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MEDICAL SELF-CARE

Discussion on age prejudice.

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PHOTO BY RICHARD ALLEN

INTERVIEWING ALEX COMFORT ON "AGEISM"

Tom Ferguson
 Alex Comfort is one of the country's most distinguished geriatricians (a term, as many of you know, for a physician who specializes in the care of older people), and his book The Practice of Geriatric Psychiatry is a standard text in the field. Comfort, 61, received his medical training at England's Cambridge University. He first worked as a general practitioner, then studied pediatrics before becoming interested in gerontology (the study of the mechanisms of aging). "When I came to America," he recalls, "I found that you had excellent gerontology but very little geriatrics, so I returned to clinical practice. At first I was a mouse doctor, a scientist trying to modify the life span, but now I'm more interested in aging as a cultural and social phenomenon, and in the more immediate problems that older people face. "

FERGUSON: The central message of your fine book, A Good Age, seems to be that many of the so-called biological changes that occur as one grows older are in fact psychological, social, and political.

COMFORT: Yes, the greater part of the aging process is culturally determined. Our folklore imposes a set of roles on people, as they reach a certain chronological age, which characterize them as unintelligent, unemployable, crazy, ineducable, and incapable of sexual activity. Some social "credit points" can be gained by being nice to these subhuman individuals—again, according to the folklore—but most of them prefer the company of other aged unfortunates . . . whose main occupations are grumbling, reminiscing, religion, and attending the funerals of friends. In fact, however, older people as a group tend to be open-minded, bright, active, adaptable, and sexually active.

FERGUSON: In other words, our society encourages prejudice against older people.

COMFORT: Yes, and the name of that prejudice is "ageism". It's the notion that after having lived a certain number of years, people either cease to be people ... or cease to be the same people ... or become somehow inferior. Like racism, which it resembles, ageism is based on a combination of fear and folklore . . . and thus needs to be contradicted by facts and, when necessary, confrontation. It's the older people—the victims of this prejudice—who must stand up for themselves in order to combat it. And to do this, they've got to become a bit more bloody-minded.

FERGUSON: Bloody-minded?

COMFORT: It's a British Army term. There's no exact American equivalent, but it implies feistiness, orneriness, and heroic obstinacy in refusing to be put down ... whether it be by doctors, bureaucrats, people on the street, or your own children. Bloody-mindedness means standing up for your right to be yourself. The Welsh poet Dylan Thomas said, "Do not go gentle into that good night." Still less should a person go gentle into second-class citizenship, a rip-off nursing home, or a state of senior Uncle Tomism. Bloody-mindedness can be an index of self-respect, and those who are the most bloody-minded are often the most gentle and most principled . . . because—while standing up for themselves—they also speak for others who are more timid. They have the capacity to write letters, telephone the media, and kick shins when assailed by the forces of a faceless society. And if their minds are bloody enough, they become all but invincible, and inevitably die with their boots on.

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