Month: October 2022

October 2022

By Richard Fleming

Autumn is a cautious time. A period of transformation. Nature presents its most vibrant hues. But it pauses to reflect on what was left behind, and what may lie ahead. It is a season of beautiful uncertainty.

Fall was always my favorite season, but I have taken it for granted for many years. Life was busy. Time in short supply. Autumn came and went, year by year, barely gaining my attention. And before I knew it another fall had disappeared. Year by year.

But now I find myself re-considering the magic of autumn. I am not sure why. Maybe it is because I’m more accepting of my post-work reality. I am fully aware I will no longer be ministering to the sick. The profession I spent so many years preparing for, and so many years practicing, is receding into my past. Or perhaps it is my increasing awareness the autumns ahead are numbered. Their appearances will not be few, I hope, but neither will they be bountiful. As I reflect on years gone by, anticipate the future, and audit my changing sense of self, I feel a need to recapture this precious season.

I am spending more time outside. I see changes unfolding with a different pair of eyes. This fall does not resemble those from the past. Why? Are my memories fraying? Is the way I perceive the world altered? Or is fall itself changing?

In our backyard, a pair of hummingbirds is intently drinking sap from the autumn sage. They are preparing to fly to parts south, hundreds of miles away. Will they make their journey safely? Will this same pair return next year? We have had hummingbirds for years. But this fall, for the first time, one started hovering outside our dinette window for long minutes watching my wife and I drink our morning coffee. Is it saying a final goodbye? Is it asking why we aren’t also preparing for the journey ahead?

The squirrels seem preoccupied this fall. They have long used the top of our back fence as a roadway, ambling from one side of the yard to the other at a leisurely pace. This fall the fence has become their superhighway. They madly dash from one end to the other as though time is short. Do they know something I do not?

The wisteria sheathing the arbor in our side yard is challenging my recall of autumnal transformation. It is continuing to bloom in purple beauty, even as the days grow shorter. This never happened before. Or is my memory leading me astray?

Then there is the honey locust we planted behind our house three decades ago. It is beautiful in the summer, though it starts dropping leaves in late August. By mid-September its branches are typically bare, before the birches and maytens shed a single leaf. This year its leaves began dropping in late August as usual. But two weeks later, the leaf fall ceased. The tree retained half its foliage for weeks before it finally resumed carpeting the patio beneath. Trees resonate with the world around them. Is the honey locust hesitant about what is to come?

California autumns are muted compared to those in Kansas, where I grew up. Fall in Topeka was heralded by thousands of elms and oaks, maples and sycamores, appearing to catch fire. In the Bay Area of the Golden State, the fall colors are less vibrant, but a vivid feeling of change is carried on the wind. The realization that summer’s passion is coming to an end cannot be avoided. And the gray, diminished season ahead is visible on the horizon.

As I enter the early years of my eighth decade, I live in the transformative days of autumn’s time. I look back and see the spring and summer of my life. Many pleasant seasons filled with growth and development. More accomplishments than mistakes, though there were full measures of each. I look around and see much to be thankful for. But there is also a looming sense of closure. When winter will come I do not know.

So I will immerse myself in my personal autumn. I will appreciate beautiful days with family and friends. I look forward to treasured time with my third grandchild, due in December. I will relish some great novels. I will spend more days traveling down the road, observing the trees, marveling at nature, contemplating the trail ahead. I will fondly recall the brilliant autumn colors of my youth and treasure the subdued autumn days of my present.

I am living with the beautiful uncertainty of growing old.

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October 2022

By Richard Fleming

Scientists are gradually unravelling the mysterious biology of human aging. DNA becomes damaged. Cells lose their ability to replicate and repair themselves. Telomeres, the regions at the ends of chromosomes, shorten. But a confounding aspect of the aging process is that different organs and body parts grow old asynchronously. Some age more rapidly. Others more slowly. For each person, the differential aging speed of body parts varies.

According to my birth certificate, I am 71 years old. But I am made up of various components. Each regularly communicates with my brain. Some proclaim their youthful vigor and demand gratitude. Others ask for accommodations because they are older. Juggling these competing claims can be challenging.

Two of the oldest parts of my body are my ears. For all intents and purposes they are pushing 87 years old. They disdain and dismiss the rich world of sound encircling me. And they try to distract me with a constant hissing noise. They insist I lower my expectations for auditory enrichment and demand I provide them hearing enhancement devices.

My eyes, myopic and with increasing floaters, celebrated their 75^th birthday when my birth certificate said I was in my 50s. But thankfully, and for no apparent reason, the premature aging slowed. Their performance level stabilized, neither improving nor diminishing further. They now appear to be biding their time until the rest of my body catches up. What my eyes will choose to do when I officially turn 75 is anyone’s guess.

My right first toe is far older than its nine compatriots, thanks to a 50 pound marble table slab doing a header on that toe many years ago. (Please don’t try to replicate this maneuver at home.) A broken bone and damaged nail bed will definitely accelerate the aging process. For the most part, the other nine toes tolerate the older digit. But some days their patience wears thin, at which point I have no option but to sit down.

On the other side of the ledger, my mouth and tongue remain quite youthful. They relish good food and drink as much now as many decades ago. Truth be told, I sometimes wish they would age a bit more quickly. But they are living life on their own schedule and their enthusiasm requires I spend more time on the elliptical in the garage.

Some organs are reticent about proclaiming their age. My heart, for example, has diligently performed its duties for 71 years with no significant protestations or announcements. My best guess is that it is about 55 years old. But who knows? Tomorrow it may divulge its age is 80. I’ve never been one to object when people or body parts are bashful about revealing their true age. I prefer to let sleeping dogs lie rather than wondering who let them out.

I could offer an inventory of other body components, but doing so would quickly devolve into the swamp of TMI. Suffice it to say my birth certificate does not accurately capture the differential calculus of my aging body.

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One arena of variability in bodily aging holds greater importance. It first came to my attention when I was in practice. My older patients often reported their surprise when they looked in the morning mirror. In their brain they felt they were 30 or 40 years old. But the mirror told them they were 70 or 80.

In my early years of practice, I sympathized with these patients. I blithely reassured them this disconnect between mind and body was common to aging. Sympathy was easy to express when my personal experience with the mind-body discrepancy was limited. But as my years in practice accumulated and I traveled further down the road, my approach began to change. I stopped sympathizing with my older patients and began empathizing with them. Empathy more accurately expressed my resonance with my fellow travelers.

Sympathy can be hollow, pro-forma. Empathy is genuine, heartfelt. When it comes to understanding aging, sympathy and empathy are separated by the date engraved on our birth certificate.

In an ideal world, perhaps human aging would be better coordinated. Each organ would grow old in synchrony and harmony with every other. But, as reality clarifies for us on a daily basis, we live in a less-than-ideal world.

If I could choose one organ to age more slowly, it would of course be my brain. I would like to preserve my ability to converse with my grandchildren in a stimulating way for years to come. I would like to listen to great music in the 2040s, wearing hearing aids of course. I want to be able to read poetry, even when my knees will no longer let me stand.

But there are downsides to a 40 year old brain inhabiting a 90 year old body. The brain’s understanding of what lies ahead grows increasingly bittersweet and profound. While opportunities for living remain, the frame of time is visibly shrinking. Some potential persists, but much potential is lost.

As we trudge forward, our powers of clairvoyance improve. We gain the ability to predict our future. We come to know that full synchronization between our brain and our various body parts lies ahead. When that time comes, our birth certificates will gain precision. And the differential calculus of growing old will confound us no more.

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