New chapter in life means challenges

Moving is a time for reflection. No matter whether it is to a new place, or to a new job, there is something in packing your old life in boxes that makes you think about the fundamentals of life. With every item you touch, memories come afloat, some of the things you considered invaluable may suddenly seem to best fit in the trash bin, other items hold special meaning.

Last week I was packing my stuff from my office at Bell Hospital: books, journals and magazines, articles, forms and guides, certificates and diplomas. In one drawer I found a collection of my driving licenses, student and employee ID cards. I do not recall why I got into the habit of collecting them, but I started years ago and I have never stopped. They are a miniature gallery of my professional life, the places I lived in, my hopes and dreams: a student ID card from Sackler School of Medicine, Tel Aviv University; driving licenses from New York, Ohio and Florida; and employee ID cards from universities and hospitals.

Looking at the pictures on my ID cards, I had two observations: first, in all of the pictures, I appear beamingly happy with a wide smile and shiny eyes. The second observation was that through the years, and despite the advances made in the technology used to produce these ID cards, the person smiling in the pictures, myself, appeared exceedingly older. The scientist in me recognized that aging is a natural, gradual process. The realization of its existence in me, however, was surprisingly and disturbingly shocking.

One reaction to the problem of aging would be immediate and complete denial. A different reaction, encouraged by the cosmetic industry among others, would be that of defiance. But I know that in the case of aging, both approaches could not withstand the test of time (or that of simply looking in the mirror). So I resorted to console myself to acceptance.

One can find consolation, for example, in the fact that aging is not a simple process of wear and tear but rather that of a constant renewal. You do not age like a car does: your parts do not rust, your engine does not fail, and you don’t just completely fall apart one day. It is because unlike the parts of a car, your cells are programmed to constantly change.

They repair and remodel themselves using nutrients they take from the environment, relentlessly replacing old parts (proteins in the cell membrane, for example) with new ones. Some of the cells in your body, your brain cells, for example, may be as old as you are, but their engine has new parts, and they are running almost like new. It is true that many cells in your body do die, even now, as you are reading my column (don’t panic, keep reading), but they do so in an orderly, planned, programmed way (a process called apoptosis) and while doing so, other cells divide, and new cells take the place of the old ones. You may find comfort in knowing that some of the cells in your body, no matter how old you are, have very many new parts, while others are brand new.

I find consolation also in observing some of my oldest patients. Somewhat surprisingly, and despite various ailments of their body, they seem to be content, happy, and at peace with the world. Research into the psychological well-being of older people has confirmed my observation. Arthur A. Stone and his colleagues from Princeton University conducted a telephone interview of 340,847 people in the U.S.

They observed that sadness was relatively flat through life, but that worry was elevated through the middle age and then declined, and that stress and anger steeply declined from the early 20s. They found that a person’s overall appraisal of his or her life and his or her positive feelings and emotions increased after the age of 50 years.

The best consolation is this: everything, including old age, is relative. On my first day in my new job I was summoned to the Human Resources office. I was asked to sit with my back against a large green screen and to smile. A picture was taken and an employee ID was made. It is the usual ritual indicating that I now belong.

A short glimpse at my new employee photo ID would reveal a man that appears to be beamingly happy with a wide smile and shiny eyes. And years from now, when I move again, I will look at this picture and think to myself: “Boy! Was I once young.”

Editor’s note: Dr. Shahar Madjar is a urologist at Bell Hospital in Ishpeming. Read and comment on prior columns by Dr. Madjar at DrMadjar.com.