I don’t care if Dylan Thomas was drinking himself to death while that was being written. It is a sentiment close to my heart, and undoubtedly the stanza of poetry I quote most often.

Do not go gentle into that good night
Old age should burn and rage at close of day
Rage, rage against the dying of the light.

I will not accept the allegedly inevitable “cognitive loss of age.”

I suppose my mother did me a service at age 10, when she dragged me fairly close to the oversized window of an oversized ladies room, and told me never to linger trying to make myself attractive, for it would be a waste of time. I was – in the opinion of my parents – destined for brains, not beauty.

Time lost in fixing my appearance would be noted sardonically by my father, and bother him, as we wasted his time.

But my strong suit was my brains, and even I agreed that I should work on them — working very hard in school — and that way I could win in life. I actually took my mother seriously, for a very long time. It was not until my late fifties that I started to be anywhere near a fashionable woman’s size, finding to my amazement that people found me attractive, and taking more notice myself than ever in my life.

But even now, I don’t give a damn if they call it “cognitive loss for age” or “dementia,” I want nothing of it.

Nothing at all.

I am not the only person I know who can’t afford to retire. I want not just to keep working as a psychiatrist, but to grow, to do new things. I am starting to see if I cannot take a more active role in developing drugs — natural alternatives in particular. I think I can, and I will. I know how to push molecules around people’s heads.

I need to know about business and regulations. I need to think a different way, understand things I have never understood.

I am lucky, really lucky, to be living in the Great Golden state of California. This is the only state in the union where you can be a lawyer without showing up for law school. Of course, you do have to register for a correspondence (online) law school and study a bit, but to me it seems quite accessible. Some content about law is already accessible. I am digging in. I explained to my husband that soon I will have to become a lawyer. He knew the doctor/lawyer is not an impossible entity.

But me, me, I am having the crying need to study and learn. It is like a high, it is the biggest excitement of my life, the joy of knowing; it was a joy long before I found and loved my husband. I used that knowing to locate and marry him. I often quote it as the best piece of science I have ever done, although I would be the first to admit that it is more than science.

But first came the knowledge. I read a lot about Alzheimer’s, starting when I was quite young and watched my mother’s father suffer from dementia for eight years before his death. It was tragic — forgetting the identity of my mother reduced her to tears.

I had not yet learned it was senile, for he was 78 when it started. The original description of “dementia praecox” (presenile dementia) was about folks in their fifties. Thank God, there is none of that in my family.

There is a genetic test to tell the predisposition. I once made a number of telephone calls, to make sure I could get such a test for my patients. Not one has ever wanted it. Not ever. This cognitive loss for age, however minimal, starts at about thirty, when you cannot quite find your car in the mall parking lot. So now people are surprised that cognitive loss seems to start at 45 — Hah?!

There has been a lot written about the prevention of whatever diminishes cognition with age. Biologically, lots of supplements; I have written about them, plenty. Now I am talking about something else. Do not plateau in life. Think instead of what lies ahead. The hardest thing to convince a young person to do is to live now, guessing — if not understanding — what life will be like later. The decisions made now will improve the quality of age. It is not just make-up and clothes and whatever pseudo sports men sometimes do, like driving little red convertibles It is avoiding drugs, or alcohol, both of which do a great job of killing brain cells. It is choosing new intellectual challenges. A college degree, even a professional degree, is no damned good if you say “Well, now I have a profession and I have it made” and only minimal continuing education is done superficially.

I know I constantly need new intellectual challenges. I know that patients or clients or whatever will profit.

Do not go gentle into that good night
Old age should burn and rage at close of day
Rage, rage against the dying of the light.

Author's Bio: 

Estelle Toby Goldstein, MD is a board-certified psychiatrist in private practice in San Diego, CA.

Practicing Medicine Since 1981

In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology).

Experienced In Many Situations

She has worked in a variety of positions, including:
■Medical school professor
■General and Orthopedic surgeon
■Brain surgeon
■Army Medical Corps psychiatrist
■Prison psychiatrist
■Community Mental Health Center staff
■Consultant to a major transplant hospital
■Drug researcher

“Whatever It Takes!”

She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine — or Integrative Medicine. Her practice is cash-only, doesn’t accept insurance or government payments, and she operates on the concierge, or “private doctor” practice model to give her patients the absolute best quality of care and the highest level of confidentiality.

Dr. Goldstein’s philosophy is “Whatever It Takes!” Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible — not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available — most of which are unknown to standard, mainstream doctors.

Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy.

The Expert’s Expert

She has written an advice column in a daily newspaper and hosted a weekly call-in radio show, and now is enjoying the freedom of speaking her mind on this blog. www.betterbrainsonline.com