Kit Andersen

A Dull, Distinct Light

ISSUE 87 | OLD AGE | JUN 2018

I’m so glad I’m young.

This is written for the young. It isn’t written for people in their sixties and seventies, who are either aware of what they’ll soon need or in denial about it; it certainly isn’t written for the truly old, or the inhabitants of nursing homes. They’re welcome to read it; everyone is welcome to read it, but we have to make choices about who we talk to, about where our words go, and these words go to the young, perhaps especially to the young and able-bodied, whose legs can pick up speed and carry them up and over trash bins on the street, feet tucked under butt at the peak of the jump, to amuse their crushes, and who still have the chance to “take better care of their teeth – and fuck more,” as Giles in The Shape of Water suggests. My attention is on the old, but my place – and your place, imagined reader – is with the young.

But for the last eighteen months I have spent quite a bit of time in nursing homes, and, having been changed by the experience, I am going to foist those changes upon you. I remember a certain moment with particular clarity – this was just after my grandpa left the hospital for the first time to check in to Lantern Park, a nursing home and rehabilitation center – I was in the hallway, one of six hallways radiating off a central atrium containing the nurse’s station. The walls were the color of liver and the space was full of old humans just parked at odd angles in various conveyances – some in wheelchairs, and some on half-reclining stretchers. It was a tiny woman lying on one of those stretcher things, wrapped up in cheap blankets and oxygen tubing, who grabbed my hand and asked me where she was, which I told her. She didn’t let go. “Where are you going?” I said I was going to visit my grandfather, in a room down the hall. She spoke very clearly and a little slowly. “Is he okay?” Of course not, he’s here. I told her he was sick. “Am I okay?” I didn’t know how to respond to this. She looked at me for a while and clarified. “Tell me I’m okay.” I don’t like lying, but I did. I told her several times. And then I pulled my hand free and said I had to go.

I shit you not, this happened.

The part of this that’s so wild to me is her perfect clarity and assertiveness in asking for what she needed. She wasn’t crying or screaming (though I know many other nursing home residents who do, and more power to them). She didn’t remember me when I walked past on my way out; she kept no mental record of the exchange. But that expression of need, which I probably couldn’t satisfy, was as clear and crystalline as an orphaned ice floe in a warming sea.

The old are us. This is a hard thing for anyone not old to accept, but young intellectuals have particular ways of denying it. These can be summed up as follows:

  1. Focusing on old age as a “universal” experience leads us to paper over the intersectional differences in how aging actually plays out. Or, in degenerate form: novels that portray old age as a tragedy of the human condition, just like those that focus on the minstrel boy who to the war has gone, are the province of old rich White men.

  2. Focusing on old age as an experience at all is not materialist, or it mystifies the reality that old age is itself a category of oppression. We should be talking, not about age, but about ageism, elder care, and elder abuse.

  3. Seeing a continuity between today’s youth and yesterday’s youth threatens to hide real generational differences – in, for example, the construction of sexuality. Eg., we should recognize queerness in the past, but people in the past did have other categories and we shouldn’t expect their experience to map simply onto our own.

Basically, if we have a principled reason for not imagining ourselves as old, it’s that we’re uncomfortable with the pronoun “we” itself. “We” is a violent pronoun: contrary to this very magazine’s issue number 64, representation, in the sense of electing a single member of a group to speak for all others, is a violent act, because it inevitably suppresses opinions. It’s often a justifiable violence; we cannot be pacifists in democracy. Anyway, that’s getting lost in the weeds – the point is that using “we” ignores the fact that differences in class, race, and social position not only play into your expected health outcomes but also determine what elder care facilities you can access, which has a huge impact on your expected lifespan and your quality of life once you have to stop living independently. It’s a legitimate concern.

When I was in my teens and read The Death of Ivan Ilyich, I made a pledge to myself that I would be like Gerasim, the steadfast peasant boy who comes to hold Ivan’s feet, a physical kindness that mysteriously gives the dying magistrate his only relief from pain. I would stay by those whose bodies were failing and neither begrudge nor look away from their discomfort.

But reading it now-- I’m uncomfortably aware that, if I were Gerasim, a peasant at a time when peasants had little hope of improving their station, I would be assured of never having the material advantages Ivan had. Not only that – but today, comfort and care for the dying are, if they weren’t always, material things, bought and paid for. Lantern Park is a cheap nursing home, and most of the time, there was no one to hold that old woman’s hand and tell her she was okay. I left pretty soon. Certified Nursing Assistants and other, un- or undercertified aides are paid barely above minimum wage for grueling work. So that “we” is a little hard to stomach.

My grandpa went through two nursing homes and one assisted living home before landing in Oaknoll, the elite “Active Lifecare Community” where members of Iowa City’s upper crust live out their days. No disrespect meant to Oaknoll. It’s a nice place if you can get in, though they could stand to be less intensely hostile to people of color – one Black couple, I’m told, balked at the last moment before moving in when they realized they would be alone and ostracized in a sea of Whiteness. They went elsewhere even though they could afford it and the care there is unrivalled.

The four institutions Grandpa spent time in were spread out across both economic and social class. And the differences were no joke. You can go read an article by a social scientist if you want a lot of facts and figures, but I’ll give you just one: at Windmill Manor, a fairly respectable but not high-class nursing home, the ratio of residents to aides was 23:1. At Oaknoll, it is 9:1.

Aides, of course, are responsible for helping residents get ready for bed, helping them go to the bathroom, cleaning up after them when they make a mess, helping them move to and from activities and the dining room, and so on and so forth. Imagine not being able to go to the bathroom until you had acquired the undivided attention of a single underpaid person dealing with 22 other charges – all of whom take at least two or three times as long to do anything as a young able-bodied person does. If you can’t see yourself living in that particular hellscape, be comforted – neither can a lot of nursing home residents, and as a result many of them fall and break bones while trying to take a piss by themselves.

The chronic understaffing has follow-on effects, too. Staff turnover rates are extremely high in these places, because no one gets paid enough for this shit. And that means that they don’t have the opportunity – even if they had the time or energy – to form bonds with individual residents. Which means that residents are met with a constantly-shifting roster of faces and they never feel connected or rooted, feelings which, along with novel brain stimulation, are top of the list for slowing the progression of dementia. Call it nursing home anomie.

After the revolution, what will be the minimum standard for care of the elderly? Surely bigger, better-compensated staffs come first – even though more labor is undoubtedly one of the more expensive items. But where do you place the border of luxury? Oaknoll has a pool, a movie theater, music therapy classes, exercise classes, a visiting barber, a tandem trike so nursing home residents can ride around the neighborhood, pretty good restaurants to meet with family, lectures, concerts, and buses to popular churches. Taken altogether, that sounds like luxury. And yet most of these amenities simply address the needs people generally have to feel good: they need to move, to see art, to be clean, to experience the outdoors and other pleasurable sensations, to make music, to feel connected to their loved ones and their communities and their gods. The nursing home might be a model, in a way other institutions like prisons and hospitals can’t be, of what a theoretically benevolent authoritarian all-encompassing welfare state might look like. It’s not democratic, and and it’s hard to make it so; nursing home residents are mostly too tired or too confused to do participatory democracy. So from a materialist standpoint, these institutions offer an interesting opportunity to think about structures of governance that could provide accountability to those who cannot advocate for themselves directly, in the service of their flourishing. Doing so feels a little academic, though, faced with the stark horror of what capitalist elder care currently does to those who haven’t earned enough and have no earning potential left.

It’s also an interesting experience, to sit in a nursing home’s dining room and wonder which of the men around you, which of the women, is gay. Which once kept a lover of the same gender secretly; which openly? Which of them, perhaps, is trans? Which of these apparent people is actually multiple people living secretly in a multiple system? Perhaps none of them are; perhaps the statistically likely gay men (and trans people, and so on) were washed away into poverty long before they could make it to a place like this. You know the absent Black people likely were – if not by the lack of wealth imposed by White supremacy, then by ostracization. And if there are upper-middle-class Black people here, or gay people – what did they have to give up to be here? There’s ample evidence that a lot of older people have to go back into the closet to survive in these institutions.

So this is how you see the old as a materialist does, and as a leftist does, from the outside, and when you do so, you see the problems they face as they are, as inequities. There is no one human old age; there is no one human race. You – we – are young, and angry; they are old and tired. None of us are human.

But there exist people – we can agree to that, right? – and those people exist through bodybrains, and those bodybrains change over time. And they change over time in ways that are unpredictable and strange and ruthless, but that nonetheless move in patterns: Lewy body dementia, Alzheimer’s, Parkinson’s. And whatever kind of human or transhuman or posthuman we are, whether we are queer or straight, an ancient Etruscan woman or a modern indigenous Mexican man living in Des Moines or an African-American person who might have been nonbinary if they’d had the chance, we break down. That breakdown looks different for everyone, but the physiological basis of that collapse is still a commonality we all share. So maybe we don’t need to define a universal humanity to try to understand what it is to be old. Maybe we can see age not as an experience but as a process that produces experience.

And from the perspective of someone who can still run and jump, who still has decades of earning potential ahead, what is most striking is how the process of age lays bare the workings of the mind. You and I (remember, reader, that you are young) have minds like crews of practiced criminals, each a near-perfect liar, each covering the others’ asses when the cops pull them in for questioning. What the short-term memory lets slip, the situational awareness catches. We keep our stories seamless and straight. But the operators of the aged brain seem to lose their perfect rapport, suffering from patchy leadership and delinquency on the part of certain co-conspirators. One stutters and another is not quite quick enough to step into the gap. And then the world sees us for what we are.

Our words become more transparently expressions of doubts and anxieties. We ask questions that aren’t really questions, because we can’t quite articulate what we really want to say.

We assume we know things we don’t because we can’t remember what we’ve been told. We create whole stories to explain how we got in this room or to this point in the conversation. It's wearying to keep asking “what?” and “where am I”?

We lose our second languages and fall back to our first. Some of us lose our first languages.

We are more obviously driven by emotion, and our emotions become realer than anything else. Feel stormy, and the man standing in front of you is trying to kill you. Feel benevolent, and the young woman standing before you is sure to make a killing in whatever field she chooses.

And sometimes the process of age takes our minds to unimaginable places. The woman who seems to live in a 10-second loop, and screams “Help” or “Nein” or “Mama” whenever she is left alone.

The man who walks in circles all day.

The woman who cradles things and sings.

This is prurient, yes. But I think this is what humans are really like. And I say that not because “humans” is a stable or politically responsible category, but because what we actually all share is the long slow road along which the pieces of what makes us seem human fall away.

And sometimes we, the old, are astoundingly clear. Old age doesn’t take everything, it just fragments it – maybe it doesn’t take anything, maybe fragments, one by one, are simply cast out of reach. My grandpa is still a razor-sharp editor. We’ve tested it. If I’d dared to show him this essay, I’m sure he could have found at least 40 superfluous sentences. Alas, this essay is for the young. Sometimes the clarity is in the service of confusion. There’s this thing called hospital delirium. It can happen to people of any age whose brains are taxed by the constant disturbance of trying to sleep in a hospital, but it happens especially to older people, when they are bouncing around from anonymous institutional bed to slightly-different anonymous institutional bed. They become confused by the dislocation from their familiar routines, their perception of time is especially distorted, and they often hallucinate. Some drugs can make it worse – so can simply having too many different drugs in your system – and it’s different from dementia because it’s neither permanent nor degenerative. My grandpa was in a state of delirium on and off for four months. One night, he had a vision of a nisse, a kind of Scandinavian spirit. The nisse came to visit him in his bedroom. He was dressed like a perfectly ordinary man, and claimed to be a representative from Oaknoll come to offer him a bed in their nursing facility. But, Grandpa told me, he knew the man was a nisse, because “Nissen make a point of being visible. I don’t say they light up like a lamp, but they exude a dull, distinct light so you can see who they are.” Those were his precise words; I wrote them down seconds after hearing them. Now, when asked, he claims he was joking; but the flimsy question, subject to neurological ambiguity, of whether he really believed those words at the time pales before the fact of their poetic precision. When we, the young, are so clear, about politics or anything else, how often is that clarity in service of our confusion?

Thanks to Meg, Kaci, Mo, and Bill. This essay has been edited from its original form.