REFLECTIONS
WHEN IS OLD, OLD?
Teresita Bacani-Oropilla, MD
R
ecently, a party was held for a departing couple who decided to downsize
and move back to their old hometown
to be near younger relatives who could help
them in the future. What was remarkable was
the vigor and independence of the hosts and
attendees. Amid laughter and tears, these
friends, many in their 70s and 80s, made plans
for future visits and reunions.
Times have really changed. In the 1940’s, a talented young teacher
named Mother P, born of a rich Filipino-Chinese family, decided to
leave her worldly life and become a nun. Caught by World War II and
threatened with atrocities, she had to remove her order’s habit and
evacuate with a motley group of teachers, a young boarder unable
to go home, and several helpers into the jungles of the Philippines.
Eventually, she found other members of her order in safer places
and resumed convent life. Later, she served as the leader of a prestigious college, and in her 70s retired to a home for elderly nuns.
Mother P voiced a hope that, having completed her life work, she
would willingly leave this earth before she was 80. In those days,
that was a really ripe old age and her former colleagues had gone
on to rest in eternal peace.
In contrast, people now in their 80s are still exercising, working,
volunteering and raising their grandchildren, making their own
decisions, and perhaps downsizing to simplify things.
However, behind the seeming youthfulness, many of these lively
people are in some ways fragile. Like old cars, defective parts may
have been replaced, modified, or improved but still require checkups and maintenance. (By the way, people who have been to Cuba
recently have ridden in well maintained cars of vintage 1956.) Good
judgments have to be made therefore, as to whether it is feasible to
just leave non-life threatening ailments alone as long as the person
is still functioning to his satisfaction. After all, the bonus years are
supposed to be enjoyed in as much of their pristine glory as possible,
without too much interference.
This presupposes a mutual understanding between physician and
patient of what are the desired goals of treatment and follow ups.
It also presupposes that physicians are free and allowed to make
such decisions and make them stick, unencumbered by unnecessary
protocols or fears of reprisal or harassment. Is this still possible with
the climate of practice at this time, in this place?
So, when is old, old? Is it governed by numerical age? By physical
disability? By mental capability? By emotional stability? By financial
constraints? Is it a state of mind? The patient, the doctor and the
family/friend must be the judge, all together.
P.S. Mother P got her wish in her early 80s surrounded by not so
old, but loving caregivers. Rest peacefully, dear friend.
Dr. Oropilla is a retired psychiatrist.
JUNE 2016
7