What strikes me most about Jerry Groopman is the way he loves his patients. Not only that but he shows that love in word and gesture. “You are a good hugger,” says Gene Brown, a forty-year-old AIDS patient shown in an extraordinary program in the series “Dateline NBC.”

This program, entitled “The Healer,” was televised this past December. I regard it as an altogether extraordinary service to the public at large, and to people who face illness in particular. Reviewing it on videotape has further inspired me with admiration for the two patients and the doctor who served them so well.

Dr. Jerome Groopman, whom this program highlights, serves as Professor of Medicine at Harvard Medical School and Chief of Experimental Medicine at Beth Israel Deaconess. He has become widely known through his articles in the New Yorker and other periodicals. His two books, The Measure of Our Days and the forthcoming Second Opinions will enhance his reputation further.

In the first of these books he wrote about a highly successful middle-aged venture capitalist who realized at the end of his life that he had invested in the wrong things – money instead of family and what really counts. His patient’s  spiritual situation confronted Dr.Groopman with a difficult challenge, in his own words “to find some way to give him comfort and to allow him, at the end of his life, to find meaning and to pass meaning on to his family.”

Beyond Dr. Groopman’s impressive scientific credentials, his personal qualities make him an admired healer, something that emerges strongly in the television documentary. Here he brings the latest medical knowledge and techniques to help Gene Brown, mentioned above, and Elizabeth Sanderson, a deeply religious 64-year-old woman, who has breast cancer.

Dr. Groopman’s continued efforts to cure the two people shapes an adventure story in itself. Ups and agonizing downs characterize the struggle that these patients and their doctor wage against their diseases. Some reports the two people get from their doctor encourage them; inevitably, it seems, these upbeat indications are all too soon followed by the dashing of hopes for a cure.

Eventually, they both die, Gene at home after having decided to forego further medical procedures, Elizabeth in the hospital surrounded by family members. Both die at peace, with Gene saying “I’m a fulfilled man, I’ll tell you,” and Elizabeth saying “I’m not afraid, I’m more overwhelmed with the goodness of God.”

So, even though they were not cured, they were healed and could die without regret. That way of dying witnesses to their strength of soul and also to the rare ability of their doctor, Jerry Groopman, to enter into their experience with deep understanding and courageous empathy.

His patients often call him “Jerry” in recognition of the personal relation-ship he develops with them and they with him. This tall, physically impressive middle-aged physician with the sympathetic face, risks much himself as he listens to the hopes and fears of his patients.

The way he clasps their hands with his own, puts his arm around their shoulders, pats Gene’s knee and laughs at moments of humor – all reveal Jerry as full of human feeling. At the same time, he tells them openly where the treatment stands and what they can reasonably hope from it.

The last time he sees Gene, they embrace upon parting. Gene tells him, “I love you, Jerry” to which he replies “and you.”

How did Jerry Groopman get this way? In the video he recalls experiencing his father’s death. He and his mother were at the beside and, when his father died, all the attending physician could say was, “Well, it’s tough, kid.” About this response Jerry now says, “I would never imagine caring for patients and their families in any way like this.”

In an interview, I asked the same question of Rev. Herbert Sanderson, the husband of Elizabeth. “My suspicion is that Dr. Groopman’s patients have made him what he is,” he answered.

The interviewer in the documentary asks him if there comes a point when he focuses more on the psychological and the spiritual element in the patient. “Yes,” Dr. Groopman responds, “and it’s in some ways much more difficult because it requires knowing the person and also knowing yourself and being able to open myself up to that person.”

He seems to draw vital strength and inspiration from his own Jewish faith. The last part of the program shows Jerry Groopman in his synagogue for a worship service. The camera focuses on him lighting a candle and reciting the Kaddish in memory of the dead.

Asked what he was thinking about at this point, he answers: “I was thinking what the lives of the people I cared for still mean to me. They live in my heart and my memory.”

He adds, “They have shaped parts of my life in very substantial ways. And I express genuine and profound gratitude to them through that prayer.”

Richard Griffin

A new friend, Ian, recently regaled me with the tale of his meeting one of his distant ancestors. At first, I found the story incredible but later discovered it to be, not the product of a fevered imagination, but a narrative solidly based in verifiable fact.

When he was a young boy, Ian took instruction from the vicar of the Anglican parish in the village where he lived. After one of his visits to the recto-ry concluded, the canon asked the boy if he would like to see something un-usual. He then led Ian to another room and brought up from its hiding place a large coffer. Opening this container the vicar lifted out a small box and opened it for the boy to view.

Inside the box was a human head, not merely a skull, but a head with flesh on it. Ian looked quickly at the head and then shrank back in horror. The vicar then explained to him that he had just seen the head of Oliver Cromwell, the famous anti-royalist leader who in mid-17th century England had overthrown King Charles I.

When Ian told his parents about this encounter, they expressed surprise that he did not know his family’s history. They explained that they were directly descended from Cromwell who was Ian’s great, great, great, great, great, great, great, great, great, great grandfather.

How Cromwell’s head came into the vicar’s possession is in itself a complicated story. After the restoration of the monarchy later in the 17th cen-tury, the British parliament decreed that Cromwell’s body be removed from its tomb in Westminster Abbey and hanged. It was then drawn and quartered and the head was cut off and placed on a spike on the top of Westminster Hall. Later it was passed around, sold and resold, until somehow the vicar of the village church received it. Now it is reportedly buried in Sidney Sussex College of Cambridge University, at a location known to only a few people.

I have related this admittedly bizarre tale, not to be ghoulish, but to stir reflection on the experience of time. At age 76, Ian now looks back on four centuries of history brought vividly to life by the encounter with his grandfather to the tenth power. For him, time is a living reality that takes him back to the earlier generations of his family.

No one else known to me can rival this personal story for its sweep and its drama but many people can reach rather far back into history. Out of family archives I recently held in my hands a photo of myself with a relative who was born in the year 1832. She was my grandmother’s Aunt Kate who came from St. Louis to visit her niece in Peabody, Massachusetts and ended up staying for forty years. She died after celebrating her hundredth birthday.

When you consider that this woman with whom I talked as a four-year-old, had grandparents who must have been born around the time of the American Revolution, history seems much shorter than we usually imagine it.

These anecdotes and reflections have been prompted by the turn of the centuries and millennia that we have lived through this month. I find it still hard to believe that I have lasted into this new era. Not so long ago, it seemed almost unimaginably far off, yet here we have arrived.

Of course, our marking of time has something arbitrary about it. You don’t have to keep to the method adopted by the western world. Instead, to cite only two alternatives, you can use the Jewish calendar and the year 5760 or reckon from the birth of the Buddha 563 years before Christ.

But however you observe it, time plays a dominant role in our modern life. Its rhythms give our lives meaning and give us reasons to look both forward and backward. Perhaps most important, these rhythms can prompt us to look more closely at the ways in which we have changed.

One of my favorite writers, Frederick Buechner explains how the pas-sage of time has affected him: “As I grow older, less inhibited, dottier, I find it increasingly easy to move toward being who I truly am, let the chips fall where they may. I also find it easier to relate to others as they truly are too, which is at its heart, I suspect, rather a good deal like the rest of the human race including me. I find myself addressing people I hardly know as though I have known them always and taking the risk of saying things to them that, before I turned seventy, I wouldn’t have dreamed of saying.”

A group of elders to whom I quoted the first part of Buechner’s statement wholeheartedly agreed with it. They, too, have discovered themselves to have moved toward who they really are. And they welcome this unsuspected benefit of time.

Richard Griffin

Like Janus, the god with two faces, I find myself at this dramatic turning point in history looking forward to the 2000s and backward over the 1900s.

Surveying the past century, I here identify a few of the public figures who have had a notable impact on my life and times. In doing so, I have arbitrarily chosen three prominent people in each of six categories.

In the political sphere, Franklin D. Roosevelt looms largest. He was the first president I was conscious of. As a boy, I thought he would always be my president, just as for me as a Catholic, Pius XII would always be my pope.

Later Harry Truman emerged to take a place the national consciousness and mine. I remember listening to him the first time he spoke to the nation. He sounded to me like a hick, and I won-dered how he could ever lead us the way his predecessor had done.

And third among American political figures, John F. Kennedy stands out. Though I now realize that historians may not rate him highly, still the new spirit he brought to Washington and the country at large, featuring respect for intellect and culture, buoyed up my morale.

In another sphere, spirituality, the three Americans who have marked my life most are Thomas Merton, Dorothy Day, and Martin Luther King. All of them people of deep faith, they wrote and acted so as to support and extend that faith in me and my community. All of them had human defects but their concern for justice, peace, and poor people place them high in my temple of spiritual heroes.

As a boy I used to frequent movie theaters and the double features they offered. Looking back, I conjure up three stars who have left strong memories in me: Humphrey Bogart, Jimmy Cagney, and Bette Davis.

I loved the hard-bitten gangster films that the first two starred in; the love stories of Bette Davis tended to bore me but left a strong impression of what screen acting could be.

In literature, three writers stand out for me: Thomas Wolfe, author of Look Homeward Angel, Sigrid Undset for her great trilogy Kristin Lavransdatter, and Walker Percy.

Wolfe’s autobiographical novel, published posthumously in 1940, is the kind of book you had to read in adolescence to feel its full impact.

Something similar can be said of Undset’s three volumes. With their stirring stories of religious and sexual passion, they ex-tended the narrow boundaries of my thinking and feeling as a teenager.

Walker Percy, in novels such as Love In the Ruins, brought a sophisticated and somewhat pessimistic Catholic sensibility to the world with which I strongly identified.

As a life-long sports fan, I have rooted for Boston major league teams through times of both glory and slump. Among the many athletic heroes who occupy a prominent place in my psyche are Ted Williams, Bob Cousy, and Bobby Orr.

Though he sometimes made it hard to like him, Ted Williams remains the consummate artist of the perfect swing.

Cousy first showed how entertaining and exciting it could be to perform sleight-of-hand on the basketball court, and Orr revolutionized hockey by becoming a big-time scorer as a dashing defenseman.

Finally, 20th century America will be remembered by social historians for the rise of the elder liberation movement. That leads me to cite three leaders among the many who led the way toward asserting the rights of older Americans.

Senator Claude Pepper in his own old age stood out as a champion of public policy recognizing both the needs and the contributions of elders.

Ethel Percy Andrus founded the now giant advocacy organization AARP (known, as of recent months, by these initials alone) that enrolls Americans middle-aged and older for rights and benefits.

And Maggie Kuhn, founder of the Gray Panthers, an organization never large in numbers or resources, but an influence for change in the way older people are regarded in this country. Maggie, living into her nineties, was a dynamic figure who insisted that Americans, old and young, should advocate together for basic social change.

So this is my list of twentieth century threesomes enshrined in my personal hall of fame. You will quite reasonably argue with my choices and omissions. I have left out whole areas of importance and, even within the categories chosen I have ignored many who helped change America.

Perhaps the best way for you to retaliate is to make your own list. It’s fun doing so and reviewing candidates can stimulate your interior life. I fully expect that your selections will differ from mine dramatically. If you wish to share your memories with me, you will find me an appreciative reader.

And, of course, this exercise raises the question of who will be the people of the new millennium most influential in our lives and in those following us.

Richard Griffin

Two old pros coming before the United States House of Representatives’ Judiciary Committee in order to plead for values which have marked their long careers—for me this was an impressive sight, as their faces loomed large on my television.  

Father Robert Drinan and Professor Samuel Beer each made stirring statements against the course of action proposed by the majority of the House Judiciary Committee. As it turned out, their testimony availed little or nothing against the House’s inexorable drive toward impeachment but they tried nobly.

Father Drinan is himself a former member of the House, having represented the Massachusetts fourth congressional district for ten years. He will go down in history as being the first member of the Judiciary Committee to call for the impeachment of President Richard Nixon in 1974.

His service in the House came to an end two years later when Pope John Paul II required all priests to give up elective office. When ordered to do so, Drinan obediently agreed not to run for a further term.

Throughout his career as priest and public servant, this New England Jesuit has built an outstanding record. As dean of Boston College Law School, and more recently professor at Georgetown Law Center, he has been a strong voice for human rights, using his legal expertise on behalf of oppressed people throughout the world.

My friendship with him began in 1953 when we were Jesuit colleagues, he an already accomplished writer and intellectual leader while I was still a mere apprentice. On a more personal note, he will always be close to my heart as the one who first notified me of my father’s last illness.

To see his bony, austere, aging face on television the day he testified before the committee and the nation, was for me a moving sight. Now 78 years of age, he belongs to a diminishing breed—avowed liberals who continue to profess political ideals now wildly unpopular in Congress.

Drinan testified before the House Judiciary Committee twice. The first time, on November 9th,  Father Drinan spoke as a constitutional expert and said there was no foundation for impeachment.

The second time, on December 8th, he was asked to share his experience of 24 years earlier. “The situation before the House Judiciary Committee today is entirely different from the scene in 1974,” he told members. Last week he told me how he felt about the comparison, “I resented the attempt to make them parallel.”

About his overall impact, he told me, “We didn’t persuade anyone. But you have to keep hoping.”

Samuel Beer, a more recent friend, also has a distinguished record. At age 87, he is Professor Emeritus of Government at Harvard University. After his retirement from Harvard he became the first holder of the Thomas P. O’Neill chair at Boston College. At this stage of his long career, he continues to consult with governmental bodies on vital issues, most recently with members of the British House of Commons.

Beer formerly served as national chairman of the Americans for Democratic Action, a leading advocacy organization on the left. Like Bob Drinan, he is an unabashed political liberal who believes in principles now quite unpopular in the nation’s capital.

Beer’s main message on December 8th was that the House of Representatives in moving toward impeachment was embarked on what is  “primarily a political, not a judicial act.” Since, in the American system, the people are sovereign rather than the legislature, the latter ought to do “what the people at their best would do.”

I am aware, of course, that some readers of this column may feel out of sympathy with the views of Beer and Drinan. They may have applauded the House’s action in impeaching Bill Clinton.

Nonetheless even those readers can find reason to admire these senior statesmen who came forward when they saw their nation in need of wisdom. This kind of public spirit in Americans who could have appealed to age as reason for no longer fighting political battles should stir respect.

These two seasoned veterans of the political wars provide a model of action for people who feel concern for our nation. Both men demonstrate remarkable consistency. They acted on principles firmly held and tested over a long period of time. Rejection of their views did not deter them from  speaking out.  

As this politically turbulent year of 1998 comes to a close, I, for one, will continue to be inspired by the sight of these two elder statesmen taking a principled stand at a time of grave national crisis.

Their distinctive faces will remain engraved in memory as I review the events of the past twelve months. For me they show elderhood at its best—the sharing of wisdom gained over long lifetimes of service and learning.                                    

Richard Griffin

“Christmas is the time of year when you feel for other people. The only time when you have that feeling in your heart that you don’t have the rest of the year. Feelings of love and affection, I guess.”

This was told me one afternoon last week by a man from Newton, aged 73, who did not share his name. He was one of a dozen or so people I approached last week as they shopped at the Arsenal Mall in Watertown.

Peg McKeigue of Cambridge, who expresses enthusiasm for this column, calls this season “a very happy time for everybody.” It means “the coming of our Lord and salvation.” “I don’t usually come into this mall,” she explains, “but I’m looking for strawberries. One of my grandchildren wants them.”

Eva of Watertown told me that she is Jewish. The age she likes to use is “39” but she acknowledged being a lot older than that. She takes an expansive view of Christmas: “It’s a joyous holiday for everybody,” she says. “We get into the swing of things, we’re very flexible.” Though she does not have a tree, she does give presents as she also did at Hanukkah.

A husband and wife from Newton happened by. Ruby has special reason for celebrating: she was born on Christmas Day. She celebrates by making twelve kinds of cookies for her children and five grandchildren. They came the day before to trim the tree and have dinner. Her husband Wilford also associates the day with family and loves to entertain family members.

George, a 63-year-old resident of Cambridge, originally came from Syria. Though enthusiastic about the day, he feels that Christmas has become “so commercialized, the commercial part is overtaking the spiritual part.” Perhaps it has been that way in the United States for a long time, he observes, but back home where he came from, he would receive a new suit and a new pair of shoes and pocket money but there would be no wide- spread exchange of gifts.

When asked about the Syrian/Israeli negotiations, he welcomes them and says that “peace all over” is important to him.  

Virginia Viall, 83 of Newton, worked with her husband in the ministry for 58 years till his recent death. Despite this blow, her spirit remains strong along with her resolve to continue her husband’s work. “I’m carrying on, doing the things I always did for him. I love doing it, I love serving the Lord,” she tells me.

Another gentleman, Jim from Chelsea, who is approaching his 84th birthday, says of Christmas, “You’ve got to enjoy it because it’s what we’re brought up with. You’ve got to believe in something; if not, we’d be running around amok.”

Seventy-seven year old Martin Grealish lives in Brighton, having emigrated from Galway, Ireland when he was still a young man. For him Christmas means peace and happiness. “It’s a peaceful time for me,” he says while taking a break on a mall bench.

A 75-year-old woman from Belmont quickly answered my question about meaning in a single word “prayer.” As explanation, she added: “because that’s the story of Christmas.” She also confessed to being helped by prayer to recover from illness.

Another woman answered: “Just about everything – family, religion.”

Florence Cleary said, “We really and truly should try to be kinder to one another, and I don’t think we are.” She grew up in Cambridge but now lives in Watertown.

Kathryn Ferguson, a middle-aged woman from  Waltham, says “it means the birth of Jesus and celebration with family and children.” Asked about Christmas being a tough time for some, she takes inspiration from a television evangelist who advises seeing the Christmas tree as the wood of the cross as well as a sign of happy times. “And we have little children,” she adds buoyantly.

Encounters with these shoppers left me with several strong impressions. First, how polite people were. Almost uniformly, they stopped to talk with this stranger holding a tape recorder in his hand. Only a few people among them indicated they did not wish to be interviewed.

Their enthusiasm for this holyday/holiday season  also impressed me – for them, Christmas has retained its allure despite the pessimism so often hears about it. Two or three mentioned difficult aspects of this holiday time but these comments were usually set in a positive framework. One man, for instance, said  wistfully: “When you reach our age, you lose people.”

The elders I talked with also seemed to put gift-giving in perspective. Their immediate response usually focused on their religious faith and their love of family. Holiday hoopla did not seem to count for much among them. Though spiritual values are always hard to talk about, these people indicated that they care deeply about such things.

I came away from these encounters feeling more upbeat about the Christmas events and looking forward to holidays with renewed enthusiasm.

Richard Griffin

In her recent book Amazing Grace, author Kathleen Norris tells of a discovery that her family made about her maternal grandfather, a physician.

“My mother says that she and her mother were surprised to find, after my grandfather died, several prayer books included in his medical library. It seemed that when he traveled to farmhouses by buckboard (and later by Model T), families would ask him to say prayers over the sick and dying.”

How many Americans nowadays have ever experienced their doctors praying for or with them? I certainly have not and I strongly suspect that you have not either.

And yet there’s evidence that many of us would welcome physicians’ prayer. At least one survey shows an astoundingly large percentage of those polled saying that MDs should pray with their patients.

This statistic, by the way, was one of many fascinating facts I learned last week at “Spirituality and Healing in Medicine,” a conference conducted in Boston by Harvard Medical School. This conference, attended by hundreds of people from around the country, many of them physicians, made the case for doctors taking an active interest in the spiritual life of their patients.

Dr. Herbert Benson, the well-known Harvard cardiologist, in his keynote talk, set the context of the conference in the research he and others have done over the past thirty years. This research has demonstrated the remarkable effects that spirituality can have on our physical well-being.

Dr. Benson describes his findings thus: “The research established that when a person engages in a repetitive prayer, word, sound, or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. There is decreased metabolism, heart rate, rate of breathing and distinctive slower brain waves.”

These changes are termed by Dr. Benson “the relaxation response.” They help to reduce stress, a strong influence in many illnesses. Thus the relaxation response has been shown to be an effective therapy in such problems as hypertension, chronic pain, and some cancer symptoms.

More and more medical practitioners are catching on to the power of the spiritual in healing. Some sixty medical schools now offer courses on spirituality. The days may have passed when a medical school graduates could say what Dr. Dale Matthews said at the conference, namely that in four years of medical school, he only heard the word “religion” mentioned once.

The same Dr. Matthews takes as established fact that “religious factors are neglected in the practice of medicine, despite patients’ wishes to have them ad-dressed.” Among other evidence, he cites a 1996 poll whereby 63 percent of adults surveyed said that physicians should talk to them about their spirituality but only ten percent had actually done so.

To make it easier for doctors to raise the subject from the beginning Dr. Matthews has developed an approach that doctors can use to bring spirituality into their dealings with patients from the beginning. Using the scheme WEB, he offers a three-part outline that can serve to raise what might be sensitive issues.

The first step is for the doctor to welcome the patient and make it clear that, whatever the person’s faith or lack of it, he or she is fully accepted. The patient can then be invited to discuss faith issues and God’s presence can be acknowledged.

Secondly, the doctor can encourage patients “to continue healthy religious beliefs and practices.” For example, if the patient has joined a prayer group, he or she can be encouraged to stay a part of it.

Finally, the physician can give an informal blessing to the patient. That might come in the form of such statements as “God bless you,” or, simply, “Shalom.”

This kind of advice, I am aware, is not going to sit well with some physicians. To them, it may seem an intrusion into territory not their own. And even if they would like to do it, many will probably feel ill at ease.

If, as a recent survey suggests, the great majority (85 percent) of medical residents feel very uncomfortable talking about death with dying patients, then surely the prospect of praying with patients would also be difficult.

In a visit to my dermatologist this week, I raised with him the question, not of praying with patients, but of asking about their spiritual life. This physician acknowledged not having done so in any explicit way but he showed strong interest in my question.

Though raised as a Catholic, he no longer goes to church. However, he retains a strong attachment to many of the religious ideas and values of his younger years. He respects Dr. Benson’s work and thinks they might be worth exploring in his own medical field.

I feel grateful to this doctor whom I do not know very well for having made it comfortable for me to raise unaccustomed questions.

Richard Griffin

At a State House forum on prescription drug coverage for elders last week, I talked to several senior advocates. Ed Schwartz of Arlington, a volunteer for Minuteman Home Care Agency, told me about one of his clients whom he has counseled.

The client is 77, a veteran of World War II who has some serious health problems. His income puts him just above the poverty level so he does not qualify for Medicaid. However he can’t afford the drugs that have been prescribed for him.

How does he handle the problem? Like most elders in this situation, he cuts back not on food or rent, but rather on the drugs. “Long run, this is detrimental to his medical problems,” says Ed Schwartz.

But Ed takes heart from the recent increase in the state’s senior pharmacy program. Elders who are eligible will find their drug allowance increasing from last year’s $750 to $1250, a rise that Schwartz calls a “real boon” for his client. Details about eligibility are available at 1 (800)  813-7787.

As this program suggests, Massachusetts is making a strong effort to provide for its elder citizens coverage that, almost everyone agrees, should be provided by the federal government. As Senator Edward Kennedy said in a speech videotaped for this forum, “Medicare is a broken promise” because it leaves so many elders vulnerable to exorbitant drug costs.

The Gerontology Institute at UMASS Boston and the Legislative Caucus on Older Citizens’ Concerns co-sponsored the forum. Its purpose, in the words of chief organizer Ellen Bruce, was “to bring together both policy makers and constituents and some drug industry people as well.”

Everyone has mixed feelings about the Massachusetts program. On the one hand, the Commonwealth has responded imaginatively and generously to serious need. As health care expert John McDonough of Brandeis University told me, “I think we in Massachusetts are making good progress.”

But, on the other hand, there is a widely shared awareness of the limitations of efforts made by any single state, however generous. Ellen Bruce puts the case well: “You can’t wait on the federal government. It probably is a collaborative effort that is needed.”

Professor McDonough, who in his time as a member of the Massachusetts House of Representatives took the lead on health care legislation, outlined masterfully the issues affecting the price and availability of prescription drugs. The continued rise in costs is highly undesirable now and can only get worse. However, he refuses to blame any one sector or group of people. “There are no heroes or villains,” he maintains.

Judith Kurland, New England Regional Director of Health and Human Services in the federal government, showed herself less reluctant to assign responsibility. “The drug companies are making more money than any other industry,” she charged. And, she claimed, some of them are using their economic power to buy up generic drug companies so as to make that cheaper option less available.

To apply brakes to runaway costs, she laid out several options. In her opinion, focusing on increased coverage would simply put more pressure on the whole health care system. Instead, she favors placing limits on the costs of drugs.  This step, however,  would run the risk of  the drug producers claiming  that cost controls will kill the industry.

Her favored option seems to be the pooling of resources. If purchasers in New England got together, she figures, they would have purchasing power equivalent to all of Spain.

Finally, Representative Harriet Chandler of the Joint Health Care Committee, emphasized the complexity of the problem and urged elders everywhere to keep lobbying the federal government for needed action.

Emphasizing the crisis that presses on elders who need drugs to maintain health, she said, “We are in a form of triage now.” Changing the metaphor she added, “We have put our finger in the dike but we need the leadership of the federal government.”

Meantime she feels proud of a new Massachusetts program that goes beyond the expanded drug coverage noted above. This new provision is aimed at so-called catastrophic costs, amounts so large almost no one can pay them.

Scheduled to start on January 1st (though some think a date in the spring is more realistic),  this emergency program has no upper limit for costs. It will include elders with incomes up to a little more than $40,000.

The next immediate challenge is to get word out about what Massachusetts is doing to help elders crushed by prescription drug costs. Over the last several years, the Senior Pharmacy Program has not enrolled nearly as many elders as expected. Of the thirty million dollars that has been allocated each year for this purpose, sixteen million is the most that has been spent. In any single year, only twenty-six thousand elders have taken advantage of the plan.

The task for elder advocates is two-fold. Spread the word about the state program to everyone you know. And let members of congress know you want Medicare expanded to cover prescription drugs.

Richard Griffin