Journal March 11, 2001

What is it like for me to be 88ish?

I have just made an appointment with my Health Maintenance Organization (HMO) for a "Health Assessment". That is an elaborate title for what used to be more simply called a Complete Physical Examination. A few days beore the appointment I am required to report to the laboratory which will take samples of various bodily fluids and analyze them for peculiarities. Depending on the extent of those peculiarities and any other irregularities which may be apparent, other tests may be ordered. Ultimately the Physician will examine me, evaluate the tests, and report his conclusions about my well being.

I am not making the appointment because of some sudden decline in my bodily health or physical condition. Rather, it is to simplify the procedural technicalities which might arise should the high-rise collection of cells which constitute my body suddenly, and unexpectedly, decide to cease functioning. Because of their age, such a decision is not unreasonable and might possibly occur soon. Some Doctor, somewhere, will have to sign a death certificate indicating the probable cause of death, before my descendents can dispose of the remains.

My interest in these technicalities was aroused by a talk I heard recently which was delivered by a retired Doctor who had been a staff member at my HMO. He observed that, in the absence of a reasonably recent health record, HMO doctors were often reluctant, or unable, to sign such a certificate. In that case, if the cause of death was not obviously apparent, the County Medical Examiner was likely to insist on official investigations which were likely to prove inconvenient for descendents at best; frustratingly slow at worst.

Since it had been almost five years since my previous "Assessment", and that by a Dooctor who had long since departed from the HMO, I decided that it would be appropriate to regenerate and up-date the official records of my cellular conditions. Some personal inter-relationship with the Doctor who would probably be asked to certify the appropriateness of sudden changes, also seemed reasonable.


The situation has caused me to reflect on the tremendous changes that have occurred in customary relationships with the medical community during the 60 years or so that I have had occasion to experience them.

My experience with Doctors began in 1942 at the beginning of World War II. Then, called to military service, I was being examined by Navy Doctors. I was 20ish, they were 40ish; much older than I and, in my eyes, wiser. More importantly, they had been 20ish in a cultural world not greatly different from my own. As I aged, my occasional medical consultations gradually changed to associations with demographic contemporaries who knew, from their own experience, what it was like to be my age.

But suddenly, about 30 years ago, I became aware that the Doctors were no longer my contemporaries; they were becoming increasingly younger than I. They had not been, they did not know what it was like to be, 60ish, or 70ish, or 80ish. Jerome touched on this point in his book "On Turning Sixty Five" (Journal February 28). He observed that "most studies of Sixty-five year olds must be taken with a grain of salt...they are usually made by 35 year old PhDs, if not by their even younger students. They have trouble understanding the results they are collecting; they think they're collecting exit interviews."

All of the Doctors assigned to my HMO Center appear to be less than 40; some are younger than 30 and have just completed their medical residency. I do not concern myself about their technical competence nor their dedication to their profession. But they have never been "old old"; some of them will never be. Nor was the world of their youth like mine. To them I present the image of an ancient grandparent, and even that image is inevitably clouded. The Doctor who will provide my assessment is Vietnamese; he speaks fluent French and Vietnamese but less fluent English. His ancestral perceptions are those of an unfamiliar foreign culture.

None of this matters; no conclusions of the "assessment" will lead to a rejuvenated youth. For me, the only time is "Now"; the only place is "Here". What I be, is up to Me!

What is it like for me to be 88ish?

Sixty years ago when I was 28ish I perceived my Doctors as very old; I was concerned about birth certificates. Now I perceive my Doctors as very young; I am concerned about death certificates!


Adjacent entries.

February 28, 2001.:
March 19, 2001.: