Monday, September 22, 2014

Should I Die At 75? Oh, Wait. Too Late.

On September 17, the very day--I mean, the exact day I turned 77, Dr. Ezekiel Emanuel's essay, "Why I hope to Die at 75" appeared in The Atlantic magazine.   You could have knocked me over with a feather.  Really?  (We old people say, "really?" while you say, "seriously?".  There's one difference right there.)

Emanuel is a bioethicist and breast oncologist who is for Obamacare and universal health care and against euthanasia for the aged.  Nevertheless, he apparently believes that because most people over 75 are no longer as vibrant as most people under 75, and many of them have insurmountable health issues, there should be an arbitrary cut-off date after which any reasonable human being would do humanity a favor and go find themselves a nice iceberg somewhere and float off into the darkness. Singing.

I have admired Zeke Emanuel for. . . I don't know. . . a long time now. I can't remember.  (Don't kill me!)  I always thought that of all the Emanuels, he had his head on straightest.  But it could be that on the very day I turned 77 my brain read Emanuel's piece, took notice that I was exactly two years past the cut-off date, and got confused about what it was supposed to do now.  Whatever happened, I don't get this guy.  Not this time.

He said:
By the time I reach 75, I will have lived a complete life. I will have loved and been loved. My children will be grown and in the midst of their own rich lives. I will have seen my grandchildren born and beginning their lives. I will have pursued my life’s projects and made whatever contributions, important or not, I am going to make. And hopefully, I will not have too many mental and physical limitations. Dying at 75 will not be a tragedy. Indeed, I plan to have my memorial service before I die. And I don’t want any crying or wailing, but a warm gathering filled with fun reminiscences, stories of my awkwardness, and celebrations of a good life. After I die, my survivors can have their own memorial service if they want—that is not my business.
Ooooh. . . weeping here.  So sweet!  (Except for that part about "dying at 75 will not be a tragedy".   Easy for him to say.)

And then he said:
. . .the fact is that by 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us. . . This age-creativity relationship is a statistical association, the product of averages; individuals vary from this trajectory. Indeed, everyone in a creative profession thinks they will be, like my collaborator, in the long tail of the curve. There are late bloomers. As my friends who enumerate them do, we hold on to them for hope. It is true, people can continue to be productive past 75—to write and publish, to draw, carve, and sculpt, to compose. But there is no getting around the data. By definition, few of us can be exceptions. Moreover, we need to ask how much of what “Old Thinkers,” as Harvey C. Lehman called them in his 1953 Age and Achievement, produce is novel rather than reiterative and repetitive of previous ideas. The age-creativity curve—especially the decline—endures across cultures and throughout history, suggesting some deep underlying biological determinism probably related to brain plasticity.
Hold on a minute.  Old Thinkers.  Processing. . .

. . .

Okay, we'll move on now.

There are people who are still brilliant--or at least special--long past the time most of us would have given up and moved on.  They're Emanuel's exceptions and the older these people get the more they become potential national treasures.  It's because they've beaten the odds and are living proof that, even at such an advanced age, they still have much to contribute.  It's also true that younger admirers have put themselves in their place and feel better about their own chances of making waves for that long.  But too often they stop celebrating that person's achievements and begin celebrating their longevity.  Any mention of them from then on ends up being a eulogy. As if whatever they were is in the distant past and now they just are.  This sort of thing doesn't help.

A cut-off date of, say, 75 when even Emanuel, the chooser of the cut-off date, admits that nobody ages in the same way during the same time-frame, is so dumb all I can figure is that he needed an attention-getter to make a few points about how terrible it will be when he's no longer at the top of his game.

Take it from me, Zeke.  You'll get over it.

_______________________

(Cross-posted at Dagblog and Alan Colmes' Liberaland.  Featured on Mike's Blog Round-up at Crooks and Liars.)

12 comments:

Linda Cutting said...

How old is he now?

Ramona said...

I guess I should have included that. He says in the article he has 18 years to go.

Labrys said...

I rather imagine he was generalizing based on what he saw happening to people from age 75 upwards. Not everyone has a life quality that makes them want to continue; especially in some particularly blighted bits of America.

I once thought I'd prefer to die by age 60. I will be 61 next month. I'd like to say I feel more happily optimistic about aging, but to be perfectly honest? Watching my country continue to decline into poverty, idiocy, and near-facsism rather depresses me more than my own possible physical decline with age!

Ramona said...

Labrys, the state of the country is depressing, but I'm old enough to remember our struggles trying to build a vibrant middle class and to bring up the poor so they could catch up..

We thought we had it won until the Republicans got a foothold and ruined it all. I'm not depressed, I'm MAD. And I'm not about to stop fighting them now. They'll be on my enemies list until the day I die--and maybe even beyond.


But just to be sure, I'm setting my end time to be 100. By that time, I should be just about done.

Frank Moraes said...

Since you are cross-posting willy-nilly, and I have been relegated to the Constant Commoner comment ghetto, I have no choice but to cross-comment. Ha!

In 1613, at the age of 66, Cervantes wrote Exemplary Novels. In the preface, he mentioned that he only had six teeth left in his mouth (“in bad condition and worse placed, no two of them corresponding to each other”). He would die only three years later. But the year before he died, he wrote perhaps the greatest novel ever: Don Quixote Part 2. I still find it shocking that he wrote the first “modern” novel (Part 1) and also the first "postmodern" novel (Part 2).

I realize that Cervantes never made it to the magic 75 year threshold, but given the environment in which he lived — his years as a slave, loss of his left hand, prison time — I think we can safely say that anyone would have assumed his best days were well behind him at 55. Yet he not only went on to do his best work; he went on to do the best work.

I understand that Emanuel would say that Cervantes was just way out there on the tail of the normal distribution. But so what?! Aren't a billion mediocrities like myself worth just one Cervantes?

But Emanuel’s argument is invalid because of its shocking level of class smugness. Were the last years of Jonas Salk a waste because he was no longer curing diseases? The argument seems to flirt very much with eugenics. If one isn't pushing society forward one is of no value? I don’t get it, or at least, I don’t accept it. But I’m sure that Emanuel is just being provocative.

I am only (!) fifty, yet I could not possibility have predicted the joys of my current life only two decades ago. It is true: the crispness of my thinking is not what it once was. I can’t solve differential equations with the ease I once could. But my mind is not riddled with holes where my brilliance once resided. Now I think about profound things that I didn't even know existed back then. And above all: I’m a better person than I was then. I look back at me then with wry embarrassment. And I certainly hope that at 75, I will look back at me now with even more wry embarrassment.

Of course, I haven’t given up on writing my own Don Quixote -- but with puppets and very likely set in the Nixon White House.

Happy birthday! I hope you have a very long tail...

Ramona said...

Lol, Frank, I'm glad you're loyal, buddy. I'll bet you're exhausted from all that running around! I almost hate to tell you that it's cross-posted at two other places, too.

So. . .I'm lucky in that I don't even know what differential equations are. I'll never know what I've missed. Ha!

And it was smug, wasn't it. I hadn't thought of eugenics, but now that you've made me, it's scary!

I don't know, I like looking back and being embarrassed by that youthful me. It means I was thoroughly engaged in this amazing gift called life. (Though I admit I could have eased up a bit and still been just as happy looking back years later.)

Thanks for the birthday wishes. I'll be here the same time next year if you want to help me celebrate.

Nancy Mannikko said...

My take on the article is that he was arguing against the many efforts to prolong dying that our society currently indulges in. Everyone thinks they're going to live forever so they opt for medical interventions that do little or nothing to enhance quality of life.


Personally, my attitude is similar to his. I've also selected 75 as my sell-by date (I'm 66 now), and once I hit it I will say No to anything other than palliative care. He does make it explicit that the people who are brilliant and productive into their 90s are exceptions, outliers, statistical anomalies, and none of us should (unless we've got strong genetic evidence otherwise) assume we're going to be among them. Emmanuel isn't suggesting any of us shuffle off this mortal coil earlier than we want to; it's more like a suggestion we be more realistic about the limits of modern medicine,stop deluding ourselves that we're going to live forever, and recognize that aging does have consequences.

Ramona said...

Why 75? What's so special about 75? Seems to me the cutoff date should be when the body makes it clear there's nowhere to go but down and getting there will be most unpleasant. I find setting an arbitrary date to stop making every attempt to live supremely silly. It's the quality, not the quantity. Healthy people over 70 are pretty common these days. So are sick people under 70.

His piece is titled, "Why I Hope to die at 75". To a country that already thinks old people have no place in it and aren't worth the expense unless they're very, very special and not a real bother, that's like adding fuel to the ageist fire.

The only consequence to aging is that the end grows nearer. The ethical arguments about who deserves to live are endless. They've been going on forever. Every person with an expensive, time-consuming illness shouldn't have to feel that they're a drain on society.

Old people are made to feel this way simply because they're old. I'm hoping when my time come I'll be able to say "enough", but I want to be able to do it because I know it's the right thing to do, not because I'm feeling pressured to stop being a burden by a generation who thinks they should be able to decide for me when I've outlived my time here.

I think the idea that old people want to live forever, no matter the conditions, is false. Nobody I know feels that way. It's something younger people have decided they must feel. Just one of many assumptions about getting old that has no basis in fact.



Usually it's the family or the medical community that works hard to keep them alive. Most people my age and older have a real horror of being kept alive beyond the time when we are still sentient. But we should be able to live quality lives without the stigma of age bearing down on us. We don't deserve that.

Nancy Mannikko said...

75 works for me based on family history and my experiences working in nursing homes, It's not arbitrary. There's nothing quite like working in a nursing home to make a person start thinking about end of life issues. According to various life expectancy calculators, I've got a good shot at making it into my 90s, but if I do, it's going to be with minimal medical intervention.


You know, you're still going strong and you're in your late 70s. In contrast, I was at a meeting yesterday where several of the attendees are graduates of the high school class of 1959. After the business portion of the meeting was over and the gossip began, I got to hear about their numerous classmates, people 7 years older than I am now, who either died recently, are in nursing homes, or are suffering from various forms of dementia. If people in their early 70s are talking about various old friends at the nursing home, I don't think it's unreasonable to decide that once I hit a certain point, I'm going to just kick back and enjoy whatever time is left instead of enhancing some pharmaceutical company's bottom line or helping a surgeon make her Mercedes payments.

Ramona said...

Nancy, I have to believe part of the reason I'm still relatively healthy and going strong is because I never bought into the constant medicating for every little ache and pain. I only take two prescription drugs, a water pill to keep a slightly elevated BP under control and Omeprazole for Gerds. I rarely take pain killers and never take cold medicines. I see a doctor once or twice a year. I have a hiatal hernia and have had pneumonia twice in the last two years. The last time I was hospitalized and after extensive tests I was told I have the system of a person 20 years younger than me.

I try to walk at least a mile a day and I try to pay attention to what's in my food. I'm a nut for sweets, however, and they are my downfall--I really think I couldn't live without chocolate. But I an not foolish enough to think this will go on forever. My time will come but there won't be a date on it.

Nancy, I can appreciate your thoughts based on what you've seen. Languishing in a nursing home is something we all have come to fear. It's not the ending any of us would wish for.

I spend time in places that are just the opposite of your experiences. We're snowbirds and spend winters with other older people who are enjoying life to the fullest. We're not rich by any means but are able to do this and we're grateful. People much older than my husband and I (My husband will be 82 in November and walks 2 miles a day and still is the handy man around the house) are still laughing a lot, golfing, scrapbooking, beachcombing, volunteering, enjoying what all of us know are the waning days of our lives.

It's not all frivolous; we're all aware of our good fortune and work at giving back. We live productive lives and wish the same for everyone. We talk a lot about aging misconceptions and wonder what we can do to change them. Someone like Zeke Emanuel--a doctor himself--should know what repercussions something like this will bring. It's one thing to talk about over-medicating or over-treating old people--that's a real issue--but it's quite another to set arbitrary and unrealistic limits on viable life.

Labrys said...

I am mad and depressed. Mad at the venal politicians and greedy corporate types. But the general state of apathy and the degradation of the educational system makes me feel very depressed and sad. Ignorance, it seems to me, produces a population that is both imminently "manageable" and also reactive -- jerk the chain and that dog barks. It pisses me off that you can't seem to alert them to the hazard of their own state of existence.

Ramona said...

Me, too, Labrys. I'm pissed but not down. My problem is that, despite my snarling, I'm the eternal optimist. I always want to believe this crap is temporary. That people will eventually come to their senses and realize they've been their own worst enemy.

I'm working on a post right now where I'm knuckle-rapping the Dems for being such non-Dems. I can't stop. I WANT people to wake up and the only way I can think to make them wake up is to keep sounding the alarms.

I don't see it as a waste of time, even when I can't see any positive results. My cross to bear, I guess. But that's not to say I'm not having fun, too. That's the crazy part--I AM!