Aging in America. Lawrence R. Samuel

workers, many of them men, were feeling pressure from younger employees as they rose up the corporate ladder, one more dimension of pervasive youth culture. Some men, worried about their jobs in certain hard-hit industries such as aerospace, were especially keen on smoothing out wrinkles. Wives suspecting their husbands were cheating on them with other women (and legitimately so, given the skyrocketing divorce rate) were, meanwhile, getting tummy and bottom tucks. Plastic surgery had long been just for the wealthy, but now ordinary folks, thinking a facelift was just the thing to maintain a youthful appearance, were going under the knife. As with the prescribing of estrogen, some doctors were refusing to perform surgery because a patient only wanted to retain his or her youth, but the genie was already out of the bottle.³⁹

      As Sontag suggested, the seeking of medical intervention by ordinary women in order to appear younger revealed the complex relationship between aging and gender. It made perfect sense that some feminists of the 1970s, most of them older women, vigorously addressed issues of “ageism.” (Robert Butler had coined the term in 1969 to describe individuals who faced discrimination and prejudice because they were considered old.) Separate from the obvious matter of injustices based on gender, women usually lived longer than men, extending the amount of time that they would be older people. The odds that a wife would eventually become a widow made getting older a different and often more difficult experience for women. Henrietta Quatrocchi, an anthropologist and gerontologist, considered many older women in America to be “the walking wounded,” with no clear purpose in life after completing their primary role of domesticity. For every Eleanor Roosevelt or Golda Meir, she felt, there were millions of older women who, because of social pressure to do so, assumed an image not unlike that portrayed in the famous painting colloquially known as Whistler’s Mother. It was up to older women themselves to stay active and defy cultural stereotypes, Quatrocchi insisted, suggesting they do things like take karate lessons rather than “do things with egg cartons.”⁴⁰

      Social critics from a variety of backgrounds took a long hard look at aging in America as the subject reached a kind of critical mass in the mid-1970s. Butler’s Why Survive? was a scathing indictment of ageism in America, detailing how older people were consistently socially excluded and routinely taken advantage of. In the spirit of the famous line from the movie Network, which was released the following year—“I’m mad as hell, and I’m not going to take this anymore”—Butler argued that it was up to older Americans themselves to adopt the kind of militancy that other oppressed groups had. Voter registration drives, marches, and whistle blowing were all things seniors could do to strike back against the virulent form of discrimination that was ingrained in American society.⁴¹ A number of experts on the subject wrote chapters for the 1978 anthology The New Old: Struggling for Decent Aging, which served as a sort of manifesto for older Americans. Seniors were treated shamefully, the book argued; its contributors made a compelling case that ageism was the last form of segregation in the nation. As with Why Survive? the book also included an agenda for action, urging that older people stand up for their rights.⁴²

      Not surprisingly, gerontologists were working the hardest to try to dispel the myths and misconceptions that surrounded aging. “Ageism is an attitude no less destructive than racism or sexism,” said Sue Smolski, a registered nurse in Connecticut who was educating other gerontologists on what was and what was not true regarding older people. First and foremost on her list was that, again, aging was not a disease, something many, including a fair share of physicians, did not understand. In fact, seniors themselves did not so much mind growing older as dreaded getting sick, illustrating the distinction.⁴³ It was a serious illness or injury that often triggered what was commonly considered “old age” and its various problems, many older people clarified, this too not very well understood by those considerably younger. And contrary to popular belief, most seniors did not spend their days preparing themselves for death; they were as directed toward living as anyone else.⁴⁴

      Nurses like Smolski seemed to have keen insight into the dynamics of aging, no doubt because they spent so much time with older people. Another Connecticut nurse serving as a consultant on aging felt that the scientific efforts to solve its mystery were, more than anything, a diversion from having to think about the fact that we were all getting older. The real problem with aging was our inability to accept its reality, Nancy Gustafson told a group of women in Hartford in 1977, explaining that it was more of a social than a biological issue. As Curtin had described in her Nobody Died of Old Age, older people no longer had a recognizable role in family life, Gustafson added, a byproduct of our more disposable and mobile society. (No need for grandma to mend those pants now that a new pair could be easily and cheaply bought, especially if she lived miles away.) If productivity was the main currency of the times, which it certainly appeared to be, Gustafson observed, things did not look good for older people given the physical changes that typically took place at a certain point. This was unfortunate, since most seniors remained as psychologically fit as ever and had much to offer if given the opportunity. “Aging is life,” Gustafson wisely concluded, “the integration of all our experiences here on Earth and with other humans.”⁴⁵

      As Gustafson suggested, the mythologies surrounding seniors were not limited to physical abilities; the mental aptitude of older people was often called into question. The majority of older Americans were not institutionalized as some thought (just 5 percent, most of them over eighty years old, were in institutions in 1977, with a mere 1 percent in psychiatric hospitals), and they did not spend an inordinate time just lying in bed. Depression was fairly common among the elderly, however, a result perhaps of the losses (of friends, family, jobs, and homes) that many endured as they outlived others.⁴⁶ Oddly, however, relatively few psychiatrists took on older people as patients, viewing them as “unfixable” because of their advanced age. Less than 2 percent of the psychiatrists in the Washington, D.C., area offered therapy to people more than sixty-five years old, for example, and even these were unlikely to prescribe any of the antidepressants available at the time.⁴⁷ Older people should be depressed, the thinking was; it was a natural state given their reduced position in life and proximity to death.

      While few psychiatrists were interested in treating older people, it made perfect sense for those dabbling in the brand of pop psychology so prevalent at the time to address issues of aging. “The September of your years can be exactly what you make of it,” counseled Tom Greening and Dick Hobson in their 1979 book Instant Relief: The Encyclopedia of Self-Help; the pair suggested that seniors counter their negative portrayal in the media through “positive thinking.” Bombarded with representations of people like themselves as having little value or worth, it was up to older folks to avoid seeing aging in a negative light. “With the right attitude, attention, and preparation,” the two wrote, “aging can be experienced as a full and meaningful maturation process, like the ripening of a fine wine or a musical instrument.” No longer having to raise children, climb one’s way to success, or move up the social ladder offered a kind of freedom younger people did not have, they argued, making “the golden years” the ideal opportunity to develop deep self-awareness and wisdom. Most important, perhaps, older people should take responsibility for their own sense of well-being and not see themselves as victims—classic 1970s self-help talk that actually made perfect sense given the profound stereotyping of the times.⁴⁸

      While obviously not a good thing, the dismissal of older people by psychiatrists was in part a function of their training or, more accurately, lack thereof. Medical schools did not at the time provide their students with an adequate education in aging, which accounted also for some physicians’ equation of old age with disease. Few if any courses in geriatrics were required at the nation’s 114 medical schools, with just thirty-one of them offering elective courses in the subject. Also, older people’s tendency to get sick and die was a frustrating fact of life to future physicians being taught to keep patients alive and well at all costs; this was a contributing factor to physicians often displaying a glaring insensitivity to seniors after receiving their degree. Practicing doctors were known to say to a no longer young patient with a particular health complaint things like “Well, what did you expect, you’re old,” not exactly what one would consider good medicine or a good bedside manner. In fact, the acquaintance many medical students had with an old person was as a corpse, hardly a good model by which to offer good health