musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

With Age comes wisdom; sometimes Age comes alone…


It’s taken me a long time to wade through my years, but now I realize I’ve lost some of my early  memories. Of course, I suppose you don’t get to luxuriate in your 80ies without a few pages disappearing -early chapters in the book hastily read in the enthusiastic joy of youth, episodes underlined or marked with checks in the margins for future reference as if they would always retain their initial importance…

But things change, and what seemed significant when I was 19 is buried under the callous of later years where the margins of subsequent chapters are replete with marks as well. I used to write margin comments about clever ideas I’d found in books I was reading in hopes I’d be equally inspired if I ever happened upon them again. But I suppose Life moves in mysterious ways and except for a few enlightening books on Philosophy, or History, I never got back to the marginalia of the rest. Perhaps I internalized those reminders though; or perhaps I modified them, but at any rate, here I am years later wondering if they would still retain their significance in the different world we now inhabit. How much have I changed over the intervening years? How much of my inquisitive youth have I managed to bring along with me? Are those chapters really lost…?

Wisdom, for example; what is it? The etymology of the word seems to reveal the obvious: it originates from the Old English word wīsdōm, which combines the terms wīs (“wise”) and dōm (“judgment, decision, law”). I rather prefer the simplified approach I gathered from my freshman university Philosophy courses: wisdom is often explained as experience plus knowledge, tempered with Age… or should it be simply Time that tempers the other two? Blends them together in a synergism greater than either of them considered by itself? Is Wisdom, then, an emergent property?

Oh, I know: too much inaccurately remembered Philosophy; not enough real world similarity… I used to think the definition was obvious and I used to look forward to Age for the rewards that a well-read life almost certainly promised; in fact, I think I once even believed that I was entitled to Wisdom.

Until I retired, I was -or am I still?- a medical doctor; a keeper of secrets about how the body works; a guardian of the Hippocratic Oath with its solemn promise to help the sick and never wrong them with the knowledge with which I was invested. It was a classic recoup of ethics, of deontology, in that I promised beneficence, non-maleficence, confidentiality, and respect for the patient’s autonomy. Keeping  that oath, we were given to understand, was not only a privilege that had been granted to a special few like us, but a sacred duty. If that  didn’t make us special and entitled, then what were our mentors on about?

It’s difficult to brandish that amount of responsibility for over forty years, and then suddenly retire. I mean, what happens to the knowledge, not to mention the experience I accrued -and, dare I admit it, the power? Surely being  invested with trust is power but is it Wisdom? Knowledge changes with the passage of time, as does what we do with the experience gained by using it. So where does Wisdom come into it -if it even does…? And where, if anywhere, does it go? Does Wisdom cease to exist if the ground upon which it was based has altered? What happens to Wisdom if there is a paradigm shift, as I believe I have undergone now…? Can Wisdom, like me in other words, become outdated?

I have to marvel at the wisdom of people like Socrates though. He was considered wise, not only because of his knowledge, but more because of his method of inquiry. As he is reputed to have said: ‘The only true wisdom is in knowing you know nothing’…  His method involved asking a series of questions to reveal contradictions and inconsistencies in the beliefs of the person to whom he was talking; they both would often end up with a deeper, or at least different  understanding. He wasn’t so much teaching knowledge, as the approach to it; the ability to decide whether it was properly understood; whether it was, in fact, knowledge. That required Wisdom on his part…

So, perhaps Wisdom is not as dependent on knowledge, as in the way of parsing it. If one could explain and understand the ramifications of its use at the particular time of its acquisition, I think we would still consider that person wise. Knowledge is a moving target, but Wisdom -the ability to analyse and use that knowledge appropriately- is less so, if at all.

Still, I have to wonder how we know if we are wise… Or is it as simple as what Lewis Caroll once wrote, ‘If you don’t know where you’re going, any road will get you there.’ Does that mean that Wisdom is similarly arbitrary if you don’t specify the rules…?

Or could it mean that merely wondering about Wisdom suggests that it lurks somewhere deep within the wonderer -otherwise why would the thought even arise? Wisdom, perhaps, requires humility, not hubris; patience as we wait for it to emerge, not arrogance about its location on the shelf. Modesty maybe, but certainly not conceit.

The title of this essay is an aphorism usually attributed to Oscar Wilde: With Age comes Wisdom; sometimes Age comes alone. Am I alone, after all those years I’ve spent worrying about it? Is wisdom biding its time somewhere, and simply waiting for a call? Maybe St. Augustine was right; maybe it is patience that is the companion of wisdom, not Age…

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gozzter

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