonate with others, every senior’s life is distinct. Each person’s feelings on reaching this milestone will vary.
* * *
Looking back. Reflecting on the past is an exercise I do not typically spend much time on, but this birthday did lead me to think a bit about my history. What struck me was that who I am today is a product of seven and a half decades of accumulated life experience. I am a person constructed over the past 75 years. That is a long time. A very long time, filled with events large and small.
I still recall the main contours, the principal hills and valleys I have traversed. These include some things I wish I had done differently as well as many more things I’m very glad I did during the decades past.
But as is true of most people, my life has been profoundly shaped by nuance. So much of who I am is a reflection of hundreds of small interactions over the years, periods of uncertainty, brief encounters I don’t even remember, fleeting comments made by friends and strangers.
How could I ever synthesize these events, large and small, profound and subtle, into a coherent life story? (My older brother and his wife gave me an online program for my birthday which aims to facilitate such a project, so at some point I will try.)
And are there lessons I can draw from my rotations around the sun? At this point in my life, I’m not sure. If I was 50 or 60, perhaps I could apply some learnings from the past to the years ahead. But at age 75, any such lessons are of limited utility and would be hard to implement. To be realistic, I am not going to change much in the years ahead. My personality will remain the same. My political views are not going to change. I don’t see much evolution in my habits, or lifestyle, or outlook on life. As Popeye the Sailor Man used to say, “I yam who I yam.”
Now to be clear, I don’t dismiss my past. I enjoy reminiscing. I like to share stories of growing up in Kansas, things I did over the years, people I knew, adventures I enjoyed. But, bottom line, these are anecdotes and do not explain fully who I am.
So while I sometimes reflect on the past, I intend to let bygones be bygones. At least that is my plan for now. Maybe as I mature more, my outlook on examining the past will evolve.
* * *
Looking ahead. At age 75, contemplating the future is a different exercise than it is for a person at age 50. Or even at age 60, when the horizon still seems far away. I feel fortunate and lucky to have lived three-quarters of a century, but uncertainty about the years ahead is unavoidable.
With each passing year, more friends and family from my generation fall by the wayside. These losses are like shooting stars – they are highly visible, and each time one blazes through the night, it seems the sky has lost another star. These deaths, increasing in frequency, are poignant reminders that my future, too, is limited.
How many years do I have? Who knows? I would love to see my 19-month-old grandson graduate from high school. But it is impossible to know whether I will arrive at that day. If seeing my grandson attain his high school diploma was to become a wager on Polymarket or Kalshi, it would be a long shot. But long shots occasionally win.
So what is a mid-septuagenarian supposed to think when considering the years ahead? I hope to maintain reasonable physical health for as long as possible. It would be great to preserve my mental acuity, though I grow ever more confused by the culture, language, and technology of the younger generations.
I try not to speculate about whether my future will be long, or short, or somewhere in between. Since nothing can be gained by dwelling on the unknowable, I do my best to keep this question in a box at the back of a low shelf in the garage. But I am human, and confess I sometimes reach for that container to look inside. Doing so never satisfies my curiosity.
* * *
Considering the present. I prefer to focus on the here and now, the most important time of life at every age. I want to live my days as fully as possible, At the same time I find it hard to embrace a concept I hear frequently: “Live each day as though it may be your last.” That perspective would put too much pressure on me when I wake up each morning.
I prefer the approach of living each year as though it’s my last. That offers the option of being very unproductive some days – or even some weeks – without feeling guilty. Maximal daily productivity might seem an ideal goal for older folks. But our aging bodies and flagging energy make it increasingly difficult to achieve.
In fact, for us seniors, there can be virtue in wasting time. As we grow older, efficiency becomes less important. Of course, we don’t want to fritter away month after month, but old folks deserve a break as far as how many goals we accomplish each day before going to bed.
So how to approach living in the present? As I considered this question on my 75th birthday, the most important thing I felt I should do, day by day, is spend high quality time with family and friends. Doing so creates memories. And as my wife regularly tells me, memories are the most important legacy we can leave behind.
I also want to continue to read, do volunteer work, follow-up on home maintenance responsibilities, and do some traveling. I like having fun in my daily life. This approach to living in the present is both rewarding and low-pressure.
* * *
In closing, I want to point out the fallacy of a throw-away line I hear more frequently, the older I get. “Age is just a number.” The folks who voice this idea imply we seniors can pick a younger number if we really want to. Feeling old is a choice. Um, no. 75 is real and indisputable. I can no more opt to be 70 than I can choose to be 55.
At the same time, it is not unusual for me to stop and think: 75? No way. I don’t feel like I’m 75. How did that happen? Being 75 years old does not seem real. It does not feel possible. But there are also occasional days I think: 75! If I feel this tired and achey now, how will I feel at age 80?
Reaching age 75 is a BFD, an accomplishment, an achievement denied to many. I feel lucky and fortunate. At the same time, it is hard to avoid the reality that 75 is damn old. I am more ancient than when I turned 70.
Think about this: our country turns 250 years old on July 4. American history has been a long, complicated journey. We have traveled through many lengthy periods, good and bad, in our unfinished quest to form a more perfect union, with liberty and justice for all, a nation of people who are created equal. For those of us 75 or older, we have been alive for about one-third of the entire time the country has existed. When you consider the length, richness, and complexity of U.S. history, living through one-third of its existence is confirmation of how old we really are.
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Happy 75th Richard. I love, love, love your thoughts about the past, future, and present. What an honor it was to work side by side with you for 7 years.
Happy 75th Richard! I will turn 69 this fall and I will be facing a new decade the following year but I certainly do not feel the decade I am currently assigned! Everyone I know says the same. I remember when I first met you as a young attending and me as a green doc just out of med school. I thank you and many of the other SF KP attendings who treated me like a younger brother rather than a whipping boy. Believe me that time affected me for my entire career in how I treat others and utilize in training others. Thank you for your wisdom, thank you for your kindness, thank you for your sardonic comments!
Happy 75th Birthday! I am so glad you made it to this milestone and wish you more years of health and happiness. I love your blog and look forward to it coming into my inbox. One of your greatest accomplishments, among many, that I know about you is that you were the best physician I ever had .
You nailed it Bro!
Happy birthday, Richard! And thanks for these thoughtful reflections.
You continue to contribute meaningfully to your community and the lives of us fortunate enough to know you.
Hopefully, here’s to many more birthdays and reflections to come.
You are blessed to have a milestone birthday with family and friends, and we are the beneficiaries of your meditation on that. Thanks!
As an 83 year old, living life to the fullest includes travels to visit family (especially grandkids) located in far-away places (Hungary and DC at present); continued service to community through a local Rotary club; sustaining friendships established over the years through organizations like Rotary and the Naval Order of the United States; researching to write my second history (of the Naval Hospital in Oakland – 1942-1996); continuing the just-59 year romance with my dear wife Gina; paying close attention to the political news; and more.
No wonder I sometimes feel busier now than when I was in my very enjoyable TPMG practice! The time seems to fly by, and there’s no sense as to how many more summers we have left (as Michelle Obama puts it).