Do Not Go Gentle into That Good Night, that old Dylan Thomas poem, is a favorite of many mature adults, including me.

Do not go gentle into that good night

Rage, Rage against the dying of the light

Let’s face it — none of us is getting any younger. And as we age, we’ve got to choose – will we rage, or will we just go gently.

I remember someone who alleged they wanted to work with me telling me they were interested in working with an emeritus neuroscientist. He was a very sharp guy, at least as far as I could tell from his academic publications. He had been with the system a long time and published much. I had not, since I’ve never seemed to fit into that system any better than most other systems. The project fizzled for a number of reasons, not the least of which was the news that his family was up in arms because this elderly gentleman had given the overwhelming bulk of his life savings to one of those delightful online scams. I have not checked what the country of Nigeria is doing in terms of industry, but they seem to be leading the way when it comes to these scams. They promise tremendous amounts of money, starting with an email to a recipient that purports to be a personal email but which surely has been delivered in bulk. All the recipient has to do is advance a little money to get a lot. A greed factor then takes over, and the recipient advances more and more money in hopes of a big payoff — which does not seem to happen. Anyone who has not received at least one such email is probably not a big internet user, to say the least. I have received them in three languages, and I do almost all of my internet work in English. It has been known for a long time that old folks are most often prey to the financially unscrupulous. Personally, I think that the isolationism and diminished social function that often come with aging play at least as much a part in this as neuroscience does. But for the moment, let’s assume that at least some of the problem is a loss of judgment that comes with age. Assessing individual financial capacities may be helpful — for families and guardians and stuff — but there is a delirious amount of variability here. The typical American solution of let’s-make-more-rules may not be the way out. At quite a young age, I saw my Grandfather-of-Blessed-Memory tell my mother that he had a daughter in Boston – even though she was standing right in front of him. He simply could not recognize her. As she stood there crying like a fountain, I knew I was in some kind of trouble.

Yes, there is a genetic propensity. But that is when it comes early, like 50′s or so. My Grandfather-of-Blessed-Memory was pushing 80 when the problems started to show, and he had symptoms for about eight years before he died. That seems to be about the average for humans. Me, I will not “go gentle into that good night,” especially when the plan is for me to continue to live by my wits.

There is no one page on the internet I can swear by when it comes to aging and Alzheimer’s. I should probably write my own. But for now, the one put out by this research and prevention foundation seems pretty good. There is a blood test to judge personal risk, there is a suggested diet, and there are lots of supplements. But perhaps the single most important intervention I know is to use what you have so that you do not lose it.

I do not like, and will never accept, the diagnosis of “cognitive loss for age.” No supernatural authority ever informed me that I am supposed to “stupid up” with age. Human authorities have certainly tried. Someone asked me recently how I was able to speak competently on so many different subjects. I shrugged my shoulders. “I am a knowledge junkie,” I replied, “I get a kick out of knowing things.” I did not elaborate; the person who asked me seemed to have little interest in that. But I realized immediately the knowledge I most enjoy is how to do things. I want to learn more skills in new and foreign fields. I love this. With the nutritional stuff, few would argue that it is possible to delay cognitive decline long enough to succumb to something else. Not good enough for me.

Any marketing course out there would tell you that prevention is the toughest thing in the world to sell– most folks won’t buy it. If we want to increase life quality in the elderly, we ought to eliminate the “cognitive loss” diagnosis and do more useful things.

When seemingly intelligent people can lose the ability for sound financial judgment; well, there ought to be a biochemical substrate for this function. More specifically, there ought to be a neurophysiologic substrate for the behavior. So let’s find this and fix it. This would be extremely worthy research, with an immediate practical application. I don’t know about you, but I for one will not go gentle into that good night. I plan to rage. I will kick and fuss – intelligently.

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.