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	James L. Holly, M.D.

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Your Life Your Health - Healthy Aging: Integrity and Wisdom

James L. Holly,M.D.

November 04, 2004

Your Life Your Health - The Examiner

Today is my 61st birthday. I am struck by the reality that at best, being into the seventh decade of life, I have lived 2/3rds of my life. My task on this day is to review my life for what is worth recommending to others. And, the only thing in that category is "wisdom." As a physician, my task is not simply to help people to be physically healthy but to assist them in their search for meaning and purpose in their lives. Also, as a physician, any help in this search must be circumscribed by my patients' life experiences not mine.

Today, Mrs. Holly and I will be attending a conference jointly sponsored by Baylor College of Medicine and the Institute for Religion and Health. The principal reason for attending this conference is to hear and meet Dr. George Vaillant, Professor at Harvard Medical School, and the author of the book, Aging Well, which this column has recently looked at in depth.

Dr. Vaillant's subject in today's conference is entitled, 'Erikson's Eighth State of Life: Integrity.' I have wondered if the program is not misprinted, as Erikson referred to his categories as 'stages,' not 'states,' and Dr. Vaillant recommend the term, 'tasks,' which I find more helpful. The concept of a 'task' is more appealing, as it implies an active embracing of the issues related to a particular age, rather than the concept of 'stage,' which could suggest inevitability and therefore a necessary passivity on the part of the one experiencing that age.

It may be that the program title is not a misprint, however, for unlike Erickson's other seven stages, and the two which Dr.Vaillant added to them, while there remains a dynamic nature to this last 'task,' or 'stage,' there is also a 'destination' element to 'integrity.' There is an element to this eight stage which provides a summary statement to one's life which makes it an appropriate point of reference both for direction in life and for the identification of the conclusion of one's journey.

Integrity with its virtue: Wisdom

Nonetheless, as I have set myself to thinking about what I have learned in my sixty-one years, I am drawn to the concept of 'integrity.' Webster's defines integrity as, 'firm adherence to a code of especially moral or artistic values; incorruptibility; an unimpaired condition; soundness; the quality or state of being complete or undivided; completeness.' As a synonym, Webster's lists, 'honesty.' This latter is the way we most commonly use the term, but the other definitions do suggest Erikson's and Vaillant's use of it.

In some ways, their use of the word 'integrity' could be considered jargon, i.e., it is used in a special way not necessarily understood by the definition of the word. Yet, their use of the word in some ways follows from the last use given by Webster's, 'the quality or state of being complete.' In Aging Well, Vaillant said, 'Finally there is Integrity, the task of achieving some sense of peace and unity with respect both to one's own life and to the whole.' He commented, 'Erikson described integrity as 'an experience which conveys some world order and spiritual sense. No matter how dearly paid for, it is the acceptance of one's one and only life cycle as something that had to be and that, by necessity, permitted of no substitutions.'

Vaillant added, 'Erikson suggested that wisdom was the virtue of Integrity...Wisdom is detached concern with life itself, in the face of death itself. It maintains and learns to convey an integrity of experience in spite of the decline of bodily and mental function. Erikson suggests that one of the life task of Integrity is for the old to show the young how not to fear death.'

The task of this last stage of life is not only to achieve a sense of soundness, of wholeness, of completeness -- in the face of and in spite of failures and inadequacies ' but to communicate the continuity of life to the next generations. And, I think, this communication is significantly non verbal. It flows from the 'life message,' from the collective values and experiences which flow together to make us who we are. It is spoken as much by choices as by achievement. It is spoken more by the focus of one's life than it is by the financial status, or the success one has experienced.

What then have I learned?

Faith: You will never live long enough nor well enough to make it worth while to compromise your convictions, or live beneath the demands and requirements of those convictions. Most often this is an expression of what you believe about the nature and value of life. For me, convictions have flowed from my belief and conviction that Jesus Christ is God and that He is the Messiah.
Family: Beginning with parents and siblings and extending to spouse, children, children's spouses and children's children, built on the foundation of faith, family is the second most important element of life. It is worth every effort and every sacrifice to succeed at family.
Friends: Relationships which are not subject to whims or emotions, but which are founded on the same 'covenantal' commitment as faith and family are the coin measuring successful living. And, this is not a matter of popularity, but of intimacy with those who share your passions and purposes, even and especially where there is not lock-step agreement on everything.

Other principles which I have learned:

Those who help you the most are not those who always agree with you.
It is the fortunate few who have a friend who will tell them the truth even when it is unpleasant.
Contentment, which is neither complacency nor covetousness, is the foundation of a long and health life. Stated by another, this means, "He that is not content with what he has, will never be happy with what he wants."
The ultimate achievement in life is to be looked upon by your family and friends as a wise and contented person, not perfect by anyone's judgment, but a valued counselor and a source of encouragement, strength and integrity.
The grass is never, ever greener on the other side of the fence. Appearances are delusionary; your only opportunity for success, joy, peace and happiness are worked out in the circumstances of your life and past, not in denying, lamenting or artificially trying to alter them.
The only thing which can hurt you is what you don't know.
There is no character trait more attractive than gratitude and none less attractive than ingratitude.
Identifying with those who are 'other' than us, those who are different from us is the ultimate manifestation of maturity and of wisdom. It is in receiving those who are different from ourselves that we ultimately become whole.
Forgiveness of those who have hurt or harmed us is the most positive thing we can do for ourselves and in this act of selfishness, we also benefit others.
All of the elements of wisdom are exercised by a decision, by an act of the will, not by accident or chance. Few things will promote physical health as will be practicing of the principles above.

Nature of Wisdom

No statement of wisdom will exceed the Ten Commandments, or the wisest interpretation of them, The Sermon on the Mount, whether read as revelation, or simply as principles of life. To love God and to honor your parents are the bookends which support all efforts toward wisdom and 'aging well.'

Wisdom is not intelligence, nor academic achievement. Wisdom is not cleverness, nor literacy. Wisdom is the ability to see beyond the immediate and the appearance to see the result and the significance of events before events play themselves out.

Wisdom is seeing value in people not in toys. The investments we make in the lives of others will return dividends far more fulfilling than stocks, bonds and real estate.

Humility

Many excellent summaries of wisdom have been written, few excel that of the Prophet Micah, who wrote, "He hath showed thee, O man, what is good; and what doth the Lord require of thee, but to do justly, and to love mercy, and to walk humbly with thy God?" (Micah 6:8)

Perhaps this is the conclusion of the matter. As much as it is contrary to human nature, the ultimate manifestation of wisdom, of integrity is humility: the humility to know how greatly we need God, our family and our friends, and at the same time knowing how unworthy we are of each one of them. And, it is appropriate that the last task for us to complete in life is one which is made easier with age, because it is the elderly, those of us who have lived beyond our sixtieth year, who are intensely aware of our need for mercy.

In remembering, I know it has been my life and it is my health. I am grateful for both.

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