On Time

I was 82 last weekend - the face that stares back at me from the mirror has only a vague resemblance to my old passport photos. When my mother made the decision, at age 95, to transfer from the independent flat she had in a small and lightly ”supported accommodation” I vividly remember her looking around at her new neighbours – most of whom were considerably younger than her – and remarking (quietly) that there were a lot of old people around! It is indeed all in the mind…..It’s more than 50 years since The Coming of Age by Simone de Beauvoir burst on the world

This masterful work takes the fear of age as a cultural phenomenon and seeks to give voice to a silenced and detested class of human beings. What she concludes from her investigation into the experience, fear and stigma of old age is that even though the process of aging and the decline into death is an inescapable, existential phenomenon for those human beings who live long enough to experience it, there is no justification for our loathing older members of society – nor should the “aged” merely resign themselves to waiting for death or for younger members of society to treat them as the invisible class. Rather, Beauvoir argues…. that old age must still be a time of creative and meaningful projects and relationships with others. This means that above all else, old age must not be a time of boredom, but a time of continuous political and social action. This requires a change of orientation among the aged themselves and within society as a whole which must transform its idea that a person is only valuable insofar as they are profitable. Instead, both individuals and society must recognize that a person’s value lies in his or her humanity - which is unaffected by age.

Thanks to campaigning efforts of bodies such as Age Concern (in the UK) and the efforts of prominent older people such as retired trade union leader Jack Jones and Joan Bakewell, I noticed signs about a decade or so ago of such positive developments….but the media and entertainment industry (which still tends to set the tone) is still remarkably “ageist. On Golden Pond was unusual for 1981 (with Henry Fonda and Katherine Hepburn as the elderly couple) but was a one-off - presumably the studios calculated they needed more upbeat messages. More recently we have had the French film “All Together” with Jane Fonda and Geraldine Chaplin and, in early 2013, another (more harrowing) French film. In the same year a Japanese politician was caught telling the elderly to hurry up and die but British think-tanks offered some reasoned discussions about housing options for the elderly in the UK and good material on the whole issue of images and perceptions of old age. The writer Penelope Lively had a more celebratory piece -

So this is old age. If you are not yet in it, you may be shuddering. If you are, you will perhaps disagree, in which case I can only say: this is how it is for me. And if it sounds – to anyone – a pretty pallid sort of place, I can refute that. It is not. Certain desires and drives have gone. But what remains is response.

I am as alive to the world as I have ever been – alive to everything I see and hear and feel. I revel in the spring sunshine, and the cream and purple hellebore in the garden; I listen to a radio discussion about the ethics of selective abortion, and chip in at points; the sound of a beloved voice on the phone brings a surge of pleasure.
I think there is a sea-change, in old age – a metamorphosis of the sensibilities. With those old consuming vigours now muted, something else comes into its own – an almost luxurious appreciation of the world that you are still in.

Spring was never so vibrant; autumn never so richly gold. People are of abiding interest – observed in the street, overheard on a bus. The small pleasures have bloomed into points of relish in the day – food, opening the newspaper (new minted, just for me), a shower, the comfort of bed. It is almost like some kind of end-game salute to the intensity of childhood experience, when the world was new. It is an old accustomed world now, but invested with fresh significance; I've seen all this before, done all this, but am somehow able to find new and sharpened pleasure.

The following year, Jenni Diski had a much nastier take on old age in a piece called “However I smell”. Atul Gawande may be a surgeon and Professor but is not your normal medic. In this interesting interview earlier this year in Guernica magazine he explains how he came to be able to give voice to his own uncertainties and to celebrate by example the importance of “listening” – something which medical training has apparently come round to only recently…… (this critical section of the interview is toward the end)

The biggest thing I found was that when these clinicians were at their best, they were recognizing that people had priorities besides merely living longer. The most important and reliable way that we can understand what people’s priorities are, besides just living longer, is to simply ask. And we don’t ask.

Guernica: How did your research on end-of-life care change how you behaved as a doctor?

Atul Gawande: As a doctor, I felt really incompetent when trying to understand how to talk to patients and their loved ones about an illness that we were not going to be able to make better. We might be able to stave off certain components of it, or maybe we couldn’t even do that. And I felt unprepared when it came to having those difficult conversations and helping patients make those decisions.

I found that these end-of-life care experts were making me feel much more competent. They were giving me the words that I could use, and I began to use those words. I’d simply say to a patient, “I’m worried about how things are going.” I’d ask questions like, “Tell me what you understand about your health and your prognosis.” “Tell me what your goals are, if time is short.” “Tell me what your fears and worries are for the future.” “Tell me what the outcomes are that you would find unacceptable.”

Books about Ageing and the approach of Winter

Title	Year	Genre	Comment	Links
The American Way of Death; Jessica Mitford	1963	journalism	Analysis of the crematorium business	Her updated version of 1996 can be read in full here
On Death and Dying; Elizabeth Kuebler-Ross click to get the entire book	1969	psychology	The book that gave us the “five stages of grief”	This extended interview with the author is quite superb
The Coming of Age; Simone de Beauvoir	1970 French version	Breaks all disciplinary barriers!	The classic	Excerpts available on this Amazon version
The Denial of Death; Ernest Becker	1973	Cultural anthro	A “psycho-philosophical synthesis” – all 330 pages	Hyperlink on title gives full book
The Loneliness of The Dying by Norbert Elias	1985	sociology	A short rather general book by an underrated Anglo-German	Note on his life and work. Click title for full book
The End of Age – BBC Reith Lectures by Tom Kirkwood	2001	Gerontology	Link on the title gives podcasts	Recent book review by Tom Kirkwood
Ammonites and Leaping Fish – a Life in Time Penelope Lively	2003	Memoir	Interview here	First chapter can be read in summary form here
Nothing to be Frightened Of; Julian Barnes	2007	Extended essay	Good on references	A rather gentle way into the subject nicely reviewed here
Somewhere Towards the End; Diana Athill	2008	Memoir	Marvellous writer covers latter stages of a long life	Click the title for the entire book
The Long Life; Helen Small	2007	Literary	Written by a Professor of English language and literature	Compendium of writing about ageing over 2000 years. A good review here
You’re Looking very well – the surprising nature of getting old; Lewis Wolpert	2011	Popular science	Professor of Biology Age 80 when he wrote it. Good interviews here and here	Got stick from this reviewer for having too many facts and quotations and insufficient analysis
“Immortality: the Quest to Live For Ever and How It Drives Civilisation” Stephen Cave	2012	philosophy	Philosopher who knows how to tell a great tale	Click on title for full book good review here
Out of Time – the Pleasures and Perils of Ageing; Lynne Segal	2013	sociology	Almost an update of de Beauvoir!	Good review here
Being Mortal – illness, medicine and what matters in the end; by Atul Gawande	2015	Reflective medical	a very literate and humane American surgeon,	See comments in Intimations of Mortality and Facing up to our Mortality
Growing Old – the last Campaign; Des Wilson	2014	Humour	was the most famous British campaigner of the second half of the century.	Superb read as you would expect from such a brilliant campaigner whom I briefly knew
The Black Mirror: Fragments of an Obituary for Life; Raymond Tallis	2015	philosophy	retired British gerontologist, poet and polymath	See this Spiked Online review
The Worm at the Core: on the Role of Death in Life; by S Solomon, J Greenberg and T Pyszczynski	2015	psychology	American psychologists update and popularise Becker’s thesis about our repression of death	see this interview
“Smoke Gets in Your Eyes: and Other Lessons from the Crematorium” Caitlin Doughty	2015	Journalism	A mortician’s tale	Review here
My Father’s Wake – how the Irish Teach us to Live, Love and Die; Kevin Toolis	2017	journalism	Poetic but doesn’t deal with issues
With the end in mind – dying, death and wisdom in an age of denial; K Mannix	2017	medical	A “palliative” doctor profiles in depth her patients	A review here
The Way we Die Now; Seamus O’Mahony	2017	medical	A Consultant “Gastroenterologist”
Every Third Death – life, death and the endgame; Robert McCrum	2017	literary		Reviewed here

Joseph Epstein penned this magnificent ode to approaching 80

https://www.washingtonexaminer.com/weekly-standard/hitting-eighty-2006010

this first part of a series

https://www.theguardian.com/books/2013/oct/05/penelope-lively-old-age