The two following paragraphs come from one of the many journals I have kept in the course of what is becoming a long lifetime. Written in July,1971, this passage describes my experience driving across the country for the first time and by myself. In addition to the external adventures of this journey, interior events crucial to my future were occurring as well. The fateful questions raised then were to find a decisive answer five years later when I left the ministry.

“Week-long search for America and myself. The idyllic moments: driving
in the evening through a plain bordered by mountains, all of the landscape
lit by a brilliant sun out of clear sky. The rhythm of the trip: sometimes
sheer speed, with the feeling of piloting a light plane; other times,
laborious plowing through roads under repair.

“The issue is clearer for me now, though not the solution. Is celibacy a culturally determined thing foisted upon me for which I have no calling? Or is it simply the background to a call which must be accepted bravely and lived austerely in faith? This is the central and agonizing question which this trip with its distance has made clearer.”

As an enthusiastic journal keeper, I hardly stand alone. Journal writing is wildly popular in America. Each year some ten million blank journals are sold in stationery stores; another four million keep journals on computers, it is estimated.

These facts and much other information I have learned from a fine new book written by Alexandra Johnson, whose knowledge of journal keeping is surely unsurpassed. Entitled “Leaving A Trace,” this inspirational yet practical volume shows how journal or diary writing can enrich the life of just about everybody. I found fascinating her excerpts from the journals of people both famous and ordinary and her commentary on them.

In her introduction, Johnson, a veteran teacher of writing and an author resident in Medford, shares her own fascination with the diary of Elizabeth Howe, a woman who, in the late nineteenth century, lived in the house where she herself now lives.

As Johnson tells it, “The pages chronicle a twenty-one-year-old music teacher secretly thrilled by solitude, love letters, fresh peaches wrapped in tissue, ice storms filigreeing the windows at night with crystal spiderwebs.”

More important, Johnson discovered in Howe's entries a woman trying “to find a narrative shape for her life, a way to tell her story, if only to herself.” That theme recurs often in “Leaving a Trace” – – the way keeping a journal or diary leads to the understanding of one's life.

Journal writers, even those who content themselves with modest efforts, almost invariably learn more about themselves than they thought possible.

The author Gail Godwin puts if this way: 'During the act of writing, I have told myself something that I didn't know I knew.” The British writer Katherine Mansfield knowingly understated the case, “It's very strange, but the mere act of writing anything is a help.”

As Alexandra Johnson's title suggests, she finds in most journal writers the desire to leave behind some relic of their having lived. Though by no means always conscious, this desire for a certain kind of immortality drives them to bequeath traces of themselves.

Journals and diaries begun or continued in later life have special value. I strongly recommend this kind of writing to people of any age; to those who have reached mature years, I judge it possibly worth even more . As a woman named Julia Houy says, “I am eighty-one. It helps me to age well.”

But many people feel intimidated about beginning. A frequent question that Alexandra Johnson hears is: “Who could possibly care about my life?” The first answer, of course, is “You.” The second is possibly “family members, friends, and a whole lot of other people.”

Though it often seems forbidding to begin, it pays off quickly. Since, as Alexandra Johnson says, “at their core, journals are about sharpening consciousness,” they help us get more value from our lives.

Part of my motivation in keeping journals is to gift family members and friends with a better knowledge of who I am. After my great leave taking at the end of life, I want my daughter( and, possibly, her descendants) to discover some day, if she wants to, the experiences that shaped my personality.

That day of her taking a deeper interest in my life will come, I feel sure. For many years I have regretted not having such a document from my own father. Though not everyone has interest in developing a journal further, Johnson emphasizes how it is a fine take-off point for a memoir.

For professional writers keeping some form of journal or diary is probably a must. Alexandra Johnson's experience is instructive: “In dry seasons, all I have to do is open an old journal.”

If you want to make your later life more rewarding, here's a sure-fire way to make it happen – – keep a journal.

Richard Griffin

“Fifty-six nursing homes have closed in the last two years, one every other week. The situation is finally getting people’s attention.”

These are the words of Scott Plumb, Senior Vice President of the Massachusetts Extended Care Federation, who attributes the problem to unrealistically low Medicaid rates paid by the state.

Plumb recently authored a report entitled “Where will your mother go?” detailing what is happening to Massachusetts’ nursing home industry. His agency sees another fifty homes closing before New Year’s Day of 2003.

“That may be true but can’t we go back and ask people what they want?”  This is what Al Norman, Director of Massachusetts Home Care, says of the nursing home crisis.

Norman quarrels with the assumptions behind the title “Where will my mother go?” In his view, mother should not have to go anywhere, if she wants to stay at home, as most older people do, and funds are available to make that possible. He also remains skeptical about the poor-mouth claims of the nursing homes industry.

The clash between the views of these two professionals signals issues of prime importance for elder residents of Massachusetts. What will this state’s leaders do about nursing homes? Will these decision makers shift long-term care emphasis toward home care services and fund enough such services to keep elders out of institutions?

The fate of proposed legislation called “Equal Choice” will give a strong indication about which direction the Commonwealth will take. This Equal Choice bill has been introduced by Senator Brian Joyce and Representative Mike Festa, both of whom see it as responding to what elders themselves want.

In a press release, Festa and Joyce regret that “the level of compassionate choices provided to our seniors is sorely lacking.” They cite the startling disparity in the amounts the state pays for home care compared to institutional care. “Medicaid pays $130 a day for nursing home care, while home and community programs are based on a payment of $7.38 a day.”

In a telephone interview, Senator Joyce told me how his concern started with his mother who has Parkinson’s disease and now lives in a nursing home. “If not for these angels of mercy, the home care workers, my mother would have ended up in a nursing home sooner than she did.”

Not surprisingly, given this experience with his mother, the senator says he does not want to pit nursing homes against home care, but only to give people a choice. In this spirit he makes the following pledge to older people: “We will spend as much to keep you at home as we are willing to spend to keep you in a nursing home.”

Al Norman takes Oregon as a model of enlightened priority shifting. That state now spends more on home care for elders than it does for nursing homes. He also thinks that Massachusetts must respond to the decision of the United States Supreme Court in the 1999 Olmstead case.

That decision interpreted the Americans with Disabilities Act as requiring states to give people who are eligible for nursing homes the option of remaining in the community. That, of course, requires public home care funds for those with incomes too low to afford to pay privately.

But Scott Plumb insists that the financial plight of nursing homes is close to desperate. The situation has been building for years: in 1999 alone, these facilities in Massachusetts lost 72.2 million dollars and the Commonwealth ranked third state from the bottom in average nursing home profit margins. Currently, one in four nursing homes is in bankruptcy, though most of them remain open.

Of every ten residents, eight are supported by public funds. Very few of these funds are provided by Medicare; almost all come from Medicaid, a program shared by the federal and state governments. Because Medicaid payments made by the state remain so inadequate, the availability of qualified staff members and the likelihood of their staying on the job have been severely compromised.

My own view includes sympathy for both positions. At this time, the state simply cannot allow nursing homes to keep closing until there are none left. After all, there will always be some people for whom home care is not a realistic option. To be responsible, our society must support some institutional care for these people, care that respects their dignity and individual needs.

To determine what the financial needs of the industry actually are, perhaps the state should appoint a commission to look at nursing homes as objectively as possible.

I also support the shifting of priorities toward home care. The current disparity of funding makes very little sense. Home care should come first and become the norm; institutional care is certainly needed but remains secondary. And our society should demand that both kinds of long-term care be a whole lot better than they are now.

Richard Griffin

Recent revelations by Bob Kerrey about his actions as an army officer during the Vietnam War have caught my attention, to put it mildly. That an attack force, under the command of the future United States Senator from Nebraska, caused the death of as many as twenty unarmed villagers, most of them women and children, shocks me as it has the public at large.

This killing has extra power to shock for at least three reasons. First, the military action itself gained for Kerrey a significant honor, the Bronze Star. Secondly, Kerrey went on to hold high political office, governor of his state as well as senator. Thirdly, he kept this action secret for more than thirty years.

Despite the shock of the secret now revealed, this horrible event seems to me of a piece with much else that happened in that war. It confirms what I felt during that time- – the whole enterprise was a moral, as well as a military, quagmire. From the beginning, American involvement was shaped by basic misconceptions, deliberate misleading of the public, and military actions that violated the rules of war and basic human morality.

A fascinating new book written by a friend, Richard Sobel, provides a case study of American involvement in Vietnam and weighs the influence of what American citizens think on the actions of our government in foreign affairs.

Its title, “The Impact of Public Opinion on U.S. Foreign Policy Since Vietnam,” indicates that the author deals with much more than a single American intervention, but I focused on the section dealing with the Vietnam War because of the part that opposition to the war has played in my life.

In reading about the effect of public opinion on the Vietnam War, I initially feared that research might suggest that the demonstrations in which I took part in the late 1960s and the early 1970s counted for very little.

But Sobel, who teaches at Harvard’s Kennedy School of Government, establishes clearly that public opinion did exercise a significant influence. “In large part,” he writes, “ public opposition essentially forced the United States to end a decade of war and withdraw from Vietnam.” He also says that both President Nixon and Secretary Kissinger privately acknowledged its impact on their actions.

I wondered also if research might support a charge frequently made by opponents of protest against the war. They often said that the demonstrations were helping the enemy, boosting North Vietnamese hopes of the United States backing out.

In discussion with me, Sobel characterizes this question as “complicated.” He reports scholars who took part in a conference with former North Vietnamese officials feeling that they would have kept fighting for their independence no matter what the United State government or the antiwar movement did.

The author’s conclusions are strengthened by the thoroughness of his approach. In addition to studying formerly secret documents and reading the memoirs of leading political players, he interviewed Dean Rusk, Clark Clifford, Robert McNamara, and Melvin Laird. He uncovers several facts about the motivation of these leaders that still come as a surprise.

In particular Richard Sobel reveals two facts I did not know previously:  1) President Nixon’s people have admitted that his early peace moves were ploys to placate the public; 2) Nixon was going to give a speech saying “there was no way to win the war”  but dropped it after Lyndon Johnson’s announcement that he would not run again.

Those of us opposing the war often guessed the motivation of the politicians but have had to wait many years before having our surmises confirmed. Even now, it comes as a surprise to hear people formerly in leadership positions admitting their deceptions.

The last time I wrote about the Vietnam War, on the occasion of the twenty-fifth anniversary of its end, some readers wrote me angry letters condemning my anti-war activities. I had not planned to discuss this part of my life this soon again, but the revelations by Bob Kerrey and the chapters on the Vietnam War in the book written by my friend Richard Sobel have stirred the waters of memory once more.

It comes as a consolation for me to realize that the instinct of my fellow citizens in ultimately recognizing the Vietnam War as a terrible mistake, militarily and morally, was basically sound. Of course, that does not negate the heroic bravery of many people who fought in Vietnam. They saw service there as a duty and, often at great cost to themselves, followed through for their country. For that, they have my respect and admiration.

But, still, it was a tragically mistaken enterprise, as a great many Americans came to see. And, without the support of public opinion, the war had to be ended. As Sobel says, “The public’s ultimate refusal to support an extension to the U.S. military action in Vietnam was a powerful reminder to policymakers and the military that public support was in the end decisive in determining the duration of military interventionist foreign policy.”

Richard Griffin

“When I was little, a day seemed to last forever, especially a school day. Now a day is nothing, just a blink of an eye. You know intellectually that a month is still a month, a week is a week, a day is a day, but it goes so much faster the older we get.

“Sometimes I play a little game with myself. I know it’s odd, but I do it just the same. I try to make time pass like it did when I was a child. First, I shut off the television and listen to the ticking of the clock. That slows everything down. Then I tell my worries to back off so I can concentrate. It works like a charm. The morning lasts a long, long time.”

These are the words of Anna Ornish at age 81, a woman interviewed by my Seattle-based colleague Wendy Lustbader and retold in her newest book, “What’s Worth Knowing.”

By way of commentary on their conversation, Wendy says: “Anna Ornish had never been exposed to Eastern meditation techniques, but when I told her that some of what she was doing had been taught in traditions a few thousand years old, she said, ‘Good. That means I’m not so peculiar.’ ”

Convincing as Anna’s experience of time is, not every older person feels it this way. For some, time drags slowly indeed. Those, especially, who live in situations not to their liking –  – in nursing homes, perhaps, or in their own home cut off from everyone else –  – find that the hours have become glaciers, slow and cold.

But in writing about older people, in speaking about them, you have to generalize. Everyone is unique, personal experience is never repeated exactly, so we must settle for approximations. It so happens that what Anna lives through comes close to what I experience.

For me, time is moving awfully fast. My daughter’s schooling is nearing completion when it seems just to have begun. Those double deadlines for newspapers each week force the days to speed up. Even the dour days of last March did not much slow down my weeks.

What makes Anna interesting is her readiness to experiment. She plays with time, manipulates it so as to adjust its speed to her own liking and for her own purposes. Drawing on the wisdom of long living, she has learned how to arrest time and make it slow down in its passage.

The amazing thing is that she wants it to go more slowly. Few of us are capable of such a bold more; it would terrify us. But she has a purpose for time, says she wants to concentrate. What she means by that remains unclear but it sounds as if she wants to enter into some higher sphere of consciousness. You could call it prayer or contemplation or peace of soul.

Whatever you call it, Anna finds a value in it that counteracts the escape of time, time passing without meaning. It’s a lot better than television. And it certainly beats self-pity and regret. Anna’s reconstituted time is pregnant with new life. It makes her old age, if not sweet, at least resonant with welcome sounds.

Anna thinks of herself as peculiar, though when she discovers herself to have something in common with millennia of spiritual traditions, she feels less so. Being back in the time warp of childhood is not so peculiar if you know what to do with your time. In childhood, many of us suffered the long summers because, once we got beyond the neighborhood games, there was not much else to do.

Anna, standing still in her new time, presumably acts interiorly, doing the work of advanced maturity. She is coming to grips with the givenness of her life, the parts of it that she has never controlled but received from others. She is learning how to appreciate each day for the reality that is packed into it. She makes it her business to unpack its meaning, to investigate all that it brings.

Anna’s way cannot be everyone’s. Listening to the tick of the clock, for instance, would drive me berserk. But for her, it serves as perhaps a hypnotic device to send her into a new sphere of time. It carries her beyond the intellectual framework that tells her about a day being still a day. She has entered a spiritual place where the daily realities have been transformed.

I would like to be as adventurous as Anna. Her spirit draws my admiration. Without knowing much of anything about the traditional techniques of spirituality, she has discovered a precious secret of how to age well. I hope that her experiments with truth, as Gandhi would have called them, continue to bring her time’s surprising gifts.

Richard Griffin

As an elder citizen of Massachusetts, I am feeling sandbagged. As a columnist, I am feeling seduced.

Just three weeks ago, I wrote about the commonwealth’s new Prescription Advantage program, welcoming the benefits it would bring to this state’s older residents. I passed on to readers information sent out by the Executive Office of Elder Affairs in praise of its affordability, among other features. It was billed as an instrument that would bring to every elder “peace of mind.”

I also took at face value Secretary Lillian Glickman’s boast about the influence that Prescription Advantage would have across the country and her prediction that “the eyes of the nation will be upon us.”

But now, thanks to some sharp reporting by David Ortiz who writes for the Boston and Cambridge TABs and the Cambridge Chronicle, we discover that the state government has misled us. The shiny promise of the new drug program has been compromised and may turn out to be just another spoiled package.

We have now learned  that the state House of Representatives wants to cut 22 percent of the program’s budget. That cut will eliminate premium protection for elders with low incomes, raise co-payments, and double deductible limits each year.

Suddenly, the House proposes making worse some features of the program that were already dubious. No wonder that some critics have already renamed the program Prescription Disadvantage.

When I talked three weeks ago to John O'Neill, Executive Director of Somerville Cambridge Elder Services and current president of Massachusetts Home Care, I discovered that he already felt mixed about the new Prescription Advantage program, even before these funding cuts came over the horizon.

“It’s good that it’s a public plan,” he said then, and he thought it would prove helpful for low-income people. But, even then, it had too many deductibles and co-payments for his taste.

He recognized that determining the amount to be paid in premiums was a problem for the program’s planners. “The premiums are a shot in the dark,” he added, “because no one knows how much the whole program will cost.”  

“They are afraid of adverse selection,” he said of the planners, because so many people who are big users of prescription drugs may sign up. And the plan depends on state funding from year to year.

These were the incisive but balanced views of an informed critic commenting on a plan adopted last July and about to be the subject of an intensive media campaign this month.

Now, given the announced cuts, many elders must wonder about what the new program really offers them, since it comes loaded down with so many co-payments and deductibles, just like run-of-the-mill health care programs.

Fortunately, some elder citizens have already taken action in the face of the proposed cuts. Busloads of them went to the State House last week to lobby members of the legislature and persuade them to restore the original features of the plan. These advocates, many of them experienced and vocal campaigners on elder issues, hope to turn their representatives around.

I talked to my own representative, Jarrett Barrios, who said of the proposed cuts, “This is obviously something I am concerned about.” I await further word from him when he checks with Ways and Means about the prospects of restoring the funding.

Back to John O’Neill, I asked how he now feels about the new plight of Pharmacy Advantage.  The 22 percent cut, to his mind, jeopardizes the whole program “before the thing even gets off the ground.” In large part, that happens because the cuts “make it easier for many older people to say no.”

As to the effect of the cuts on overall costs of the program, the state has put itself in a strange position. “Instead of helping,” O’Neill observes, “it may perversely make it worse.” That’s because fewer, perhaps many fewer, will now register for a program that may cost them so much more.

A leader among citizen advocates, Phil Mamber of Lynn, agrees. Current president of the Massachusetts Senior Action Council, Mamber last week led some 200 elders at the State House protesting the cuts and pushing for amendments that would restore the program.

Asked about the 22 percent cut, Mamber says: “I think it was absolutely horrible. It took us by surprise. Now people don’t know what to register for.  It’s a terrible way to do business. Everyone is confused.”

Eileen Ginnetty, director of the Council on Aging in Cambridge, agrees. “It is discouraging,” she says of the situation. “If you are going to pay $4,000 a year, that’s what you pay for Medex Gold.” That removes any incentive for moderate-income elders to sign up for the new program, she believes.

As this column goes to press, no action has been taken to restore the money needed for  Prescription Advantage.

It will be fascinating to see how the state government gets out of this mess. More important, the health care needs of many elders hang on the outcome.

Richard Griffin