From Denial to Acceptance: An Essay on Aging

When I look in the mirror, I don’t see a middle-aged man suffering from hypertension and pre-diabetes. I see a head of thick brown hair. A still-youthful face. A body capable of running five miles then deadlifting a dump truck. And the jarring disconnect between what I am in the mirror versus what the numbers say I am has shook me. 

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I’ve always dreamed of being a teacher. I’ve always understood it was my destiny to do this all-important work. As a child, I arranged my stuffed animals on the bedroom rug in rows and taught them pretend lessons. Sometimes we’d take “field trips” to the backyard. Every few weeks I’d use colored paper and crayons to craft progress reports for my stuffed animal-students. Two decades later, I made the dream come true: I was hired to be a real teacher, charged with educating real students in a real school. Right from the start, I had this idea that a career in public education would keep me young. My thinking went like this: if I worked among a population that never aged, perhaps I too would never age. I’d stay excited about simple pleasures like pep rallies and Winter Recess. I’d be the kind of teacher who climbed on his desk to deliver a lesson. There’d be no dusty classics in my English room. I’d only teach contemporary pieces the students, and I, could relate to. By doing this, I’d trick my body, and by extension my mind, into agelessness. And for a while, it worked, or seemed to work. I felt as if I’d done the impossible. I’d found the fountain of youth.

At forty-two years old I was the picture of perfect health. I didn’t drink, smoke, or do drugs. No salt or butter. I exercised six days a week. My bloodwork was immaculate. My resting heart rate was in the mid-sixties. No major surgeries. Not a single copper-colored pharma bottle in my medicine cabinet. The rules of aging—rules that ravaged those who worked nine-to-five cubicle jobs in halogen-lit offices—simply didn’t apply to me.

Today I’m forty-four. I’m pre-diabetic. I’m on two blood pressure meds (Losartan, Chlorthalidone), an anti-anxiety med (Imipramine), plus Famotidine for acid reflux (at some point in the past year, food started getting lodged in my esophagus when I tried to swallow it, forcing me to stick a finger down my throat and throw it up). When I asked my primary doctor how this could be, he said, “Brian, it’s aging. You can’t outrun genetics forever.”

I once believed growing old was better than the alternative. 

Now…I’m not so sure.

We mythologize those who live fast and die young. What would Kurt Cobain be if he was still alive? What would Elvis be? Chris Farley? Tupac? Biggie? There’s no way to know for sure, but I can almost guarantee they wouldn’t be considered the cultural giants of their generations. 

In March of 2000, my Aunt Nora’s husband, a man named Dave, died at thirty-three years old. Even though “Uncle” Dave was only in our circle a short time, having first met Nora in June of 1992, I cite his demise as the watershed moment of my life. For the past two decades I’ve talked about Dave. I’ve written about Dave. I’ve dreamed about Dave. When he was alive, I loved him. Now that he’s dead, I deify him.

Following Dave’s death, I came to believe it was my destiny to die as he’d died. Then I turned thirty-four, thirty-eight, forty-two…and that idea disappeared. So, what would become of me? I soon concluded the answer had been hiding in plain sight since childhood. 

When I was in first grade, my maternal grandmother suffered a hemorrhagic stroke. This left her a quadriplegic, unable to move, speak, or interact in any observable way. Once a week we’d visit her at a nursing home that reeked like urine. Rolled washcloths were always stuffed between her fingers and palm. Every so often she’d present with a bruised hip or busted wrist. Her heirlooms would routinely go missing from her room without explanation. And that’s how she lived for five nightmarish years, an uncommunicative prisoner in her own body, until she finally passed in April of 1991.

I wouldn’t be so concerned if my grandmother was the only family member whose blood pressure problems led to such a debilitating demise. She’s not. Virtually the same thing happened to my great aunt, my great uncle, and their son, my cousin, who had “the big one” in his late fifties, then stayed wheelchair bound and drooling until he died in a “residential health facility,” aka a nursing home, at sixty-four. If you want to visualize what my family looks like in our sixties, picture a person in a wheelchair, blanket folded over his legs, hands folded limply against his chest.  

Fear of the forthcoming stroke was reinforced when a coronary scan in late 2022 revealed I had a calcium score of 0. “No coronary disease,” my primary doctor concluded. Of course, I was relieved to hear this, but if given the choice between a heart attack or stroke, I’d probably opt for the former considering my less-than-desirable genetic disposition(s).               

In the past year, I’ve degenerated into a twitchy, nervous wreck. Every minor ache and pain, every tug and tingle, throws me into a full-blown panic attack. I often feel wobbly, a bit dizzy, depleted. I obsessively check my blood pressure. I urinate all the time. One night in early autumn, I stumbled half-asleep to the toilet at two a.m., and while peeing, I felt something let loose in my rear, then a waterfall of feces filled my underpants. My doctor assured me these are the predictable side effects of medication, “Your body needs time to adjust.”

When I look in the mirror, I don’t see a middle-aged man suffering from hypertension and pre-diabetes. I see a head of thick brown hair. A still-youthful face. A body capable of running five miles then deadlifting a dump truck. And the jarring disconnect between what I am in the mirror versus what the numbers say I am has shook me. 

And suddenly, the repetition of any given school year has begun to wring me out. The excitement I once possessed for those simple pleasures–pep rallies, Winter Recess–has gone away, and I’m afraid it won’t ever come back. I now sense that my life is collapsing towards catastrophe. This is my new destiny.

From what I’ve been told, my grandmother wasn’t prescribed blood pressure meds until she was “sixty-two, maybe sixty-three.” Less than two years later, she was bedridden. What does that mean for me, who was put on similar meds at forty-three? Am I now in the last few years of ambulatory life? Is it too late to save myself from a fate as cruel as hers? Even if I had a time machine, and could turn back and change things, what would I do differently?

“I want off these meds,” I told my cardiologist in our last telehealth.

“No, Brian, these medicines will prolong your life.”

When preparing this essay, I discussed aging and mortality with a thirty-six-year-old woman named Mariah. Today, Mariah works an HR job, but there was a time when she was a freestyle swimmer at Union College, a division one school in Schenectady, New York. “A little while ago, I got Botox,” she admitted. “I didn’t like the way I looked. It was really spinning me out.” I asked Mariah if she feared dying the same way she feared aging. She described an abdominal surgery she underwent in 2021. “I got on the operating table,” she said, “they put me under and that was it. Lights out. Experiencing that, I know death isn’t as scary as people make it out to be in their minds. It’s just darkness. Nothingness. I refuse to waste my life worrying about it.”      

I then spoke with Timothy Winston, a forty-year-old investigator with the Albany County Sheriffs. Tim told me he’s seen “quite a few dicey situations on the job.” Regarding the fear of death, Tim echoed much of what Mariah said. “At the Police Academy, you’re taught to come to terms with your own mortality. If dying in the line of duty happens, you won’t even know it. You’ll just be gone. Goodnight. Game over.”

After interviewing Mariah and Officer Winston, I thought about my own family. My wife, Lynda, and I have a seven-year-old daughter, Annalee. We named her after a character of the same name from the 1968 song “The Weight” by the Band. I love watching Annalee grow and learn. I savor every moment. I want her childhood to last forever. Of course, it can’t. One day Annalee will have her own family. Do I want her saddled with a stroke-stricken father? Do I want her to have to lug her kids to some nursing home for the once-a-week obligatory visit? Would it be better, for everyone involved, if I checked out quick and clean? If so, my family would inherit my term insurance, plus my pension, both of which could be used to usher Annalee comfortably into adulthood.  

When I say this sort of stuff to my wife, she tells me, “You’re being stupid. No one knows how it’s gonna play out.” In April of 2013, Lynda was diagnosed with breast cancer at thirty-one years old. For the next fifteen months, she went back and forth to Sloan Kettering in New York City to receive treatment. That cancer took everything from her: her hair, her body, her feelings of self-worth. But it couldn’t take her life. She stared death straight in the eye and won. And now, over ten years later, she’s a full-time survivor. Her whole goal–in everything she does–is to earn another day in remission. There have been countless tests and scans, half-a-dozen surgeries along the way. She still gets a shot every three weeks. She ingests a palmful of pills every morning. She won’t eat or drink anything out of plastic. No scented soaps or detergents. Nothing with sesame seeds or flax. No petroleum jellies. “Cancer, I could’ve given up,” she told me. “I could’ve assumed my destiny was decided. But I didn’t. I won’t. I never will. No one knows how it’s gonna play out.”        

I never used to pay attention to those pharmaceutical commercials on TV. The pills with their unpronounceable names. The paid actors playing frisbee in the park. The laundry-list of terrifying side effects. I wrote all that off as someone else’s issue. Nothing I needed to worry about. That’s no longer the case. I’m officially on the pharma train. When I watch these commercials now, I get frustrated. I yell at the screen, “Why are you fools playing frisbee in a park? Don’t you know how this story ends?”  

October of 2019, when Lynda achieved five years cancer-free, we began talking up plans to retire to our favorite place: Newport, Rhode Island. We’d buy a little house by the beach, and every night we’d sit on its front porch in matching teak chairs and watch the sunset over the ocean. I still believe we can get there. I can still picture us on that porch. But now I see one teak chair which holds Lynda and a wheelchair for me. A blanket is folded over my legs. Both hands lay limply against my chest.

“Brian,” my cardiologist said when I painted him this grim picture, “I can’t go down that wormhole with you. I can’t get into wheelchairs and quadriplegia. Your labs look good. Your numbers are steady. See you in three months.”  

A recent study determined that eighty-five percent of what people worry about never comes to pass. Perhaps all my self-induced stress is more corrosive than hypertension itself. So, I’ve decided to make a mental reset. I’m no longer going to live in fear of “what if.” Instead, I’m going to eat better, drink less coffee, take the pills. I may not be able to “outrun my genetics,” but I sure as heck can try. I’m going to channel my Inner-Mariah, my Inner-Officer Winston. I’m going to follow my wife’s model of never-give-up grit in the face of adversity. And then I’m going to do what I was born to do. I’m going to teach…     

I now teach twelfth grade at an urban high school in Upstate New York. The poverty rate here is high. Violent crime is a common occurrence. I consider it my chief duty to prepare these young people for a meaningful life in the “Real World.” I’ve helped students fill out job applications. I’ve instructed others on how to conduct themselves if ever confronted by a cop. I’ve worked with homeless students. Victims of domestic violence and sexual abuse. I’ve purchased prom tickets for students. I once gave a student a hundred bucks to buy Christmas gifts. When you do a job like mine, in a place like this, reading and writing is just one part of that aforementioned curriculum.

As you can imagine, in such a setting, an alarming percentage of the population is overweight and/or obese. I can’t count the number of times I’ve seen a student come to one of my classes carrying a bag of Honey Barbecue Lays in one hand, a sugary soda in the other. In the past year, I’ve begun talking openly about my battle with blood pressure. I was surprised to learn that many students had no idea what the term “hypertension” meant or why it was bad. I’ve encouraged them to ask their family physician or our school nurse about their own risk factors.

One day, a short time back, a twelfth grader walked in while I was checking my blood pressure during a free period. He asked what I was doing. “This is a home cuff,” I explained, and he said, “Can I try?” Since then, he’s come in every day to do his reading. Eventually, a second student came with him, then a third, then a fourth… I’m not sure if this is a good thing. And I’m always careful to remind them that official numbers can only come from a medical professional. But I suppose it’s never too soon to take an interest.    

I’ve orchestrated a text-message chain with a group of colleagues who also suffer from high blood pressure. We check in with each other every evening, “…how ya feelin’,” “…what’cha have for lunch,” “…did you get to the gym,” “…when’s your next check-up,” “…stay healthy,” “…stay strong,” “…be good to yourself!”  

In an email, dated September 27th, 2023, at 8:41am, the morning after my forty-fourth birthday, Lynda wrote, “I know you’re upset about this. But I think it’s a good thing. I think it could be a blessing in disguise. You’re taking real steps to better your life for me and Anna and yourself. I love you. And I’ll see you after school.”

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