You’re Looking Very Well

by Lewis Wolpert

  There is an old saying that old people yearn for retirement, but that many who have retired regret it. Ernest Hemingway said that retirement was the worst word in the English language as it indicated the loss of the activity that was at the centre of one’s life. Denial of ageing can be very common. The restaurateur Antonio Carlucci sees retirement as death. Compulsory retirement below 65 is unlawful unless the employer can provide an objective reason. A worker can see their employment end at the age of 65 without any redundancy payment—even if they do not want to retire. However, there is a compelling case for the retirement age to rise, mainly so that the individuals can continue to earn money. The UK coalition government has recently decided to abolish the compulsory retirement age by October 2011. The young see the increase in the retirement age as blocking their own promotion, but not that there is a problem in how to financially support all those who have retired.

  A survey suggested that about half of retirees found the current law satisfying, and only 7 per cent found it unsatisfying. One third said that spending more time with their families was a good reason for retirement, yet an increasing proportion of those in their mid-50s expect to be working after 65. Poor health plays a major role in deciding when to retire—more so than finance. But the nature of the job has an influence, as one third of those over 70 with jobs held managerial and professional positions.

  The Employment Equality (Age) Regulations 2006 gave an employee approaching 65 the right to ask to continue working, but an employer can refuse without any explanation. The age regulations do not require an employer to give a reason for a refusal to grant an employee’s request to continue working; the obligation is only to consider the request, to follow the correct procedures in relation to adhering to the time limits, and hold a meeting with the employee to discuss the matter. Some 25,000 are forced out of work each year for this reason. The Horndal effect shows how useful and competent older workers can be: production at a steel mill in Sweden went up 15 per cent as workers aged, with annual output per worker increased steadily for 15 years with no additional investment.

  When the UK government scrapped the mandatory retirement age for civil servants from April 2010, they were lauded for being progressive. It would have been hypocrisy to send 65-year-old civil servants home for good, while the House of Commons was, before the recent general election packed with 89 MPs over the retirement age of 65. People over 60 are more active than ever before, and it is only right that the state recognise this. Many of the votes that keep MPs in office are from the over 65s. The House of Lords is often referred to as Britain’s most expensive retirement home, since in 2010 the average age was 69. It can be argued that they have a significant collective wisdom that comes with age. Judges in the UK retire at 70, while in Canada, for federally appointed judges, retirement is mandatory at age 75, and in the USA Supreme Court judges have no retirement age and effectively have life tenure. An 89-year-old Supreme Court Justice recently commented: ‘You can say I will retire within the next three years. I’m sure of that.’ University professors in the US do not have a mandatory retirement age—lucky them. In Germany, a new law abolishing the compulsory retirement age of 68 for GPs and specialists in primary care recently came into effect.

  Politicians can also work till they are old in other countries. But these days, not even in China do politicians work as long as they do in Italy. Former President Giorgio Napolitano was 84, and former Prime Minister Romano Prodi 70. In India—a young nation, where almost 75 per cent of their billion-plus population is below 40 years old, and over half have not even passed the age of 25—some see it as ironical that most of their top politicians are in their 70s and some are over 80.

  I have now, aged 80, found retirement quite hard. I miss my group of fellow scientists, mainly PhD students with whom I worked. I still have a room at University College and go in to seminars and very occasionally lecture. I am fortunately still invited to talk at various meetings, including some outside the UK. Most of my time is spent at home writing books, like this one. I do it lying on my bed with the computer on my lap. But I still play tennis twice a week, jog slowly once a week, and cycle here and there. One of the pleasures of being a retired scientist is that I no longer have to apply for research grants and regularly publish good papers, or mark exam papers. But I do miss the research, even though I doubt that I am now competent to cope with the new technical advances in my subject, developmental biology. There are, for example, new techniques for identifying which genes are active in different places at different stages, which are now a bit beyond me. There are also, I regret, times when I wonder what the point of continuing to live really is.

  * * *

  Comparatively, Eastern civilisations have shown more respect to the old than those in the West. But even in India, where the old have not been seen as an eyesore struggling for existence as in some other societies, the elderly face a number of problems, such as poverty, illiteracy and inadequate health care. Most of the elderly in India are dependent on their children or close relatives. When the young leave home, there is a loss of sense of purpose to life. Youngsters dominate the workforce, with 20–35 being the desired age. Plans for 470,000 needy elderly to remain in their own homes will cost £670 million, and where will this money come from? And the definition of ‘old’ in other cultures can be very different: 40 may be considered over the hill, you do not stand a chance once you cross the landmark 50, and 60 is positively ancient! In China attitudes towards the elderly are more positive than those in the West, but a 2007 survey showed that student-age Chinese were less positive than the middle-aged.

  In some societies the old are revered. In non-industrial societies the office of chieftainship is not infrequently occupied by aged persons, although in late life some of their authority and duties may be delegated to others. Among such people it is most unusual to reach the age of 65, so generally those of 50 are looked upon as being old. Important factors in societies where the old are respected include their active association with others, and assistance in their interests and enterprises. They can be regarded as repositories of knowledge, imparters of valuable information, and as having the ability to deal with the fearful supernatural powers. In societies without magic the attitude to the aged varies. The proportion of the old who remain active in these primitive societies is higher than in wealthier civilisations, for they utilise the services of their few old people. Probably nowhere has age received greater homage than among the Palaungs of North Burma, who attribute long life to virtue in a previous life. ‘No one dares step upon their shadow lest harm befall him.’ It is such a privilege and honour to be old among the Palaungs that as soon as a girl marries she is eager to appear older than her age. Examples of the glorification of old age in legends and stories are common in these societies.

  Among the Zande in the Sudan magic predominates, and the old can have authority by virtue of their supernatural powers. Similarly among the Navajo in Arizona, magic gives the old authority. Memory can also give authority to the old, as among the Moslem Mendes in Sierra Leone; the chief must know the country’s history and the lives and families of the founders. The Incas were a militant nation and everyone had to work from an early age; when over 50 they no longer had to do military service but continued to do useful work, sometimes to over 80.

  But in most pre-industrial cultures—as Leo Simmons’s book Role of the Aged in Primitive Society, on which this section is largely based, shows—life’s last chapter has been a bitter one. There have been examples where the old were actually killed off. Surviving folklore reflects widespread resignation as to the inevitability of impoverishment, failing health and vitality, and the loss of family and community status. Such euphemisms as ‘golden years’ and ‘senior citizens’ rarely exist. Many primitive societies did not encourage the survival of the old; either they were left to their lot or sacrificed. Among the Yakuts, who live a semi-nomadic life in Siberia, life was very hard, and the father dominated the family until old age m
ade him feeble, at which time the sons took over and treated him almost as a slave.

  The extreme authority of aged fathers over their descendants is not uncommon. Nevertheless, there are cases where very aged parents are pitifully abused by their children and other relatives. In general, both old men and old women tend to receive better care in agricultural societies, where residence is permanent and where the food supply can be kept more or less constant. Among the Hopi in Arizona, a herding and farming people, old men tend their flocks until feeble and nearly blind. When unable to go to the fields any longer, they sit in the house where they can do handiwork like weaving blankets, or making sandals. The old frequently express the desire to ‘keep on working’ until they die. Among the Hopi there are many accounts of the amazing powers and exploits of old people.

  One observer notes: ‘Retirement is impossible at any age.’ The old are less useful in societies characterised by collecting, hunting and perhaps fishing, as these are not skills they any longer have. For the old without children or wealth everywhere, times can be hard.

  5. Curing

  ‘All diseases run into one, old age’

  — Ralph Waldo Emerson

  The hieroglyphic for ‘old’ in ancient Egypt in 2800 BC was a bent person leaning on a staff—perhaps the first depiction of the ravages of osteoporosis. Like all humans, our ancestors wanted to know the cause of the things that affected them, and so it was with ageing. They were also looking for ways to prevent it. Different from the legends about immortality, which will be discussed later, were the theories as to why ageing occurred and how to avoid it, and these go back a long time. Originally it was the function of religious beliefs to provide such explanations. Eventually such enquiries led to the true study of ageing and how it might be treated—geriatrics.

  As long ago as 1550 BC the Ebers papyrus from Egypt, one of the oldest preserved medical documents, suggested that debility through senile decay is due to accumulation of pus in the heart. This is probably the first non-religious explanation of ageing. The Taoists in ancient China believed that ageing was due to the loss of some vital principle which they equated with the loss of semen in men, and thus taught secret techniques by which men could have an orgasm without ejaculation. Such men, they claimed, would age much less. Plus, if you learned to undertake effortless action, take vital breaths and eat magical foods such as ginseng, you could also slow down the ageing process. In Ayurvedic medicine in India the ancient sage Maharishi Chyavana propounded his idea of anti-ageing therapy. When the Maharishi was bogged down by old age and low energy levels he started taking chyavanaprasha, an astonishing tonic and anti-ageing medicine, and claimed he soon found himself on the road to complete recovery. Gooseberry is the main constituent of this tonic.

  Around 400 BC, medicine in Greece was steeped in religious belief. Illness and ageing would automatically be attributed to the activities of gods or demons. But some of the earliest non-mystical explanations for ageing also came from the Greeks. The ‘father’ of medicine, Hippocrates, instead of ascribing diseases to divine origins, discussed their physical causes. He believed that certain diseases afflicted certain ages. His theory was that ageing was due to loss of heat and moisture. Aristotle, who had a very negative view of the old, perceived the aged body as dry and cold, and also thought that old age was due to the diminishing of heat in the body, as heat was the essence of life generated by the heart. Galen, for whom old age was due to the dry and cold constitution of the body, recommended that the old should take hot baths, drink wine and be active. For Galen old age is not a disease, and is not contrary to nature. For St Augustine, some 800 years later, illness and ageing were the result of Adam and Eve being driven out of the Garden of Eden.

  It must be remembered that there was no chance in those times of acquiring any scientific understanding of ageing, as it was only some two thousand years later, in the nineteenth century, that it was at last discovered that the body was made of cells. Darwin’s theory of evolution was also of great importance, as we shall see.

  The Arabic philosopher Avicenna (981–1037) followed Galen and saw no way to prevent the drying out that caused old age. The Canon of Medicine, written by Avicenna in 1025, was the first book to offer instruction for the care of the aged, foreshadowing modern gerontology and geriatrics. In a chapter entitled ‘Regimen of Old Age’, Avicenna was concerned with how ‘old folk need plenty of sleep’, how their bodies should be anointed with oil, and recommended exercises such as walking or horse-riding. One thesis of the Canon discussed the diet suitable for old people, and dedicated several sections to elderly patients who become constipated. The Arabic physician Ibn Al-Jazzar (c.898–980), also wrote a special book on the medicine and health of the elderly.

  Roger Bacon (c.1214–94), a Franciscan friar, was the first to propose a scientific programme of epidemiological investigations into the longevity of people living in different places, and under different conditions. He also noted that the pursuit of knowledge depended on ‘the fresh examination of particulars’, and that there needed to be a systematic observation of nature. He wrote a book on ageing in which he suggested that old age could be warded off by eating a controlled diet, proper rest, exercise, moderation in lifestyle and good hygiene. So far so good, but he also suggested inhaling the breath of a young virgin. Following a common theme in those times, that ageing was the result of the loss of some vital material, Bacon claimed that the breath of young virgins could replenish the loss of this vital essence. This belief most probably came from the biblical story of King David sleeping between two virgins when he was old to restore his youth, though not necessarily having sex. A young virgin could preserve a man’s youth because the heat and moisture of the young woman would transfer to the old man and revitalise him.

  Roger Bacon also claimed that life could be extended and that Methusaleh was an example, that the neglect of hygiene shortened life, and some individuals had used secret arts to prolong their lives. One example was a farmer who drank a golden drink he found in the field and lived a long time, and this supported Bacon’s alchemical convictions. In Italy, in the mid-sixteenth century, Alvise Cornaro said that life could be extended by eating less as it used up less innate moisture, and it was necessary to keep the four humours that had been the basis of Greek medicine—blood, phlegm, yellow bile and black bile—nicely balanced. There was still no serious science of ageing.

  It was Francis Bacon, a key promoter of the renaissance of science and author of The History of Life and Death (1638), who first proposed a study of ageing in order to find out its causes and how to prevent it. He was the first to acknowledge the prolongation of life as an aim of medicine. He argued that ageing was a complex process, yet capable of remediation, but ‘It is natural to die as to be born.’ He did not believe that old age was due to a loss of some vital substance. He made little progress, but he did recommended exercise. He also apparently had a light touch: ‘I will never be an old man. To me, old age is always 15 years older than I am.’ There is a story that while travelling in a coach towards Highgate in London he concluded that cold might prevent ageing. He tried the experiment at once, stopped the coach, bought a hen, and stuffed its body with snow. But the cold affected him and he died a few days later. His interest in ageing was an important stimulus to its being studied by others.

  Dr George Cheyne, an eighteenth-century doctor, believed the English were dying due to an excess of comfort, wealth, and luxury—the ‘English Malady’—and that the way to prevent ageing was by eating only enough food to allow the body to maintain its heat. A little later the German physician Hufeland argued that fast living led to short living, that you should drink no alcohol, chew your food deliberately, and be positive. He stated: ‘We frequently find a very advanced old age amongst men who from youth upwards have lived, for the most part, upon the vegetable diet, and, perhaps, have never tasted flesh.’ He accepted the view that at birth an individual was endowed with a finite amount of vitality and that this decre
ased with age.

  The scientific study of ageing only began to make progress with the work of Benjamin Gompertz, whose paper in 1825 described human vital statistics from several countries, and showed that the prevalence of many diseases increased in the same way as mortality. He concluded that death may be the consequence of two generally coexisting causes; the one, chance, without previous disposition to death or deterioration; the other, a deterioration, or an increased inability to withstand destruction, namely ageing. Gompertz was interested in the latter situation: how can we model the probability of a person living to a certain age, if nothing unexpected happens to him? His important results showed that mortality increases exponentially as age increases between sexual maturity and old age.

  The Belgian scientist Adolphe Quetelet recognised that both social and biological factors determined how long humans live, and made important contributions to life histories. Quetelet began his research by the physical study of the ‘average man’. He laboriously recorded population statistics surrounding the birth, height and physical proportions of men at various ages. Among his findings were strong relationships between age and crime. Charles Darwin’s theory of evolution came out at this period, and Quetelet wanted to know whether selection for those who are better adapted continued after the individual’s reproductive phase. Darwin’s cousin, Francis Galton, was interested in ageing, and collaborated with Quetelet to measure the correlation between age and strength. In 1884 he collected the physical reaction times of some 9,000 people aged from 5 to 80, which were not analysed until much later.