“Do you feel safe to travel?” the concerned doctor asks. It’s eight hours after I first arrived in the emergency room on a bitterly cold February morning, eight hours after multiple retellings of the fall in the night that has brought me here, eight hours after a battery of tests produced “unexceptional results,” a phrase that brings relief and concern about the cause of the sudden collapse.
Dr. A, in a kind and authoritative voice, had just recommended a round of specialists to see during the weeks to come. In turn, I had hesitantly replied that I was leaving in 24 hours for a trip to a considerably warmer climate than Toronto in midwinter. Hence her query about the safety of a monthlong delay in further tests.
“I’ll be fine,” I blurt out along with a raft of rationalizations for why it will be okay.
Her follow up questions — Is there good medical care where you are going? Do you have insurance? — are cautions and reminders of the excellent, free care available via the Ontario Health Insurance Plan. When I reassure her that the care, if needed, will be good, the plane trip only five hours with my husband to accompany me, she concludes with one last admonition, “Do not go out on long walks by yourself.”
I grew up in an era when the advice of physicians was unquestioned and am usually cautious when it comes to health-related decisions. At 82 I’ve also accumulated a history of discomforting interfaces with medical professionals and am learning to trust my own judgment about when to accept and when to resist their recommendations. Inevitably there are still moments when, like a teenager thwarted and relieved by a parent who firmly refuses permission for an unchaperoned party, I can still feel comforted by professional decisiveness.
In the emergency room conversation that February morning I was experiencing a frothy cocktail of emotions — equal parts anger, determination, and disappointment over previously canceled trips. No doubt it was Dr. A’s final recommendation not to go out on my own, a foreclosure of basic independence, that took me aback and most sorely piqued my indignation.
The following day, comfortably ensconced on the plane southward with time to unpack my experiences of the previous morning, I understood that the emergency room exit interview marked an existential Rubicon from which there would be no return. I had crossed into the country of middle-old age, where I would undoubtedly be making many other risk/benefit assessments, with ample opportunities to pit my desire to remain actively engaged in life against the threats posed by vulnerabilities that tell me to cocoon at home. How can I successfully navigate this new craggy geography filled with unanticipated obstacles? Indeed, what would successful navigation even look like?
Biologists remind us that we are all aging from the moment of birth, both a reassuring and unsettling reality. Growing older, however, is decidedly different from old age per se, and for this octogenarian who was fortunate to have a relatively healthy life, a bevy of new medical challenges that can at best be managed but not fixed is a daunting confrontation with impending mortality.
On Saturday mornings I resonate in synagogue with the Jewish prayer for the sick that does not seek a cure to illness but rather healing, a concept that more broadly embraces our mental, emotional, and spiritual sense of well-being. This shift in focus from physical remedies to the more intangible aspects of our lives points to the ability to experience a sense of wholeness and calm in the face of adversity. This acceptance of who we are in the moment is not a matter of resignation or defeat but rather a prompt to be the best possible version of ourselves that we can be.
As a conscientious medical professional, Dr. A focused on my latest vulnerability, finding the cause and making sure that effective assistance was always close by during an initial period of uncertainty. She performed due diligence. With time, and my own sort of due diligence, I have been developing another perspective, one that allows me to see my increasing age-related vulnerabilities with less fear and less determinative power over my daily life.
As an educator I long ago came to understand how our emotional vulnerabilities can function as a strength, rather than weakness, that links us to others. Now I am beginning to imagine this might be true of physical limitations as well. Vulnerabilities of all forms can offer a critical connective tissue that willy-nilly binds us together in a common world. When we are vulnerable we are open to others, and others open themselves to us. From this perspective vulnerability is not about loss or dependency. Rather it reveals our fundamental interdependence and highlights the myth of independence that is so powerfully promoted across Western cultures.
Next week, eight months after crossing an existential Rubicon into the territory of middle-old age and eight months after all the tests and consultations with specialists failed to result in a confirmed diagnosis, my husband and I are planning another longer, more complicated trip to visit family in Asia. I think that Dr. A might understand.
Jonathan Silin, Ed.D., lives in Amagansett and Toronto.