Defy the expectations
In dispelling some of the preconceptions and myths that old age is all doom and gloom, I hope to allay some of the fear, and help people to age better
Joanna Nell, Sydney-based best-selling author, GP, and advocate for positive aging
I had a long pair of striped gloves when I lived in Milan. The lines were uneven, and the colors unusual. Here and there, the designer added a thinner line of a color that stood out louder among the pack, a bright pink or a powdery blue. The gloves were of a soft, velvety, and slightly elastic fabric. As they worked as arm warmers, I had to remember to wear them before I put my coat on, but they brilliantly kept the cold damp air outside my sleeves during my bike rides on the winter nights.
One of the privileges of living in the city center was having a dozen movie theatres within a bike ride’s reach. Movies used to come out on Thursday and every morning, on the big oval editorial table at work, I scrolled down the theaters’ list and picked my night’s destination. I used to prefer independent movie theatres, those with a handful of middle-aged couples waiting in line outside. The gloomy nights that took us one step closer to the heart of the winter were my all-time favorite times to dive into one of the red velvet armchairs. It was a feast of contrasts, like sitting in front of a fireplace on a cold night. Sometimes it had rained and there was still mist in the air. Too shy to turn into a real fog, it was more like a veil that made the traffic lights flicker. The roads - finally empty - looked suspended in an undefined dimension. Pedaling down the narrow streets in a restoring silence, I could hear the subtle splish-splash under the wheels of my bike. I loved going to the movies alone as it allowed me to pick a front seat without having to negotiate its closeness to the screen with my companion. The lonelier I was in the dark, the deeper I immersed myself in the story. On one of those nights, I was drawn to a movie with the strangest title, Fried Green Tomatoes at the Whistle Stop Café. From the third row in the middle of the screen, I was blown away by the unusual constellation of characters: an old lady, a homeless man, a couple of queer girlfriends, a menopausal woman, and a racially diverse cast. The three male characters were either marginal or villains. Thirty years on, the movie is still standing out as one of the few aspirational portraits of old age, and more often than not, I wonder why so many stories remain untold.
Joanna Nell is one of the persons filling in this void. She did it not out of marketing calculation but out of her experience first as growing up in a multi-generational household, then as a GP with her patients. She does it with empathy, without patronizing. In other words, she had a chance to bridge the gap that our society artificially creates in a game of mirrors that, like those vintage attractions in an amusement park, enlarge or reduce some aspects of the person. Joanna's work lifts the veil on this trick and gives us a glimpse of what we could see if, as she puts it, we had a chance of "time travel to our own future." It would undoubtedly be a transformative journey if - even in our imagination - we could look back to our present instead of trying to look at our future from our present selves with all the bias we are trained to fuel.
Tell us a bit about yourself. How did you go from being a doctor to being an author too?
As a child growing up in a small market town in the middle of England (famous for making the gates to Buckingham Palace), I loved books and making up stories. At school, creative writing was always my favorite subject but back then, ‘writer’ was never a career kids were encouraged to pursue. In fact I always saw writers as a kind of mythical creature, as if they were somehow born as fully-fledged Agatha Christies or Roald Dahl’s. My parents bought me a typewriter at the age of eight and I attempted several novels, invariably involving ponies, and for some reason that I am yet to figure, boys named Andrew (for the record I married a John).
My interest in people led me to study medicine, but it was probably as much because that’s what society expected studious girls to aspire to back in the 1980s. As a consequence of choosing science subjects, the only books I had time to read were medical textbooks, although I always tried to embellish my essays with beautiful descriptions. In fact I’m sure my wordiness used to drive my tutors nuts!
As the years passed I forgot any childhood dreams to be a writer, especially once I started a family and moved to Australia. In fact I only started writing by accident. Literally, after a tenpin bowling accident in which I did the splits and ruptured my hamstrings. I had surgery and ended up incapacitated for several weeks. My busy life had come grinding to a halt but during that recuperation I had time for some serious soul searching. I realized that aside from working and raising my children, I did very little for myself beyond my daily walk. So I made a bucket list of all the things I’d been putting off. Top of that list was finding a creative outlet and in particular, writing for pleasure. Whilst I was forced to lie on my back I Googled online writing courses and discovered the Australian Writers Centre’s Creative Writing Stage One. This was the start of a brand new love affair. It was like finding a missing piece of myself and I’ve been a much happier and more balanced person ever since.
Where does your interest in old age come from?
I think it goes way back to my childhood. My mother was a young mother and we spent a lot of time with her parents. There were always more elderly relatives at our family functions than children and I loved being with them and listening to stories about ‘the olden days’. My grandparents were always fabulous role models for positive aging with busy social lives and were very active into very old age. One of my grandmothers was still wearing high heels in her wheelchair and the other was still doing the accounts for family business well into her nineties.
At medical school, unlike many of my peers, I naturally gravitated towards the older patients. I found them more interesting, more stoical and definitely more accommodating of my incompetence with a stethoscope than the younger patients! I also found their medical conditions fascinating and once it dawned on me that aging was not a disease to be cured but a normal, natural process, I deliberately chose to make care of the elderly the focus of my practice.
Talking about aging, what are you interested in as an author in particular?
I never made a conscious decision to write about aging. I certainly wasn’t smart enough way back when I started to spot that gap in the market for literature featuring older protagonists. It was more organic than that. I must have absorbed that advice to new writers to ‘write what you know’ and because as a GP a large part of my working week was spent visiting retirement villages and nursing homes, this was a world I was very familiar with.
Looking back at the writing course exercises I did very early on, and the many short stories I wrote before my first novel was published, what they all had in common was that they all featured older characters. Perhaps this was in response to the lack of older protagonists in the books I was reading at the time, with some notable exceptions like The Unlikely Pilgrimage of Harold Fry, The One Hundred Year Old Man Who Climbed Out of the Window and Ran Away or These Foolish Things (on which The Best Exotic Marigold Hotel was based). What seemed to be lacking in these stories however were strong female protagonists and realistic portrayals of older women and their everyday lives, highlighting the invisibility they often told me they felt.
As a novelist I find older characters offer much richer, layered storytelling too, with interesting pasts, often first hand experience of world wars and having lived long lives, a breadth of human experience to draw on that will include falling in love (possibly several times), raising families and almost always grief or heartbreak too.
What does our society get wrong about aging?
Just about everything in my opinion! We are undoubtedly a youth-obsessed society. You only have to look at the beauty industry and its focus on ‘anti-aging’ to see that age is something to be ashamed of, something we must try to hide and disguise with expensive products and procedures rather than celebrate. This is particularly true for women who experience what the writer Susan Sontag described in the 1970s as ‘the double standard of aging’. In other words, while men are enhanced by age (think ‘silver fox’ archetype or wealthy older man tropes), women are expected to stay young and beautiful for as long as possible then conveniently disappear. In fact older women experience the double whammy of both ageism and sexism, so no wonder so many of us are speaking up!
The lack of representation of older people in fiction, on the screen and in the media implies that they have passed their usefulness and this idea that old age is a burden is sadly often internalised by older people. However, what I see and want to broadcast is that in spite of these outdated stereotypes, many older people are continuing to live full and active lives and that age is no barrier to trying new things, making friends, laughing, having sex or even falling in love. Yes, an aging body and mind can throw up challenges but age itself should not prevent us having fun and living a fulfilling life by focusing on what we can still do rather than what we can’t.
What strikes you about the way we are culturally conditioned to think about aging?
What strikes me most is how different cultures vary in how they value their older members. In certain cultures, especially in Australian indigenous culture, elders are venerated and treated with tremendous respect for their wisdom and lived experience. In some societies, where multigenerational households are the norm, older members are highly valued and looked after in later life within the family unit. By contrast, in many western societies older people are more likely to be cared for in their own homes by paid carers rather than family, or in larger institutions where one study estimates that as many as forty percent of residents never receive a visitor.
I believe this ‘warehousing’ of old age out of convenience is a direct consequence of the loss of respect we have for our older citizens, and I doubt the broken aged care sector will see any real change until we address this fundamental attitude to aging.
Your books are praised for the ability to mix laughter and compassion: are these the best lenses to look at aging or at any season of life?
I am a firm believer in laughter as the best medicine. It releases endorphins, the body’s natural painkiller, as well as dopamine, serotonin and a bunch of other feel-good chemicals. I grew up on a diet of good old 1970s British comedies such as Fawlty Towers and the Monty Python Show. Doctors are also renown for using gallows humour as a coping strategy.
As a writer I use gentle humour to guide the reader through themes such as sickness, death and grief. It’s like painting with light and shade. I can only throw my reader to the bottom of an emotional well if I can lift them out again. I also want to entertain the reader with my observations about life’s accidental comedy. Life is inherently funny, even at what seem inappropriate moments.
I would like to think that the compassion comes from understanding the world I write about. I try to approach the work with empathy, respect and the greatest affection for my characters and their situations rather than being patronising or exploitative. One of my favourite writers is the British playwright Alan Bennett whose style has been described as ‘affectionate satire’ and I think that’s what I aim for in my own writing.
The representation of old age is always stereotyped and never glamourized. What suggestions would you give to go beyond our preconceived view?
I think it all comes back to empathy. Attitudes are more likely to change in response to personal experience. If people had the opportunity to time travel to their own futures (we are all going to be old one day if we’re lucky, so ageism is the most illogical form of discrimination since we are effectively discriminating against our future selves!), there’s a chance by seeing the world through the eyes of an older person they might change their view of how the elderly should be treated. We know that reading increases empathy. This is why I write from the point of view of older characters, allowing the reader to walk for a while in the shoes of someone they might one day be and experience first hand the patronising and paternalistic attitudes of society towards older people.
Another way to change people’s views might be to encourage mixing between the generations; we only have to see the beneficial effects on all the participants – young and old – in the social experiment filmed for the wonderful TV show The Old People’s Home for Four Year Olds to see what is possible. In my latest book The Tea Ladies of St Jude’s Hospital (out in October) I have included a teenage point of view character and I really enjoyed exploring that interaction between the generations.
You’re offering a peek behind the scenes of aging, the thoughts and the emotions we rarely get in mainstream media. How important is it to re-evaluate the individuality of the person?
Individuality is the key to improving the experience of caring for the older person. Aged care facilities are too often a one-size-fits-all offering, in which residents are expected to adapt to the rules and routines of the facility rather than the other way round. This leads to institutionalisation and ultimately depersonalisation. This was something I tried to highlight in The Great Escape From Woodlands Nursing Home in which my two protagonists Hattie and Walter have trouble adapting to life in care including a set bedtime. Sleep patterns in particular are highly personal and change with age. The nursing home’s clandestine social club the Night Owls is a whimsical invention but I wanted to demonstrate how it was possible to design something that sees each resident as an individual with their unique life story. As a writer with a passion for creating older fictional characters, it means there are potentially as many stories as there are people.
What are the most unexpected aspects of aging you came across with your patients and by creating your characters?
It has always been my impression that my older patients were a fairly content group. When I searched for evidence to back this up, I found study after study showing that statistically, older people enjoy better mental health than younger or middle-aged people. They suffer lower rates of anxiety and depression and contrary to what people might imagine, are not overly afraid of dying. There is also evidence that when it comes to thinking about aging, those who are more optimistic about aging actually live longer and are less likely to develop dementia. In other words thinking positively about getting older is the key to aging well. This is undoubtedly part of my motivation for writing hopeful and uplifting books featuring aging. In dispelling some of the myths and preconceptions that old age is all doom and gloom, I hope to allay some of the fear, and help people to age better.
My first novel The Single Ladies of Jacaranda Retirement Village started out as a romance and actually won the RWA’s Valerie Parv award in 2017. At the time there were very few books featuring romance between older characters which surprised me considering the number of my patients who were embarking on new relationships later in life following the death of a spouse for example (including one man I knew at the age of 99½). I maintain that intimacy is an important part of any loving relationship and that with a little imagination can be enjoyed at any age!
How has your perspective on aging changed because of your books?
At 54 I am not afraid of getting old and now celebrate my age. I have finally embraced my grey – sorry, silver – hair (what a relief not to have to spend hours sitting in the hairdressers every four weeks) and try to focus on the unexpected benefits that age has brought me in terms of greater self-confidence and self-knowledge.
I worry less about small things and can finally delight in seeing my children find their own way in the world. I’ve proved, to myself at least, that it’s possible to have a second career in your fifties and that many things improve with age. This is especially true for writers. When the time comes and I need a higher level of care, I promise to talk to my love ones about what I want – and more importantly what I don’t want – long before they load me into the back of an ambulance with a broken hip. I can’t promise to go quietly or age gracefully however. No surprise that my favourite poem is Jenny Joseph’s WARNING… ‘When I am old, I will wear purple and a red hat that doesn’t go.’ And if I do find myself in a nursing home like Woodlands, there’s an excellent chance that I will try to escape. You have been warned.
