Teacher, mentor, friend, and philosopher Howard Stein died two years ago today at the age of 90 — and I still miss him every day — and yet his death strangely seems so far in the past as to be unrecognizable. Because of all the surgical procedures he had at the end of his life, Howard would often refer to himself as the “Frankenstein Monster” held together with stitches and sealing wax.

I will never forget all the important things Howard taught me — but one of the things that has stuck with me the most was his fear of the night and not waking up in the morning — as well as a curious and condemning something his dentist said to him a few years before his death.

For many years, Howard had lots of health problems, and for the last decade of his life, his heart was troublesome. A few years before he died, and always in a tempering, failing, health, he visited his longtime dentist to have a back tooth removed and replaced.

After the dentist removed the infected tooth, Howard asked for another appointment to replace the missing tooth.  His dentist flatly asked him, without emotion or concern, “Why, Howard?”  That simple, direct — and humanly brutal! — question stuck Howard like a Devil’s pitchfork right between the eyes.  His dentist, and friend, didn’t think — over the course of the coming time and tide — that replacing the tooth would matter much since Howard was in his waning days.

Howard was always teetering on the edge of death for the last decade of his life and yet he always recovered and sustained and pulled through, but “Why, Howard?” hit Howard like a death sentence that no other doctor had yet to presume.

I, too, was bothered by the dentist’s denial for tooth replacement.  What difference would it make to him if Howard had a tooth for the last couple of years of his life?  Was the dentist unkind to not want to replace the tooth?  Or was he just doing his job and trying to save everyone some time and money?

That question alone — “Why, Howard?” — sent a chill into every bone as any notion of hope was bet and lost.

If Howard had pressed the matter, the dentist certainly would have replace the tooth, but Howard was a realist and he accepted his dentist’s diagnosis and begrudgingly did not have the tooth replaced, though he loved to privately rage against his dentist’s denial of putting a “live tooth in a death mouth.”

A couple of years later, and at the actual end stage of his life, “Why, Howard?” would make a sudden, if unspoken, and unexpected, final appearance as — on the night before major open heart surgery –Howard’s surgeon called to cancel the operation as “too risky.”  For months, Howard had prepared for that life-extending surgery and, in the final analysis, and in consultation with other surgeons, his doctor had decided against doing the operation.

Howard said that news was devastating, a death sentence, and that he now had a ticking time bomb in his chest that used to be his heart.

When he told his family of the surgeon’s refusal to operate, they were relieved.  His wife and children had silently been against the surgery from the start and did not want Howard to move forward on the operating table because they feared they’d never see him back alive again.

Howard asked why none of them said anything, and their reply was stolid, universal, and heartfelt: “Howard, it’s your life.”

Once that final, and poignant, yet silent — “Why, Howard?” — had been unearthed, and ruefully accepted, Howard lived the rest of his life and was dead in his grave before the end of the year.


  1. What a beautifully written and touching story, David. Thank you for sharing it with us.

    1. Thanks, Gordon! I’m not so sure I would’ve had the same, accepting, reaction Howard had in his dentist’s office. I would’ve wanted the tooth replaced no matter what — just so I could, in my own mind, “leave behind the most complete corpse possible.” SMILE!

  2. wow, this raises all sorts of end of life issues, David. Whose life is it, indeed. I don’t know how I will approach getting old(er). Sometimes elderly people do not want to have risky, potential life saving surgery, but sometimes they reach for all chances. But if Howard wanted his tooth and his heart surgery, I think he should have been allowed to go for it.

    1. I agree Howard should’ve had whatever he wished.

      I know there’s a tendency to over-operate on the Aged for profit — lots of my older friends in the Midwest use surgery to cure their ills as if they’re taking an aspirin and the doctors are happen to cut them open for easy Medicare money. One surgery tends to instantly lead to another. Removing the gall bladder “just in case” since “you’re already open” was a big moneymaker for awhile.

      I know Howard’s heart surgeon was one of the top in NYC and that doctor consulted late into the night with many of the other best heart surgeons in the City and none of them said they’d risk the surgery. Just “touching” his heart would kill Howard, they felt, and so the doctor declined even though Howard had repeatedly said he didn’t mind risking dying on the table to get a little better quality of life.

      That begs another question: When is the patient right and the doctor is wrong? Does the doctor always have to listen to the patient’s wishes, or does experience trump selfish wants to live? When the top guy in NYC tells you “no” — where do you go then? Howard felt he’d been given a death sentence instead of a fighting chance.

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