In my 70’s, the experience of decline partly defines my every day. Each morning I look to the window for a sunny day. I think of all the interesting things I might do. And I conduct a bodily inventory. How’s that knee feeling? Did the Prilosec ward off heartburn during the night? How’s my hearing? How energetic do I feel? I laugh a little as I go through my list. But there’s more sadness and weariness than laughter in this downward journey.
For years now, I’ve tried to offset the sadness with irony and a focus on my extraordinarily good fortune, but the inventory acts as a constant companion to these attempts. The social critic, Malcolm Crowley beautifully captured the feeling. “I feel old,” he says,
- when it becomes an achievement to do thoughtfully, step by step, what he once did instinctively;
- When his bones ache;
- When there are more and more little bottles in the medicine cabinet, with instructions for taking four times a day;
- When he can’t stand on one leg and has trouble pulling on his pants;
- When he hesitates on the landing before walking down a flight of stairs;
- When he spends more time looking for things misplaced than he spends using them after he (or more often his wife) has found them;
- When he forgets names, even of people he saw last month;
- When everything takes longer to do—bathing, shaving, getting dressed or undressed—but time passes quickly, as if he were gathering speed while coasting downhill.
Now if my daily inventory grades out on the positive side, I feel optimistic, ready for the day. If not, I prepare to fight through the day, to make it as good as possible. Laying around, for instance, would be a step too far, the first in a downward slide that I don’t like to even imagine. I’ll exercise even if I’d rather not. Read or make some calls when a nap seems like a good idea. And I take pleasure in fighting through the wish to give in to the negative.
There’s a purpose to this checklist: to determine a baseline of possibilities. The challenge is to conduct it as honestly as possible, leaving aside both wishes and fears.
Of course, honesty isn’t entirely objective. All of us screen reality through cultural filters. In stoic cultures, for instance, we ignore signs of decay. In self-indulgent cultures like ours, we give freer reign to complaining about our fate. If culture glorifies “successful aging,” we’d best ignore the negative, or shame on us. So, change our diet. Exercise. Cultivate optimism.
Sometimes it’s hard to read the signs. Some years ago, for instance, I felt a constant weariness and turned to the most obvious explanation: I had passed my 70th birthday. I must be getting old. “Get used to it,” I told myself. But as it turned out, I had iron deficiency anemia, which was treatable. After a few weeks of iron infusions, I felt like my old self. So there’s some learning involved in translating the results of these inventories.
In the May, 2019, issue of the New Yorker, Mark Singer published an interview with David Milch, an acclaimed screenwriter and producer (NYPD Blue, Deadwood, and other heady and popular TV series). Milch suffers from Alzheimer’s. and is now in the middle stages of this dreadful disease. He’s become increasingly anxious and depressed. Sometimes he gets lost and has to call his wife to rescue him. Normally, a brash and decisive man, Singer tells us, Milch now seems tentative, almost frail, at 75.
Yet he continues to write every day with a commitment that belies—maybe defies—the terrifying decline in his mental capacity. As I read the interview, I felt that Milch’s attitude spoke authentically and deeply to my own concerns about decline, so I thought to share my own musings on this topic with you.
The interview begins by exploring what having Alzheimer’s has meant to Milch, He notes, “(T)here’s an experience you have as every day goes on of what you’re no longer capable of and…it’s an accumulation of indignities. At a more fundamental level, it’s an accretion of irrevocable truths: this is gone, and that’s gone.”
The image of one thing after another drifting away is so damned powerful. I imagine myself grasping after these floating objects, reaching and reaching, trying not only to hold them and bring them back but somehow also reintegrating them within my body or my mind. But I can’t. Much as I know that they are gone, I can’t readily reconcile myself to their absence. I’ll pretend they’re still here. I’ll pretend for a long while, until I really believe that they are gone.
What drifts away—or what is severed by disease and accident—isn’t like a replaceable machine part. Each part, each memory, each tendon and organ, has been a member of an intricately organized whole. It is the whole that constitutes our essential being; and the decline of the parts threatens the whole, threatens our sense of ourselves. The drifting parts whittle away our selves.
The “accumulated indignities” that Milch talks about, shame us—shame me. Unlike mere embarrassments, shame is a primitive, painful feeling that harks to early childhood: to being physically exposed, caught naked, being criticized harshly in front of others. My cheeks burn. I want to hide. And many older people do run. They “hide,” or better…find refuge, in elder communities, comforted by the shared decline of most of those around them. I won’t yet abide this solution. I still feel vital and strong. But I’ve begun to understand its appeal.
To ward off the shame of decline, Milch says that “…we all make deals,…, in terms of how we think about the process of our aging. It’s a series of givings aways, a making of peace with givings away…It’s kind of a relentless series of adjustments to what you can do….” There is an “accumulated deletions of ability. And you adjust… whether you want to or not.”
At this point in the interview, Singer asks: “…whether, despite what Alzheimer’s was stealing from him, it had given anything in return. Yes, Milch responds, there is. “There’s a continuous sense of urgency…There’s an acute sense of time’s passage. Things are important. You don’t want to be inconsequential in your perspective on things. I feel that with an increasing acuteness—that everything counts.”
What Milch asks for in the time he has left is “for the grace and dignity of a lucid cogitation. I’m asking of my faculties such as they are, in whatever diminution they are, to meet you fairly.” What I think he means is the ability to live life without artifice and evasion. Practicing a radical honesty, Milch believes, bestows a “grace and dignity” to life.
He has “disabused” himself “of any thought of a normal future” but allows himself “a provisional optimism about the possibilities of what time I will be allowed. And I’m determined to experience what life will allow me… And I permit myself a belief that there is possible for me a genuine happiness and fulfillment in my family and the work I do.”
Alongside Milch, I also feel the gravitational pull of decline. I ache with it and I know that there’s no avoiding it. There are a thousand books now being published that practice one form of denial or another. And indeed, I have written my share of blogs that join the poets in trying to transform the fear and trembling of aging into some form of wisdom and excitement. But I am coming to believe that there may be a greater dignity—and liberation—in simply acknowledging the ache and the place it has in my life. It is another way to be unapologetically myself.