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.