I have been asked to speak at this conference as an older person. When the invitation came it was something of a shock but then I am not different than most other people who do not consider themselves old. We, individually and collectively, tend to exercise mass denial about aging and death. The invitation itself has been a graceful experience since it has challenged me to give consideration to those things that have enabled me to be here today. I really must consider myself old since tomorrow I will celebrate the completion of my 79th year on this earth.

In the brief time allotted to me what I would like to make a series of assertions and perhaps contribute to an agenda not only for this conference but for the work of the Pan-American Health Organization.

No person is an island nor does anything exist in isolation.  All things exist in relationships with continual exchanges. Some of these exchanges go on without anyone’s awareness though they affect us profoundly. The coins of exchange are chemical and electrical.  They go on within us and throughout the universe.

There are other exchanges some of which we are aware and some not; some over which we can exercise some control and then there are others that we can only react to. These exchanges are critical to the growth and development of every individual and to every society. What we are about today is to identify some of these exchanges, highlight how important they are and how in some instances when we can  influence them.

As you will see I feel we must be careful about the phrase “healthy aging”, being neither too pessimistic or too optimistic. Being too pessimistic may further “agism” and discourage individuals but, on the other hand the phrase may create too much optimism. It may both create “a blame the person” attitude for an elder’s limitations and unwittingly absolve society from taking measures to minimize losses in old age and to assure the continued participation of older persons in an age integrated society.

Human beings are part of a species, a special species that can have ideas and act on them, that exists with many others influenced by them and influencing them in turn. In some ways we are in competition with them and among ourselves. Within our species and in relationship to others, there is a constant tension in choosing what is good for me , for us and what is good for others both animate and inanimate.

Concentrating for a moment on the individual, each of us grows old and is old within the context of three realities; the first is the human genome which we inherited from our parents,  the second influences are those externalities that impact us as we strive for a homeostasis; physically emotionally intellectually and yes spiritually and the the third element in human growth and behavior are choices that I make  have made over these and make today; choices that others have made with me and for me and the choices that we make together as a society.

Considering our basic biology , especially within the context of evolution, we can identify three ages of human beings the first of which is from conception of through the period  we  growth to physical maturity and the capacity for production and reproduction.

The Second Age is a period of maximum cellular efficiency that enables us to reproduce and to have the strength, at least necessary in the past, to sustain the species and last, a Third Age, new, at least as normal in the life course, beyond reproduction.

During the First Age an individual grows physically, emotionally, intellectually and spiritually. The primary influences are those nearest and dearest. Gradually other persons become significant as one develops friends, fellow students and workers as well as a very special friend. Human interactions involving affection and instrumental help do not cease with the First Age but continue to be important throughout our lives even for 79 year olds.

Concurrently there are many other externalities that either sustain life and growth or compromise them. Time does not allow a cataloging all of them from the most proximate and significant to the more distant but still influential.

In the Second Age individuals have the opportunity to have children and produce what is necessary to sustain personal and social life. Historically both the first and the second age were marked by high mortality, and frequently, by disability. Relatively few people lived beyond that which is necessary for species survival. However at the beginning of the 20th century a new age Third Age became normal, more usual than not, in which the majority of people in developed countries would experience a significant period of life after the period of reproduction.

The introduction of new medical techniques, vaccinations, other public health measures such as better sanitation, and water supplies as well as new pharmacological agents all contribute to lessening early death with resulting increase in life expectancy and perhaps longevity. Fortunately we have seen improvements in various medical interventions, rehabilitative techniques, prostheses, patient self management approaches as well as societal attitudes and public policies  all mitigating disability as well. In some ways and at least for a time we have interfered with natural selection and survival of the fittest.

However, The basic cellular activity and its consequences have not been altered. In the Third Age cellular repair and replication can not keep pace with cellular deteriorations and losses. These have impact similarly on some populations and differently on others. The menopause is an example of the latter. Changes in skin, eyes, hearing, teeth, short term memory, changes in organ reserve and musculoskeletal losses are virtually universal. Fortunately we have developed approaches to compensate for some losses but the inevitably of death is still omnipresent.

Throughout life there is a gap between individual capacity and external demands. We are always in need of other persons and things outside us. Nothing is more dependent and frail than a child. At all stages of life we seek to narrow the gap by changing the capacity of an individual or making the “environment”, social, physical and even financial, more hospitable.

This gap can render a person frail, to a greater or lesser degree, i.e. living with a disequilibrium between capacity and need. In the Third age this frailty is likely to be  be progressive and intermittent even on a given day.

This relatively new Third Age  leaves us in a terra incognita as individuals and societies work toward identifying the structures, attitudes and behaviors which are important all during life but especially during this Third Age that will make it satisfying to individuals and significant the species as a whole.We are  struggling to further develop and support the mitigating structures needed both for the individual and for the species as a whole, the purpose of this convening.

With the ability of human beings to have clear and distinct ideas and to make choices individually but particularly collectively we can  manipulate our environment to make it, in some instances, more congenial to human survival and personal satisfaction . However, in other instances  in the interest of short term or personal gain we damage it.

In conclusion may I also cite something that is vitally important but often is often overlooked; the importance of civic virtue both in regard to this processes whereby we make decisions and also in regard to the values that undergird them. If societies are to exist, to say nothing of flourish, there must be a degree of civility and conversations that are marked by humility. We live in an era of rapid  increase in knowledge and understandings that challenge us to absorb them. No one has all the answers. In addition to the process considerations he must also invoke and be committed to the importance of social justice and social solidarity, balancing autonomy and social responsibility, the development of the common good and common goods, of reciprocity and solidarity, of adequacy and equity.

It seems to me that this kind of activity today and more importantly what the Pan-American Health Organization strives to articulate and to concretize all of these values in a very practical manner.

On a personal note I can identify a series of externalities that have contributed to me being here today I look back at loving parents educational systems that have enabled me to continually grow even until this present time. I am grateful for health systems that not only have saved my life on several occasions but have developed various compensatory approaches, prostheses and pharmaceuticals that have minimized my actual and potential frailty. I appreciate an economy while flawed and even fragile in some instances still has provided the goods and services which we need and want. Vaccinations have almost been taken for granted. I have lived within the context of a decent physical environment with minimum air pollution, good sanitation and the supply of good drinking water. I have been an am the beneficiary of public commitments resulting Social Security and Medicare that afford me me and millions of others with a degree of economic security and access to needed medical services without undue burden.

We live in a society with governmental structures and that foster freedom but also promote, albeit sometimes uncertainly and unevenly, social goods, concern for the marginated.

I must admit be somewhat unique position , hardly typical, since I am a single, white, straight, old Catholic priest, living in a religious community having been in the academic, professional worlds that have afforded me the opportunity to continue to be fully alive and to be significantly involved in the well-being of others and of society as a whole.

It is my hope that all persons in the”ThirdAge” have analogous opportunities.

In conclusion I am grateful to the Pan-American Health Organization’s challenge for me to remember, to  reflect more deeply and to appreciate more fully the structures and the people who have contributed and sustained the life giving environment that have given me the gift of seventy nine generally satisfying years.

Among all these things that which is most precious and sustaining are people who from the very beginning of my existence even till now  have and do love me and who allow me into their lives as well.

~Msgr. Charles J Fahey, Address to the Pan American Health Organization, Washington D.C. USA, 12 April 2012

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