from THE GLOBE AND MAIL, Feb 20, 2019.

Like pretty much everyone of extraordinarily advanced age, Dr. Robert Wiener was continually peppered with one question: “What’s your secret?” He preferred to show a visitor rather than tell them. After cordial small-talk about politics and hockey, he slipped into his workout togs and, moving his dumbbells out of the way, hopped on the CCM stationary bicycle that sat next to the window in his top-floor residence overlooking Montreal. And then, with St. Joseph’s Basilica looming below, he demo’d his daily regimen: fifteen minutes fast, then fifteen minutes with the tension cranked up, until he was sweating.

The retired oral surgeon, who died on February 17, was Canada’s only male supercentenarian, a term reserved for people who are at least 110 years old. A highlight of his 55-year career was founding the dental clinic at the Jewish General Hospital for those of limited means. When he graduated from McGill University’s dental school, most people were still brushing their teeth with short pieces of bone fitted with pig bristles or badger hair; the first modern nylon-bristle toothbrush wouldn’t go on sale until two years later, in 1938.

According to the UCLA-based Gerontology Research Group, which tracks and verifies supercentenarians, Dr. Wiener is considered the oldest man ever to be born and die in Canada. There are thought to be between 600 and 1,000 supercentenarians in the world, the overwhelming majority of them women. Dr. Wiener, at 110 years and 113 days, was believed to be the 18th-oldest man on Earth.

Dr. Wiener was fastidious about his healthy habits, including a Mediterranean diet, regular exercise, a cultivated optimism and two squares of dark chocolate a day. His daily perusal of The Montreal Gazette and numerous health journals he subscribed to online may also have been medicine, although he mostly did it for fun.

Robert Manuel Wiener was born in Montreal on Oct. 27, 1908. The youngest of seven siblings (“I was the one who always had to run the errands,” he once told The Canadian Jewish News), he grew up in the Mile End neighbourhood – Mordecai Richler’s stomping ground – an ethnically rich area of fruit sellers and outdoor staircases where his parents, Louis and Anna, immigrants from Poland and Russia, respectively, had settled after moving from Amsterdam, where they met.

In grade school, he and his classmates knit towels for the soldiers in the trenches – of the First World War.

With no mass media as a diversion – commercial radio didn’t arrive until he was 12 – there were a lot of pick-up games of almost every sport. Street hockey was interrupted not with shouts of “Car!” but “Horse!” (A hockey fanatic, Dr. Wiener remembered rising from his seat in the old Mount Royal Arena, then home of his beloved Habs, to watch speedy Howie Morenz take the puck end-to-end himself – a testament to both the centreman’s skill and the fact the NHL didn’t allow forward passing in all zones until 1929.)

He was 13 when Charlie Chaplin’s The Kid opened at a cinema on St. Catherine Street and in his 20s when women became “persons” under the law in Canada.

He followed his older brother Judah into dentistry and his career in oral surgery included teaching dentistry at McGill for 25 years.

One measure of the spread of Dr. Wiener’s life was the number of his Zelig-like brushes with history, as cultural figures one after another somehow ended up his chair.

In 1942, while Dr. Wiener was chief dental surgeon at the University of Chicago, Enrico Fermi and his team took over the squash courts under Stagg Field to make the first nuclear reactor. When Mr. Fermi developed vision problems that no specialist could solve, it was finally suggested they look south, at his mouth. Dr. Wiener took X-rays, then extracted an abscessed molar that was pressing on the optic nerve, restoring the great scientist’s eyesight.

Four years later, the novelist Thomas Mann came striding in. The German Nobel laureate, then based in California but passing through town, complained of a toothache on the left side – just like the character Thomas Buddenbrook in the eponymous novel. (In the book, the dentist buy ambien cr 12.5 mg online wrenches out the tooth and soon after, the man falls dead on the street of a stroke – and Buddenbrook Syndrome becomes a medical term for toothache as a potential red flag for cardiac stress.)

Curiously, Mr. Mann appeared to speak no English, instead asking his wife to translate every question, right down to “Where does it hurt?” But at the end of his last appointment, he extended his hand and said, impeccably, “Thank you very much, Dr. Wiener.” And presented him with an autographed copy of The Magic Mountain.

Missing continuing contact with patients, Dr. Wiener left the University of Chicago’s Zoller Clinic and returned to Montreal, where he set up shop on Mackay Street in downtown Montreal. Dr. Wiener’s easy manner provided a kind of sanctuary unusual for a dentist’s office, and he soon built a client list that included Montreal business royalty – among them most of the Bronfman family.

In 1968, Charles Bronfman, then the new majority owner of the fledgling Montreal Expos, arrived for an appointment. It was stressful early days, with stadium issues and other hiccups making league brass nervous and there was a real chance the club would be moved. Dr. Wiener delivered just the right tonic. “My son’s very excited about the team!” he said. The next day, a limousine appeared at the house and when young Neil opened the door, the driver handed him an Expos cap – signed by Mr. Bronfman himself, because no actual players had been drafted yet.

Four years earlier, in 1964, Dr. Wiener took on a patient whose fine dress and old-fashioned manners belied his day job of sausage-making and intimidation. This was Vincenzo (Vic) Cotroni, a.k.a “the Egg,” the local capo for the New York-based Bonanno crime syndicate at the time, charged with overseeing heroin trafficking out of the port. Some called him the Godfather of Montreal. Mr. Cotroni would arrive for his dental appointments flanked by a bodyguard and accompanied by either his wife or mistress. He always paid cash and was the only patient who ever tipped Dr. Wiener’s assistant.

Twin studies have established that, on average, longevity is around 30 per cent determined by genes and 70 per cent, lifestyle and environment. But considering Dr. Wiener’s advanced age, he was undoubtedly very lucky in his DNA. His ferocious good health spoke to a genetic tailwind scientists are still trying to understand. Indeed, nine years ago, Angela Brooks-Wilson, a geneticist and researcher at BC Cancer, collected DNA samples from both Dr. Wiener and his older brother Dave – a near-supercentenarian himself at the time – as part of her study on “super seniors,” investigating the puzzle pieces of healthy longevity.

There is no known case of two supercentenarian men in the same family. The Harvard geneticist George Church put the odds of it happening at north of one in 100 million. The Wiener brothers – Robert, who was 110, and Dave, who was 109 and 324 days when he died – may have come closest. Indeed, an online community called “The 110 Club,” peopled with supercentenarian enthusiasts and curated by the head researcher for the Gerontology Research Group, saluted the pair in a post on Oct. 27, Robert’s birthday. “Together, they are the oldest known brothers of all time – not counting Joan and Pere Riudavets, who were half-siblings. Happy 110th birthday, Dr. Wiener!”

Even well into his 110th year, Dr. Wiener prided himself in not asking for help with routine tasks; he got himself out of chairs and picked up dropped pencils. Apart from hearing issues, he had no real health complaints until the very end.

The only thing he suffered from was heartbreak.

Ella, his wife of almost 73 years, died seven years ago. In her last years, when he was more than 100 years old, he cared for her by himself. Dr. Wiener was not a religious man, but after she died, he burned the Shabbat candles, not so much in honour of her faith, but in honour of her. Although it wasn’t strictly necessary for support, he often picked up her cane while going out. “It’s like holding her hand,” he said.

from NEW TRAIL magazine, July 2018. Illustrations by Hugh Syme

In June 2015, Megan Strickfaden and her grad student Nicole Gaudet arrived at a little village on the outskirts of Amsterdam with a Harry Potter-ish name: De Hogeweyk. An octogenarian gentleman was visibly thrilled to see them.

This called for wine.

He took Strickfaden by the arm and squired her into the village grocery store, she recalls. He found a nice red and brought it to the till. He pulled a handkerchief from his pocket and paid for the wine with it. The clerk accepted the payment, bagged up the wine and gave the man back his handkerchief as change.

To its residents, De Hogeweyk — a dead-ringer simulation of a traditional Amsterdam village — isn’t a cutting-edge experiment at the frontier of humane dementia care. It is simply home. They cruise on tandem “cosy cycles” down the cobblestone streets. They munch pastries in the café, catch films at the cinema. They wander among gardens so cunningly designed as to appear limitless. They return to family-sized living spaces that closely match the tenor of the household they grew up in, whether country-cosy or artsy-cultural, full of music and light. Trained geriatric nurses and caregivers form a kind of stealth army of invisible support. They’re dressed not as authority figures but as shopkeepers, neighbours, friends, perhaps relatives.

People with dementia, it turns out, are especially good candidates for such interventions. “A person with dementia is suggestible,” Strickfaden says. “You work with that.”

Elements similar to the De Hogeweykian approach are being introduced in care facilities around the world. One of these is Canterbury Lane, the dementia wing of the Canterbury complex in west Edmonton. Strickfaden, a design anthropology professor in the Faculty of Agricultural, Life & Environmental Sciences, has been hired to consult on the multimillion-dollar revamp. It will include features such as a garden that allows residents access to the outdoors without having to be escorted. Hallways that don’t dead-end, but loop back into the heart of the action. Little designated spaces for purposeful activity, such as folding laundry. And a cottage system of living spaces divided by theme or feel, matched to the residents’ upbringings.

The renovations will take close to four years. Unfortunately, the resident in one room is unlikely to live to see it completed. That’s just my guess, knowing that resident quite well.

She is my mother.

More than 50 million people worldwide are afflicted with dementia right now. And since the human lifespan is increasing more quickly than medical science seems to be closing in on a cure (which is to say, not quickly at all), dementia will be part of all our stories: your story or the story of someone you love very much. “Its shadow lies over us all,” writes Jay Ingram in his book The End of Memory.

So what to do — beyond saying a prayer and giving power of attorney to your most trustworthy blood relative? As recently as 20 years ago, people living with dementia who could no longer manage in their homes were simply institutionalized. In that setting, doctors were authority figures and patients were the passive recipients of meds, directives — and very little in the way of treatment.

But another paradigm is emerging. Dementia treatment is coalescing around the idea of patient-centred care.

In an analysis of dementia care studies published in 2015 in the Journal of the American Geriatric Society, researcher Hannah O’Rourke, an assistant professor in the Faculty of Nursing, found four things are of central importance in working with people with dementia. A sense of place. Connection to others. A sense of purpose. And shoring up those three poles of the tent supports the fourth, which is linked to physical well-being: a sense of wellness.

So, while scientists continue their search for ways to prevent and treat the disease (See The Elusive Cure), caregivers are doubling down on tactics that promise benefits right now. Call it the “3 Ws” model of dementia care: focusing on the Where, the Who and the Why of the subjective experience of this devastating syndrome.

To family members, the hardest part to fathom about dementia is the staggering difference between Good Days and Bad Days. Good Days make you second-guess your decision to move your loved one out of their own home into extended care. Bad Days grimly confirm it.

On a recent visit, my mom positively lit up when I walked through her door. We spent a great day together, at the end of which I promised I’d be back tomorrow. Ten-kilowatt smile. But when I walked through her door the next day, she greeted me with a face that looked as if a bad fish needed taking out. “What are you doing here?” she snarled.

Mom was officially diagnosed with Alzheimer’s when she failed the “mini-mental” exam 10 years ago, at age 84. Though in truth, we noticed her slipping as early as her late 70s, one “W” after another. The “where” seemed to go first. On an Alaskan cruise, to celebrate her “80th year,” she struggled to find her way back to our cabin and had not cracked the nut even by our last day at sea.

Then the “when” became wobbly. On a visit to the West Coast, she became deeply concerned that we’d miss our flight if we didn’t leave right now. So I raced us to the airport, only to hear upon our arrival: “Why the heck are we here so early?”

Social filters fell away. Mom started making derogatory comments about people standing right next to her. She began repeating herself every 30 seconds. Sometimes she noticed herself slipping. “I feel like … I’m … not right in the head!” she’d say and she could barely contain her terror.

The changes in her reflected the brutally quixotic nature of the disease. Like a tornado through a trailer park, it destroys some faculties while leaving others bizarrely intact. On a recent visit, I told Mom it was our dog’s birthday — we were having a couple of the neighbourhood pooches over to celebrate.

“Penny,” she said, remembering the name of an animal she’d never met. “How old is she, again?”

“She’s four.”

“So, our 28,” Mom said instantly.

Sometimes my sisters and I leave the facility feeling gut-punched, yearning for the sweetness we know is in Mom to surface more often. And our questions are everybody’s questions: what must it be like to be her? And what can we do to help make this a little more bearable — for everyone?

Are We Our Memories?

Who are we without our memories? For people with dementia, recovering even some of the experience they have banked is a crucial part of feeling, well, like themselves again.

One theory of dementia-related memory loss is that it’s a retrieval issue, rather than a data-loss issue. In other words, the memories are still in there, only their tags have fallen off. In recent years, researchers have experimented with using sensory triggers to call some of those memories up.

In Scotland, aging soccer fans living with Alzheimer’s are exposed to reconstructions of big games. In North America, people with dementia are supplied with iPods loaded with personalized playlists. Out of Sweden comes an ingenious invention called the BikeAround: a stationary bicycle attached to a wrap-around movie screen onto which a moving landscape is projected. Plug in the client’s childhood-home address on Google Street View and suddenly there they are, back in the old ’hood, cruising down streets they probably haven’t since they were a kid on a Schwinn.

Reminiscence therapy, this kind of intervention is sometimes called — and preliminary research suggests it can not only boost happiness levels but improve cognitive function. This year, the Canterbury Lane staff tried a simple version of it in the run-up to Mother’s Day with a scrapbooking activity. Family members were asked to contribute photos of mom or dad through the years, surrounded, if possible, by the people they have loved the most. “You’re really trying to get them to live in those moments,” activities supervisor Mbalia Kamara told me. “And then to really validate the feelings that emerge.”

For Mom, it was pretty profound. As she turned to a snapshot of her and Dad circa 1980, both of them tanned and smiling in Hawaiian sunshine, she began to cry. A staff member allowed her to sit with that sadness for a few moments, and then steered her toward the light. “He must have been a great guy,” she said. “Tell me about your wedding day.”

The tonic here, as much as the memory work, is the attention. People with dementia often lose their voice as the disease progresses. The world stops listening. “People used to think that because there was cognitive impairment there wasn’t insight — but that’s not true,” says nursing professor and researcher Hannah O’Rourke. “People with dementia still know what they like and don’t like.” To pull that insight out is not that difficult, she says. “You ask. You just ask.”

A couple of years ago, Elly Park, a post-doctoral fellow in the U of A Faculty of Rehabilitation Medicine, undertook a project with researchers from Simon Fraser University and the University of Toronto on digital storytelling. Facilitators helped people with dementia create a digital story with photos, music and narration by the participant. “Storytelling is a tool,” writer Ursula K. Le Guin put it, “for knowing who we are and what we want.” People with dementia are no different from the rest of us in this way. Park’s research found that encouraging participants to think about and share meaningful stories enhanced relationships with caregivers, increased communication and interaction, and gave participants a sense of accomplishment. “In several cases, participants said they surprised themselves with the stories they were able to remember,” says Park.

With Mom, I have found that if I press her too much for family history, she often clams up. For her, the fact-finding is stressful. This is not uncommon. That’s why University of Wisconsin theatre professor Anne Basting received a MacArthur Fellowship, sometimes called a genius grant, for her invention called TimeSlips. It replaces “the pressure to remember with the freedom to imagine,” as she puts it. TimeSlips is like a book club where no one has read the book, except in this case it’s a photograph. Each photograph is striking and mysterious. It looks as if it has a story to tell, so everyone makes one up. There’s no way to be wrong, which seems to loosen tongues. “The absolute key to the entire process,” Basting says in a video about TimeSlips, “is that we validate everything they say.” This sounds like — it is like — improv theatre.

Something a little magical happens when we start telling stories to each other, whether they’re true or not. Neuroscience has shown that it boosts the sense of connection between the teller and the listener. As the story unspools, the brains of teller and listener sync up — a phenomenon psychologists call “linguistic alignment.” Another bonus: for people who can no longer have out-there-in-the-world adventures, storytelling is an excellent proxy. It stimulates many of the same parts of the brain that light up when we are actually experiencing things — just as reading does.

For the scrapbooking exercise at Canterbury, not all the families contributed photos. So those residents instead received pages of their scrapbooks with stock photos of a random family. Which sounds a little sad but turns out to be a perfectly serviceable alternative. “Just the idea of family can get people talking about their own,” says Kamara.

For some reason, my own earliest memories of Mom are all tagged to scents: the cinnamon-y Bee Bell Bakery, the chlorine of the Y swimming pool, the baseball-mitt smell of Jack and Jill Shoes. We’d march into these places hand-in-hand and, invariably, she’d spot someone she knew and tractor-beam them in with her smile. She’d let go of my hand — she needed both of hers to talk — and that would be it. I waited beside her as ice ages came and went. Eventually she’d track me down in some corner of the facility. I could smell her coming.

But wait: how many of these details are true? “Every act of memory is to some degree an act of imagination,” the neurologist Oliver Sacks wrote. We’re all unreliable narrators. That doesn’t mean we all have neurodegenerative disease; dementia in its various forms is a syndrome with specific physiological signatures. But it does mean that people with dementia cannot be dismissed as Other. Every time we call our kid by the dog’s name or drive off with our coffee cup on the roof, the difference between the two worlds, practically speaking, grows moot. And somewhere a busker plays There but for Fortune.

Our Purpose, Our Selves

“If the residents here were able to describe their biggest frustration, what would they say?” I asked Wendy King, executive director of the Canterbury Foundation, not long ago. “I think maybe they would say, ‘You don’t understand me,’ ” she replied.

Hence, a recent trend in dementia care toward what you might call deep client profiling. In the old days, staff received an incoming resident’s medical charts, some basic biographical data and not much else. Now, families are often asked to flesh out the story of mom or dad. The more data, the greater the likelihood a resident ends up where they belong, doing things that pluck the strings of their hidden enthusiasms.

At Canterbury, one resident used to be a millwright, so he’s routinely given things to tinker with. Another was a homemaker who raised a big family. She struggles to find words and can get frustrated and withdrawn, but she positively melts when handed lifelike “Baby Sophia.” She dresses the doll in tiny clothes warm from the dryer, whispering and cooing to her and, after a while, “she’s more open to the activities the rest of us are doing,” says Kamara.

But there’s purpose and then there is purpose — something closer to what the Japanese call ikigai. Roughly: the sense that life is worth living because we are needed here. Japanese research has found that people with ikigai live longer. A study published in JAMA Psychiatry in 2012 found that people with Alzheimer’s who are animated by purpose staved off cognitive decline longer. No one knows quite why it matters to feel as if we matter — only that it does.

“Feeling you matter is at the core of being a person,” British dementia consultant David Sheard often says. “Knowing you matter is at the heart of being alive.” Sheard is the founder of Dementia Care Matters, better known as the “butterfly” model of dementia care. I could see its principles in action the day I visited Copper Sky Lodge, in Spruce Grove, Alta., Canada’s first butterfly facility. Copper Sky’s CEO is Phil Gaudet, well-known in Alberta as the former head of the Good Samaritan Society, a long-running non-profit care provider. But the lodge is mostly run these days by his daughter, Nicole Gaudet. The same Gaudet who, with her thesis advisor Strickfaden, was embedded at De Hogeweyk.

As dementia advances and individuals turn inward, they’re less able to seek out the multi-sensory stimulation they may need. So the stimulation must come to them — as butterflies come to flowers. “Even things like this soft sweater I have on are part of it,” Gaudet says of the fuzzy sweater she’s wearing. “I’ve been getting lots of hugs today.”

At the centre of the butterfly model is emotion. The theory: people will forget what you say, and even what you do, but they will never forget how you made them feel. That’s because feeling is processed in a more primitive part of the brain; it’s protected, in a sense, from the damage to the neocortex that dementia causes. And so the staff at Copper Sky are trained to circulate, alighting here and there, touching, affirming, offering a cup of tea or a taste of mint, introducing short activities. “Ultimately, we are all feeling beings,” says Gaudet. “So if you can connect to what somebody is already feeling, you’re four steps ahead.”

But there’s research and then there’s practice. Changing how we care for people with dementia isn’t easy. After their experience at De Hogeweyk, Strickfaden and Gaudet were gung-ho to update legislation around dementia care in Canada. They soon discovered they were facing frustrating headwinds, some of which were cultural.

A country’s dementia care can reveal a lot about its values. China, for instance, is a culture of service, notes Strickfaden. “But that can actually get in the way of good elder care. People are literally served to death.” The Netherlands is big on personal liberties. How far you want to push your limits is up to you, within reason. Quality of life reigns supreme.

Canada has made a different choice. Here a dementia-care facility gets accredited or not based in part on how safe it’s deemed to be, says King, head of Edmonton’s Canterbury Lane. So De Hogewykian elements like cobblestones, public fountains, accessible barbecues and knives, unfenced kitchens are red flags. In Canada, safety trumps freedom. So does efficiency. Funding here is task-based. “Staff have a task list and a limited amount of time to do it,” says King. “So if a resident puts up resistance, it creates stress — because the staff person knows, ‘I’ve got to go to Mrs. Jones next.’ ”

The task-based funding model is, predictably, frustrating for more progressive voices in dementia care. “You’re regulating to the point of strangulation,” says Gaudet.

After Copper Sky received a poor grade in its first effort to become a certified butterfly facility three years ago, Gaudet spearheaded massive staff retraining. The first thing she impressed on caregivers is that human connection comes first. You are not going to be fired if you don’t get this task and this task and this task done, she told staff. Even though by some measures the extra TLC means more work for them, there’s evidence that such an approach leads to lower burnout, since it puts caretakers’ actions more in line with the reasons they got into this work in the first place.

“I would abolish long-term care in Canada and start over,” says Gaudet, “because I think we’ve got it wrong. We need to be given the freedom to deliver new kinds of care in inspiring environments.”

O’Rourke is cautiously optimistic about the future of dementia care in Canada. “If we — clinicians, researchers, community members, society — can set aside our own fears, assumptions and stigmas about the disease, there is hope. People with dementia have identified many ways to achieve a good quality of life. We just need to listen.”

one recent wednesday afternoon at Canterbury Lane, residents sat drowsing in easy chairs in front of an old Jimmy Stewart movie on the big-screen TV. My mother wasn’t among them. She likes the privacy of her room and to pick her own shows — and to crank up the volume.

On this visit, I had a plan. Having steeped myself in the Alzheimer’s literature and the best ideas of countless experts in multiple domains, I was eager to try a few things. I wanted to help Mom grasp where she is, who she is and why she is. I’d brought an artifact: a tennis racket. Not one of the fancy big ones people wield now but a vintage wooden one. This is what you used in the era when Mom learned to play, gliding around the shale courts of Garneau tennis club, not long after she and my dad met. People can see it on the wall and ask Mom about tennis. And maybe some of those locked-up memories — a serve tossed into the sun, the fitz of a new tin of balls, my dad so gentlemanly out there that he actually cheated against himself — will come rushing back.

Not long ago my sister Lynn noticed Mom paging through a magazine that had a big splash about the Royal Family. Mom pointed to a gentleman in a waistcoat. “That is the man I’m going to marry,” she said. A few years ago Lynn might have laughed or corrected her. But we have learned that it’s not our job to pull Mom back into this world. Our job is to meet her in hers. Lynn raised her eyebrows in enthusiasm, nodded and asked for details about the wedding.

These days Mom’s eyes reveal a lot. There’s not much reminiscing going on. Nor is there planning. The headlights reach to the next bend in the road and that’s it. But this is what people with dementia have, most profoundly, to teach us. They are champions at living in the now. The question, for all of us, is how can we make the now better?

I believe the answer is to just be there. Or in the case of my own too-infrequent visits, make sure I’m therewhen I’m there.

So Mom and I go for silent wheelchair tours to check out the action over in the nearby manor — past the kitchen, down the long, carpeted hallways. Little bios outside each resident’s door tell of their unique strengths. That’s right out of the David Sheard playbook: “Search for the treasure in each individual.”

“I’ve learned that if I attach too much to whether she remembers my visit, I’m going to be bitter,” Lynn told me on the phone recently. So you shift the bar. A cup of coffee, a stab at a cribbage game, a trip to the atrium to hear the piano player plink out Moon River: that is a win. We are not our memories.

Even though it sometimes feels that way.

from the NEW YORK TIMES MAGAZINE, OCT. 22, 2014

One day in the fall of 1981, eight men in their 70s stepped out of a van in front of a converted monastery in New Hampshire. They shuffled forward, a few of them arthritically stooped, a couple with canes. Then they passed through the door and entered a time warp. Perry Como crooned on a vintage radio. Ed Sullivan welcomed guests on a black-and-white TV. Everything inside — including the books on the shelves and the magazines lying around — were designed to conjure 1959. This was to be the men’s home for five days as they participated in a radical experiment, cooked up by a young psychologist named Ellen Langer.

The subjects were in good health, but aging had left its mark. “This was before 75 was the new 55,” says Langer, who is 67 and the longest-serving professor of psychology at Harvard. Before arriving, the men were assessed on such measures as dexterity, grip strength, flexibility, hearing and vision, memory and cognition — probably the closest things the gerontologists of the time could come to the testable biomarkers of age. Langer predicted the numbers would be quite different after five days, when the subjects emerged from what was to be a fairly intense psychological intervention.

Langer had already undertaken a couple of studies involving elderly patients. In one, she found that nursing-home residents who had exhibited early stages of memory loss were able to do better on memory buy cheap tramadol tests when they were given incentives to remember — showing that in many cases, indifference was being mistaken for brain deterioration. In another, now considered a classic of social psychology, Langer gave houseplants to two groups of nursing-home residents. She told one group that they were responsible for keeping the plant alive and that they could also make choices about their schedules during the day. She told the other group that the staff would care for the plants, and they were not given any choice in their schedules. Eighteen months later, twice as many subjects in the plant-caring, decision-making group were still alive than in the control group.

To Langer, this was evidence that the biomedical model of the day — that the mind and the body are on separate tracks — was wrongheaded. The belief was that “the only way to get sick is through the introduction of a pathogen, and the only way to get well is to get rid of it,” she said, when we met at her office in Cambridge in December. She came to think that what people needed to heal themselves was a psychological “prime” — something that triggered the body to take curative measures all by itself. Gathering the older men together in New Hampshire, for what she would later refer to as a counterclockwise study, would be a way to test this premise.

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