Blog – “If We Live Long Enough” – Aug 2026

“If We Live Long Enough”
On the disability we all postpone imagining, and the childhood folded inside it.¹

Michele S. Piccolo, PhD – August 2026

Said that way, the sentence lands less like a warning and more like the punchline arrives too late for a joke you didn’t know you were being told. Most of us receive it the way we receive weather forecasts for a city we don’t plan on visiting: technically true, filed, forgotten. We organize a good deal of daily life around the tacit assumption that able-bodied is a fixed address rather than a temporary lease, and that the people down the hall who move into wheelchairs, hearing aids, or a memory that no longer holds a name belong to some other category of person, one we happen not to occupy. It is a comfortable arithmetic. It is also, for nearly everyone who gets to grow old, wrong.

I want to sit with why the fact is so easy to hold intellectually and so hard to hold anywhere else.

Imagine a patient. A man in his late fifties, say, who has built a competent and admired life around doing things himself, and who arrives one week rattled by nothing more dramatic than a knee that has started catching on stairs. The orthopedist’s language was mild, almost bureaucratic: some wear, nothing urgent, worth watching. What arrives in the session is not mild. He describes lying awake running an inventory of every task he performs without asking anyone for help, as though the knee were the first domino in a row he had never let himself count. “I keep picturing being carried,” he says, and then laughs at himself, embarrassed by the word. Carried. Not helped. Not accompanied. Carried, the way an infant is carried, by someone whose arms do the deciding.

That word is worth pausing on, because it isn’t really about the knee. Notice the order of operations here, which is the reverse of what we usually assume. We tend to think the thought comes first and the body follows: he considered the prognosis, concluded it was frightening, and then his stomach dropped. What actually happened is closer to the opposite. The body registered something before he had any idea what he was registering, and the fear came up from underneath, and only afterward did a word arrive to give it a shape. The word that arrived was carried. It did not arrive from the orthopedist’s office. It arrived from considerably earlier.

Long before any of us could stand on a joint that might one day fail us, we were wholly given over to another pair of arms, and our survival depended on that person’s willingness to hold us in a way we could not yet evaluate, negotiate, or refuse. We do not remember this arrangement. We are built out of it anyway. Nothing about it was ever put into words, because there was as yet nobody there to put anything into words, so it was recorded the only way it could be, in the muscles and the gut and the skin, as a kind of weather rather than a memory. And it is my growing suspicion, watching patients circle the same dread from different directions, that what we fear about future incapacity is not really the future. It is that old wordless recording, filed before we had a self capable of filing anything, returning to us now dressed as prophecy.

There is a curious logic here, one I have come to trust more than I once did. The collapse we are afraid is waiting down the road may not be waiting at all. It may already have happened, in a period too early to be felt as an event, and what frightens us now is less a new catastrophe than an old one, finally close enough to be sensed, still lacking a name.

Though I should be honest that the arithmetic runs in two directions at once, and my patients usually get there before I do. Being carried is how the story opens. It is also, for most of us, how the story closes. The infant and the person at the end of a long illness are held in nearly the same posture, and some part of us has always known this, which is why the prospect of a stair rail is so rarely just a prospect of a stair rail. What comes back is the beginning; what comes on is the end; and the knee, poor innocent hinge, has managed to summon both in the same sleepless night. Patients almost never say this outright. They say something about a knee, and then they go quiet in a particular way.

Which is why I pay such close attention to the particular words patients choose when they are frightened, especially the ones that embarrass them. A man does not say “carried” by accident. He says it because the word still has a body attached to it. In my native Italian there is a single verb, sentire, that does the work of three English ones: to feel, to sense, to hear. I have always thought English lost something in the divorce. When a patient stumbles into an oddly physical word in the middle of an otherwise reasonable account of his knee, he is doing something closer to what a poet does than what a witness does, reaching for an image because the thing underneath cannot be stated directly. Patients become poets without meaning to, and usually without noticing. The job, much of the time, is simply to notice on their behalf.

My summer reading this August has been Yourcenar’s Mémoires d’Hadrien, which I picked up meaning to read a few pages an evening and have instead been rationing like something that might run out. The emperor, dying, writing to Marcus Aurelius, arrives at this same recognition from the far end of a life:[2]

This morning it occurred to me for the first time that my body, my faithful companion and friend, truer and better known to me than my own soul, may be after all only a sly beast who will end by devouring his master.

What strikes me is that Hadrian doesn’t stay in the accusation. Almost immediately he says he still likes his body, that it has served him well in every way, that he doesn’t begrudge it the care it now requires. The betrayal and the loyalty sit side by side without cancelling each other out. That, rather than any resolution, is probably the actual task. Not deciding whether the aging body is friend or traitor, but tolerating that it is, uselessly and permanently, both. It matters, too, that the man writing has already worked out roughly how much time he has left. He is not describing a knee. He is describing the whole arrangement, and doing it in the calm voice of someone who has stopped negotiating.

If Taussig is right about the arithmetic, this reframes the whole posture we take toward disability, aging, and dependency, in others and, more quietly, in ourselves. We treat the able body as the room we live in, and disability as a different building we might be relocated to against our will. But if the wear is universal, if it is simply what a body does when granted enough time, then the able body was never the room. It was a stage of the room, furnished for a season, always due for renovation. The person using a cane at eighty has not been evicted from anything. They have arrived, later than some, at the part of the lease the rest of us are still pretending isn’t printed on the contract.

Something similar shows up, in a gentler key, in how we speak about the very young and the very old in the same breath, usually without noticing we’ve done it. We say a parent has become like a child again. We say an infant is utterly dependent. What we rarely say, because it disturbs the tidy story of a life moving in one direction only, is that dependency is not a phase we graduate out of and might later regress into. It is closer to a thread running the whole length of the fabric, sometimes thin enough to be mistaken for absent, never actually cut. The competent adult in the middle of the story is not the truth of the person with the dependency edited out. It is the stretch of thread pulled taut enough to look, for a while, like it isn’t there.

Clinically, this shows up as a feeling a patient cannot yet think, only feel, and that needs, for a while, to be put somewhere else before it can be handed back in a form a person can hold. Our imagined patient does not need reassurance that his joint will probably be fine, which it probably will be. He needs, first, for the dread to be received rather than corrected, turned over in the room until it stops being a wordless weight and becomes instead a sentence he can look at: I am afraid of being carried the way I once had no choice but to be. Only once that sentence exists can the two of us examine it and ask what, exactly, is unbearable about it. What tends to emerge is not a fear of the knee at all. It is a fear of needing without having asked to need, the way an infant needs, with no adult self present yet to negotiate terms. And underneath that, rarely stated and never in the first year, something quieter about how the needing ends.

Here it helps to say plainly what usually stays as atmosphere rather than instruction in a good course of therapy. A mind in real distress does not first require information, correction, or a reassuring set of facts about orthopedic prognosis. It requires somewhere else for the feeling to go for a while, a second mind willing to sit with raw and unmetabolized dread long enough that it can come back changed, thinkable, sayable. This is, incidentally, most of what an infant requires from the adult holding it: not an explanation of hunger, but a presence that can bear the hunger until it becomes bearable, so that terror gradually becomes appetite, and appetite becomes, eventually, patience. We do not outgrow the need for this arrangement. We only get better, with luck and enough of the right kind of company, at supplying pieces of it for ourselves.

There is also a question of company across time, which surfaces whenever a patient tries to picture an older, more limited version of himself and recoils, as though meeting a stranger who has come to take something away. That recoil softens, gradually, not when the facts change but when the future self stops being an intruder and starts being someone already, quietly, known. A version of you that has simply had more time. Less a ghost arriving from a future you didn’t choose, more a relative you hadn’t yet been introduced to, carrying forward the same stubbornness, the same jokes, the same particular way of narrating a bad morning, now walking a little differently through the kitchen. The future self stops haunting once it is recognized as kin. Even, I think, the last one.

It is worth adding, since the topic invites a certain overcorrection, that none of this argues for making peace with pain, or for romanticizing what disability actually costs people in a world built without them in mind. Taussig’s point is sharper than sentimentality. The misperception is not that disability is difficult, which it plainly can be, in ways a well-meaning able-bodied observer routinely underestimates. The misperception is the dividing line itself, the idea that disabled and able-bodied name two permanently separate populations rather than two positions on a single road that most of us, if we are fortunate enough to keep walking it, will travel between.

Which returns us, by the long way round, to the man and his knee, and to the word he chose without quite meaning to. Carried. By the end of that stretch of work, the word has not become comfortable. It has become familiar, which turns out to matter more than comfort does. He no longer needs the future body to be a stranger he refuses to meet. He can let it be an early acquaintance instead, someone he has known the whole time, from the very beginning, before there was a self separate enough to be afraid.

If we live long enough, we will all be carried again, one way or another, and then once more after that. The only real choice in the matter is whether we spend the years beforehand treating that fact as a stranger’s threat, or as a letter from someone we have already met, writing ahead to say they’re on their way.

1. This is the fifth in a series of blog posts that will deliberately set aside scholarly references in favor of a more familiar and easygoing language. And yet, between the lines, one may still glimpse psychoanalytic ideas, sensing their presence without needing to name them outright. ↩︎

[2]Marguerite Yourcenar, Mémoires d’Hadrien (1951). English translation by Grace Frick, in collaboration with the author (Farrar, Straus & Giroux, 1954).