Authors: Dick Van Dyke
My brother is trudging along too. Life may slow down, but it shouldn’t stop. Every day you wake up and don’t find yourself listed in the obituary is an opportunity to take charge of your health—and your happiness.
Old dogs. New tricks.
Live the life. Get the T-shirt.
Why Write It Down?
Why Write It Down?
I keep a notebook by my bed
and lay out the day that’s ahead.
When it’s there on the page,
my thoughts disengage,
and my brain turns to dreaming instead.
Other Tips and Truths About Old Age
Other Tips and Truths About Old Age
TRUTH
: They say the knees are the second thing to go. They’re wrong.
TRUTH
: Money can’t buy happiness. But it can pay for good doctors and medicine.
TIP
: If a doctor tells you he can make you look twenty years younger, don’t believe him. Everybody will notice. And nobody will think you look twenty years younger.
TIP
: Collect experiences, not memories.
TRUTH
: You are never too old for romance. A candlelight dinner, a slow dance, a stroll under the stars—these are as potent and magical at eighty-five as they were at twenty-five.
TRUTH
: After a hundred, everything should be free. It’s not—but it should be.
TIP
: Health foods no longer matter after eighty years old. At that point eat anything you want for the rest of your life. That’s healthy!
TIP
: Look your age. But don’t act it.
TRUTH
: Most people aren’t as grown-up as they look.
TRUTH
: Some of life is planning. A lot of it is luck.
TIP
: Forgiveness is the best sleeping pill.
TIP
: Old age is not the time to be scared. Instead, be curious.
TRUTH
: Yes, you wasted too much time worrying about things that didn’t matter.
TRUTH
: When you answer every question by asking, “What?” it means you are hard of hearing, not old.
TIP
: If your children tell you that you are wearing your pants too high or your sweater is inside out, they are probably right.
TIP
: It doesn’t matter if you can no longer remember your grandchildren’s birthdays anymore. Or even your children’s birthdays. They’ll remind you.
TRUTH
: As you get older, you start to shrink. But your heart still retains the capacity to grow and expand.
TRUTH
: A spoonful of sugar really does help the medicine go down.
TIP
: New experiences are the only things you can collect in life that end up being worth it.
TIP
: Carry a tiny flashlight with you. It’s helpful in dark restaurants.
TRUTH
: All the different ways you thought you might die by now didn’t happen. That’s a good thing!
TRUTH
: Social Security is the only security you have in life. Let’s hope that doesn’t get screwed up.
TIP
: Easy Street doesn’t exist. Stop looking for it or wishing you had found it.
TRUTH
: Parties were more fun before everyone else was dead. But don’t let that ruin your time.
TRUTH
: Old people really do know most of the answers to life’s important questions. But no one knows if there really is a God.
TIP
: Don’t take it all so seriously.
TIP
: Everything really does looks better in the morning.
TRUTH
: In the end you realize only two things matter—love and hope—and as you get closer to the end, it’s only love.
TRUTH
: Life goes on.
Good Health Without Drugs . . . Sort Of
Good Health Without Drugs . . . Sort Of
About ten years ago I was in New York when I was beset by a mystery affliction. It was afternoon, and I returned to my hotel to take a nap. I got comfortable on the bed, and moments later it started. My brain felt like it was expanding and contracting, pushing against the inside of my skull. It didn’t hurt. It was simply weird and something I knew wasn’t normal.
My nap never happened, and for the next few months the same odd sensation of my brain expanding and contracting interrupted future attempts at afternoon sleeps. Then it started to wake me up in the morning. It was not anything sharp or unbearable—nothing that made me wince or scream or run for the medicine chest in search of a quick fix. I did think the T-word, tumor, but only briefly. I didn’t dwell on it.
Maybe it’s my easygoing constitution, but I felt it more as a distraction. After it woke me up, I rubbed my temples and squeezed the sides of my head, trying to massage whatever it was away. Eventually it would go away—for a little bit. Then it would return.
Each time was a sneak attack. There was no warning or predictability. As I told my doctor, there was a sort of regular irregularity to its onset. If I anticipated the feeling, it didn’t happen. If I forgot about it, the knocking arrived, like an eye twitch or a muscle spasm. This went on for months, and then months turned into years.
I saw specialists, who sent me to different specialists. I was given brain scans, CAT scans, a spinal tap, and numerous other tests. I called the Mayo Clinic, hoping to schedule an examination there, but they said I had already had every test. I went back to my doctor. He was stymied.
“About the only thing we know for sure is it’s not fatal,” he said. “You’ve done all the tests.”
“So you don’t know . . .” My voice trailed off. I hoped he would finish my sentence.
“It’s a mystery,” he said, closing my folder and, presumably, my case. “I’m sorry. I wish we knew. I wish I could tell you there was something you could take. A magic pill. But there’s nothing I can give you.”
Nothing he could give me? It had to be the only malady on record (even if it was only my record) for which medical science had not invented a pill. I had never heard of an ailment for which there was not a medicine. It is
almost un-American. According to research I found online, seven out of ten people in this country take a prescription drug, and more than half take two. The most popular medications include antibiotics, painkillers, and antidepressants, and not far behind are pills for high blood pressure and cholesterol.
I am not taking any of those, something for which I thank my parents for every day. Good genes—I have been lucky that way. I have enjoyed good health without drugs . . . sort of. In the 1960s, back when I was holding down jobs in both TV and theater, I started taking sleeping pills, as many Americans did, and I still take one nearly every night. A good night’s sleep is habit-forming, I suppose. I also take Vicodin when my arthritis acts up. Otherwise, having quit alcohol and cigarettes decades ago, I am practically as pure as filtered water.
But still, I am not anti-prescription medication. I am also pro-over-the-counter medicine if it helps. Imagine the scratching, sniffling, and swelling in a world without Benadryl. Drugs are the Band-Aids that keep many of us here. And with the majority of Americans on them, they are also potentially great conversation starters.
According to the statistics, you can go up to almost anyone and ask, “What are you taking? How’s that working for you?” Total strangers have something in common to talk about, especially those who have acquired a lot of chronology: “Do you get generic? What’s your co-pay? Where do you go to get it filled—Walgreen’s? CVS? How’s the line there?” Those are not bad questions.
As the miles pile up, you realize how much we all have in common: baseball, barbeques, hamburgers, homework, jobs, the desire for companionship, children, TV shows, . . . allergy pills. As we get older, our similarities are more pronounced: gray hair, old clothes come back into style, grandchildren, goodbyes, . . . restaurants close. When you get to be my age, now all that matters is family and health. Priorities become clear. Are you loved? Do you have someone to love back? And does anything hurt?
As all that related to me, well, nothing hurt per se, but I did have this persistent weirdness, that dull ache, in my head. I felt it early in the morning and when I tried to take a nap in the afternoon. Always without warning. As the years passed, I tried to park it in the back corner of things that mattered. It was my inconvenient reminder that life, if nothing else, is a mystery, that not everything can be figured out or cleared up with a prescription.
Then one day I made an appointment with a neuropsychiatrist friend, Dr. Hamlin Emory. Though it followed an episode, I scheduled the appointment more from a desire to figure out the mystery than the frustration with not having a remedy. Dr. Emory, a former Malibu neighbor who practiced in West Los Angeles, was a brilliant man, a bracing intellectual, and an unabashed contrarian, particularly when it came to practicing medicine—and with the way medicine is practiced.
As he explained in our initial consultation, he didn’t treat symptoms. Instead he approached symptoms as
indicators that the brain was out of balance. His thesis was based on research that the brain’s main job was to keep the body running and that the majority of its work went into regulating the myriad autonomic systems that keep us alive. A symptom like the weirdness in my head was a sign that something was out of kilter.
“Physiology generates mentality,” he said, breaking his thesis down to its most basic components. “Mentality does not generate physiology. You may be able to train yourself to a certain degree to alter your physiology somewhat, but in terms of your visceral brain, you’re not going to alter those genetic influences. And that’s what I look at when I examine you.”
He gave me a thorough diagnostic workup, covering the gamut—physical, mental, psychological, and biological, starting with an eight-page questionnaire that covered my family’s medical history as far back as I knew it, along with my own history. His exam also included blood work and an assessment of my cognitive ability. He ordered brain scans. He also gave me an EEG, hooking electrodes up to my head to measure my brainwaves—the alpha and the delta, I think they are called—while explaining that the results would be the foundation of his diagnosis and any accompanying treatment.
In the most simplistic terms, he gathered a ton of information about what was wrong, what had been wrong in the past, and then he looked at the brain in a resting state, like a car idling, for insight into whatever was causing the misfire.
“I’m looking for the slightest irregularity in the patterns,” he explained as he went through the readouts.
Eventually he tapped his finger on the test results. It was his ah-ha revelation. He hypothesized that the relationship within my hypothalamic-pituitary-adrenal axis was slightly out of sync. It was not spiking as high as it should, he said, and that could be the reason for the pulsing sensations that had bothered me and baffled other doctors for years.
“Think of the hypothalamus as the orchestra conductor,” Dr. Emory said. “He tells the musicians to play faster or slower, or louder or softer. It’s like Zubin Mehta, the longtime conductor of the Los Angeles Philharmonic, used to do—except the members aren’t able to play like they did before. In my opinion, that’s happening in this part of your brain. The conductor of your orchestra is getting a performance that’s a little less vehement than it should be, resulting in a homeostatic failing that is very likely the palpitation you experience.”
“I think we need to focus on increasing the dopaminergic activity,” he continued, “and by doing that, improve the brain’s neurophysiology, adjusting your awake cycle—or your diurnal or quotidian rhythm—so that it improves to where you can take a nap or have a decent night’s sleep without being interrupted by the palpitations.”
Dr. Emory prescribed a drug called Nuvigil, a mood enhancer that would provide an “up-regulation in amplitude,” as he put it. The drug had been developed to keep
military pilots awake and alert over long periods of time. Air traffic controllers used it too. He thought the increase in amplitude might decrease the lows, return balance, and let me rest without the palpitations. At the same time, he warned that drugs don’t work on everyone, and he didn’t know whether Nuvigil would work for me.
“If there are adverse effects, they don’t fit,” he said. “The trick is to find the drug that fits you.”
I began taking one pill every so often—for instance, before performances or interviews—and found it sharpened my thinking and elevated my mood slightly. It took me from a seven to a nine, making me feel the way I did thirty years earlier: sharp, quick, and bright. I thought everyone should try it. But when I gave one to my brother, he went bananas. It caused my friend Bob Palmer’s heart rate to spike—he hated it. Arlene couldn’t sleep or catch her breath for three days after she tried one. I quit experimenting on my family and friends.
As good as it made me feel, Nuvigil didn’t stop the weird feeling of my brain expanding and contracting. But it did diminish the frequency of the palpitations, as Dr. Emory had suggested it might, enabling me to take more naps and sleep longer most mornings. And that was okay with me.
Ten years into this thing, I know that one pill doesn’t necessarily lead to a cure for anything. But I’m fine with a compromise, especially one that lets me keep moving. I do not wait and wonder whether the sensation that started all of this will manifest itself today, tomorrow,
next month, or ever again. At this point I know it is not terminal. Terminal is bad. Annoying is something I can deal with. I don’t dwell on the negative. That’s crucial to keep in mind as the machinery slows and wears out. Perspective is as important as any pill—even more important, as I think about it.
The best medicine comes from within. Even my friend Dr. Emory, who asserts that mentality doesn’t influence physiology, agrees with me when it comes to ignoring the onset of old age. I asked him, “If sixty is the new forty, as I heard on one of the morning news shows, and eighty is the new sixty, what is the key to feeling and acting young?”
He pointed at me. “Genetics is number one,” he says. “You hope and pray for the kind of genetic endowment you were bequeathed. Beyond that, be the person who finds the diamond in the haystack. Have a good attitude. Be able to entertain yourself. I think the essential ingredient to being joyful in life is to have stuff you enjoy doing and then to do it. Let me ask you something.”
“Sure.”
“Do you dance like you did twenty-five years ago?”
“No.”
“But you haven’t stopped.”
“No, I haven’t.”
“Right. You’ve continued to refine yourself as you move through time. Though people deal with a range of issues that come with age, I think the concern has to be less on what is lost and more on continuing to evolve,
learn, grow, change, and develop new talents. It’s the difference between being a spectator and a participant. Too many people become spectators instead of continuing to initiate new chapters in their own adventure. But you get the most joy from doing what you are passionate about in the world. You have to keep doing it.
“Chronology eventually gets the best of all of us in that we experience to some degree a reversal of physical prowess. So you ask, then what? Well, I point to children who are not unlike older people at this stage. Both have limited physical prowess. Both can be dependent on others for care. However, a child of three, four, and five still has fun. Even as your capacities may limit you, you can still have fun. You can still play in your mind. In fact, this kind of self-amusement is essential.”
Very true.
But how ironic that this whole thing started ten years ago when, like a child, I wanted to take a nap—which I may do right now.