age, polio, medicine, a compelling personal history, and my book

 This weekend I received a remarkable letter from my friend Eva Rubin, who is herself remarkable. It illuminates the way ageism and ableism interact, which goes largely undiscussed, and it does so with uncommon clarity and grace. Here it is:


What doesn’t kill you makes you stronger. This less awkward iteration of Nietzsche’s aphorism ran through my mind as I was thinking about your extraordinary book, Ashton. As a woman crippled by polio at the age of 3, it was remarkable how much of what you described in the book applied to my own adaptations to disability and, at the same time, how complex and confused those adaptations were.

Fight, adapt, accept, resist, get on with it, relax, find a partner(s), learn to live happily alone, … The options are endless but what is clear is that whatever options we choose–and being able and permitted to is all important–we all need help at some point.  That American society often conspires against us in getting the help we need is something you also make abundantly clear.

As a child, I was more afraid of old people than vampires.  Only my immediate family had survived the Holocaust and my exposure to the truly old was very limited.  I managed to get through my teens and early twenties without really knowing any olders.  It was only on the wards during medical school and internship that I encountered olders and became fascinated by them. When they weren’t thinking I was their nurse (sexism, partly, but mostly the belief that a disabled person couldn’t possibly be a doctor. In reality, it would have been much more difficult for me to be a nurse) or complaining that I was too young to be their doctor (a different form of ageism), I was treated to wonderful stories of joys, hardships and often remarkable resilience. It might seem paradoxical to have developed an appreciation for olders from people who were ill or injured. And, of course, I had to deal with some who were depressed, disgruntled, and not compos mentis or even sentient.  But, over and over, what I came to realise is that what most of them wanted from me was to get them back to their lives in as good a condition as possible and that those lives were considered worth living.

Geriatrics was not a specialty I was aware of in medical school nor was there much attention paid to disability or rehabilitation.  I do remember one lecture from an orthopaedic surgeon where he stated that the reason most people with lower limb problems did not walk on crutches even when they could was the energy expenditure involved. He said that the only sport with exertion greater than that of walking on crutches was cross country skiing.  I figured that didn’t bode very well for my future and that I was still right to be fearful of age. But at 69 I’m still walking, albeit more slowly and with more difficulty.

One of the things I truly love about the book, Ashton, is how much of you comes through in it–your questions about your own fallibility, your doubts, your humour,  your kindness, your boldness, your empathy, and your search for answers. I admire your ability to synthesise a large body of research so that it is easily understood. I could go on forever about what I learned and what more I wanted to understand, personally and globally. Thanks.

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