On the other hand, I had an elderly patient earlier in the year with a different approach. He was taking a couple of drugs, but had refused others. His cheerfully held philosophy was that it was inevitable that his body systems were going to gradually wind down, and he was not going to take drugs to counter what he saw as a natural and inevitable result of ageing. It was also noticeable that he did not appear too much bothered by the prospect of death, which he referred to charmingly as ‘being gathered’. At the end of his treatment I would say, “see you next week”, to which he would reply that he would if he had not been ‘gathered’ in the meantime!
Some would perhaps consider this gentleman irresponsible in not always following his doctor’s advice, but at least he has the initiative. Passively and unthinkingly doing everything someone else tells you is not the height of responsibility either. Of course one might responsibly be of the opinion that one’s doctor or doctors know more about it all than one does oneself, so the best thing to do is to do what they say, always remembering that in the final analysis the buck stops with oneself, not them.
Taking responsibility for oneself of course necessitates some self-knowledge. As we grow old, we need to grow in understanding of ourselves and how to live wisely into old age. This is one of the things which appeals to me about Traditional Chinese Medicine (TCM) - it gives us a framework to understand ourselves. At its most basic this comes down to the classical Chinese concept of Yin and Yang. A wise and healthy life is one in which Yin and Yang are dynamically balanced.
To illustrate how this works, it may be that you have a constitutional tendency to Yang deficiency (no one is perfect!). As you get older, this deficiency of Yang may become more pronounced. In terms of human life, the Yang is to do with warmth and movement, and so you start to notice that you can’t keep your feet warm and generally feel the cold more, you find it hard to get going in the morning, your mind isn’t as quick as it used to be, your digestive system becomes a bit sluggish, and so on. So what you need to do is to stimulate the Yang. You can do this on a basic level by making sure that you keep warm, wrapping up well in cold weather, invest in some thermal underwear for instance. Respect the fact that your constitution and your advancing age make you particularly vulnerable to the winter.
The Yang is also stimulated by warming foods. Nowadays everybody thinks that healthy food is salad, but for the Yang deficient person (especially in winter) cold and uncooked food is not the thing. The thing is well cooked warming soups and casseroles, maybe using a few pungent spices such as ginger or cinnamon.
Since Yang is to do with movement, some appropriate exercise is needful. Doing too much, especially outdoors in the cold, is counterproductive, but doing too little is just as bad. Someone once told me that there are two reason why old people (in our society) have health problems: one, they are old; two, they don’t get any exercise. Not much you can do about the first one, lots you can do about the second!
(Yang is also to do with outward movement and therefore perhaps with self-expression. One of the things I noticed about the second gentleman mentioned above was his relationship with his granddaughter. Once he brought her with him to watch him have his acupuncture, and the next week they went off on holiday together, walking in the Lake District. Maybe this relationship gave him the opportunity to communicate and express himself, pass on whatever wisdom he had built up.)
Of course it may be that it is the Yin that is depleted more, in which case you need some different strategies. But beyond these basic things, visiting a TCM practitioner might be a good idea. They will be able to understand in much more detail what you need to do to manage your health as you get older, and to do some acupuncture or other treatments to help with this. For the Yang deficient person mentioned above, they may, for instance, use an ancient Chinese technique called moxibustion, where certain key acupuncture points are warmed with the herb mugwort. Chinese people have used this herb on themselves for centuries to warm the Yang and support themselves to be well into old age.
Anyway, the point I am trying to make is that if we take responsibility for our health and look after ourselves, especially as we approach old age, we have got a better chance of avoiding the situation in which the first patient above found himself, taking multiple pharmaceuticals and suffering perhaps from some of the side effects. We need, as we get older, to know how to look after ourselves, know what food we need to eat, what exercise to do, know about the seasons and how the changes in the seasons affects us, know our own particular weaknesses and how to protect against them. This is more than just general ideas about what is healthy, we need to tailor these things to our own particular case. Maybe we need some help from the GP, the consultant, the acupuncturist, or whoever, on top of that, but it is our body, our mind, and we need to be the one in the driving seat.