Aging and the Art of Losing

“The art of losing isn’t hard to master,” writes Elizabeth Bishop in her poem One Art. “So many things seem filled with the intent to be lost.” 

In my third year as a geriatrician, a doctor who specializes in the care of older adults, I find these words are often in my mind as I listen to the stories of my patients. I’ve learned from them that aging is an emotional experience as much as a physical one. Doctors and nurses caring for the growing numbers of elderly need to recognize this.

I take histories from patients well versed in the art of losing: The widower who tries, unsuccessfully, to recreate his wife’s pork chops, and instead sustains himself with whiskey and cigarettes in front of a flickering late-night TV. The Air Force veteran with swollen legs who can no longer walk to the bathroom and smells faintly of urine, swearing he would rather take a gun to his head than move to a nursing home.

One reason I chose geriatrics is that it offers the chance to help older adults have an excellent quality of life, in spite of disability and illness. And for sure, many of my patients continue to lead vibrant, joyous lives in their 80s and 90s — volunteering, traveling, remarrying, spending time with family. One is 97 and takes classes in memoir-writing, music and the Supreme Court. Another, 93, sings in his church choir, bowls in a league and dances the shag at the American Legion. 

Still, I know there are some calamities I cannot fix, tragedies so ordinary and yet so singular: A patient, down nine pounds in the past year, who hits her face on the curb when she trips on the way to the store. Her daughter flies in from across the country and finds the refrigerator empty. The older woman misplaces the car keys, accuses the daughter of stealing, grows suspicious that people have been breaking into her house. 

When I administer a short test of her memory and executive function, the ability to plan and organize behavior, she becomes flustered and annoyed. She looks at her daughter imploringly, but continues out of politeness. Young enough to be her grandchild, it feels cruel to ask her such ridiculous questions, but I know it is a necessary part of my assessment. I feel crueler still when she is unable to complete the task, and later, when I have to say, “You should not drive anymore.”

I can only begin to imagine what it is like for her, and for other patients who lose spouses, confidants, homes brimming with memories. Mobility, independence, dignity. Their minds. Their identities. This is what I’m learning: Although I can’t fix everything, I can ease suffering, and offer hope, understanding and dignity.

My patient’s daughter has been taking notes in a spiral-bound notebook throughout the visit. I wonder if she will show them to her mother later, as proof of my conclusions and recommendations. When we are finished, the daughter returns the notebook to her tote bag, gathers their belongings – their role reversal an act of love that signifies how much has been lost. They walk down the hall away from here, the old woman taking small, cautious steps, heading out into the waning sunlight.

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Ariel Green is a geriatric medicine fellow at the Johns Hopkins University School of Medicine in Baltimore.

Staying on the Bus

The bus is a pretty powerful metaphor for my generation. In 1954, Rosa Parks’ refusal to ride in the back of one was a turning point in the civil rights movement. The 1964 cross-country odyssey of Ken Kesey and his Merry Pranksters in a school bus named “Further” was equally iconic.
    
Kesey really threw down the gauntlet: you’re either on the bus or you’re off the bus. Like any analogy, if you examine this one too closely, it can collapse under its own weight…or invite so many exceptions they disprove the rule. Still, when I describe someone by saying, “It’s like, when he got married, he got off the bus,” or, “as soon as she became an investment banker, she got off the bus,” most of my contemporaries know exactly what I mean.     

The signs are easy to spot: Predictable responses to every situation. Opinions so fixed they’ve become gospel. The insidious phrase, “When I was your age.” Rest assured, none of these behaviors mean you’re condemned to a life full of sound and fury signifying nothing. We all have to get off the bus once in a while. Settle in at various places long enough to take care of the important business of being human. Although you may want to be prepared to trade in your Lexus or Lear Jet, if necessary, when the time comes.
    
As many of us struggle to transcend the stereotypes of the 60s, in both senses of the phrase, we’re being encouraged—in the language of the Huffington Post’s Third Metric—“to redefine success beyond money and power” so that it includes “well-being, wisdom, our ability to wonder and our ability to make a difference in the world.”
    
But, even if you manage to achieve that particular reinvention, it doesn’t guarantee you’re still on the bus. Or will stay on it. Perhaps because any fixed definition of the word “success” can be limiting.
   
Ralph Waldo Emerson, a guy who struggled to hang onto the bus by his linguistic fingertips, defined success as that which “inly rejoices me, and the heart appoints.” Yet, many of the powerful moments along the way take place when you’re “inly” despairing…when you feel that circumstances and/or brain chemistry have actually thrown you under the bus instead of on it. (I should know: I travelled the country in an aging VW Van during just such a period.)
   
Even people who have achieved enlightenment—or to put it in contemporary terms, learned to “live in the now”—may have been left in the dust years ago. Especially if, as they read this, they smile koanically and think, “there is no bus.”
     
One unsettling thing about aging is the subtle fear that the bus has left you behind. Or that you’re lugging around so much baggage you won’t be able to get back on at the next stop. That instead of heading towards the light—transcendent or otherwise—your so-called “golden years” are in the rear-view mirror.
    
I don’t particularly care about aging gracefully. But I do care about staying on the bus. I may not be able to define that. But I can feel it. And I don’t think I’m alone.
   
Fortunately, Kesey’s next line offers more than a little hope: “If you’re on the bus, and you get left behind, then you’ll find it again.” 

David Blistein is a writer who has spent his life in the pursuit of wisdom, transcendence, and humor. He is the author of David's Inferno (Hatherleigh, 2013). To learn more: www.davidblistein.com.

Our Days Go By So Quickly

Recently I have realized that I am 86 years old, and there is nothing I can do about it, since each day that passes us is lost forever.

I take short walks, love my work, cherish my clients and have wonderful friends. I have loving children - I hope you can see how lucky I am.

Yet I wake up each day - sad that yet another day has gone.

Up to now I thought there was not much more I could do - but now I feel as though my life has a long carpet to walk on: it lives on.

I have begun to see that all lost days are alive.

The experiences and memories of the life that we have lived and are living, as well as the fiction we have read and the images we have seen in the theater and the films, all contribute to the richness of our being.

Once we understand how much we hold within our hearts, we easily turn them into stories – stories which will live long beyond us.

Realizing this has shifted the way I feel, and how I am looking at my life. I’m amazed at how it comforts me.

But what matters the most is how much I can still do in this difficult world:

• I want to turn my interest to even more people I have never met and talk to them. That might be one of the roads to peace.

• I will keep paying attention to my generosity. There is so much needed that I can be giving.

I hope my long carpet stays very long. I will keep enjoying my life and doing all the things that I love.

I hope you all join me.

Sonia March Nevis is the co-founder of the Gestalt International Study Center in Wellfleet, MA.  
You can read more of her thoughts on the GISC blog: http://www.gisc.org/giscblog/

Pay Attention

As I age, each moment becomes more precious. Here’s the easier part… I lose the color of my hair, and lines deepen down the edges of my mouth. Here’s the harder part… people I love sicken and die. Maybe because of this, I am often gathered more fully into the experience of the present moment.  “This is it”, an inner voice whispers, “pay attention.”

Poets commit their lives to paying attention. In her seventies now, Mary Oliver calls paying attention “our true and proper work.” In her poem “Sometimes”, she offers this directive:

Instructions for living a life:

Pay attention.

Be astonished.

Tell about it.

When elders pay attention to our own experience, one thing we notice is an increased vulnerability.  We may try to hide this vulnerability but ultimately there is nowhere to hide. Maybe we have nothing to lose in showing our vulnerability, and maybe that is what can make us stronger, clearer, and less afraid to speak and act with integrity and courage. Maybe when vulnerability is a shared experience, it connects and strengthens us. Maybe our entire culture could use a huge dose of the humility and strength that arises when we lead with our vulnerability.

I see the groundswell of energy accumulate as my cohorts and I age. Can we harness this awesome energy, and could it tilt our trajectory towards a more viable and sustainable future? Help create a path for elders, and we will blaze the trail ahead.

Bonnie Morrissey practices as a licensed Psychologist-Master in Burlington, VT., and teaches the embodied meditative discipline of Authentic Movement.  www.bonniemorrissey.org

The Essence of Nell

The old people in my family were not hidden away in nursing homes. My great grandmother who lived with her daughter Lucille, was a calm quiet figure, sitting in the shade of a pecan tree, shelling beans or darning socks, never too busy to hold one of us on her lap. As my family members aged it seemed to me that they just became more vivid, more themselves. 

            My own mother, Nell, who had learned early in life how to be a charming and diplomatic southern belle, became more plainspoken as she aged. Even in her nineties, as she faded into long periods of silence, you felt the strong presence of her being, as if the essence of Nell was even more present in her long silences. Her warmth and curiosity shone out of her. And occasionally she would surprise us. The women who came to her home to help us care for her often shared the most intimate details of their personal lives with Nell, knowing their secrets would be safe with her. Once one of them, who had perpetual boyfriend problems, was telling me about going to a Halloween costume party. Her boyfriend was going as a dirty old man. My mother, who had appeared to be napping and who hadn’t spoken a word in weeks, opened her eyes and said, “Then he won’t need a costume.”  

            Last week I went to at a party and met Carolyn, an eighty nine year old woman who lives in an apartment above the general store in Charlotte, Vermont. Climbing all those stairs keeps her strong. She says she tells people she’s in her ninetieth year because it sounds better than eighty-nine. When she left the gathering to drive herself home she turned to all of us and said, “I love you. At my age now, I can say that to you.” 

- Anne Damrosch is a published poet and writer living in Burlington, VT  

Role Models

I count myself very lucky to have grown up with positive models of what growing old looks like. My grandmother, Lucille, lovingly tended her TB afflicted husband for years at home in their small north Louisiana town. But when her husband died, she became an intrepid solo traveler. One day she surprised everyone, just packed her bag and flew off to Paris. My great aunt Helen, an accomplished and eccentric painter and author was married to John, who dropped out of high school at sixteen to take a job. John’s first job was cleaning cages at the Bronx zoo, but eventually he became the zoo’s director. Helen and John flew around the world collecting animals, and fascinating stories, which they recounted over martinis to their wide-eyed grand nieces. I always think of Helen, who was large in every way, dressed in her favorite outfit. She had persuaded my mother to sew it for her, my mother who favored beige cardigans and trim little navy blue A-line skirts. Helen’s voluminously full skirt was made from fabric she brought home from China, printed with giant pandas munching bamboo. She always wore it with a purple vest, red leather sandals and bright green ankle socks. 

 - Anne Damrosch is a published poet and writer living in Burlington, VT  

A Self-Fulfilling Prophesy

We are people living in a culture which anesthetizes birth and death. We birth our babies just as we die, numbed and hidden away behind closed doors, in places most of us fear to go. We hate hospitals and nursing homes because when we open the door we smell the scent of our own fear. We fear death and we pretend it doesn’t exist. Maybe for other people, not for me. Not yet. And anything which reminds us that we are aging, that’s the stuff we make jokes about. For example, check out the birthday card aisle in your local Hallmark store. We fear becoming the stereotype we ourselves have perpetuated: irrelevant, ineffectual, nodding off at meetings. Not invited to the meeting. A self-fulfilling prophesy, we will feel irrelevant if we have helped to create a belief system which marginalizes old people.

           
It has not always been so. If we lived in a more traditional culture, birth and death would happen in our midst, and would give meaning to the rest of the life which happens in between. Old people, who had grown into their roles of midwives, shamans and healers, would be our guides and companions as we make our journey from one life to the next. Aging and death would simply be part of living.

- Anne Damrosch is a published poet and writer living in Burlington, VT