Category: Aging (Page 5 of 6)

January 2023

By Richard Fleming

This post refers exclusively to the common mental lapses of aging. It does not apply to dementia. Dementia is a serious and sad disease that robs people of their identity and self. Many of us have family and friends suffering from dementia. I will write about this condition in the blog at some point, but now is not the time.

Senior moments are unfairly saddled with a bad rap. Brief memory lapses are common at all ages. But labeling them senior moments turns them into a source of ridicule. When a young person forgets a name or engagement, they are chucklingly accused of having a senior moment. Ha ha. When an older person forgets a name or engagement, people often comment with a wry smile, “You’re having another senior moment.”

But disrespect of senior moments comes to an end, right here and right now. I embrace my senior moments. You will see what I mean by the end of this post. And I hope you will come to value yours also. Senior moments can be cute. They are often endearing. And just because their frequency increases as our years accumulate is no reason to view them with disdain.

What causes senior moments? They are probably due to misfires in the electrical circuits in the brain’s hippocampus, where memories are stored. But these short circuits are momentary. Though I was not taught this in medical school, I envision a microscopic team of skilled electricians and cleaners busily reattaching loose wires and sweeping away the cobwebs which accumulate deep in our skulls. Our brain’s nimble repair people help us retrieve memories that are briefly misplaced.

Senior moments are delightful precisely because they are moments. Their duration is brief. Last week, I traipsed forgetfully down the length of the canned goods aisle at Raley’s Grocery Store. I then remembered I was seeking mayonnaise, one row over. See, it didn’t take long. I was at least in the general vicinity of where I needed to be. And I got in some extra walking. A month ago I spent several minutes wandering aimlessly around the dining room. I knew my journey had a purpose but could not recall what it was. Suddenly I spied a lone coaster on the dining room table. This prompted me to remember I had trekked to that room to retrieve the coaster. Mission accomplished. No harm, no foul.

Try telling me these episodes aren’t a bit charming.

Consider your own senior moments. That time you forgot a friend’s name, but remembered it just in time to avoid embarrassment. Or when you couldn’t recall who became president after Nixon resigned. You ended up remembering Gerald Ford pretty quickly, even though you had a small assist from Google. You have to admit these kinds of glitches are kind of cute. Certainly they should not be a source of ridicule.

Any day of the week, I prefer senior moments to senior hours, which I sometimes experience. Senior hours share nothing in common with happy hours, when bars put drinks on sale. They are unrelated to seniors getting discounts at movie theaters at specified times. Senior hours are prolonged memory gaps that take time to clear. Sometimes I cannot for the life of me remember the title of an enjoyable movie my wife and I streamed last week. Or where we went on vacation two years ago. And these missing data points can be difficult to retrieve.

I assume senior hours are due to the brain’s cleaning crew being overworked. Thank goodness they finally manage to make progress and the data I’m seeking resurfaces.

When I forget something these days, I hope it will be a senior moment. But there are times the data remains out of reach, and I simply give up and move on. Sometimes I even forget that I forgot something. If you know what I mean.

Senior hours are still uncommon for me. But they are not rare. I periodically do a mental self-check. How am I doing on Wordle this week? Can I at least get to the Solid Level on the New York Times’ daily Spelling Bee challenge? What was the title of the last book I read for my High Crimes Book Club at Bookshop Benicia?

Fortunately – so far – I appear to be passing my mental audits. But I do wish I could reduce my cleaning crew’s workload or beef up their staffing levels so that I have more senior moments and fewer senior hours.

I hope you now understand why senior moments, in their brevity, are a source of levity more than shame. Try not to forget that our senior moments are actually reasons for optimism.

And the next time some young smart alec condescendingly accuses you of having “another senior moment,” you can respond with confidence, “Hey, whipper snapper, thank goodness it’s not another senior hour.”

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December 2022

By Richard Fleming

The end-of-year holidays are a time of joy. Family gatherings abound. Festive tables encourage gluttony. Crackling fires and warm blankets are an invitation to watch holiday classics on TV. Cold winds blow through the streets, and I shiver and smile when returning to the cozy warmth of home. Hot coffee tastes better on cold holiday mornings than at any other time of year. Joy is defined by our grandchildren running to the front door to deliver snug hugs while whispering, “I’ve missed you so much, Papa” and “I love you so much, Mama.”

Joy.

For the past 10 years, my wife and I have baked holiday goodies in mid-December and delivered them to the eleven houses on our home court in Benicia. When we deliver our treats, we are always repaid with neighborly smiles and thanks. This project was inspired by my mother. She made holiday cookies and cakes for our neighbors in Topeka when I was growing up. It felt like a nice tradition to continue.

This year we discovered our decade of holiday baking has become an ingrained part of our neighborhood’s culture. One neighbor, a lady who lost her husband two years ago, called us after Thanksgiving to say she would be spending the holiday in L.A. with her son, so we should not deliver treats to her in December. But she added she would be back home in early January just in case. Another neighbor asked in early December what we would be making for the neighborhood this year. He then smiled and said, “No pressure. If you don’t bake anything, that’s OK. But…” The comments of both neighbors made us smile. It is not a big project to make holiday goodies for our home court. And the fact it is a neighborhood tradition is satisfying beyond measure.

Joy. It rules the season.

But it is inseparable from its twin, whose name is sadness. As I grow older, I notice sadness plays a larger role with each holiday season.

Joy’s twin reminds me of my parents’ absence. The sights, the sounds, the aromas, the emotions of joyful childhood holidays are imprinted deeper in my brain than memories from random weeks in February or August. My parents were integral to my holiday memories for so many years, even long after I left home. It is during this time of year I feel their absence the most.

Yesterday’s joy is linked to today’s sadness. They are twins. Inseparable.

Joy’s twin also likes to murmur in my ear that my holidays are numbered. And its voice grows louder as each year passes by. Every holiday season is filled with warmth. But each one I cherish means one fewer ahead. The holiday season is too joyful to miss out on. But miss out I will. How many have I still? Four? Ten or twenty? Who can say? Who can know?

Today’s joy is linked to tomorrow’s sadness. They are twins. Inseparable.

As I age, it would be easy to let sadness overwhelm joy. Especially during the holidays. But I fight back. I struggle to understand the lesser twin. I have learned – I’m still learning – to spend some time communing with sadness. To know its depth. To not feel threatened or intimidated. Sadness abides, but does not ask me to forsake its twin. Rather, sadness illuminates the power of joy.

And so it comes to this. I accept that sadness will accompany the holidays. But I stand up for joy.

I think about my children and grandchildren living through another fun holiday season this year. They are creating and embedding their own holiday memories, which will grow richer over time. And my wife and I are integral to their joy. Our kids and grandkids will look back at the delicious feasts we prepared, and laugh at how they ate too much. They will fondly recall us awaiting them in the warm doorway, our arms extended, as they run into our tight embrace. They will remember us whispering in their ears, “I missed you so much” and “I love you so much.” And perhaps they will start neighborhood holiday traditions of their own creation.

Time will pass. Our children, and then our grandchildren, will themselves grow old. They too will experience the holiday seasons with an evolving mix of joy and sadness. My wife and I will be part of their joy. And we will be part of their sadness. Hopefully they will treasure the joy and come to understand that its bittersweet twin means them no harm.

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December 2022

By Richard Fleming

I’ve never been handy with tools. When growing up in Topeka, many of my friends learned how to build things and fix broken gadgets. Their parents taught them these skills. Usually their fathers. It was the early 1960s. Other kids my age learned how to replace door hinges. Attend to leaky pipes. Build small stools for their younger siblings to sit on while watching the old black-and-white.

But not me. I knew how to rake leaves. I could change batteries as adeptly as any young person. But anything involving tools was outside my realm. My parents preferred I focus on mental construction projects. When I had the option to take Mr. Huber’s Industrial Arts class (we called it “shop”) as an elective at Roosevelt Junior High, my parents made me take Art with Mr. Burgess instead. My friends in shop class learned how to use various and sundry tools. They produced small devices made out of wood and metal. Over in art class I learned how to apply random swaths of watercolor to blank pieces of paper. I have utilized the skills I learned in art class exactly never in the past 54 years.

To avoid any misunderstanding, I want to say I admire artists and I love art. Even watercolors. But I must also say my enrollment in junior high art instead of shop class has haunted me my entire life. Actions have consequences.

Over the years, my attempts at repairing broken doors, clogged drains, and malfunctioning toilet flush handles frequently went awry. My efforts to assemble beds from kits and install overhead racks in the garage were exercises in frustration. I usually succeeded eventually, after several trips to the hardware store for advice and strained wrists from using tools incorrectly. Each project took hours to complete, far longer than the instructions claimed.

As my age has increased, my adventures in home repair have become even more difficult. The obstacles are both physical and mental. My body no longer readily contorts into the posture needed to address a garbage disposal which has gone on strike. My neck objects to the prolonged hyperextension required to work on a recessed light fixture in the kitchen ceiling. What happened to the nimble fingers and flexible joints I possessed just ten years ago? When I was in my 60s.

But the cognitive challenges are more humiliating. I recently discovered that in the third decade of the 21^st Century, you learn how to fix broken home fixtures by going to YouTube and searching for videos demonstrating how to proceed. When assembling home furniture kits you need to – listen to this – use your cell phone to scan a little square filled with weird dots which takes you to a video demonstrating what to do! Can someone please tell me how a video on a cell phone’s tiny screen can be the least bit helpful? Whatever happened to simple written instructions with clear diagrams? Honestly, I don’t mind putting on reading glasses to carefully read written instructions on large pieces of paper.

Last week I had to replace a broken spring in a dishwasher door. I dutifully searched for, then watched several videos on this subject. Each described the repair as an “Easy Fix!” or a “Simple 5-Minute Repair Project.” After 45 minutes alternating between trying to dislodge the broken spring and replaying the two most relevant videos, I was making little progress. My knees and ankles were threatening to report me to Adult Protective Services. The videos incorrectly assumed I knew the right tools to use. I just learned what an Allen wrench is one month ago. How can I be expected to know what a Torx screwdriver looks like?

My wife is patient with my difficulties restoring sick appliances and fixtures to good health. She suggested I call someone in to take over the dishwasher door repair job. I was on the verge of doing so when the broken spring popped out of the door (largely of its own accord) and went flying across the kitchen. This miracle allowed me to complete the project after an hour and a quarter.

If I had taken shop class in junior high, no doubt I could have finished this “simple 5-minute repair” in half an hour, leaving valuable time to work on my many pending mental repair projects. Don’t get me wrong, I loved my parents and they raised me well. Overall. But they misunderstood the importance of learning how to use hand tools.

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Now that I’m in my 70s, I see more clearly that the chickens are coming home to roost. This phrase conveys two meanings and both apply to me. First, as most folks know, it indicates we must live today with the consequences of past mistakes. Or to put it another way, those who don’t take shop class in junior high are destined to be embarrassingly inept in home repair projects, and this problem worsens with age.

The second meaning may be more familiar to those of us who grew up on the Great Plains. When chickens come home to roost, they are returning to their shelter to rest and prepare for sleep. At present, I am fortunate to still have a fair amount of energy. And I have many projects yet to complete. But there is little doubt that I too am on the verge of coming home to roost.

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November 2022

By Richard Fleming

There is a funny aspect to old age I did not understand until I suddenly found myself old. Not funny ha-ha, but funny strange. Old age is not a uniform period of life. We enter the land of seniority at age 65, but after that point we travel through three very different worlds. For the sake of simplicity – and we seniors benefit from simplification of ideas – I will refer to these stages as Early Old Age, Middle Old Age, and Old Old Age.

For every individual, the time spent in each stage varies. Some move through at a quick pace. Others linger in one stage before traveling on.

Early Old Age is the exciting period of one’s senior years. It generally starts shortly after retirement, when we are freed from the necessity of going to work. If we are fortunate enough to have good health, a reasonable financial situation, and a supportive family and community, Early Old Age can be quite rewarding. Energy and enthusiasm remain high. We can explore new opportunities. Schedules loosen up. A typical day might open with a slow coffee or tea while consuming the news. Those of us lucky enough to be grandparents often spend gratifying time babysitting grandchildren. The day’s errands and chores can be completed at a leisurely pace. Or they can be put off until tomorrow, since tomorrow’s schedule looks pretty wide open. Travel options expand. Opportunities for volunteer work open up. When our adult children mention how grateful they are for an upcoming three-day weekend, we can nod empathetically while silently reveling in our seven-day weekends.

But time marches on. After dwelling for a while in Early Old Age – perhaps just a few years, but hopefully a decade or so – we move into the Middle Old Age period. I feel I’m on the cusp of entering this second phase myself. Hallmarks of this time of life are both physical and mental. Our bodies begin to more clearly assert their limitations. Aches and pains in various and sundry locations become more common than in Early Old Age. Energy levels drop. Motivation flags. Home projects are harder to complete. Especially those we put off when our schedules were wide open in Early Old Age. Folks traveling through the second stage of old age come to realize if they have a doctor’s appointment next week, they don’t have time to clean the garage today. Tomorrow looks pretty dicey too. As for babysitting duties, we still love seeing our grandchildren… but folks in Middle Old Age find caring for rambunctious young humans to be more, shall we say, draining than previously.

Mental acuity diminishes. We forget people’s names more easily. We frequently go into another room for some reason, but after getting there we forget why. To do this once in a day may not be significant. But twice in one day confirms the diagnosis of Middle Old Age. And financial concerns often increase during this phase of senior living.

In Early Old Age, denial can be useful, even healthy. But Middle Old Age brooks no compromise and no negotiation. Aging’s reality sinks in like a 40 pound weight in a quiet pond. Or – resorting again to idea simplification – the Golden Years inevitably transform into the Fool’s Gold Years.

And then. No matter that we eat right and exercise. No matter how nice we are. Old Old Age sooner or later comes to embrace us with its firm hug. In this final stage of our senior years, physical and mental limitations dominate. Our time spent in hospitals and doctors’ offices expands exponentially. Medication trays become an absolute necessity. Our ability to travel, volunteer, spend time with friends, all rapidly taper. Instead of babysitting grandchildren, people living in Old Old Age are often the ones requiring babysitters.

This stage of life can be peaceful or painful. It can be serene or it can be stressful. Commonly, it can be a combination of all. Daily activities become restricted. We spend more time contemplating our legacy and what we will miss out on as our children and grandchildren grow up and grow old. And we start to wistfully look back on our years in Middle Old Age. Back when we could live life much more fully.

It is this prospect of living in Old Old Age that I find truly daunting. I hope when I stand in the doorway to that final phase, I will be able to look forward, breathe calmly, and enter gracefully into that uncertain land with a sense of peace.

But I tell you frankly I’m just not ready. And let me add that I’m not sure how I’ll ever get ready.

Wait. Let me not get ahead of myself. (That is the worst thing one can do while growing old.) As I mentioned before, today I stand on the threshold of Middle Old Age. The land I will be entering presents its own set of challenges. I struggle to accept what these coming middle years will bring.

Thankfully the door which will one day usher me into Old Old Age remains a distant image, closed and locked. But it is not a mirage.

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November 2022

By Richard Fleming

I never imagined I would evolve into a crotchety old man. It was not on my bucket list and I’m fighting this archetype. The battle is joined, the outcome uncertain.

When I was young, I envisioned maturing into a suave, sophisticated, silver-haired older gentleman. This goal was wildly optimistic. Clumsy and awkward are better descriptors than suave and sophisticated. My hair is mousy gray, not silver. And I’m becoming a mite irritated with young people.

Apparently my struggle against becoming a cantankerous old guy continues.

In my own defense, my grouchiness is selective. There are many aspects of youth I admire and respect. Their energy. Their enthusiasm. Their curiosity. Their ability to lift heavy objects which would guarantee me a lumbar disc herniation if I attempted such a maneuver myself. I could not survive in the manner to which I am accustomed without the support and spirit of the young.

However. Young people uniformly manifest one of the most irritating traits known to humankind. In doing so, they defy longstanding precedent and the expertise of their elders. The persistence of this annoying habit may yet transform me into an irredeemably irritable senior citizen. If your year of birth precedes 1972, you know the negative attribute to which I refer. It is young people’s infuriating obsession with using their thumbs to type.

In case you are mystified by my irritation, let me explain. Please look down at your hands. Two of your ten digits are wider and thicker than the others. They have two joints. They are clumsy. They are called thumbs. Now observe the other eight digits. They have three joints. Their tips are thin. They are lithe and flexible. They are called fingers.

So far, so good. I’m trying to remain calm.

From time immemorial, there has been a division of labor between thumbs and fingers. Thumbs, intrinsically awkward, serve principally to stabilize the hand’s grip. Occasionally they engage with large objects, like the space bar on a keyboard. But they are too large to take on detailed activities independently. Fingers, intrinsically agile, are used for actions requiring dexterity and accuracy. There is a reason flautists avoid playing their instrument with their thumbs. The thumbs support the flute. They cannot create the music.

Another example. When reading War and Peace, we rely on our most discriminating finger to turn the 1,225 pages. The second finger is the most precise digit. Doctors refer to it as the index finger for good reason. The thumb can play an auxiliary role in turning pages, but the index finger takes the lead. Trust me on this. I passed anatomy in medical school in 1972. Human anatomy has changed little over the past half century.

OK. The structure and function of our ten digits has now been scientifically established.

Cutting to our current problem, young people decided some time ago to ignore the wisdom passed down from their elders and deploy their thumbs to the task of typing. And they do so on microscopic cell phone keyboards. Older and wiser folk opt to use their fingers – or more commonly their dominant hand’s index finger – to type slowly and carefully on cell phone keyboards. The results are wondrous. Few misspelled words. Punctuation is crisp and clear.

For young people, typing with the thumbs generates myriad problems. Misspelled words abound – “ur” instead of “your” or “you’re,” “n” instead of “and.” How does “to be honest” end up as “tbh”? And excuse me for asking, but what became of periods and commas in young people’s writing? Is capitalization a crime? My index finger never misses the period or comma keys. It never views the capitalization key as an inconvenience.

Truth be told, I long for the days of typewriter keyboards. Sixty words a minute was a snap. All ten digits knew their roles. Written words could be produced quickly, easily, and accurately.

But nostalgia holds a faint candle against the winds of change.

As I continue my journey, I pause to contemplate two diverging paths ahead. To pick one route means sticking with the world we older folks created. To take the other requires accepting that young people are creating the future.

Taking the first path will feel more comfortable, initially. But I fear I will become the grumpy old man I’m trying to avoid. If I choose the second path, I may feel awkward. But I will come to accept that young people are the ones constructing our new world. They are creating many new approaches to living and doing their best to solve the myriad problems we older folks created. If I am lucky, I may get to live in this new world for a while, as a calm older man. And I can try to help clean up some of the messes made by us older folks.

I hesitate a moment more. Which path will it be? The sun is coursing westwards and I must make my choice. Slowly at first, I place one foot in front of the other. My pace picks up as I decide to acknowledge the oncoming generation. It is time.

And this choice apparently requires I start typing with my thumbs.

tbh im jus sayin u no

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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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September 2022

By Richard Fleming

Despite my age, or perhaps because of it, my understanding of what it means to grow older is evolving. I will open by deconstructing this phrase. Growing means developing, expanding, increasing in size or substance. Older means more advanced in the years of life.

Growing older is best understood contextually. In my youth, I embraced it enthusiastically. Growing older meant a driver’s license. Voting. College. Marriage and family. An interesting field of work. Travel. For the young, growing older is aspirational.

But youthful exuberance carries an expiration date. At some point in each of our lives, growing older loses its luster.

For me, this transition happened in my 50s. The idea of growing older became daunting. Turning 60 or 70 was less appealing than turning 20 or 30. Further, I failed to understand how people could grow old. Aging seemed the antithesis of growing. People became old. We attained old age. Actually, as we aged, growing ceased, replaced by diminishing. Diminishing height, stamina, cognition and, importantly, skin texture and elasticity. Our bodies may expand and increase in size or substance, true that. But aging seemed more a process of running down than of growth.

I formulated two theories to explain the fallacy of linking the concept of growing to aging. First, perhaps the term growing old arose from an unintentional mistranslation of Old German root words many years ago. Or second, it was intentionally developed as an ironic device to insure senior citizens know we are no longer evolving in a positive and useful way.

Fortunately my ability to learn and adjust persisted. As I reached my 60s, my understanding of aging continued to develop, thanks to lessons from those older and wiser than me. I reflected on the fact this phrase, growing old, has been in widespread use for centuries. Its longevity suggested it rested on a solid foundation. Was there a path that could help me understand that aging is – scientifically speaking of course – a growth process?

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During decades of family-building and work, one’s time is constrained. While they are years of growth, they are also years restricted by sturdy fences. The highest level action items are helping one’s family and contributing to the Social Security Trust Fund by remaining gainfully employed. Other activities rank lower on the priority scale.

As people attain higher levels of seniority in the job of life, their energy and fortitude lessens. Multiple well-performed medical studies offer confirmation.

But – assuming their health allows – people also have more freedom. Barriers which delimited family and work responsibilities become weathered and worn. Some of the fencing collapses. And new vistas emerge.

I thought back over my years practicing medicine and recalled many of my elderly patients becoming first-time photographers, book club members, overseas travelers, knitters, exercisers, community volunteers. They became mentors to troubled youth, part-time teachers, learned new cooking skills, got politically involved, took online courses to learn about medieval history or modern art.

Objective scientific assessment could only conclude these elderly people were growing. And, yes, they were growing older.

Unfortunately, not all senior citizens embrace the opportunities which open as the years accumulate. Some are unable to because of physical limitations. But others opt to rest after many decades of hard work. Or they prefer to dwell in the seductive lands unspooling on television and social media. They are getting older but not growing older.

*    *    *

I continue foraging  down the path. Day by day, step by step. As I do so, I have learned what lies ahead is not strictly a process of simple subtraction. The equations of my future years can incorporate the process of simple addition.

And this is already underway. Since retiring, my wife and I travel more. We volunteer for Meals on Wheels. Spend more and better time with our grandchildren. Are active in voter turnout efforts. We gave Covid-19 vaccines at a local community clinic for six months. I teach medical students. Exercise more consistently. Joined a city commission on sustainability. Started a blog.

Of course some growth activities remain off limits. I refuse to sign up for art appreciation classes. Learning to crochet is not on my bucket list. Ballroom dancing is a dicey proposition because I would like to avoid fracturing my wife’s foot bones. The jury is still out on pickleball.

But novel opportunities abound. My challenge is to pick wisely among them.

Thanks to my fellow travelers, I have come to understand that whether to get old is not a choice. Whether to grow old is.

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September 2022

By Richard Fleming

An unusual feature of aging is the rapid acceleration of time. Each year goes by quicker than the preceding one. And much faster than those we lived through 5, 10, and 20 years ago. Astrophysicists advise us that time is not a fixed concept. As an object accelerates and approaches the speed of light, time slows down. And conversely as that object slows down, time moves more quickly. So it should not be surprising that for humans too, as we grow older and our rate of speed slows down, time speeds up. It is just basic astrophysics.

In my early years of practice, older patients often told me about this phenomenon. Most presented it as a complaint, a discriminatory experience. People in their 70s and 80s said how unfair it was that time accelerated as they aged. Time should be prolonged, not abbreviated. I sort of understood what they were reporting, but it did not really hit home until I was around age 50. After I had accumulated a half century’s worth of living, I began to notice this basic principle of astrophysics applied to me also. The interval between major holidays appeared to shorten. The time between birthdays shrunk noticeably.

Seasons began to fly by. In the old days, autumn – my favorite season – would shape the land for three months or even longer. When I was young, I loved to be outside as the temperature gradually cooled and leaves lazily turned to red and gold. Trees slowly shed their ornaments, and birds I had seen throughout the summer flew off and away. My friends and I played touch football in Topeka’s Edgewood Park, a short walk from where we lived, and the games seemed to go on for hours. Dusk gradually came earlier, but each day lingered for hours.

As I grew older, I noticed autumn growing shorter. No sooner did I start enjoying the magical fall transition than it was over. Trees grew bare quickly. The world assumed the gray hues of winter before autumn even matured. Time accelerated before my eyes. In grade school, an autumn weekend day would last forever. Now that I’m in my 70s, these same days vanish before I even take a deep breath.

There are other ways to understand the startling compression of time as we age. For example, when I took American history in high school, the country’s existence seemed to extend back for centuries. Because that was actually true. So much had happened. We studied our country’s major military conflicts, including the Revolution, the Civil War, and two World Wars. These conflicts were meaningful parts of our history, even though they were so ancient.

But aging casts the unspooling of history in a different light. I recently realized I have been alive for 29% of the total time the U.S. has existed. I have been breathing, living, and walking the earth for well over one quarter of the years since the country’s founding. (Am I being optimistic or pessimistic if I round this off to about one third?) I’ve been alive 45% of the time since the Civil War. That is close to half! It turns out the Civil War did not end all that long ago. OK, since I’ve piqued your curiosity, I’ve been alive for 68% of the years since the end of World War One. Don’t even ask about World War Two.

What happened? Where did time go? There are so many things I’ve been intending to do. I need to face the reality I won’t have time for them all. So many books will go unread. Those novels incubating in my brain will go unwritten.

I’m not full of despair, though. Not at all. I have done many things, seen many places, and read many books. I had a rewarding career. I’ve maintained many friendships, including a group of friends from Topeka I’ve been close with for over 60 years. I’ve been a good husband, step-father, and grandfather, and am proud of the family I’ve been part of building.

But there is always more. Always so much more. Why didn’t I manage my time more efficiently? Why didn’t I listen to those wise elders who told me a few decades back to not wait on things I wanted to accomplish. Or did they offer that advice just a few years ago? Time is amorphous, unstable, illusory. Clocks try to fool us. Calendars are deceptive and dishonest. Wristwatches are liars and cheats. Trust me when I say that none of these markers of time can be trusted.

So what lessons can I draw? While I wish my years ahead would be more and longer, I am where I am. Aging is helping my ability to focus. I will concentrate on fewer, more meaningful goals. I have months and years ahead and much life yet to live. I have memories still to create, both for myself and my family. And when my time comes, these memories will be the main legacy I bequeath to my family and loved ones.

Yes, it would be nice if time would slow down as though I was approaching the speed of light. But it can be fulfilling and rewarding to live fully at the speed of life.

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August 2022

By Richard Fleming

It may seem strange, but I feel I missed middle age. What happened? Where did it go?

I’m 71. For most of my life I have felt fairly young. I have been full of energy and confidence. Life was rich with possibilities. Middle age always seemed a nebulous concept, off in the distance. It was the gateway to old age, and I certainly did not feel I was approaching that threshold. Middle aged people lacked energy and mental acuity. This was not how I saw myself. While I didn’t spend a lot of time dwelling on precisely when middle age started, it always seemed to be five or ten years beyond my age at the time.

When I was in my thirties, middle age seemed to apply to those 50 years old and above. In my mid-forties, I still possessed vim and vigor. I assumed middle age would probably hit in my early fifties. But when I reached my early fifties, I certainly did not feel middle aged. It seemed middle age might drop onto my shoulders when I hit 60. You know, the age when folks often start having more aches and pains. When they become less sharp and snappy. But when I made it to 60, I still did not feel middle aged. I was blessed with good health and an active mind. I did not feel I was standing on the threshold of old age, and decided middle age must start around age 65.

It was when I applied for Medicare shortly before turning 65 that the erosion of the brick wall of denial began to accelerate. I looked in the mirror and the marks of a long life, well lived, were etched permanently on my face. My stamina remained reasonably intact but I noticed yard work was more taxing. It was increasingly hard to think of myself as a mature 50 year old. Reality forced me to accept I had finally left the realm of youth. And decisively so. My Medicare card brooked no equivocation. My game of dodge ball was over.

And I began to see increasing instances of newspapers and other media identifying “seniors” and “the elderly” as those 65 and above. Sometimes even 60 and above!

Truth became even harder to avoid when the covid-19 pandemic hit. In discussing risks from covid-19, news sources identified those 60 or 65 and above as being at highest risk of complications. This age group – my age group – was being labelled by physicians and epidemiologists as elderly! Wait, I wanted to shout. How could members of my own profession, physicians, betray me in such cavalier fashion? I was just beginning to accept that I might be entering middle age. Was I expected to suddenly, with no advance warning, accept being viewed as a senior citizen? Something was desperately wrong here.

As I reflect back on why I missed middle age, I think it is because the idea of middle age gets precious little respect. Youth is a valued concept. Young people are full of energy and potential. They enjoy their lives with few limitations. They are the engines of our culture, society, and politics. They are the genesis of our future.

And as far as seniors are concerned, they too are treasured in many respects. They are solid and stable. They serenely carry the weight and responsibility of history. Sometimes they are viewed as wise. And they are exempted from many societal responsibilities, like working, building families, and paying into the Social Security Trust Fund. They even get discounts at movie theaters.

But middle aged people? For too long, I thought they had little value. They had lost the virtues of youth and were yet to acquire the dignity of the elderly. They lingered precariously at the gateway between youth and old age, looking wistfully back at a past which cannot be reclaimed. And yet they were also not eligible to apply for the benefits and respect accorded the golden years. Who would want to claim the mantle of middle age?

But wait. Now that I am an officially-certified senior citizen, I feel much more positive about the virtues of middle age. Those inhabiting this oft-neglected stage of life’s journey survived the impetuosity and risk-taking of youth. And… they are not yet elderly. Though senior citizens are intrinsically virtuous, there are unavoidable downsides to the golden years: mental and physical frailty, financial insecurities, constricting social circles. And a dwindling desire to take advantage of senior discounts at movie theaters.

I have now decided I was wrong to view middle age as the crazy uncle in the attic. Each time of life is precious and should be cherished, even middle age. In fact, I’m beginning to consider claiming the identity of middle age for myself. Just as the entry point into the middle years is poorly defined, the exit point of middle age is also murky. Maybe I’m not too late.

But no, this would not be a viable claim. It’s time – nay, it is past time – to accept my station in life. I am unavoidably, irretrievably, irredeemably, old. I need to come to terms with this reality. Middle age is receding in my rear view mirror.

Who knows, maybe I’ll set a stretch goal. What if I move beyond tolerating being old to actually embracing this stage of life? Many of my elderly patients were able to do so. Why shouldn’t I?

Therein lies my challenge.

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