Outsiders tend to be the first to recognize the inadequacies of our social institutions. But, precisely because they are outsiders, they are usually in a poor position to fix them.

People who reach certain levels of frailty, more important than getting their mammogram, more important than getting their blood pressure tweaked, they're at high risk of falling. If they fall and break their hip, they not only die sooner, they die miserably.

These are folks that keep people out of hospitals, out of emergency rooms, out of nursing homes. And not only that, they help people achieve more fulfilling lives.

When we lived in a society where we had large families that lived together, especially in agricultural societies like my grandfather and father grew up in, the result is you always had family around to take care of you.

No matter what measures are taken, doctors will sometimes falter, and it isn't reasonable to ask that we achieve perfection. What is reasonable is to ask that we never cease to aim for it.

We have medicalized aging, and that experiment is failing us.

What is needed, however, isn't just that people working together be nice to each other. It is discipline. Discipline is hard--harder than trustworthiness and skill and perhaps even than selflessness. We are by nature flawed and inconstant creatures. We can't even keep from snacking between meals. We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.