Aging in Sneakers

This blog is about outrage against stereotypes of age, sex and marital status. I also rant about the medical profession and talk about comedy. When you put these together, being old, single and female completes the perfect trifecta, making you a target for society in general and the medical profession in particular.

I’m not amused when a fifty-something author jokes about not remembering her ATM pin number. I know my pin number. I also know my library card number and my credit card numbers. It makes life easier.

I’m even less amused when someone asks me if I use email. I tell them I build websites.

I don’t laugh at jokes about old people. Google “old people having fun funny.” Now try, “black people having fun funny.” We laugh at children, cats, and older people who are just being themselves.

It’s time to stop accepting a second place, subservient role just because you’ve had a birthday. Instead of quiet acceptance, let’s belt out the old George Jones anthem, “I don’t need no rocking chair.” Let’s recite Dylan Thomas: “Do not go gently into that good night. Old age should rave and burn at close of day …”

This is a blog for raving, for gym memberships instead of rocking chairs, and replacing calm acceptance with a few well-chosen four-letter words. I want to be blown out like a candle, while I’m still burning.

Why sneakers? I’ve worn nothing but sneakers for the last fifteen years (with a few brief exceptions for dress-up occasions). Sneakers are associated with having fun, relaxing and being yourself. Stilettos have become associated with female success; books have titles like “Success in stilettos.”

The idea is that people, especially women, should accept pain and discomfort in exchange for beauty. In the 21st century, when women are landing fighter planes on Navy carrier decks and running major companies, this idea seems a little dated, to say the least.

Associating high-heeled shoes with success incidentally associates beauty with success, and for most people, beauty equals youth. Part of the pain of aging does indeed come from looking in the mirror. Even worse is the experience of being judged by one’s appearance. Compliments are conditioned by “for your age,” as in, “It’s impressive to see a woman your age who is bungee jumping, running a marathon, doing stand-up comedy or simply surviving without medications.”

Aren’t those accomplishments impressive at any age?

I may have to go down for the count but I don’t have to go there quietly.

Review of Third Chapter: Past Midlife And Searching For Meaning

[Review was originally published in 2009.]

The Third Chapter: Passion, Risk, and Adventure in the 25 Years After 50

As aThis book seems to be about preparing for the years right at midlife — the fifties and early sixties — and just past midlife, which Mary Pipher characterizes as the “young old.”

As I’ve noted in reviewing other books, I often think it’s impossible to write a really helpful book about this stage of life because (a) there just aren’t a lot of choices for everyone and (b) there’s such a variety of people, health levels, skills, aptitudes, background and more. Sara Lawrence-Lightfoot deals with (b) by focusing on a small slice of the population: educated, healthy people without financial worries. Within that group, she finds common patterns: a yearning for something that can’t always be named, a resistance to change (possibly because successful people tend to resist changing a cherished identity) and finally a learning that differs from previous classroom experiences.

It is insights like this one that led me to give the book a 4-star rating rather than 3-star. I agree with reviewers who complained about the length of interviews, details of subjects’ lives and narrowness of subject range. I also agree that the book doesn’t present as many original ideas and frameworks as readers might expect from extensive research. But as a former academic myself, I think it’s appropriate to work with a narrow sample, as long as you make it clear upfront, preferably in the book’s title. There’s value in asking explicitly, “If money were no object, how would people choose to enter their sixties and seventies?” At the same time, these people are insulated from many consequences of aging.

I also liked the author’s review of the way the notions of aging and retirement have changed. I would have liked to see more on this topic. When I lived in New Mexico I met people who lived in those “55 and up” communities, including one woman who took care of her aging parents. When her mom died, she was in her early fifties: too young, according to the community. I also met people who wondered why I didn’t want to live with my age-mates, an idea that makes me feel suffocated. It’s good to have the historical perspective.

The best part of the book was the author’s interview with economist Matthew Gladstone. Gladstone’s perspective makes sense, possibly because I have a b-school background and enjoyed my economics courses. Gladstone suggests that as we continue doing work, the law of diminishing returns sets in. If I understand him correctly, I believe he might suggest that a successful lawyer might get enormous joy out of winning her first case, then her second…but at some point, she will be less joyful. It’s like eating a meal when you’re hungry; as you start feeling satisfied you don’t enjoy the food as much.

I think we could extend economic thinking even further. When you reach a certain age, you certainly can invest whatever time, energy and money you have to learn something new or start a new venture. But your ROI – return on investment – will be limited. You might write one novel and maybe you will even sell it, but you won’t have time to go on and write a series that would bring you the real rewards that come to authors after a long career.

I don’t agree that the book reads like an academic article or a dissertation, having seen too many examples of the real thing. In fact, I think the book would be stronger if the author had introduced more sociological concepts to frame many examples. For instance, the interviewees made transitions from high-level professional or organizational settings to a more right-brained, artistic and/or spiritual focus. I know many people who never want to stop working. Volunteer work and the arts will never be enough for them (and I feel that way myself). The author notes that one interviewee, Pamela, feels frustrated because there are structural and institutional limits to her contribution. Yet anyone over 50 who wants to continue earning money faces much bigger challenges.

Finally, I admit to being jealous of those who found their new artistic callings. I wish I’d thought of singing lessons, but suspect I will still be advised to tap along to the songs rather than try to sing them. Over the past ten years, I’ve taken pottery classes in two different states. Each time I had less talent than anyone in the class. It was fun, though, and I just resumed. This time I decided to take on throwing. I still have less talent than anyone and I also have sore deltoids in my left arm. Still, I resonate to the experience of the interviewee, Josh, with learning the piano: trying to aim for a higher level does bring psychic rewards.

“You’re so wise…” is not a compliment

Someone posted on Facebook: My husband gave advice to a guy who’s feeling discouraged in dating. I overheard him advising the guy, “You can practice by talking to women in their 70s, just to learn how to relate to women as real people, and maybe get some advice on how to approach younger women.”

So now the role of an “older” woman is to be unpaid relationship coach to a clueless guy. And of course she’s filled with advice on how to deal with women in their twenties, since it’s been awhile and dating norms have, um, changed just a little.

And of course she’s a wise old crone. Never mind that she had a string of affairs throughout her life, most of which ended badly, mostly with guys with drinking problems who left her broke.

Or she’s always been an uptight lady who believed “save it for marriage.”

Or she’s wary of casual dating because she remembers the vulnerability she experienced growing up in the days before birth control pills were readily available just for the asking.

Or she’s a gay woman who isn’t quite the expert to advise men of a certain age.

Nope…she’s in her 70s. That makes her wise. A truckload of books supports the notion of wise old people. There’s even a whole book called “Replace Aging with Saging.”

When I think of “sage” I tend to think of spice you use on poultry; according to some spiritual healers, saging your home is a way to drive away the bad spirits.

And speaking of spirits, I’m not crazy about comparisons to wines that grow better as they age. Remember they have to be kept under special conditions so they won’t go sour.

First, why is “aging” a verb now? We don’t talk about “adolescenting” or “youthing” or even “midlife-ing.” We don’t talk about “health-ing” or “sick-ing.” The implication is that adding years to your life calls for some action on your part. If you’re healthy and active along the way, you’re “aging well.” If you’re happy and you demonstrate a positive attitude, you’re also “aging well.”

This concept takes responsibility away from your environment. Dealing with ageism every day? It’s up to you to be bright and cheerful. Your doctor says, “What can you expect at your age?” Well, you’re not aging as well as you thought … or you’ve chosen a doctor who deals in stereotypes. Catch pneumonia or fracture a bone in a fall? Definitely not aging well.

But let’s get back to being a sage. When you think about it, assuming you’re a sage can be just as stereotypical and destructive as assuming you’re a technological idiot.

When do we ascribe good things to a demographic group, universally?

Hopefully we’re beyond saying, “Black men play basketball,” or “Black people have rhythm.”

And hopefully we realize that not all Asians are natural mathematicians and engineers.

A lot of people – including the late Joan Rivers – joked about the stereotype of gay men and fashion. Hopefully we know that’s not true. I had a gay neighbor who wore plumbers-crack jeans and oversize sleeveless t-shirts with holes.

So let’s look at this one: “Older people …say, over sixty … are filled with wisdom.”

What’s wrong with this?

For one thing, not all people over a certain age are wise. Just take a look at some politicians around the world.

People of all ages can make poor decisions. Once they’re outside their areas of experience, competence and expertise, they’re like everybody else.

A sixty-plus person can deny climate change, insist that abstinence is the cure for teen sex, and believe fervently that anyone who doesn’t share her beliefs will go straight to hell — literally. A sixty-plus person can believe that we’re too puritanical and we should make sure teenagers get initiated into intimacy with experienced women. Conversely, another person the same age might have trouble naming the part of the body the British call the “naughty bits;” they might think the sex act is something inherently nasty — something women endure for the sake of marriage.

And I’ve met lots of mothers whose mothers delivered awful advice about child-rearing based on their own background. Someone who grew up in the forties and early fifties might respond to a misbehavior incident with, “That kid just needs a good swat.” Wisdom? More like an expression of values.

One problem with the “elder as sage” stereotype is that it’s hard to joke about. A famous female basketball player once joked, “I can’t dance. People tease me about it – my assistant coach asks, ‘Are you sure you’re black?'” My gay neighbor used to joke, “People ask, ‘Are you sure you’re gay?'”

But who’s going to joke, “Are you sure you’re old? You’re so dumb!”

Third, giving people pseudo-respect comes across as patronizing. “You’ve got experience. You have so much to offer!” reminds me of the way people speak to a five-year-old who stumbles across the stage in an ill-fitting ballet costume. “Wow – you’re really good!”

Finally, a lot of people over 60 would like to remain in the workplace. They want to take ordinary jobs. They may not be qualified to be Supreme Court Justices or Minority Leader of the US House of Representatives or coaches on basketball teams (both Paul Westhead and Marynell Meadors were a year or two away from 70 when their teams competed for the WNBA championship).

The thing is, who wants to hire a sage? Who wants to work alongside a sage? We want to hire a competent person who can pull her own weight and make a good colleague. We want someone who will be just another person.

If you want to hire someone with wisdom, find a consultant who understands the problem your problem to solve. Worry about experience, not age.

“You’re Sick. Whose Fault Is That?” Response to NY Times Article

This article by Dhruv Khullar was published in the NYTimes.

Jan. 10, 2018 –

The author writes: “Behavior contributes to nearly half of cancer deaths in the United States, and up to 40 percent of all deaths.”

The first citation refers to a popular news magazine with no links to the actual study. The second refers to a NEJM article that draws the 40% statistic from yet another article, this one appearing to be a summary in JAMA, associating numbers of deaths with specific behaviors, with virtually no info dabout how that number was calculated.

How do we assign causes of death? I knew an 80yo woman who smoked a pack a day, with no symptoms of heart or lung disease. Got checked regularly. When she dies in her 90s, will her death be attributed to cigarette smoking?

Thin, fit people get diabetes. Non-smokers get lung cancer. Donald Trump avoids exercise, eats junk and remains free of heart disease and diabetes.

From that NEJM article: “Smoking is increasingly concentrated in the lower socioeconomic classes and among those with mental illness or problems with substance abuse.”

Missing from the discussion are (a) medical error: a heart surgeon’s fatal mistake gets recorded as death from heart disease; (b) assuming longevity as desirable outcome, when an early death might be kinder than a long period of painful illness

Perhaps we should encourage a new form of health behavior: learning to interpret statistics in a medical report.

What people can do in their 30 40 or 50 0 MASTERY

On a Friday in 2012 was walking home from my coworking space, carrying two laptops. My load was unbalanced. Right outside my elevator I tripped. One of the laptops landed on my arm.

The pain was intense and my arm felt strange. But, I figured it was no big deal. I’ve fallen before. I’ve had injuries.

On Sunday I woke up and saw my arm had turned black. Not just black and blue. Solid black.

So I pondered what to do. At that time I was in an HMO plan so I figured I’d call my assigned doctor’s office. A pleasant-voiced doctor on call said, “It should be seen. Call tomorrow for an appointment.” Let’s call her Dr. Smiley.

When I got to the office, Dr. Smiley turned out to be a young, well-dressed Asian. She wasn’t interested in my arm. She tried to talk me into getting “bloodwork.” As I sat before her, with my arm a solid black, she pushed hard for a bone density scan. She asked how many cups of coffee I drank in a day. She asked about problems with earwax.

I hadn’t been to a doctor for years and wasn’t at all prepared for these questions. I did, however, refuse bloodwork and tests. Something didn’t seem right. I work in marketing and I know a sales pitch when I hear one.

When I finally got to the x-ray (where I should have been referred the day before), the tech chatted cheerfully. He asked me to wait and came out into the waiting room looking frazzled. “I’m calling the radiologist,” he said.

About fifteen minutes later, he returned. “You can go home now,” he said. By now it was dinnertime. They sent me home with no instructions. I went to my pottery class, where I was lifting things. I took the dog for a walk, pulling her leash as usual.

The next day a clerk from the doctor’s office left me a message saying my upper arm was fractured and I needed to see a specialist. The doctor called, not to give advice on how to take care of myself, but to sell me on coming in for a bone density scan.

What happened? I hadn’t mastered the formal and informal rules of the medical system. And I hadn’t studied up on tests and procedures that make up “preventive” medicine. I didn’t know that many experts believe bone density doesn’t predict likelihood of fractures, and that drugs intended to increase bone density have been reported as less than 3% effective. And I didn’t know that internists (also known as internal medicine specialists) have little or no training in the musculoskeletal system.

And, quite frankly, I wanted to believe in magic. I didn’t want the hassle of looking up information myself and making tough decisions, including decisions to change doctors. I didn’t want to do the tough work of mastery, which is the most important part of aging gracefully.

Mastery vs. Magic

All too often I see people approaching old age with one of two positions:

Magic: Believing you can trust a system, a person or an organization to prevent bad things from happening. As I write today, many doctors encourage us to believe in magic. And all too many people want to believe they can go to a Great Wizard for perfect advice.

We’re told that if you do certain things, you’ll ward off disease and even death. “Eat well and exercise,” we’re told. “Get annual screenings.” The doctor I saw in the opening story actually encouraged me to believe in magic.

Others place complete trust in a financial advisor, without bothering to check up on what they’re doing.

Fatalism is the opposite of magical thinking. It’s about believing you can’t do anything about your future so why bother.

Of course we can influence our futures, but not by doing magic.

Mastery means knowing how to do things and how to get things done. Mastery is what gives you confidence and lets you live life on your own terms. Sometimes you also need to add some moxie, the topic of the next chapter.

You may notice I’m not recommending a particular diet or exercise program to age gracefully. Nobody can. If you’re in your thirties or forties, and possibly in your fifties, anything I recommend today will be obsolete by the time you reach The Age. David Hatch, author of End Medical Reversal, says many screening tests we take for granted in the first two decades of the 21st century will be gone in another decade or two. So preparing for old age means learning how to learn and applying what you learn to whatever you experience in life.

Nor am I recommending a particular type of career path or investment strategy. In fact, I’m recommending you avoid leaving these decisions to the experts.

For one thing, your options and opportunities will be very different in the next ten or twenty years. Today’s seniors need to learn technology. Your learning requirements will be very different. But you can be sure of one thing: you will need to learn.

Learning to Learn: Your Most Important Skill

We all have different learning styles and you need to become familiar with your own style, as early as possible.

Are you a visual, auditory or kinesthetic learner?

I’m a combination of visual-kinesthetic. When learning new material, such as ancient history, I listen and take notes. Taking notes helps me focus and I remember more when I review my notes. I am, after all, a perpetual student.

But when I’m taking a pottery class, I don’t learn much from watching a demonstration. I learn by doing. I have to feel the clay and make the mistakes.

When it comes to exercise, I have a pretty lame kinesthetic memory. I walk away from an exercise class and can’t remember a single thing we did, even after attending the class for weeks. That’s why it took me forever to learn to drive a car, although eventually I mastered a five-on-the-floor stick shift. I learn an exercise routine after going to class a zillion times.

I’ve learned to compensate. When a trainer recommends an exercise, I ask to video him doing a demonstration or take detailed notes. If I go to physical therapy, I insist on diagrams.

Begin noticing how you learn so you can build on your strengths and avoid wasting money on programs and that don’t operate in your learning style. You can also learn to compensate for your less effective learning styles when your preferred style isn’t available.

Perhaps most important, when you understand your learning style, you will be able to stand up to stereotypes. You’ll recognize that you’re not having trouble because you’re getting old. You’re having trouble because you can’t use your preferred learning style.

What environments help you learn? Do you prefer formal classes or do you like to “just pick things up?”

Linda, in her late 50s, faced a steep learning curve when her job required her to learn spread sheet software. She balked. Her evaluations began heading south.

Linda kept fighting the system until she turned 60 and was offered early retirement. Linda’s boss undoubtedly jumped to the assumption, “Older people resist learning.”

But Linda’s friend gave me a clue. “They didn’t offer her classes!” she said. “They just insisted she learn.”

If Linda had been more aware of her learning style, she would have realized what was going on. She could have enrolled in a class on her own to learn what she needed. She lives in a large city with a community college and dozens of live training opportunities.

She could go further, choosing a class based on whether she wanted hands-on practice during the course (something I would want) or if she’s the type of learner who moves easily from observation to practice on her own.

Linda was also demonstrating a cohort effect, although she’d probably never heard the term.

Generations ago, when you wanted to learn how something worked, you consulted a manual. You could call customer service and gets one-to-one help.

When I set up my first online shopping cart as recently as 2002, I phoned the company. A tech rep courteously walked me through the set-up in minutes. Now, just a few years later, the company charges exorbitantly for telephone support.  Independent consultants charge upwards of $400 to give clients what the tech gave me for free.

Today’s generation resists formal training and manuals. They learn dynamically, searching online for exactly what they need to know.

This style of dynamic learning has become more than a preferred learning style. It’s a necessity because formal training often becomes obsolete very quickly. 

Back in the year 2000, I took a course in HTML – the language used to code websites – at a community college in Florida. Most of that training became outdated after less than ten years. Now, when I need to code something, I just do an online search for, “How to do X in HTML/CSS.” I know enough to interpret the code and adapt. And I do the same for Photoshop and other software.

In fact, the Internet world has changed even more dramatically since I drove to that evening class in Fort Lauderdale. Today I rarely use HTML because I use WordPress and other software. I still use Photoshop but I’m more likely to turn to Canva, an online free program that lets me create images quickly with almost no learning curve.

My 68-year-old dentist says, “Less than ten percent of what I studied at Harvard Dental School is applicable today. Ninety percent of my knowledge has been learned since I graduated.”

The Mastery Challenge

As you look forward 10 to 30 years, when you’re confronting issues of aging, be aware that you’ll be faced with knowledge that doesn’t exist today. You’ll undoubtedly need to learn new technology.

You might discover you’re learning in a style that hasn’t been identified yet. You’ll need to be aware when you have a clash of learning styles, not a clash of age and generation. And you’ll need to know what you need to keep learning throughout your lifetime.

So, what do you need to master while you’re in your 30s, 40s and 50s?

  • Critical Thinking
  • Decision Making and Choice.
  • Physical Activities that give you fitness and enjoyment. If you don’t enjoy doing them, you’ll feel tortured. And if you don’t spend time to achieve mastery, you won’t get maximum enjoyment.
  • Creative Activities that recharge your brain and are different from what you do for work.
  • Skills that help you make money.
  • Entrepreneurial mindset and practice.
  • Learning how to learn


Critical Thinking means you know how to assess information so you can make choices.

Once a medical technician, from the lofty perspective of her young millennial age, scoffed at me: “The Internet? There’s a lot of bad stuff on the Internet.”

She was obviously picking up on what she’d heard from her senior peers. But she was showing her own ignorance.

The problem isn’t with the Internet. It’s with our ability to evaluate sources and judge what’s likely to be solid information, versus buying into the latest quack salesmanship. When you read an article in a magazine, you need to question the quality of the magazine and the author. Is the author qualified? Does he work for a company with an interest in the topic under discussion? Does she seem to have an ax to grind?

You need that ability whether you’re on the Internet, facing someone wearing a white coat with an office wall of advanced degrees, or deciding who to support in an election campaign.

If you’re learning about the latest medical discovery, are you reading an article in a peer-reviewed medical journal? Or are you reading a tabloid? If you’re reading a book about medical invention, is the author affiliated with a reputable institution?

If you’re reading an article about the wonderful new opportunities for seniors to get jobs, does the author refer to published studies? Or does he use anecdotes that might be one-of-a-kind? Does she support an organization, such as AARP, which promotes an optimism that’s not always tied to reality?

For example, one of the worst career books I ever read and reviewed was The Dummies Guide To Get A Good Job After 50.

Critical thinking skills would alert you to be suspicious. You might suspect the book is biased when you see AARP’s endorsement on the cover. To attract members, AARP offers discounts for all sorts of travel and recreation. What kinds of people will respond to those inducements? What image of seniors does AARP want to promote? That’s AARP’s target market.

Critical thinking is a skill you can master. You can even take courses on line through Coursera or The Great Courses. Once you’ve learned to think critically, you can go anywhere to learn about whatever challenge you’re facing. You can search your library or talk to “experts.”

Most important, you learn what questions to ask when you’re dealing with advice. When you’re advised to buy a certain financial instrument, you actively search out criticisms so you can make a wise decision.  When your doctor advises you to take a certain test, you ask about the research behind the recommendation. In both cases, you question, “Does the person who’s advising me have a financial incentive to point me in one direction or another?”

The Ultimate Take-Charge Mastery Tool (Not As Bad As You Think)

If at all possible, arm yourself with an understanding of basic statistics, especially for health care information.

Forget what you’ve learned about statistics. Many college courses begin by deriving formulas filled with Greek letters. You don’t need those.

Start by listening to the online videos by Dr. Gilbert Welch, published on YouTube.  Learn to distinguish absolute vs relative differences in medical outcomes. If you can make change in the grocery store, you can learn how to do this.

You can find readable discussions in
Less Medicine, More Health by Dr. Gilbert Welch

Singled Out by Dr. Bella DePaulo
DePaulo, a sociologist, reviews the research on marriage and identifies significant flaws. You can use Chapter 3 of her book as a guide to understanding research in general.

Decision Making will become more problematic as time goes on – but not because you’re getting older. It’s because you are forced to make choices in areas where you have no experience.  You’re choosing among three or more options that didn’t exist five years ago…sometimes that didn’t exist even a year ago. Your challenge will be to develop your own personal decision system that you will apply when making choices in an arena that is new to you.

So you need a system to get the information you need, not just a path to information. You need to identify questions to ask and criteria for making a choice.

By way of analogy, if you’ve bought a car, you probably know how to choose your next one. You might ask about frequency of repair records for that particular model. You ask about gas mileage.

If you’ve bought a home, you know that roof replacement might be a disqualifier in most circumstances. You know how to choose a home inspector and why you need one.

But if you’ve never needed a particular kind of health service, you won’t have criteria for choice before you take action. If you’re exploring career paths, you need to know how to ask questions and where to get the best answers.

Often these decisions tend to be rare, so you can’t build on experience. It’s all about “learning to learn.”

For example:

(1) When forced to choose health insurance companies, I’ve found that insurance brokers save me money … but choosing an insurance broker is also a risky decision. Mine actually notified me of a way to switch to a plan to save $30 a month. I found him on Angie’s List.

Overall, I’ve found that online reviews tend to be more reliable than anything, even referrals from trusted sources. So that’s part of my decision strategy. But you have to decide what’s right for you.

(2) Many new businesses spend thousands of dollars on useless website development because they have never had to make those decisions before. Many web development companies have no qualms about charging thousands of dollars for add-ons their customers don’t need; a dog-walker who can barely turn on the computer was set up with an Adwords account. Some even charge for free services, such as getting a QR code.

(3) When I started working for myself on the Internet, I found lots of people who were eager to advise me for a hefty fee. I talked to people who claimed to be helped. I hired some. Nearly all turned out to be worthless; I actually got money back from some, because I was brave enough to ask. 

Eventually I wrote an ebook on guidelines for choosing a business mentor. It sells for $10 yet my audience has been reluctant to buy it. Perhaps they wanted to believe the hype – the magical thinking.  Or perhaps they didn’t realize the decision was complex and risky, requiring as much thought as purchasing a new car.

Medical decisions can be the most difficult because people feel helpless.

In his book Nonsense: The Power of Not Knowing, Jamie Holmes writes about the need to resist momentum when confronting a medical decision. He describes a woman who found a lump on her torso. Diagnosed with a rare form of cancer, she was ready to bow to the inevitability of painful, debilitating chemotherapy.

By sheer luck she was referred to a new oncologist who was more familiar with her rare disease. While waiting for her appointment, she went through her medical records. To her surprise, the lab reports used terms like, “most suspicious for…” and, “most consistent with…” Neither of her two lab reports seemed definitive. Her new oncologist ordered a new biopsy which revealed that she had no malignancy – no cancer at all, let alone this unusual form.

Later, this woman found a new growth. Her new doctor wants to refer her to a surgeon, but she says, “If I see a surgeon he’s just going to tell me I need surgery.” Her doctor agreed, prescribing three weeks of antibiotics. The new growth completely disappears.

Holmes quotes the JAMA Internal Medicine editors from 2011: “No test (not even a non-invasive one) is benign, and often less is more.”

Unless things change, doctors will keep offering and even pushing tests. It’s up to you to develop a decision-making strategy, even (or especially) if you’re labeled a patient.

Mastering Your Physical Body

In theory, we can decide what levels of fitness we want to achieve. In practice, we fall into a practice (or non-practice).

I didn’t make a conscious decision to be fit. I’d always been a wuss – the one who hid from gym classes since junior high. I never played sports. I was uncoordinated and some people even said I was “clumsy.”

The truth was, I didn’t know how to use my body. When I was growing up, ordinary people didn’t run races. Women went to places like Elaine Powers with the goal of weight loss, not fitness. Jane Fonda hadn’t come along to make exercise glamorous.

In my early 30s a friend dragged me to an exercise class in New York – something I’d never have done on my own.

My friend was a lawyer and a tough cookie. She even loaned me a leotard and tights, which is what we wore back then.

After one session, I was hooked. I went on to jazzercise and aerobics. I wish I could say they made me graceful and coordinated. They didn’t. But they did give me muscle tone and a higher level of fitness. And I am slightly more coordinated than I would be otherwise.

When I began going to gyms in my thirties, you wouldn’t see a woman in the weight room. In the 1990s I took a class on weight training for women. The idea was to get us more comfortable with lifting weights. Most of us hadn’t so much as touched a barbell.

I loved weight lifting and still do. I try to mix it up with dance, movement and lots of dog-walking. Now you see men in the dance classes and women in the weight rooms.

You probably get some health benefits from working out. There’s lots of disagreement on just what you get.

I heard a gerontologist on a television program say, “Exercise  is the single most important factor in aging – even more important than diet.”

A trainer at my gym said, “What you eat is much more important than how you work out.”

Susan Jacoby, in her book Never Say Die, dismisses the long-term effects of exercise. It might make you feel better, she says, but won’t keep you from a difficult death.

If you’re concerned about health benefits, use your Critical Thinking skills and do the research.

I’m biased. Exercise has been the only constant of my adult life. (OK, I also read murder mysteries, but I’ve been doing that since I was ten.) I’ve moved, changed careers, dabbled in ceramics and comedy, written, got bored with writing … and all this time I’ve held a gym membership and worked out faithfully, at least three times a week.

Because I’ve done it so long, I get a sense of mastery because I can walk into any gym, anywhere, and feel at home. When I visited Cairo, Egypt, I visited the hotel weight rooms. The equipment was familiar and the guys working there treated me with respect. Both women and men were working out.

The best part of working out comes on the rare occasions I see a doctor.

I ask my eye doctor: “So you see a lot of women my age in here?”
Eye doc: “Oh yes.”
Me: “Do most of them look like me?”
Eye doc: “No way.”
Me: “I bet I’m more fit than half the people in this office.”
Eye doc: “Only half?”

OK, I’m being a bit obnoxious. But doctors treat me better when they see I’m fit.

You may not want to develop mastery of your body the way I did. You may have genetic physical conditions that preclude exercise. You may prefer a totally different kind of exercise.

But if you’re reading this book in your 30s, 40s and 50s, don’t wait. If you’re not working out now, try different possibilities till you find one that fits. I’m not a doctor, but I’ve noticed that fit people do seem to age better. Women who work out seem to have less trouble with menopause and other medical issues, although I haven’t found supporting research.

A special note for women in the US:

Title IX came into effect in 1972. If you’re 50 in 2017, you were born in 1967 and you were 5 when Title IX was passed. You probably can’t remember a time when schools didn’t have athletic opportunities for women. You certainly don’t remember girls playing half-court basketball on six-person teams.

The WNBA started in 1996. I immediately became a fan, although I’d never shown the slightest interest in sports. As a younger woman, you probably take professional athletic opportunities entirely for granted.

Sure, the League has struggled with attendance. A lot of people don’t take it seriously. But when a woman has played on an intensive college or pro team, she’ll view the world differently. She’ll handle meetings with confidence. She’ll understand how to deal with tough bosses.

It doesn’t matter how you achieve mastery. But keep in mind that a 60-year-old with 20 years of working out will look and feel differently than a 60-year-old who’s just making the trek to the gym for the first time.

Personally, I would do two things differently:

  • incorporate stretching and balance into exercise routines
  • find a sport that you can continue at any age

You’ll find lots of aging swimmers, golfers, and hikers. I don’t do any of those things. You can probably get a good gym workout at any age, especially if you can hire a trainer. I’ll be finding out.

Opening Your Mind

I started meditating in my mid-thirties and kept it up for about twenty years. I still dip into a meditation session every so often. Back when I started, you could learn Transcendental Meditation for $75. The TM people set up a storefront in central Philadelphia, where I was beginning graduate school, and I figured, “Why not?”

It was a life-changer.

After exercise, meditation has been the most powerful influence on my life. In fact, without meditation, I might not have been as open to exercise.

Despite the jokes, research journals have documented the benefits of Transcendental Meditation (TM). My blood pressure has been fantastic, to the amazement (and annoyance) of doctors. My personality is still very New York; I’m not exactly the poster child for tranquility. But meditation changed everything about the way I live.

Back then, many educated people were getting involved. I remember hearing a Park Avenue psychoanalyst – complete with beret, pipe and accent – talking about the benefits he’d receive personally.

“I’ve been through three analyses,” he told an audience, holding up three fingers for emphasis. “Count ’em. Three. And I couldn’t forgive my mother. After six months of meditating, I noticed I wasn’t angry with her anymore.”

I, too, noticed that a lot of issues just went away when I started meditating. I still get angry. I still swear (especially at insurance companies and my dog who just chewed up my favorite earphones). But I’m much more in charge of my feelings and decisions.

Meditation worked beautifully for me, but I’m not recommending a particular style or even recommending that you meditate at all.

I do recommend that you pick up some mental health tools you can use on your own. It’s important to have those tools at your disposal and even more important to recognize what works for you and what doesn’t.

Some people really do well with psychotherapy or coaching. They feel better and function better. The downside is, you can’t do it alone and you need to keep paying. Then again, gym memberships aren’t free either. Some people continually go on meditation workshops.

Recently I learned about the Emotional Freedom Technique, EFT, or “tapping.” The idea is to tap on different parts of your body while making statements about issues or concerns. In many cases you can get immediate relief from problems, such as being annoyed with a difficult boss. Some people get over fear of flying. Some report being healed from physical and mental symptoms. You will find therapists incorporating EFT in their practices.

I’ve used EFT mainly on the rare occasions I have trouble falling asleep. A few taps and I’m gone.
To be fair I’ve never used EFT consistently over time. Many people I respect have reported strong benefits. Others dismiss EFT as voodoo.

If you’re interested, you can go online to learn more.

Some people turn to religion and prayer.

Choose what helps you function best. You’ll be saved from trying expensive techniques that don’t help you. And you’ll be happier longer.

Getting Creative

Become as proficient as possible in a pleasurable activity that’s not part of your job. Since writing has always been a major part of my work, I personally don’t get much creative juice from writing anything. But some writers do feel they’re turned loose on a playground when they switch from copywriting or tech writing to fiction.

You can choose just about anything. If you choose the arts, you can opt for photography, ceramics, painting, drawing, instrumental music, singing, dance … anything that gets your brain wired in new directions. You might like carpentry or gardening.  The key is to start early so you can enjoy your accomplishments and get genuine enjoyment from  whatever you do by the time you’re 60.

Learning something new can be fun, but it’s also frustrating. If you dabble in, say, ceramics when you’re in your thirties, you’ll be better able to dive in again when you reach your 60s.

Make your own rules. If you’re active in a competitive sport or just enjoy working out, this activity will become your creative outlet. If your ability to participate depends on physical assets of youth, though, you might decide to pick up a side hobby.

Let’s apply these skills to two areas – health and career.

For example, you’ll notice I don’t have a section on health.  Rather than health information, you need to start learning how to learn about health. What information is relevant? How do you sift through conflicting reports? How can you evaluate information critically, whether it comes from a doctor, an alternative medicine specialist or your next-door neighbor?

You’ll need to apply critical thinking skills to evaluate any information you receive.  You run huge risks if you simply follow your doctor’s advice. Unless the medical world changes drastically by the time you turn 60 or 70, you won’t enjoy a personal relationship with a doctor unless you pay for concierge medicine. Chances are you’ll get a busy doctor who’s considerably younger than you are. Doctors apply stereotypes as well as anyone else.


If you choose concierge medicine, or decide to find a doctor anywhere, you’ll need to know what to look for, what questions to ask, and where to get referrals. That’s all part of mastery.

(2) Doctors often give you recommendations based on the official party line, i.e., whatever they’re incentivized to do. So if you’re eighty years old and decide to take up smoking, your doctor might scold you about the health hazards; in reality, some experienced doctors have told me, if you start smoking late in life your longevity won’t be affected. You won’t have time to get lung cancer. If the guidelines call for cholesterol screenings and you’ve never had symptoms of heart disease, your doctor could recommend statins without advising you that many respected professionals question the importance of cholesterol in predicting heart attacks and also question the value of statins for people with no symptoms of heart disease.

(3) Your values probably aren’t the same as your doctor’s or hospital’s values. The medical establishment, as I write in the mid-teens of the twenty-first century, focuses on keeping you alive. If your life is saved by surgery, and you end up in an institution with limited mobility, where you can’t get out of bed or do any of the things that make life worthwhile, many doctors will consider your recovery a success. Keeping you alive but so severely impaired that you need assisted living or round-the-clock attendants? That’s a big success for doctors. You may not feel that way.

The truth is, a lot of what passes for conventional wisdom is not based on research. Some advice you’ll get from a white-coated MD in a mainstream hospital will actually be contrary to published research. For instance, many doctors recommend cardiograms to screen for heart disease, yet in the absence of symptoms, cardiograms have no predictive power. The false positive rate has been estimated as high as 80%. If 1000 people get  a positive result (i.e., “you have heart disease” message) following a cardiogram, up to 800 will be subjected to follow-up interventions they don’t need. Some of these interventions carry their own risks. Therefore, when you’re advised to get a cardiogram, and you have no symptoms of heart disease, you need to speak up. Should you refuse? I don’t know, but you need to make an informed decision.

Another example is CPR.  When you read about successes of CPR you read that the patients “survived.” But how did they survive? If you don’t get advanced life support in 8 minutes, according to some studies, you’ll be brain damaged. Many of us would rather have bystanders skip the CPR if the result means living with lifetime brain damage. If you’re hours away from a hospital, you might be better off with no CPR.

Again, don’t take my word for this. Google “CPR success.” You’ll become aware that CPR is very controversial. Many doctors and nurses shudder when they think of receiving CPR. Yet the CPR industry continues to grow. CPR is presented as something that’s uniformly good.

I’m presenting these examples not specifically to question the medical system, but to show why you need to do your own research and analysis. Some things you need to know are:

— The difference between a disease and risk factors for a disease
— The difference between absolute and relative risk
— The differences among prevention, early detection and risk reduction


Another area of mastery involves money and careers.

You can’t turn over a pot of money to a financial advisor and forget about it. Learn how to read statements and ask questions. And learn what is realistic for a portfolio.
One of my friends told me, “We have quite a lot of money – about a million in one account. I keep seeing losses and fees on every statement.”

I encouraged my friend to go talk to my own advisor, Gene, who’s totally realistic. When I told Gene the story, he said, “You won’t win big every year. Anyone who tells you that is showing off. But I would like to see the numbers and the fees.”

The best way to take charge of your finances – and your health – is to look at your career and plan how you can bring in money when you reach 60 and over. Many people no longer want to retire and do nothing. More and more of us plan to continue working well into our 70s. When you read about people who “aged well,” chances are they’re working at a career or they’re extremely passionate about an unpaid, creative activity, to the point where that activity becomes like an unpaid job.

Just as you need to interpret information about health care, you need to interpret advice about “careers after 50” and “careers after 60.”

Most of what you’ll read will be nonsense.

Lists of “best careers for seniors” includes some highly skilled fields, such as biomedical engineering, which call for considerable formal education. At the other extreme, you’ll be encouraged to seek jobs that pay $15 an hour or less, as I write this. The truth is, as you get older, you’ll have trouble being taken seriously in the workplace.

Forget the advice to “show you have technical skills.” Once you cross the threshold into “older,” it’s assumed that you love babies and hate computers. Even people who go through a hard-core code-writing boot camp often have trouble landing jobs if they’re over forty.

Frankly, crossing this threshold was the biggest shock for me as I grew older.  I never expected to stop working. I continue working out so I’m fit. I work online and build websites. I use social media. Yet when I attend networking events, I’m not asked, “What do you do?” I’m often asked, “So, are you retired?”

This is where mastery comes in. You need to ask careful questions and take charge of your career while you’re still in your 30s and 40s – certainly by your 50s.

Not all careers will be created equal. I’ve covered some of these points in the Money Section.

Bottom Line

If I had to pick the single most important component of preparing to age, it would be this one – Mastery. With Mastery, you can find ways to earn more money. You can be more effective at exercising choices and being your own advocate.

Simplistic article on suicide in the elderly from Milesetones

Milestones is a tabloid type newspaper published by the Philadelphia Corporation for Aging and distributed free in Philadelphia and downloadable online. It’s the usual party line pep talk stuff.

Their November 2017 issue included an article about suicide. Here’s how I responded.

I was appalled by your article on suicide among the elderly. Milestones reaches a large, diverse audience with a tabloid type newspaper. You have a rare opportunity to share accurate information and raise concerns. Instead, you present a simplistic view of a complex subject, in a way that could actually harm the very people you are targeting for help.

(1) The article conflates suicide with depression. The truth is, not all suicidal people are depressed, and not all depressed people are suicidal. Yet following an opening paragraph on suicide, the article segues into a discussion of depression, without making this distinction.
For many people, suicide can be viewed as a rational response to a diagnosis of Alzheimers or any other condition that removes the person’s opportunity to live pain-free and with dignity. Pain is not always responsive to treatment and side effects of medications can be so horrific as to take away all quality of life. The view of all suicide decisions as irrational is based on values, not medicine or science.

Last year, the New York Times Magazine reported the suicide of Sandy Bem, a distinguished research psychologist diagnosed with Alzheimers. She was perfectly sane; she just wanted to avoid the miserable life that lay ahead. In her book Never Say Die, Susan Jacoby describes a man who could no longer live alone, after living in solitude for many years and valuing his privacy; he stole his caregiver’s car keys, drove to a bridge and jumped. She argues that he should have had easier access to death, not psychiatric treatment.

To put this in context, at one point the CIA gave cyanide tablets to spy pilots who were in danger of crashing into POW camps. For many innocent elderly people, a nursing home will resemble a POW camp, but with no possibility of rescue and no opportunity to live a good life afterward. About 1/6 of nursing home residents are subject to abuse, and that’s a conservative estimate, omitting behaviors that deprive people of their peace and dignity; tying someone to a chair in front of a television set is considered normal.

Your article totally ignores this issue, suggesting that people want to die to avoid being a burden. Some just want to live a life free of pain and misery. Think of Patrick Henry’s “Give me liberty or give me death.”

(2) In lieu of Patrick Henry, the article quotes someone named Patrick Arbore, an Ed.D. Apparently he says, “depressed older adults often respond positively to intervention,” and, “In most cases their depression can be treated.”

“Often” and “most” aren’t exactly scientific terms or precise quantifications. Often could mean 51% or even “not rare,” i.e., 10-30%. Why aren’t you quoting statistics, which are easily available on the Internet?

Anything can be treated, but not all treatments have good outcomes. The truth is that only the most severe cases of depression respond to medications. There’s a strong placebo effect. Treating depression isn’t like giving someone aspirin for a headache; you have to work with the medications, trying one and then making modifications. Talk therapy has been indicated as more desirable for sadness associated with life events, such as bereavement.

(3) The article suggests that older people avoid therapy because of the stigma. People who came of age in the sixties — who are now in their sixties and seventies — grew up with therapy. They know that therapists differ widely in skill and experience. And they can’t find the good ones, let alone pay the going rate.
The New York Times has reported that only 55% of mental health professionals accept Medicare, compared to 86% of other medical professionals. Anyone seeking treatment faces an uphill battle to find a provider, let alone someone who’s competent and experienced with the relevant age group.

Another NY Times article found that 27% of people with depression were not receiving treatment. At the same time, about 29% of those being treated for depression were not clinically depressed; they were receiving unnecessary, potentially harmful treatment.

When readers get exposed to simplistic articles like this one, they may be tempted to push healthy people into treatment that’s at best a waste of time and at worst leading to side effects that would make anyone depressed. I personally know two people who presented with physical illness, yet were misdiagnosed as mentally ill, leaving them traumatized from receiving unnecessary treatment and suffering from delayed intervention in their genuine medical conditions. And according to Steven Hatch, MD, author of Snowball In A Blizzard, psychiatric diagnoses are prone to systematic flaws that can be summarized in one word: Rosenhan.

Practical measures should include fighting to make assisted dying more widely available. We need more awareness of the difference between depression-related suicide and the desire to die with dignity. And if someone truly is depressed, they need access to competent professionals, instead of the bottom of the barrel therapists willing to accept Medicare.

Simplistic articles like this one do a lot of harm. The elderly are abused because they’re not taken seriously. Many are depressed because there’s no place for them in society; that can be cured with a pill or a year of talk therapy. Writing in a simplistic tone about a complex, challenging situation can be viewed as dismissive, exacerbating the problem. I hope you’ll reconsider your editorial policy and start to do some good.

Answer to an article

Here’s what I sent to the author of Milestones, a tabloid for “seniors.”

The story on “elder orphans” raised several questions for me.

The term “elder orphans” is deeply offensive to many people who are aging without family. An orphan is a child without parents. We’re talking about adults without children. The term is infantilizing.

Additionally, the problem of planning for end of life as well as care during illness is not limited to elders. Anyone’s spouse could die or decide to leave; I know a woman who was “dumped” in her mid-fifties. Children can be unreliable, far away, or estranged. There’s no guarantee that children will carry out your wishes; we’ve all heard stories of the grown children who fly in and start making decisions even when they haven’t seen their parents in years.

As for care, something like 90% of elder abuse comes from family.

Your story also implies that older people who live alone are lonely. Many of us would rather be dead than share our living space. In her book, Never Say Die, Susan Jacoby describes a man who’s forced to start living with a caretaker. He steals the caretaker’s car keys, drives to a bridge and jumps off. Many older people can relate.

What’s needed are three things:

1 – A way to allow the elderly to see meaningful employment — something that gets rewarded for good performance. Not every elder wants to leave a legacy Many older people are isolated because of age discrimination in the workplace. One of Trump’s lawyers is 84 years old. Nancy Pelosi is in her late 70s. Most people their age would be considered too old for any job except greeter in a big box store. Getting paid means being recognized and valued. Many older people have trouble reaching out and getting involved because they don’t have money — and because working creates bonds.

I’m older than the people you mentioned in the article. I work on the Internet; there’s no way I could get a meaningful face to face job. And when I meet people, they don’t ask what I do; they ask, “Are you retired?”

2 – Currently age discrimination is not considered politically incorrect. Older women are disrespectfully addressed as “Gramma” or referred to as “grannies.” Jokes about older people needing diapers don’t help. Think of the song, “Grandma got run over by a reindeer.” Imagine a similar song about black people or gays.

3 – Everybody – not just the elderly – needs to be able to set up advance directives for end of life care, stored in the cloud. Those who set this up could get a bracelet or tattoo with the URL holding these wishes. We need strict laws to prevent overeager medical people from violating these wishes. This is the 21st century. I did my last mortgage without touching a piece of paper. Our ability to die as we wish should not depend on a live medical proxy.

And we need assisted dying. There’s no way to maintain quality of life in most nursing homes. Without constant vigilance by a capable advocate, the inmates will be abused.

Good article here:

Tracking Aging Concepts

Back when I was doing improv, we were at the last class. One of the guys says, “It’s nice to see you playing with the kids.”
“Kids? That guy over there has white hair. He’s not a kid. Anyway, what difference does it make?

7/15 – In the Clay Studio I tell the joke about telling tourists my dog is an authentic colonial dog. Nice guy says, “They think you’re this crazy old lady.”
Me: Crazy? I’m going to come here and make a crack about gays.
Him: “I’ll probably agree with you.” OK…I’m on that one.

7/17: Image on LinkedIn: “Software so simple even a grandma could use it.” Ageist AND Sexist.

7/18 – Today I’m watching a CreativeLive video on vlogs. The charming, very young presenter (who speaks with the usual “young people’s accent”) says, “You vary your presentation for your audience. If they’re older, you might want to go slower.”

Yet another age stereotype of “careers after 50”

Baby Boomers Look to Senior Concierge Services to Raise Income – by Liz Moye

What I wrote to the Times:

As an aging Boomer I’m appalled by this article. The headline suggests that baby boomers could “raise income” by working as low-paid service workers.The rest of the article reinforces the stereotype of “seniors” as caring and nurturing people who are more concerned with doing good and leaving a legacy than earning money.

This stereotype encourages discriminatory attitudes among prospective employers and clients in the mainstream, profit-oriented business world. Not everyone wants to play a nurturing role, nor are many suited to perform these duties. Yet prospective employers, most authors of books about careers after 50, and even organizations like AARP, assume that seniors aren’t interested in demanding, competitive jobs with pay commensurate with their skills.

Additionally, the article suggests ghettoizing the elderly. The idea is that people of the same age will find a “social bond.” The NYT would never suggest that people will find a bond on the basis of race, ethnicity, religion or gender. Just being part of the same demographic doesn’t mean you have anything in common or even want to spend time together. .

Think of all the 70+ legislators and politicians who run this country. They’re not exceptional in physical or mental capability. They’re exceptional because they aren’t forced to walk away from meaningful, challenging jobs that bring them enough income to hire their own repair and transportation services. They have access to good medical care, not desperate doctors who force them into rounds of unnecessary tests and debilitating drugs. They’re taken seriously in conversation with people of all ages.

Get real.