44 Days to 50. Wow the days are really shrinking, it’s starting to feel MORE real. Speaking of feeling more real, there’s nothing more unreal than the real feeling of having your period on a day that you wish you could just erase your responsibilities. Everything is so much harder on those kind of days; simply getting ready and going out the door is that much effortful on a physical and mental level. But I did it. And in so doing, I felt old. Lower back ache, digestive issues, bloating, everything in slower and more resistant motion. Blah.
Flash forward to a patient toward the end of the day. At 70 something years old, he’s telling me how funny it is to be in an “old people’s home.” Was is that much more unfathomable to him, with a prosthetic knee, open knee lesion and now requiring a gerichair to leave his room and attend activities for enrichment? I will have to explore this further with him.
An 88 year old woman with a catheter foley is in emergency crisis mode because it had taken a third catheter to finally work on her after not urinating “enough”. Catastrophic thoughts of toxins building up in her body and dying instantly plague her mind, body, spirit and soul. Reframinng what she sees as a clunky, burdensome and awkward catheter to an instrumment that helps her health to keep her alive is a work in progress. Her panic. Her broken record thoughts. Reassurance seeking that going to the ER to have a catheter replacement monthly will sustain her until the end. Fragility. Emotional and physical and mental fragility. Reconciling youthful strength and vigor with wisdom, a new type of strength, agility and resilience… but also an accompanying visible fragility. No. A paradoxical puzzle that never end for all of humanity?
So another patient in her mid 70’s, wheelchair bound with MS and psychosis and confusion secondary to dementia tells her husbannd and me of the challenges in being on the other side of the power differntial. Once a high ranked VP at a bank and now at a long term facility, at what she believes to be in the mercy of others’ hands for her activities of daily living, is an unrelenting experience for her. How anxiety over the physical strength of others whom one depends on can have one project dark beliefs– such as “they” would hurt her if “they thought they could get away with it,” given their intimidating presentation and approach. Vulnerability at 360 degrees. Switch in power differential relationships. Power. Privilege, earned or not within context of race, ethnicity, sexual orientation, gender expression gender neutrality, social class, ability cisgenderism, what did I miss?. With wisdom and using street smarts, my patient learns to work with her fear for self-protection. Could I do that, given my ailments and fragility that comes out to those I trust or when I’m most distressed? As a South Asian, Nepalese-American heterocis, upper middle class woman, how will I face my inner and the social structural demons to navigate whatever aging throws my way past 50?
Quote of the Day “Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.: —RIP Steve Jobs.
Feeling trapped regardless of age is an unappealing existence. Subsistence. Jobs’ quote makes it easier to live in the moment as I approach 50. Maybe I’ll just go naked; wherever you go, there you are, says Jon Kabat-Zinn. 🙂