AGEIST: Yes, working is living if it’s work you love.
CM: And find your purpose, and also have partners. I want to still be part of that dance where you have a partner who loves you and you have a family that loves you and you don’t want to leave yet. It’s not time to die. My patients give up when they think, “I am only in the way of my kids.” That’s when they die. They think, “I don’t have a reason to be here.” That’s when they die. And I have patients who are CEOs and still running companies in their 70s. They are not going to give up. They are the founders of the company; they are not turning it over to their kids. They are vital: “I don’t have time to die, I am too busy to die.”
AGEIST: I love that. It seems to me some of what you’re speaking about has to do with— these people all have a certain curiosity. You mentioned in your email that you were writing something about women over 60. What’s that about?
CM: That was a chapter in a book [by] Dr. Joyce Knudson, a Ph.D. in Psychology. I write a chapter about rejecting stereotypes. It talked about how we approach aging, and I really came from the message that I have always rejected stereotypes so I would do that as well when it came to aging.
AGEIST: Ah yes. I mean why stop pushing on the expected. Right? You were the first Rear Admiral of Filipino descent, first woman White House Medical Director; I can’t imagine you doing anything other than living the life you want to.
Even so, It’s very interesting that you talk a lot in your book about how you felt like you were never quite…
CM: Good Enough.
AGEIST: But you made yourself not just good enough but you made yourself better than everyone.
CM: But you know a part of this is that you’re just competing with yourself. You grow up in a family that says, “Don’t be big on yourself, you’re just got to be humble.” But part of it is, I always believed that I can be an example to somebody else and give them a hope. And it is not about me being great, it’s me being an example to somebody else to give them a message that they needed to hear, that: “You’re not old,” that, “You’ve got years ahead and it is not too late to look better. You don’t have to look 20 but you can look a really good 60 years old.” I have been vain enough to train myself not to read the menu with reading glasses because automatically makes you feel older.
AGEIST: So you clearly don’t feel 60. How old do you feel?
CM: Probably in my 30s— without having anymore periods, which is nice. Probably 30.
AGEIST: Tell me a bit about this investigation you are doing into longevity. You mentioned The Blue Zones. What are your findings on longevity that really interest you?
CM: You know, I based it on my experience with presidents. I read The Blue Zones. I think that it’s fantastic. I loved studying what makes those civilizations, those cultures live until they’re a hundred. But the thing is, I don’t live in Loma Linda, I don’t live in Costa Rica, I do not live in any of the Blue Zones. But what it is about them that I can remind my patients every day? And what I have done is looked at how presidents lived, having known 3 of them. Even after they left office…the presidential perk is you outlive your constituency. And I call them “The Eleven”—which I won’t reveal, because I will put them in the book—but it is also looking at the longevity...they are physically active, they are always moving, none of them are obese and really it’s a mindset that they truly believe they have a calling in this life.
AGEIST: What I am hearing you say is, really the defining variable is this idea of having a purpose. People talk about diet and exercise and courage and curiosity, but what I am hearing you say is that it really comes down to the purpose. This sense of purpose is what drives the rest of it.
CM: Exactly: “Why I am going to look at that if I don’t have any reason to be here?” I took tennis lessons way up in Colorado. My instructor is 70. He just won a tournament. He is running around at [high] altitude, slamming tennis balls and he is 70 years old. At 70 people say, “Wow… a senior citizen.” One of my oldest patients is 91 and he plays doubles tennis.
AGEIST: If someone is our age and they have this expectation that they think they are going to live much longer, they then tend to live much longer. What are they doing?
CM: Number 1, they don’t do risky things, but they also are pro-active. They don’t wait for things to happen to “get fixed.” They come in for their annual physicals, their colonoscopies, they get their prostate checked. They make sure they avoid the preventable things that fall on people. They listen to their bodies…they are religious about working out. They want to look young, they also want to look younger than what they are.
AGEIST: So people manage physical risk, but what about other sorts of things people may think would be risky?
CM: Yeah they will take a business risk. They realize, “Do I want to do the same thing I am not happy with? Do I really want to do it for next 30 years?” It’s like a bad marriage. “Do I really want to be stuck? So I will make a leap of faith.” Part of it is hope. Hope that it’s going to be better than what I have experienced. The other is taking the risk knowing that you also have financial stability…that is when they do the encore careers.
CM: What are you going to do? If you won the lottery today, let’s say you won 180 million, what would you do? How would your life change? Get more stuff? Not really. What are you going to do?
AGEIST: And how do people approach that question of essentially reimagining, reinventing. How do they do that?
CM: They look at what brings them joy, because instead of the things they had to do like a career to support their family, it’s what they want to. They go from have to, to want to. You know if money wasn’t the issue, what you would be doing tomorrow. For me, I will love doing what I do. If I had [won the] lottery and hired another doctor on this practice and make visits periodically to see the patients, I would be writing. I’d be writing full time because I like doing that, and speaking. Writing and speaking, because those bring joy. And doing my radio show, that I like doing. I will be doing that.
AGEIST: We talked a lot about people not wanting to age. “Raging against aging” I think is what you said. You think society as a whole perceives people who are older…
CM: It’s all the unglamorous things that Hollywood does, it’s all the marketing. Aging has gotten a bad rep. It is almost equivalent to being useless.
CM: But I look at my dad, he is 91, he is retired military guy, retired post office, and he lives in the same house he lived in 1970. My brother lives with him. My dad doesn’t drive…he walks one to two and half mile every other day. He gets up every day and works on the garden. [If] you put him in a nursing home and he couldn’t take care of the garden, couldn’t make sweet tea, he will die. I am certain of it. He works on his garden every day, he has a project every day. That mentality— he always worked hard all his life. My patients to whom things have been given are really the losers, because they don’t have the “can do.” They have never struggled. For my patients who have always been sort of the feisty ones, they have always fought for things all their life, they have always struggled, they have always worked hard, they have not been lazy, and nothing has been given to them.
AGEIST: So you said, maybe society thinks that old is useless, then we have this group of people who are really determined to stay purposeful and significant. If there is all this messaging coming at us, that we at a certain age should be useless, we need to be able to fight against this. I thought that was really interesting about the people who were given things early on, they are the ones having problems because they are not ready to resist and make their own way.
CM: No, because all was given and there is no reason to work for anything. Right?
AGEIST: And perhaps the fight now is this fight; it’s actually the same fight that you had when you were younger, the fight of the internal message or the internal truth versus the external messages coming in.
CM: Yes it is interesting for you to do an article of every person over 60, over 70, who still works full-time. What they do? You know many people are still employed, I mean look at the presidents. Potentially you may have a president who is 68 years old. (laughs) I mean look at who you got running for office. None of them are 40 or 50. They are all older, they are in the 60s. So look at these people, how old they are. Look at world leaders, how old are world leaders.
CM: Look at Warren Buffett. Look at all the billionaires, guys on Wall Street who run companies. How old are the big ones who run companies? You know the companies that don’t have the restriction on age and you can be here as long as you want. I mean the guy who handles my finances at Morgan Stanley is 60. I ask him, “How long do you want to work?” He said, “Until I die.” Until as long as your brain works, you know. He does what he loves.
AGEIST: These people have real sense of agency in the world.
CM: Yeah, Yeah. You can’t wait. We need you.
CM: You essentially become ageless. You know when you look at age you are ageless. At that point it does not matter how old you are if your brain still works. You are still able to get around. I mean, if you are still able to function, you have a purpose. Does it really matter how old you are after a while? No, in Hollywood it does because they look at how you look, they worship what looks like youthfulness, but again you are having actors like Meryl Streep who is what, in her 60s, Helen Mirren, who are still very very good actors. Still they have not given up.
AGEIST: One of the things I read was Madonna who gave a rant about ageism —she and I are the same age —and how her feeling was that racism is kind of out of the window now along with sexism, sexual orientation, and all that is left is ...
CM: Ageism: “They are picking on me because I am old.”
AGEIST: Right, exactly. That’s the last thing you can make fun of somebody for. How do you feel about that?
CM: Yeah I agree, it’s the last thing. You know, when someone says “old person” you think of somebody in a walker who’s got a Cassidy or a diaper.
CM: Look at the rockstars. One of my patients is the doctor of the Rolling Stones. Look how old Mick Jagger is. On stage they dance around, they have incredible energy. They smoked, they have young wives and children. But they are out there, and they have tremendous aerobic capacity because they are out there bouncing around entertaining. I mean, they are working.
But they are still vital. I mean, so the point is, does it matter? Since I would say if someone dies at 60 or 65, that is not old. 70 is young. 80 I called “the glide”; we fly a lot so, “final glide slope.” Getting up to 80 can go very smooth and then from 80 to 90 can be an acute drop or very smooth. Depends on what you can do to lessen the trajectory and how severe that angle is to 90. How you can minimize that is by being slender, being active, being purposeful. Part of it is access to good care, making sure you are get checkups. You know, listen to your body…have a doctor who listens to you.
AGEIST: How do you feel about people doing hormone replacement?
CM: I do it. Oh I do. I think it is important. My own story-- yeah, I started doing [testosterone] pellets and estrogen. I absolutely do. I mean, you look at the risk versus the benefit, and the whole thing with the women’s health care initiative that came up 10 years ago. They reversed the lot of the risk factor. I mean what you have to do, is talk to your doctor individually, one on one. Meet with your doctor, look at your risk factors for cancer. It’s not been proven that hormones cause cancer. What they do is, if you have breast or prostate cancer, they make the cancer grow faster. But they don’t cause it.
CM: But what I noticed from my experience and my patients, is that women that go into menopause, the brain fog, the feeling old, the waking due to lack of hormones; body is dying. So if you have the technology to slow that down by replacing hormones, why not do it? People will go, “Why would you do that? That is not natural.” What about antibiotics? We use antibiotics a lot. That is not natural. So why? I mean, you have the technology and we keep an eye on our patients, we monitor them, make sure we do no harm. They feel great, their minds are active. We think it gives them more time, so be it. The quality of life is so much better.
AGEIST: Right. Absolutely. I am glad. I am glad to hear you say that. I think a lot of people take an almost religious approach to this, which does not make a lot of sense to me. And as you said, antibiotics aren’t really natural so… (laughs)
CM: I mean, God, there is a lot of stuff. I mean, my gosh, why not?