Contrary to T.S. Eliot, April is definitely not—at least for me—the cruelest month. To the contrary, April has always meant springtime, sunshine, light rains (“ … April showers bring May flowers …”) and the promise of summer warmth and vacations.

My mother was in labor struggling to deliver me for more than two days. Finally, on Wednesday, April 26, 1939, I entered the world weighing almost 9.5 pounds, explaining the difficulty. In those days once a woman started labor she stayed in the hospital for the duration and my birth was not one of my mother’s best memories. Even then it was understood that big babies are often associated with maternal diabetes mellitus but my mother, who lived to be almost 94, was never diabetic. My grandmother, her mother, was diabetic but it was most likely related to her moderate obesity rather than a genetic propensity. The genetics of diabetes was not well understood 70+ years ago and my mother mostly that I would be diabetic since a common bit of misinformation was that “diabetes skips a generation.” I also did not become diabetic.

I am always happy when I think about my family and I often glance at their photographs on the top of a nearby bookcase. My mother worked during much of my childhood, especially the war years, and my grandmother influenced me considerably. She came to America from czarist Russia by herself when she was only 15 years old. She had a heavy Russian-Polish accent and never learned to read English with ease but she was a canny businesswoman who ran a small ‘candy store’ (also selling toys, magazine, ice cream, coffee, soda and, especially, cigarettes and newspapers) on Church Avenue in Brooklyn. She also ran my gentle, highly educated, grandfather. My parents and I lived in the same Brooklyn apartment with my mother’s parents until my grandmother died. She was a strong and dominant force who treated me as a prince, somehow without (as far as I can tell) spoiling me. It is she whose wisdom I often quote. When I was an adult with children of my own, long after my grandmother died, my mother recounted how unsympathetic my grandmother could be when she, my mother, was a teenager. She was unkind to her as mothers can sometimes be with their daughters. My own daughter, who loved my mother almost as much as my mother loved her, is angry at my grandmother for that reason. My grandmother also fed me too much (“children in Europe are starving …”) including those delicious Ebinger chocolate cakes; ‘devil’s food’ cake is still one of my favorites flavors and I understand the name as completely appropriate.

1939 was one of the most momentous years in the history of our world. Among the hundreds of historiocally important events were, in chronologic order, the appointment of the first woman dean of an American graduate school (Frieda Wunderlich, a German emigré who was Dean of the Graduate Faculty of Political and Social Science at the New School in New York City), the first NFL pro bowl (New York Giants beat All Stars in Wrigley Field), the debut of Superman, Joe Louis wins the heavyweight boxing title, Enrico Fermi splits the atom (fission) in the basement of Pupin Hall at Columbia University, Hitler’s speech to the Reichstag specifically threatens Jews, France and Great Britain recognize the Franco regime in Spain, Gandhi begins a fast to protest British autocratic rule, Nazi Germany occupies Czechoslovakia, Madrid falls to Franco and the Spanish Civil War ends, Italy invades Albania, Marian Anderson sings before 75,000 at the Lincoln Memorial (after the intervention of Eleanor Roosevelt when the Daughters of the American Revolution refuse to allow Anderson to sing in their auditorium), John Steinbeck’s great novel “The Grapes of Wrath” about the depression years is published, Josef Stalin signs an anti-nazi pact with France and Great Britain, New York World’s Fair opens and President Franklin Delano Roosevelt is on the first public demonstration of television, the debut of Batman, Lou Gehrig ends his streak of 2,130 consecutive games (and subsequently announces that he has amyotrophic lateral sclerosis – “Lou Gehrig disease”), Germany and Italy announce an alliance, George VI becomes King of England, the Baseball Hall of Fame opens in Cooperstown, Frank Sinatra makes his recording debut, The Wizard of Oz premieres (1939 becomes the greatest year in the history of Hollywood with The Wizard of Oz, Gone With the Wind, Stagecoach, Goodbye Mr. Chips, Of Mice and Men, Mr. Smith goes to Washington, Love Affair, Ninotchka and Wuthering Heights), the Soviet Union and German sign a non-aggression pact, the first flight of a jet plane, Chaim Weizmann informs England that Palestine Jews will fight in WWII, Hitler orders the extermination of the mentally ill, the first scientific paper on “black holes,” World War II officially starts as Germany invades Poland (September 1), the inhabitants of a ghetto in occupied Poland are exterminated, England and Canada declare war on Germany, President Roosevelt declares United States neutrality, the first flight of the Sikorsky helicopter in Connecticut, Sigmund Freud dies of squamous cell carcinoma of the mouth in London (September 23), Albert Einstein advises President Roosevelt of the possibility of an atomic bomb, the NAACP Legal and Education Fund begins, New York’s LaGuardia Airport opens, Nazis require Jews to wear the Star of David, nylon stockings go on sale for first time in Wilmington Delaware, first animal (rabbit) conceived by artificial insemination, first jet plane (Heinkel HE 178) demonstrated to German Air Ministry, first air-conditioned automobile (Packard) exhibited in Chicago, Kate Smith sings Irving Berlin’s God Bless America for the first time, President Roosevelt lays cornerstone of the Jefferson Memorial, Nazis begin mass murder of Polish Jews.

Whew!

What a year!!

And I had the presumption to begin then.

Although I certainly had no role in selecting my date of birth I did, for many years during my childhood, harbor the fear that I had, in some unknown way, been responsible for the start of World War II and also that Sigmund Freud died because there wasn’t enough room on Earth for both of us. I don’t recall when I had these fantasies or when they left me but for a long time in my childhood I still tended to impart some mystical significance to my being born in 1939.

Now, 78 years later, I have different thoughts.

Each day now begins with anxiety about some new craziness from the White House or the Senate or the House of representatives, or all of them at the same time. The first time I cast a vote for President was for John F. Kennedy. His assassination was the start of the increasing distrust of government fostered then and now, as I read history, by individuals whose vision is so focused on the past that they seemingly have no idea that they are distorting reality and are slowing the inexorable progress of history. In the time immediately after JFK’s death the idea that Lyndon Baines Johnson was an accomplice percolated for years, despite the fact that there was never a hint of evidence to support that and also despite the very public way in which Johnson acted allowing insights into his personality and, particularly, his patriotism. Often, especially in recent years, the word ‘patriotism’ is used to obscure self-interest, greed and ignorance. The historic image of LBJ, a real patriot in every sense of the word whose historic image, is appropriately marred by horrors of the Vietnam years. He was, however, one of the finest and ablest person to occupy the oval office. He was more than a little self-centered but not out of touch with the ways in which his behavior might be interpreted. Instead, he used his huge personality to accomplish major legislative goals rather than reversing human progress.

It is not my intent to make this essay a political diatribe on this, my birthday, so I will move on.

As a candidate for an M.F.A. I am now almost always writing or reading. I am enjoying it immensely and am happy with my progress because of all I have already learned about writing but I am also mindful that I have only limited time left (“I have so many songs in me that won’t be sung” – Charles Aznavour). I am determined to complete at least two more novels and get some short stories published (“I want to be understood by those yet unborn” – Blanche Glover, in A.S. Byatt’s Possession).

I miss working with residents and am concerned about things I know about pathology that I will never pass on but otherwise am content with my new life. I try not to think of the person who succeeded me but was reminded of him in a New York Times article today about Tasmania and the effects of climate change. A Tasmanian cemetery close to the seashore is threatened by the erosion of the island because of the rising sea (I have no understanding at all of people who do not accept that our planet is threatened by man-made climate change). The cemetery includes an 1843 tombstone for the schoolmaster Benjamin Horne which says: “Sincerely regretted by all who knew him.”

Yesterday my wife Kate and I completed work on revisions to those legal documents important for people of our age: the trust to establish the means to best benefit our children when we are gone, the will for the same purpose, the power of attorney to try to avoid legal hassles when they occur and the all-important advanced health directive to try to assure that we have some say in how we die. Kate does not want any dependency on life support systems and, wise and experienced nurse that she is, does not want to endure unnecessary and inappropriate resuscitative efforts. I am less confident of how to handle those last days; I think I would like to be sustained for as long as I can still enjoy music.

The day before we visited our caring and patient physician, John Harold who was, more than 35 years ago, one of the students when I taught at the Mount Sinai School of Medicine. Kate and I both seem to be well although he had me undergo another stress test combined echo cardiography to better evaluate my mild arrhythmia and other heart ‘things’; I earned a ‘gold star.’ I continue to not worry about health issues since I feel fine.

More importantly, this past weekend was spent in San Francisco where we went to a few art museum exhibits. Matisse and Diebenkorn at the SF MOMA was quite good, I enjoyed the Stuart Davis exhibit at the de Young Museum, but the ‘Monet: The Early Years’ at the Legion of Honor venue was spectacular. We are all so familiar with water lilies at Giverny and hay stacks, cypresses, and Rouen Cathedral, Parliament and the many other extraordinary creations of Monet’s later years but the less familiar early paintings are no less thrilling. Quite the contrary. More than one painting made me literally breathless. This was one of the most wonderful exhibits I have ever seen, I wish I could go again.

Yesterday I was invited to contribute to a new autopsy textbook by Jody Hooper and Alex Williamson, two former students and present colleagues and friends. I increasingly have concerns about the future role for autopsy in modern healthcare but am encouraged when I think about students, most prominently Jody and Alex, but also others, who understand the continuing importance of autopsy. When I decided to be a writer of fiction for the rest of my life I vowed to never again commit to writing medically-related articles. I violated that vow a couple of times last year but was determined to adhere to it until Jody and Alex asked me to write the chapter on the history of the autopsy for their book; it was an offer I could not refuse.

As the sun starts to set I am at my desk, listening to Clifford Brown’s wonderfully mellow horn-playing. I worked on a short story today after going to the gym and then had breakfast with Kate. I conquered today’s New York Times crossword puzzle. For the last couple of hours I have been working on this non-fiction musing about my birthday. I have heard from my children, from my brother and sister-in-law, as well as from some good friends who somehow manage to remember my birthday each year.

Kate and I watched another installment of Bosch on amazon-tv after dinner and will read before going to bed.

It was a good birthday.