Second Opinion: Our ageing selves can become our truest selves with the right attitudes

Faced with a gerontology conference with 20 sessions occurring simultaneously, the texting argot of teenagers comes in handy. To LOL and YOLO has been added FOMO: Fear of Missing Out. Effective FOMO management strategies involve several ingredients. The first is not to switch between the academic sessions as, invariably, the timetable will have changed in the other room, undermining the experience of both sessions.

The second is reassurance that repeated scrutiny of the programme book to choose sessions bestows a flavour of the hot issues in gerontology. Mixing during coffee breaks and receptions to hear what other delegates found interesting is equally important.

Finally, the ever-larger poster sessions offer the best opportunity to pick and mix, as well as for serious discussion. Platform presenters are as moved by fear of looking foolish as by science, so dialogue at oral sessions tends to be correspondingly less free-ranging.

For the 4,000 delegates at last week’s Gerontological Society of America meeting in Washington DC, the leading annual scientific congress on ageing, the choice was again awesome, from cell biology through geriatric medicine to transport and policy.

The ever-increasing profile of ageing in society was highlighted by the keynote address of Dr Francis Collins, the director of the huge US National Institutes of Health (NIH).

Ageing is now integral to the work of many of the 42 constituent institutes of the NIH, particularly the Brain Project and the cancer and genetics institutes, as well as the National Institute on Ageing (we need one of those in Ireland). The clear enthusiasm of Collins’s presentation was invigorating, and will have gained many new readers for his excellent NIH blog (directorsblog.nih.gov).

I directed my focus on sessions largely related to the humanities and ageing, and, in particular, the philosophy of ageing, as well as transport and ageing, and was richly rewarded.

Analogous to growing interest in medical humanities, humanities research in gerontology seeks to illuminate the deeper and wider meanings of ageing. As outlined by a leader in the field, it embodies three intrinsic ingredients. Through compassion we recognise our vulnerability and emotional, moral and spiritual response to others; we acknowledge the relationship between the knower and the known; and we seek an emphasis on moral and spiritual aspects of growing old, especially meaning.

The impact of the sessions on the philosophy of ageing gained particular impact from wide publicity given to an article in the October edition of the Atlantic Monthly by Ezekiel Emmanuel, entitled "Why I Want to Die at 75".

In presentations of philosophers ranging from Aristotle to Martha Nussbaum (with telling contributions from Dr Ricca Edmonson of NUIG), we were drawn into reflecting on wisdom and virtue through the prisms of gerontology, classical studies and philosophy.

A particularly effective and gentle riposte to the Emmanuel piece was delivered by a philosopher from Utrecht, outlining its contamination by three pernicious and persistent popular narratives of ageing. These include active ageing, a highly productivist notion with little room for our existential vulnerability; the decline narrative of ageing; and the age-defying narrative, with its emphasis on staying young and denying growth, a self-effacing strategy doomed to fail.

Turning to virtue ethics, we are reminded that what makes life good is intrinsically fragile: the emphasis on “control” in modernisation can conceal this from us. Strategies to liberate us from this require a better articulation of living well and actuating the Aristotelian virtue of practical wisdom, in particular for dealing with the inevitable unexpected contingencies of life.

With ageing we can become our truest selves if we allow ourselves to embrace an alternative notion of activity, that of practising the right attitudes.

Virtue ethics aim at self-realisation and flourishing while acknowledging the vulnerability of this striving. It also incorporates our fundamental social embedding, with its benefits and challenges.

Building resilience towards fragility requires a lifelong process of development and practise of relevant attitudes and qualities, balancing the demands of self and the world in a way that is flexible and context-dependent. In this way we can see practising virtue as trumping the unhelpful tropes of passive surrender or actively fighting ageing.

It is tremendously reassuring to see such profound and often challenging debates embedded in mainstream gerontology, and bodes well for liberating the gift of ageing from the tired, negative and limiting attitudes that persist in public life.

A version of this column originally appeared as a British Medical Journal blog. Prof Des O'Neill is a consultant in geriatric and stroke medicine. His book, Ageing and Caring: A Guide for Later Life, is published by Orpen Press.