There are all sorts of macho mottos associated with aging. Old Age is not for sissies. What doesn’t kill you makes you stronger. Old age and treachery beats youth and exuberance.

Those all sound tough and defiant. Good for you, Gramps. But there are several flaws in such thinking. First, what if you are a sissy and not treacherous? Second, sissy or not, old age wins. You lose. Remember the Grim Reaper leading the dance of death? He hasn’t gotten the upbeat memo from AARP.

I am now old enough that my motto is: Everything hurts and there’s no cure. By everything I mean feet, knees, hips, shoulders, neck, fingers. Essentially any moving part. And the cure recommended by sadistic young people is to keep moving the painful parts. Very funny.

And joints are just the beginning. Sooner or later, the heart attack, the stroke, the cancer, the Alzheimer’s of some creepy, more obscure assassin will get me. Old age is waiting for the terminal diagnosis. To add insult to injury, the medico-pharmico-insurance complex is on the case.

It is an elaborate system contrived to make your misery last as long as possible so that by the end the accumulated wealth of every American over 65 has been transferred to hospitals, doctors, imaging services, pill pushers, rehab experts, and extended care facilities.

The image I see in my imagination is of people at a certain age suddenly finding that the solid ground on which they’ve stood all their lives suddenly tilts, and everything they have earned, saved, owned, the house in which they have lived, the car they have driven, the clothes they have worn as well as their flesh and blood selves, rolls downhill to fill the coffers of the medico-pharmico-insurance complex, which I imagine resembling an extra large version of Scrooge McDuck’s swimming pool full of money.

To assure this happens, the process goes like this. You get a little symptom and set up an appointment with your doctor. He does lab tests. Ca-ching. They are inconclusive. He does some more tests. Ca-ching. Still unsure, he sends you to an old Med School chum, a specialist.

His tests are more elaborate, invasive, painful, unpleasant. He also sends you to people he knows for imaging. He probably has a piece of this subsidiary. There you get X-Rays, MRIs, sonograms, CAT scans, carbon dating. Ca-ching, ca-ching, ca-ching.

If your expanding team has learned their trade, this will almost certainly lead to new tests or procedures, biopsies, explorations. And the more invasive, protracted or esoteric, the more doctors, nurses, anesthesiologists, consulting specialists, pathologists radiologists, pain management specialists, gerontologists, rehab professionals will earn a place at the trough.

You may feel as if they are not actually diagnosing your problem so much as playing darts. Unfortunately you are the dartboard. There will also be numerous prescriptions, injections, infusions, drips and inhalations along the way, so that the pharma boys aren’t left out. Some of these nostrums can cost tens of thousands of dollars for a few weeks or months of treatment. Some are addictive, which everyone knows is really profitable — either keeping you on the stuff or weaning you off.

Many of the maladies of old age aren’t actually ever cured, but simply managed. That helps keep the whole Complex employed and billing for as long as you can stand it. And if the misery causes you to despair, there are counselors and analysts and more Pharma to modify your mood, though not your underlying condition.

Nor should we ever forget that managing the billing, the record keeping the compliance with the insurance and government rules for this immense machine employs, and enriches thousands of additional accountants, actuaries, help-line personnel, formulary judges and jurors, archivists, clerks and on and on.

The patient at the center of all this is no longer a person nor even a product of this gigantic industrial process, but more akin to raw material necessary to keep the mechanism working but discarded once used up — slag from the blast furnace, husks or hulls from a mill. What matters is the survival of the edifice, the complex, the medical center.

Once each considerable medieval town was dominated by its cathedral. Today, what our towns have instead, as Philip Larkin realized in “The Building,” is the medical center. Not Chartres, but charts. We are part of a congregation “called to these corridors” to “rooms, and rooms past those, and more rooms yet, each one further off and harder to return from….All know they are going to die. Not yet, perhaps not here, but in the end, and somewhere like this.”

Larkin wasn’t cheerful, but he wasn’t wrong.