Barrett L. Dorko, P.T.

          Did you know that you were once able to order an entire house out of the Sears-Roebuck catalogue?

          You were responsible for digging your own foundation, but beyond that, the whole thing would arrive by train and then be dumped on your lot, each piece numbered for assembly.

          I know this because I grew up in a Sears home. Our model was called "The Westerly", and seventy years after Mel Jenkins (a local undertaker) ordered and had it put together, it still stands there on Dover Center Road in Westlake. Jenkins Funeral Home still thrives just three doors away, now run by Mel's grandson, Keith. We were in the high school marching band together.

          I'm certainly no expert on geriatric care, but on some days the majority of my patients fit that category. I've learned not to assume that this will mean anything predictable about their complaint of pain. I honestly don't feel that chronic or even acute pain is a natural consequence of aging. The behaviors that concern me simply cannot be said to appear more readily at a certain age. I've seen too many exceptions to any rules about this to try to predict it any longer.

          The home I knew as a child is different today, and different in ways that will never allow it to be restored to its youthful appearance. As I walk about, I see the effects of prolonged settling in the basement, I sense the stillness of some of the rooms no longer visited by me or my far flung siblings, and I see the roof being reclaimed by the vines that we would have trampled to the ground in our play.

          I notice that this home somehow requires less of the vigorous labor that my family would often dedicate itself to, or fight over. The big events, the gatherings, are few here. The house is through trying to impress strangers with its appearance.

          Often I see patients about the same age as the house on Dover who are not as concerned with health as they are the appearance of youth. They constantly elevate their diaphragms in an effort to flatten their stomachs. They yank themselves erect even though a little settling of their posture would feel much better. In short, they pretend to be something they're not, physically at least. Most of the time they've learned by now that verbal authenticity is the healthiest way to be in the world but, until they meet me, nobody has given them permission to be physically themselves.

          I give them a line from the Nobel laureate poet Derek Walcott; "The day will come, when, with elation, you will greet yourself arriving at your own door".

          People long estranged from their own bodies will often find great comfort in these words if they are said at the right time, by the right person, in the right way. I think it's part of my job to find those moments.

          Now when I return to the home that watched me grow, I simply note that it is clean and safe, warm and dry. I know that its architecture is outdated and its plumbing a problem at times, but it will do nicely for those who love it, and remember how it sheltered them.

          Sometimes I can get an older patient struggling with the bodily changes that time provides us to feel the same. They can learn to come back to a place that is familiar and warm, even a little homely.

          When they find comfort there, the pain they assigned to aging just might diminish a bit. And major alterations in their appearance don't seem nearly so important.