Aging is Isolating

If These Old Hands Could SpeakAging is isolating. Friends move away, effectively disappear, or die off. Others drift out of the relationship. We spend less time together. The younger ones appropriately have their own agenda. It is their time to take care of themselves. Furthermore, they may have already learned what we have to offer. It’s time for them to move on and build their own life experience. Moreover, things have changed since you and I were their age, in some ways drastically. Consequently, some of the things we have to offer them are less relevant.

So what can we do? How can we address aging? One thing is certain, our time here on Mother Earth is limited. Since that is part of our reality, one thing each of us can do is do our best to take care of ourselves. By doing that we will be less of a burden on others and less of a drain on society’s resources. Another is to pay attention to our limitations. We can’t do everything and certainly not as much as we used to. I can certainly vouch for that.

We can start by admitting to ourselves that we have a finite time left here on earth. Each of us has skills and experience. We can use them to the best of our ability to take care of ourselves and to continue to make a contribution. It is a good time to decide what is important, to figure out what we really want to accomplish in the relatively brief time we have left, and what we would like to be remembered for.

Think seriously about your relationships with others. Do you have any issues with those who are still alive, where by doing or saying something now could make a difference? We can all start by acknowledging our errors. And perhaps saying, “I’m sorry. What I did was inappropriate. I certainly didn’t intend to cause you any pain or harm.” Those are some of the things each of us might consider doing while we are still alive. This is not just good advice for the old, really none of us knows how long we will live.

In that way, when we leave, and trust me we will, our departure will make things easier for those who we leave behind. 8033522652_97090eabda_oAging is part of a larger process called life. If we go through it, we are the lucky ones.

Aging brings along with it some other things. We are less mobile, feebler, more likely to forget and less able to take care of ourselves. That makes us more of a drain on others, on their time and energy. It also makes it harder for us to take care of ourselves. If others choose to devote some of their time and energy to support us, the least we can do is say, “Thank you.” It is important to remember that the care provided in our declining years also places a greater drain on society’s limited resources. For example, it leads to fewer resources being available for children’s education, for developing new ideas, or for anything else. Hopefully, each of us has put enough funds aside to reimburse those for the services they provide.

I find myself sleeping longer, taking more time to do things, and making more errors. How about you? All that takes time away from our limited time — the 24 hours in a day. That includes the time involved in maintaining contact and communicating with others, in maintaining relationships. I realize there may be a time when I can no longer drive. In order to get together, friends must come to see me. That will further limit contact and contributes to the isolation.

It is harder to make new friends. There are simply fewer people around with common experiences. My friend Jeanne is five years older than I. In our phone conversations we treasure the fact we can discuss the “good old times,” including the songs we share. Younger folk often have no recollection of them.

Often us older folks are not familiar with today’s ways of doing things — including the new ways of staying in touch, of communicating. When we grew up we did not have computers, cell phones, iPhones or smartphones. They simply did not exist. When you called someone, either the phone rang and rang; or you got a busy signal; or they answered and you spoke to them saying who you are. You talked to a real person. Today, more than likely, you are talking to a computer. It pretends to be listening and has its own preprogrammed way of doing things. How frustrating and time-consuming that is. It takes away from your limited time and energy, often without successfully accomplishing what you intended, leaving the problem unresolved. Boy, is that frustrating.

Here’s another example. You decide you want to give someone a call. You can’t remember their phone number. The old way of looking it up in the phone book doesn’t work anymore. They’ve moved and kept the old number. The area code tells you they are living in Richmond and you know they live around the corner. Oh, you forgot, they now carry their phone with them. Unlike the old days. Now you know who I am without my saying anything. You know where I am, but I have no idea where you are. Or, the only way some people communicate is by e-mail. That’s no help. You don’t have, or can’t use a computer, an iPhone or a smartphone. Perhaps you call and all you get is their answering service. Apparently they never check it. In any case they never get back to you. Even if you’ve heard about texting, you don’t have the equipment or the know how. It’s all so complicated, so frustrating. From your perspective it is a waste of your time, draining and unproductive. It contributes to the feeling of isolation.alone

Those are just some of the hassles of being an older person living in today’s world. They create obstacles even when you have no infirmities or disabilities. As we get older, as with any other complex machine, the system is likely to breakdown. The longer we hang around, the more likely that becomes. Add that to the mix, and things become even more complicated. It is harder to achieve our objectives or even to take care of one’s self. In fact, that may even become impossible.

All that, as well as the realization of it, leads to one conclusion, “Aging is isolating.”

Stepping back, however, there is a bigger picture. The fewer relationships we have — that is what isolation is all about — the less of an impact our dying will have on others. By pulling back in the relationship with us now, others are effectively going through part of their grieving process. That is only true, however, when they have already dealt with any “issues” that they have in their relation with us older folks who are still around.

Should I Enter a Clinical Trial–Part Four

What to Consider Before Deciding

choiceIntervention is frequently based on the medical and public perception and assumption that doing something is better than doing nothing. That is not always the case. There are times when the net benefits of all interventions are negative — that is, anything you do will make you worse off.  Rather than starting with the underlying philosophy, “You/We should be able to do something that will fix it” begin by asking what are the likely benefits and costs of each of the alternatives. Then chose the one where the net benefits — the benefits minus the costs — are likely to be the greatest. Take no action when that provides the best results.

When the patient/consumer is not paying for the service, he/she is placed in the position of not having to consider what they are giving up when having the procedure. When that happens they are more likely to elect to have more services than they would if they had to pay for them. Historically, that goes under the name “Moral hazard”. Moreover, the prescribing practitioner and the PhysicianFirm almost always benefit from the additional revenue they receive from providing those services. Often it is someone else, like an insurance company or the government, who ends up paying the bill. Continue reading “Should I Enter a Clinical Trial–Part Four”

Should I Enter a Clinical Trial–Part Three

An Example of What Happened

We would like to provide a concrete example about the consequences of participating in a clinical trial. It is based on Amanda Bennett’s The Cost of Hope. She is a fine journalist and currently Executive Editor of Projects and Investigations at Bloomberg News. The book documents her husband, Terence Foley’s, seven year bout with kidney cancer. Initially, Foley was diagnosed with an atypical and aggressive form — collecting duct kidney cancer. It was spotted in December 2000 during the operation to remove his intestines to treat his ulcerative colitis. There were only 50 known cases of it worldwide at the time. This alone makes questionable whether his participation in the clinical trial contributes to our understanding of the potential benefits for future patients. In January 2001 when it was diagnosed, the prognosis was that he had a few months to live. [Bennett, p. 66] He died of it seven years later in December 2007. Continue reading “Should I Enter a Clinical Trial–Part Three”

The House I Grew up in

bernie's houseAbout a month ago Grace Camblos, a biographer, photographer, and author, invited me to participate in a four week memoir writing class.  One of the “prompts” she gave to us was to write about, “The house I grew up in.”

I remember it well. The address was 144-15 33rd Ave., Flushing, Long Island, NY. We moved there in about 1938. It was a two-story house with a finished attic and basement and was the third of three houses on the block. They were the first of many, built by Abraham Levitt, who went on to develop Levittown on Long Island and in Pennsylvania.

I was 14 in September of 1942 and I just got back from eight weeks at Camp Man, the Queens County summer Boy Scout camp, at Ten Mile River in upstate New York. It was a Monday morning and the High Holidays had just begun.  My grandmother’s room was just next to mine at the head of the stairs. I got dressed and was heading off to school — to Fieldston. As I passed my Mema’s room, her full-time nurse came out and said, “I can’t revive her.” We went into her room and turned her over so she was face down with her head to the side. I climbed on top of her and rhythmically pressed down on her rib cage administering artificial respiration 1940’s style, that I learned how to do as a Boy Scout.There was no resistance, no push back. Her body did not respond to the pressure. I could not revive her. Reality struck. I felt the difference between life and death. I felt it in my hands.

Continue reading “The House I Grew up in”