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'Art of Aging' a helpful and hopeful primer

The Art of Aging: A Doctor’s Prescription for Well-Being, By Sherwin B. Nuland, Random House, 302 pp., $24.95

Some years ago, I heard a woman, vibrant and lovely, read aloud an appreciation to her body for serving her well for 85 years. Her closing words: "I am ready to be ashes in somebody's rose garden." Not eager but ready, she had mastered life's final stage: the art of aging.

Most who have long walked hand in hand with time deem the art of aging very hard to master. They will find Sherwin B. Nuland's "The Art of Aging" a valuable guide. Professor of surgery at Yale, Nuland, 76 , blends medical expertise, eclectic interests, and erudition into a graceful and gracious primer rich in humanity.

As in his National Book Award-winning "How We Die, " Nuland steers readers away from harmful diets of pie in the sky while prescribing how to keep tarnish off our golden years.

The first step is to adapt the way we think of ourselves. We should desire to maintain good health, not "the delusion of being still young." Then, aging can become "the gift that establishes the boundaries of our lives."

We live longer than our forebears. The average man reaching 65 in 2007 can expect to live nearly another 17 years; the average woman, close to 20.

To live them well, Nuland advises maintenance of our bodies. While "aging is not a disease," it is a risk factor for many diseases and a time of decline in hormonal systems, muscle mass, vision, bladder elasticity, gastrointestinal efficiency. We must keep hearts and immune systems strong with exercise and weight training. Aerobic fitness not only strengthens the heart but also the brain, reducing loss of cerebral tissue, improving brain functioning, and reducing psychological depression.

As he had in "How We Die," Nuland makes superb use of real- life examples of laudable aging: 98-year-old cardiovascular surgeon Michael DeBakey ; Hurey Coleman , who overcame a massive stroke and typifies the attitude Nuland finds among those who've remained undefeated because they have gone on trying: "The crisis was an event in their past, now behind them and perhaps necessitating certain changes in their lives, not something that marks them as sick people."

Nuland observes that "fear of aging is more than fear of decrepitude. Ultimately it is fear of death." So he urges caution as desperate people turn to the promises of scientists whom Nuland believes wildly optimistic. Nor should we wish to emulate Tennyson's deathless Tithonus and "pass beyond the goal of ordinance / Where all should pause, as is most meet for all." Says Nuland, "Both individual fulfillment and the ecological balance of life on this planet are best served by dying when our inherent biology decrees that we do," approximately 120 years maximum.

Nuland fears well-intentioned efforts to prolong life or choose the genetic makeup of children could "[breed] out variety [and] alter factors necessary for the survival of our species and its relationship to every form of life on earth."

Nuland counsels, "It is when we practice virtue in regard to its value to individual human beings other than ourselves that it rewards us the most." The greatest aids to joyful aging, then, are connectedness ("No one can live a solitary or a lonely old age when feeling understood by those who matter in his or her life" ) and forgiveness, for "every retained grudge is a clue to immaturity."

Chiefly, as we approach the end, our prize is wisdom. If we retain our "receptiveness to change," if we continue to grow, Nuland feels, we acquire a wisdom that leads to love for our fellow humans and an understanding of how to die, which Montaigne pointed out is also understanding of how to live.

Fittingly then, it is Montaigne whom Nuland quotes toward the close: "I want Death to find me planting my cabbages, neither worrying about it nor about the unfinished gardening."

Andy Solomon teaches literature at the University of Tampa.