Feb 26, 2005


We don't often turn 60 with the same cheery denial that hitting 50 generates.


But we should, and as more boomers pass 60, we will reframe its importance, and that's as it should be for a number of reasons.


First, at 60 you have to come to terms with the fact that you're in the downhill skid of your fourscore and ten. This isn't necessarily a bad thing: I believe that until you actually speak the words that plant the notion of the end -- "I am going to die" -- you don't really begin to grab a hold of the life you've got.


Second, those children you thought would never move out have indeed moved on, matured, succeeded or not.


Third, in your 50s, the sandwich crunch is a very real one. You're caring for your kids and your parents . By 60, most of us don't have independently living parents.


Sixty looks and feels more serene than 50. But it doesn't mean that dramatic changes won't happen.


"I'm going to send him away for a while. I need to be alone," one of my patients told me. She was telling her husband to scram temporarily. She had accommodated his snoring and his restlessness for years. Now, she wanted to sort out her own terrible sleeping patterns for herself.


It was more than just moving to the spare bedroom. No, this was a chance to rediscover herself at 60 and for her, that meant writing through the night or shaking loose from all her routines.


Her husband came to my office a week later; I had used the occasion of his flu a few weeks before to get some long overdue blood work done for him, which led to a prostate ultrasound. I was following up with him when I discovered a remarkably different take on the true meaning of turning 60.


His father had died at the age of 62 of prostate cancer. By the time it was diagnosed, it had spread to his bones. So the last three years of his life were a terrible passage. Somehow the notion of being treated with female hormones (back then, the only treatment available) was deemed by those around him likely to cause too much shame, and so he wasn't told much, not about the spread into his bones, or the awful pain or what to expect.


A huge cone of silence hung over this family and after the father died and hung on for another 50 years with my patient, his son. When I went through my plans for him and it became clear that it would take weeks and not days to complete the tests and arrange for him to visit a specialist, he said: "I have a speech to give two months from now that I would dearly like to see through."


That sentence stopped me dead in my tracks. He told me about his father's sorry end. He didn't see any other future than dying, and I had to quickly nip my breezy manner.


I soberly took him through the many likely scenarios: The first was that it was highly unlikely that he had cancer. It wasn't the accuracy, but the limitations of ultrasound testing for his prostate that were forcing the next step. This is an experience much more familiar to many women undergoing screening mammography. The test proves too blunt and leaves them in a morass of diagnostic dilemmas.


Now he can imagine life beyond 62.


Another patient told me her task, now that she was 60, was "learning to detach."


She hadn't had an easy life, emigrating to Canada as a young bride; having her children without the help of relatives and mothers, working long hours to master a new language and succeed. Depression wasn't even a blip on her culture's radar. So when the black despair hit, it was solitary, silent and deep. At its worst, her depression had resulted in a "suicidal gesture," or so the kindly doctor in the ER had labelled it after they had finished pumping her stomach.


But for her, this gesture was a shocking and shameful affair, and unforgiving. She was vigilant thereafter. Dark thoughts were not permitted, mantras and affirmations became her guideline and antidepressants helped.


Now, life is easier by far. She spends half her year back in the old country, among scores of relatives and aged parents. She pushes back the darkness with meditation.


This is her discipline now, her road to detachment, and that is a wonder for her.


I was enormously impressed by the final column -- called "Never Retire" -- by William Safire of The New York Times. Every decade, we seem to need to redefine ourselves, and as my patients demonstrate, to retrain ourselves as well.


Said Mr. Safire: "Athletes and dancers deal with the need to retrain in their 30s, workers in their 40s, managers in their 50s, politicians in their 60s, academics and media biggies in their 70s. When you're through changing, you're through."

Dr. Jean



Doctor. Writer. Athlete.

Advocate. Adventurer.