by Dr. James Boritz
"You've got to have guts
to grow old. Life courage refers not to a single dramatic act of heroism or death-defying bravado, but to a steady, controlled
commitment to facing the tough moments and staying the course. It is a life affirmation.
Most people die in the hospital.
For most, this is not necessary--it just happens because of our collective inability to arrange to die at home. A good and
decent death has three components--no pain, no tubes, and no loneliness. When these three criteria are satisfied, Woody Allen
and the rest of us should have few complaints about our final exit.
Death is rarely characterized by pain that
is not manageable. I surveyed the terminal trajectories of the ninety-seven patients in my practice who died in 1989. I analyzed
their abilities to move, think, and toilet, and whether they had pain at the end of their lives. Only four did, and it was
Every life, no matter how seemingly blessed, has multiple episodes of assault and outrageous unfairness.
If your response to these injustices is to curse the darkness or turn inward to melancholy, then time will not have its chance
to play a correcting role. If, however, you are tough enough to face adversity coolly and dispassionately, you can capture
the energy of the assaults and turn them to your advantage.
Routinely I see bent, tormented people to whom nature has dealt a
cruel hand. I am constantly in awe of the marvelous resilience that many of these people show, and they are great heroes and
heroines to me. Just how they got to be that way is obscure to me. Further, they themselves cannot
describe where their guts come from. They just have them. Some, when questioned, even assert that the condition that has cursed
them has even been a blessing in disguise, as it has shown them how to cope and revealed strengths they didn't otherwise know
that they had.
Conversely, I see hordes of patients whose whole lives become unraveled
when a minor hurt or loss presumes to come into their lives, and the doctor's office becomes the courtroom for this conflict
resolution. Rarely do we physicians cure; always should we comfort. This is a basic premise of
medical practice. To comfort is important and appropriate, but this goal should not extend to patronizing. All of us hurt
and need comfort at some time or another, yet all of us need courage to see the circumstances in their fullest context and apply our best energies to their solution. Courage by proxy can't work. As a physician, I cannot
feel my patient's hurts or comprehend fully the bruises. These hurts and bruises must heal by an innate process. An affirmative
approach to life makes the bumps easier to cope with.
Courage in the Face of Danger
As I visualize a human life span, it is a bit like a minefield. All over the place, in unexpected places and unexpected
times, there are hazards small and large. Of course you need the intelligence not to put your foot down in the wrong place,
but more importantly, you need the guts and the courage to venture forth at the onset and to keep going, even while you recognize
that danger lurks everywhere.
As you've grown older, you should have developed advantages from past experience. You've
become accustomed to challenge--how to confront it and steer around it if it is too much, or how to apply its energy to a
constructive pursuit. All successful older people demonstrate cool courage and a firm competency that accepts--even seeks--challenge.
Without challenge, there can be no flow in life, and not to experience and confront challenges would make life a pretty pallid
That's why you have to have guts to succeed.