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September 29, 2014

Managing the Dread of a Therapist’s Vacation

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Vacations should be care free. I suspect they were in the days before therapists and portable phones. Now, if you want some freedom from responsibility, limits must be set on how much of your “work” you take with you. Therapy patients, however, have little choice in the matter. After many years of hearing my clients’ concerns about my departures, I realize to some of them my farewells sounded as if I were saying, “Goodbye and good luck.” Today I shall address the problem of vacations from the therapist’s side of the treatment process.

I saw those interruptions as both essential to my well being and as an opportunity for therapeutic growth in my clientele. You might not agree with how I approached the issue while I was in practice, but I hope you understand my reasons.

The blogger What It Takes To Be Me, explains the client’s dilemma in this excerpt from her post, Reconnecting:

Regular readers of this blog will know that psychotherapy breaks is a topic I have written about a lot over the years, because it brings to the fore all of my fears about being abandoned and forgotten. It is also one of those things that people who haven’t been in therapy never seem to fully understand or appreciate. And, to me, that is also part of what makes breaks in therapy difficult; the sense that others don’t understand how hard they really are. Whenever I mention to ‘non-therapy’ friends that I feel really anxious about an upcoming break, I always get the feeling that they are thinking that I am worrying over nothing. And if I, during the actual break, say something along the lines of finding it hard that my therapist is away, the immediate response is invariably ‘When will she be back?’ followed by an equally predictable ‘Well, it’s only X weeks left’. This, of course, feels terribly invalidating, since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.

I was “forgotten” on the first day of kindergarten at Avondale School. I recall all my classmates being picked up by their moms. I was alone but for the teachers. Indeed, the school janitor, push broom in hand, was already making his rounds before my mother showed up. She misunderstood when school ended. The event did nothing to cement my own sense of security!

Much more serious and repeated abandonment issues fuel counseling sessions. Trust builds gradually, if (a big if) the therapist is sensitive to the kinds of feeling so well described by What It Takes To Be Me. Nonetheless, vacations are tricky.

The issue of credibility is near the heart of the problem. The people you treat are asking themselves an essential question: will this guy do what he says he will do? To fulfill the implicit or explicit promise of therapy, you must listen carefully to what people say to you, remember what they report from week to week, show up on time, be available by phone to a limited extent, and not be overwhelmed by the harrowing, heartbreaking stories you hear. Judging is not permitted either. Regardless of whether the client is aware of his motives, a part of him is testing you. Given his history, this kind of appraisal is more than fair. The vacation is one of the bigger tests.

I always tried to prepare clients by announcing my vacation schedule weeks in advance. Those who were in therapy for a considerable time knew when I predictably took off. Not all holidays, of course, were predictable. When I began outpatient practice I usually took four weeks vacation. Closer to retirement, respites from work were at least double the time, with roughly thirty years in between. Indeed, the need for more breaks signaled work-caused depletion and aging. Retirement beckoned.

The need for refueling is one of the funny things about doing therapy. The psychologist or other “provider” (as the insurance companies like to call all healthcare professionals) just sits, listens, and talks. A pretty soft life, eh?

If, however, you take it seriously, it is not. You must listen with intensity: hear, understand, and interpret the words; the tone of voice, watch the facial expressions and body language. To find out more about what is going through a therapist’s mind during the session, read What is Your Therapist Thinking?

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I have written the above to enable you to understand what I am about to say, even though many of you already know: therapy is hard work and vacations are necessary if you are to perform a desperately important task without burning out, becoming resentful of clients, and using yourself up so as to be of no value to yourself, them, or your family. I was privileged to do therapy, permitted access to secrets never told, and to know some amazing and courageous people almost as well as they could be known.

The practitioner must also present a model of self-care, an ability many of his clients lack. A counselor who is overwhelmed, preoccupied, or exhausted, benefits no one.  Your offer of yourself as a human sacrifice is a well-intentioned mistake. A portion of the good people you treat have lived in the same self-effacing style for years and are searching for another way. You are exhibiting all the wrong things about how to lead a life. Such a therapist is not a rock to hold on to in a torrent, but himself adrift.

Just so, you are giving an unfortunate impression if you do not take enough time or interest in your own family. This is complex. You do not wish patients, about whom you care, to experience guilt because you are taking time from your spouse or children. Some clients want as much of your presence as you can give, but you will almost always be respected more if you are good to yourself and your family. Your behavior, more than words, demonstrates sincerity and balance in the way you manage and (usually) do justice to the competing interests.

That said, by the time I was taking eight or more weeks off, I had accepted as patients only those people who could withstand my absences. Remember what What It Takes To Be Me wrote, “…since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.”

A therapist needs to put off very sensitive issues in the few weeks before his vacation. Just as a surgeon does not want to leave an operation before suturing the incision, a counselor shouldn’t leave anyone wide-open emotionally as he heads out the door for a holiday. Consultation with the client about what is safe to discuss is essential.

Part of a healer’s job is to factor in every conceivable variable in approaching his client, including his own mental and physical health. As Hippocrates wrote, “First do no harm” and he might have added, “to anyone, you and your family included.” I tried to be as thoughtful as possible. Young therapists, in particular, need to experiment to find an approach honoring their ethical responsibilities to others and their private needs.

I found out what worked best for me and my patients was not what I did early in my career when I took less vacation or, in a certain sense (as I will soon describe), none at all. A practitioner risks becoming too responsible as much as he risks being careless of others’ needs. One does not want to assume everyone you see requires access to you at every moment, thus stealing the initiative needed for them to grow. This is similar to an overprotective parent’s hovering over a child.

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I recall one patient in particular to whom I gave my private phone number with the instruction to call if she were in crisis while I was taking time off. She did, although I can’t remember how often. What I do recall is the effect on me: I was unable to unwind because I anticipated the possibility she might call. As a consequence of my decision, at vacation’s end, I felt as though I had not been away from my normal work routine. I soon ended this permission and discovered that she and others survived my absences and eventually grew from them.

That left the problem of how to best create the circumstances for such growth. I needed to stay bonded to those individuals who feared I would forget them or never return, or believed I was refraining from scheduling only them and not my entire clientele.

Therapists have many ways to approach this. The patient and I worked on my upcoming time away and how he might find support elsewhere. We talked, too, of the “transference” of his abandonment fears: parental figures who had been undependable, indifferent, or who disappeared during childhood create expectations of similar behavior by the healer.

Who was “covering” for me in emergencies was another important topic. If the colleague was in the building, I sometimes made sure there was a meeting between my client and this stranger before leaving.

I also used what are called “transitional objects.” Just as children will hold fast to a doll or a blanket to mediate the time until a parent returns, so do therapists offer tangible items for patients to take home while he is away. I sometimes employed a stuffed bear to maintain the connection between me and the person who was afraid of being abandoned again. A recording of my voice was another such device.

Ideally the client discovers, over many therapy breaks and an equal number of reunions, the healer is not identical to whomever abandoned him previously. In this way, the patient can begin to prevent his past from recreating a sense of anxiety in the present. Eventually, he sees the relationship-portion of the life project from a more hopeful perspective. In therapy and out, parting is inevitable. Treatment will end one day. A vacation by the therapist is a step in preparation for such a time.

Healthcare professionals are notorious for taking off during the holiday season. I was guilty of this, as well. These periods are often a temporal reminder of many of the worst experiences in a client’s life. The healer must help develop an adequate plan to get beyond the holidays. If the patient has supportive relationships outside of counseling he is well-positioned. Finding these is easier said than done, but with time it can be done. Without such people, activities (for example, working at soup kitchens for the down-and-out) are crucial to avoid the despair of a season that contributes to the unhappiness of many. The joyful images of TV programs and commercials are not a commonplace reality. Inevitable comparisons with idealized lives make us less than thrilled about our workaday existence.

There you have it. I do not mean to suggest I discovered the secret to perfecting a challenging part of being a clinical psychologist, and the potentially frightening and dangerous aspect of trusting a person like me. I am friendly with at least one psychiatrist who takes calls from his patients while on vacation. He is a conscientious man, but also one who doesn’t treat the phone as a burden to himself or his family. My hat is off to him. I did not have his magic formula within me, much as I searched early in my practice. Yet I believe I served my clients honorably and well within my limitations.

Remember, the Temple of Apollo at Delphi was inscribed with the Greek aphorism, “Know thyself.”

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The top photo is a Surfer at the Beach of Costa da Caprarica, Portugal by Alvesgaspar. Next comes a Beach Sunset, Newport  Coast by Axion23. Finally, more of Axion23’s work: Crystal Cove Beach Sunset. All are sourced from Wikimedia Commons.

August 17, 2014

Our Musical Future? “Live” Performances and the “Second Machine Age”

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I love attending concerts, but musicians may think my upcoming words are heresy. I hope technology doesn’t reduce the need for live performers, but the technological future includes many possibilities — more than anyone can imagine. Prepare yourself.

We must start by revisiting the Hartford Wagner Festival, the enterprise of Charles M. Goldstein. He expected to begin a cycle of The Ring of the Nibelung in Connecticut this month. The details leading to its postponement until 2015 can be read on Norman Lebrecht’s Slipped Disc blog, A Ring Without Musicians, or the New York Times.

Mr. Goldstein knew a performance of Wagner’s four opera event would be too costly to stage with a conventional orchestra. According to the New York Times, his monumental effort to create a substitute began in 2005. He started to enter every note of music for the 15 hour epic into musical software, having purchased “access to the Vienna Symphonic Library, a collection of sampled sounds of orchestra instruments (played by real players).” The idea was to create a computerized version of the orchestra out of the orchestral bits. “Singers from the Metropolitan Opera were engaged for the major roles, along with young artists for smaller parts.” Mr. Goldstein collaborated with the musicians to establish tempos. The plan was “to set up 24 speakers to mimic the positions of instruments in (a genuine orchestra) pit.”

Publicity produced a backlash. Singers’ careers were threatened. The inflexibility and sterility of computerized music was attacked and words like “absurd” and “travesty” were written. The Hartford Wagner Festival’s website now lists a 2015 start date.

Is the battle over or is it only beginning? The truth is, the conflict began much earlier. The New York Times covered the story in 2003. Local 802 of the Musician’s Union picketed Broadway shows in response to the threat of fully electronic delivery of what was previously the instrumentalists’ in person artistry. Anthony Tommasini, the critic who described the conflict, thought their argument had some holes. Orchestral and choral amplification with electronic support, synthesized instruments, and body microphones of principal singers were already a staple of the stage, he argued. The Union won, but technology has advanced in the last 11 years.

The Vienna Symphonic Library (VSL) is a tool intended to allow the creation of a good, albeit recorded, orchestral performance for the purpose of the user. In the case of Mr. Goldstein’s planned public presentation, input from the singers expected to be on stage, as well as the “conductor,” would determine the interpretation of the composition. Thus, the VSL holds the possibility of something greater than getting actors to lip-sync. Nonetheless, critics believe it does not permit the nuance, spontaneity, and sound of a real orchestra. Moreover, some say, unexpected mishaps on stage during an opera (an early or late entrance by a singer, for example) would be difficult for the conductor to adjust to.

I consulted a couple of musicians familiar with the VSL and its use. How much time might it take to “assemble” a fully realized rendition of a major symphonic work like Debussy’s La Mer? As Mr. Goldstein’s example suggests, they thought the time involved would be far too long to compete with today’s marvelous live instrumentalists (even for a talented, computer savvy conductor familiar with the VSL and musical notation software). You can listen to Andrew Blaney’s version of the second movement of La Mer on the VSL website and judge the quality for yourself. A first-class orchestra typically accomplishes its own magic in a few rehearsals using traditional printed scores. Wouldn’t live musicians therefore be safe?

Not so fast. Once the notes and instruments are “in the machine,” another conductor could come along and tweak the performance to his or her satisfaction. Still, for now at least, a computer-experienced maestro would have to learn how to use the VSL. The time involved in preparing his interpretation would be large even after that.

Does the situation change when we look only at opera and its audience? Might some music lovers be willing to attend an opera of live singers and a digitized orchestra if the price were cheap enough? Perhaps some who live in the provinces would.

Imagine a generous donor purchasing loudspeakers, the computer, musical notation software, and the VSL (one time expenses) for a small community with a decent auditorium, thus enabling staged operas. There exists a plethora of talented young singers and competent conductors of high school, college ensembles, and community orchestras. We are not talking James Levine or Riccardo Muti here, of course.

A digital orchestra reduces costs after the original outlay by our hypothetical donor. Goldstein’s long effort to enter the notes into the software for his “Ring cycle,” once done, needn’t be done again. Of course, he would have to be willing to sell his work product for an affordable price or simply give it away. Alternatively, several small communities could band together to pay whatever price Mr. Goldstein would set, or hire someone to do the job of entering the notes for an agreed upon opera. From that point, it could be widely and cheaply shared among them, as digital music commonly is today.

The cost of such an arrangement would be far less than hiring an orchestra and paying a major conductor tens of thousands of dollars per performance. Still, the result would be both poorer and different, at least until robots and androids are far more developed than they are now; replacements, that is, for some or all of the musicians!

Did I say robots and androids? The latter are robots designed to resemble humans. I’ll get to androids in a moment. Nonetheless, we are already in the world of the “second machine age.” Erik Brynjolfsson and Andrew McAfee, two MIT professors, elaborate in their book, The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies. Even Goldstein’s idea of a digital orchestra puts us well beyond the era of steam engines, a prime contributor to the first machine age.

Would an enterprise such as Mr. Goldstein’s have an effect on major opera houses? Much depends upon the audience’s perception of the product. If most opera lovers believe the human beings at the Lyric Opera or the Met are worth the ticket price, as I hope they do, their orchestras have no worries. If, however, a sizeable number of patrons don’t, downward pressure on prices would follow (or at least the portion of the admission fee attributable to the orchestra). Instrumentalists and their salaries may be more vulnerable to the technological changes because they are in the pit, unseen by much of the audience. The human contact between the listeners and the players is more easily realized by the singers and the chorus in an opera house, unlike a concert hall where the ensemble and the podium focus our attention. Nonetheless, I don’t expect the technology we have now puts a superb opera orchestra in danger.

Ah, but the future — a different question altogether. Scientists speculate about something called “the singularity.” The singularity represents the point at which a fully conscious machine with greater than human intelligence is achieved. Coupled with the advanced android capabilities of that time, many of today’s jobs might vanish, perhaps even those of violinists and tuba players. The MIT professors cite evidence of the exponential growth of technology in recent years, predicting acceleration as we go forward. Self-driving cars already exist, as do computers that can beat the best Jeopardy or chess players. Ray Kurzweil, in The Singularity is Near, made a 2005 prediction placing the singularity somewhere around 2045. Kurzweil is a member of the National Inventors Hall of Fame, won MIT-Lemelson’s half-million dollar prize for innovation, and received the National Medal of Technology from President Clinton.

If one lets the imagination go wild, the possibility of android orchestras, conductors, or singers is conceivable, regardless of the year they turn up. I didn’t say preferable, particularly since the friendliness of such machines to humans is also an open question. Nor is it clear whether they would be interested in music, in the artistic history of the human race, or in presenting concerts of the works of humans in the formal way it has been done until now.

Assuming they are well disposed to Homo sapiens, however, it might become possible to pour all the recorded performances of the conductor, Wilhelm Furtwängler, into a capable machine and generate imagined interpretations of pieces for which we have no evidence of his work. A Furtwängler performance of Beethoven’s Missa Solemnis comes to mind. Does this violate Furtwängler’s memory? Were Mahler and Elgar violated, respectively, by completed performing versions of Mahler’s sketches for his Symphony #10 or Anthony Payne’s elaboration of Elgar’s unfinished Symphony #3? And could an android “inspire” human or robotic musicians in the hypnotic fashion of some of the greatest conductors? Would inspiration even be required? Live long enough and perhaps you’ll find out.

IBM is already working on a machine to do something similar for physicians minus the inspiration “to better diagnose what’s wrong with their patients. Instead of volumes and volumes of general knowledge, the supercomputer is being trained to sit on top of all of the world’s high-quality published medical information; match it against patients’ symptoms, medical histories, and test results; and formulate both a diagnosis and a treatment plan. … IBM estimates that it would take a human doctor 160 hours of reading each week just to keep up with relevant new literature,” according to The Second Machine Age authors.

Today we have opera supertitles and a giant in-concert video screen display of the Chicago Symphony in the Ravinia music shed, its summer home. We have digital music at our fingertips and in our earbuds. Robots guided by surgeons work on delicate human body parts. Some operas and orchestras simulcast their work around the world.

Once men thought Jules Verne’s 1865 novel, From the Earth to the Moon, was silliness.

The MIT authors remind us, never say never.

August 10, 2014

Understanding Angry Old White Men

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He might be your father, brother, or uncle; a friend or a neighbor. He goes off like a roadside bomb or sits and simmers before boiling over. He could also be you: a grumpy, irritable, angry old white man. The kind of creature whose head revolves like a searchlight, looking for something or someone to piss him off; the guy who yells, “Get off my lawn!” Bitterness personified.

Endocrinologists point to low testosterone as a possible cause, especially past 60, when some males begin the hormonal decline. I’ll focus on the human rather than the chemical equation: what it feels like to be an aging white male. Don’t discount the hormonal changes, but research them elsewhere.

Let’s start with what constitutes a young man to better understand the same person in 50 years time.

Males pass through a stage of feeling almost invulnerable and immortal, at least on occasion. They rush to fight wars, compete for mates, and try to climb higher than others. Women perform a selection of these tasks, but few teenaged girls believe themselves indestructible.

I was neither a great athlete nor the smartest person I knew at any point in life. Yet, I know whereof I speak. There are moments when a young man believes he can do almost anything. For some the hubris comes in athletics, in academics for others. The babe-magnets fancy themselves as sex machines. Kids I knew took pride in intimidation, rocket-like racing, placing first in fierceness, or towering over others as regents of recklessness. Even those who broke rules grew in foolish conceit. Boasts were heard about consuming the most beer in the bar.

This silliness seems built-in, tied to the need of early men to attract females and save their own skin from beasts and bullies. Ambition and power fed your chance of spreading your genetic seed, an evolutionary but unconscious imperative. From a survival standpoint, wars wanted winners and trees needed climbing for their fruit.

Among my youthful acquaintances, I’m sure much of this was already present in the watery womb. But I am not talking about angry kids; rather, how the sense of immortality and competitiveness necessary in youth sets some men up for a disappointing and overwrought old age. If a man lived through injustices and disappointments early or late, his rage — once bottled up or transformed into ambition — now goes nowhere productive, at least to no meaningful arena for a staged competition. Such battles as he fought in the world of work or on the athletic field are foreclosed. You can still be an award-winning body builder at 65, but all the comparisons are with people your age. A real man of the old school knows the difference.

The indignities of aging seem to cause women less trouble, or at least less public aggravation. They are better sports and, ironically, superior at manning-up to the depredations of time. The suicide rate of old bucks skyrockets. Data from the American Association of Suicidology indicates the elderly made up only 13% of the population as of 2010, but accounted for 15.6% of all suicides. Moreover, men over 65 committed 84% of suicides by seniors, and this percentage grew as they aged.

Grumpy2Unless you are a rare old man, indeed, you’ve lost a step, an edge, a bit or more of your balance and grace. The IQ and neuropsychological tests display the results; so does the mirror. Even the beer drinking boaster takes longer to recover from his hang-over.

Some domains are uniquely problematic for the male. My physician tells me there are only two categories with respect to an enlarged prostate: those men who have one and those who are going to get one. Nor does the sexual trigger work as dependably and well. A 55-year-old male patient proclaimed: “I’m not the man I once was, but once I’m the man I was.”

I could go on to infinity about aches, pains, loss of hair and color, sun damage to the skin, and more frequent urination. The sixty-something male is sexually less relevant (his studly days having passed), evolutionarily irrelevant for the same reason, invisible to almost everyone (including young women), and gets called “sir” much too often for comfort.

The twenty-first century adds to this list: frustration over mastering the exponential growth of technological change, the supreme domain of youth. You are probably sick of reading my catalog of slow decline, so just imagine the poor guys who are living the descent and whose age-related sleep problems give them more time to stew.

Either retirement or involuntary unemployment is perhaps the biggest loss and driver of a man’s ire. Unless he is extroverted, job site friendships tend to fade away and he has not usually nurtured intimacy outside his family. Too many men lack an identity beyond labor. Women suffer labor pains in childbirth, but men suffer them by the absence of meaningful work. By 60, unless you are so grandiose as to run for President or be a major CEO, your working future is foreshortened.

The situation is different (but no less frustrating) if you remain on the career treadmill due to financial necessity or a failure to accomplish long-time goals. Few of us are like Warren Buffett, Picasso, Stravinsky, or Frank Lloyd Wright, producing wonders late in life.

Voltaire said, “Work saves a man from three great evils: boredom, vice, and need.” Once his formal working life ends, unless the old man possesses enough cash, interests, and friends, he is in trouble. A narrow vocational focus sets him up for a painful retirement or unemployment. Labor provides a sense of worth and accomplishment. Men need to be useful. A job normalizes and distracts him, keeps depression at bay while dissipating the “fight” in the surly chap we are describing.

There is considerable data linking an early retirement to an earlier death: Retirement kills. A vocation orders any life, providing a timetable and a list of tasks. Without the scaffolding that structures perhaps 50 hours or more a week (if we include travel to and from the job) retirement or unemployment can be disorienting and frustrating. It is only a short step to depression, alcohol abuse, anger, or all three. Think again about the place of vice on Voltaire’s list of “three evils” and remember: one of the “seven deadly sins” is wrath.

Time is a cruel and ironic jester to the angry old white male. The latter is both idle during the day and imagines too little lifetime ahead. Moreover, the years pass with a psychological rapidity unknown to the young. Three-hundred-sixty-five days still make a year, but somehow the revolutions around the sun go faster.

The irrelevant elder must either reinvent himself or suffer an internal upset that has eyes: it looks for a target. Neighbors, politics, friends, relatives, children, young people, and minority groups are the usual suspects. The partisan broadcast media stir the political pot and fuel the sense of unfairness. Their incentives, whether a genuine belief in how to right the lopsided world or the lure of big money and influence, spell trouble for those whom they transfix. The poor old exasperated white man is their white bread and butter, regardless.

Once king of his castle, he finds his loyal subjects (aka, his children) have their own lives. Perhaps his proud and powerful fortress is both emptier and shabbier with the passage of time. Since it is not manly to weep, he rants.

Ensign_of_the_21º_Gruppo_(Angry_Wasp)_of_the_Italian_Air_Force.svgNone of this is good for blood pressure or happiness. Nor is the irritable and ancient buck likely to read this or anything else for advice. His anger seems righteous. The problem is perceived to be elsewhere. A spouse hesitates to complain or utter worries about the mental state of a man who resembles Caligula, the insane Roman tyrant. Still, a family intervention might be needed, with the group of relatives and friends reinforcing each other’s concerns about their kinsman. A trusted physician is another possible voice to enlist for advice, diagnosis and treatment of any contributory medical issues.

Therapy or retirement coaching is indicated, but only if you can get this injured soul to submit with an open heart. The odds do not favor a trip to a counselor. Regardless, our subject has a selection of possible tasks to complete for a better life:

  • Develop hobbies if they are absent. Join community organizations or volunteer for causes he believes in. Serving as a mentor to the young can give value to the experience of a lifetime.
  • Erect a new structure for his days both to keep him focused off his grievances and on to something to give him meaning. If possible and necessary, get back to work part-time or start a new business.
  • Learn cognitive-behavioral methods to control rage.
  • Make new friends or search out old companions, especially if they can make him laugh.
  • Learn to take the aging process as a less personal affront. Life has not singled anyone out.
  • Go back to school. Take a free MOOC (massive open online course) such as those found at Coursera, join a lifelong-learning program (National Lewis University), or something like the University of Chicago Basic Program of Liberal Education for Adults. The latter two examples provide not only the stimulation of learning, but face-to-face interaction with same-aged peers who might become new friends.
  • Limit exposure to the news stories or political pundits whose job is to fan the glowing, incendiary embers inside.
  • Join a story-telling group. Old men with a gift for performance can deliver some wonderful reminiscences, so they might as well be put to good use with a receptive audience.
  • Stretch and exercise regularly. Take good care of the body.
  • Any excavation underneath the anger to an elderly person’s hurt is a dangerous business. Grieving is the work of the young and middle-aged. The old rarely have enough future time or opportunity to redeem the past. Some can handle grieving the failure to achieve early goals and life’s losses, but many can’t. For those carrying too much disappointment, age dictates a more supportive therapy rather than one to search the depths of the soul.
  • Learn to appreciate what remains.
  • Consider antidepressant medication.

Lost time, diminished abilities, and the realization of mortality drive a few people mad — mad in both senses of the word. There is no time to waste. Most men are offered two opportunities for heroism: the risk-taking of a robust youth and a walk into the twilight of life. Dylan Thomas’s recommendation to “Rage, rage against the dying of the light” (listen to him below) doesn’t serve most of us well. The twilight can be beautiful or terrifying. Which one depends on luck and attitude. Since we control but one of these, the only real choice is to change the latter from terror and anger to gratitude for what we still have, acceptance of what we don’t, and pride in a life well-lived.

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The image of the Angry Man is by Emery Way. The cartoon is the Ensign of the 21° Gruppo (Angry Wasp) of the Italian Air Force by       F l a n k e r. Both are sourced from Wikimedia Commons.