DavidHilfiker Essays and Other Writings

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Essays and Other Writings

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Welcome to my website!


I've posted here a number of my articles, speeches and sermons.  Things are a little different for since my diagnosis of Alzheimer's Disease, but that's going to become grist for this mill, too.

Clicking on an item from the primary menu (say Economics), brings up all the Economics essays, lectures, and sermons on one page.  Clicking on a submenu (say Essays), brings up just the essays from the Economics section.

You may notice substantial duplication among lectures and between lectures and sermons.  I've tried to keep these to a minimum, but in lectures and sermons subtantial new material is sometimes woven into old material. If you are perusing the entire site, I beg your tolerance.

All the material on the site is published under a Creative Commons license, which basically  means that you're free to use anything here as long as you reference this site and don't make any money off the material.  For details click here.

I also welcome the opportunity to teach or to speak to your group, especially about my cognitive impairment. For details, click here.

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About My Cognitive Impairment

In September of 2012 I learned that I had a "progressive cognitive impairment," almost certainly Alzheimer's disease. On this site and on my blog is the story of my day-to-day life with this illness and my reflections upon it. We tend to be scared of Alzheimer's or embarrassed by it. We see it as the end of life rather than a phase of life with all its attendant opportunities for growth, learning, and relationships. We see only the suffering and miss the joy. We experience only the disappearing cognitive abilities and ignore the beautiful things that can appear.

In October of 2013, the near-certainty of my diagnosis was downgraded to "subjective cognitive complaints," a far more ambiguous diagnosis.  (Click here for details.)  I'm not going to rewrite the entries of this blog for they remain valid for the time they were written.  But the story is more complicated.

So the memoir on this site is a story of my journey from diagnosis of cognitive impairment to the current confusion.  So far I have been able to welcome this period of my life.  In fact and unbelievably, these months so far have been one of the happiest periods in my life.

There's a lot here: a longer letter to friends and readers making public my diagnosis, my autobiography in order to give context to the disease, a briefer story describing the months before my diagnosis, and all of the posts from my blog (see menu),  I have also written a spiritual autobiography, my history written from from a special point of view.

(In addition to this writing I am very interested in speaking to or teaching in any venue, but especially universities and medical schools, about my experience.  Please contact me.)


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This is a teaching that I offered to my own Eighth Day Faith Community in June of 2014.  At the initiative of some of the African-Americans in our community, we have finally begun to look honestly at the issue of racism within our own community.  As might be expected, this discussion has caused no little pain and some bitterness.  This is my reflection on our current status.

Racism in Our  Small Faith Community?


Acts 10:28-35
Col 3:11-16

The inclusion of all people within the worshiping community is a recurring theme in the New Testament.  “Here there is no Greek or Jew, circumcised or uncircumcised, barbarian, Scythian, slave or free, but Christ is all, and is in all.” (Col 3:11)   Jesus goes to Samaria;Peter baptizes the gentile Cornelius; slaves and nobles attend the same churches; and so on.  Today, we say, “Well, of course, everyone is welcome.”  We may forget that inclusion was a huge issue in the early church, and they faced it, actively and purposively.  All divisions disappear in the New Creation of being one body in Jesus.

Read more: Racism in Our Small Faith Community?


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This is a lecture I gave to medical students at Michigan State.  It was a yearly lecture series on the relationship between spirituality and medicine.

April 16, 2014

I’m going to speak with you this afternoon about spirituality and medicine.  So I should probably start with my simplistic definition of spirituality: It’s anything that brings you closer to your true self, to the deepest parts of you, to your values.  Specifically, I want speak about the spirituality of vulnerability and weakness.  We don’t like to think about our frailty and our failings, of course.  We live in an officially optimistic culture in which we’re supposed to see the bright side of things, find the silver lining, and have faith that everything will work out in the end.  Hopelessness is unpardonable; giving up, the ultimate sin.  But that spirituality of optimism is false, for it denies and excludes a fundamental part of us: our brokenness. 

Stories are the best way to teach, I think, so I’m going to offer you stories of vulnerability, pain and, I hope, transcendence.  I hope that one or two of them speak to you in some way. 

Read more: Spirituality of Weakness


My Alzheimer’s ** Skechers Skechers Femmes définissez vous B01MED7VKJ définissez Sneaker Taupe 8a442c8

In June of 2013 I spoke at the Second Annual Bioethics, Spirituality and Humanism in Medicine Conference in Kansas City MO.  The participants were a select group of health care specialists (social workers, nurses, chaplaijs and doctors) who were particularly interested in the ethical and spiritual issue is medicine.  One section of the conference invited health professionals to talk about their own chronic diseases and what it was like to be on the other side of the stethescope.  I was asked to give the keynote for that section.

I have Alzheimer’s disease.  It’s been quite a journey; and this morning I’d like to share part of that with you.

The onset was insidious, but I mark the beginning as June 5th of 2010, the day I lost a day.  I drive several times a year from Washington down to southern Virginia to visit a friend in prison, Jens Soering.  Jens had recently been transferred from one prison to another, and this would be my first drive to the new prison.   

During my visit, the prison chaplain stopped by to say hello.  I introduced myself.  “Yes,” he said, “I remember you from last time.” 

“No,” I said, “this is the first time I’ve been here.  But he insisted we’d met, and I let it pass. 

After he’d moved on, I asked Jens about the chaplain’s comment.  “Yeah,” he replied with concern, “you were here last December.”

Read more: My Alzheimer's Disease


A Theology Out of My Life with Alzheimer Disease **

February 24, 2013

The following is a teaching I presented at our Eighth Day Faith Community.  I'd previously made my diagnosis public, so there were very few who were surprised that I chose to preach about it.  I felt that I'd been taught enough about Gospel values through my disease that I wanted to share it.  We're a small community, so it was an intense morning.

As most of you know, in September, I was diagnosed with progressive cognitive impairment that's almost certainly Alzheimer disease.  Living with Alzheimer's has helped me to internalize a lot of theology in these past five months, and I want to share some of that with you this morning.  Actually, I can't attest to it really being theology, but Fred has assured me that when we talk about the deepest human issues, we're talking about theology. 

As I've described to many of you, I've had symptoms for over two years but didn't recognize them as Alzheimer's until a visit to a neurologist in September.  Since then there's been a slow but noticeable decline in my ability to remember and to think clearly.  If you talk with me much and pay attention you'll notice my memory loss and my trouble finding the right words; I've made enough mistakes as treasurer in the past few months to ask Kate Lasso to take over the books within the next several weeks; and I've had a few episodes of confusion. 

Read more: A Theology Out of my Life with Alzheimer Disease


More Than Surviving the Crisis


Street Medicine Conference
Salt Lake City
September 28, 2012

I spoke the following lecture in Salt Lake City, Utah, at the annual conference of the Institute for Street Medicine, an advocacy and support organization by and for professionals who offer health care (broadly defined) to individuals who live on the street.  Rather than serving homeless individuals in institutions, however, these professionals work on the streets themselves in the United States and other nations around the world.

This is my last speech to a professional audience and it brings together the themes of the American political, ecnomic, social, and environmental crises to explore their complex, virtually impenetrable interweaving.  I suggest that given this impentrability, the necessary changes that offer a sane way out will only be possible after a significant breakdown in the current capitalist system.  Several other pieces of my writing The Earth's Immune System, Hope in an Environmental Wasteland, Theology of the Cross, and Moral Lapses and Economics) have explored various facets of this subject but this is, I think, the clearest and most complete presentation I have to offer.

Read more: More Than Surviving the Crisis


Facing Our Mistakes

This 1984 article in the New England Journal of Medicine is the writing for which I am most notorious in the medical profession. It's about the inevitability of making serious mistakes as a physician, the agony it brings to the physician, and our usual inability to deal with it. Although the article received wide coverage in the medical literature, it would be over ten years before other doctors began writing about their mistakes publicly. The article became one of the chapters in my first book, Healing the Wounds.

On a warm July morning I finish my rounds at the hospital around nine o’clock and walk across the parking lot to the clinic.  After greeting Jackie, I look through the list of my day’s appointments and notice that Barb Daily will be in for her first prenatal examination.  “Wonderful,” I think, recalling the joy of helping her deliver her first child two years ago.  Barb and her husband, Russ, had been friends of mine before Heather was born, but we grew much closer with the shared experience of her birth.  In a rural family practice such as mine, much of every weekday is taken up with disease; I look forward to the prenatal visit with Barb, to the continuing relationship with her over the next months, to the prospect of birth.

En marchant Read more: Facing Our Mistakes


Hope in an Environmental Wasteland If we can’t fix something, does it make sense to try?

It's too late to prevent climate change; it already happening, and much worse is coming. The powerful forces of consumerism, a capitalist economic system, government, the power of the corporations, and the influence of the media create a web that we will not untangle without profound changes in our society. If we can't actually solve the problems of global warming and climate change, if the results are going to be tragic, where do we find hope? How do we respond? Paradoxically, responses are is popping up everywhere. Something new is afoot.

Read more: Hope in an Environmental Wasteland


Geoengineering ... because we must[1]

As climate change denial fades as an argument, geoengineering techniques will become the focus in delaying adequate CO2 controls. Suggested geoengineering solutions are blocking the sun's rays, manipulating Earth's biology to absorb more CO2, and scrubbing CO2 from the atmosphere.  These techniques are expensive, dangerous or both.  Nevertheless we must probably use some form of geoengineering but not as a replacement for carbon controls but as a necessary adjunct.

Read more: Geoengineering ... because we must


The New Jim Crow

Attorney Michelle Alexander has written a most astonishing book, The New Jim Crow, about the mass incarceration of black men in America. The facts themselves are astonishing enough, but even more important is the evidence that mass incarceration is not an attempt to solve a drug problem but to subjugate poor black men. Mass incarceration is how our society keeps the inner-city ghetto devastated. The following is an extensive review. I hope it only whets your appetite to read the book.

Read more: The New Jim Crow


A Theology of the Cross—Part I

The environmental crisis--especially global climate change--has reached such a point that it is no longer reversible and that considerable further damage to the Earth and us its people is inevitable. Yet very few people--even within the environmental movement--seem to be willing to acknowledge (at least in public) that fact. This sermon and the following one along with the lecture Finding Hope in an Environmental Wasteland explore some of the depth of the environmental crises and the forces that make them virtually invulnerable to the usual modes of attack and explores some possible reasons why the American "positive outlook" may be obstructing our view of reality. The two sermons also look at the Christian "theology of glory" and how Christianity may have played a historical role as well as a continuing role in our illusions. Finally all three begin to look at what hope might look like in our situation.

Read more: Theology of the Cross - Part I


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