Sixty by Ian Brown

Author:Ian Brown [Brown Ian]
Language: eng
Format: epub
ISBN: 9781615193516
Publisher: The Experiment
Published: 2016-04-07T04:00:00+00:00

AUGUST 6, 2014

I have decided to grow a beard. My plan is not to shave it off until I turn sixty-one. My wife is against the plan. “It makes you look older,” she says, which in turn makes her look younger, or at least as if she is with an even older man. But a beard, I feel, has the charm of stating the truth, of purveying no false advertising on this human package. In any event, the beard is coming in white and grizzled. It does make me look older.

I am on my way to Rockport, Massachusetts, on Cape Ann, north of Boston, to spend two weeks at my brother’s house by the sea. I plan to read and write and swim.

On the way, I have stopped in the Adirondacks for a couple of nights to visit Tecca and Al at their place here (Tecca is turning sixty herself this month). They seemed very happy to see me, which I took as a compliment. The last time I saw Al, in the Cotswolds, he was still trying to understand what had caused him to pass out on that bike ride, and why his eyelid wouldn’t quite open. Within three minutes of my arrival today, he told me that he has been diagnosed with an autoimmune disease, myasthenia gravis—a chronic (not good) autoimmune (not good) neuromuscular disorder characterized by fluctuating weakness of the voluntary muscle groups (i.e., that eyelid). The incidence is 20 out of 100,000 people, which speaks to the bad luck that can beset you after sixty—eventually it besets us all—but which seems graver in the young. But luck is relative: Tecca mentions an old pal from high school who has been dead ten years from breast cancer. Al is unlucky, statistically, but the friend was unluckier.

The good news is that myasthenia gravis is not fatal, and that it can be managed, even suppressed; that is what I wanted to know first and foremost. Myasthenia gravis occurs in all races, both genders, and at any age, though onset at fifty to sixty is commoner among men. (Al almost made it out of the danger zone.) When a nerve sends an impulse to a muscle telling it to move, a chemical in one’s synaptic fluid called acetylcholine travels across the space from the nerve ending to the muscle fiber side of the neuromuscular junction, where it attaches to many receptor sites. The muscle contracts when enough of the receptor sites have been activated by the acetylcholine. But someone with myasthenia gravis can have 80 percent fewer receptor sites because of the presence of an antibody that blocks or destroys them (and which, in an uncompromised body, would attack viruses and foreign proteins like, say, Ebola, which has just landed in New York City as I write this. Is the world coming to a fucking end?). There are a number of treatment options—including plasma exchange and the removal of the thymus, which sound, respectively, futuristic and extreme. The most common treatment is steroids such as prednisone.

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