Keeping On

He was the 70-something version of many of the males in Harvard Square, arriving on his bicycle dressed in khakis, worn running shoes, a polo shirt, helmet, and backpack. A retired NYU physicist, he had asked to talk with me over lunch about my time at MIT for a book he was writing about the history of its physics department. After a bit of animated discussion about MIT it became clear I couldn’t help him much; my work had been in mathematics education research, not physics. Our talk soon turned to Trump’s latest atrocities, by now a ritual among the liberal-minded.

As our conversation wound down he got up to leave. “It’s time to take a nap,” he said, “the rest of the day is much better if I have a nap.” We paid our bill and he took off into the crowded streets. As I watched him maneuver his way around pedestrians and cars I was taken by his last statement – not that a 70-something man needed to take a nap, but that he had mentioned it so casually. Napping is one of the conditions of aging that is not often mentioned in public. It is a discussion to be avoided, especially amongst younger folk, lest one be thought of, and treated as, older than one wants.

 

Loss of stamina is a feature of aging that plays out differently in different people’s lives. But it happens to all eventually. In general, aging is affected by genetics, body maintenance over time, conditions of life such as disease or the residue of accidents, and attitude or personality. There are many pathways. The older we get and the less active we are, the faster stamina fades. Evidently, muscle strength is well preserved up to about age 45. From there on we lose about 5% in performance every decade so that now, at 75, it is predicted that I would have lost 15% of the level of performance I had when I was younger. We exchange about 1/4 pound of muscle for fat every year.

 

Not only do I now nap, but bedtime itself rushes forward. Over the years my New Year’s Eve dinner parties have ended earlier and earlier. My friends and I haven’t seen the ball come down in Times Square for quite a while. Nine is the new midnight. Becoming weary earlier in the evening, we now prefer the matinee performances of movies, concerts and plays. The last time I was at a Friday matinee concert of the Boston Symphony the young-looking grey-haired woman sitting beside me confided that she and her husband, who live in Maine, used to drive down and back for evening concerts. They can’t do that any more. We shared a moment of wistfulness but also solidarity. We were among the disproportionate number of grey heads at this afternoon concert.

 

While stamina inexorably decreases over the years, the process is somewhat reversible through exercise. When we consistently ask more of our bodies every cell rises to the challenge. The cardiovascular system delivers more blood to our muscles, and the heart begins to recover more quickly after activity. Muscles become more efficient at burning fat and storing glycogen so we can work longer and harder without tiring. Older people have the same ability to respond to strength and endurance training as do people in their twenties and thirties, though we may not return to the levels we had achieved when younger. Of course, like everyone, if we stop exercising, the process reverses.

 

Because of injuries sustained about a decade ago when I was smashed by a van while crossing a street, while I am generally quite healthy and active the only vigorous exercise I can do is to walk. Running and swimming, which I love, are out; upper bodywork is out. So I try to walk briskly for at least half an hour every day as an investment in increased stamina and better overall health. My neighborhood is colorful and active, often full of out-of-towners pulling suitcases; backpack-laden students careening around corners on bikes; the Harvard crew practicing on the river, the clank of oars in oarlocks echoing the coxswain’s call. My quest for increased stamina takes me out and joins me to this youthful, energetic community, bringing out the youthfulness and energy in me.

Energy levels vary a lot among 70 and 80-year olds. My Fit bit tells me that I typically walk about 7,000 steps or 3 miles each day, about half of which comes from that half-hour exercise walk. A more active friend, who walks her dog several times a day, swims laps for half an hour most days, and runs around town doing more errands than I do, logs in about 17,000 steps each day.

 

Loss of stamina means doing less in a day. Even taking into account my exercise investment, to my regret I find that now, at 75, I can do in a day only about two-thirds of what I used to do.   Not only must time be set aside for napping, but also I move more slowly and everything takes longer. Doing less in a day is hard for me, partly a feature of my personality, I suspect. Years ago my mother told me that when we were young, my sister would just go to sleep if she were tired. I, on the other hand, would stay up, fighting weariness, if anything of the slightest interest were going on. That is still true. There is always something more interesting than sleep – one more phone call to a friend, the reveal in my current whodunit, the last episode of Mad Men. Exhaustion follows the next day.

In what I remember as my glory days energy was abundant. When I was mid-way in my career, conducting research on how children learn mathematics and developing instructional programs for teachers based on that research, I often travelled around the country to visit research field sites, present academic papers, or hobnob with colleagues at conferences. At that time, one of my research team’s games was to see who could waste the least time in the airport. In those pre-9/11 days when there was no airport security the idea was that our work, or that last drink at the bar, was much preferable to languishing in the airport, so we aimed to get to the plane just before its door closed. The last one on the plane won. The image in 1970’s TV commercials of handsome, NFL running back OJ Simpson, not yet infamous, decked out in a tan three-piece suit, racing through the Atlanta airport, leaping over turnstiles, briefcase a-fly, conveyed the general spirit of the thing as we gulped that last drink and ran for the plane.

I now forgo the airport game. Not only does airport security slow things down, but also so does my changed muscle/fat ratio. Less of me is trying to lug more of me around. I don’t pack my daily schedule as tightly as I used to, allowing time for moderate moving, relaxing moments, and naps. Some things scheduled for one day get moved out to another and may even fall off into the next week. This slower pace is enjoyable but I miss the zest of days packed with activity and stimulation. It’s a bittersweet time.

While I do less in a day than I used to, it is still quite a full and rich life. On a recent Monday I had early morning coffee with the young man who winds my grandfather clock, cleaned up the kitchen from a large-scale cooking enterprise the day before and wrote for a couple of hours. I then took a brisk, half-hour exercise walk during which my unconscious mind worked on the sentence structure snarl that I had left on the page, ate lunch and took a nap. In the afternoon I went to a meeting about the Sanctuary work in which I, and others, look after an immigrant mother and her two young children who have sought sanctuary from ICE in a nearby church. It’s my one regular anti-Trump activity. In the evening I phoned a long-time friend to catch up. We exchanged stories about having cancelled this or that because of weariness and about our evolving plans for housing at the next stage of our lives. I wound up the day around nine.

 

Doing less in a day requires making choices. One way to cope with the diminution of energy and retain a pleasurable and happy life is to use the available energy for things one cares about and minimize or off-load the things one doesn’t like to do. For me, that’s all the household things – grocery shopping, cleaning, paying bills, running errands. I am fortunate to be able to hire helpers to take care of many of these tasks. During my working years I put in long hours, earned a reasonable salary, lived modestly, and saved up, anticipating extra needs in retirement. I did not have the expense of putting children through college and I was good at deferred gratification. I am fortunate to now be able to tailor my life to my liking, within reason. Many of us are able to achieve some degree of such control through a variety of arrangements, others, unfortunately, very little. I am grateful.

One becomes aware of loss of stamina gradually, through one’s 60’s and 70’s, and it is only now, as I look back and take note of it, that I realize the degree to which helpers have become part of my life, adding color and zing. Rosalita is a lovely Brazilian woman who comes every other week so that my apartment is always sparkling clean and neat. She has been coming for twenty years and we are now friends. Now a U.S. citizen, she is full of stories of how dysfunctional the Brazilian government is compared to the United States, though she is no more admiring than I of our current political situation. I am also learning some Portuguese.

The grocery delivery service has been in my life for about five years. They take orders online and I do internet chats with the shoppers about what to substitute for my favorite Kashi Go Lean cereal that is out of stock or the bananas that don’t look as good this week as usual. When they deliver the groceries I learn that most do occasional grocery shopping as a way to add a little money on the side of their work in IT, or as sales people at places like Radio Shack, or as students. Some arrive with toddlers in tow. We talk about how shopping for others fits into their lives (makes life a hassle), whether the pay is good (no), what it’s like on a very rainy day (messy).

For three years Steve has been coming once a week to wind my grandfather clock and do other things I can’t reach like change the smoke alarm battery, which he can do without a ladder or stool. Steve is a Harvard undergraduate who majors in economics, writes modern music, and plays on the football team. He brings the breeze of youth into my house. He also acknowledges being somewhat obsessive, which may explain his willingness to help me keep the boxes of batteries and light bulbs on a high closet shelf carefully arranged. “This helps me more than you,“ he quips. He is taking a course on the ‘60’s (yikes) and is interested in hearing what it was like to be part of it. He knows my limitations and offers to help with any thing, any time.

The work the helpers do changes over time as my needs change. Eventually, when I move there, staff at a Continuous Care Retirement Community in New Hampshire will do these tasks. My current helpers enable me to save energy for the things I love to do – reading, writing these essays, going to films and concerts, having coffee with friends, meeting with my writing group, doing political work. They also add variety and richness to my life beyond what I might choose on my own. I’m not sure I would have watched this year’s Harvard-Yale game were it not for my clock winder, nor seen my Sanctuary work as a human as well as political enterprise if I did not have a Portuguese-speaking helper from Brazil.

 

Along with reducing the number of things one does in a day, and changing the mix of the pleasurable and the annoying, another way to construct a pleasurable life in the face of decreasing energy is to savor what one does. The dominant ethos of American culture is to work hard, get lots done in a day, keep on schedule; aspects of the Protestant ethic that have become built in to our society and our expectations of ourselves. We rush through every day, always slightly out of breath. Work sits like a big box, plunk in the middle of our lives, deforming the shape of everything else. We squeeze family activities, leisure, household work, and church or community life around its edges. By and large, we have accepted this as the way of our lives.

However, this is only one way to live and, in the face of declining energy and with the delicious freedom of retirement, I choose another. I can do less, do the things I enjoy, and also do them more slowly, savoring them. When I can, I linger in my morning shower and revel in it – sheets of hot water stream over my head and down my back, loosening tight and achy muscles along the way. A roughly textured washcloth scratches my skin, warm lotions soften and lubricate afterwards. I walk on a winter day, taking in the impeccable whiteness of new fallen snow, its crunch underfoot, the crisp of the cold. Even an otherwise tedious task that can’t be avoided can be savored. Stuck in a traffic jam on the way to the dentist I notice the brightness of the sunlight, glinting off the edges of cars, tracing them in diamonds.

Such savoring is often called L’Art de Vivre – the art of living, from a French point of view. Taking the time to slowly drink tea with a friend, quietly enjoying both the friend and the tea. The deepening affection and love of long-time friends with whom I have shared the coming and going of husbands, the destruction of a home in a flood, the tragic fading of a father with Alzheimer’s. These, too, add richness and depth to living and a larger sense of significance.

 

There are forces in our society that do not accommodate older people, neither our wisdom nor our limitations, and make it difficult for us to adjust ourselves to declining stamina – inflexible working hours and retirement ages, the need to do physical labor long after our bodies can tolerate it, the bureaucratization and rigidity of many social services. Those of us for whom political activism is gratifying could well devote some of our energy in this direction.

But all of us can contribute to the battle against ageism not only by living well but also by being transparent about it, like my physicist friend who was quite open and straightforward about the benefit of naps, the lady at the symphony who talked about her need for afternoon performances, or Steve, the clock winder, who sees in my life different images of aging than he finds at home. Travel agents, hotels, and those who run senior living establishments advertise the possibilities of a youthful retirement – skiing, going on exotic and energetic vacations, cocktails at sunset after a day of golf. In better health than previous generations, many of us can maintain very active lives for many years. But a focus on staying young forever obscures the realities. Age does bring a lack of stamina and other physical ailments that eventually slow us down. The more my generation can age well with transparency and not shut our limitations away, out of view, the more we can support each other and give the next generation images of how to age wisely. Here we are, over seventy, and this is what it looks like. We are a big generation that has dominated each age level it passed through, changing definitions along the way. Well, old age, here we come!

“Eh?”

hearing-30097_1280.pngWhen I first began to wear my hearing aids I was amazed at how much I could hear. More people said hello to me in the street than I had realized, quiet murmurings with a friend around the edges of a concert became possible again, the rustle of dry leaves in the wind and underfoot, marking fall, returned. I was back in the world of friendship and warmth, quick jokes and laughter, love. This world also was bangy and clangy. The sounds of pans knocking together in the kitchen had a new ring, like the cymbals in an orchestra. The set of keys in my hand were noisier than I remembered, chattering away to each other while I searched for the right one. The grind of the garbage truck in the street had more layers – several different gears to grind away at paper, garbage, cans and bottles, each advertising itself individually. The little pieces of plastic-coated technology in my ears were bringing me both the beautiful and the ugly. Regaining this complex world of sound had involved a journey through denial, anger over the diminution of my world, and finally the charting of a new, and happier, path.

 

I had begun wondering about my hearing several years earlier when I found it difficult to hear the soft, light voices of my nieces and watched them contort their faces in the effort to speak to me more loudly. Or when I could not hear a piano playing in a distant room when asked what that piece of music was. I had brushed these lapses aside, thinking they were isolated events and my hearing was fine, for most purposes. Denial is a very convenient defense. But the experience of an evening meeting persuaded me that the time had come to acknowledge my hearing deficit, wrestle with what it was teaching me about the declines of aging, and do something about it.

It was a two-hour meeting; ten people sitting in a lush, comfortable living room, with wine and Brie, discussing how to raise money for a favorite charity. The light was elegantly dim, antiques gleamed, and the 19th century aristocrats on the wall, one by Sargent, seemed part of our group. I found it extremely difficult to hear what was said; words and phrases slid in and out of focus but didn’t add up to full sentences. Granted, the atmosphere encouraged quiet talk; curtains, rugs, and upholstery absorbed sound; and those particular people tended to speak softly, but still, they seemed to be able to hear each other. Later, minutes of the meeting were written and distributed, all agreeing that they were an accurate rendering of what had transpired. I learned the details of that meeting for the first time.

Missing an entire event terrified me. It had been like watching a TV movie with an erratic mute button on. Piecing together what was going on was work; participating, close to impossible. This was not the way I wanted to be in the social world. What else had I been missing? Finally being honest with myself, I recalled other hearing problems – being on edge before social events, wondering if I would be able to figure out what was going on; asking people to repeat or speak louder, which slowed conversation considerably, damping the joy of quick wit; pretending I had heard things, which always left a gaping hole in the conversation I was sure the other person could feel. Denial didn’t work any more. I really couldn’t hear well enough. I wanted my world of sound back.

While hearing loss is a normal part of aging, perhaps made more prevalent by our generation’s immersion in the high-decibel music of the Beatles and the Rolling Stones when we were young, it seems to be particularly hard for many people to acknowledge and address. The number of people my age who need words repeated, or spoken more slowly and loudly, is so large as to have become a stereotype. New Yorker cartoonists have made careers poking fun at elderly couples in restaurants, older men standing at bus stops, and pedestrians in Central Park nearly clipped by skateboarders; all oblivious to important messages headed their way.

Members of my generation often look young – hair suspiciously near its original color, dressed in Spanx-enabled slim pants and jackets – and move along briskly thanks to regular exercise and physical therapy. Hearing aids are visible and unambiguous signs of aging, though acoustic engineers are getting better at making them close to invisible. Many of us would rather suffer the embarrassment of not knowing what is going on than wear these devices that shout, “Old. Old.”

The very practical family in which I grew up, and my reaction to it, shaped my process of accepting the need for hearing aids. In my family, issues were dealt with in a rational, practical way, with little attention to the emotional side of things. Our clamor for a cheeseburger at an exotic (for the early 1950’s) roadside stand was rejected in favor of sandwiches when we got home, on the grounds of affordability. Sibling arguments resulted in everyone being sent to their room, with little concern for who really started things. Of course, “little attention to the emotional side of things” left me vulnerable to different problems later, but that’s another story. My family’s orientation did have the advantage of getting on with life, with little muss and fuss. I still have the problem-solving skills I developed then.

As I grew away from my family’s focus on the efficient accomplishment of tasks and focused more on being comfortable in my own skin, I learned how to navigate the world in such way that an inner feeling of wellbeing, as well as the virtue of task-completion, was a state to aim for. I began to value things that made my life fulfilling – time spent writing and deep in good books; long conversations with friends and family; careful listening to music, tracing out the inner harmonies played by oboe and viola. I found ways to minimize time spent on things that did not contribute to my sense of wellbeing. Inconveniently, these included mundane household paperwork, and laundry.

Navigating to maximize a sense of wellbeing requires acknowledging when things are uncomfortable. Denial is not an asset here. When terror after that evening meeting brought to my full attention the unsatisfactory state of the world I was living in, anger at the decline of my hearing translated quickly into the search for improvement. I wanted my world back as quickly as possible and saw hearing aids as much like eye-glasses – one might not want to wear them, but they were useful. The trade-off seemed worth making – wearing a barely visible sign of aging in exchange for getting back my world of sound.

“Costco is the place to buy hearing aids,” advised a friend. It might be true. Unfortunately, the glories of the modern hearing aid are not equally available to all of us. Because of the sophisticated digital technology and miniaturization, prices can range from less than $2,000 a pair to more than $8,000 for a pair with all the bells and whistles. Unfortunately, they usually are not covered by insurance or Medicare, though organizations like AARP and the Veterans Administration offer special discounts. Hearing aids are considered medical devices and require a medical hearing assessment done by an audiologist, which functions like a prescription in customizing the hearing aids. Hearing amplifiers come with pre-set sound profiles rather than settings customized to individual hearing needs. These are very inexpensive and can be purchased over the counter, like reading glasses.

I went for the medium/high-end of hearing aids, on the theory that conversation with family and friends and the nuances of good music were basic for me and I wanted to hear them well. My Phonak hearing aids amplify sounds within about 10 feet, toning down background noise; great for dinners in restaurants, where the clinking of glasses and silverware and guffaws of laughter from two tables away would no longer overwhelm conversation with my friends. They also have special programs I can turn on with the flick of a finger – one for expanding the ten-foot perimeter to amplify live music without distortion, another for dealing with the telephone’s close-up electronic sound waves. The former also allows me to eavesdrop on conversations across the room, a feature I discovered quite by accident at a cocktail party a few months ago when I overheard two women discussing stocks from thirty feet and three conversations away, raising the ethical dilemma of when to use my wonder woman hearing. Being digital, my hearing aids have been programmed to amplify just the frequencies where I need help. If my hearing further deteriorates they can be reprogrammed. Mine also use Wi-Fi, allowing the two hearing aids to operate together as one system, mimicking the way two ears work with the brain to process sound. It is now possible to get hearing aids with Bluetooth wireless technology that streams music and calls from computers, Smartphones, and TVs directly through the hearing aid.

Different brands of hearing aids have slightly different qualities of sound. I chose Phonak because it captures the depth and overtones of sound – a rich mixture that is interesting to listen to. Other brands made sound thinner and sharper. The distinction is like the difference between analog music recordings on vinyl and digital recordings on CD’s. The sound of vinyl is fuller, with more depth. The sound of CD’s is crisp and the notes have sharp edges.

My hearing aids are close to invisible. Vanity has influenced the development of hearing aids for decades. The most primitive form of hearing aid, used for millennia, is the hand cupped around the ear, creating a larger area for catching the sound, and signaling to others that volume is an issue. In the early 17th century sailors held long trumpets to their ears to hear the calls of other sailors on distant vessels. Later, smaller versions of those “ear trumpets” were adapted to help ordinary citizens with hearing loss. Over time, increasingly extreme efforts were made to hide ear trumpets. Furniture makers went so far as to build chairs and couches with sound intake cavities hidden in ornate arms and output cavities hidden in the carving of the upper back, near the ear. This drive toward invisibility was more about hiding the individual’s disability than about helping him cope with his problem. It wasn’t until the 1970’s, with the invention of the microprocessor, that truly small hearing aids became possible and our vanity could be satisfyingly assuaged. In an age of wearable computation, hearing aids of the future might become part of our jewelry, jackets, scarves, or hats.

It turns out that mine was the most common cause of hearing loss – loss of hair follicles in the inner ear that convert sound waves into messages to the brain. This follicle loss first affects the higher frequencies of sound, which accounted for my ability to know that people were speaking but be fuzzier about exactly what they had said. Vowels, which I could hear, consist mainly of low frequencies and, for me, speech was a quiet rumble of largely undifferentiated sound. Consonants consist of high frequencies. It was the consonants giving shape to the words that I couldn’t hear well. In correcting for that my hearing aids were also bringing back to me the higher frequencies of pots and pans, keys, and garbage trucks that I had always heard when my hearing was normal. I have re-adjusted to this noisy world. When I am not wearing the hearing aids the sound of the world is quite muted and, I must say, a bit dull.

 

My encounter with hearing aids leads me to wonder if I had inadvertently stumbled on a more generally useful strategy for dealing with aging. First, face the facts. Denial at this stage had only trapped me in a diminishing world that it took a dramatic event to shake me out of. Second, absorb the feelings of loss, anger, or fear of inevitable decline, but don’t get stuck. A sense of wellbeing does not lie here. Third, chart a new and happier path with all the inventiveness and energy I can muster.

I now live in a slightly more bangy and clangy world but one that also lets me hear my nieces’ jokes about the dorky guys their age on dating websites and appreciate the edgy music of Prokofiev and Miles Davis. It’s a trade-off, but if I can accept these little pieces of plastic in my ears and the minor inconveniences of managing them, rather than push them away, frightened that they mean “old,” they will bring me the ugly and unpleasant noises of pots and pans and garbage trucks as well as the nurturing sounds of my nieces’ jokes and good music. My hearing aids are bringing me more of both – more of life.