Better lives, not longer lives

According to the Greek philosopher Seneca, as is a tale, so should be life: not how long it is but how good it is. The reality is that our control over how good our lives can be goes only so far, even if we follow the proffered advice given about adopting a proper lifestyle, that is eat prudently, exercise regularly, avoid risk factors such as stressful situations and addictions and so on. In this way we are more likely to be spared of suffering from disease and live beyond the proverbial three-score and ten – but at some point, for many if not most, old age which may have been till then creeping in slowly can show its true face in unexpected and unannounced ways, with greater or lesser suddenness depending upon what condition is responsible for the deterioration.

Take the case of that 83-year old ex-teacher who had been very active after he had retired from his job and had stopped giving private tuition too. He was passionate about his garden which he indulged in daily, kept his mind busy through reading, and had a pleasant social circle. For the past year now he has been practically bedridden, and he responds weakly and in monosyllables to his wife who ministers to him so lovingly. Fortunately there is a home help who comes to bathe and change him. ‘Even then, doctor,’ she told me, ‘it’s not easy, because I have to do the rest, feeding him, changing the nappy, coax him to move his limbs a bit. Thank God I am still fit enough at my age, 82, but how long will I be able to sustain this situation, for I will not be getting any younger isn’t it.’

She had been told he was suffering from a malfunctioning of his brain, for which there was no treatment available. The exact diagnosis was not known, and even if it were, such as Alzheimer’s, there may be no remedy. A physician friend to whom I had referred an 80-plus year old who felt ‘imbalanced’ when he walks, and all of whose tests had not shown anything, told me that in nearly 75% of such cases of disturbance of the ‘vestibular mechanism’ (in the ears) that is responsible for imbalance in the elderly, no cause could be found – and therefore no medicine could be prescribed, except a placebo which would soon prove ineffective.

The only thing I could offer this lady – who had come to see me for a bout of shoulder pain – was to have a philosophical discussion about the aging process, and to offer kind words, following the adage of Ambroise Paré: ‘Guerir parfois, soulager souvent, consoler toujours.’

Among the most distressing sights that can confront a medical practitioner is that of an elderly person curled up in bed, suffering from bed sores, hardly able to communicate or to take food. There is a gradual shutting down of body functions as it were, with progressive deterioration and not knowing how long this state will last. And the worse irony is to have seen this person but a couple of years previously in good enough health, going about his daily routine with cheerfulness, giving thanks to the Almighty for his grace towards him. Save the maintenance measures to keep such a person free of pain and keep the sores from getting infected – since more definitive treatment is not possible – there is little that medicine can offer.

These are but a glimpse of what old age can inflict upon us, and whenever the topic comes up for discussion in any circle, everyone expresses the hope that there will be no such languishing in dependency and suffering, knowing full well that this is only a wish, and one does not know what turn one’s life will take.

And yet last month the news was that five research teams had claimed that ‘there is no compelling evidence there is an upper limit on mortality’, that maximum human lifespan could far exceed 115 years. Of course there are many centenarians around the world, and their numbers are increasing, but comparatively they are still a very small proportion of the total population, and although they may be relatively healthy, there is no guarantee of such luck in the individual case. Meaning that, even if we wished to live longer and this possibility was present from a scientific and medical point of view, there is no saying in what state of health one would be. And so the question is whether this quest for extending the lifespan, making humans live longer years, is really worth it?

After all, in physical terms, as a book review on the subject notes, ‘We are creatures of light and air. Life’s a gas, in every sense. We are oxygen, hydrogen and nitrogen, packed together with the carbon that photosynthesising life has plucked, one molecule at a time, from the atmosphere in the form of carbon dioxide. At cremation, our bodies bake down to a handful of minerals. When Hamlet beseeched his too, too solid flesh to melt, thaw and resolve itself into a dew, he got it about right: the Prince of Denmark would have been about 70% water, which is itself an atmospheric vapour. And he certainly could have been blown away.’

And as someone else opined, ‘Some scientists think there’s no upper limit on ageing. Let’s hope they’re wrong.’ It seems that ‘the basic creed of amortalist theology seems to be that all our organs are simply machines that, like car parts, start to malfunction with use and age, and that, to continue the analogy, can be either repaired or replaced. The idea is that we report in every few years for a service that not only keeps the motor running but, with progress, will positively enhance its performance.’

And yet ‘the reality is that the body is the least of our worries. It is all in the mind. And as many experts insist, we simply do not understand the mind. But we do know the consequences of its decline. As the cells (of the brain) misfire, the chemicals unbalance, the synapses disconnect, we are losing our mental faculties along with our keys, spectacles, directions. We are demoralised as our cognitive triggers fail and we alienate neighbours and confuse friends with our social dyspraxia. These memento moris of growing frailty are reinforced by increasingly frequent attendance at the interment or combustion of erstwhile companions.’

I could not agree more that ‘the prospect of another 20 years or more of this appals me and my geriatric companions. For the vast majority of us, our aspiration is for a dignified culmination that will impose the minimum burden and distress on our friends and families. We are all too aware of the strain that we put on society through our increasing dependence on medical resources. We are conscious of the calls we make on our own elderly children, who too often are torn between us and their own grandchildren.’

And this brave writer concludes: ‘I would appeal to the scientific elite to stop squabbling over the medical equivalent of angels on pinheads and to use their privileged talents to attend to the real needs of the elderly. We need purpose not redundancy, meaning not irrelevance, dignity not distress. In other words, we simply want to lead better lives, not longer ones.’ Who wouldn’t agree?

RN Gopee

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