Misery versus pleasure

Mrs Kablunshki has been my patient for many years. Never would I call her Emma. Just as she would not call me Claus. Somehow, we grow old together. I know many, perhaps all her woes. It's a litany so familiar to so many in primary care—chronic obstructive lung disease, coronary heart disease and heart failure, hypertension, diabetes mellitus, osteoporosis, and so on. You'd think she could not smile. Yet, when I enter her hospital room, that's what greets me, her faint and sometimes beaming smile. Occasionally, she pushes the nasal prongs upward, like a scholar putting the glasses on the forehead when someone interrupts. For a short time she does well without supplemental oxygen.

It seems to me that what she …