Soon after I arrived on Martha's Vineyard and began practice as a general practitioner, a certain statistic caught my eye and cooled somewhat the enthusiasm with which I had jumped into the world of medicine to establish a thriving practice in a community I would grow to love. I read that the average age of general practitioners at that time was 65 years. I was mildly shocked to say the least. That meant to me that I had dived into a dying breed of medical men and women, but the die was cast and we had moved into our new home and the first patients had already crossed my threshold.
Then they began to arrive in numbers, hardly stupendous but enough to require filing with the Internal Revenue Service. For better or worse, I was off to a good start, I thought. My businessman father-in-law visited on some weekends, and after reading his morning Boston Herald, he would sit by the window with a view onto my office walk and count the number of patients who entered through my door. Of course, he had no way of knowing who the persons were who entered. Some probably were salesmen detailing medical products.
Gramp would divide the number of visitors who passed through by the minutes or hours he had monitored. At the standard fee of three dollars per office call in the fall of 1955, he calculated the gross income I produced for that afternoon. He was discouraged about possibilities for a successful career.
As the months passed, the number of patients increased and there would come a time when I was as busy as I could be and understood why the older doctors had been so anxious for me to join them.
Now, after 50 years of living on the Vineyard and into my 81st year of life, I am faced with many of the features of old age. One of my friends said to me last week that my recent Times columns had been down-beat. Couldn't I write some pieces in a positive mood?
My first reaction was of impatience. My second reaction, unspoken, was that I couldn't think of anything in that mood.
Our family's lives in most ways have recently changed. Change is often difficult in itself. But my friend made me think a great deal about what we or other people we knew were going through. Easily I made a list of the possible losses people frequently undergo after retirement, for example, personal identity as in a job or occupation, memory, concentration, independent living, faltering motor skills and balance, sight and hearing, driving a car, financial stability, one's home or neighborhood, spouse and family members, good health and friends. We have encountered some of the losses on this list, certainly not all of them. If many losses occur at once, which often can happen, depression may be a serious result.
I began to think about Jane and Peggy Thayer's book, "Elderescence," which they published in 2005, concluding a fascinating study of retired persons. One of their conclusions was that serenity and a feeling of personal value and accomplishment during the retirement years are of crucial importance and depend primarily on a coming to terms with personal mortality.
It was a profound statement for me to hear at the time, and I have tried to answer for myself what coming to those terms means. I think most of us come to terms with our own dying in different ways, but some not at all. As the Thayers said, the latter continue to compete with the young until they die, still scared to death.
The week of Easter observance for Christians is a time rich in reinforcement for the message of the church. I think a religious belief and affiliation are some of the great strengths which help individuals come to terms with their mortality.
Recently while I was thinking about and working on this article, I experienced in a very personal moment the strongly felt sense that a higher power exists within me. I choose to call that power God. I felt encouraged that there is within me a power to help me make atonement for my having entered into a sinful state at times in my life, and yet able to receive forgiveness. As for the dreadful loss of loved ones, I have come to believe that my loved ones would always remain in some spiritual contact within me.
My religious teachings are full of mystery, which I accept without question. As a much younger man, I could not make such a declaration nor could I have declared this moment. I no longer search for plausible answers. I believe this is called faith.