Two months after turning 40 and it's finally hit me.  I think I have Post 40th Birthday Traumatic Stress Syndrome. 

It's one of those things you can't really explain to the "age is just a number" crowd.  Suffice it to say, if age is just a number it's an awfully funny one.  And not funny-ha-ha.  And while people say it to console you, they assume your anxiety has to do with your age relative to, say, theirs. But I don't look at it that way.  Age is relative to one thing: death.

Probability of death, to be precise.  It's really not about age so much as odds.  And your odds of living another day get longer every day you live. The odds aren't great to begin with — your odds of winning a 5/37 lotto game are better than to live another day — but according  to the venerable Gompertz–Makeham Law of Human Mortality your probability of dying increases exponentially with age — it essentially doubles every eight years, which means the probability of surviving to a particular age is falling super-exponentially — expressed mathematically as an exponential within an exponential. (Check out this handy death probability calculator for a demonstration.) 

Yeah.  It's ugly.

It's like from the minute you're born you're just waiting for the other shoe to drop. 

If you're still reading, it hasn't yet, of course.  As for me: just had my yearly physical last week and everything's in working order.  But I still can't shake this nagging sense I'm going to die someday, of something.  Now, I'm not one of those people who fantasizes about a violent death, or daydreams about drowning myself in the bathtub.  But it seems to me no matter how you go it's kind of a raw deal. I mean we're all fugitives.  On the run from death.

And all that's at just 40 and two months.  I can't imagine what 41'll be like.

So at my physical I told my PCP I was experiencing a touch of PTSD and thought I might like a psych referral.  He told me: "you know there's a wait list."  That's just what you want to hear when you're going off the deep end, innit?  I was like: "Oh, sure, ha ha, no biggie.  It can wait.  I mean, it's not an emergency.  The probability that I'll die before my next physical is — what? — only about 2.2%.  And anyway, who needs MENTAL HEALTH when you've got a bottle of peppermint schnapps under your pillow and Beverly Hills Chihuahua on your streaming Netflix?" 

No really, it's cool.  It'll give me more time to pore over my Emily Dickinson.  I recently picked up a reprint of the first collection of her poems (entitled Poems, go figure), edited posthumously by Mabel Loomis Todd and Dickinson's literary mentor T.W. Higginson (who discouraged her from publishing them in her lifetime)... 

Pain has an element of blank;
It cannot recollect
When it began, or if there were
A day when it was not.

It has no future but itself,
Its infinite realms contain
Its past, enlightened to perceive
New periods of pain.

See, there's always something to look forward to, y'know? 

Wait lists are great for that, too.  The anticipation.  Will this be the week, month, year, decade I get to see a mental health professional?  Could be!  You never know!  Better not leave the house!  They may call your number any minute!

No, that's not depressing at all.

I mean, of course there's a wait list.  It makes perfect sense.  I'm a reasonable man, and I understand that nobody has anybody to talk to, which is why there's a wait list.  I mean, I have plenty of people to talk to, but not to talk to talk to.  About things you don't want to talk about.  There are things you just know you should have to pay to tell people.  Why do you think we have prostitutes, hairdressers, cabbies, and shrinks?

Saying things changes them.  Hearing yourself say things — well, it's the difference between singing in your head and singing out loud.  Funny how you can sing arias like Pavarotti at La Scala in your head but open your mouth and it sounds like cats fucking in a back alley, innit?  Same principle applies to a lot things people think, or think they're thinking, until they try to put it into words and it basically sounds like cats fucking in a back alley, too.

If you have to pay someone to say things you're thinking all the better.  It'll teach you some restraint. You want that new pair of shoes, or you want to talk some more smack?  Your choice.  A listening ear is a luxury item. 

And if you think your friends and family want to hear it, I hate to break it to you.  You know how you end up paying for it?  By having to listen to them bitch and moan in turn, and who the hell wants to spend what little time they're not bitching and moaning listening to other people doing it?  Unless you're getting paid for it.  And the truth is: unlike, say, a cabbie, your friends aren't really gonna give you useful advice anyway.  It's always, "Oh, hang in there, champ!" or "You think you've got troubles — listen to mine!"

Sometimes you need to hear: "dude, if you weren't a paying fare I would be calling the cops on you right now.  You better be tipping."

My doc went on to politely explain how they prioritize psych cases according to other health conditions.  I'm at the Fenway now, and HIV+ and addicts get priority, he told me — which made me feel guilty for thinking I had problems — and then people in the neighborhood — which had me calculating which would be costlier, a studio in the Fenway, or my sanity? 

But I'm an optimist, as you can tell.  So I asked him: "whaddya got there's not a wait-list for?"

Well, he slapped on those latex gloves.  It was my lucky day.  They were apparently having a two-for-one special on prostate exams.  Perked me right up, I have to say.

One or two of those a day: better than Prozac.

Truth is, there's nothing wrong with my prostate or my Prozac.  It's boredom, again.  Boredom is the obesity of the mental health field.  I mean, I think as with obesity, people suspect it's nobody's fault but your own if you're bored.  Sitting around overstuffing yourself with stimuli. And the reaction you get is certainly similar.  Basically: "Get up off your lazy mental ass and do something!" 

But just like you've got morbid obesity, there's a kind of boredom that's profound, and hard to motivate your way out of (while maintaining a reasonable standard of living at least).  Because the kernel of it is the recognition of the futility of anything you can come up with to alleviate it.  In a sense, then, you could call this profound boredom morbid as well.  Everything you can think of that might occupy you leads you to the same conclusion: nothing matters. 

Of course, when you're not bored near to death, you know that the truth is just the opposite.  Everything matters.  Everything.  It's huge.  Beautiful.  And equally maddening.  You want to scoop up every moment.  But they're like grains of sand.  There are too many. 

I'm no rocket scientist, but the common denominator seems to be futility.

Some combination of stubborn denial and vigorous activity seems to assuage the symptoms, but the disease remains. 

It's time.  Time is the disease.  And there's only one cure.

Like the Stoics say you should, I think about it a little every day.  Seneca says we should "rehearse death".  "To say this," he says, "is to tell a person to rehearse his freedom."  The future is a fluke of our imagination.  It doesn't exist.  But it is an ingenious repository for hopes and fears, a pandora's box with everything that won't fit into the present stuffed inside and ready to burst out and wreak havoc.  But death isn't freedom.  That's not what the Stoics are saying.  Freedom is now. 

But getting to now is not easy.  And it's not cheap these days.  There's a wait list.  And sometimes you just don't have the time for it.