I’ve had unusual difficulty in preparing this article. I managed to put together a number of pieces for the our local newspaper, the Hamakua Times, some years ago, focusing on the natural and cultural history of our part of the Island of Hawai`i, and the research and formation of the essays generally flowed rather easily. This time the subject matter is much more personal and subjective: getting older and making choices that help determine the quality of the time we have between now and our death. Sickness, disability, dying: not the most attractive of subjects; not the easiest to write about.
Though we usually won’t argue that we’re not going to pass out of this life, we are even so inclined to push the reality of our coming death out of our consciousness. But as get older and our grandparents pass, and our parents, aunts and uncles, then our acquaintances, friends and our siblings, it becomes harder to ignore the reality of aging, disabilities and death.
Dr. Atul Gawande’s best-selling book, Being Mortal, is a masterful conveyance of the obvious but seldom-confronted fact that our mortality means at some point each of us, as we conceive of ourselves, will cease to be. Every reader of the book with whom I’ve talked to has spoken about an initial feeling of discomfort with it because of its effectiveness in forcing us to confront the reality of our eventual demise. How cheery, for example, can one be when contemplating Dr. Gawande’s assertion that, “…sooner or later, independence will become impossible. Serious illness or infirmity will strike. It is as inevitable as sunset.” Such disabilities are what many of us fear most, and the reason for this writing is to call attention to the welcome news that a majority of the problems that may beset us as we get older can be advanced or delayed by the choices we make. To a significant degree, aging is a matter of choice.
There is a vibrant and growing body of information about aging, fueled in large part by the huge population bump that occurred with the generation born after World War II. So many people are turning 65 these days that the impact of getting old is riveting the attention of the 26% of the U.S. who are part of the “Baby Boom.” In 2011 this group started reaching the age we have commonly thought of as the time to retire, and will continue, at the rate of 10,000 each day, to do so until 2030. It’s not just the Boomers, of course. We’re all getting older and aging affects not only us individually but our family, friends, co-workers, employers, healthcare providers, creditors, as well as _____________ (fill in the blank). The sense we have of the passage of time changes as we age, and while younger people may wish for the advantages that come with “growing up,” those who are already “grown up” tend to be less eager for what more years will bring. Dr. Gawande makes the point that “…how we seek to spend our time may depend on how much time we perceive ourselves to have.” Greater awareness of our time’s limits helps us refine what we attend to and how we use the time available and I can think of few things better to think about and act on than, as Sherry Anderson puts it, how to “ripen well.”
The positive effect of knowing that our choices can contribute significantly to the quality of our life as we age is augmented by the fact that most of the helpful choices are easy to grasp and not difficult to do.
I will expand on this theme in articles to come and must, before ending this, identify one of the very best choices we can make to help ourselves: keep moving. One of the very best bits of wisdom I’ve heard came from an elderly couple camping in the Pacific northwest, who said, “If you want to do something when you’re old, never stop doing it.” So if you are conscientiously exercising, good for you! Keep it up. If not, become more active. Walk, garden, stretch, dance, climb a tree, get out in the yard with the grandkids…. Look for opportunities to get out of your chair, out of your car and move your body. Even a little natural movement is good and will lead to a little more as the benefits build. Having a companion or two to share your activity will make it even more enjoyable and thus more likely to become a part of what you regularly do. Soon, when your friends ask how you got to where you were going, you can say, as Hawaiians may,
“Maluna mai nei au o ka wa`a kaulua, he `umi ihu. (I came on a double canoe with ten prows.)
Meaning, “I walked. The ‘double canoes’ are one’s two feet and the ‘ten prows’ are his toes.”
© 2015. Hugh R. Montgomery, PhD
 Being Mortal: Medicine and What Matters in the End. Atul Gawande, Metropolitan Books
 `Olelo No`eau: Hawaiian Proverbs and Poetical Sayings. Mary Kawena Pukui, Bishop Museum Press