“I am very impressed”, said the surgeon – “about how much damage you’ve managed to do to your hip. “You need a full replacement, so let’s see how soon we get you scheduled”. Two thoughts occurred right on top of one another: a) boy, am I lucky to have an option to reduce the pain, b) wow, I am officially old.

I admit to being a surgery rookie – fortunate to have avoided hospitals since my tonsils were removed, so many years ago. So many years ago, that Robbie the Robot was the toy of the year. But now, I am joining the Society of Waiting Room Junkies, an exclusive club of seniors who inhabit a labyrinth of calendar conflicts almost totally devoted to medical service. I figured to be pretty good at this, as my working life taught me to wait productively in airports, but I have to admit that doctors’ waiting rooms have their own vibe. Mostly, older and infirm individuals emit auras of fading energy, but I have witnessed some full-on, call the cops outrage with the administrative process.

Problems tend to arise when patients do not understand insurance-speak or waiting room ethics… and some admins tend be unaware that folks may need to be ‘socialized’ into appreciating the specialized tasks assigned to various members of the medical team: front desk reception (‘what is your birthdate, please’), intake nurse (what is your birthdate, please’), medical history admin, phlebotomist, x-ray tech, surgery scheduler (‘what is your birthdate, please’), co-payment processor – oh, and the physician or PA.

Since western medical practice is a symptom-oriented approach, specialists exist for every symptom. Your medical team wants to know (in addition to your birthdate) the names of your urologist, cardiologist, nephrologist, neurologist, oncologist, physiatrist (yes, that’s a thing), psychiatrist, ophthalmologist, dermatologist, proctologist, and pharmacist. In addition, your team will be pleased to hook you up with an anesthesiologist. Look at all the new friends! We may have not found the cure for COVID, but we have certainly cured loneliness in our lifetime!

Obviously, I speak with tongue-in-cheek, observing a rite of passage that people of a certain age must cleave to, or not survive past that certain age. We are fortunate to have excellent healthcare, even if at times the process gets in the way of the service. How nice it is to encounter the upbeat nurse, the skilled practitioner, or the pleasant fellow traveler… they keep us keepin’ on!

Organ Recital

When I was in my forties I had a phone conversation with my colleague Jack.  He asked about our health insurance coverage to see if I had any knowledge of reimbursement for a procedure he had scheduled.  One thing led to another and soon we found ourselves immersed in a completely health-obsessed exchange of body parts, broken bones, previous illnesses, and surgeries.   He paused, chuckled, and then said we sounded like two old men who talked about little else than their medical conditions – he called it the Organ Recital!

Ever since that day I remain observant when I find myself pulled into such a conversation and seek to make it more about gathering information rather than enjoying it as a new mode for social entertainment.  And now Wal’s post reminds me that, in fact, I am an old man who will have more and more medical issues waiting for me on the horizon.  The question remains how much of the “concert” I choose to participate in and/or listen to.

As Wal points out the challenges that lie ahead include more than just the condition of eroding body parts; they include the endless stream of paperwork, administrative error or incompetence, and waiting rooms that bombard us with a myriad of conversations and germs!  I’m thinking that George’s approach from his previous post will likely serve him well; expect the worst and you’ll likely be surprised that it wasn’t as bad as you expected.  And, as Wal reports, sometimes these conditions can lend themselves to pleasant surprises when we might experience highly respectful and efficient check-in and follow-up services and the opportunity to make a positive connection or two.  I try to combine my optimism for the latter with preparedness for an experience that might require much patience and a Zen mind.  After all, if this is the new normal for “Old Guys” then it makes sense to adapt and accept it.

I think the part that I have control over is whether I make these medical interventions a symphony I play in regularly or an intermittent recital I can leave behind when the visit is over.  Perhaps if I choose to bring my playful and curious nature to this venue rather than become an organist playing and replaying the same old song, I might just continue to enjoy the music!

“We don’t stop playing because we grow old. We grow old because we stop playing.”

-George Bernard Shaw

Relatively Speaking…

Everything is relative! I just had a major revelation about everyone’s fixation about my glass being half empty all the time.  It just occurred to me to get a smaller glass and pour my concerns into it and magically my glass is FULL!  Not half full but all full (say it slowly and enunciate so it doesn’t sound like ‘awful’) See?  Relative!

In our youth our social life consisted of parties, big events and social gatherings!  Every weekend was filled and work took up our weekdays!  Life was busy and full (not half full), fun and laughter were the currency of those gatherings.  Life was good!  In our mid-life prior to the crisis, our social engagements quieted down slightly. Our social calendars were filled with weddings, christenings, work related parties, road clean ups.  Life was getting softer, quieter and cozier.  Life was comfortable if a little quieter.

The Golden Years, which sneaks up on you mercilessly, changes the nature of our social calendars.  The weddings and christenings are finished for the most part, gatherings become less frequent but the one commonality we all face at this stage is the maintenance of our physical bodies.  Life can become concerning.  They say in your mid-fifties your ‘check engine light’ comes on and predicts the ailments and medications soon to be arriving at an organ in you! The friends you maintained over the years are in the same boat and remain faithful at your side, sympatico to what you are going through.  Hence the conversations Henry refers to as organ recitals.  Now here’s where my new revelation about my glass kicks in.  You begin to see your week is filled with blood work, X-rays, appointments with specialists, Medicare physicals where you get extra credit if you remember the four special words in their right order! But as Wal pointed out, the new socializing opportunities are in the waiting rooms of all these new and exciting locations.  New friendships develop as you run into the same person you met at your general practitioner’s office pops up the following week at your cardiologist’s office! “How is your son doing with the divorce?” Or “Social Security thinks you died?  I have a friend that was declared dead by them and he had to be resurrected!”  Meeting new people is always fun and the conversations are so much more interesting than in our youth.  So you see, everything is relative!  Just a little digression.  Wal and I have the same general practitioner so I had to fill out that list of specialists as well, so after I listed my Cardiologist, Nephrologist, Dermatologist, Therapist, Orthopedist, in my snarkiest printing I added one that wasn’t on his list….I figured since they want to know everything about me I listed my Veterinarian too!  The doctor asked me if I was trying to be wise and I told him I didn’t have to try, it came with old age…

Tower of Song

Hen suggested the topic of diminishment — particularly of physical decline. We wrote about a similar sense of aging in George’s earlier post The Golden Years. However, this topic is a bit more pointed. George ended that post with a poem that fits the bill – about the inevitable crankiness of the body… or as Leonard Cohen sang: “I ache in the places where I used to play”.

Ending on a poem was a nice touch in The Golden Years, George. I drift toward poetry when confronting life issues. Somehow poets seem to capture large thoughts with few words. Three poems catch my fancy in this regard:

1. Dylan Thomas’ Don’t Go Gentle into that Good Night

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.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night… (and further verses)

Dylan Thomas kicks it up a notch! Some years ago, this was my anthem. Thomas not only wants to resist the acceptance of diminished ability, he wants to fuel his energy with anger. Go out with a flair! In addition, this poem conjers up the lament that one feels not just at physical decline, but the accompanying despair that life is too short and accomplishments too meager to meet the first rank. Thomas wrote this lyrical poem for his father, but he himself raged so at the loss of youth that he drank himself to death at age 39. Thomas spent his energy rubbing against the grain. He never came to peaceful terms with the inevitable arc of life.

2. Alfred Lord Tennyson’s Ulysses

…Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

This is the stoic solution – head down, keep moving forward. Marcus Aurelius would have endorsed this sentiment. If you ever followed Rumpole of the Bailey, that aging barrister used to quote these verses to pump himself up to face difficult circumstances. The context of the poem chronicles poor Ulysses, forced to wander for many years and fight battle after battle, who finally makes his way home and finds he has to fight one last battle to reclaim his household. It’s a call to marshal one’s infirmities and soldier on. However, I’m not sure that it encourages a person to find new solutions, but rather to make good use of what you still possess – work with what you’ve got.

3. Emily Dickenson’s We Grow Accustomed to the Dark

The Bravest – grope a little –and sometimes hit a Tree

Directly in the Forehead –

But as they learn to see –

Either the Darkness alters –

Or something in the sight

Adjusts itself to Midnight –

And Life steps almost straight

I find this portrayal by Emily Dickenson most apt, most human. My friend Lee recently pointed out that we are bound energy… energy can’t be destroyed, but it can be transformed. As our physical presence transforms over time, we learn to adapt.  We find a way. Senses and abilities previously dormant begin to bloom. We compensate. And perhaps we better appreciate the skills still remaining in our tool bag.

Oh – so why is this post entitled Tower of Song? Well, it’s a song by Leonard Cohen. I consider him more of a poet than a performer. If you chance to listen to this wistful song, it might touch a chord. I’m pretty sure that Cohen was contemplating something other than a jukebox. Perhaps eventually some remnant of our energy will reside in a Tower of Song.

Accepting My Diminshed State

Wal’s invitation to reflect on diminishment as we age provides, as one might expect, a range of perspectives.  And offering it through poetry and song only enhances the number of interpretations. 

Refusing to go quietly into the night reminds me of my friend Bill who once told me that when his time comes, he wants to be completely used up, having lived fully, without compromise, until there was no more left to give.  I get that, I too, fueled by a youthful spirit and sense of adventure, welcomes the adrenalin rush when I can.  But influenced by life’s experiences and the ever-increasing limitations of the body, they are less spontaneous and more measured.  As Wal, continues in his post, the wisdom of working with what we still have and consciously honing skills we may have barely acknowledged allows us to adapt to our new normal and still live fully.

For me, it’s about acceptance.  Not acceptance of defeat.  Acceptance of what I can still do, with or without difficulty, and recognizing when it’s worth it and when it’s not.  Acceptance that it’s time to shift my tempo, or ask for help, or be more forgiving (of my limitations.)  Acceptance that it may be time to let go and revel in the joy of watching someone else dance wildly into the night.  So easily said, so challenging to practice.

I came across the two following poems that represent many of my feelings.  I also liked I Still Matter, by Pat A. Fleming but didn’t include it in this post.

The Little Boy And The Old Man by Shel Siverstein

Said the little boy, sometimes I drop my spoon.
Said the little old man, I do that too.
The little boy whispered, I wet my pants.
I do too, laughed the old man.
Said the little boy, I often cry.
The old man nodded. So do I.
But worst of all, said the boy,
it seems grown-ups don’t pay attention to me.
And he felt the warmth of a wrinkled old hand.
I know what you mean, said the little old man.

I like the parallel that we end in similar ways to how we begin.

Maya Angelou wrote:

“When you see me sitting quietly, like a sack upon a shelf,
Don’t think I need your chattering. I’m listening to myself.
Hold! Stop! Don’t pity me! Hold! Stop your sympathy!
Understanding if you got it, otherwise I’ll do without it!
When my bones are stiff and aching and my feet won’t climb the stair,
I will only ask one favor: Don’t bring me no rocking chair.
When you see me walking, stumbling, don’t study and get it wrong.
‘Cause tired don’t mean lazy and every goodbye ain’t gone.
I’m the same person I was back then, a little less hair, a little less chin,
A lot less lungs and much less wind.
But ain’t I lucky I can still breathe in.”

Lucky indeed!

Diminishing Returns

Getting old sucks- sure it beats the alternative but it causes us to watch the demise of the persons we used to be.  Sure medication helps- Blood pressure, cholesterol, and other old age conditions can be controlled with pills but the one thing that can’t is the mind.  The mind remembers how it used to be and wants to be back there but the body says, “No way, Jose,” unless you aren’t Spanish and don’t know the expression.  Things hurt, slow down or function differently than in the past.  And you remember how it once was and wonder why it can’t be the same as it was.  But intellectually you know that things wear out.  Tires go bald, mower blades dull, plumbing breaks down.  Same thing happens to our bodies.  The only difference is there is no technician who can come and service your furnace, repair the elimination system in your body, or even fertilize the hair on your head.  You know what I mean!

But we are complex!  Our bodies consist of organs that break down, but we also have senses and sensitivities.  My ears have diminished. Tinnitus and hearing loss have cause me to say, “What?”  My eyes have deteriorated so I have to have my glasses on my forehead at all times so that I can see clearly.  Fortunately smell and taste have not deserted me. I don’t know what I would do if I couldn’t smell the lilacs or taste the sweetness of an apple pie!  But touch- now that is a different case.  Living alone during the pandemic I don’t get to touch another person.  I crave the feeling of someone’s head on my lap or a good foot rub!  Sure I can feel the dishes while I am washing them, the soap when I am washing myself in the shower but I can’t feel the human touch!  The feel of a hand touching my face tenderly or shaking my hand or brushing the dirt off my arm after I come in from cutting the grass.  My sensations have been diminished!

In general my world has diminished.  No poetry can express it!  My family has diminished.  From a large Italian family we are reduced to 3.  My son moved south but my daughter is nearby, thank God.  In the last two weeks I have lost 3 friends.  I didn’t lose them, I know where they are…. they died!  So my sphere of people who make up my world is diminishing as well.  It is hard for me to be optimistic in this limited environment.  In my youth I could always say things will get better.  In my senior status I know more than likely my world will continue to diminish so I have to accept it and find a way to be comfortable within this circle of life. Life can still be comfortable!  I can take comfort in the fact that over the years I have gained experience and wisdom that merely passing through years afford us.  It feels good knowing that wisdom can be accumulated over the years IF you are open to it.  Some people never gain wisdom.  It is just who they are.  I am fortunate in that I have accumulated positive information that I can apply when needed.  And at this time in my life and this time in a country full of unrest I guess I have to take comfort in the fact that it may be all I have left to give and that has to be enough!  As the body deteriorates, that isn’t such a bad thing!