The process of getting older reminds me a lot of what Ernest Hemingway had to say about going broke. He commented that people go bankrupt in two ways: “…gradually and then suddenly”. That seems to be how old age sets in too. There’s the slow cumulative effect over decades…arthritis, change in blood vessels, osteopenia.
They surprise us by their erosive power, presenting like strata laid bare with geologic confidence. And then there’s the sudden thrust of mortality…The heart attack, a stroke, cancer. The fearful crack of our life’s timbered foundation suddenly shudders, as mortality’s delivers its hammer blows.
Of course, the irony is, as Kierkegaard put it: “Life can only be understood backwards, but it must be lived forwards.” But looking in the rearview mirror, we may see some pointers to help guide us down the road:
1. We have to take charge of our own health care. The currency of life is health. Unfortunately, most of our doctors are not health care providers. They were taught to be disease managers. They are interventional practitioners. We see them for an appointment. They recommend tests, or give us medications, or perform procedures but rarely does one single physician develop an integrated picture of whom we really are holistically as patients, of where the emotional, physical, and psychological factors meet. They see the flesh of our lives, but the not meat. No one can do that for us. So we need to enumerate the healthcare problems we have and map out a strategy to follow, fix, or live with each one of those issues.; and, maybe, a few that still have not yet reared their ugly heads. It may be like herding cats but no one else is going to prevent a stampede.
2. Activity is at least half the solution. Stay as active as your body can tolerate to keep it from failing prematurely. Run it up, if you don’t want it to run down.
It’s a sad fact of life in the West that most of live such soft lives that we’re compelled to schedule exercise if we don’t want to turn into jellyfish. We need to safeguard our calendars to ensure there’s enough physical activity to keep ourselves in the best physical condition we can. Goethe wrote: “Take care of your body with steadfast fidelity. The soul must see through these eyes alone, and if they are dim, the whole world is clouded.”
1. Find an “elder mentor”. For some reason, we’re under the delusion that we reach a certain age and then stop learning. Or, perhaps more specifically, we no longer need to look for teachers. Getting older means we have to learn new skills, new perspectives, and new habits and that means we have to find new—older–role models. We need to search out the people who seem to be living life older but better than we are and to learn from them. Clint Eastwood recently turned eighty years old. He may be getting older but he’s still climbing to greater creative heights as a film director. He inspires all of us to look for ways to grow as we age. We’ve got to find “our elder heroes”. Fortunately, there’s more coming of age every day.
2. We’ve got to let go. If being forty is about being “large and in charge”, whether it be our job or our kids, then getting older is about “peace and release”. It’s about changing our patterns of thinking and reacting. The later decades of our lives are about developing wisdom, generosity, and insight. That begins with letting go of the need to be right and be in control. Control’s an illusion. As the lyrics to film “Crazy Heart” state so sublimely: “Funny how falling feels like flying, for a little while.”
3. Take time for the affairs of the heart. We need to celebrate the people and things we love. We should never hold a grudge and never go to bed mad. Always give our loved ones a kiss goodbye and a kiss goodnight. And, shoot, let’s forgive ourselves for being the asses we’ve been.
4. Last, but perhaps most importantly, we need to fight back! One of my favorite poets, Dylan Thomas, wrote:
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Growing old is about combat. It’s about looking mortality in the face, balling up our fists, and then spitting right in its eye. It’s about realizing we’re in for the challenge of our lives and declaring that we will fight for every day of strength, vigor, dignity, and passion that is in our power to wrest free from the gathering conclusion. It’s about defiance, struggle, and courage in the face of a world that may often prejudge, ignore, or condemn us based on our age or appearance. It’s about living defiantly simply because we know we cannot live forever. Living would not require so much courage if it didn’t come to an end. Some may say it’s about learning to close the gap between our dreams and how we live. I’d like to think it’s about learning to live the way we always dreamt or, perhaps, having some new, different dreams too. It may not be in our power to always succeed, but the inspiration to try is one of life’s thrilling callings. Theodore Roosevelt wrote: “Old age is like everything else. To make a success of it, you’ve got to start young.”
So let’s start because this is the youngest we’ll ever be.
Allan J. Hamilton, MD, FACS, Boomer-Living Director. After studying art in college, which earned him a career as a janitor, he went on to attend Harvard Medical School, and to become the chief of neurosurgery and chairman of the Department of Surgery at the University of Arizona Health Sciences Center. He currently holds a main appointment as a Professor of Neurosurgery as well as professorships in Radiation Oncology, Psychology, and Electrical and Computer Engineering. Dr. Hamilton also is the Executive Director of The Arizona Simulation Technology and Education Center at the University of Arizona College of Medicine.
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