Random Thoughts from a Restless Mind

This weekend was spent in Chicago at the annual meeting of men and women with whom I share my day job. As I noted in “Sunday musings…” I’ve been suffering a bit from some sort of degenerative issue in my hip. Traversing the longest indoor “bridge” outside of the Providence airport rental car connector, my discomfort made me think of my Dad and the back pain that grew to consume him as he aged. Mind you, my discomfort is minimal in comparison, and my particular problem is quite amenable to a surgical fix with a high success rate. Still, it made me feel older, and it made me think of my Dad, gone these 3 years.

Below is what I wrote some years ago when I started to notice the changes in Dad.

When did my Dad get so small? Close your eyes. Think of your Dad. What does he look like? How old is he with your eyes closed? He’s younger, isn’t he? And bigger. MUCH bigger.

I spend most of every day in the company of people decades my senior. I’ve watched some of them age over 20 years or so. There are a few with whom I’ve bonded, who I remember and can conjure up an image if asked. I never appreciate the change in size in them, though.

It’s a strange phenomenon. It’s uncomfortable, no? There really IS a physical change that occurs as we age; we really DO shrink physically. No, it’s more than that when you look at your Dad, more than the physical decrease in size, the loss of vigor and all that goes along with it, the stuff I might actually notice in my patients. What makes it so striking when it’s your Dad is that it’s more than just physical, but a diminution in all dimensions and domains including the one inside your head.

He WAS strength when I was a kid. Literally, a rock. Immovable and unshakeable at all times. Unmoved by excuses or explanations when he knew he was right, or if he MIGHT be right. The final arbiter of discipline (“wait ’til your FATHER gets home…”) in a very traditional family, every thing about the guy was just huge.

When did he get so small? It’s almost scary, you know. He was the guy who stood between me and everything that might be dangerous, at least figuratively. At least in my mind. It’s hard to reconcile the guy I just put on a plane back to RI with my Mom, and the guy who’s there–right in front of me–when I close my eyes. So small now, almost frail. That classic love/fear thing now replaced with something more like love/protect. Does he see it, too? How small?

Will I see it, when I’ve become small?

Christopher Robin: “I’m not going to do Nothing anymore.”

Winnie the Pooh: “Never again?”

CR: “Well, not too much. They don’t let you.”

Toddlers rule the world. Seriously. Beth and I are watching the Man Cub and his tiny baby sister (“Pippy”, at least for now) as their parents take an afternoon to be the young couple that they are. A two year old is nothing but non-stop movement, all curiosity and instant gratification in a tiny bundle of Brownian Motion. There’s no sorta minding the toddler while you “get stuff done”, either. When it’s your turn on watch you are either on them like a hawk or you beg to be relieved of duty.

We are (mostly) blessed that our little guy is also quite bright and very verbal. It makes the time quite a bit more enjoyable while simultaneously taxing. “What is it?” pops out every 2 or 3 minutes, and every activity is preceded by an announcement–“I gotta do whatever”–and then accompanied by “play by play”. The announcements are quite handy in that they let you know where the next disaster is headed so that you can be ready to avert.

Having said all of this I am nothing short of astonished by how much more I am enjoying this stage than I did with my own kids. Don’t get me wrong, the sense of discovery and the unconditional love were there when my kids were toddlers for sure. The difference in the experience has everything to do with me: I have given myself permission to enjoy it this time. On Sundays now I muse whenever, whereas if I were a muser back then I would have tried to muse while on duty, an impossible task guaranteed to increase frustration and diminish the joy in both activities.

Therein lies the key, the gift of grandparenthood: you realize that you really do have a choice. If you are wise (or live with a wise spouse like I do) you give yourself permission to do what once upon a time felt like doing Nothing. It’s not, of course. Not for you and not for your little one. For you the gift is to re-live the wonder of discovery in a child while you witness the purity of the experience your grandchild is having. What your grandchild receives is you. All of you, all to themselves, for what feels like to them at the time like all the time in the world.

In the end the most fortunate among us are those who get to live in the chapter that A.A. Milne never wrote. The one in which Christopher Robin realizes that “he” has become “they”, and that it is only for him to decide that it is time for him to return to the Thousand Acre Wood. In the guise of his grandchild he will find that Pooh is still there, that he still loves Pooh and Pooh loves him. There to sit doing what “they” would call Nothing.

With his grandchild at his side, to sit together doing Everything.

Man, turning 50 has not been an easy proposition. I’ve been turning 50 since the day after my 49th birthday and quite frankly I haven’t been doing such a great job of it. The highway between mile markers 49 and 50 seems to be strewn with all manner of psychological speed bumps and potholes, pretty much all of which I’ve placed there myself.

Why is this? Why so much angst about 50? I didn’t really have any issues with 18, 21, 30, or 40, at least not any that I was so keenly aware of. In fact, I don’t recall ever thinking about the process of TURNING any of those milestone ages, not a minute spent thinking about the run-up to any of those birthdays. I suppose 40 might have presented an opportunity for at least a little introspection, or at least a little taking stock, but “turning40” angst was preempted in the course of a single ride on a chair lift in Utah the week prior to my 40th birthday. My chair-mate, noting his own near existential angst at the prospect of turning 40 several years prior shared the wisdom a priest friend had offered. 40 is when your still healthy, strong, and vibrant body meets the experience and wisdom of your now mature mind. That worked for me! 40 made sense after that.

In a dazzling display of prescience and foreshadowing, my lovely bride Beth responded to my epiphany with “wait ’til he turns 50! That’s gonna be a problem!” Shortly thereafter she contracted the mother of all cases of pneumonia and tried to die on me. Any little bit of an issue with turning 40 got pretty much short circuited in the elation that accompanied her recovery.

And yet, here I am. Turning 50.

What’s the big deal you ask? It’s just a number. You’re a January baby. It’s nothing more than another calendar to throw out.  One more tax return. What’s the problem here? Aren’t you the guy always looking forward, wanting what you have? The “no regrets” guy? Cut the crap! Find your balls. Snap out of it.

To which I respond: sure! There you are going all left-brain/left nut on me. Trying to impose logic and rational thought on what is clearly a right-brain, visceral “feel” kinda thing. It’s all about the right nut, the squishy can’t get your hands around it illogical nonsensical unease that resists both explanation and resolution.

My own left-brain gets it. Hari, one of my Crossfit buddies, nailed the rational aspect of turning 50. According to Hari our first 50 years are all about preparing. We spend our lives preparing either ourselves or someone else for something that is yet to come. We grow and get ready for kindergarten, so that we can prepare for grade school. Grade school begets junior high where we get ready for high school. High school prepares us for college which leads to job and adulthood. We then transition to the task of preparing others, our children, and spend the next however many years engrossed and engulfed in that pursuit. 50 is when we are done with the preparing. 50 is when we we exit Route Preparation and begin our journey on Route Me. At 50 we can learn for the sake of learning, not because we need to knock off a pre-req. We exercise and eat for the here and now, for how we are hoping to feel right at the moment. The first 50 years are about preparing; the next 50 are about living.

Why then, if I get that, am I having so much trouble TURNING 50?

As I’m sure you’ve gathered if you’re spending any time here on Random Thoughts, I am a physician by day. I finally think I figured it out one day in the office when one of my patients mentioned that she was having some issues with turning 60. We took a little detour, talked a little while about our “turning” issues rather than her eyes. 60 meant “old” to her, and old was more than a little frightening. She didn’t see “old” in the mirror, and didn’t want to think about any part of “old”. Her tactic? Classic–She simply decided that she was younger and told everyone she’s  55! How about me, she asked. You’ve made it. Successful practice and a wonderful professional reputation, healthy family, a marriage to be envied. Your biggest problem should be deciding how to celebrate! How will you mark this milestone, this success?

And there you have it. There, in that lovely compliment from a patient I barely know, was the issue. How indeed would I mark this milestone? The cartoonist would have put an enormous light bulb over my head, for here was at once the solution and the problem. I couldn’t say how I was going to celebrate turning 50 because I can’t celebrate in the way that it turns out I always thought I would, and that fact lies at the base of all of my angst, all of my discomfort, all of my difficulty in turning 50.

Physicians play a game early in their lives called “delayed gratification”, a game in which they willingly put up with the hardships of training and postpone most of the trappings of success. Tiny apartments and old clunker cars are OK because there is a world of plenty just over the horizon, a reward for both the sacrifice and the success that students of medicine encounter on their journey. Their preparation, as Hari would say. Once out in the real world, out of medical school and finished with residencies and fellowships, both the willingness and the ability to play “delayed gratification” slip away to be replaced by a sense of pride in having played,  not terribly fond memories incentive to never play again.

There’s the rub–I am once again playing “delayed gratification” and I simply can’t even consider doing some of the things I thought I could think about to mark this milestone. You know, classic 50 year old dumb guy birthday stuff like, I dunno, buying a Porsche. I don’t think I’d actually do that, but I DID always think that at 50 I would have been able to decide NOT to buy a Porsche, even though I could have if I really wanted to. Even the more meaningful stuff I’ve talked about to mark turning 50, stuff like climbing Kilimanjaro with my sons or accepting that invitation from Geoff Tabin to teach native surgeons how to do cataract surgery in Nepal, I’m not going to do those things because I CAN’T, because I am once again playing the game of “delayed gratification”. I might never have done any of those things, or any of a number of other things I might have thought of, but I always thought I’d be able to decide, that I COULD if I wanted to.

I can’t, and I find that I resent that. It makes my sad, and both of these feelings make my left-brain more than a little unsettled, for there is no rational response. No solution. No pithy sentence to conclude this particular Random Thought on an up note. At the end of the day there will be nothing other than sucking it up, moving on, and getting over it, getting over myself. There will be nothing other than trying to play the game of “delayed gratification” just as well at 50 as I did as a much younger man, for in the end I really have no other rational choice. I will have to hope, to try to be much better at BEING 50 than I have been at TURNING 50.

Because I’ve really sucked at turning 50.