April 11, 2022

t’s what I call birthday week again. Yesterday would have been Tommy’s 57th birthday and Wednesday will be what would have been Steve’s 74th. It’s a bit hard to wrap my head around that latter one. I have enormous difficulties imagining a septuagenarian Steve. He was a pure early baby boomer, always conceiving of himself as young, even into his fifties when I lost him. He would have fought the infirmities and indignities of age every step of the way and I imagine by this time the bills for hair treatment, botox, teeth whitening, and various other youthening procedures would have been relatively exorbitant. Tommy was much more philosophical about the aging process, given his burden of various diseases due to bad genetics and bad luck long before his early departure. He did spend a small fortune at the hair salon every few months to stay strawberry blond but other than that he just let the chips fall where they might.

Having been a student of aging and watching the psychological battles of thousands of people from a number of different generations over the years, I just let my body do what it’s going to do. I don’t color my hair (I figure I’ve earned the white), do botox, expend large amounts on various facial creams or the like. I try to keep my weight under control (sometimes difficult to do on an erratic diet due to my erratic hours), shower routinely and occasionally put a little cheap moisturizer on my face. That’s it. It seems to have worked so far. I haven’t had a surgery since my tonsillectomy at age three, rarely become seriously ill, and my aches and pains are pretty controlled with judicious use of Tylenol. I know I’ll have to have my knees done eventually. They let me know that every time I climb stairs, but they’re not bad enough to have to think about that prior to retirement when I’ll have time to cope with such things.

Why are we so afraid to grow old in our culture? Our youth obsession is fed by our capitalistic society. Everything revolves around the advertising dollar and advertising is a science that’s been studied fervently for well over a century. One of the things that’s well known is that it’s not possible to brand or sway a consumer over the age of thirty five by advertising. Older brains are too savvy to fall for the ploys and the glitz and the glamor. Therefore, general advertisers really aren’t terribly interested in attracting much of anyone over forty. This makes our pop culture skew young and explains why when you’re fifty or sixty, you can’t find a movie or new music that speaks to you. As television has migrated away from advertising based networks to subscription based streaming, there’s less need to grab a younger audience, just to grab a paying audience and older people have disposable income for Netflix so television over the last decade or so has created the well written well acted dramas and comedies leaving the movies the purview of super heroes and special effects that entice teens and twenty somethings.

I suppose as we go hurtling through the space-time continuum to our inevitable destination of mortality, we have difficulty coming to grips with our non-existence. This chafes at the Western mind. Ever since Rene Descartes posited Cartesian dualism – life of the body and life of the mind separate but parallel – we’ve built our culture around the cult of the individual. The most fundamental building block of our economics, politics, and social arrangements is that we are all different, unique individuals and the self is the most important thing in our lives. Anything that threatens the self is anathema and the annihilation of self posed by death, combined with our very linear thinking about time, means we tend to become more and more frightened thinking about the end of the journey. It’s also why Alzheimer’s is so feared. We recognize it as obliteration of the self while still leaving the body alive. That’s too scary a prospect for most of us to contemplate.

Personally, Alzheimer’s and dementia doesn’t scare me. If we just approach it as a regression backwards through the stages of development, we recognize that most of the misery is caused by trying to make a person who no longer has a functional adult brain still lead a functional adult life. At the beginning of the life cycle, we’re very good at matching development with environment. One does not send a five year old, a ten year old, and a fifteen year old out into the same world, we tailor it to needs. If we do that for the demented, constantly fitting the world around them to their needs and abilities, they are quite capable of being happy and contented. We’re just horrible at doing that, both as a medical system and as a society. It’s one of the first things I start to evaluate when I get a new patient with cognitive problems. My mother had a genetic dementia. As such diseases are autosomal dominant, I have a fifty percent chance of carrying it. Fortunately, it doesn’t start showing up until about age 75 so I have plenty of time. I’m leaving strict instructions to my family to help my environment and abilities match. Give me someplace with my books and my music and a cat to cuddle and dessert with every meal and I’ll be fine. I am much more scared of diseases such as ALS which leave an intact mind in a completely nonfunctional body. To me, that’s the definition of hell. Over the years, I’ve met a number of people with what is know as locked in syndrome. It’s a condition where a serious stroke leaves the thinking and feeling part of the brain intact but destroys all motor function. They can’t use their bodies, often can’t communicate, and usually end up spending years in nursing facilities as their care is too burdensome for home. I’d likely have a psychotic break internally if it happened to me.

I’ve often thought that we’d be better off as a society if we had formal death education. Classes in school or in community institutions where there was frank discussion about mortality, the causes and mechanisms of death, what kinds of medical care can help serious disease and which simply prolong the inevitable, the importance of wills, powers of attorney, and advance directives, and other such subjects. The problem is that death is probably even a bigger taboo than sex in American culture and we all know what sorts of wars are propagated by sex education in the schools and elsewhere. The cultural battles over death education would probably touch off fighting in the streets. Speaking of sex education, the governor of Alabama signed bills this past week stipulating felony charges against those who try to provide medical care to trans children and major threats against anyone who tries to bring discussion of gender or sexuality into elementary classrooms. The bills are badly worded and vague and will be tied up in court for some time. They are so vague that I suppose I, as a concerned citizen, could lodge a complaint that Sally, DIck and Jane should be banned as there are clear gender roles present in the material and such things are not to be discussed. Sally, Dick and Jane need to be retired for all sorts of reasons but it does go to show how piling on the conservative bandwagon is not the best of ideas.

Trans issues are being used as a wedge to open up anti LGBTQ sentiments again. Three steps forward, two steps back. I really resent the ‘grooming’ language that has all of a sudden become ubiquitous when it comes to issues of gender and sexuality and the education of children. Kids are curious creatures. They’re going to start making assumptions about such things whether you want them to or not and often at earlier ages than you might think. You can either give them correct information or don’t and let them pick it up haphazardly from peers or the internet (and every ten year old has hacks to get around parental filters and controls). I don’t groom kids. I’ll answer questions appropriately and honestly. None of my LGBTQ friends grooms kids. We don’t want to or need to. Those kids who understand that we are their tribe seek us out of their own accord when the time comes, usually in later adolescence. As for the parents of trans and non conforming kids. They aren’t trying to push an agenda on anyone. They’re frightened to death that a cruel and misunderstanding world will push their children into misery, addiction, and suicide and they’re doing everything in their power to prevent that. Being told by the state that that’s abusive is unconscionable.

I have no idea why I wrote about this tonight or where this all came from. I was going to write about BA 2 and Covid numbers but they remain low and I hope everyone is enjoying a bit of a pandemic respite. I’m not certain it’s going to last. But get out and enjoy spring weather while you can. Just keep your hands washed and pay attention to local transmission rates and put your mask back on if they start going up. (This has already happened in Philadelphia – other large cities my need to follow suit. We shall see).

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