A Swedish sociologist Lars Tornstam describes this by asking what a 10 year old would say if we asked him what it would be like to be 20. It would be awful to him. There would be no play time. There would be no summer vacation. He would have to get a job! But at twenty he would look back at the age of 10 and say: “There’s no way I’d want to be 10 anymore. I have so much more freedom now. I’m making money. I can do whatever I want.” But what if you asked him what it would be like to be 40? “It would be awful. I’d be stuck in the rut of a job. I’d be stuck with a wife and kids.” And so on. But the end of Dr. Tornstam’s analogy is our concept of old age. For some reason our culture fears old age. In general we fear becoming elderly. Our concept of old age is associated with a lack of contentment with life.
Why is this? Why do we despise grey hair and wrinkles? Why do we fear those “golden years”? Why do we scramble to embrace the concept of youth? Why are we so quick to be associated with that insecurity and inexperience and foolishness of youth? How insecure, inexperienced and foolish of us! What do we think we will lose with old age? Is it the excitement of a new experience, or the opportunity of new tests and challenges? Is it the virility of sexual experiences?
It was a typical clinic day. I was seeing patients with diabetes and hypertension, colds, and a recent broken bone. The next patient on my schedule was Carl Fisk. I had never seen him before. He was scheduled to be in my clinic because his regular doctor was gone that day. The reason he was here was for a medication refill. I looked through his chart and found that he was 82 years old and about 3 years ago his wife of 51 years had died of breast cancer. “Oh no” I thought. “This is going to be a totally depressing visit”. I had thoughts that his visit would be filled with discussions about depression and sadness. With this I took a deep breath and entered the room.
Mr. Fisk sat in the corner of the room reading a magazine. He had shiny grey hair and a bright smile. As I walked in he stood up to shake my hand. He wore circular glasses that shined in the light of the clinic room. He was well dressed with khaki pants and a tucked in, blue plaid shirt. I introduced myself, “so what brings you here today?” I asked, prepared for an onset of tears and a possible discussion of antidepressant medications.
“Well doctor”, he began, with more energy than I had expected. Mr. Fisk had a strange smile on his face. Like a 10 year old who just got into a jar of cookies. “The last doctor I saw gave me a prescription for Viagra, and I wanted to see if I could get a refill.”
Caught off guard I stammered and looked through his chart. He was in the clinic only 2 weeks ago and had a prescription for 10 Viagra pills. Did he use them up already? After regrouping, I continued on. In his chart there were no contraindications for him to take Viagra, and he had no adverse side effects. There was no reason he couldn’t continue taking this medication. As I was writing his script (for twice the supply and refills), he said a peculiar thing. “You know doctor,” he began. “People think that as you get older, you can’t have sex anymore, but I haven’t been this sexually satisfied in years.”
We shook hands as he left and I moved on to my next patient. But I couldn’t stop thinking about how happy he was. My initial notion was that he would be a sad lonely old man. But he was the exact opposite.
Over the next few months, I saw Mr. Fisk a few more times. Each time he was as friendly and happy as the time before. We began to get to know each other better. He had a new girlfriend, and was busy spending time with her and his daily golfing games. At the time, I was doing a Geriatrics Fellowship and it was exciting for me to find an elder so excited about life. We talked about this for a while, and he invited me over to his apartment to see for myself. I decided to take him up on the offer. After working around his busy schedule of golf, dating, and volunteer activities, we agreed to meet on a Saturday afternoon.
Mr. Fisk lived in a retirement community with a combination of houses and apartments, surrounded by wooded trees and the Blue Ridge Mountains of North Carolina. His apartment was on the first floor in the center of the community. He answered the door with the same smile he always had, and invited me in. Mr. Fisk was a humble man. His apartment was Spartan in its decoration. As I entered, the kitchen was on the right, and the living room on the left. There were only a few pieces of furniture in the living room. A comfortable old green couch and a soft matching arm chair opposite it. There was no television in the room. There was just an old stereo with a record player. Mr. Fisk invited me to sit down on his couch and he sat in the arm chair. I started by asking him how his girlfriend was. His smile immediately broadened and his eyes beamed. “Oh, you mean my sweetheart!” he suggested, “well, we just got engaged! You have to see a picture of her!” Mr. Fisk jumped to his feet and ran to another room. He returned with a 4×6 framed picture of himself standing next to a lady with his right arm wrapped around her shoulder. She looked about his age. They were both smiling broadly. Her name was Janet. As we continued our conversation, he could not stop talking about his “sweetheart”. It was as if he were a teenager smitten by love. Even when the subjects of our conversation would change he would find something about his new fiancé to bring up in the conversation.
During the afternoon, we talked about other aspects of his life. He was a retired pastor, he played golf almost every day with a group of friends. He volunteered in the community at a Nursing Home. His previous marriage had been wonderful. He had three children who were spread all around the country, but he was still very close to them. I left his apartment that afternoon with a sense that his days were busier, and fuller than mine seemed to be.
Since that day, Mr. Fisk married Janet. His children, came from all over to be at the wedding and he had a honeymoon at a beach in South Carolina.
Carl Fisk is extremely happy with life. He is content, and the opposite of what we think old age has in store for us. We fear the onset of old age as if it is the first nail of our coffin. But with old age we don’t have to lose our ability to enjoy sex, we don’t lose the excitement to fall in love again. When we are older and full of experiences, by stepping back and looking at our life, we only change the paradigm of what happiness is. Maybe that is what we don’t realize when we fear old age.
Arsheeya Mashaw is a geriatrician who blogs at A Doctors Guide to Healthy Aging.