I am a resident in psychiatry at an academic medical center. My blog posts describe patient encounters I have had in the course of my training, both past and present. Names and identifying details have been changed. My blog conforms to the information-privacy standards detailed on If you believe you have been a patient of mine and have concerns about the effects of this blog on the privacy of your medical record, please let me know and I will be happy to withdraw any offending material.


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SEPTEMBER 28, 2010 1:52PM

beauty and age

Rate: 11 Flag

The patient before me is seventy years old.  She wears enormous starlet sunglasses and a sleek pageboy wig.  Her mouth is pursed, plaintive.  As we talk she touches her wig every few minutes and apologizes repeatedly for her appearance, which gives no cause for apology other than that she is seventy, and a woman. 

She quickly tells me that she used to be a model.  She compliments my appearance.  She apologizes again for her own.  In the space of a few minutes, the frame of reference for her world becomes obvious.

 I see this in women of beauty, and of former beauty, in our society that worships youth but ridicules age and dismisses experience.  Accustomed early to the admiring glance and the extended hand, such women become dependent upon these things. Enfolded in admiration, they expect at some level that it will be there for them always.  All their manners and concerns are enmeshed in this identity: I am a lovely woman.  They adopt the secure and easy laugh, the slow knowing whisk of the eyelashes.  For many years, these devices serve so well as to become nature itself: not tools or toys but the woman's very person. 

Then when the facade begins to crumble, so too does the human being beneath.  What am I now, if not lovely?  Who am I?   

Some successfully adopt other identities for themselves: wife, mother, grandmother; artist, healer, traveler.  Others, like this woman in the sunglasses and wig, do not.  She hovers forlornly over the carcass of her own beauty.  She seeks at every turn to remind others of her former glory, hoping that they will now accord her just a fraction of that beauty's due.  She cannot accept that she and loveliness have come unbound.  Have the longing glances really evaporated so?  Can she not recall them with a well-timed reminder of what she was? 

The woman is labile, irritable, angry.  She lashes out easily, then instantly begs forgiveness.  At one moment imperious and demanding, the very next she turns and asks for mercy. 

Better to praise and placate, or to reason and limit?  This patient nurses a deep wound.  Though her hurt seems cheap and reasonless, to her it is despair.  She will be comforted only if I can conjure up the eager appreciation, the limitless sympathy which she came in some past existence to expect.  But to what end such falsehood?  Should I better demonstrate to her what she can expect to see from others?  Explain that her treatment will be neither better nor worse than that of the fellow next to her?  Upset her with the purpose of pushing her to understand?

 I choose to soothe with admiration.  I ooh and aah at the dog-eared photos of a slim young girl in a high-waisted Fifties bikini.  We become friends, the former model and I.  I give her what she wants, and she gives me what I do not want: a window into the future, a lesson to be tucked away for now and drawn out when I enter my own old age.

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beauty, age, feminism

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"I choose to soothe with admiration" That made me ache, even as I knew it was the best choice. Well put.
This rings true. You don't realize how much people's reactions to you are based on your appearance until your looks start to fade. But it's a good opportunity to wise up, if you can.
This is just beautifully rendered, ponti. Not only is it true, but you say it so well.

I've thought this before about my sister, one of five of us girls, but she was the "beauty." She has handled her aging gracefully so far--she's 47 this year--but I used to wonder if someone who literally got stopped in streets for her looks could ever adjust. Because she's also intellectually gifted, she was able to understand it and move on.

But I have also seen this in men of their careers. My uncle, in particular, a doctor. Head of a hospital in WNY, defined by his practice, put on a pedestal, really, by many, many people over the years, not only patients but other doctors. By the time he retired, I don't think he thought of himself as anything whatsoever besides a doctor. Retirement has been really rough for him, I think.
I remember my mom talking about having become "invisible." She felt that those around her almost literally did not see middle-aged mom types.

I also remember my own experience of "becoming visible" at 14 or 15. At the time it was something of an unpleasant shock. By now it's so much a part of the landscape that it may be more of an unpleasant shock when it goes away, as it is currently doing (I'm 32, and can say that becoming a mom is definitely a huge 'visibility' hit).

Or maybe it will be pleasant. Who knows. I've always kind of preferred to hang out in the background anyway.
I like the spotlight, ponti, and am definitely moving into the invisibility zone at 48. Trade places?
Incredibly true and poignant and sad. And although I was certainly no model, I am a woman and I understand. Beautifully told.~r
Identity is complicated, and the inevitable invisibility factor does take a bit of getting used to. As an identical twin I always felt uncomfortable with the attention the "two peas in a pod" attracted. Pete and Repeat smiled and looked at the ground. The ultimate question we were asked was, "How do you know which one you are?"
Who, indeed?
These are lessons I never thought to learn, but so necessary. I hope I remember when I need to remember. Or that I have kind, indulgent people around me at that point!