Preserving People – Preserving Place

July 10, 2014
The Ward-Franzmann House circa 1840

The Ward-Franzmann House circa 1840

I believe there is a natural fit between the movement to create age and ability-friendly communities and historic preservation. This may have grown from my lifelong interest in all things old. My house, above, and I are growing older together, and, as it seems, both entering the winter of life. It’s a good fit. My personal passions and biases aside, nevertheless, I feel a case can be made that proponents of these two movements have much to say to each other and then much to do together.

Indiana Landmarks is one of the most highly respected and the largest private statewide preservation group in the U.S. There is another story there, of course, about leadership, vision, commitment and creativity. This last quality, I believe, helps account for its recent support of a day-long conference in Indianapolis on the subject of this old people-old place connection. Co-organized by another uniquely statewide Indiana treasure called the Indiana Philanthropy Alliance, the conference brought together preservationists and aging/disability professionals in what may have been the first meeting of its kind in the U.S.

Presenters addressed many of the technical issues surrounding accessible modifications for historic homes and commercial properties, the potential for a virtuous relationship between history and the ADA, and financial resources communities can use for historic preservation that benefits older populations, including Main Street restoration.

My contribution was to tender some thoughts about the relationship between the preservation of place and the preservation of community memory. In many ways, they are an identity. Place is the concrete expression of community memory and old people are its vessel, or, perhaps I have that backwards. It reads both ways because it is an identity. In any case, preservation of place is more likely to occur when it retains a presence in community memory. Buildings that fall into history without those personal connections to our current lives are more at risk for destruction unless, perhaps, they exude some extraordinary beauty or character, or are associated distantly with an officially recognized event or person. The position of older people in a community as holders of memory valorizes their role when other sources of status have diminished. A comment by Scott Roden in my previous blog on memory is evidence of this, “I had an elderly friend who passed away last year–he was very influential in my life. He once told me that his job now (at 85) was to remember…”

I try to avoid nostalgia; hope the Golden Age is something in the future, not the past. I am not naïve about the dark side of the places we have created. In a folklore field school we organized several years ago to study the Bloomington Town Square, we were curious about the lack of stories told about on-the-square experiences by older African-Americans. While the town square on Saturday nights in the 40’s was truly hopping, African-Americans, we were told, were not welcome. What was, and remains, a truly central and iconic feature of the place we call Bloomington was, despite the democratic image, an exclusive environment. I like to think that has changed, but it is something we should never forget.

Gerontologists often argue in favor of a policy called “aging in place”, understanding that the personal preference of most older people is to stay put. I would agree that people need the places, for the benefits to their social and physical well-being. I would add, however, that the places need the people just as much. When people stay put, the places benefit. Preserving place and preserving people is one job, not two.

And the house? Linda and I grow old together there and I am so lucky to dwell in her love as well.

Now, as a person also trying to attract valuable older people to our wonderful community, leaving their own, this presents some professional conflicts. I am working on this question and can try to pose a resolution of this paradox in another blog.


Memory and Place as Shared Experience

May 2, 2014

As I approach 65 years on this planet, May 24, 2014, I find my dreams increasingly populated by people from my past. I’m happy to say that the dreams are uniformly pleasant, if typically inscrutable. Gerontologists tend towards a view of memory as a psychological phenomenon and I suppose these dreams are a form of memory, an interior experience. Yet, as for these people, I believe it is their “thereness” that perhaps carries the meaning, aside from any symbolic or psychological interpretation one could craft. Better said, it is their “hereness” again in my life that is the key to understanding.

In a world of individuals self-absorbed with personal growth, pop psychology, and aging as a uniquely internal experience, memory becomes equated with the self and, conversely, the loss of memory is seen as the loss of self. But there is an alternative way to view memory.

Not simply “self-serving,” memory exists in the social world as a cultural resource – a device by which people do things together. Memory doesn’t merely represent or signify me, or the group, but helps to build it, to sustain it in an active, constitutive process. This does not require us to ignore the personal uses of memory but challenges us to understand memory as it lives outside of people’s heads and, I would argue, in people’s lived, collective, and bodily experiences of place. *

Having recently attended a Reunion of the Hobart High School Class of ’67, I can report that, in these circumstances, in conversation, we sometimes quickly run out of things to say, especially when we realize our lives and political convictions may have diverged significantly. I think the pleasure I experience from these reunions is not derived from what is said, nor what we have done but from the fact that we are, once again, together in place.

So memory and, I would suggest, “sense of place” is not a psychological phenomenon that can be measured. It exists only in its manifestation, its emergence into the real world. So many concepts in gerontology – memory, attachment, home, identity, age itself – are characterized (and measured) as individual and subjective phenomena, I have to agree with philosophers who would see the very science itself as representative of the modern project of self-absorption. We see the same history in the field of disability, where disability was, and often is, seen as a quality of the person. I am happy to report this field is increasingly moving towards an understanding of the reality of disability being found not in the individual but in the relationship between the individual and the environment. Would that gerontology move in the same direction.

About memory, Molly Schuchat once told me, “It only counts if you share it.” As for being old, I would say it is not psychological metaphors that we need, but locational ones. “Oldness” is a place-based phenomenon.

 

*paragraph adapted from Elderburbia: Aging with a Sense of Place in America, 2009, p 85 ff. (Santa Barbara: ABC-CLIO)

 See Phil’s Adventures in May 2009 for Turning Sixty :-)


Being and Dwelling: in praise of occupational therapists

March 20, 2014

Recently, I had the privilege of participating in a small conference on Palliative Care convened by the Center for Practical Bioethics (https://www.practicalbioethics.org/) with support from Kathy Greenlee, head of the Administration on Community Living and Asst. Secretary (HHS) of the Administration on Aging. The presentations were outstanding and gave me some new insights into the role of the health care system in communities for a lifetime. I was under the false impression that palliative care was all about end of life care when, in fact, it’s about quality of life, whether one is near death or not. While most participants came from the fields of medicine, I was invited to offer a “community” perspective on the issues. I would like to share my comments with the Phil’s Adventure audience, and solicit yours in return.

Being and Dwelling

In praise of occupational therapists

In the final days of his life, unable to dictate and suffering from immense pain of throat cancer, U.S. Grant scribbled a few final thoughts…

“I do not sleep though I sometimes doze a little. If up I am talked to and in my efforts to answer cause pain. The fact is I think I am a verb instead of a personal pronoun. A verb is anything that signifies to be; to do; or to suffer. I signify all three.”

I find the quote evocative for its relevance to an understanding of the concept of home in the lifeworld of elders. In short, if home is in any way an object, its meaning only derives from use. Hence, as outsiders, we must pay constant attention to movement in the lifeworld of elders, which is a challenge to our stereotypical view of old age as a period of stasis and rest.

Consider this beautiful passage from Wendell Berry’s The Memory of Old Jack, its description of the old farmer Jack Beechum and the identity between self and environment that is created by movement.

He had known no other place. From babyhood he had moved in the openings and foldings of the old farm as familiarly as he moved inside his clothes … Now when he walked in his fields and pastures and woodlands he was tramping into his mind the shape of the land, his thought becoming indistinguishable from it, so that when he came to die, his intelligence would subside into it like his own spirit.

When I was Director of Senior Health services at an Indiana hospital, we often asked seniors “What do you want the health care system to do for you?” Invariably, the answer would be…”to help me manage at home as long as I can”, what Marian Barnes calls “being well enough.”  Seniors saw the concepts of health and home as an identity, one unrecognized by both the health care and the housing systems I would add.

With this in mind, we undertook ethnographic research on the meaning of home for older adults in our community. A deep map of home emerged, organized around several basic elements.

First, home is a complex concept, far more significant than “house.” In our research we encountered individuals who have lived in the same house for over 75 years! It requires a virtual archaeology of memory to peel back the deep sediments of meaning of a life in such a place. These memories, good and bad, are codified in the physical contents of the place. As she walks through the house the tenant walks through her life. Photos, furniture stains, knick knacks, postcards, window vistas, even dents in the woodwork signify and embody important events and individuals in her life. How could she be expected to easily leave behind the door jamb marked by a pencil with the advancing height of her children and grandchildren?

Home is a physical support. Over time, home and body coalesce, a hand in glove. We can walk through our home with our eyes closed because we maintain its physical representation within our body. This is very comforting. Managing the home (sometimes trivialized as homemaking) anchors daily life, provides markers for our temporal experience, and provides cues and incentives to keep our body and mind active.

Home is a social base. When you are home, it’s your territory, your turf. You control who enters. When you are home you are at the node of a social network of friends, neighbors and family, where well-being is not an individual state but is generated through relationships. As Berry says, in another essay, “Community is the smallest unit of health.”

Home is an aesthetic. You design its appearance for self-satisfaction and display to others. The aesthetic reflects your own sense of self just as importantly as does your clothing and your car.

With all these things in play, the home becomes a mirror for the self. It represents you to yourself and, as such, provides a constant reminder of your uniqueness and contributions to your family, your neighborhood, your community. Is it any wonder why someone would want to stay put?

Understanding the lifeworld of older persons from the inside is an essential starting point for design, whether of environments or of services. This requires close observation and deep listening. Psychiatrist Robert Coles, trained by physician poet William Carlos Williams, spent some time with Nellie Benoit, over 90 years of age, in preparation for his book Old and On Their Own .

Nellie reports that they say she’s legally blind with glaucoma and “all I can see is ‘forms’ or ‘outlines’ of objects. But I say (to myself) that they are way, way off track. I can see a whole lifetime of scenes, people and places, all the details, in black and white and in color, even if their medical instruments say I can’t!”

For Nellie, the sun is her daily companion. “…without the sun, the whole planet would die… so when I can catch sight of that light, creeping in here, I talk to it, I say ‘Welcome and please make yourself at home… I say I know you’ve got other folks to visit, and I don’t want to get possessive, and try to hoard all your treasure, and not share it with others – but it’s so nice to have you here and I’d like you to know that.” …Now after a while, I can feel the sun getting ready to leave. Things will cool down! Things get darker! I’ll start gabbing again. I’ll talk to that fading light; it gets dimmer, saying good-bye, and I feel my heart sinking. But I try to be cheerful, and express my gratitude: ‘Thank you ever so much’, I say. ‘So long and I hope and pray I’ll be here, and see you tomorrow’. I say, ‘You’ve been kind, to visit us, and I sure wish you a safe and sound trip.’ I say. ‘What joy you’ve brought us, and we are all so grateful, ‘ I say.”

Though Nellie herself moves only so slowly through her house, she participates in a daily round and shares a path with the sun. In fact, home is the path.

Among philosophers, Martin Heidegger has spoken extensively about the identification of self and place, of dwelling and thinking. He notes that the etymological history of the word dwelling, bauen, in German, means to build, but has as its cognate the word bin, as in ich bin, I am, du bist, you are, the imperative form bis, to be:

What then does ich bin mean? The old word bauen, to which the bin belongs, answers: ich bin, du bist mean: I dwell, you dwell. The way in which you are and I am, the manner in which we humans are on the earth, is Buan, dwelling. To be human … means to dwell (1971, 147).

He proceeds to elaborate on the old definition of home to mean to remain, to stay in a place and compares it to the Old Saxon woun, which also means to be at peace. Hence, the word home comes to mean retreat, a place of safety and security – dwelling as a noun, not verb.  Heidegger misses the possibility of home as path, so beautifully enacted by Nellie.

If being and dwelling are identities, and if home and travel are not antithetical, it follows that achieving a sense of place in old age does not require “aging in place”, in its narrow sense of aging in the house. Aging with a sense of place can be accomplished in many ways. The question is not whether staying put or relocating south is the right solution. The question is… can we fill our spaces with meaning and memory? Can we attain a sense of agency, where what we do makes a difference? Can we dwell in the other? Can we transform space into a place that reflects who we imagine ourselves to be? This is why the occupational therapist, working exclusively at the fulcrum of home and health, may be the most important member of the palliative care team.

In the end, we return to the starting point – home is a verb, not a noun. Home is created by going in and out of the circles of life that surround us. I have found no better definition of this premise than one provided by a poetry group of Adult Day Care participants with dementia:

I have several homes

I know a home is a home when I can

Go there

Stay

And go out again.

Home is where the dog goes

When it gets too cold to roam

When winter’s coming on

That’s when I want to go

Home.

 

Phil Stafford, Ph.D., is a cultural anthropologist and Director of the Center on Aging and Community at the Indiana Institute on Disability and Community, Indiana University, Bloomington, IN. staffor@indiana.edu. He blogs at Phil’s Adventures in Elderburbia: http://agingindiana.wordpress.com/

 

 References and readings on the meaning of home: a brief list

Bachelard, Gaston. 1994. (trans.) The Poetics of Space. Boston: Beacon.

Barnes, Marian, Taylor, D and Ward, L (2013) ‘Being well enough in old age’, Critical Social Policy, vol.

33, no. 3, 473-493.

Berry, Wendell. 1974. The Memory of Old Jack. San Diego: Harcourt Brace.

___1995. Health is Membership, in Another Turn of the Crank. New York: Counterpoint

Csikszentmihaly, Mihaly, and Eugene Rochberg-Halton. 1981. The Meaning of Things: Domestic Symbols and the Self. Cambridge: Cambridge University Press.

Coles, Robert. 1997. Old and on Their Own. With photographs by Alex Harris and Thomas Roma. New York: Norton.

Ekerdt, David K. and Julie F. Sargent. 2006. Family Things: Attending the household disbandment of older adults. Journal of Aging Studies 20: 193-205.

Gubrium, Jaber. 1993. Speaking of Life: Horizons of Meaning for Nursing Home Residents. New York: Aldine de Gruyter.

Gubrium, Jaber F. and Andrea Sankar, eds. 1990. The Home Care Experience: Ethnography and Policy.

Newbury Park: Sage.

Heidegger,M. 1971 (orig. 1927). Building, Dwelling, Thinking. In Poetry, language, thought. A. Hofstadter, (trans.).New York: Harper and Row.

Jackson, Michael. 1995. At Home in the World. Durham, N.C.: Duke University Press.

Korosec-Serfaty, Perla 1985. Experience and Use of the Dwelling. In Home Environments. Irwin

Altman and Carol M. Werner, eds., New York: Plenum Press.

Marcus, Claire Cooper. 1995. House as a Mirror of Self: Exploring the Deeper Meaning of Home. Berkeley: Conari Press.

Sanders, Scott Russell. 1993. Staying Put: Making a Home in a Restless World. Boston: Beacon.

Snyder, Gary. 1990. The Practice of the Wild. San Francisco: North Point Press.

Stafford, Philip B.  2001. When Community Planning Becomes Community Building: Place-Based Activism and the Creation of Good Places to Grow Old. In L.F. Heumann, M.E.    McCall, D.P. Boldy, eds., Empowering Frail Elderly People. Wesport, CT: Praeger.

___2003. Homebodies: Voices of Place in a North American Community”. In Gray Areas: Ethnographic Encounters with Nursing Home Culture., Philip B. Stafford, ed., Santa Fe: SAR Press.

___2009. Aging in the Hood: Creating and Sustaining Elder Friendly Environments. In The Cultural Context of Aging: Worldwide Perspectives. Jay Sokolovsky, ed., Westport:

Praeger.

___2009. Living Large while Living Small: The Spatial Life of Aging Boomers. In Boomer Bust? Economic and Political Issues of the Graying Society. Robert B. Hudson, ed., Westport: Praeger.

___2009. Elderburbia: Aging with a Sense of Place in America. Santa Barbara: ABC-Clio.

Tuan, Yi-Fu. 1977. Space and Place: The Perspective of Experience. Minneapolis: University of Minnesota Press.

 

 

 

 

 

 


Risk vs. Challenge

July 2, 2013

 

I heard a fascinating presentation by Lamine Madjoubi (Bristol University UK) at the International Making Cities Livable Conference in Portland, OR last week.

http://www.livablecities.org/conferences/50th-conference-portland

Lamine studies the culture of childhood and has done research on children’s play in the UK. Using accelerometers and GPS monitoring, the research team is able to track children’s level of activity and their range over the course of a day. Given the interest in physical activity and obesity these days, the research is very important and helps us learn what factors in the built environment promote higher levels of activity.

The team compared intensity and duration of activity across formal to informal environments. Formal play environments would include playgrounds with equipment and some supervision and informal environments would include, of course, those in-between spaces that children love – alleys, streets, the spaces between buildings.

What the research demonstrated is that play in informal environments is more likely to be of higher intensity and longer duration. Those spaces that are informal but also allow for parental supervision (courtyards, for example) promote higher quality play but that unaccompanied children are more likely to play longer and choose informal areas over formal ones. Growing up in a small town 60 years ago with lots of independence, these findings are, to me, not surprising at all.

Dr. Mahdjoubi asks – “Can we take back the streets for children?”, knowing full well that the psychology of parenthood these days is very protective, often for legitimate reasons. Yet, have we gone too far?

Can we move the discussion from risk to challenge?

I think the same question would enervate our discussion of aging and frailty. As caregivers for elders we are often faced with the same dilemma. Certainly, in this age of litigation, the balance in institutions is shifted towards risk-reduction. Yet, in families too, the dreaded “Fall” is loaded with psychological burden and we have come to use the “Fall” as the marker (justification) for “placing” people in institutional environments. I am as guilty as others on this score. Is it no wonder that elderly individuals living alone don’t report falls?  They know full well what this can mean.

Discussions of safety are not productive when we frame the issue in black and white terms. Let’s think of this as a continuum and design built environments that push the envelope a bit without being totally negligent or totally over protective. We can’t eliminate risk from childhood or elderhood. We can reduce risk through smart design while promoting environments that challenge us, physically, mentally and socially. Indeed, facing risk and successfully coping promotes resilience and a new balance, at a higher level of fitness.

I don’t have the answers. The designers do. But this design, to be smart, must be informed by an insider’s knowledge of childhood and an insider’s knowledge of what it is like to grow old. Who has that knowledge?  Why children and elders of course!


Home is a Verb: Designing around the lifeworld of elders

April 15, 2013

My latest blog is found at the newsletter of the American Architectural Foundation: http://www.archfoundation.org/

If you live near Bloomington, come to our spring workshop: Places with a Purpose: Communities for a Lifetime, with Jan Hively, Kim Irwin, Scott Ball and Zach Benedict.

Flyer found here: http://lifetimecommunities.org/

and see what else we are up to at the Center on Aging and Community: http://www.iidc.indiana.edu/index.php?pageId=31

Apologies for double postings. The subscription list is growing and someday I won’t have to bother you with yet another email.

Happy spring!

Phil


From Complete Streets to Complete Communities: Moms Needed

December 10, 2012

 

Fred Kent, the founder of the Project for Public Spaces, spoke in Indianapolis last week, at the annual Indiana Governor’s Conference for People with Disabilities. PPS is an incredibly valuable and creative organization, now engaged with cities around the world as they re-design public spaces that promote harmony, beauty, sociality and peace. As the conference was focusing on livability this year (in itself a creative twist from the ordinary), Fred was discussing the concept of “complete streets” – all the rage these days in the healthy and sustainable community movement. He suggested that we need to take the complete streets discussion (streets designed for all forms of transportation) a step further (no pun intended). He argued that a street is not really complete until it becomes a destination and not merely a thoroughfare. Think about the greatest streets in the world for a moment, and you’ll realize what he’s talking about.

It got me thinking about what the next logical step would be. I awoke in the middle of the night recently with the revelation – we need to move the discussion from complete streets to complete communities. What would a complete community look like? A partial answer came by way of a meeting a few days later…

I was in a meeting with our local (and terrific) Bloomington Mayor Mark Kruzan the other day. We got to talking about my mom, who was among a group of older women that Mark considered matriarchs of the local Democratic Party. (My mom died in 2007 at age 89.) He noted that when he was starting out in politics, it was like he had a “bunch of moms” to guide and support him in his career.

His comment was a perfect segue into our agenda topic: the qualities of a “lifetime community.” Yes, in a great community, a complete community, young people have access to mentors. In a community that attracts young people from elsewhere, these mentors become surrogate parents and grandparents. A community that attracted young professionals without grounding them in relationships with elders (who is anybody with local experience) would be falling short. Certainly, yuppies should and do enjoy their peers, especially after work. But a complete community engages young professionals with experience. This doesn’t mean that elders are always right. In fact, much of their wisdom comes from failure, not success. When I think of the benefits of age and of staying put, I would point to the “bridging capital” represented by the network of relationships accumulated by people with experience. Young people hanging out together build a strong base of “bonding capital” – the camaraderie that derives from being part of the gang. But, as important and satisfying that may be, the gang needs bridging capital – it needs connections to other resources and influences outside of the group. Often, these connections can be made through those people who know everybody and whom everybody knows – a community’s elders. That’s what President Obama was talking about when he said “You didn’t make that.”

I sometimes wonder if the tragic disappearance of a young IU student by the name of Lauren Spierer couldn’t have been avoided if she’d had a strong relationship with a surrogate mom or grandma here in Bloomington. She bonded strongly with her peers. She needed a bridge to someone outside of her network. Lauren’s mother, visiting town recently, noted how she wished she could simply pass along her own wisdom born of loss to those women she saw walking alone at night in this college town. As a community, we failed to protect Lauren. Can we design more complete communities that provide the stability derived from  intergenerational relationships? Mars may need moms but we need them even more desperately.

 

 

 


Aging in Community

April 27, 2012

utility pole is placed directly in front of wheelchair ramp

As a recent lunchtime stroll taught me, we have much to learn about planning communities that work for all ages and abilities!

Aside from the obvious issue of getting the utility guys to talk to the concrete guys, we must acknowledge our own mortality and stop creating Peter Pan communities where no one ever grows old.

How do we do this? Let’s start by a creating a non-medical discourse about aging. (Note: This blog started out as a column for the NY Times Op-Ed page. It didn’t “make the cut” as you see.) The Times’ New Old Age blog, while well researched and beautifully written, is almost totally devoted to medical issues and, appearing only in Tuesday’s Science Times, reinforces the notion that science is going to solve the “problem” of aging.  Why not place the Times New Old Age blog in the Arts section? Can the arts not provide a proper framework and discourse for this issue – the art of aging?

If, as I believe, aging is about community and not about individual bodies, we have some challenges ahead. As we have fragmented the individual body into pieces with associated specialties, so have we fragmented communities into silos that separate housing  from working, schools and shopping from neighborhoods, and, as a consequence, old from young. Face it… we live in an age-segregated society, and people with disabilities, as well, continue to find themselves on the margins, barely visible to the mainstream community.

We have created this disaggregated society because our model of aging sees old people only wanting to be around other old people, old people as needing to be cared for,chronological age as an accurate marker of needs and interests, and old people as consumers, not producers.

As a consequence we produce environments that are: age-segregated, clinical in character, risk managed, and commodified,  therefore expensive, with consumable goods and services that we used to be able to access by virtue of our own labor.

Creating livable places for all ages and abilities should be the guiding mantra as we enter an era of rebuilding our infrastructure. Small towns and cities all across the country are struggling to find their future identity and are rightly worried that new investments will favor old patterns of urban sprawl. Yet, these communities often retain significant community fabric, with main street infrastructure and wonderful core neighborhoods that echo the former, pre-suburban character of walkability, mixed-use, density, and architectural richness.

A savvy media would turn its attention away from glitzy sunbaked, often gated  “active aging” communities to where the real action is. Linton, Indiana is  a blue-collar (former) mining community of 5,000 in rural southern Indiana. Here’s a “naturally occurring retirement community” (a NORC) where a hard-working committee of older citizens organized to retrofit an aging neighborhood by modifying 19 homes for safety, independence and mobility. A progressive Mayor and City Council added its support with the approval of a golf cart ordinance that provides new cost-saving mobility options for the nearly 100 residents who purchased licenses in the first few weeks. Now, the owner of the local pharmacy has put his personal economic livelihood at risk to restore and develop two entire blocks of Main Street as affordable senior and family housing, converting the old Ciné movie theater and creating new street-level space for retail and service.

For an urban example, look at Amsterdam Towers, a NORC in New York City, where the acronym originated. This post-war high-rise complex of 13 public housing buildings is called home by close to 600 mostly African American and Hispanic elders who have raised their families and aged in place successfully. The 60-year-old Lincoln Square Neighborhood Center, serving the Towers and surrounding neighborhood, engaged the seniors’ advisory council in a partnership with the Visiting Nurse Service of New York AdvantAge Initiative. The Initiative surveyed elders in the community and the Neighborhood Center community organizers put seniors in touch with local public officials across the spectrum of housing, transportation, local government, hospital care, police, fire and even the US Postal Service. Enabling the seniors to speak firsthand to their experiences and needs with influential people was all it took to foster rapid response that resulted in new on-site mental health services, an enhanced food program, increased police security, and even a new, closer mail box. All this community building work is a testament to the power of good data put to use with enthusiastic community organizing.

In the next ten years, we will see these examples replicated a thousandfold; this, not the gated village, is the future of senior living. It’s a future based on the notion that aging is about place, not body, and about relationship, not the individual quest for eternal youth. As Wendell Berry writes, “community is the smallest unit of health.”


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