A Look in the Mirror
Posted November 8, 2010
“I want to thank you, Lord, for life and all that’s in it.
Thank you for the day and for the hour, and the minute.”
Maya Angelou
I had been in pain long enough. Multiple knee injuries (ACL, left knee) complicated by years of wear and tear were causing too much pain. The orthopedic surgeon entered the examination room to review the results of x-rays and an MRI. We were there to discuss options. He was blunt. “We don’t usually operate on people as old as you.” I was stunned, and for a moment I wanted to be an 18-year-old again and say, “Dude! Have you looked in the mirror recently? You’re like 70, and I’m too old?” That was more than five years ago and the surgery was a great success – despite my advanced age.
I also had the recent experience of hearing some members of my extended family describe how much I remind them of my maternal grandfather. Apparently the way I walk and some of my physical characteristics offer quite a resemblance. He died when I was in preschool, so I never really knew him. Just a few faint memories remain with me. I was honored to hear this since I know how much he is admired in my family, until it dawned on me that I was being told, “You look like your grandfather!” Maybe a few more sit-ups will help. And I’ve seen Rogaine sold in large containers. Does it come in a 55-gallon drum?
It seems the middle of life brings us to a threshold; a kind of liminal space where we become too old for some things and see before us the challenges of aging that are inevitable. We care for the young and the old at the same time. This hit me hard when I spent several days in Pennsylvania recently to be with my Mom. She is 85 now and has lived without my Dad for the past 16 years. A stroke took him in his sleep.
Mom has a range of medical challenges and I have watched as her quality of life has eroded. She endures a great deal of pain, sleeps very little, and is finding it hard to eat. Her doctor described this situation gently by noting that she is in a very “fragile” state of health. The retirement community she has resided in for many years is a gift and now that she has entered the wing that provides “skilled care,” the decisions ahead become more complicated. Like many elderly individuals, she has a living will that outlines her wishes for “end of life” scenarios. This brings our family some comfort, but my last visit with her was an in-your-face experience of the realities represented in that document.
The intellectual dimensions are simple. The instructions are clear regarding the interventions she will allow and those she will not. I was asked on several occasions to confirm this with her doctors and remained steadfast in ensuring that her wishes will be followed. But the emotional dimensions are far more complicated. As I joined my siblings in the hospital room at her bedside I sat next to Mom and offered a few funny remarks that brought a faint smile to her face. It made me think that she is far from ready to die. Yet the next morning I had occasion to sit with her quietly for several hours. I witnessed the pain she is experiencing as I held her hands while she faded in and out of sleep. I could only hope in that moment that all this would end, and that became my prayer.
A dedicated medical staff provided superb care, and to our amazement she responded to treatment and her condition improved. Her pain was being better managed and her breathing and body relaxed. After a week-long stay in the hospital, she returned to the small place she now calls home. It has become a haven of rest for her.
We have all returned to our everyday routine, but lingering in my mind are the images of that hospital and the knowledge that one day a similar scenario will play out as the end of her life approaches. I remember a comment she once made reflecting on her mother’s death, “It doesn’t matter how old you get, there is just something about the death of a mother (or a father) you never get over. There is no longer anyone ahead of you.”
And so the cycle of life continues. We revel in the innocence of the very young as we come to revere the courage of the very old.
According to the Administration on Aging in the US Department of Health and Human Services,
The older population–persons 65 years or older–numbered 39.6 million in 2009 (the latest year for which data is available). They represented 12.9% of the U.S. population, about one in every eight Americans. By 2030, there will be about 72.1 million older persons, more than twice their number in 2000. People 65+ represented 12.4% of the population in the year 2000 but are expected to grow to be 19% of the population by 2030. (www.aoa.gov)
Our society is in for a big wake-up call and I don’t think we are ready. Life expectancy is increasing as the population of older adults is expanding. There are challenges coming to our health care system, economic implications from major changes in the workforce, and an infrastructure insufficient to meet the coming demand for support services.
We also have many families ill-prepared to meet the challenges of aging loved ones and provide the needed care. Care givers often suffer along with the infirmed as already complicated lives spin out of control with needs that overwhelm the best of families. The consequences can be tragic as the collateral effects bring stress that severs familial relationships.
On the day I returned to Iowa, I sat with my family as our Mom slept quietly. We had a deep conversation about the next steps. I have the comfort of knowing that we are all in agreement about these final stages, and we are confident of the quality of care she is receiving. My hope is that our story is the story of every family. As I look around me, however, I can’t help but wonder . . .
Are we doing enough?
About the Author
I'm the lucky individual who carries the title, 21st president of Central College in Pella, Iowa. Passionate about higher education and the issues facing it and the world today, I hope to invoke an engaging conversation with all who are ready to dig in, make a difference and build for the future. Share your thoughts. I'm listening and interested.
Comment
34 responses to A Look in the Mirror
Dr. Putnam, have you ever heard of Facebook? Evidently not. That’s the place for this drivel. Using Central’s resources/money, Central’s connections, and your POWER as Central’s President to obsess on your own illogical insecurities is so completely sickening! Suggestion: Write about something we’d actually be interested in. Central. Hello?!
Mr. Truth, it might behoove you to look into the mirror. You seem to have a great deal of aversion to the new president. What would be of interest to you? I don’t think the president is using up that many resources writing this blog, and I enjoy hearing his (and others’)ideas about a variety of topics that are relevant to all of us.
I’m with my classmate Lois on this (and many other things). It seems to me that a key value of a Liberal Arts education is to enable one to see and articulate connections across a wide spectrum of life experiences. The aging demographic of our country has clear implications for the world in which Central’s new and future graduates will be living and working. I trust that Central will help them in knowing how to respond to those realities.
Mr. Truth, next time you have a few minutes, please spend them removing your e-mail address from Dr. Putnam’s blog (you can still follow him on Facebook). I think all of us will feel better.
I think Dr. Putnam’s blog is very insightful and addresses a situation that impacts everyone at some point in his or her life. Dealing with a parent’s immortality is a life-changing experience.
And as with almost everything, it’s only as we reflect and discuss that we can find ways to make a difficult experience a little better. To me, that’s education.
Thanks for allowing us to understand you as a person, Mark Putnam!!
I agree with my brother-in-law, Perry. Good comment!
Yes, Perry, Dr. Putman’s blog is very insightful. And we all deal with aging parents and end-of-life decisions (even for ourselves) at some time or another. Life is a continual education and understanding another’s experiences through their reflections may give us fresh ideas to deal with those end-of-life decisions. Thank you Dr. Putnam for opening yourself to others with your very candid and articulate reflections.
CUI Class of ’65
Mark Truth is a troll. Please do not feed the troll. It only makes the troll more trolly.
Mark Truth,
Please stop commenting on this blog. I have a feeling you won’t be interested in anything Dr. Putnam has to say, which is your own right. Just go away.
If not, then keep your heinous, immature, unsupported comments to yourself. Noone cares.
I agree with Mark Truth. How about writing about sports at the Division III level and what they do for a college as far as fundraising, recruiting,school spirit and education.
Mark Truth #2, Your request for blogs about NCAA Div.III sports is a cut above the suggestions of Mark Truth, but not much. As interesting as D-III sports are, they appear fairly insignificant when compared with deeper concerns of our society at large, or the concerns of liberal arts goals and values derived from life’s experiences.
Central’s fine arts programs are just as successful and just as worthy as our athletics. Stop being narrow minded.
Dear ’10 Graduate,
Of course fine arts programs are just as worth as our athletics. If you read my comment about “deeper concerns” and concerns for liberal arts goals and values. I hope you’ll agree that these deserve one’s attention well beyond any of the co-curricular activities, despite the importance of these.
First, Mr. Truth (perhaps used very loosely as you obviously aren’t truthful enough to use your name), I am sorry to read your disrespectful diatribe. Maybe you need to get on the CUI mailing lists. I must get 3 messages a week about Central – I’m certainly tuned in on what’s going on there. I’m also very interested to get to know Dr. Putnam. By exploring life OUTSIDE of Central, maybe we’ll get some insight into the man running the college and be better prepared to dialogue with him on issues that he seeks (or we feel we need to offer) insight and opinions on. I would hope those opinions would hit the Mark on the Truthful target!
Dr. Putnam, your observations are very relevant. Our current healthcare system is not prepared to handle the aging population and I encourage you to explore how Central may help fill that gap.
Our family recently spent 12 months in hospitals and a nursing home with both of my parents as patients a good part of the time before they both passed away. They were in what I would consider very good regional and local facilities in rural Iowa staffed by good people who cared about and for them to the best of their abilities. However, I could write a book on the disturbing incidents that we experienced. Almost all of the incidents had a root cause of lack of adequate staffing to provide a acceptable basic level of care – from surgery errors to basic personal hygiene needs.
I shudder to think about what might be happening to patients who are in a hospital or facility in the city and/or to those who lack a family member or advocate to help direct their care. (My wife works in a metropolitan health care facility, so perhaps I have a bit too much inside-scoop/bias).
The current system is not ready for the day when we baby-boomers will need these services. And I have not learned of anything in health-care reform addressing the service side of this issue – all is focused on the financial side to date. We need new solutions to address these needs.
As my wife’s grandparents continue to work through the process of the loss of all of their possessions in a house fire, I am continuously grateful that we did not lose them in the house fire.
The positives in life are all around us and we must cling to them.
Are we prepared to serve our elders in a way that is respectful and appropriate? I hope we have the mental capacity to do so, the other parts will take care of themselves.
Mr. “Truth” must be of a young and tender age and is not ready to face his mortality or deal with aging parents yet.
I was blessed to have my father with me in his last years, a victim of Alzheimer’s Disease. It was sad to witness such an intelligent and talented individual lose his sight, hearing and mental capacity, and find myself in the position of “parenting the parent”. It was a tough job to have to be in control without making him feel as if he had no control of his life. It was an education for my children, as someday they may have to make choices for me. My mother once remarked that she looked in the mirror and saw her mother. It shocked me to see her face in my mirror one day! It pains me to realize there are things I am “too old” for, and some of those things cannot be included on a “bucket list”.
Mr. “Truth”, blogs are for reflection and to inspire reflection in others. Get your news and information on the Central website, and let Dr. Putnam reflect and inspire us, thank you!
Aging? I’m only 63 and have been sick with several incurable and one very hideous disease for 24 years. My husband who is much older than I is my caretaker. We lived in a country where healthcare is FREE and you get it right away, no waiting. Here we have to pay through the nose AFTER insurance has paid their part. Twenty percent of a huge amount is a lot. I have multisystemic sarcoidosis, kidney failure, two heart problems, osteo arthritis, and more. I no longer go to my specialists as we can’t afford it. Healtwise, this country SUCKS. We make too much for Hill Burton funds, and not enough to pay the many many 20% bills. Screw them. With all of this, I was also turned down for disability. This was when an alcoholic or a drug addict could get it – but not me. Excuse me? If we could afford it, we’d retire in another country. Having been to 22 countries, I can tell you there are some just as good as this one, and healthwise, much better, and they treat the elderly much better – with respect. I just survived a major car accident because of the medicine a doctor gave me which puts you to sleep at a second’s notice. Thank you very much. Now, as we are on social security – see if this can be fixed. Aging with health issues in this country is a death watch, and strangles family’s incomes to the max, or ruins them completely. We do not honor our elderly. We shove them away. I still volunteer as an art teacher, sing at places when asked, etc. But I’ve been blind, not able to walk for months at a time, crawl, nothing. And what help do we get from our great government? NOTHING. Give us the same health care Congress gets and we’d all be fine in our old age. One good thing about being old is we don’t have to give a rip about what others think.
Why are you still here then if you hate it so much? You just want a free ride and to b and m. You don’t care what others think, well I don’t care what you think. You are so wrong. Many people do value the elderly, but you don’t deserve to be valued just because you are old and NEED something. We all need something. I have never seen anyone denied health care, but they just may not get everything they want when they want it and free.
nowhine, I work in the health care industry and know of many people who cannot get adequate care and who are burdened financially when they can. Please be careful about your generalizations.
Lois – thank you. I wasn’t whining. I was trying to get across a point – and your response is appreciated.
Nowhine – who doesn’t have the GUTS to use their own name. Yes, I have been denied health care. I’ve also worked for hospitals for 15 years and know this happens on a daily basis. I wasn’t here to Bitch and Moan as you call it. I was here to say the healthcare system in this country SUCKS. Bigtime. If we all had the healthcare our congress has, we would all be better off. However, they won’t share it. It doesn’t matter how sick you are, if you don’t have the money, you can count on going into terrible debt or just die for many people. Why do you think the government pays for Dialysis? Because so many people in the early years of dialysis had spouses working 3 jobs just to pay for it, and still going broke. Many dialysis patients committed suicide in protest. Now they receive the help they need. I’d like basic healthcare we can afford. Do we want to lose our home? No. Now I make a choice. Health or keep our home. Do YOU have to make that choice? I hope not – you who won’t even use their real name – coward. And if you didn’t care what I think, then why the “piss off” attitude? I hope you never have to make the decisions we have had to make in this country regarding health.
Forgive me if I don’t respond to Mr. Truth’s remarks. He apparently has issues that he must deal with and adding fuel to the fire is not worthy of my time. Our esteemed author hit the nail right on the head. Unfortunately our country is not prepared for what is ahead. Our current healthcare system is not prepared to handle the aging population. If you speak with most politicians (Democrats or Republicans), most would agree. Unfortunately, we can’t get past the politics to resolve the issue. It is time for our government to come together, put differences aside and solve the problem. The decisiveness is not helping.
I live in a fifty-five and older community. Our ages range from a young 50 to those reaching the golden ages of 80’s and 90’s. The average age of the community is around 65 which in today’s standards is young. There are approximately 266 homes in our development. It was only established about 4 years ago. Recently we lost our first community member. Words can not express our loss. Even though not everyone knew the individual it was as if we all lost a member of the family. The beauty of the community is that everyone, regardless of our differences, has made it a practice to support one another. As we grow older we will need that support. As one matures in age it is then that you realize how important life is. Life passes us all in a flash.
Your blog is very insightful and addresses a critical subject that young and old should examine carefully. Only by working together can we hope to bring our country together to solve the problem.
In a world where what one does is valued more than who one is, I find it refreshing to see the willingness of the CEO of a regional philanthropy be vulnerable. In so doing, he might inspire others in similar commanding roles to do likewise and demonstrate themselves to be servant leaders. In addition, Dr. Putnam also identifes societal trends that potentially can effect curriculum and funding, something that he must do as he presides over my alma mater. Thanks, Mark, for showing us the way.
As one who chronologically is certainly expected to find this an interesting blog, I find Mark Truth’s inference that these blogs are drival and of no interest to be typical of that part of our society whose intrests are trapped in an unfortunate misunderstanding of what all of us should be attuned to, and what characterizes maturity of intellect.
The images which Dr. Putnam asks us to view and consider are both real and inevitable. With even the best of medical care and the latest technology, we all have faced, or will face, those times of life when compassion and knowledge are necessary to deal with the reality of challenges we’ll experience in the twilight of our lives. To do less than that is to be something less than fully human, intellectually or spiritually.
Gotta say, Dr. Putnam, your blog idea has proven to be the most entertaining thing to come out of Central in a long time! Well done. Mr Truth, keep up the great work!! In my opinion you got off on the wrong foot Dr. Putnam, in taking credit for the Gulf oil spill (almost made me ill…). However, I thought you rebounded nicely in addressing your experiences and observations regarding your Mother and the aging population. I found your comments poignant and hitting-the-mark in addressing some very real concerns I have moving forward as I’m aging and many of my friends deal with aging parents (fortunately…or unfortunately both of my parents went to that great golf course in the sky due to “cardiovascular events.”).
I appreciated Mr. Jones’ comments and insights. I’ve got a couple of friends who’s parents are at ‘The Villages’ in Florida and LOVE IT! …may be the way to go. Also, what struck me about a couple of the replies is the reliance on the government to fulfill your needs?! Hello!? I’m not opposed to legislation that benefits our aging population, particularly in helping with financial realities, however, I’m not optimistic that these yahoos have the wisdom, insight, or courage to address these challenges.
The reality here Dr. Putnam, is that there is a tremendous opportunity to prepare our youth to enter into both healthcare opportunities and business opportunities concerning our aging population. If we are ill-prepared to meet this challenge, you (…and all of us to a certain extent) are in a position to provide leadership moving forward.
Bottom Line: live each day as if its your last…no regrets…(and stay of the good side of your kids!!)
I am not going to comment on the President’s blog entry. I realize that that is the intent when one makes a comment in this situation, but it is not what I am going to do. I would like to comment, instead, on the comments.
No matter what your opinions are, a person should be able to share them in a respectful manner. Never assume that you know everything because you do not. It is possible to have a difference of opinion yet share them in a conversation rather than an accusation. I encourage everyone to simply think before you commit yourself to the typed word, and give a person the same respect that you would prefer to receive were you in a similar situation. I would also like to make it known that I am currently a college student at Central, and not all of us are so short-sited on the varying aspects of the world and people around us.
Way to go S. Alberson. great comment. in response to all and to the blog, I am a parent of a Central student, I am a Register Nurse who is currently laid off, I am also at the tail end of the baby boomer years. I know there will not be Medicare or Social Security for me when I turn 65 in just a short 17 years. why because of all the abuse and fraud going on that are govt has allowed to happen for so many years. I see it every day in my professional life. But when I question the lawmakers about health care and how there will not be anything for me or others, I get a blank stare. you really have to be in health care or have a working knowledge of health care to be able to make any changes within this govt.
I lost my mom July 30 2010, she was in hospice for 5 long months I worked 2 jobs and took care of her, why because even with my mom on Medicare the system does not work. All the current baby boomers in the medical field that are at retirement age have left the field, there is a shortage of medical providers that will only get worse. I know I will be working as a nurse until the day I die why because the need for insurance and an income.
To all: really take the blog to heart because it is so true, speak up and start to be a voice for change. to get rid of the fraud and abuse and the thinking that your are entitled to all of this, we all work hard for the benefit it is not an Entitlement. take an active role in your health. ask questions, none are dumb or stupid especially if your are not in healthcare and do not understand the language. Keep your self healthy, active and live your life
Opening some dialoge with the community in this manner is a tremendous idea.Keep it up.It will help us to know each other.
Many of the submitters ask what the government and others will do FOR us as we age. How many of those asking the questions are doing everything they can to keep themselves in good health (or improve their health?) Obesity is such a tremendous problem in the US; it contributes to diabetes, heart problems, some cancers, kidney problems, arthritis, and many more health issues.
My husband and I try to live healthy physical and financial lives. We hope our children will not have to burden themselves financially or physically take care of us. If something should happen (disease or accident), we hope to take care of each other or pay for our own skilled care. (Yes, I realize how high the cost is!) There are many items our friends and neighbors purchase that we pass up in order to grow our 401 plans.
I agree that skilled care needs a tremendous amount of improvement. Too much of the money going to these businesses is “at the top.” The staff working directly with the elderly needs better pay and education.
We boomers should not expect to live the type of retirement that our parents did. With the improved lifestyle and longer life expectancy we are now given, we should be working into our late sixties. Optimistically not in the hectic, everyday mode that we are now in – leave those jobs for the young. But maybe in jobs that are less stressful and could be done on a part-time basis. Hopefully, society will change as the population changes.
I work in the healthcare field; I have for 27 years. My salary is now capped. I have many more years to give the hospital (and its patients) and feel that I should be paid for the knowledge, time, and commitment I continue to give.
This is indeed a subject that should be addressed. I feel the students of Central College will find this to be a common public discussion for many years to come and a subject that will be addressed in many election campaigns due to the large number of boomer voters.
Do we truly ever know if we are doing enough? My mother died of breast cancer in 2008–one month shy of her 69th birthday and one month shy of her 50th anniversary.
My brother, my husband, and I, along with many other family and friends, offered to take her to any medical center in the world, if just she’d seek a second opinion. But she always graciously refused.
Now that she is not with me, I wonder if I should have “forced” her to go to Mayo, or some other place that may have “cured” her, allowing her to live into older age cancer free. I wish more often than not I could have “made” her do what I would do in her shoes, if I am ever faced with it.
But she knew herself better than I…she knew exactly what she wanted, and had planned for it. And that’s one lesson we all can think about: it’s not what I want, it’s what she wanted.
Dr. P, if your mom has it “figured” out and planned; let her wishes remain–as tough as it will be for you and your family, and those of us who have to stand by and witness it with you, it is ultimately what is right to honor her.
Your grief is something different..it’s the gift of being able to figure out what is best for yourself when your times comes, and hoping someone else at least respects you enough to follow those wishes, and then grieve for you.
Dr. Putnam, I find it very refreshing that you use your forum to discuss topics that are relevant to current students, parents of students, and alumni at the same time. While many of us are worried about the job economy or other issues, it is a good thing that we’re being reminded of the more important things in life, because too often do we forget about such things.
Thank you for your honesty and openness, and I’m very sorry to hear about your mother’s difficulties. I hope you can find some comfort within your new Central family.
Dr. Putnam is my beloved nephew so I regularly read his blog with great interest. Like many in the “sandwich generation,” he experienced the difficulties of being senior vice president of Northeastern University in Boston with its heavy work load and extensive travel, while at the same time being the person most responsible for his mother’s care. How he has juggled so many interests and professional duties remains a mystery to me.
The subject he chose for this blog is all the more relevant because of the expected rise in the number of older people who will require nursing home care or some kind of assistance as their health begins to fail, yet advances in research and medicine keep them alive for years longer than they normally would have. I thought his subject for this blog was timely, compassionate and informative.
Yes, Mark has heard of Facebook and he posts his blog there regularly. Additionally, I make his blog available to all my Facebook “friends” as do many others. Many had not yet heard of Central before, but the attention Mark’s timely blog is drawing to your outstanding college is something of which you can be justly proud. He is an enthusiastic, gracious and exceedingly well-qualiified spokesman for Central College and an exceptional choice for the office of president.
Wow, what have I stumbled upon? I must admit that I knew of Dr Putnam’s blog, but had not read it until today. Quite a poignant & touching post. We all must remember that ALL of our lives are interwoven and what affects one person affects us all.
Having to make “end of life” decisions is something relatively new to our society. It is a burden and a blessing brought on by the advancement of medical technology. We navigate “uncharted waters” as science and technology out-pace our experience and ethical acumen.
As a physician, I am faced with similar situations in my work, and these uncharted waters wash up on my personal doorstep as well. I agree with “klrjohson” in that we must strive to honor the wishes of our elders/loved ones; but I have seen that, even with these living wills, etc in place, those wishes are not easy to carry out. There will always be the “what ifs” and “if onlys” left behind. We lost my father-in-law this past summer, just one day before his 64th anniversary. Though he had a living will, my mother-in-law chose not to follow it. As Dad did not appear to suffer from her “oversight”, no one challenged Mom on her decision.
I find it comforting to hope that my 3 sons will honor my wishes and allow me to finish my life in the way that I see fit, remembering all the while that it was advanced medical technology that allowed me to give birth to: 1 Central freshman, 1 incoming Central freshman & a potential future Central student.
See, we are all connected.
I have participated in decisions having to do with discontinuing invasive procedures prolonging the physical lives of my father and my mother-in-law. It was painful and difficult to watch over a period of approximately a day in one case and a week in the other case as their bodies seemed to want to deny the readiness of their spirits to leave this life. Today I saw death from another perspective at the funeral of a 21 year-old killed instantly in a car accident. In all three cases, our mourning was mixed with celebration of their lives and the hope we have in Christ, knowing that they believed: “For it is by grace you have been saved, through faith” (Ephesians 2:8a). I would in no way diminish the pain of parting with a loved one or the need to work on improving care for the elderly. However, our physical death is inevitable. I believe that one of the best ways we can prepare for it and help others prepare for it is by seeking, knocking and asking for the hope that comes in knowing Jesus Christ as Lord and Savior.
Pauline Chen writes incisively about these issues in FINAL EXAM, noting a tendency among her medical colleagues to deny the mortality of their patients, as well as their own. “In a profession made attractive by the power to cure,” she notes, “it is rare to find the young medical student who dreams of caring for terminal patients. But in a society where more than 90 percent of us will die from a prolonged illness, physicians have become the final guardians of life.”
Chen argues that rather than viewing death as a failure of medicine, a more thoughtful approach to end-of-life care requires both patients and doctors to face mortality, searching for meaning and purpose in those last days and years. She writes, “The process of dying can be cast as full of potential rather than as devoid of any final opportunities. There is a chance for real interpersonal reconciliation and emotional expression rather than the hasty symbolic gesture of aggressive treatment.”
Longer life expectency adds considerable ambiguity to the latter stages of our lives. Chen suggests that wrestling with that ambiguity more openly might improve the quality of life for all involved and transform our understanding of death.