Chapter One: The Next Fourty Years
Okay, you’re a terrific woman, maybe in your late forties, maybe your early sixties, and your life has gone pretty well. You have good energy, decent gifts, and right now you seem to be heading into a particularly nice stretch. The kids are getting big or are gone. Old Fred, if he’s around, is taking care of himself, and the relationship is taking some nice turns, getting a little calmer. For some reason— menopause or whatever—you feel as if it’s time, at rather long last, to look after yourself and your own, serious business. Time to take your own affairs, your own life, your own needs in hand and do something. Maybe something pretty big.
There’s a lovely quote from Isak Dinesen that goes, “Women, when they are old enough to have done with the business of being women, and can let loose their strength, may be the most powerful creatures in the world.” You may feel that you’re never going to be “done with the business of being a woman”—maybe you don’t want to be—but you know what she means and you know that it’s true. And nice. Very nice.
Harry (that’s Henry S. Lodge, M.D., my doctor, coauthor and close pal) and I have been picking away at this project for several years now, and we have talked to an awful lot of women your age and older. We have come to realize just how right Isak Dinesen may be. Unlike men, who are often getting a little shaky as they approach their sixties or retirement age, many women are feeling more independent, more optimistic, more powerful. Freed from lots of the caregiving, perhaps some girlish posturing and other stuff that Dinesen may have had in mind, they are liberated to look at other, possibly larger issues. Such as themselves. Not out of selfishness, or narcissism, but out of interest. They’re not going to shove Old Fred out of the boat, you know, but they’re not going to lose track of themselves anymore, either. I spend a lot of my time with women—especially able and ambitious ones—and I see it and hear about it all the time. It is exhilarating, it is striking, and it is very different from what we hear from men.
Men may be at the actual height of their careers and powers, but they’re uneasy, too . . . starting to worry about what’s going to become of them next, when they hit sixty, or retirement. When they no longer have the lifelong robes of Office, Job and Position in which to wrap and comfort and define themselves. They’re starting to wonder, ever so slightly, just who the hell they are under that blanket. Or who they’re going to be in the Next Third of their lives when they have to take it off and hand it to someone else.
All generalizations are flawed, but women seem to see the situation differently. For one thing, few women have the luxury of wearing one lifelong robe. They slip into one role after another, juggling and doing the best they can. Few have the time to fall in love with themselves as the Great This or the Important That. And so, after whatever detours life has thrown their way, women are nowhere near as likely as men to stew about what’s going to happen next. To lift Faulkner out of context, women don’t just “survive,” they “prevail.” Which makes them a lot readier than many of their spouses or lovers to tackle the next phase, whatever it is. So, you ask, what’s next? What about this Next Third you mention? And how about this business of getting younger next year? Is it true? Is it for me? And what do I do?
That, of course, is what the whole book is about (and yes, you bet it’s true . . . and absolutely, it’s for you). But before we get to that, let’s talk for a minute about what you think you know about the aging process . . . the pictures you carry around in your head. They are probably not that great.You’ve been reading and talking a lot, and everywhere you look, there are these scary problems, fluttering down like feral birds at the edges of an uneasy garden party. You know you’re supposed to live a long time, but it may not be that much fun. Runaway osteoporosis after menopause. Breast cancer. Epidemic levels of heart attacks and strokes. Failed retirement plans and a good chance of dying broke. Failed marriage, loneliness and the utter impossibility of finding sex after sixty. Hell, after forty. And other, formerly nameless horrors like incontinence, for God’s sake. There’s June Allyson (who was so young and whom I loved so achingly when I was ten) talking on TV about incontinence. Yikes! You have visions of yourself as an old woman, bent double over her cane in some lonely place . . . looking for all the world like the old girl in the gingerbread house with the wart on her nose. Or maybe a bag lady in New York, shuffling along with mountains of crap, muttering strange incantations under her breath. Great.
So look, could you use some good news? Fine, try this: That’s not going to happen to you. Not even close. Bad things do happen to some older women in America. Bone loss is a terrible problem. Heart attacks and strokes are the great killers of women. Lots more women than men do die broke. (More women than men die rich, too; however, that’s another matter.) But the terrible things are probably not going to happen to you. Because the worst things turn out to be voluntary. You do not have to go there. So don’t.
Two amazing numbers, right up front: 70 percent of aging, for women as for men, is voluntary . . . you do not have to do it. And you can also skip 50 percent of all the sickness and serious accidents you’d expect to have from the time you turn fifty to the day you die. Skip ’em. Altogether. Harry will explain the details later on, but for now just remember those numbers. They’re numbers to live by, and they’re real.
In fact, the Next Third of your life—and that’s what we’re talking about here—can be absolutely terrific. Instead of getting old and fat and ridiculous in the thirty- or even forty-some years after menopause, you can remain essentially the same person you are today. It’s better than that. Learn some of the new science that Harry is going to talk about in the rest of the book, then do some of the hard stuff that will seem obvious after that . . . and most of you can be functionally younger next year and for a good many years to come.
That sounds like baloney or hype, but it is literally true. Limited aspects of biological aging are immutable. Like the fact that your maximum heart rate goes down a bit every year, and your skin and hair get weird. So you’re going to look older. Tough . . . what did you expect? But 70 percent of what you feel as aging is optional. No joke. No exaggeration even. There’s a new, tough game out there. And congratulations: You are eligible to play. You just have to learn how.
Again, here’s what you think you know: You turn fifty-five or sixty and your feet are on the slippery slope . . . the remorseless slide into old age, foolishness and death. Every year a little fatter, slower, weaker, more pain-racked, more apathetic. You can’t hear and you can’t see. Your hips go . . . your knees. You develop that becoming “widow’s hump” because your bones are turning to chalk. You get petulant, except when you’re absolutely furious, which is half the time. Your conversation goes stupid and you start calling strangers “dear.” You don’t have any money, and your muscles look like the drapery in Great Expectations. You break your hip . . . go to the Nursing Home.
That can certainly happen. In this country, it often does. But it’s a choice, your choice, not a sentence from on high. It’s a choice that you control by how you are living right now. And it is not the only choice. You can, just as easily, make up your mind—and tell your body—to live as if you were forty-five or fifty for most of the rest of your life. If you’re willing to send your body some different signals, you can get off the slippery slope. You can stay on a gently tipped plateau until you’re eighty and beyond. Way beyond. There are women out there skiing slalom races in their late eighties; I’ve seen it with my own eyes. Harry has a patient who is playing tennis in her late nineties. And other older women are biking in the steep hills outside Barcelona, where Lance Armstrong trained. Not just crawling along, either, like little old dollies, but doing it. Going for it. Having a major good time. Nice sight, believe me. I travel in these circles and I see it all the time. Honest.
And there are other older women who are not interested in athletics but who are still in great shape and having a vigorous, amusing, deeply sensual (and often sexual) old age. So here’s the lesson of the book: You do not have to get old the way you think. You can do all the same things, almost the same way. Bike, ski, make love. Make sense! Roughly the same energy . . . roughly the same pleasure. Roughly the same woman. In fact, if you’re a bit of a mess right now, you can become a radically better woman over the next few years and then level off. No kidding. I might kid you a little, to keep your spirits up, but not Harry. If Harry says you can do all this, it is simply true. Alot of the book is in my words, but Harry sets down the heavy timbers. I tell the stories. Harry tells the truth. You’ll see.
If you haven’t been there...you probably can’t imagine how bad “normal aging” is in this country. Take it on faith for a minute: normal aging is pretty grim, and the difference between the curves is profound. We are begging you, Harry and I, we are begging you to get off the slippery slope. It will make a fundamental change in how you look at aging and how you feel and who you are in the Next Third of your life.
You Do Have to Age, but You Don’t Have to Rot
Harry and I want this book to be fun for you . . . want you to sail right through it before you realize just how serious we are. But let us have a candid moment. We are deadly serious. The stakes here—the potential changes in the rest of your life—are enormous. Think again about those numbers I mentioned: 50 percent of all illness and injuries in the last third of your life can be eliminated by changing your lifestyle the way we suggest. Not delayed until you are a little older . . . eliminated! By the way, 70 percent of premature death is lifestyle-related (like dying after you break a hip). “Premature” means before you are deep in your eighties or—if you’re in your forties now—your nineties.
And, again, 70 percent of the “normal” decay (that’s the rot) associated with aging . . . the weakness, the sore joints, the lousy balance, the feeling crappy . . . 70 percent of that horror can be forestalled almost until the end. That is a huge difference in how you lead your life and who you are. Believe me, it’s true. I have had some interludes of normal aging in my life, when my joints hurt so much that regular walking was painful and I looked for the cutout in the curb so I wouldn’t have to “step up” three inches to get on the sidewalk. Think about that. Think about being so puny that you have to rock just a little to get out of a normal armchair. That stuff happens. It happened to me. It will happen to you. It really, really will. And it doesn’t have to.
All this sounds extreme, but it is not. Harry—whose credentials are bulletproof—knows and will tell you about the emerging science to prove it. It is head-turning. I will tell you about the life. I may not be as good a model for women as I am for men, but men and women are mostly in this Aging Boat together. My stories—about skiing like a maniac at seventy and taking long, scary bike trips and all that—could just as well be coming from a woman. There are plenty of women my age doing the same thing. Most of the women in my bike group are in their sixties and they go howling along, in the mountains of Austria, out west, all over the place. It could just as well be a woman talking when I say I am functionally younger today than I was ten years ago. So extrapolate a little . . . this is not chest-thumping nonsense from some delusional old guy, this is a preview of your own story.
What I Bring to the Party: A Report from the Front
Okay, let’s talk about structure. My part here is simple: I have lived through my sixties and I have been retired for a while. At seventy-one, I have absorbed and followed the message of this book for a number of years, and I am prepared to tell you the exact truth about the process. Mine is the report from the front. Optimistic, sure, but honest and unadorned. Not a woman’s report, but almost as relevant because, as I say, we’re in this Aging Boat together. Same joints, same gut, same apathy, same drifting mind. Unless we do some stuff I happen to know about.
Here’s the good news. I have done pretty well. Not stunningly well: I am not thirty-eight. But way better than I expected: I am functionally a surprisingly healthy fifty . . . more healthy aerobically, I recently learned, than most fifty-year-olds. And this despite the following truths: I am an indifferent athlete at best. I am hugely self-indulgent (at one point I was forty pounds overweight). I drink almost every day, and I am hardwired for pleasure. Absolutely hardwired. But once I got it into my head what the stakes were and how modest the commitment was—compared to the results— I was there. I made a job of it. You’ve made a job of a lot of different things in your life. Make a job of this one, too . . . arguably the most important job you’ve ever had. You’re a lifelong juggler: okay, get one more ball in the air. Learn to handle it, and you won’t have to turn into a pathetic old lady.
And here’s another nice thing. The process is pretty good fun. (By the way, the appetite for and appreciation of this stuff is gender-free.) Some of the process—the exercise part, maybe—sounds appalling and you’ll think we’re kidding. But it isn’t and we’re not. I wouldn’t have done some of the stuff we’re going to urge on you for a month, let alone years, if it weren’t fun, but mercifully it is. Slightly addictive, as a matter of fact. We’ll explain. It’s tough, but it’s fun, and it works. How do you like that?
What Harry Brings to the Party: The Truth
Harry is the real McCoy. A board-certified internist and a gerontologist, he has long been ranked as one of the best doctors in America in national surveys. He is the head of a cutting-edge, twenty-three-doctor practice in Manhattan and on the clinical faculty of Columbia University’s College of Physicians and Surgeons. Importantly for us, he is also a serious student of recent developments in cellular and evolutionary biology. His is the report on that science— which has not yet made its way into the medical journals and won’t for a while—and on what he has learned from his own profound experience treating patients in their fifties, sixties and beyond for the last fifteen years. The science is heavy, but Harry makes it accessible and persuasive. Okay, sort of accessible. But when you read his chapters, the logic— indeed, the near-necessity—of embracing his suggestions becomes clear and doesn’t sound crazy at all.
By the way, the science is sufficiently new that Harry— a profoundly conservative man in this area—warns that some of what he says will turn out to be wrong as research goes forward. But not the basic themes. The revolution in aging that he talks about is here, and the science is real. Harry makes it clear that there are remarkable forces in your body—in your cells, all over the place—that are at work all the time, building you up or tearing you down. Darwinian forces—preservation-of-the-species stuff—that have everything to do with who you are and how you live. In his chapters (we more or less take turns), he tells you what they are and how they work. He also tells you how to manipulate and redirect them to your own ends. Like holding age at bay to a remarkable extent and for a very long time. Not completely and not forever, but a lot more than you can believe right now.
What you’ll learn is partly what you have always known: There are tides in our lives that carry us forward or back. When you’re a kid, the tide is behind you and you go forward regardless. Stronger, more coordinated, better focused . . . better able to understand and cope. But at some point the tide inside your body goes slack and the free ride is over. And then, in an instant, it turns against you. You get a little weaker, your balance is funny, you’re bones turn out to be frail . . . you can’t remember things. And it begins to look as if before long the tide will be running pretty hard. And it’s going to sweep you up on the rocks. Where the gulls are waiting. And the crabs. To eat your wattles and your gut. And your eyes. Take the guck out of your nose and your hair to make a nest. Go up there and eat you. Sorry.
But the interesting thing, Harry says, is that the tide is not that strong. It looks strong, because it’s so steady . . . so remorseless. But it is not strong. It is manageable, in the sense that you can turn its relentless power to your own purposes. Like using the terrifying force of a wind that is rushing you toward the rocks to sail into the wind and safety. Harry’s chapters are not frilly. And Harry is not a breezy guy. But he’s awful smart and his stuff is worth a close study. All he wants you to do is change the way you live. Fundamentally and forever. And he cares like crazy. We both do, as a matter of fact. We want desperately to have the Next Third of your life be absolutely terrific. Read this book closely and maybe that’s what you’ll want as well.
Meeting Harry and Getting a New Start
I went to Harry because a pretty, redheaded skin surgeon named Desiree told me to. She had just taken off half my nose with a local anesthetic and I was still crazy about her, which requires a certain charm. I had just moved back to New York from Colorado, where I’d gone to be a ski bum for a couple of years when I first retired. (I couldn’t afford it when I was a kid because I got married at nineteen and had three children before law school.) Anyway, I asked Desiree if she could be my doctor and she said no, but she had just the guy. Smart, decent . . . a terrific person. A WASP, she said, but not a dope, as if that had to be cleared up. He’d been her teacher of something in medical school and I’d like him.
So there I was in Harry’s examining room, wary as a cat. Because (a confession) I don’t like doctors. I don’t like the haughty way they say, “Hi, Chris . . . I’m Doctor Smith.” (I’m “Chris”? And he’s “Doctor Smith”? What’s that all about? And why do I always have to wait an hour to get this abuse? Lawyers don’t do that. Doctors, man! And then the stuff they do to you!)
Harry has lovely manners and is a conspicuously decent guy. I am still wary. We’ve just been through all this terrible stuff. He’s drawn gallons of blood . . . taken long, dubious looks in my ears and down my throat . . . asked lots of vaguely scary questions. And, of course, stuck his finger up my butt. Finally, it’s the old “Why don’t you put on your things and come into my office and we can talk a minute.”
You just know he’s going to say, “Uh, listen, I found a little lump up your butt . . . the size of a pomegranate, actually. Probably nothing, but there is some gangrene, so let’s get you booked into the hospital and . . .” I go into his office, and no, he has not found the pomegranate yet. In fact, he says, I am in fairly good shape. Overweight but not bad. The fact that I get regular exercise helps a lot.
Harry is tall and oddly shy for a guy running this big practice. He looks at his computer a lot while he’s talking to you. You wouldn’t say nerdy, because he’s actually kind of handsome, if you think about it. But . . . well, “nerdy” might cross your mind. He was a serious oarsman in college and looks it. Women find him attractive, for some reason. But he dresses and carries himself so that I think “New England frump.” Which, of course, is fine by me because I look about the same. I once had a male secretary who said, “Chris, you wear your clothes as if you hate them.” Harry and I were cut from the same rumpled cloth in the same part of the world, the North Shore of Boston, five miles and twenty-five years apart. He drones on. Numbers, parameters. Blah, blah, blah.
Then, because I’m interviewing him for the important position of becoming my doctor, I say, “So, what is it about the practice of medicine that you like most?”
He stops, but only for a second, as if he’s been waiting to talk about it. “What I really like is the notion of long-term relationships with patients and keeping them in good health. Not just curing disease but promoting health, which is a different thing. I would like to help them have a better life, not just cure them of this and that.”
Bingo! “What do you mean?” I ask innocently.“
Well, I’ve always been interested in aging as well as internal medicine. I actually got board-certified in both, although I’m not sure how separate gerontology is from internal medicine.” Then he turns and, very quietly, drops the bomb. “What I am sure of is that there is a fundamental revolution at hand in the way people age.” He pauses and thinks how to get at it. “In the old days . . .” And he goes into the business about the slow, steady curve from fifty to death on the one hand and the new plateau on the other. Actually draws the lines in the air with his hand. “And you could be on the frontier of that change.”
“Yeah. With your numbers . . .” He fools around with the computer. “Yup, this is pretty good. Uh, you don’t smoke, and with these numbers and a more aggressive exercise habit, you could go on about the way you are today until you’re, say, eighty. Maybe ninety. In fact, if you do a few things, you can actually be functionally younger. You’re already in better shape than most of the men who come in here for the first time, but yes, you could be younger next year in all the ways that matter. Younger next year and for quite a few years to come.”
I go over and sit in his lap. “True?”
“Yeah. You ski. Well, you can ski hard through your seventies. Slow down and eventually go to cross-country at some point in your eighties. Bike . . . you can do that forever. There will be a certain decline eventually, but basically you can be as athletic, vigorous and alert as you were at fifty until you’re eighty or older. And for the first five or more years you can be functionally younger.”
“What do I have to do?”
“It’s hard to summarize, but there are three things.” Did you ever notice how there are always three things? “Three things,” he says. “Exercise. Nutrition. And commitment.
“The biggest one—and the biggest change for most people—is exercise. It is the golden key to great health. You should exercise hard almost every day of your life. And do strength training, lift weights, two or three of those six days. Exercise is the great key to aging. This long slide . . .” again, the arching curve with his hand in the air, “can simply go away. Or go up for quite a while. And you can be yourself for the rest of your life.”
I have about four hundred questions but, uncharacteristically, I sit and wait.
Harry goes on. “Nutrition, too. You should eat the way you know you should eat but probably don’t. If you possibly can, you should get down to your true weight. You’re . . .” peek at the screen, “one ninety-four. You should be . . . what? What’s your normal weight? One seventy-five?”
“One sixty-five, I guess. Maybe less. I rowed a little in college at one fifty-five and weighed about that until I was in my forties.”
“Okay, if you could get back to one seventy someday, that would be great, but don’t stew about it. It’s much more important to exercise, regardless of what you weigh, and then learn to eat rationally from here on out. Quit eating the things that you know are rotten for you, like fast food and lots of fats and simple carbs. And eat less of everything.” He says dieting is dumb and doesn’t work, but my weight will drift down, over time, if I exercise the way I should and quit eating junk.
He looks back at the screen. “Social drinker,” he quotes me from the questionnaire. “Two drinks a night.” Then those lovely manners cut in and he does not lean across the desk and shout “LIAR!” He just does the familiar thing about how a glass or two of wine is good but more than that is a negative. A lot more can be a real negative. Obviously.
“Commitment.” He shrugs, as if to say this next part is harder to talk about. “What I mean is, you have to be involved with other people. And you have to care about something. Goals. Charities . . . people . . . family . . . job . . . hobbies. Especially after retirement, you have to dig in and take hold or things can take some bad turns.” He stops, stuck for a minute, struggling a little. “It’s specific to you, obviously. And it’s awfully hard to generalize, but there have to be people and causes you care about. Doesn’t seem to matter much just what they are. They don’t have to be important to society or make money, as long as they’re important and interesting to you. As long as you have some passion for them. There have to be people you care about and a reason to keep yourself alive. If not . . .” a little smile, “you’ll die.”
“That’s it?” I ask.
“In a nutshell, yeah.”
“Okay.” I’m ready to go. “How much exercise? What do I eat?”
But that’s the rest of the book. You are going to like it. It’s going to save your life.