SOAP notes (Subjective, Objective, Assessment, Plan) are a traditional way of making entries into a medical chart. On this, my 68th birthday, my SOAP note:
Subjective: At his annual physical, or, rather, his wellness exam, Vince’s doctor enters the room with a cheery, “how are you doing today?” and Vince replies, “I was going to ask you the same. How *am* I doing?” “What do you mean?” “Well,” Vince says, “what is 68 supposed to feel like?”
Vince is a 68-year-old male who states he is in good but not great physical condition. He reports that he is active but not maniacal about it: fly fishing; long walks with his dog; nature hikes and photography excursions with his wife (the photographer). His chief complaint is that he’s 68. He reports that some days he says “I’m 68” with a vigor, a sense of wonder and awe that he made it this far. “Damn, life is really going well.” Other days, he’s all like “I’m 68. What the fuck is that pain?” His physical therapist asks if he has a fear of falling. “Every day,” he says. Not that he is afraid of falling every day ... just the fear lurks every day. And it’s not like he dwells on getting older, but he sees evidence that his body is aging. Physically fit, world-class athletes often talk about the realization that they have “lost a step” before they retire from the game. Vince reports that it is not the lost step that is bothersome but the awareness that he has lost a step. It’s not just that his hearing is fading, but the awareness of that loss. It’s not that he recognizes so few of the singers and songs on the Grammy’s or the CMAs, but that he is consciously aware that he doesn’t know them. They’re just kids; are they even out of junior high school? He won’t admit that he silently longs for the Country Music Awards with singers and songs that he knew by heart. When did they disappear from the night? It’s not just that he isn’t cool, isn’t rad, isn’t hip anymore, but the awareness of his own uncoolness bothers him. He realizes that the coolness may have slipped away long before he realized that it had.
Objective: BP: 128/72. Pulse: 62. Respiratory: 18. Height: 6’4” and shrinking. Weight: 233 lbs and increasing. BMI: 28.8. Currently takes meds to treat the symptoms of this-and-that but those meds cannot address the cause: he’s 68.
Assessment: Diagnosis is that Vince has 68-year-old-ism. Could be worse.
Plan: Accept your body. Be grateful for your intellectual acuity and emotional stability. Take longer nature walks. Walk the dog more. Pet the cat. Take medications as prescribed. Meditate when feeling blue. Meditate when feeling joy. Snap that photograph. Monitor sugar intake, but for Pete’s sake, do NOT cut out all sugar. Sketch that flower. Be present. Write that poem. Hug your wife. Call your daughter. Live in the ever-present now.