How We Think of Old People

A review of Elderhood: Redefining Agind, Transforming Medicine, Reimagining Life, by Louise Aronson, M. D.. New York: Bloomsbury Publishing, 2019.

On a Friday evening in June, driving home from a week at church camp, I tuned into a random radio program where the interviewee grabbed my attention with compelling stories of her geriatric practice and her care for old people. She both critiqued how we care for old people, and offered a hopeful vision for what needs to change. At the conclusion of the interview, I pulled off the road and wrote down the name of the author and her book. The physician was Dr. Louise Aronson, and the book was Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life. Reading this book as a guide for reflection on how we grow old and how we care for the aging has been for me like a still picture in grayscale develop color and spring to life. It has fundamentally changed the way I understand that last third of life that we call growing old.

As life expectancies extend, generally speaking we’re spending more time in that part of life we call old age. What used to be a few years can now easily be thirty, fully a third of our lifespan. While we treat childhood, not as a single span of time, but as a complex multiplicity of developmental stages, as a society, as a medical care community, and I would add as a church, we tend to treat old age monolithically as if it’s one uniform span of time. As a leader in the church, I have attended to the pastoral care needs of individual persons, but haven’t thought very carefully about the different needs of the specific stages of old age. This book has pushed me.

Aronson dives deep into a reflection on old age. As a practicing geriatrician, it’s not surprising that she critiques the way the medical community treats (or doesn’t treat) old people. At the heart of her assessment is that middle age adulthood is seen as the norm for what a healthy human looks like. Fair enough. Something has to be the baseline. Yet, when our bodies begin to age and we change physically, mentally, emotionally, and socially, the changes are seen as pathological rather than as part of normal development. What often makes things worse is that medicine tends to treat the maladies of old age the same way it treats a healthy 40 year old, even though administering the same treatments in old age often have much different outcomes, are more dangerous, and routinely lead to a decline in health rather than an improvement. As I think back to my accompaniment of scores of people interacting with the medical community in their old age, other than the effects of chemotherapy, it simply never occurred to me that a treatment that is routine in middle age could be harmful in old age. In addition, the medical community tends to neglect the social setting of the aging person, a factor that becomes more and more important as we age, and a factor for which there is great potential for meaningful, purposeful congregational ministry.

Aronson doesn’t confine her critique to the medical community, even though much of the book is about just that. She draws on philosophy, sociology, history, and personal experience to give a comprehensive picture of how our society regards old age. The richness of her experience makes the book read almost like a memoir, offering vulnerable glimpses of her own mistakes and learnings and of the complexities and oft-time failings of the medical system. Yet she also offers both hope and guidance for how we as a society and as individual persons can reimagine this significant span of life. We can do better.

As a pastor, I have been thinking about the content of this book a lot. We lament that the church is aging, and we wonder what that means for the future viability of the church. Youth remains a dominant metaphor for American culture, and for the church as well. We collectively look to family programming, energetic youth ministry, and comprehensive children’s ministries as the salvation of congregations. Yet for many of us, that’s not our reality. We look out on our congregations on Sunday morning to a sea of gray hair. By and large, I serve an aging congregation in an aging denomination. Honestly, I have not seen the aging congregants as the focus of my ministry, even though they are the people I spend most of my time with. What if I (and we) spent as much time and effort thinking creatively about how we might use the gifts of our elders and how to serve with and to the aging population of our communities? After all, as Dr. Aronson points out, the aging years are not just a time of maladies and diminishing capacities. They are also a time of joy, meaning, and fulfillment.

I found this book provocative in the best sense of the word. It has stayed with me and pulled me back into multiple readings. It is prompting a creative reassessment of my own rapidly approaching elderhood, and my ministry to and with the elders of my community and my congregation. There’s not much more I could ask of a book.

O King of All Nations — December 21

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel.” Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

A strange king, the king we worship, the king whose coming we soon celebrate, the king whose first cradle was a feed trough.

The king wore no crown of precious metals and jewels, but  crown of thorns. He sat on no gilded throne, but was nailed to the throne of the cross. That unkingly ascension transformed all of history – divided it into before and after, made possible the transformation of our lives from slaves to sin, lost, condemned – to children of God, free to serve God and serve our neighbor, subjects in a kingdom of grace and love.

Because Jesus chose to wear a thorny crown and not a kingly crown, it tells us not only about Jesus the king, but about God. Because we have come to know God in Jesus suffering, death, and resurrection, this is what we know about God:

  • God loves us. Period. Doesn’t depend on how we feel or on the strength of our faith. It doesn’t depend on what we do or who we are. We aren’t excluded because of what we’ve done or who we aren’t. God loves us. Period.
  • God is with us. Yes, God is with us in the joys, the pleasures, the successes. That’s not hard to believe. What’s harder to believe is that God can also be with us, even bringing us blessing in the times of our grief, our pain, our suffering. God has come to us. God has chosen to meet us in the messes of our lives, the tragedies that come along, the disappointments, the failures, the broken relationships.
  • God is even now bringing all things to the fulfillment of God’s purposes. Through Christ the servant king, all the contingencies of human history are moving along toward the fulfillment of what God intends to accomplish.

O King of all nations and keystone of the Church:
come and save man, whom you formed from the dust!

O Radiant Dawn — December 21

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel.” Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

I’m a morning person. It’s my best time of the day. I live in the woods and in these short days and long nights here in the north, I get up in the dark. I make a cup of coffee and go to my desk, surrounded by windows and sit in the quiet. It’s my prayer time, my quiet time, my thinking time. And it’s also a time to watch the day gradually dawn.

The day doesn’t explode into light. It’s a gradual transition from darkness to light. Even though the weather app on my phone tells me the precise time of the sunrise, in actual experience, there’s not a precise time when I say, “ok, the night is gone and the day is here.” Gradually the light overtakes the darkness and almost imperceptibly, the day is here.

During these days of advent, we have stood with the prophets who waited patiently for the coming of the Morningstar, the One which today’s O Antiphon calls the Radiant Dawn.

In the darknesses of my own life, the Light has come. Often slowly, sometimes imperceptibly, but always relentlessly, irrepressibly, the light comes. Into the dark corners of my heart, my life, and into the dark corners of a fear-ridden world, the Light comes.

Maranatha. Come, Lord Jesus.

O Radiant Dawn,
splendor of eternal light, sun of justice:
come and shine on those who dwell in darkness and in the
shadow of death.

O Key of David — December 20

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel.” Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

In Charles Dickens’ novel, Great Expectations, there’s a scene in which Barrister Jaggers’ clerk, John Wemmick, walks through a London prison. “Wemmick walked among the prisoners much as a gardener walked among his plants.” Wemmick was highly popular among the prisoners, personally recognized each of Mr. Jaggers’ clients. Wemmick inquired about each of them, taking note of their condition since his last visit.  But it was clear that he was not there to bring them the deliverance the prisoners were hoping for. When a prisoner might ask for something that Wemmick could not deliver, his reply was, “It’s no use, my boy; I’m only a subordinate. . .don’t go on that way with a subordinate.” At the end of the scene Pip and the clerk come to the end of their walk through the jail, they come to a man known only as the Colonel; the Colonel speculates that he’ll be out of jail by Monday. As they leave the jail, Wemmick instead reports that the Colonel is to be executed on Monday.

The Key of David is no subordinate. Indeed he cares about those locked in their deathly prisons, those of us — all of us — sentenced for our rebellion. The One whose birth is near, was born to die and in his death and resurrection he has opened the prison doors, set the prisoners free, and invited all into Life and Freedom.

O Key of David,
opening the gates of God’s eternal Kingdom:
come and free the prisoners of darkness!

O Root of Jesse — December 19

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel.” Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

The last few years I lived in Illinois, I volunteered at the Nachusa Grasslands tallgrass prairie conservancy in Lee County, Illinois. I was part of a small crew that would walk through stands of prairie grass spotting and removing invasive plants, making room for the remarkable diversity of native prairie grasses and flowers. The steward that I worked with was an encyclopedia of mind-blowing information about the prairie plants that we were making room for. I learned that for most of the prairie plants, the root system is deep and substantial. In fact, most of the biomass of prairie plants is below the surface of the ground. The deep and substantial root system insures that the plants will have water even in the driest summers. They enrich the soil and for some plants provide the network for forming new plants. The deep and substantial root system allows the plants to survive the prairie fires that are so vital to the health of the prairie ecosystem. The root systems of grasses and plants in the silphium family go down as far as 20′-25′.

The roots of Jesus go deep. The O Antiphon for December 19 takes those roots all the way back to David, son of Jesse, shepherd boy who rose to become king. John 1 takes those roots back even further. “In the beginning was the Word and the Word was with God and the Word was God. He was in the beginning with God. All things were made through him and without him not one thing was made.”

The One by whom all things were made, the One who spans the long reaches of time and space, the One whose existence lies far beneath the surface of the humble birth in Bethlehem comes to us, comes now, comes to save us.

O Root of Jesse’s stem,
sign of God’s love for all his people:
come to save us without delay!

O Leader of Israel — December 18

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel.” Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

In the O Antiphon for December 18, Christ is called the Leader of the House of Israel.

Call to mind the great leaders of the nation of Israel: Moses, who let God’s people out of slavery, through the long wilderness wandering, and into the promised land. Deborah, the prophetess who masterminded the assault against Jabin, king of Canaan and his military commander Sisera. David, the great warrior king who got his start as a young shepherd boy who slew the giant. Esther, the Jewish queen of Persian who foiled the plans of Haman to have all the Jews in the land killed.

The Messiah was to be the great leader of God’s people all rolled into one. “He will lead his flock like a shepherd,” Isaiah proclaimed.

The shepherd who himself was led to slaughter. The shepherd who became the Lamb. The shepherd who was stripped, beaten, crowned with thorns, and led outside the gates of Jerusalem to the place of the skull where in his mighty cruciform power he rescued all creation.

O Leader of the House of Israel,
giver of the Law to Moses on Sinai:
come to rescue us with your mighty power!

O Wisdom — December 17

Since the 8th century, during the last seven days of Advent, leading to the Christmas celebration, the Christian Church has been singing a set of antiphons that were written as introductory prayers for the singing of the Magnificat at Evening Prayer. They are popularly known as “The O Antiphons” and serve as the basis for the well-known hymn, “O Come, O Come, Emmanuel. Each day uses a name for the coming Messiah drawn from the messianic hopes of the First Testament. They proclaim the coming of Christ as the fulfillment of God’s promised salvation.

They say that wisdom comes with age and experience. I wonder.

While I hope that my blunders are fewer and that have learned a few things along the way, I still manage to do some things that in hindsight are pretty dumb. And with age and experience comes the possibility (the probability?) of making mistakes that are more costly, both economically and relationally, and have deeper lasting consequences.

In the O Antiphon for December 17, Christ is called the Wisdom from on high, the one who brings divine knowledge.

Throughout the gospel of John, the gospel writer is nearly obsessed with the theme of Christ as the one who has come so that we might know God. Except contrary to the way western theology has typically been ordered, the truth about God that Christ came to bring is not propositional truth; it is relational truth. God comes to us, dwells with us, takes up residence with us, hangs out with us, so that we might know God in God’s unimaginable, never-ending, limitless love.

Certainly there is a certain practical, utilitarian wisdom that smooths the skids of daily life; it may or may not come with age and experience. The greater Wisdom comes to bring life; that wisdom is rooted not in facts and figures or the school of hard knocks, but in divine love, Love Incarnate. Only when we acknowledge that we cannot know God — and therefore, cannot know real Life — except by God’s grace, God’s invitation, and God’s enlightenment, do we begin to know true wisdom.