After close to three decades practicing medicine, I sometimes naively fancy myself an expert on the human condition in general and the aging process in particular. I have certainly borne witness during my years in practice. On my watch, I have shared much with my patients. Tens of thousands of iffice visits. Hundreds of hospitalizations. Thousands of operations. Problem lists growing longer with each passing year. Around 800 deaths.
And the cycles of life, unending: marriages, separations, divorces. Second marriages. And third. Childbirths. Grandchild births. Greatgrandchild births. And a few births of greatgreatgrandchildren. New jobs and jobs lost. Buying homes. Losing homes to foreclosure. Graduating from college. Graduating from grad school. Submersing in drugs. Battling against drugs. Drinking too much. Climbing on the wagon. Joyful holidaus. Tragic holidays.
But despite the diversity of life experiences — the successes and setbacks, the joys and the sorrows, love found and love lost — there is a common and unforgiving thread which tightly strings the years together. For each individual, no matter how good they are, no matter how true, the years sneak by and their body progressively betrays their hopes. Commits treason against their dreams.
Mrs. Francis, an 84-year-old, told me she looks in the mirror and sometimes does not understand why an old lady is looking back at her. “In my mind, I still feel like I’m 30, but my body looks so old! And I can’t do the things I used to do, the things I want to do.”
Mr. Norton, an 88-year-old, says he’s not sure whether to complain about being tired so much. “Is it just part of being my age? I’ve never been 88 before, so I’m not sure what to expect.”
I long ago lost count of the number of elderly patients who told me that calling their senior years the Golden Years was a pile of rubbish.
Aging with grace is an Olympian challenge. Coming to terms with the onslaught of contracting options is tough. Especially because the infirmities so often sneak in stealthily, unannounced. Each individual incursion tends to be small, a mere pittance, unthreatening, easy to overlook. But the insults accumulate exponentially and amass their power until one day it dawns on the individual, “Hey, those stairs are higher than they used to be.” Or, “Why am I getting so short of breath walking the waterfront.”
Things long taken for granted become major hurdles. An elderly gentleman, a retired internist actually, finally had to stop carving totem poles. Another had to give up and sell his cabin in the foothills, no longer able to do the routine maintenance the cabin required. And this after 25 years of sharing family gatherings there.
How the aging process affects couples can be remarkable, or cute, or bittersweet. Or all three. I have couples in their late 80s who have changed from being vibrant world travelers while in their 60s to both being in wheelchairs with mild cognitive impairment, living together in assisted living. I have another couple where the wife, who has metastatic lung cancer, has to push her husband’s wheelchair because of his debility from multiple sclerosis.
When half of an elderly couple dies, the survivor’s response can be striking. Grief, of course, is inevitable. But relief is also not unusual, especially when the partner who died had been suffering for years. I have widows who, when their frail elderly husband died, finally were able to resume aspects of their lives they had put on hold for years. They lost half of themselves, but at the same time they regained the other half which had long been missing.
There are few guidebooks for how to age appropriately. Despite the ubiquity and difficulty of the journey, our culture provides precious little help. It is an uncomfortable topic which receives little air time in the mass media. So it is often left to physicians and other clinicians to point the way, validate the concerns, encourage the progress, and promote understanding.
But I must confess, it is still so mysterious to me, this aging process. In spite of many years of clinical encounters, and despite my increasing personal experience, I am still befuddled. I feel inadequate to be a guide or mentor to others in how to grow old.
For some, aging seems to bring a measure of peace and stability. Bur for others, it chaffs and pulls and frustrates. Why the difference? I have no clue, not yet. Will I ever? All I have learned so far about aging is that it is either a blessing or a curse. Or it may be both.
Some days, it feels more like a curse, and I think of the words of Leo Rosenberg, “First you forget names, then you forget faces, then you forget to pull your zipper up, then you forget to pull your zipper down.”
Other days,. it seems more of a blessing, and I recall the words of poet Robert Browning, which John Lennon used in his final song, written in 1980. “Grow old with me! The best is yet to be.” John Lennon was assassinated later that year and never had the opportunity to grow old. Whatever the challenges of aging, it is so much better to have the chance to face them, than to have this opportunity denied.
(November 2010)