The Martha Stewart Show often takes a personal turn -- but never quite so personal as on December 17, 2007. That day, Stewart said farewell to one of her show's most beloved recurring characters, her own mother, "Big Martha."
Martha Kostyra, who passed away on Nov. 16 at the age of 93 after suffering a stroke earlier in the month, had appeared on more than 40 episodes, preparing her famous pierogi, cheesecake, and meat loaf recipes, learning how to use a computer, and demonstrating her exercise routines. Each time, the merry, gentle interplay between Big Martha and her daughter warmed the stage.
But on that December day, Stewart, wearing a simple brown ruffled blouse and supported in the audience by a dozen or more family members, had to introduce a tribute instead of show segments starring her mom. In typical Stewart fashion, there were no tears or breakdowns -- just a few wistful smiles at fond memories of Big Martha. But she stumbled on her words a few times, finding it hard to talk of her mother in the past tense. "My mom is so modest -- was so modest," she corrected herself.
A few days before the tribute aired, Stewart spoke with WebMD, and then, too, had difficulty putting her loss into words. "It's just -- make the most of every day. What else can you say?" she said. "Time sometimes runs out, and you don't realize how precious it is."
The year 2007 was a rough one for Stewart -- although perhaps not as rough as 2004, the annus horribilis when she spent five weeks on trial for charges related to insider trading and then began a five-month term at Alderson Federal Prison Camp in West Virginia. Still, in addition to losing her mom last year, she faced health challenges of her own: Progressive damage from torn cartilage led Stewart to seek hip replacement surgery in June. Fortunately, Stewart had already begun laying the groundwork for a major new focus of her powerful podium: not just gracious living, but healthy living, with a special emphasis on health care needs as we age. Her personal experience over the past year highlights just how important that is.
In October, Stewart cut the ribbon on the new Martha Stewart Center for Living at The Mount Sinai Medical Center, a geriatric outpatient facility in Manhattan. Big Martha's health kept her away from the grand opening, but she was the primary inspiration for the center -- and Stewart's tribute video featured film of her mother in a hard hat and wielding tools as construction began.
"We want to help people devise a way of life that will get them through old age healthily and happily -- in good shape and in good humor," says Stewart. "That's something the center can help with tremendously. During the three years my mom had to do rehab and various procedures, none of those places was where you'd want to spend your time."
Funded by a $5 million donation from Stewart and dedicated to her mom, the center, with its bonsai tree symbol and Stewart design touches, feels more like an upscale spa than the depressing, fluorescent-lit outpatient clinics most seniors visit. The 7,800-square-foot facility houses a staff of 20 geriatric specialists, social workers, an integrated wellness program, and a memory evaluation clinic.
Other specialists, including cardiologists, nephrologists, rheumatologists, and psychiatrists, are available onsite and can be consulted as needed -- eliminating multiple trips to different offices. (Care is covered by most insurance plans.) And the medical center's patients can take an active role in their own health and wellness, participating in activities such as mindfulness-based stress reduction, yoga, tai chi, and nutrition programs.
"We wanted to create a place that feels good, that treats you nicely, that makes you think somebody cares about your experience there," says Stewart.
Senior Care in America
Stewart's right about the need for coordinated senior care, says Knight Steel, MD, a pioneer in geriatric medicine who now heads the division of geriatrics at Hackensack University Medical Center in New Jersey. We all could benefit from having our doctors under one roof -- but the elderly have the most to gain from coordinated care. "There are issues related to aging per se, and then there are issues related to diseases and organ systems, so you need a cardiologist, a neurologist, a pulmonologist, and so on. It's clearly best to have a place where you can be managed comprehensively, rather than having care fragmented at different locations and practices," he says.
Stewart learned about this issue firsthand while helping care for her mother. "My mom went to four, five, six different doctors, and she wasn't always totally open about what medications she was taking, or not taking," she says.
The more medications a senior takes, and the more doctors prescribing them, the greater the opportunity for error -- for example, prescribing medications that have dangerous interactions. More than half of fatal hospital medication errors involved seniors, according to a 2004 report in U.S. Pharmacist. "That's the value of a senior center with excellent geriatricians who look at a person's health in a comprehensive way, rather than having them diagnose and prescribe independently," says Steel.
Ultimately, Stewart hopes the new center at Mount Sinai will serve as a model for similar geriatric centers across the country. She's working with Brent Ridge, MD, her company's vice president for healthy living -- they first met when Ridge, then a Mount Sinai geriatrician, approached her with the idea for the center -- to make that happen. "We want to show other hospitals across the country how they can go about creating the same kind of excellent program, where the aging population can be taken care of well," she says.
"Being healthy is all about being prepared," agrees Ridge. "Our health care system is not prepared, and the vast majority of individuals are not prepared. Having someone with Martha's clout and her ability to speak will raise awareness of this issue. Just like they look to Martha for planning other aspects of their lives, we think they'll look to her for this aspect as well."
Steel, for one, hopes Stewart can bring these issues to the forefront -- because he sees a tidal wave coming. By 2050, according to the U.S. Census Bureau, nearly 87 million people in the United States will be older than 65 -- more than 20% of the projected population. "I can tell you that American geriatric medicine has gargantuan problems," Steel says. "There's too much expensive hospital care, and there needs to be more care at home. But unless we have places like Stewart's center that can make good outpatient care for seniors possible -- and good geriatricians to provide it -- there will be a serious crisis in geriatric care."
Big Martha, RIP
She may have had her own struggles with the health care system, but Martha Kostyra, in many ways, was just about the perfect example of living well into your later years -- still active and energetic as she approached her 93rd birthday. She seemed indomitable, so her death was likely a shock to her daughter, says Pamela Sollenberger, MS, a certified grief counselor who serves on the advisory board for the American Academy of Grief Counseling.
"When someone has been very ill for a long time, we're a lot further along in our grieving when that person dies," she says. "But if it's a relatively sudden loss, we have no time to prepare.'
The loss of a parent is particularly devastating. "It doesn't matter what age you are, you end up becoming that orphan," says Sollenberger. "We look to our parents as the protector, the guide, the nurturer, the unconditional love source."
And just because Stewart isn't wearing her grief on her crisply ironed sleeve doesn't mean she isn't struggling in private. "Your grief is unique only to you. Yours is different than mine, Martha Stewart's is different than ours," Sollenberger says. "We may go through the same stages of grief, but we do it differently. The process takes a lot of time, and nobody can tell you when it's time to move on."
One way of grappling with loss is to channel energies into something that honors that person and creates a legacy for them. For Stewart, this could mean deepening her involvement with the Martha Stewart Center for Living, which mattered so much to her mother. Others, says Sollenberger, might work with underprivileged children, fund a scholarship, or contribute their efforts to some other cause that was important to the person they lost. Some people engage in what Sollenberger calls "instrumental grieving," which could be anything from chopping wood to hoeing the garden to kickboxing. "Sometimes it's easier to exercise your grief than to talk about it," she says.
Martha's Health Plan
That may also be a good outlet for Stewart, who is committed to a healthy workout routine. "I do more exercise than I ever did before, but that's because I am living a very hectic life that requires exercise. I feel I need it," she says. She'd squeezed in an early-morning workout and then another hour of yoga with a trainer the day she spoke with WebMD. "That's a lucky day. Usually I get about an hour a day. But I have to insist on it."
Her fierceness about fitness likely contributed to her quick recovery from that surgery back in June, when ongoing pain from torn cartilage of the hip spurred her to get the hip replacement. Stewart was riding her horse the day before the procedure and was back at work five days after (not the five-week break her doctors insisted she'd need).
"I get zillions of emails from all over the country asking what I did for Martha," says her surgeon, Steven Stuchin, MD, director of orthopaedic surgery at New York University Hospital for Joint Diseases. "In terms of technique, I did some very cool stuff. But what's really important is what you do before and afterward. Martha went into this in as good a shape as she could be."
And afterward? "That's when the process really starts with a joint replacement surgery," says Stuchin. "Some people think they'll just lie down on the table and they'll be good to go, but the real work is what the patient does afterward. If you go to rehab two or three times a week, but you're not exercising every day, you're not going to get the maximum results. Martha went into this saying 'I want to be a good patient, I want good results,' and she got them because she worked at it."
But c'mon, now. Does Stewart have any health flaws herself? After all, this is a woman who doesn't drink much, eats from her own organic garden, and has made healthy living a core initiative within the Stewart empire that promises to span all of her magazines (yes, even Martha Stewart Weddings), as well as her television show and web site. "I don't eat a lot of artificial foods and never have -- I don't open a lot of cans and bottles," she says. "I just refuse to imbibe or eat things that I think are dangerous."
But even Martha's not perfect. She confesses there's one thing she probably neglects: "Sleep. It's an exhausting lifestyle, and I always say sleep can go," she says. "I never stay in bed late -- I can't! In my house, the first people arrive at about 6:30, and I have to be up well before that." Could she perhaps turn in a little earlier at night? "Well ... I like watching David Letterman."
She also admits that, while she relaxes with yoga and insists on at least an hour of exercise every day, she doesn't have a true personal formula for really unwinding. "I wish I had one!" she laments.
Then she thinks about the question a little longer. "Although, when I get on my horse and go out into the woods, the thing I always say is, 'It doesn't get any better than this.' That's a good little motto. We all need to look for those moments when we can say that."
It's all part of Stewart's personal philosophy for aging well, which she's hoping to spread broadly through the center and her new multimedia health initiatives. "You have to find the path to wellness. Drugs and medical attention are a part of that, but it's also about diet, and exercise, and a calm way of thinking about your everyday challenges.
"That's much more appealing to me."
Originally published in the March/April 2008 issue of WebMD the Magazine.