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#7 Growing Old Gracefully


My work gives me some insight into the lives of others. Not being able to travel these days (and who knows for how long), having different kinds of people come to the clinic is another horizon-broadener. In a fundamental way, I believe we are all more similar than different, but my podiatry chair sits me in a privileged perspective to witness a wide spectrum of human life. Life, that is to say, as the cards one is dealt, in addition to Life - with another capital ‘L’ - as the game one brings to the table.

Burdens to Bear

Just as I see the same foot problems over and over, I am afforded glimpses of general life problems. The problems of the various demographics; they do come in classic sets. Teenage problems, problems at work, money problems...marriage problems, single person problems, problems with health. Problems that the same demographics have had (to some degree) in every previous generation. Problems swapped one for the other through life.

Some problems are sought out voluntarily. Other problems are sheer black hole problems that have been fallen into. To try to retrospectively untangle the proportions of ‘voluntary’ from ‘falleness’ is problematic itself. Trying to attribute what percentage was ‘you’ versus ‘what happened to you’: it’s a waste of your grey matter.

Twenty-twenty hindsight might now wince at the ‘decision’ to ‘choose’ the mortgage and 2.7 kids - it must have seemed like a good idea at the time - but on the face of it, this was your idea. At least this boulder on your shoulder will be easier to make meaning from than a burden unexpectedly loaded on you. And while there will be unexpected burdens to bear, the relatively chosen problem - if you have been lucky enough to choose it - will not be as notorious to emerge from as are black hole problems that you are unconsciously sucked into.

“The truth is, everyone is going to hurt you. You just got to find the ones worth suffering for.”

- Bob Marley

The Oldies

And leaving choice aside, there is inevitable old age; the twin assault of gravity and time will sag your face and bend your spine. In my clinic room, I get to see how the elderly - reliably called ‘the oldies’ here - cope in their dotage. Sometimes - if they’ve received a terminal diagnosis - I see how they approach the last challenge and chapter of life.

In the first few minutes of my thirty minute sessions, my elderly patients will sigh in resignation about their specific foot problem. This is what they came for in earnest, but they’re not entirely hopeful. “It’s just old age I suppose”. More age-associated struggles are soon revealed further up the body; Bad backs, botched hip replacements, fading eyesight, faulty hearing aids.. “Bit of advice”, my patients will conclude while sitting in my chair; “never get old”.

Have you tried orthotics?”, I venture, trying to veer them back to the issue at hand while checking their familiarity with shoe inserts.

“Oh yes dear, I wear them all the time”.

Oh right. And how do you find them?”

Oh fine. Obviously, they come out with my teeth, but that’s only when I’m eating”.

Darkness into Light

I will try to diagnose and manage their specific foot problem as they talk. Usually they talk more than me. Shiny happy people are more of a pleasure to interact with, but those who have won the lottery bestowing that level of happiness are rare.

In many cases, the limit of my intervention will be toenail-cutting. Sometimes, in attending to their feet, my attentive listening will be the most appreciated thing. In quieter moments, away from the conveyor belt of patients, I realise there is a privilege too in listening to people who aren’t doing so well; those who are speaking vulnerably with you, and who otherwise don’t get heard. The quality of your attention here goes a long way. In sitting with someone, just as in painting their portrait, the sitter’s darkest parts respond most strikingly to the added contrast of the lightest light.

Progression to Childhood

I also enjoy those contented old patients who have long ceased caring what people think of them. They have thrown off the shackles of self-consciousness, and like a child’s un-self-consciousness, their directness can be a breath of fresh air. I'm thinking of the sprightly ninety-something great-grandfather who I recently asked what his secret was. With his sixty-something designated-driver son in the room, the old man didn’t miss a beat: “Loads of great sex”.

Perhaps because sex is finally off the table (but perhaps still on the bed), it seems to take centre stage in the humour of extreme old age. It is usually the butt of my eighty-six-year-old patient “Mary’s” jokes. The same singular joke, that is to say; forgotten about between visits and reliably re-told just before leaving my clinic room: “What” she asks me then, “do sex and bank accounts have in common?” I chuckle, knowing the punchline, but grateful for Mary’s determination to bring back her sense of humour into the room.

“I don’t know Mary. What do they have in common?”

“When you withdraw, you lose interest”.

And all the old folks would agree that they must not lose interest in life itself. Vitality is a key ingredient; an antidote against disinterestedness and inevitable deterioration. It is why the ninety-seven year old inspiration, “Michael” still works out at the gym every day. It is why so many others who still live a life of quality, exercise a positive attitude. Coming to each day with the right attitude remains a necessary buffer against the never-ending vicissitudes. To lose the positive attitude is to lose interest. To lose the interest is to give up. The giving up - at any age - is death.

“At the moment of life is death; at the moment of death is life”.

- Zhuang Zi (Taoist thinker)

The Luck of the Draw

There is always the unforgiving lottery of circumstance. Grace is not equally easy for everyone. While my most unfortunate patients still emphasise the importance of mustering a positive attitude, lady luck can erode the most resilient heart.