I’ve been reading Patrimony by Philip Roth – a true story about his 86-year-old father, Herman, who is suffering from a brain tumor. But it reaches far beyond illness – the story is also about identity and the body as it relates to aging. It’s about a son’s growing understanding of a father who, as Roth says, possesses “stubborn discipline, the source of all my frustration.” It’s about the difficult decisions Roth must make concerning his father’s care, which lends universality, as most of us will face similar decisions on the behalf of our aging parents who likely will become steeped in illness. I know, this sounds terribly morbid, but at least, Roth’s story is poignant and honest.  He isn’t maudlin or over-sentimental. He tells it to us straight via mostly dialogue, which allows us to hear the idiosyncratic voices of father and son, their everyday exchanges that lure us into the most intimate aspects of their lives. Here’s a brief section from the book, where Roth shares with us his father’s wishes concerning his care. It underscores what we (at least for those of us over forty) fear most as we age – loss of independence:

He repeated to me, to everyone, that he didn’t want a biopsy or an operation through the back of his head or the roof of his mouth – all he wanted was what he had wanted from the start: to be able to see his food and to read his paper and, as he put it, to navigate on his own.

Believe me, if your read this book, and I hope you do, you will likely find moments when you need to put it down and take a deep breath. But there are also moments when you will laugh – I promise.

Enjoy!

A few weeks ago, when a companion from a local volunteer agency dropped our ninety-year old neighbor, Shirley, back home after running errands, she realized she had forgotten her key. I knew this only because she buzzed our unit number on the callbox outside of our condominium complex, and my husband answered from his cell phone at work (his cell phone is hooked up to the callbox). He buzzed her in then called me on my cell phone (we don’t have a land line) to let me know Shirley was in the lobby. Why am I telling you all of this? Be patient, I’ll get there.

Fortunately, I was home, where Shirley’s spare key hung on the rack by the kitchen. I ran down the three flights of stairs – no Shirley. I ran back up the three flights, now out of breath because I’m out of shape. I found her pushing her walker toward our door, which is directly across from her unit. “Silly me,” she said, blushing. Her voice was tired but clear.

“No worries,” I said. After I unlocked her door, I stayed for a while to talk with her and her companion, an unassuming woman with soft features and a subdued voice. I joked with Shirley: “What are we going to do with you?” She laughed, slipped back a few feet, but grabbed the doorframe to balance herself.

Then her companion spoke up: “Now, Shirley, you really should hide an extra key somewhere so this doesn’t happen again.” Shirley nodded, her pencil-thin lips pressed so tight together the red lipstick she wore looked like a single stripe spread across her face.  “When I come back next week, I expect that you’ll have another key made,” the companion said. This time, Shirley looked at me, her Caribbean blue eyes shiny and round, like pinballs.

When her companion left, Shirley let out a huge sigh. “Why does she have to be so patronizing?” she asked. I bit my lip, nodded in agreement. She’s mentioned that word before – patronizing. She said it when a different companion used to visit her each week to take her places like the grocery store and pharmacy. “She’s a nice girl,” Shirley would say, “But she’s too nosey. She wants to make sure I have the right dress to wear to my grandson’s wedding. It’s patronizing.” She said it again when I asked her how her physical therapy sessions were going: “They’re helping me with my walking, but they always want to know what kinds of things I do at home. It’s patronizing.” I gave her one of those looks that says, “I don’t get it.” Certainly, they were just looking out for her.

As I stood in her hallway, my hand on the doorknob, I didn’t know what to say about her companion, so I said, “For some reason, as people age, we tend to treat them like children.” I hope I don’t do that, and certainly know better than to treat Shirley like a child. Of course, since we’re good friends, she would tell me, right? Though she’s ninety and a bit off balance when it comes to walking, her mind is far from off balance: before I left, she folded her arms across her chest, held her head up high, like Maggie Smith from Downton Abby, and said, “Just to bug her, I think I won’t get another key.”

“Why does it have to pass so fast – time?” My husband asked me the other day. “Why can’t I slow it down?”  He was rummaging through the kitchen pantry for peanut butter while I was tying my sneakers, anxious to get to the gym for a quick workout. I startled at the sound of the pantry door clicking shut, looked up, and saw him leaning over the kitchen sink, staring into the garbage disposal. He swiped the tear dripping down his cheek. I let my shoelaces fall to the side, pushed myself up from the floor, my forty-six year old knees cracking, and walked over to him. I didn’t know what to say. Maybe my mind was too busy with other things – get to the gym, dinner, call dad.  Then he said, “Maybe we just need to do more, live it up. But then time will pass faster.”

I rubbed his back, feeling heat rise from beneath his shirt, the in and out of his slow breaths. I tried to come up with a good answer, wanted to come up with a good answer. Aha! “Maybe we just need to be aware of every single moment of each day,” I said.

“Yes, that’s it,” he said, pointing his finger into the air.

But he had reason to feel sad about the passage of time. That afternoon, we saw a movie in which the wife suffers from a stroke, then another stroke soon after. Her husband cedes to her wishes and refuses to stick her in a nursing home to rot. Though he hires nurses to help care for her at home, he takes on most of the responsibility. After all, it is his wife. He feeds, toilets, and dresses her. At the end of the film, when the credits rolled, my husband and I sat for a while, along with several others, stilled by the weight of grief. Save for a few sniffles and whispers, everyone eventually walked out of the theatre, respectfully quiet, as if we had just attended a funeral.

On the ride home, I watched the windshield wipers sweep back and forth, clearing the glass of snow, making space for us to see ahead, into the distance. But what lies ahead? How far can we see before everything turns hazy? I’m nearsighted, meaning I can’t see very far without squinting. Sometimes I don’t want to see far; sometimes I prefer haze. Seeing far into the distance means seeing things I don’t have control over, like aging and all the inevitabilities that come with it: weak bones, stiff blood vessels, loss of bladder control, constipation. Yes, this all sounds terribly drab and pessimistic, but wasn’t it just a few years ago when I graduated high school? No, it was twenty-eight years ago. Wasn’t it just a few years ago when I pedaled my bike, on my own, down the hill for the first time? No, it was nearly forty years ago, almost half a century.

My husband had another reason for feeling sad about the passage of time. His dad is turning 90 in May, a milestone that has prompted him to reflect on the past, and anticipate his own future – “I have about thirty-five years,” he recently told me. He plans to make it to 90, just like his dad.

And so, as part of his nostalgic tour, that afternoon, my husband decided to drag the box of family photos from our shamefully cluttered closet. He fanned them across the carpet, their yellow edges and antique store smell stark evidence of the distant past.  He picked up a photo of his three girls when they were all under the age of ten. Now they’re in their middle to late twenties. “Look at them,” he said, then dropped his head into his hands, shook it side-to-side.

Meanwhile, I was gazing into the faded photo of a toddler: his close-cropped hair is the color of a pale sun, and he’s wearing a straight-lipped grin. His eyes look suspiciously familiar – narrow with a sliver of hazel peering through. “Who’s that?” I asked, my finger planted on the little boy’s ivory face.

“That’s me,” my husband said.

Almost fifty years ago.

I handed him the photo, watched his face – the wrinkles, each one longer than the next splayed from the corners of his eyes. Like lifelines. The pale sun is gone; it set a long time ago.  But his full head of soft gray hair is a playground for running fingers through.

I left my husband alone, went to the gym. On my way back, I stopped to check the mail. In the pile of credit card offerings, there was an envelope addressed to me, from my dad. I ripped it open, pulled out a photo. There we are, my dad and me, at Disney world. I must be seventeen. I’m wearing shorts and a tank top. My hair is blonde. My legs and arms are smooth, and Coppertone tan. I’m leaning on a penguin, not a real penguin, but someone dressed-up as a penguin. He’s wearing a hat of all things (aren’t penguins used to the cold?) My face is wrinkle free, and just as tan as the rest of my body, so tan that my white-white teeth gleam. My dad is standing on the other side of the penguin. If I’m seventeen then he must be forty-two, four years younger than I am now. He’s trim, with barely a potbelly. His hair is as blonde as mine. I stared at the photo for several seconds, ran my hand over it, as if doing so I would be transported back in time.

When I got back home, I tucked the photo in a book of poetry laying on the nightstand next to the bed, then went into the bathroom and looked at my face in the mirror. The same Melissa, with the same brown eyes, the same broad smile. The only difference is that I’m an older Melissa, with darker hair and puffy lower eyelids. When I look at myself tomorrow, and the day after that, and the week after that, I’ll likely look the same. But when I look at myself a few years from now, a decade from now, what will I see?

I don’t have an answer for how to slow the passage of time. Perhaps if we stop looking at ourselves in mirrors or dispose of all timing devices, like those digital clocks with red LED lights that keep us insomniacs up at night.  Still, the sun and moon rise every day, the seasons change – and tax day arrives every year.

Though no one possesses a magic remedy to slow time, the good news is that there is a reason for our perception of time moving faster as we age. Starting in our forties or fifties, time flows through us differently. There’s a change in our internal clock so that our brains no longer measure time accurately. I know, this sounds inane and metaphysical, but I encourage you to listen to the following National Public Radio broadcast, “Why does time fly by as you get older?” If anything, you can rest assure that you are not alone with the ticking clock.

http://www.npr.org/blogs/krulwich/2010/02/01/122322542/why-does-time-fly-by-as-you-get-older.

A few days ago, when driving to the grocery store, I came to a stop sign. Like I had learned in driver’s education, I came to a complete stop, then started counting, one-two … Before I got to three, the car that had just approached the stop sign to my right did not come to a complete stop. It glided past the sign. I peered through my front windshield, squinting to see who was behind the wheel. I could have sworn I saw a woman with white hair. It’s an elderly driver, I thought. I continued in the direction of the store, following her. When she approached the next stop sign, about one hundred yards ahead, again, she glided past. She made a wide arc across the parking lot of the grocery store, driving faster than she should have been, then pulled into a handicapped spot. I parked my car, got out, saw the offender – indeed, it was a white-haired woman who looked like she was in her late seventies. I wanted to run up to her and say, “Do you know what you just did? You went through two stop signs.” But I didn’t. Why? I thought I was over-reacting. In the grocery store, I saw her shuffling along, pushing a cart down an aisle. I walked close behind her, wanted to say, “Excuse me,” but, again, I didn’t. Instead, I purchased my groceries then left, still thinking about why I didn’t tell her she had failed to come to a complete stop, and that she could have hit someone. The truth is I figured she would scream at me, and say, “What if I were an eighteen-year old, would you scold me then?”

Legitimate question.

Maybe; maybe not. Probably. No. Yes. I don’t know.

What would you do?

My husband I recently escaped Vermont’s unforgiving cold and traveled to the west coast of Florida to visit with his aging parents – his mom nigh on eighty-five years; his dad approaching ninety. In the three or four months between visits, my husband speaks with them on the phone. Sometimes it goes like this: “Mom, it’s me Johnny, not Chris.” And, Dad, “You sound weak. Have you been eating?” Other times, it goes something like this: “Mom, Good. You’ve finally decided to listen to the doc. So you’re going to take your meds, right?” And, “Dad, it sounds like physical therapy is helping.” Still, we never quite know the truth of their physical and emotional state until we actually see them.

So, during our recent visit, we noticed marked changes: The progression of Mom’s macular degeneration, to the point where she needs to be with someone when leaving the house. As for Dad, if he walked for more than, say, a few feet, he’d wobble, nearly topple onto me. He’s fallen seven times in the past few months. Once he fell alongside his car (no, he does not drive anymore) and it took twenty minutes before someone found him. Fortunately, he did not suffer any injury. Unfortunately, he does not have one of those lifeline buttons – we have yet to convince him to get one.  And he’ll go hours, all day even, without eating: “I just don’t have the taste for food anymore.”

Since I’m the nurse in the family, Dad appointed me to speak-up at the appointment he conveniently scheduled during our trip to the Sunshine State. And we, the family, knew Dad wouldn’t speak up for himself: “I don’t want to take up too much of the doctor’s time.” So, when the doctor walked into the examining room, I was prepared with a list of requests: a physical therapy referral, a referral for a nutritionist to discuss Dad’s dietary needs, and another one for a home health aide to help with bathing.

Bingo! The physical therapist made it to his home within a couple of days and the home health aide two days after that. By the end of the week, Dad had perked-up and, though not his favorite culinary cuisine, ate some scrabbled eggs and a few jars of baby food. “I’m gonna listen to the physical therapist and do my exercises,” he said.

As for my mother-in-law, we have yet to assuage her fear of eye surgery. If she doesn’t go through with it in the next six months, her doctor says she’ll be blind. How then will she care for herself? If she can’t see Dad’s pills – the ones for high blood pressure, high cholesterol, high blood sugar, leg spasms, depression – who will make sure that he takes them? How will they manage meals, get dressed, what we health care professionals call ADLs, or Activities of Daily Living? My in-laws are lucky in that one of their adult children lives with them while two others live nearby. They cook meals and pick up prescriptions and/or groceries, and they take Mom and Dad to medical appointments.

What happens to our elders who have no one to advocate for them, to make sure that, at the very least, they are fed, bathed, and dressed each day? Unless they, or a family member, are savvy with the complexities of our health care system – things like what insurance does and does not cover – or have the chutzpah to speak up for themselves, they go hungry, left un-bathed. At the end of the day, they are left bereft of dignity.