Chester Buckenmaier III, MD, COL (ret), MC, USA

My wife and I have had the good fortune to spend the United States’ semiquincentennial (July 4, 2026), the 250th anniversary of the Declaration of Independence of the 13 United States of America, with a rare gathering of our entire clan at the Maine family camp. Like many Americans, I have used this landmark July 4 celebration to reflect on myriad positive aspects of being born and raised in this country. Of late, the 24-hour news deluge of graft, corruption, war and disaster that consumes American media can challenge the patriotism of the most ardent United States citizen.

Gen. George Washington penned this month’s quote in a 1777 letter to Dr. William Shippen Jr., the Continental Army’s medical director, ordering all Philadelphia recruits for the Continental Army to be inoculated for smallpox. Washington had personal experience with the disease, contracting the virus on a visit to Barbados in 1751, marking him with scars but providing him with lifelong immunity to the disease. As a military commander, Washington witnessed how the scourge of smallpox could burn through his army and devastate combat effectiveness. During the ill-fated winter campaign in Canada (1775-1776), more revolutionary soldier casualties were due to smallpox than enemy fire.

During my medical career, I was involved in managing the consequences of falls in my patients. In those days, I was more consumed with providing care in reaction to a patient’s fall, usually in the form of a regional anesthetic to manage perioperative pain. Now that I have a few more decades under my belt, the issue of falls in friends and family has taken on more personal significance. In her 80s, my mother experienced a fall, severely injuring her shoulder; my 80s father-in-law sustained a fall, breaking his neck; my wife fell a few months ago, breaking her patella; and my sister-in-law recently fell, injuring her face. A common thread among these tragic family injuries is older age, universal shock and surprise at the fall. They all said versions of, “I was fine; then I was on the ground.”

The word hospice is derived from the Latin hospitum, meaning “a place of rest and shelter for the ill and weary.” As I have aged, the reality of death and dying has occupied more of my time as aging parents and friends enter the twilight of their lives. At times, as with my father, this process can be excruciatingly sudden and swift. The undisputed reality that we are all in the process of dying from the moment of our birth does not ease the shock of a loved one lost unexpectedly. When my father died suddenly, he had a brand-new car in the driveway and a new suit hanging on the bedroom door for my first daughter’s wedding. The shock of his loss still reverberates in my life today. I do recognize that the sharp edge of my father’s passing spared him the realities of a slow, plodding demise. He would not have been a model citizen within a nursing home (enough said).

I have been attempting to process one of our country’s recent tragedies. Pam and I can stay abreast of the news in America while exploring the Bahamas with satellite internet. The cold weather back home in Baltimore makes us grateful to be here, but the rest of the news is challenging to consume, to say the least. As I write this in the clear-water beauty of a tropical harbor, I cannot free myself of the heart-wrenching image of Alex Pretti, a VHA critical care nurse, being brutally beaten, then executed by U.S. Immigration and Customs Enforcement’s (ICE) federal agents.

Pam and I are presently island-hopping in the northern Bahamas. Sailing my own boat to the Bahamas has been on my personal “bucket list” for over 40 years. We are on the “hook” at Allans Pensacola Cay (pronounced “key”) and will be adding our boat name to the famous Signing Tree soon. To say we are in an isolated region of the world would be an understatement. The majority of the cays we visit are uninhabited and accessible only by boat. Our mornings begin with coffee and a check-in with world news and family via satellite internet. The news has been as challenging as ever to consume as we start 2026 in another foreign war with Venezuela.

My wife, two close friends and I have recently completed a three-night passage around Cape Hatteras, North Carolina, on our Lagoon 42, Shavasana, as we move our sailing vessel south for the winter and the end of the 2025 hurricane season. The Cape Hatteras region of the Atlantic is notorious for shipwrecks, as wind, weather and the mighty Gulf Stream often collide there in a dangerous mix that can be perilous for unprepared mariners. The famous Union Civil War ironclad, the Monitor, foundered and sank in a Hatteras storm in 1862; the recently discovered wreck is now a marine park. My son-in-law, Dan, likes to remind me that the region is nicknamed “the graveyard of the Atlantic.” Thank you, Dan, that is helpful.

Garry Kimovich Kasparov (born 1963) is a renowned Russian chess grandmaster and political activist. Kasparov has been a political opponent of Russia’s President Vladimir Putin, so he is likely very familiar with misinformation. A series of events in the past few months has led me to consider the dangers of misinformation and its consequences for those who are misinformed.

T.D. Severin is a professor of surgery at the University of California and a writer. The quote comes from his debut novel, Deadly Vision. Beyond this column, in which I have had the good fortune to express my anxieties concerning the American medical profession, I have utilized reading and my own fictional book writing (Terminus – Trip Buck) to cope with the ongoing stressors of modern reality. Through fiction, the myriad shortcomings of the human species can be explored without the stark and morally bankrupt reality of actual human behavior and its consequences of injustice and death revealed on the nightly news. Regardless of your life’s occupation, reading remains the most viable method of understanding yourself and the world in which you live.

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. made the quoted statement during a May 2025 House Appropriations Committee hearing. The secretary’s comment was made in response to a hypothetical question regarding his willingness today to vaccinate his children for the measles. Kennedy responded, “My opinions about vaccines are irrelevant.”

This month’s quote comes from a speech made by Ronald Reagan (“Ronald Reagan: A Time for Choosing Speech,” 1964). It was essentially a warning against socialism and the expansion of government. He stated, “Public servants say, always with the best of intentions, ‘What greater service we could render if only we had a little more money and a little more power.’ But the truth is that, outside of its legitimate function, government does nothing as well or as economically as the private sector.”