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70
Cabbages & Kings
Melvyn H. Schreiber, MD, Editor
70 Much has been written about the joys and satisfactions of old age, most of it baloney. Some writers, having reached advanced age, feel obliged to assure everyone that they are alive and well, healthy and happy, productive and desirable. If that has the good effect of pleasing the author, it is probably worth the effort. Celebrations and markers of various kinds are important in the lives of most of us, representing occasions that define periods of accomplishment, another mountain climbed, another plague avoided. Here are the observations of an aging academic. I finally acknowledge that I am unlikely to grow taller than my puny 5 feet 91⁄2 inches, and I may be shrinking a little, as desiccation overcomes the juiciness of my intervertebral disks. Neither is my hair likely to grow back, though I seem to have stopped losing hair some time ago. It’s all gray or white now, and even middle-aged people call me “Sir.” The grinding away of articular cartilage finally exposes bone to bone, and osteoarthritis (please don’t call it degenerative arthritis) has begun to affect some of my vulnerable joints. Years of less than skillful tennis playing have ruined my rotator cuffs, so the technologists don’t call me any more when they need lifting help. The bottoms of my feet burn all the time, and I’m sure that never-completely-relieved discomfort heralds the onset of gangrene, since diabetes runs in my family. My twice-yearly blood sugar evaluation has always been normal, but where is it written that all my fears must be reasonable. My memory is not as good as it used to be. What seems to be winking out is the memory of names. I have learned to divert my attention to some other subject when I want to remember someone’s name, and it usually comes to me quickly. But concentrating on it is dependably unsuccessful. I’m still okay with numbers, especially my social security number, without which life in modern America is impossible. I carry a card in my wallet on which I have written my Texas medical license number, my DEA number, and the cell phone numbers of my wife and children. I refer to them frequently. But I know from perfect memory the last four numbers of my usually used credit card. I have finally acknowledged that I need not be seen in all the public places I used to frequent in order to maintain either my dignity or reputation. Consequently, I have dropped out of a lot of organizations to which I used to belong, saving the department plenty of money, relieving me of the
922
guilt that used to accompany not reading the journals (they don’t come any more), and having no other deleterious effect I can notice. And I no longer feel obliged to respond affirmatively to people who call to ask me to lecture in suchand-such medical school course. I pick and choose now those I really enjoy doing. The trick is not to say, “I’d love to accommodate you, but I have other plans for the day you want me to lecture.” That never works. They always find another day. Just say a decisive and unembellished “No.” The joys of parenthood have been replaced by the even more exquisite pleasures of grandparenthood, and I understand perfectly those who say that if they had known how much fun grandchildren are they would have had them first. They are truly the consolations of old age. Standing here on the far side of life, realizing that many fewer years remain than have passed, I have decided to expunge other unnecessary impediments to satisfaction and happiness. I have become a stranger to embarrassment, shame, anger, and guilt, sometimes by strong effort, mostly by simple abandonment. I no longer raise my voice to people who try to sell me things over the telephone, no longer bang the phone down on its cradle. Once I realize what’s happening, I just quietly hang up. My hearing isn’t as good as it used to be, but that’s not all bad. I mostly hear what I want to. My vision is good, as is my digestion, and I sleep at night like a stone. Best of all is my professional life. I still work full time and have little interest in retirement, and finally, after all these years, I mostly know what I’m doing. I do not frequently encounter unsolvable diagnostic dilemmas, and I rarely have to think twice about how to perform a certain procedure or to innovate when that is required. I usually know the answers to questions people ask me, and I rarely go home from work any more wondering what that strange thing was that I saw in the colon this morning. On balance, I wouldn’t want it much different. I could do without the burning feet and the tinnitus, but not without the joyfulness that contact with the grandchildren brings or the sweet taste, at last, of competence. Finally, when one is old, one has avoided forever the pitiful observation that “with a little effort he could have made something of himself,” and no one can ever remark that you died tragically young. Melvyn H. Schreiber, MD University of Texas Medical Branch Galveston, Tex
Melvyn H. Schreiber, MD, Editor
70 Much has been written about the joys and satisfactions of old age, most of it baloney. Some writers, having reached advanced age, feel obliged to assure everyone that they are alive and well, healthy and happy, productive and desirable. If that has the good effect of pleasing the author, it is probably worth the effort. Celebrations and markers of various kinds are important in the lives of most of us, representing occasions that define periods of accomplishment, another mountain climbed, another plague avoided. Here are the observations of an aging academic. I finally acknowledge that I am unlikely to grow taller than my puny 5 feet 91⁄2 inches, and I may be shrinking a little, as desiccation overcomes the juiciness of my intervertebral disks. Neither is my hair likely to grow back, though I seem to have stopped losing hair some time ago. It’s all gray or white now, and even middle-aged people call me “Sir.” The grinding away of articular cartilage finally exposes bone to bone, and osteoarthritis (please don’t call it degenerative arthritis) has begun to affect some of my vulnerable joints. Years of less than skillful tennis playing have ruined my rotator cuffs, so the technologists don’t call me any more when they need lifting help. The bottoms of my feet burn all the time, and I’m sure that never-completely-relieved discomfort heralds the onset of gangrene, since diabetes runs in my family. My twice-yearly blood sugar evaluation has always been normal, but where is it written that all my fears must be reasonable. My memory is not as good as it used to be. What seems to be winking out is the memory of names. I have learned to divert my attention to some other subject when I want to remember someone’s name, and it usually comes to me quickly. But concentrating on it is dependably unsuccessful. I’m still okay with numbers, especially my social security number, without which life in modern America is impossible. I carry a card in my wallet on which I have written my Texas medical license number, my DEA number, and the cell phone numbers of my wife and children. I refer to them frequently. But I know from perfect memory the last four numbers of my usually used credit card. I have finally acknowledged that I need not be seen in all the public places I used to frequent in order to maintain either my dignity or reputation. Consequently, I have dropped out of a lot of organizations to which I used to belong, saving the department plenty of money, relieving me of the
922
guilt that used to accompany not reading the journals (they don’t come any more), and having no other deleterious effect I can notice. And I no longer feel obliged to respond affirmatively to people who call to ask me to lecture in suchand-such medical school course. I pick and choose now those I really enjoy doing. The trick is not to say, “I’d love to accommodate you, but I have other plans for the day you want me to lecture.” That never works. They always find another day. Just say a decisive and unembellished “No.” The joys of parenthood have been replaced by the even more exquisite pleasures of grandparenthood, and I understand perfectly those who say that if they had known how much fun grandchildren are they would have had them first. They are truly the consolations of old age. Standing here on the far side of life, realizing that many fewer years remain than have passed, I have decided to expunge other unnecessary impediments to satisfaction and happiness. I have become a stranger to embarrassment, shame, anger, and guilt, sometimes by strong effort, mostly by simple abandonment. I no longer raise my voice to people who try to sell me things over the telephone, no longer bang the phone down on its cradle. Once I realize what’s happening, I just quietly hang up. My hearing isn’t as good as it used to be, but that’s not all bad. I mostly hear what I want to. My vision is good, as is my digestion, and I sleep at night like a stone. Best of all is my professional life. I still work full time and have little interest in retirement, and finally, after all these years, I mostly know what I’m doing. I do not frequently encounter unsolvable diagnostic dilemmas, and I rarely have to think twice about how to perform a certain procedure or to innovate when that is required. I usually know the answers to questions people ask me, and I rarely go home from work any more wondering what that strange thing was that I saw in the colon this morning. On balance, I wouldn’t want it much different. I could do without the burning feet and the tinnitus, but not without the joyfulness that contact with the grandchildren brings or the sweet taste, at last, of competence. Finally, when one is old, one has avoided forever the pitiful observation that “with a little effort he could have made something of himself,” and no one can ever remark that you died tragically young. Melvyn H. Schreiber, MD University of Texas Medical Branch Galveston, Tex