Back-Up Plans


Back-Up Plans


Leonard Zwelling

It’s always a good idea to have a plan B.

I don’t know about you, but I am used to most of my plans not working out as I had hoped—on the golf course or in life.

When I was a senior in high school, my only desire was to go to Yale as an undergraduate. I have no idea why. I just got it into my head that I had to attend Yale. Well, surprise—I only made it as far as the waiting list and never got in. I never got into Cornell, the University of Rochester, the University of Michigan, or Amherst either. I needed a plan F. Fortunately, I had one. Duke.

April 15, 1966 thus became one of the most important days of my life. I did not get into Yale, and instead was headed for North Carolina where I learned to eat barbecue and Brunswick stew, saw my first alpaca sweater and pair of tassel loafers, became a Cameron Crazy, learned about segregation and antisemitism first-hand, and got a fantastic education that led to Duke Medical School, Duke house staff training, a career in biomedical science, and most importantly meeting a really cute first-year medical student in the library who is now the BW. Lucky for me I had a plan B that was actually plan F.

The two attached opinion pieces from The Wall Street Journal on May 15 also discuss the need to be open to other plans. As John Lennon said, “Life is what happens to you while you’re busy making other plans”. But you better make them anyway.

The first piece insightfully addresses the need for the Democratic Party to consider an alternative to President Biden in 2024. As this blog has pointed out repeatedly, the President is showing his age and he will not be getting any younger if he is re-elected. Furthermore, if he is unable to complete his second term, the one figure more unpopular than Mr. Biden would take over, Vice President Harris. That’s a mighty poor plan A. And if Harris is plan B, that’s not much better.

The authors of this piece, Douglas Schoen and Andrew Stein, are both Democrats in good standing and suggest that the only possible successful Democrat to supplant President Biden is Michelle Obama. I don’t think she is really interested, but might be persuaded to reconsider if her party and her country needed her. The point of the editorial is that the Democrats desperately need a plan B as Mr. Biden is both unpopular and infirm. Furthermore, he actually lags behind President Trump in the polls. Surely, Mr. Biden does not want to end his political career the same way President George H. W. Bush did. Why not go out on top? If he decides to do that or if a recession, war with China, or another pandemic makes it clear to him (I told you he was infirm) that he really cannot win, the Dems need to be ready and running Vice President Harris is not a good plan B. How about Mrs. Obama?

The second opinion piece by attorney John Sciortino makes a point I had never considered. The laws in most states are more restrictive about young people getting tattoos than they are about them getting gender-affirming surgery. Hmmm. That doesn’t sound right. But it is, as Mr. Sciortino makes clear.

With tattoos, as I understand it, the technology to reverse an ill-considered lapse that leads to body ink at age 15 is possible. The same is not true with gender-affirming surgery. Hormonal treatment for those who believe themselves to be transgender is exactly my idea of having a plan B. It is not irreversible and allows for quiet consideration by an impressionable young person and, most importantly, his or her or their doctors and parents.

You have to have a plan B and it’s best if plan A is not irreversible.

My own decision at age 17 to attend Yale was foolish. It was not the right place for me. Duke was. It was not irreversible.

Young people can make bad decisions. It’s part of maturing, but the more of those decisions that aren’t permanent and that are accompanied by a plan B, the better.

Dr. Zwelling’s new novel, Conflict of Interest: Money Drives Medicine and People Die is available at:,

on amazon if you search using the title and subtitle,


directly from the publisher Dorrance at:

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