Jewish Herald-Voice (Houston, Tex.), Vol. 102, No. 47, Ed. 1 Thursday, January 20, 2011 Page: 2 of 44
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Page 2A
Jewish Herald-Voice
January 20, 2011
Up Close
What it means to grow old often
depends on one’s perceptions
Miami Juuinh Hamt
and Hospital
Afonin. M.D.
Marc Agronin, M.D.
By AARON HOWARD
When we’re young, we anticipate
getting older. As we age, we often
don’t relish the changes the process
brings. When we get old, we often
view old age as a tragedy.
What is old? And, what does it
mean to us?
Our individual experience of
aging is heavily influenced by how we
imagine it to be, said Marc Agronin,
M.D. Agronin is the psychiatrist at
the Miami Jewish Health Systems,
formerly the Miami Jewish Home
and Hospital at Douglas Gardens.
He’s also the author of “How We Age:
A Doctor’s Journey Into the Heart of
Growing Old.” Da Capo Press will
publish the book in February. Dr.
Agronin is 45.
The process of aging is
fundamentally a physiological
process of change. “On a cellular
level, we refer to it as senescence,”
said Dr. Agronin. “The term
refers to the slowly accumulating
changes in our cells. With each cell
division and with the accumulation
of waste products, senescence
leads to decline in cell function
and eventual cell death. This is a
process that underlies every single
thing in nature, as a result of time
and entropy, the tendency of the
molecular order to become more
dispersed and unstable during the
course of time.”
Everything ages. Biological
living] systems come equipped with
growth and repair systems. These
systems work well from the time
of birth through reproductive age.
Then, our growth and repair systems
begin to wane.
“If we didn’t reach reproductive
age, we wouldn’t exist,” said Dr.
Agronin. “But, once you reproduce,
your value begins to drop
precipitously. From a historical
perspective, our life span used to be
about 20-25 years. There were too
many factors, at least historically,
that were threats to our aging. But,
that’s changed in the last 100 years.
Our average life span has gone
from about 50 to the late 70s, and it
continues to increase.”
From a biological point of view,
we’ve wrestled aging away from
nature. We can prolong our lives.
But, we cannot defeat growing old
and death.
“The only true anti-aging strategy
would be a time machine,” said Dr.
Agronin. “No one has identified
any true anti-aging technique. If
you see the word ‘anti-aging’ on any
product, someone is trying to make
money. And, it probably won’t do you
much good. It might make you look
better, but it won’t make your body
any younger. If you look at all the
famous anti-aging proponents over
the past few decades, they have all
turned out to quite mortal, just like
the rest of us.”
The biological process of aging is
just one facet of the process. As each
of us grows old, what aging means to
us is biased by the experiences of
those elders in our lives. Dr. Agronin
called it the “image of oldness.”
“When most people reflect on old
age, they think of the people they
grew up with. And, these images
imprint our first image of aging
in our minds. For instance, I had
two sets of grandparents, great-
grandparents and lots of aunts and
uncles who all were colorful people.
I had many wonderful relationships,
and old age imprinted on me as an
active and interactive time. So, my
first assumptions of aging are based
on those experiences. It influenced
my decision to go into geriatrics.
“But, if someone grows up and
the older individuals they grow
up with are very debilitated and
depressed, that may affect their
views in a different way. There are
distinct limits to the aging process.
But, the experience of aging doesn’t
necessarily have to have those
limits. The joy, vitality and meaning
that people can find throughout
their entire lives, particularly in old
age, have no such limits, other than
what we impose on ourselves.”
One might imagine working in
a practice where the average age
of his patients is 90 years. Dr.
Agronin is used to seeing nothing
but increasing deficits in the aging
brain. However, reflecting on his
experiences at the Miami Jewish
Health Systems, Dr. Agronin found
many aging individuals develop
a new ability to think, strategize
and devise solutions. This kind of
thinking allows the older individual
to look at both sides of
the coin simultaneously -
and then reason without
being hampered by the
apparent ambiguity or
contradiction in the
situation.
Dr. Agronin also
described memory as
“the glue that holds
together our identity and
functioning.” He uses
the metaphor of “exile”
when he refers to memory
impairment.
“Most of us view
memory in terms of verbal
experience: what we
can retell, experiences
we can put into words,”
he explained. “For
individuals suffering from
Alzheimer’s or other forms
of dementia, those worlds, in terms
of words and names and so on, begin
to slip away. From one perspective,
I liken that to exile. The recognition
begins to slip away. Aspects of our
identity change dramatically.
“At the same time, there are
other forms of memory that are
more enduring: sensory memory
such as sounds, sights, smells and
motor memory, having to do with
movement, that don’t need names
but stay with us to the very end, even
in the throes of dementia. By finding
ways to access those forms of
memory, we can bring contentment
and meaning to people’s lives.
“For example, on our grounds
we have a small synagogue. A
number of the men who participate
in the services suffer from memory
impairment. But, if you were to
watch them during the service,
you’d never know it. The tunes, the
Hebrew they learned as children,
the sight of the Torah, these are
deeply ingrained. They are such
deeply engrained sensory and motor
experiences that individuals are able
to experience them and participate
in rituals that tap deeply into their
lives. Working with these individuals
has taught me the deep meaning and
relevance of ritual. Ritual literally
immerses us in Judaism in ways that
go above and beyond the intellect.
There’s a method to all of this. It’s
so important to immerse children
in the ritual. It enwraps us in the
meaning of Judaism in very deep
ways.”
In his book, “How We Age,” Dr.
Agronin quotes Rabbi Avrohom
Korf, Florida regional director of
Chabad, who spoke about old age
as something to be viewed, not
as a failing, but as an ongoing
opportunity to accomplish one’s
purpose in life.
“That quote is from is from the
Rebbe, from a little book of his
called Attaining Sagacity.’ A Chabad
friend of mine gave me the book.
It’s the Rebbe’s writings about late
life. In Judaism, there’s no sense
of reclining or retirement. Judaism
really looks at the possibility of
greater meaning and wisdom as one
ages. And, it’s encompassed in that
book.
“I’ve been at the Miami Health
Systems for 11 years. During this
time, I’ve grown immensely as
a person, by virtue of what I’ve
learned from the older individuals
I’ve worked with. I’m one of their
doctors, but I describe myself as
one of their students, as well. These
experiences have taught me about
all of the possibilities of growing
old as much as it’s taught me about
the realities of the aging process.
The whole point of writing the book
was to tell this other side of the
story, this other side of aging that
we often miss.” □
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Samuels, Jeanne F. Jewish Herald-Voice (Houston, Tex.), Vol. 102, No. 47, Ed. 1 Thursday, January 20, 2011, newspaper, January 20, 2011; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth544132/m1/2/: accessed July 12, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; .