By Dick Weinman
Hank hates prunes. At least in liquid form. At the dining table, when a caregiver/server pushes a glass of prune juice in front of him, his nose wrinkles, his nostrils spread, the lines on his forehead squeeze together, his eye’s external apparatus - lids, lashes, and brows – squish down - as though he were constipated. Ironic, because that’s the majeure raison for the prune juice in the first place. He turns to me with a wondering smile, raises his shoulders, spreads out his arms, palms open - as if to say, Ech! What did I do to deserve this?
He didn’t do anything. It’s his G.I. system that’s misbehaving. From all outward appearances, Hank, seems to be continuing smoothly – but haltingly - towards his ninety-sixth year, without the wear and tear common to all of us. I believe he can blow hard enough to extinguish the birthday candles.
When Hank exhibits his facial contortions, and denies access to the prune juice, the server always pours it in his glass anyhow, and tells him his doctor ordered it. Thus, the command comes from up high – the abstract, but omniscient – voice of the MD. (Well someone has to be blamed for earning Hank’s disdain and distaste.)
Which brings us to the modern perplexity for geriatrics and gerontologists: to have to or to want to. (Whether it’s nobler in the mind, to suffer the slings and arrows of an outrageous colon, or to take prune juice to oppose it, and obtain regularity?)
The issue can be the dichotomy between a ninety-five year old person liking two scoops of ice cream before bed and the warning that it’s bad for his health and longevity. Really! Come on now!
Atul Gawande addresses this dichotomy in his book, Being Mortal. As a surgeon, he knows of the medical lengths elders and their families go through to fix – even stop - end-of-life gerontological illnesses. His admonition is to face the fact of old age. Don’t try to interfere with the natural processes of the cycle of mortality. Don’t try to fix something that just happens naturally.
Difficult choices, to be sure. A child of an elder parent is concerned for their security and safety. Or, as Dr. Gawande puts it, the concern for security and safety is “directed more toward the people planning to leave Mom then than toward Mom.” Thus, the children of elders are the marketing target of the long term care industry and are the main marketing ploy used by nursing homes and assisted living facilities. But the elder may want “to write their own narrative” of their final journey.
Should Hank drink the prune juice?
Let’s leave it to him.
Editor's Note: For your own exploration into healthy eating, check out AARP.ORG