Getting old, being sick, dying—all these normalities of life—have been badly misjudged as something of a mistake, a misfortune, an umglick, a fault, a lapse. Somehow, we have been lulled and fooled into thinking that we are supposed to be above such things as aging. Our social system has it that there be no disorder, no distress, no difficulty that we cannot quickly cure with the right drug, or surgical intervention, the right bumper sticker, or new therapy.
There must be many reasons for such social silliness, for such blatant disregard of the ways of nature. Let us try to begin to think about how it is that we humans are not supposed to have been made of organic life-stuff. All organic life-stuff, we know, ages and eventually dies. All organic life-stuff, we know, suffers disorder and occasional unrest in its very clinging to life. There is no such thing as an untroubled life without misfortune of one kind or another, as we know. And yet, we have been collectively and foolishly convinced that such difficulty is an aberration, a sign of failure, an error to be corrected. But, perhaps even more true, is that we “simply” may not want to die, or to get sick, or to get old—or to think about it.
I believe that (a) the myth of eternal youth is one aspect of our delusion. I suppose because we (Western industrial society) are still a very young culture, we may not yet be ready to think about getting old. Also, (b) we believe anything is possible. The clock can be turned back not only from Daylight Savings Time but also from aging and dying. Because we can erase wrinkles, perhaps we can erase the underlying condition as well. We can do and be and have anything we want. We want to be a girl? So be it. We want to make babies and can’t? We can. We want to fly like the birds? Yes. We want to live forever? Fine. In our modern world, limits cannot be taken seriously. Wish fulfillment takes its place, and not just in dreams, but as a principle in all of life. Could it be said that life itself has become like dreams. “Row, row, row your boat gently down the stream. Merrily, merrily, merrily, merrily. Life is but a dream.” And (c) the dismissal of limits goes even further. The infirmed, the old, the crippled, the too short or too tall, the too thin or too fat, too dark or too light—anyone marked by “imperfection”—has, for the longest time, been kept in the closet. People hate seeing such visual reminders of the possibility of imperfection and failure and call for their erasure whenever possible. Then, (d) in terms of the needs of the economic system (late Capitalism), such persons with such disorders (e.g., aging) yield no advantage to the overall system. If anything, they are seen as deficits, costing the rest of us money and therefore costing us our own security. Finally, (e) economically, a vast sum goes into an industry devoted to eliminating such perceived failures. From drugs to yoga, from machines to diets—billions of dollars are devoted to the elimination or disappearance of the disaster. So there are plenty of reasons for the delusion that aging is a bad mistake.
But, if aging is not a mistake, then it is a natural and normal and expected part of life. And if natural, it has within its experience important virtues, patterns, and lessons. I have felt closer to my wife and my children in my aging. A beautiful day feels wonderful. I value more and more each moment. I read and write as much as possible. I acknowledge the changes, the slowing, the hesitance, the possibilities of injury, the need to take it easy, to rest more, to avoid certain risks. I understand that certain activities are no longer possible. I can’t drive my car. I can’t run, or X-country ski, or carry heavy weights up or downstairs. I can’t swim more than two laps at a time (or any). I won’t go out in bad weather or slip and slide on icy walks. I know I have done all that in my younger time. I remember fondly all the adventures, all the runs, the skiing, the dogs, the excesses, the slipping and sliding, the joys of exercising in too hot and too cold weather. All of that is still fresh in memory. I don’t miss it because I really, really lived it. When I watch a runner, a skier, a swimmer—I don’t feel personally deprived. I remember most fondly all these experiences. They live within. They exist in sweet memory.
And I know the ending is near, approaching, almost touching me. There is mystery in this. I know I am soon joining all those who have passed on, who have died, who have left the land of the living. There is, in this knowledge, much of a mix—some fright, some ignorance, plenty of reluctance, some anxious anticipation, some small welcome bit of a feeling of going home, plenty of guilt toward family left behind. In addition, for me, there is a long-awaited sense of finally, finally, joining my murdered Holocaust family—my uncles and aunts and cousins and nephews and nieces and all their children and their children’s children and all their friends and comrades who were hounded, hunted, rounded up, selected, gassed, burned, shot, slaughtered, eliminated. To join them has been a dark, forbidden, and secret yearning all these years. Now, finally.
Actually, I would like to feel, to experience, to become aware of the aging itself, without the added complication of serious cancer. Natural and normal experience as it is, I want to know it, savor it, have it be part of me. I liked much of being a kid, being an adolescent, being a young adult, an adult—now an old man. Each phase had its own color, design, feel. Each phase required something new and built on something of the past. Each stage, and now old age, traveled in a different and often unusual and unaccustomed direction. Each stage was something of a surprise.
I like getting old because it is new for me. It never happened before in my life although I’ve witnessed it in others. But because it is new for me, it contains a freshness that I find lively and even pleasurable. But that’s not at all how I feel about dying. I really truly don’t want to die. I feel lucky that I’m not in such physical or psychological pain that I would welcome an end to it all. I still have stuff to do, ideas to write about, seasons to experience, children and their children to learn about, the senses—diminished though they are—to light up being itself. I don’t want it to end. I am not yet tired of it all. It’s still such a gift—much of the time. I look out the window in my office—perhaps while talking to a patient on the phone—and I see those tall trees across the Housatonic waving and dancing in the wind or growing and shedding leaves, their colors changing with the seasons, with limbs housing all sorts of birds, glowing in the sun against a dark sky. Such a marvel of life. Why, on earth, would I ever want to leave that? No, I don’t want to die. But getting old is a different matter. As I wrote—it is new. And, also, it’s not death! So, it’s OK with me. I am all for considering the good and the bad of getting old. But I see no reason to seriously consider the good side of dying. Leaving more space for the young? Bah! Humbug! Only if the pain of living is too much to endure would dying become OK.
Unfortunately, however, they go together. Aging and dying. Like tea and crumpets. There is no getting old without the last line on the last page being—and then he died. I’m so sorry it has to end that way. It seems like such a bad idea. I wrote earlier that the body’s design is so excellent that it has needed to change very little over many thousands of years. Well, in one major respect, the design is terrible. It ends in death. I certainly know that a fatal ending is common to all living matter. But our body design could have included—well perhaps just for me, and a few others—no dying.
Certainly, getting old is no picnic. But neither is being born, or being a kid, or becoming middle-aged. Each stage has its own crises, Erikson wrote. He certainly, of all the psychoanalysts, had the right idea about the stages of life. But getting old is no picnic in its own particular way. Many complain about its extreme awfulness, its humiliations, its leakages, its inability to keep inside and outside the body what is meant to stay inside or outside the body, its all too familiar return to infantile helplessness, its messiness, and need for intimate body assistance. I have been in close contact with three people dear to me, all in their 90s, all suffering from various ailments of aging, but all so different. My dear brother, Meyer, at 95—following a fall and hip fracture, very similar to the one I suffered just a few days earlier but, in addition, accompanied by a mild heart attack—found that orthopedic surgeons were reluctant or unable to do surgical repair. He decided he could not and would not live a bed-ridden life. Deciding it was time to die, he withdrew from his medications and expired quietly, surrounded by children and family. In hospital, recovering from my own femur surgery, I was unable to attend my brother’s funeral, an absence I will forever regret. The other two friends, while suffering the limitations of age, both are able to go on with some vitality and plenty of their undiminished intelligence and humor. It is always a great pleasure to be able to be real with them, whether grim or bright—much more so than with most younger friends.
In discussing resistance, Freud wrote that neurotic individuals sometimes choose illness. I wonder about such choice in my own life. I wonder whether I fell and broke my leg bone not only because of severe neuropathy in both feet, but also, unconsciously, because I “needed” to be impaired, laid up, damaged. Over time, I began to feel the advantages of the severe disability I may have brought upon myself and slowly saw that I had altered things, not only in my body, but also in my family. Unable for many weeks to master and control matters at home, I finally began to insist that my children “grow up” and stop harassing me to manage potential financial and other difficulties. Surprisingly, they did “grow up” to a great extent and began to respect the fact of my genuine loss of capacity. I realize some of the difficulty was caused by my own need, in the past, to have control, to take care of all of it, to have a say, to be “the Man.” In the month’s long stay in hospital and rehabilitation following surgery—during which time I was bathed and changed and washed and fed and put to bed and brought to a commode and cleaned and carried about—I was clearly no longer in charge of things, least of all my own body and its needs. I could do nothing but yield, submit, let it be.
An interesting series of events then began to take place. Within the obvious manifest experience of being an infirm old man, I found I was going through an inner micro-life cycle that was completely unexpected. I was living through a kind of infancy in which I was being cared for in the most intimate fashion in my body, in my mind, in my soul. The nurses, their assistants, physical and occupational therapists, cleaning personnel, food preparers and deliverers, the doctors, all were cleaning, washing and wiping me, and changing the bed linen when I soiled myself, and feeding me, and trying to make sure, day and night, that I was not in any distress or discomfort. To my surprise, during all this intimate handling of my infirm naked body, I felt absolutely no sense of embarrassment or shame, something that ordinarily would have forced me to cover up, hide, and make sure no one witnessed my naked, disordered, infantile loss of control over bodily functions. Lovely women and young men were touching and washing me where I was once highly sexually arousable. But I had no sexual feeling, no games, not a moment’s interest in the erogenous sensuality that accompanies all the social-sexual gamesmanship of life. I was living the life of an infant, being cared for in such an intimate fashion without any of the nervous energy of seduction. I believe I enjoyed this caring more deeply than I could have imagined. I remember one midnight, in anger at a night nurse who was acting with much more impatience and brusqueness than any of the other care-takers, I half-deliberately moved my bowels in bed after she said she would help out but forgot to. I felt in that brief moment, the actions of an angry and petulant child wetting or shitting in the bed as an act of defiance and revenge—the simple freedom of a child without manners.
Following a prolonged period of this infantile existence, it became clear to me that because I could no longer walk, the next phase in my rehabilitation involved learning all over again about how to locomote. This ability returned very slowly, painfully, effortfully. And most of the rehab work, on the gym floor, was aimed at learning again, with great effort and some pain, how to walk across a room with a walker, how to move up and down a few stairs, how to get in and out of chairs and bed. Interestingly, during this whole time, I did no reading and no writing. Both reading and writing had been a major activity—more a force—in my life during the 3 years since the cancer diagnosis. But during this period of infancy and toddler locomotion, reading was just simply not going to happen. I couldn’t and didn’t feel like reading and felt not the slightest interest in it. I believed that in the secondary late-in-life internal life-cycle I was living through, language was not yet on the agenda. It might follow learning to walk. And, indeed, that is exactly what is happening. After walker and cane and then walking without assistance, I began slowly to read again—at first magazine articles, then short journal pieces, then parts of books. And writing went apace with walking as well.
There are probably more micro-life-cycle occurrences that are taking place without awareness in all of us. Perhaps such interweaving of major and minor life-cycle happenings is always going on. But my accident and resultant infancy and inability to walk have brought to light the complex and intimate interweaving of aging together with a meaningful and patterned sequence of earlier phases of life. Following infancy, locomotion, and interest in language, I think there is more to come—perhaps an erotic awakening, perhaps a reinterest in other people, perhaps a return to the genuine investment in work. I feel that as an infant, being cared for intimately, I was able—or was forced to be able—to receive the care that I desperately needed. Under the surface of my “successful” adult life, a depression was brewing in relation to cancer and all, and my “accident” brought to me exactly what was needed but what I couldn’t arrange in my life as it was being lived. Illness can lead the way, unconsciously, to important and fundamental healing—at least it seems so in my case. Could this be a function of illness in general, especially in relatively busy, complex, more or less successful lives in this busy complex culture?
Getting old, becoming ill, being a failure, losing out, all may turn out—often enough—to represent opportunities to survive and to live in interesting ways. But one does not experience failure in such a positive way. Failure is painful. It is accompanied by shame, guilt, humiliation, a sense of a life badly lived. And yet, failure is ever-present. In all sports, at the end of the season, one team is the winner, all other teams are failures, every single one. One candidate wins, all others fail. One gets the job, the others fail. One has children who succeed, the others fail. Failure is all around us. Yet it is hard to admit, to accept that one has failed. One may feel in one’s bones that one has failed, but it is very difficult to really acknowledge it. “I feel like a failure,” he said to his friends. “Oh no! Don’t say that. You’re no failure. Look at all you’ve accomplished.” No one wants to acknowledge failure in themselves or in their intimates. And yet, I believe it is difficult to go on without a genuine admission of the realities of failing.
I don’t think aging is a failure. I don’t think of most sickness as a failure. I don’t think of dying as a failure. But there are failings. Not accomplishing enough. Not writing enough. Not making enough money. Not providing sufficient security for one’s family. Not being well known or respected enough. Not having a successful marriage. Not having successful children. Not feeling loved or loving. These are among the failures we fear and are prone to. And the feeling of failure is real and can and should be faced if possible. Because then you can live in the real world, where failing is more usual than imagined. So, we are failures. Not just “feel like” failures. Failures. Period.
For those who started out famous in our mother’s and father’s eyes, failure will have to be a major life theme. Also, it’s a major life theme for those who, for one reason or another—outstanding intelligence or beauty or strength or money or fame or talent—find themselves the center of attention. One can get hungry for such a response. But mostly, very hard work is required to keep that adoration-affection coming. Often, we resort to fantasy wish fulfillment of various kinds. And we feel like failures when the adoration dries up and eventually ceases. What is it to be a failure, at the heart of it? I believe it leads to all sorts of complex compensatory experiences—different in the critical details one from the other. It can lead to a drive to succeed, with good results or with more failure. It can lead to hiding and escape. It wants more than it can have. It has a large appetite for the fruits of success. At its worst, it teaches pain, envy, pleasure in the pain of others; it teaches the intricate ways of hatred; it teaches revenge because the dark side of failure is bitter fruit. And it may take a strong stomach and an even stronger will to face failure as a source of bitterness in oneself.
If failure can be faced, even in small doses, one has achieved a bit of freedom. Such realization of failure also causes one to know that one is no hero, but a small person, unkind, vindictive, sort of a nasty person, at times. Such self-awareness, hard to take, is life serving to the extent that it has truth in it. Failure breeds distress breeds angry and hurtful reactions. Sometimes knowing such sides of oneself makes it possible to react with a bit more flexibility and even with a little friendliness to the unhappy self. You poor ass-hole. On the one hand. On the other, you are an extraordinary work of art, made of star-stuff, a complex ever-evolving, live throbbing being. You are a god. On the one hand, unhappy failure. On the other hand, hero star. Best to stay in motion.
But being in motion will not delay the reality of dying. I don’t want it. I wouldn’t choose it. But it is coming. It will happen. I will die. Facing it straight on may be the best I can do. Farewell world. Once around and done. Farewell.
But wait, before I head out, there is one more thing I want to discuss. It is common for many old people to lose recent memory. A close relative has lost some of his capacity to remember recent events. Me, too, but to a lesser extent. I was just in session with a patient whose memory losses are significant and who spoke of feeling as though he is “in the Bardo,”Footnote1 without signposts, directions, destinations, feeling disoriented, lost, confused. My relative doesn’t speak of feeling confused or disoriented. Each of us is different in the effect of, and overall response to, recent memory impairment. Some are haunted with disorientation. Some redouble efforts to control and in agitation can’t stop thinking, talking, moving, planning. Some hide out in soft hazy depression. Some get bitter, sour, and surly. Some enter a second childhood and allow their playful imaginations free rein. Some can’t tolerate the loss of memory and can’t stop thinking about it ruefully, or talking about it. Some just want to be left alone within their reduced selves. Some write poems. All of us respond in ways built upon and recognizable to our entire personalities. In whichever individual ways we respond, changes in cognitive competence will touch most of us. No big deal for some. Cataclysmic for others. An emergency in family life for many.
The ways in which intimates respond is most worthy of note. A patient of mine was most distressed and angry at the changes in mental and emotional life that correlated with the memory loss in her husband of 50 years. He had been a successful, strong, and proud person, and resented any suggestion that he might be suffering memory loss. He insisted that his wife was projecting her own losses, that she was gas-lighting him, that she was really describing others, that she was ignoring how capable he had always been, and so on. It was a very bad time for them. My patient was unable to accept and was grieving—in anger and in pain—the loss of her beloved partner, her dearest friend and advisor, her funny, ironic, brilliant buddy. She simply couldn’t accept and live with what was happening to him and what was happening to their relationship.
In my own situation, to conclude, we are enormously lucky. Our children and their families are genuinely loving and helpful to us. They show care and kindness and are not (yet) putting us out on an ice floe. We share our large house with our dear son, his deeply helpful wife, and his family; my most divine daughter and her most divine daughter live very nearby and all are ready, willing, and able to help us live as well as we can and to survive the ravages of aging. Many are not so lucky. But many are, and they exist within their complicated families hoping for the best, trying not to despair, trying not to ruin their old age. Such people deserve our respect, admiration, and support—and our sympathy.
OK. Now. Goodbye.
Notes
1 The “in-between.” See: https://tricycle.org/magazine/awakening-bardo/ for a discussion of the various meanings of Bardo in the Buddhist tradition.