Based on algorithmic predictors of longevity such as actuarial calculations made by insurance companies, my life is slated to end at 90 years old (12 years from now) or as late as 103, unless I die sooner after some unwelcomed and rapidly progressive cancer, or maybe even tragically during flight on one of my journeys out of state or country. Thus, only if I make it to 103 will I be able to celebrate the coming of the year 2050. God knows what the world will be like. And God knows whether, even if alive, I will be able to appreciate my surroundings. Accordingly, the present period of my life, while still relatively lucid, will inescapably serve as my last chapter. However many days are left for my living body to be destined for this world, I faithfully resign myself to the reality that I have heretofore experienced the most active parts of my life, as well as the lion’s share of it. This naturally motivates me to yearn for more good days, months, years, and to reflect more seriously about the past, present and hope for a comfortably uneventful future. It’s not as if this moment of self-realization has suddenly emerged, but I think humans generally avoid reflecting about life and death until faced with a terminal condition or otherwise find ourselves at death’s door. While I’m not looking forward to that moment, for some tangential reason I am short on explaining, I have become progressively consumed by this harrowing eventuality, i.e., the inevitable downward spiral of my physical and mental wellbeing leading to that immutable moment when I cease to exist.
This is a personal journey. Not many will find my thoughts interesting or edifying or earth shattering. Indeed, I am not certain why I find myself putting pen to paper or delving into these downtrodden thoughts as I conjure my own mortality. Am I fearful of the inevitable? Indeed, I am no longer as comfortable as I was in the past, when I visit the doctor and perform blood tests and stress tests……that my results would continue to provide evidence of a healthy body and mind.
At 78, I convince myself that I am active and healthy. I walk, I dance, I swim, I ski, I have reduced my caloric intake and have controlled my weight, I consume fresh fruit and eat a reasonably good diet, my laboratory results are controlled by a bunch of drugs that I faithfully swallow or inject. Only one cancer diagnosis – a scalp melanoma picked up in the early stages “in situ” that was rapidly cleared by excision, a prostate gland that continues to challenge my mental and physical wellbeing but so far has not deteriorated into cancer, and a hereditary elevation of a lipoprotein “a” that increases the risk of cardiac events, that heretofore has not manifested itself with any clinical signs of disease. A little paint on my beard attempts to trick me into believing that I am younger than I am, but I have only one well-functioning eye, ear, knee, ankle and I am truly thankful that God gave us two of each, considering the present constellation of my physical defects.
I started this essay in my suite in the Hanoi Pearl Hotel early in the morning on January 2nd, 2025. I decided to cogitate on my past life, as best as I can recall, in century quartiles: i.e., the years 1950, 1975, 2000, 2025 and maybe 2050.
In 1950, I was 3 years old living in West Hempstead, Long Island, New York. I think my father paid $11,000 in cash for our cute brick and stone two-story house. I lived with my two sisters, mother and father. My third and oldest sister Widad married in 1949……. and I remember being robbed of her presence with few childhood memories except that of her marriage the year before. She is still alive living in New Jersey at 96. My next oldest sister Leila unfortunately died at 86 in 2017; she acted for many years as my surrogate mother after my mother’s passing. My youngest sister Sue is 5 years older than me at 83, healthy and living well in a two-bedroom condo in Valley Stream, New York. Throughout her life, Sue got the short end of the stick on many levels but presently is doing well living in good health and leading a healthy lifestyle. As the only living son after trying 11 times to produce one, I was spoiled rotten, catered to and protected like no ordinary human could imagine. I was spoon fed by my mother (I’m embarrassed to admit for how many years) and I remember my mother imitating my chewing motions while forcing the next spoon full into my mouth, consoled only after the consumption of the full contents of whatever I was being force fed at the time. She cleaned my hands and mouth with resolve, while forcefully scraping a few layers of epidermis from my face during each cleaning. My mind was a tabula rasa, my English language skills were limited due to Arabic being spoken as my first language and the only defining moment of that fully protected environment was a dog bite I received by a little puppy that clamped on to my ankle and left me frightened of dogs for the next five decades.
It’s funny, I have nothing meaningful to say about high school and college. I was voted Mr All Around in high school – which documented that I was not great at anything during those years. In college, I worked hard to get into medical school and tacitly avoided the hippy and free love movement of the 60’s to do so. I had already learned that nothing in this life is free. Perhaps the most exciting aspect of those years was the many European trips I took hither and yon. Frommer’s Europe on $5 a Day was my bible. I was almost a frequent flyer on the low budget - Icelandic Airlines. And in addition to exploring Europe on multiple occasions, I met a lot of girls and had many exciting and even some R rated adventures that I have only relayed to a few confidants in my lifetime.
In 1975, I was 28 years old. I had just completed my two-year pediatric residency at the University of California, San Diego (UCSD) and started my two-year fellowship in Neonatology at the same location. By then, I had made most of the major decisions in my life. I was married to a wonderful woman who carried with her a level of serenity, order and humanity to our lives. My two children were alive and stumbling and bumbling through their own journeys. My career path chosen; I was training with one of the foremost academic scholars in the burgeoning field of Neonatology. The field was a perfect fit for my interests, talents and aspirations. Outside of work, I learned how to play tennis, how to be a father – not sure how well I succeeded -, how to manage my first home purchase, and how to lead a team of nurses and residents and fellows and neonatology colleagues in the care of the most vulnerable of humans -directly or indirectly- for the entire state’s population of infants. I worked harder than I had ever worked, and I enjoyed “most” every moment. I was too busy to worry about the world, politics, the environment, who was protesting or what they were protesting about. I found San Diego a wonderful place to live, the few moments of time I spent with friends, at the Shakespeare theatre at Balboa Park, playing tennis, eating at a seafood restaurant, sailing, and entertaining family visitors at my home. Most of the time it was work and sleep and babysitting and driving the kids to swim or soccer practice or reading to my children. And my readings were done with ease, as my children rapidly memorized every children’s book read to them so all I had to do was turn the pages. I remember my wife Scherer hired our first house cleaner; a Mexican woman named Senora Partita. Before every house cleaning, Scherer would cook food to serve her for lunch, as well as perform a cursory clean-up of the house, not wanting our house cleaner to think the worst of her employer. In 1975, I was in the early stages of my career contemplating all the possible scenarios for my professional future; there was so much that was unknown, alluring but also worrisome at the same time.
In 2000, I was 53. I had accomplished most of my clinical goals and aspirations. I was well respected, self-assured and confident of my clinical skills and overall accomplishments. I had orchestrated affiliations with all hospitals in the state, had a leadership role in three of them (Kapiolani, Queens, and Castle), and recruited a diverse clinical menagerie of 12 neonatologists to provide the needed services to the regional hospital community. My work in surfactant research was moving along including laboratory animal studies at the Tripler Department of Clinical Investigation. Our affiliation with Tripler extended to an affiliation with the Neonatology fellowship program that I orchestrated with its director, Frank Smith. I had also begun to transition my career to research administration as I assumed the role of Director of the Clinical Research Center at Kapiolani, funded by an NIH grant provided for minority institutions such as ours as well as the pseudo–Associate Dean for Clinical Research at JABSOM (Dr. Cadman, our Dean at the time, did not bother to get the UH Board of Regents to approve his leadership choices – thus, officially I was the Director of Clinical Research at JABSOM).
But many other onerous things had happened in the prior quarter century. Maybe too many and too quickly. After my fellowship in 1977, I moved to Honolulu and within a few months assumed the position of Director of Neonatology. My life was drowning in work and family. I was able to occasionally play tennis during the infrequent down times. My children went from public school to Punahou to college (Duke, Princeton) to graduate school (U Penn, etc). My wife of 25 years developed breast cancer. I followed her for most of her cancer treatments locally and at Duke University in Durham. She died four years post diagnosis in 1995. It remains the most horrific event of my life, even after 30 years of her passing. I have tried very hard over the years not to relive this tragedy; I never once thought that I would outlive her, but I have long since given up asking why.
Nonetheless, I could not ignore my overwhelming clinical responsibilities. To be sure, in that preceding 25-year interval, a thousand infants were admitted to the neonatal units at Kapiolani Medical Center per year. That included infants transferred from the neighbor islands, an occasional one from Tripler and Kaiser as well as some from the Pacific Basin. It was necessary to focus my full attention on providing care and orchestrating a call system with a burgeoning cascade of trainees at all levels and full-time neonatologists.
In the final 5-years of this quartile (1995-2000), my career transitioned from leadership in the Division, and providing clinical care, and clinical research, to several research administrative and leadership roles that would define the subsequent phase of my career. The 20-year period that followed was marked by participation in the acquisition of ½ billion dollars in federal funding for research. I no longer provided extended care in the ICU but accepted assignments to selected nights on call. And after a few years of part time call, I ended my clinical service call rotations. I had only one patient left to care for of any concern – myself. I was ready to transition from intensive care to more scholarly endeavors and leadership – partially as a distraction after Scherer’s death. Nevertheless, the stresses of the past 30 years as an intensivist left many scars and long-term consequences. Sleep was never guaranteed as the director of an intensive care unit. I would be called when I was on call, as well as anytime day or night regardless of my call schedule. Enough is enough!!! I don’t think I have had a perfect night’s sleep ever since. And my cardiologist believes that my grossly out-of-range calcium deposit scores in my coronary vessels are the result of the physical and mental stresses of my neonatology career (although I believe it is mostly due to my genetically determined elevation in Lipoprotein “a” levels).
And now its 2025. I retired 7 months ago; I now find myself in May, 2025. I have been struggling over these last few months to focus on what to write. I’m filled with a whirlwind of competing items and concerns, but I don’t want to be trite or clichéd. I’m close to 78 1/2. I am enjoying my life and do not feel a need to justify who I am, what I think, what I do, and how I spend my time and money. I do seek advice but not validation. Perhaps Popeye the Sailer Man can best describe my sense of self, at least metaphorically.
“I am what I am and that’s all that I am, I’m popeye the sailor man.”
Using AI, "I am what I am, and that's all that I am" is a statement of self-acceptance and a declaration of who someone is, without the need for external validation or change. It can be seen as a prophetic statement, particularly when considered within the context of Popeye the Sailor's famous catchphrase, "I yam what I yam!". This declaration can be interpreted as a refusal to be defined by external forces and a firm embrace of one's true nature.
I am what I am, and that’s all that I am, I’m David Easa the retired septuagenarian.
Not sure why I was so enthralled by Popeye. I remember wondering why a measly can of leafy spinach would give Popeye the strength to fight off Bluto and other foe. Why not an energy pepping sugar containing juice? Why not a slab of meat with protein? Why not an undisclosed mysterious concoction? But the last laugh is on me! Indeed, it has taking me a lifetime to realize how important spinach is in human nutrition, truly one of the best vegetables that any of us can eat, filled with fiber, nutrients, and antioxidants and protective of those nasty glucose spikes that play a role in just about everything that can go wrong in a person’s health. Yea Popeye, yea spinach!!!
Getting back to the topic at hand, there are too many topics that are swirling around in my head to include in this already not so short pseudo biography. To the point, with so little time to live – relatively speaking – how can I best spend the remaining time to provide the best return on investment? Rather than talk about my exercise routines, my quirky diet concoctions and intermittent fasting, my numerous medical appointments, my travel plans and destinations (and love of Asia), my overall health and mental and physical challenges, I would rather focus on personal questions that may possibly resonate with others who reside in the general vicinity of my age.
It is axiomatic that if one intends to live a full and happy existence consisting of a variety of diverse activities, and or to complete a bucket list of things to do, a realistic allotment of time spent on any one activity needs to be carefully calculated to accomplish one’s overall goals. It’s not always a simple matter. Do we all have the will to exercise (for cardio, for muscle strength, for flexibility, for pleasure and artform) as much as needed to remain as healthy as possible? Some of us enjoy watching sports; how do we control the time in front of that big screen when we also have news stations, Netflix and other streaming services alluring you into a state of progressive dementia. This concern is of particular relevance to me, although acknowledging the problem puts me one step closer to the solution.
One problem that I have defeated is my alcohol consumption. Two drinks a night (sometimes more) for 50 years is TOO much booze especially now with the current dogma that no amount of alcohol is safe. Mix it with two cups of coffee (that I have also cut in half) and some green tea, and you can just imagine what a continuous infusion of a mixture of coffee, tea and alcohol (and in my younger days add a few cans of sugary drinks – coke, orange crush, etc) might do to your metabolic and cellular homeostasis over a half century. I now live with an occasional non-alcoholic beer.
Aging is no fun. Humans require resolve to transition from certain activities that pose unnecessary risks to an aging body. For me, this translates to asking myself when I should stop skiing, and when I should stop serious ballroom dancing? How easy is it to admit that you should curb certain activities to protect your future moments of life rather than to have it forced upon you after injury?
Well, at 2050 I am either dead or better off dead even if a heartbeat can be detected at 103. Is there life after death? A question that only those once dead can truly answer.
My default best guess is that the consciousness that one shares with another individual constitutes a surrogate life after death. When my wife Scherer died in 1995, I felt a part of me died. I realize this is a clichéd notion, but I experienced it literally. After 25 years of marriage starting at the young age of 24, I was less a product of the first 24 years of life than the subsequent. I was a puzzle that took 25 of marriage to solve, only to suddenly lose half of its pieces at her death. But despite this fracture, what remains of me to this day (the remaining 50%) is her constant presence in my life. And I believe she protects me (and my children) from myself and from the evils in the world. Scherer lives in me as long as I am living. Will I inspire this shared pervasive consciousness with my children and/or with my partner Gerri when I die? Will I live in the thoughts and memories of those I presently love and care for? Will this effect continue in future generations ad infinitum?
My wife of 25 years was also a very religious episcopalian. Religion was also strong in my family; my mother, my sisters, as with my partner Gerri. These very strong religious beliefs were based on bible studies and a Christian brotherhood, not from blind zealotry. And yet, my own religious beliefs continue to be tentative, wishful but somewhat wistful. I would prefer to believe that a God exists and is watching over me rather than the alternative randomness of the universe. And I suppose life after death also falls into the category of God, heaven and hell. I have no answers, only questions. What I will admit is that if there is a God watching after me and my family, he/she has done a great job of making my life healthy and prosperous overall with perhaps one or two exceptions.
Epilogue: I’ve recently started the gargantuan job of reorganizing my closets and draws with the objective of downsizing my possessions overtime. My recent focus is a box of my old publication reprints from my 48-year academic career. It was a large box! I had forgotten that I had conducted so many animal studies and been a part of many industry-sponsored and investigator-originated studies. I must have worked really hard during those years; I’m awed at the volume of work and data produced and manuscripts published! It was fun glancing at these articles while unearthing a random barrage of associated memories. One outcome from this writing is that it has done precisely the same – it has unearthed an onslaught of memories of past and present experiences. It has been a great journey and the good news is that it is not over. Perhaps there will be more to say the next time this quirky biography comes to mind - to update it – I can only hope that I will have the opportunity and the time left on earth to do so in the future.
