Sunday, October 26, 2014

Hope I Die Before I Get Old

Ezekiel Emmanuel published an essay in the Atlantic last month titled Why I Hope to Die at 75 that has been getting a lot of attention. There isn't anything particularly original in Emmanuel's piece, but that only makes it a better expression of the great America fear of aging. Young Americans don't seem to spend much time worrying about death. Instead, we worry about lingering on as wasted, demented, drooling wrecks, strapped to hospital beds and hoping for a sudden stroke to end it all. A few years ago some of the men I play basketball with noticed a news story about a man who dropped dead on the basketball court at the age of 82, and they all agreed that that was the way to go. Suddenly, after a long life, but at a point when they could still do the things that make them happy. That has become the American model of a good death. Contrast that with what Emmanuel fears:
Here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.
Emmanuel is am ambitious, hyperactive man from a whole family of overachievers, and much of his essay deals with the decline in creativity that sets in after 50 or so. Of course, he says, a few people remain creative into their 80s or even 90s, but we can't all be outliers. One friend of Emmanuel's told him that while he doesn't publish original work like he once did, he is still useful in other ways, especially by mentoring younger scientists. Emmanuel is not impressed:
We accommodate our physical and mental limitations. Our expectations shrink. Aware of our diminishing capacities, we choose ever more restricted activities and projects, to ensure we can fulfill them. Indeed, this constriction happens almost imperceptibly. Over time, and without our conscious choice, we transform our lives. We don’t notice that we are aspiring to and doing less and less. And so we remain content, but the canvas is now tiny.
Emmanuel admits that a decline in publishing output is not an issue for most people, but, he says, we all get weaker and sicker  as we age. Some doctors have written hopefully about a coming “compression of morbidity.” This is, they think that as we live longer we may also stay healthy longer, so that the trials of old age are compressed into a shorter and shorter period at the end of life. Sadly, that is not happening. Instead, as we live longer we spend more of our lives in a state of decline:
Over the past 50 years, health care hasn’t slowed the aging process so much as it has slowed the dying process.
So, says Emmanuel, he plans to stop seeking medical care after about 70 and hope that he dies rather than doing anything in particular to prolong his life.

I imagine that millions of Americans feel as Emmanuel does, and in their 50s make the same sort of plan Emmanuel is making. But a lot fewer of them actually follow through. When they reach the ages that seemed so scary to them at 50, they find reasons to go on. For some this may be simple inertia, or even cowardice. But others may find that old age is just a lot happier and more fun than they feared. After all, aspiring to do less and less has its own joys.


Unknown said...

Emmanuel seems to believe that a life without a lengthening professional resume isn't worth living. If he believes that, what does he think of most of his fellow humans? Is there no worth in simply enjoying life? I guess not.

pootrsox said...

At 70, I am still trying out for plays, have volunteered to direct a readers' theatre, write for a local monthly magazine, and create my own interpretations of traditional quilts.

None of these things (other than acting/directing in HS, college, and several years thereafter) were part of my life as I "matured."

One can move in different directions, thus continuing to learn and grow.

And one can find pleasure in so many things, even when one is less physically able to do other things, and even when one's mind is less flexible than in younger years.

I have given up, for example, some of the more "energetic" online gaming (e.g. running more than one game character at a time). But I've not given up NYTimes crossword puzzles, nor glorying in the beauty of a moonrise or the haze of willows in the early spring.

There is much left for me to cherish in my life!

But there is the other side-- a dear friend and I had talked more than a few times of how-- if we had a fatal disease-- we'd pick the time and place of our departure rather than waiting for nature to take its course. She'd seen what ALS can do watching her husband. (I believe he made his own decision, but do not know that for certain.

Then *she* developed ALS. I actually talked with her about being there for her as she took whatever action she determined.

She was approaching that point: losing the ability to speak, already no longer able to walk nor do much with her hands.

Then her son told her he and his wife were expecting my friend's first grandchild. She wanted to wait to see this baby born.

By which point she was totally physically incapacitated: inert below the neck, receiving nutrition via feeding tube, etc.

She was fortunate to have financial resources to have 24 hour inhome health aides. But that did not spare her the horror of a functional mind in a totally functionless body.

Dearly as we, her friends, loved her, we did not despair when she finally died; we were relieved that she was finally free.

So while I surely do expect to find life delightful for some years to come (and my dad made it almost to 90 enjoying life), I also hope that I will be able to leave that life with some dignity, and without having to endure debilitation.

Unknown said...

I can certainly see that there are circumstances when death would be a form of liberation. I'm not opposed to that. But I'm deeply troubled by the implication in Emmanuel's and similar pieces that one needs to be able to list activities and contributions in order to justify living and breathing. Hundreds of millions, even billions, of people have never contributed anything original to their professions, or done community theater, or worked with kids, or protested injustice, or performed even mildly creditable athletic feats--and not because they were denied the opportunity, but because they weren't interested. Their lives are their own justification.

Unknown said...

I am not saying that a person who cannot move or communicate and looks forward to the liberation death will bring should be forced to remain alive for the sake of living. I am saying that a person who has, for example, never done anything but play video games, and who can no longer play or move or communicate, but wants to lie there being kept alive so they can think back on all the great video games they played, at public expense, they have a right to that.

Bundle Brent said...

I think that dude is just hanging around with the wrong old people.