Perhaps no other people on earth are more optimistic than Americans.

We walk the streets of this world as if we own them, and if we do not own them today, we will own them tomorrow.

Two of our most beloved Presidents of the 20th Century were elected and reelected not so much for their programs but for their optimism and soaring rhetoric: FDR and Ronald Reagan.

When faced with a problem, we have a Plan B, and if Plan B doesn’t work, well, their are 24 more letters and lots of numbers to follow.

However, sometimes optimism runs into brick wall reality.

My step father is 96 years old. He is in a hospital bed this evening, for the third time in a month.

When he was younger, he was a swimmer and later a swimming coach. In his 60s and 70s he played golf regularly and still turned heads at the community swimming pool. In his 80s he could no longer play golf so he turned to crossword puzzles, books, and television.

A few days ago he fell at home. Sometimes older people fall and break something, and sometimes something breaks so they fall.

He has a compressed fracture of the spine. He could have gone to rehab, but Medicare requires 2.5 hours of daily exercise to qualify. He has aged beyond that. So, he went home with some non-narcotic painkiller.

The next day he returned to the hospital in excruciating pain.

Here are the choices I see for him:

1. Endure excruciating pain

2. Take painkillers that will render him drugged unconscious or nearly unconscious.

Since he is metabolically in pretty good shape despite a pacemaker, he can choose 1 or 2 for up to five years.

So, what do we do, optimists that we are, when there are no more good options?