Field Notes: The Arc of Aging

In the early morning hours—when the world is quiet and the page is still listening—I often find myself returning to the stories I’ve inherited, those I’ve told many times, and others I’m only just beginning to reclaim.

Lately, as I explore the world of longevity, those stories have circled around aging—not simply as a biological process, but as a reflection of culture. A culture that tells those in midlife and beyond: you’re disappearing. Your symptoms are glitches. Your wisdom has an expiration date.

 

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It has me wondering: what might shift—personally and collectively—if aging were seen not only as diminishment, but as a deepening? It’s a question I’ve been sitting with, not just as a practitioner or teacher, but as a woman likely past the midpoint of her own spiral.

The spiral is an image we’ve explored in my longevity book club, The Long View. Picture it now: a forward-moving unfolding. A journey that allows the past to inform us, but not define or trap us. A path that makes space for who we’re still becoming, while honoring where we’ve been. Round and round it moves, never quite returning to the same place.

And perhaps that’s what a more expansive view of longevity invites—not just a longer life, but a fuller one. If we’re going to reimagine longevity—truly and fully—we’ll need more than science and technology. We’ll need stories. We’ll need cultural conversations that evolve alongside the research.

Because how we live longer will always be shaped by how we value those longer lives—our own, and each other’s.

I’ll keep turning this over in the quiet hours. Maybe you will too. And maybe, in doing so, we can start to shape a different kind of story about longevity.


Warmly,
Andrea

 

What I’m Exploring: Aging & Ageism

I’ve been exploring the realities and ripple effects of ageism—both systemic and internalized—and how it quietly shapes our decisions and perceptions as we enter midlife and beyond.

When we talk about ageism, we often think about older adults—the elders and elderly. But I’d like to invite us to look more closely at the menopausal and postmenopausal seasons as a life stage where ageism quietly appears—too often without being named. This period of time is also—and often—framed as a decline. 

In healthcare, menopause is often medicalized—treated as something to “fix,” as if it’s a malfunction, a drop in estrogen, a body gone rogue. But these years bring more than symptoms or hormonal changes. They carry transformations of identity. Emotional reckoning. Physical recalibration. And yes, above all, opportunity.

Let’s pause here…

“It’s time to become the elders we never had. To claim the power of age, the insight of experience, the clarity that only comes from having weathered the storms.”
— Sharon Blackie, Hagitude

When we fail to honor this phase of life for all that it is, we don’t just fail the women experiencing these transitions. We contribute to the erosion of one of the most important assets for true longevity: meaning and purpose.

We deprive maturing women of this possibility—and we perpetuate a culture where women with valuable insight, experience, and resilience are pushed aside in favor of what’s newer, younger, and more easily defined.

We place meaning in one direction—on becoming, on a specific definition of beauty, on drive and productivity—and, in doing so, we strip it from another: the wisdom earned, the depth developed, the clarity that only comes from having lived through it.

Can there be space for both to exist?

For vitality and aging to live side by side?

For youth and maturity to not be in competition, but in conversation, even collaboration?

That’s the future I believe we must write—together. One where longevity is measured not only in data, technologies, and years added—but also in wisdom honored, wholeness reclaimed, and the stories that bring us back to ourselves.

Ironically—or perhaps inevitably—my deep dive into the field of longevity is leading me right back to the very principles I teach in Functional Nutrition. Because Functional Nutrition, when practiced as its truly meant to be, gives us the keys to flip the script. It moves us beyond “symptom chasing” and into a more holistic, systems-based understanding of the changing body. (And in case you didn’t know, the body does—and will—change with time lived.)

When we integrate the tools of Narrative Medicine with Functional Nutrition, we create space not just for biology—but for biography.

Because our health is shaped not only by our hormones, but by our histories—not just by our symptoms, but by our stories—not only by our genes, but by our gut and by the fires of inflammation we’ve carried, knowingly or not, over time—our time, lived in bodies that have endured, adapted, and ushered us forward.

By what we hold. 

By how we’ve been seen—or not

By the threads that live inside of us, waiting to be heard.

And to be clear, this isn’t about turning away from vitality, or telling anyone to “just accept” or embrace decline. It’s about expanding the definition of vitality itself. And while the physiological shifts may differ, the invitation—to reimagine aging as a time of growth, not erasure—is one that transcends gender. While I’m focusing here on women’s midlife experiences—because they are too often overlooked—the call to reimagine aging with reverence, agency, and depth is one we all can benefit from.

Here’s how I believe we can start to change the narrative:

  • Personalized, systems-oriented lifestyle practices. Support both the maturing body and mind. Gut health. Stress resilience. Detoxification pathways. These aren’t just clinical buzzwords—they’re the physiological foundations for meeting midlife as a time of integration and potential, rather than a pathological failing.

  • Reclaiming purpose and vitality. These years are not the end of something. They are a beginning. A threshold. A time to spiral forward. To integrate wisdom from lived experience. To stop striving for the version of ourselves that lives in the rearview mirror—and start honoring the person we’re becoming and have yet to become. This is where it gets exciting!

  • Challenging the “fix-it” culture. We are not broken. We are not problems to be solved. We are whole beings with complexity, capacity, and stories worth telling. By shifting from symptom suppression to self-agency, we offer ourselves not just care, but dignity.

  • Redefining longevity as meaning. Over and over the message is that longevity is not just about lifespan—it’s about healthspan. And healthspan is enriched not only by nutrition and movement, but by a sense of purpose, contribution, and connection. 

Too often, the cultural narrative whispers:
“Go back.”
“Look like you used to.”
“Be who you once were.”

But wait... We don’t ask that of our high school or college graduates. We don’t ask that of newlyweds or new parents. Why do we ask that of ourselves at this stage of life—at this next threshold?

What if we stopped spiraling backward—and started spiraling forward?

Toward vitality. Toward wisdom. Toward a new way of inhabiting this life stage and the body that carries it, not in resistance, but with reverence for this next initiation. 

 

What I’m Writing: The Roots of Care

I've been returning—spiraling, really—back to the early stories that shaped who I am. They remind me how I came to care, how I learned to listen, and how I continue to help. This story holds many layers for me: memory, loss, healing, and the invisible threads that connect us. It's part of what I'm writing. And part of what I'm remembering.

My second memory after my six-year-old walk of shame down the hospital corridor, hand-held by my pediatrician, chest exposed, was one of abandonment. That word stays with me—even now—across the decades. Through Isamu’s death. Through Gilbert’s growing independence. Though, obviously, none of those experiences qualify in the traditional sense. But they stir the same sensation. 

A hollowness. A reaching for something—or someone—that doesn’t come. That’s left me behind.

During that childhood hospital stay, it was my mom who I’d felt had abandoned me. All morning I waited for visiting hours. I’m not sure how I understood the concept or how I even knew when they would begin. Maybe someone told me. Maybe there was a bell, or a signal, or the shuffle of footsteps and voices moving past in the hallway. A rhythm I began to track, breath by breath.

I was mostly alone in that room. It felt big. And sterile. At one point, another girl appeared in the bed next to mine—lying inside a plastic tent that encased her like a greenhouse. I can’t say for sure if this happened, or if I’ve filled in the gaps of memory with fragments from dreams or movies of later years. But I believe it did. She must have been contagious. And I must have been scared. Back then, we didn’t have the same standards for explaining things to children. No one softened the edges or translated the unknown. And I wasn’t the type to ask questions—especially not of strangers. I was shy. Quiet. Watchful. And I waited.

One day, I waited longer than usual. Before visiting hours began, it was as though I was holding my breath. And when they finally arrived, I exhaled, sure that my mother would walk through that door—across from my bed—at any moment.

I don’t know how much time passed, but it was long enough for panic to take root. My fear grew wild and uncontained. I remember curling into myself, whimpering, then crying softly, tucked into the corner of that long bed—guardrail to my left, wall to my right—like a trapped puppy, separated from its mother too soon. It was before cell phones. Before updates or ETA texts. No one else on the ward knew my mommy the way I did. Knew to trust her. Knew that she wouldn’t be late. So their reassurances didn’t land. They didn’t understand.

When she finally arrived, she was frazzled. Apologetic. She had spent a very long time searching for parking in the lot, and eventually gave up, street parking far away and rushing the distance just to get inside. To me.

When Gilbert was just a little older than I had been in that hospital bed, I worked with a girl his same age who had a rare form of leukemia. Her name was Stella. I supported her and her family in all the spaces between medical visits—filling nutritional gaps, adapting her diet, and doing everything I could to help her body not only fight the cancer, but withstand the brutality of treatment, including a bone marrow transplant.

I remember visiting her at the children’s hospital. Walking down the long corridor. Pressing the buzzer at the metal security door. Announcing myself at the nurse’s station and being told where to go. The family was expecting me.

Inside, everything was dim. Hushed. The soft murmur of voices. Beeping machines. The quiet whir of wheels on linoleum. A cartoon playing faintly in the background. The atmosphere was one of fragile hope, tinged with exhaustion. A different kind of waiting.

Stella’s hospital room was nothing like the one I had stayed in as a child. Her bed was low to the ground so she could get in and out on her own. A cot sat in the corner where someone stayed with her around the clock—her mother, stepfather, or grandmother. She was never alone. The room was decorated with art and balloons and full of activity, bustling in a way that was both respectfully acknowledging where they were, and quietly festive. Spirits were high, even when frayed. They had to be.

Thinking about it now reminds me of the “widow humor” I shared with a friend. Nan (whose name I’ve changed to protect her privacy) and I met at The Dougy Center—a nationally recognized nonprofit here in Portland, Oregon that provides grief support for children, teens, and their families after a death. It took some time for Gilbert and I to be eligible—kids must be at least three, and he was less than two-years-old when Isamu died.

Nan had two boys—a baby and another, just Gilbert’s age. Their father, her husband, had died suddenly. We’d often marvel at the contrast in our stories—hers like someone flipping on the lights in a dark room, abrupt and disorienting. Mine more like a slow sunrise. Unexpected beauty, but the ache of rising early to witness it.

Nan didn’t stay at the Dougy Center for long, but our friendship lasted for years. We lived 40 minutes apart but talked on the phone, met for dinner, and shared stories that no one else could understand. She was my “widow friend.” And we laughed at how we sounded like Elmer Fudd when we said it, and made the diners at nearby restaurant tables uncomfortable when we dissolved into tears of laughter—the kind that made us pee our pants—over the absurdity of being everyone’s walking nightmare. What had we done to earn this reality?

We made jokes and kept our spirits up because we both lost our soul mates, and the father of our boys. On Father’s Day we would head to the park with helium balloons and sharpies and the boys would write notes on the awkward surface of the orbs, the markers screechy on their surface, the letters misshapen, and release them into the sky. 

“Happy Father’s Day!,” we’d shout. And watch the dots grow smaller until they faded into the heavens.

Nan and I are no longer friends. It’s one of those losses I don’t quite understand. I assume I did something—said the wrong thing, focused too much on my vision, on building my practice and then business, or maybe we just drifted. Maybe I was inattentive. Maybe I wasn’t present when she needed me. Maybe I believed something she couldn’t. There wasn’t a clean break. I wasn’t ghosted. I just slowly realized she was gone. And that might’ve been the problem—I didn’t even notice it was happening. 

The truth is: I haven’t been the best kind of friend in adulthood. I’m loving. Devoted. Caring. But I can let too much time pass. I’m not the check-in type—not daily, not even weekly. My best friend from college—who lives across the country—keeps me on a quarterly calendar. She’ll text to say it’s time to schedule a catch-up. For years, it was once a year. Twice, maybe. I’m lucky for the friends who stick with me through my distractions and many projects.

Stella, the little girl I visited in the hospital, is now 24-years-old. Thriving. She’s traveled the world, become a massage therapist, and is working in that same ward in the children’s hospital where she was once a patient, tucked into that room at the corner, surrounded by a mix of love and worry, determination and sweat in the close, dim, quarters. 

I see Stella on occasion. Her mother cuts my hair and we’ve known each other for so long that it’s like sitting with an old friend. The studio is in their beautifully converted free-standing garage, their pet pig sometimes visible behind the screen door to the family room behind the entry gate, and every so often, if she’s living at home, Stella will pop in. She doesn’t remember those years so clearly, but I do. And when I think of her now—showing up for children in that space—I’m reminded that even the most fragile beginnings can grow into fierce devotion. That sometimes, what holds us up isn’t just healing, but the act of helping others heal.

 

What I’m Watching: From Patient to Advocate

When I think about what it means to spiral forward—to carry our past with us while becoming something new—I think of Stella.

In the story I shared above, Stella was a little girl in the hospital, facing leukemia with a persistent courage. Today, she’s a thriving young adult, bringing that same gentle presence to other children navigating illness—this time as the Studio Coordinator at CHAP (Children’s Healing Arts Project).

This short video offers a glimpse into her work, supporting healing through art, imagination, and presence. It’s a reminder that healing isn’t just about what we survive. It’s also about how we show up for others. How we turn hardship into holding. How we root care in lived experience. And how we find meaning from even the messiest parts of life. 

Watch CHAPs and Stella’s story here. 

 

What I’m What I’m Listening To: The Test (Search Engine Podcast)

In this deeply human episode, host PJ Vogt walks us through a medical moment that I’ve heard time and time again—a frightening health update that triggered an anxious spiral of searching and “research”. 

In this story, ravenous scrolling through Reddit threads and obsessively harassing ChatGPT didn’t calm guest and author Amanda Hess—it only fed her worries. And that’s the crux of the story: our compulsive information-seeking, driven by the hope of control, often leads us further from peace.

By episode’s end, the medical journey resolves, but leaves deep questions in its wake: What do we gain—or lose—through relentless information? When is enough, enough?

I found this episode resonant with the tensions of midlife and longevity we often explore—caught between craving control and learning to trust presence. It’s a timely reminder… Sometimes we need less information and more grounding in what’s here.

Listen to Search Engine: The Test here

 

Narrative Medicine Invitation

If you’ve made it this far, kudos! I hope it’s leaving you with some juicy things to ponder. If so, I invite you to set your timer for 5 minutes and write freely to the following prompt:

Write about a version of yourself you’ve circled back to—only to meet them again with new eyes.

Feel free to send your writing to me at scribe@andreanakayama.com


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Field Notes: The Quiet Hours & The Stories They Reveal