The suburban town where I work three days a week abuts the northern border of the city. It begins with a lower middle class black neighborhood, small one story homes tightly packed together. As you head north the houses get gradually bigger. On the mountain that lines the north and west of the town are the million dollar houses. In between are five nursing homes and many elderly housing projects. The average age of my patients is 69. Last year it was 68, the year before 67. I’ve learned a lot about aging, about decline. It isn’t limited to any one part of town. *** Today we are up on the mountain. A woman in her early fifties, a trim attractive brunette wearing a grey turtleneck and a gold necklace meets us at the door. My husband was just released from the hospital today, she explains as we follow her through the expansive house. I note the wood floors and modern art. He had a kidney transplant a year ago, she says, now today he doesn’t even know what medicine he is supposed to take. The overweight man is slumped at the kitchen table. His body is bloated. His skin is cool, and clammy. I’d say he is at least fifteen years older than his wife. On the table in front of him are his prescriptions, some bottles standing, others knocked over. There are discharge papers from the hospital. I see glyburide written on one of the bottles. His wife is beside herself. I wonder how long they have been married. Is she the first wife or the trophy second wife taken when he was a leader of industry? “It’s probably his sugar,” I say as I prick his finger. “Yeah, sure enough. 23.” “His sugar! They said they fixed that at the hospital.” I tell her how being sick can really mess with your sugar, it can wear your body down. “Why can’t they fix it?” she says. “Why can’t they just fix it? He just got out of the hospital today. He was there for seven days. Shouldn’t they have fixed it?” “It doesn’t work like that,” I say. “I can’t believe this,” she says. “He was there for seven days.” She looks at him and shakes her head. She tries to explain. “This was once a vibrant man,” she says. I push the D50 and gradually he opens his eyes, but his body is still bloated, the skin on his balding head is discolored. “Where am I?” he asks. She stands back, her arms crossed, shaking her head. She looks very unhappy.