The Wisdom of Old Curmudgeons

The bad reputation of elderly curmudgeons is well known: angry guys raging at the declining world, their failed, decadent society, the younger self-centered generation, the crooks elected to public office, and the local trash pick-up dictatorship forcing the sorting out of bottles and newspapers. At the risk of being outed as one of those guys, I have some comments to make: maybe those aspiring curmudgeons of our age now need to pay more attention to the future than the past.

I first got interested in generational comparisons when I was in high school. I was friendly with a man who was born about 1883. He complained about the decline of reading among children, no doubt responding to a new competitor at that time, television (this was 1948). I wasn’t impressed. My friends and I read a lot. Abe Lincoln’s reading selection–Shakespeare, the Bible, and great classics–was probably better than his. I once asked my mother, born in 1895, whether she thought life was better or worse than it was in her era. She instantly answered with “better now.” That was in 1940 and I never heard her explain why, but I can guess.

Consider the Gilded Age of the late 19th and early 20th centuries with which my mother overlapped. It was the era of the robber barons, great economic inequities, continued lethal segregation in the south, and considerable poverty and squalor in many places. The nastiness among politicians was even worse than ours. Stephen Pinker’s book, The Better Angels of Our Nature, made a compelling case that violence has gradually declined over the centuries. Global poverty is decreasing. Good progress has been made on seven of the eight 2005 United Nations Millennium Goals, including literacy and women’s rights, and reducing hunger and child mortality.

While every diligent curmudgeon can find something to complain about and harken back to earlier days, life has probably become better in more rather than fewer ways; at the least it is a draw. The future is a different story, and the wise curmudgeon–always looking for something to grouse about–should turn his eyes in that direction.

 The one area where the U.N. Millennium goals have not shown progress is climate control, steadily getting worse not better. While not Millennium goals, the same trend is true of global food and water resources, chronic illness, and obesity. No assured way out is envisioned for any of them. In the sphere of foreign policy, no good pathway ahead is seen for the Middle Eastern countries, caught up in ever-escalating sectarian and political clashes. Who foresees at the moment a satisfactory solution to the Israeli-Palestinian clash? Then there is China and the U.S., and one does not have to be of a hawkish temperament to see a troubled future gathering steam. Russia under Putin is not a comforting thought either.

But at a more domestic level I have my own grumbles about current trends, likely to dominate the future. Three of them stand out: a decline of community, the growing economic inequality, and for want of a better phrase, good taste. By the decline of community I mean a growing insensitivity to poverty and welfare needs. Two currents are coming together. From the conservative side it is market freedom and distrust of government. From the liberal side it is the right to live the unencumbered kind of life one desires with ethical values of one’s choosing. It is not a good combination. It is destructive of social solidarity and the understanding that life with others is one of chosen captivity to the need of others, many of which require the sacrifice of our liberty for the good of others. Marriage is one of those captivities, raising children is another, taking care of elderly parents, and a willingness to pay high taxes for the well-being of others is still another.

Inequality is my second complaint. It is not just the fact of income inequality, but the embrace of it as an economic and community benefit. It is said to be good for people to be free to make as much money as they like, an expression of a self-chosen life. It is good to have such people in our midst, a model for the young on getting ahead and depending only on oneself to make it. We celebrate celebrities, the entrepreneurial billionaires, the highly paid corporate CEOs. My local paper, The New York Times, nicely mixes in plentiful stories about them with no less plentiful stories about the unemployed and the homeless.

But at least the Times does not allow too many four letter words in its pages, though it has more than it did a decade ago. But utter crudity of language is now pervasive on regular TV and even more on cable channels. It is now thought cute to have children speak as much potty talk as adults. Soft porn is now the norm as well. All this comes from the cohabitation of the market (it sells) and liberalism (an expansion of free speech is always a good thing).

I do have some nostalgia for the days of yore when it was still possible to talk about “good taste,” that grey area between ethics and etiquette. We middle class kids were taught to have it. Nice men treated women in certain ways, just as we all were taught to respect the old. Good table manners were expected, and we were informed that one should not interrupt others when they are talking. No T-shirts at funerals. If you are not sure quite sure what I am talking about, you may be part of the problem.

Darn it, as we used to say, I have probably succeeded in persuading you I am an old-fashioned curmudgeon. We always talk too much.

Daniel Callahan, 83, is co-founder and President Emeritus of The Hastings Center and an editor of Over 65.

           

 

 

 

 

 

                                 

 

 

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Albert Schweitzer’s Advice about Aging

A friend recently quoted a saying from Albert Schweitzer that was especially meaningful to him as he approached his 70th birthday:

The meaning of maturity which we should develop in ourselves is that we should strive always to become simpler, kinder, more honest, more truthful, more peace-loving, more gentle and more compassionate.

 This advice captured my aspirations for the over 65 phase of life eloquently. To me it seems obviously true. But the skeptic in me asks – “Why should these be our goals?” Didn’t Dylan Thomas urge us not to “go gentle into that good night“? Continue reading…

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A Caregiver’s Near-Suicide

An article on “caregiver burden” in the March 12 issue of JAMA (Journal of the American Medical Association) opens by describing a painful, nearly fatal, situation:

Mrs. D, at 84 years of age, was the primary caregiver for her functionally impaired 86-year-old husband and shot herself 3 times in a suicide attempt. Mrs. D’s family did not perceive the severity of the caregiver burden as a family picnic was planned for the day of her attempted suicide. Mrs. D did not leave a note and later stated she fully intended to kill herself. While recovering in the hospital, she expressed relief at not having caregiver responsibilities. Two months later, her husband died, which Mrs. D described as a release for her.

What stands out for me as a psychiatrist is that despite the depth of depression that led to Mrs. D’s potentially lethal suicide attempt, when she no longer felt trapped in the caregiver role, suicidality and depression lifted without psychotherapy or medication. Changing the situation provided the “cure.” Continue reading…

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Shift Retirement Plans Away from Employers

Lots of proposals have been put forth for a new and better retirement system, but they don’t answer the question of how we get from here to there. (For examples of proposals, see the SAFE plan or the Guaranteed Retirement Accounts proposal.) We have a fairly extensive – albeit far from perfect – 401(k) system that people have just begun to understand.  In my view, it makes more sense to transform 401(k) plans into our ideal rather than to superimpose a new system on top of what we already have.  But figuring out just what steps to take is hard.  I am beginning to think that the single most important step is to shift the responsibility for sponsoring and administering retirement plans from employers to independent entities. Continue reading…

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Is 70 the “Right” Retirement Age?

I keep thinking about this notion that 70 is the “real” Social Security retirement age.  It is the age at which people get maximum monthly benefits, and if they work beyond this age they see their lifetime benefits decline.  But is 70 the right age? 

“Right” can mean a number of things.  One issue is how 70 in 2014 compares with 65 in 1940 in view of the increase in life expectancy.  Another is how to rationalize it given the large dispersion in life-expectancy gains between high- and low- income groups.

People are certainly living longer in 2014 than they did in 1940. The increase for those age 65 has been about seven years for both men and women.  How should these additional years of life expectancy be spent?  Continue reading…

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Writing your Own Eulogy

“Begin with the end in mind.” (From Stephen R. Covey: The Seven Habits of Highly Effective People: Restoring the Character Ethic.)

Did you ever wonder about the veracity of the eulogies given at funerals? Was this really the same person you thought you once knew?

I know, I know. Eulogies are meant to convey the best of the deceased person, to leave us with happy memories. Eulogies are a way of honoring the person. Most people deserve to be honored in some way, do they not?

Now, maybe this is just the psychiatrist in me, but there may be some drawbacks, side effects if you will, in this practice, too. Continue reading…

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Income and Life Expectancy

Today’s New York Times has an excellent article on income and longevity that compares Fairfax County, Virginia, to McDowell County, West Virginia. In Fairfax, median household income is $107,000. In McDowell it’s about one-fifth of that. In Fairfax, the average life expectancy for men is 82. For women it’s 85. In McDowell, the comparable life expectancies are 64 and 73.

On average, men in McDowell County don’t survive into the age cohort the Over 65 blog is about!

In 1975 Samuel Preston used data from the 1900s, 1930s and 1960s to show that the relationship between greater wealth and longer life is a worldwide phenomenon, a finding named for him as the “Preston Curve.” The correlation is well-established. The causative factors are less clear, and most likely include health behaviors such as smoking, community factors such as access to affordable nutritious foods, poverty-related factors such as chronic stress, and more.

Liberals focus on income inequity as the core problem. Conservatives focus on individual responsibility for health-related behaviors as the core problem. In all likelihood, each “side” is allied with a portion of the truth. But whatever the causative mechanisms, in the U.S. the correlation between income inequality and divergent life expectancy is getting stronger. The current effort to raise the minimum wage is a small step in the right direction.

Jim Sabin, M.D., 74, is an organizer of Over 65, a clinical professor of population medicine and psychiatry at Harvard Medical School, and a Fellow of the Hastings Center.

 

 

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Remembering Sherwin Nuland

The death last week of Dr. Sherwin Nuland, author of the prize-winning 1994 book, How We Die, reminded me of a line in that book “about our society’s denial of the naturalness, even the necessity of death.” Death in an ICU, he wrote, was the “purest form” of that denial, but more broadly he wrote, “Nowadays, the style is to hide death from view.” I suspect that death has become more open since then, in great part because of his book. It is still not an easy topic for most people.

Continue reading…

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Aging and Balance

Like many other skills we take for granted, our upright posture and balance are amazing unappreciated functions.  Imagine balancing a five or six foot top-heavy object on a one foot base and you get a sense of how precarious it is for us to stay upright, no less add movement, twists and turns, leaning and bending.  The epitome of balance complexity for me is a basketball player with a six and one-half to seven foot frame leaping and twisting and still managing to come down upright on the ground.  This is all managed by a series of functions that each instantly take in data about one’s position in space, coordinate inputs with each other and make fine adjustments in the time of an eye blink.  Watching a young child learn to walk demonstrates how much time and practice it takes to master this skill.  They spend years learning to master walking and running, constantly trying, falling and learning to interpret the inputs to their nervous system.

There are at least five functions that are associated with our ability to maintain balance: Continue reading…

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