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Christmas has never been the same since my sister’s sudden death eight years ago. I still remember the wonder we felt as children and I remember waking her up so we could sneak into the living room at 2 or 3 in the morning to see what Santa had left.

It does help to see my grandchildren and nieces and nephews have that same wonder, but I do miss my sister. She was the guardian of most of the family memories and my other sister and I often feel lost trying to remember family stories. The losses just seem more painful at Christmas because it is such a magical time of year. It is of course very materialistic. The Church always wants us to remember the “ reason for the season”. This is difficult with all of the pressure of the ads and the expectation that “this will be the best Christmas ever”. I think it helps to remember that this was really a pagan feast that the Church absorbed. The Winter Solstice was also a time of celebrating. Now almost all of the traditions of Christmas– Trees, Yule logs, Gifts , etc. have ties to those ancient feasts. The Christian churches want us to remember that Advent is the season to focus on the return of Christ. This is not what the media focuses on. All you hear is “sale, sale, bargain, bargain”. For me it helps to focus on this as a time of family celebration. The food, gifts, laughter all seems to be a sign of who we are. I think that is why this is such a bittersweet time. If you think about it, you really began your own self-definition in your family.The special events, birthdays, anniversaries,graduations, marriages,health issues of all your family members build your picture of what family was supposed to be. You carry on the values and traditions that you experienced there. As you grow older you have your own experiences, but the family imprint, good, or bad, will always be there. If you lose a family member thru death or alienation you really lose a part of yourself. You don’t have that person to talk to and say, “Remember when”.

The old proverb that “ Time Heals All Wounds” is true for the sharp pain that happens after the death, but the ache comes back and is always there. A sudden word, a certain smell, a special time of year, all bring back the memories and pain of loss. I once had a patient whose main issue was the drive-by death of her 19-year-old son that had happened 15 years before. She would have sudden migraines and overwhelming episodes of depression. She was very active in her Church, but had never been able to talk about it there. A real breakthrough for her occurred when she was finally able to talk about it with her fellow bible study members. She had a feeling of letting go and talked about the comfort they provided. Even that did not make the pain go away.

Another patient had trouble accepting the death of her four-year-old son. She would keep his room exactly the same as the day he died. She would continue to celebrate his birthday every year. She would drive by the school he would have attended and watch for the friends he would have had. She had another child, a daughter who was younger than the boy who died. She finally began to realize the effect this was having on her and began therapy. The day she packed up her son’s room was for her a real sign of acceptance. However this also didn’t make the pain go away.

The pain is always there and just becomes another part of life. We all have this marvelous ability to prioritize. As life goes on the pain can begin to slip into the background. However our brains are like giant hard drives and when the right trigger is pushed-be that a sound, a smell, or even a holiday, the memories come flooding back. The reality is that those losses are always with us,. As time goes on we adjust and we begin to get on with our lives as our loved ones would have wanted us too.

I know that we all go thru losses and that really is a part of life, but the general truth of this doesn’t help. So at sometime over the next two weeks I may even shed a tear as I think of those years we were all together. I hopefully will also have much laughter and love at the ones that still surround me. Merry Christmas. Remember what you had and treasure what you have.

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Sometimes I think I have lost the ability to be surprised by people and their motivations. This probably comes from the many years I spent listening to people and every sort of problem imaginable. From incest, to murder, to stealing candy bars, my patients would come in with all of their unresolved issues and try to work them out.

I think by the time I retired I was just tired of listening, but then something will happen that challenges this. In mid August we went on a Viking River Cruise thru Prague and southern Germany. A friend of mine had done it last year and recommended the trip. The cruise was beautiful and well worth it. We liked the whole experience. We met lots of new people and they were almost all in our age group. The typical age for this according to the cruise director is 60-75. There was one very independent 91 year old who had more energy than almost anyone on the ship. She does a cruise at least yearly. Every night we would have dinner with at least one new couple at our table of eight.

Besides the usual questions about occupation, location, and grandchildren, people became comfortable enough to really open up. I think the atmosphere and environment of the ship encouraged people to talk and share about their lives. I am still trying to understand this whole experience.

One couple in particular has really made me think. He and his girl friend sat at our table and we began to talk. Between the two of them they have 10 grandchildren, but the families really don’t mix. We asked how they met and he said that they met dancing the Tango. He is 68 and works in heating and air conditioning. He is thinking of retiring by the end of the year. She is 62 and has been a hospice nurse for over 25 years. He told us that he was a competitive roller skater for many years, but then hurt his knee. As he recovered he began looking for some other form of exercise. Just by chance he saw an ad about a class for learning the Tango. He took the class and it overwhelmed him. He became so involved with it that he would use his vacation time to go to Argentina to learn more. As he talked it was evident that this was one of the grand passions of his life. He met his girl friend at one of the classes and she liked the way he danced and talked. She told us she had been a widow for many years. She had dated occasionally, but nothing really serious until now.

The Tango apparently is culture unto itself. There is a specific way of moving and communicating. He said that he learned in Argentina that when you first met someone you wanted to dance with you didn’t speak. You stared intently at someone and if they stared back and nodded you would walk in a very specific way until the two could begin dancing. He told up that at this one class there were hundreds of couples and people began dancing without really being able to move very much because of lack of space. The Tango doesn’t require a lot of movement as much as it does the ability to communicate to your partner what you want to have them do. He told us that they had stepped back a little from the culture because they both loved to travel and this may become his new passion.

I think the reason I keep thinking about this is the realization that new passions and fascinations can enter your life at any time and at any age. I had been thinking that retirement meant a time of slowing down and contemplating the past and trying to reach that stage of “Ego Integrity vs. Despair”. Sometimes I thought this was really within my grasp, but now I do need to rethink.

When we decided to go on this trip we also planned on spending an extra week by ourselves in Paris. We had been there before and wanted go back and see more. One of the places we went to is the Pere LaChaise Cemetery. This is somewhat like Forest Lawn in Hollywood in that many famous people are buried there. The difference is that the French cemetery is almost 400 years old. I wanted to see Jim Morrison’s grave. His grave is one of the more visited along with Oscar Wilde’s. What struck me was that no matter how important or famous, all lives have a beginning and an end. I suppose you can sit and contemplate your life and what you have accomplished. One friend of mine had an image he shared of an old man sitting on his porch and cutting cheese. This sounds very peaceful, but it also sounds very limiting. Even in this last quarter of life new passions are still possible. I need to continue to be reminded of the importance of continuing to grow until the end. I might never learn the Tango, but maybe I can still learn to waltz.

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Memory is still a very important topic for people in my age group. Every Tuesday I have breakfast with a group ranging in age from 68 to 78. Sooner or later one of us will talk about problems remembering words, events, appointments, history, etc. A neurologist has said that this is a normal function of aging. The time to become concerned is when you forget the function of certain objects i.e. you don’t know what a stove is. I had a patient many years ago that had severe organic brain damage. Her family was still letting her drive. When I began questioning her about this, she admitted she didn’t know what a stoplight was and thought that it was a clock. Thankfully her family removed her car keys.

The thing about memory is that everything we have seen or done is stored somewhere in our brain. Sometimes a word, a song, a smell can bring back very vivid memories of the past. Imagine walking into a house where someone has just baked Chocolate Chip cookies. What would that smell do for you? Would it bring back memories of your childhood? For many people it does.

I had another patient who began to have extreme panic attacks in the summer when road construction was happening. The smell of fresh asphalt reminded him of the smell of helicopter fuel in Vietnam. He would often stay in his house all summer long and not want to come outside because of it.

I am thinking of this because my sister and her family are going to spend a week at a lake in Michigan that we went to as children. My uncle owned a small cottage there. His son and I were the same age and we would often spend the entire summer. The more my sister talked the more memories came back. It was a very small and primitive place, but we thought it was the grandest place in the entire world. We had a very small boat with an outboard motor. My uncle would let us take the boat and go out on the lake. We would swim all day and then collapse at night. One of the highlights of the summer was when would go to a small restaurant/store near the cottage. They had some small arcade and pinball machines. We would save our pennies and small change and look forward to playing them. It was a very innocent time. The more my sister talked, the more memories of that time came back.

I once heard Carl Whitaker say that he never really thought you lost anyone. He said that if he tried, he could bring back all the sounds and smells of the room his father died in almost 60 years ago. As long as you have those memories you are never really alone. The more I thought about it, the more I agreed. When someone close dies or leaves, the pain is very sharp. It feels like it will never end. As time goes by the pain is still there but some of the sharpness goes and you get on with life. Some people never get thru it. My grandmother would say two rosaries a day for my grandfather after he died until her own death. My mother would break down in tears years after my father died. Other people have told me they can go for weeks, months, years without thinking of a deceased love one, and then suddenly something will trigger them. The memories, both good and bad, burst thru. I have had many people say things like: “ I haven’t thought of my mother, father brother, sister, etc—in years. Why am I thinking of them now? “

Sometimes it seems like we all have these hidden passwords to our own past. We don’t know what the passwords are. We don’t know where they are or what they will unlock, but when they appear we are amazed at the result. Sometimes this can leave us laughing. Sometimes it can leave us in tears. Sometimes it can terrify us. I had a patient who suddenly remembered severe episodes of abuse that happened when she was 5 or 6 years old. She remembered when she was 25 because of seeing something on TV. The memories literally overwhelmed her. Our mind really does try and protect us, but sometimes that can also be a problem. Those who suffer from PTSD would like to find a way to safely deal with their memories. Their memories are not the happy ones, but the terrifying ones. They creep in and seem like they will never leave. I know that there is now an experimental drug that produces a sort of amnesia so these poor souls can let go of the trauma of their past.

For the rest of us we just have to deal with this enigma of our own memory. We all have so many memories and our individual filing system remains very mysterious. It would be great if we had a magic key to enter and file clearly and really discard the unpleasant ones. However that is not the way our minds work. So I will try and be thankful for the memories I have—both the ones that make me laugh and the ones that make me cry.

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April is again the cruelest month. The weather is unpredictable and we all wait for Spring to appear. It’s a busy family month with birthdays for my two sons and my wife. It is amazing to think that both my sons have grown into adults with adult responsibilities. I still think of them as children and have to continue to remind myself not to give them advice and just to offer them my love.

I still think this aging thing is difficult to accept. I know I cant do many of the things I used to- or if I do, it does take longer to recover. The memory lapses don’t bother me that much. It doesn’t seem that different from when I was younger. I don’t think even death concerns me right now. I know it will happen and it is certainly a reality I have to face every day. I see the music, film and sports stars of my youth all fading away. I can even criticize their appearance and think that I don’t look as bad as they do.

What has been bothering me is thought of lack of function. The television show “60 Minutes” had an episode this week about Alzheimer’s. They presented an actual couple they had been following for 10 years. The wife was diagnosed in her mid 60s. Her deterioration over the ten-year period was graphic and tragic not only for her, but also for her caretaker husband. Fortunately this is not a common condition in either of our families, but both my parents and my wife’s mother died fairly young. I hope if this does happen, my sons will convince which ever one of us is the caretaker to make a decision to let go.

I saw a lot of families struggling with addiction and mental illness. The addict or person with mental illness certainly had their own struggles, but what always struck me was the impact on the family. I would spend a lot of therapy on the importance of setting limits and encouraging families to realize the effect this was having on their own lives. One family struggled with the husband’s heroin addiction for over 40 years. I remember a family conference after another period of relapse with the wife and adult children trying an intervention. Despite all their pleading and tears, the addict continued to say “I just like the high”. He had been using since he was 16 and had two lengthy prison terms on his resume. His wife just would not let go and it adversely affected her own health and her relationship with her children. I would see parents of rebellious adolescents trying everything to help their children only to begin blaming each other for what was happening. The whole concept of enabling and contributing to someone’s illness came out of studying alcoholic and addicted families. The idea of giving someone “just one more chance” is often just a way for the problem to continue. One husband spent over a million dollars on his wife’s treatment. She never got better until after they divorced. Another father would send his son thru endless treatments and hospitalizations. He would always blame the therapists when his son relapsed. He could never understand how his constant rescuing and helping his son avoid consequences was one of the real reasons therapy was not working. He also had difficulty seeing what was happening in his own life. His marriage was failing, his weight was out of control, and he had developed diabetes.

The 60 Minutes episode showed the progression of the illness in just not the wife, but also the real deterioration of the husband. He talked about his own depression and thoughts of suicide. He was committed to caring for her, but finally after 10 years, he could not do it anymore and agreed to place her in a nursing facility. I’m sure he had very mixed feelings about this- both of guilt and relief. However he really had no other choice.

I think it’s this choice that I am thinking about. Our decision to move seemed somewhat impulsive, but it had been simmering away for a long time. I really did not want to move. I don’t like change. Maybe that is a real sign of ageing. However I finally realized that if something happened to me, my wife could not physically manage the home we lived in. Both of our sons were over an hour away and would have difficulty getting to us in an emergency. Now we are closer to our sons and this house is more manageable for my wife.

So what I simmer about now are all the senior concerns about illness and loss of ability to function. I certainly don’t want to be a burden on my family. I also would not want to get to the point of suicide or mercy killing. Right now I don’t really know what the answer is. This, like much of this stage of life, is just one more important thing to think and talk about.