I put Middle Earth Journal in hiatus in May of 2008 and moved to Newshoggers.
I temporarily reopened Middle Earth Journal when Newshoggers shut it's doors but I was invited to Participate at The Moderate Voice so Middle Earth Journal is once again in hiatus.

Monday, February 04, 2013

Immortality Is Not An Option

This is a repeat of a post I put together three and a half  years ago following the death of Senator Kennedy. It  mentions a dental appointment "yesterday" but that's not 
important. The realities remain the same. 
Ted Kennedy's death is a reminder that dying is the only universal fact of life. The country swirls in yet another argument about the role of government as frightened crowds of white-haired people, some close to tears, vent their fears in trembling rage at elected representatives. It is a fitting tribute to Kennedy that his passing has done nothing to calm the political fire lines at which he so vigorously fought. The first order of business is arguing over the argument itself, carping over whether it is fitting to discuss a successor, naming reform legislation in his honor, or speculate about how other political dominoes will fall. I imagine him looking down sadly at chattering over unimportant matters, avoiding the real challenges that threaten the country. And white-haired fears ratchet up another notch as Michael Steele continues to fan the kindling.

Changing the subject for a moment, over at Deron's Blog [now deleted] are these good questions.
  • Do we need to live past 85? Is 20+ years of being a senior citizen worth it? 
  • Is it better to go out with a bang as opposed to going out while barely being able to walk, jumping from physician to physician, on 15 medications?
These are just some questions that each of us should be asking ourselves. In healthcare, it used to be the family doc and the patient. Now there are 12 other people involved. Did you ever try comparing TV today with TV from 25+ years ago? The editing today is absurd. Has our attention span gotten so short that we lose interest if we're not seeing a new frame every half second?
I'll get back to them later, but first a little anecdote about yesterday's dental appointment.

Last month I broke a tooth and had to be fitted with a crown. (I learned years ago why they call it a crown. It takes a king's ransom to buy one.) Removing the temp and seating my new custom-made tooth took only a few minutes. I was pleasantly surprised but a little anxious that he didn't give me a pain shot. I've been down this road before and cold rinse water followed by air-drying on the stump of an broken tooth is like something from a James Bond film. This time, no problem.

"It didn't hurt at all," I said. "I guess it didn't break off that close to the nerve."
"You would have to bring that up," said the dentist. "How can I say this... as we mature the nerves shrink in our teeth. If you were younger I would have given you a shot, but considering your... maturity... I figured you didn't need it."
"Got it," says I, looking over at the assistant. "What he means is that I'm getting old. And as we get old our teeth die. Right, Doc?"
"Well, yes. I didn't want to bring it up, but you wanted to know."

The cat is out of the bag. I'm aging. It's okay to say so. I don't care and I don't take it personally. Thanks to working in the retirement community for the last six or seven years I have a different attitude. I see aging up close and personal in a way that most people never see. Until a family member gets there the reality of age remains as distant to most people as the details of how the mechanic repaired the car or where trucks go when they pick up this week's garbage. As long as the car goes when they put in the key or they don't forget to put out this week's garbage, that's as much as most people want to know. Sometimes an adult "child" enters the world of aging in a way that understands the reality of what it means but more often than not, even those who are aging remain in personal denial as long as possible.

When I had a colonoscopy last week I realized it was for one purpose only, screening for colorectal cancer. Just before they knocked me out I took advantage of the sixty seconds or so available to ask the doctor what my chances are at actually having colorectal cancer. He didn't know. He said "I should know those numbers but I really don't know at the moment. We do know that the rates have been going down, however, because by screening we catch a lot of them before they become fatal."

Not satisfied with that answer, I looked it up at the CDC website. I learned that as a male my chances of getting colorectal cancer were slightly worse than those of a female. The rate for someone my age, 65, is not provided. But for a man at the age of sixty...

The table shows 1.55% of men who are now 60 years old will get colorectal cancer sometime during the next 10 years.  [Hey, that's good news! That was just three and a half years ago and the number is now down to 1.46. Science and medical progress marches on.]  That is, 1 or 2 out of every 100 men who are 60 years old today will get colorectal cancer by the age of 70.

The numbers increase with age, of course, just as with any other form of cancer. The longer you live the more likely you are to get sick and die. Hello. But another way of looking at it is that I have a ninety-eight percent chance of never getting colorectal cancer by the time I'm seventy or so.

Statistical odds are not the same as individual events. The victim of a lightning strike or brain aneurysm at the age of thirty isn't interested in hearing about the odds. Theirs is a more personal challenge. But for those of us who have survived six or seven decades and still seem to be in fairly good health can have a more sanguine view (excuse the adjective, please) of disease, death and dying. I told my wife afterward that unless symptoms appear sometime in the future (bleeding, blockage, suspicious blood signals, whatever) I have had my last colonoscopy. I see no reason to go through the procedure again just because another five years goes by.

I underwent a less sophisticated version of the same exam about fifteen years ago. I think the doctor called it a sigmoidoscopy because they didn't turn the corner and look all the way around to where the colon begins, way down there where the appendix lives (or in some cases used to live). Science is fifteen years further along now. So instead of chatting with the doctor as he does something intensely personal where no man has ever been, today's procedure is conducted under the darkness of propofal, currently fashionable thanks to the late King of Pop and his physician.

Speaking with my sister and other lay people about the effect of anesthesia on elderly patients we all recollect noting that problems with memory and dementia often accelerate following general anesthesia. Obviously many old people seem never to show any after-effects. (Just as there are young people who regularly smoke grass and never get more than the muchies.) I'm sure there are studies about that phenomenon, but I don't expect to see them advertised in an era when knocking old people out for surgery is as lucrative as it is. Even faced with facts, most people, both old and young, tend to follow fears more than facts as illustrated by the current health care debate.

Back to Deron's questions.

  • Do we need to live past 85? 
  • Is 20+ years of being a senior citizen worth it?
As long as my mind hold out and my ability to communicate remains tolerably good, I'm all for living as long as the Lord allows. The biblical ration of "three score and ten" is coming up for me in less than five years, but science seems to be returning us to longer lifespans. America may have forty other places ahead of us in life expectancy but we're still ahead of Cuba, China and most of Africa. Don't forget, we have "the world's best medical care." [More good news. In just three years we now only have thirty-nine ahead of us. That's progress, no?]

  • Is it better to go out with a bang as opposed to going out while barely being able to walk, jumping from physician to physician, on 15 medications?
Given the option, I choose the longer life, even with multiple medicines and doctors. But between now and then I would like to see all my records in one place, preferable with a software program looking over many shoulders as they prescribe the fifteen drugs, sending the doctors and me a message if any of the drugs cause side effects when combined with others. (As for the walking part, I have already accepted that no matter what other problems come with age, mobility is the issue that crosses all the lines. If the pain can be controlled and I can still pee, dress and get into bed, I'm good to go. Walkers and motorized chairs are becoming part of the landscape.) I'm not wasting time taking care of other seniors. I'm taking notes.

In a perfect world we all have one primary care physician, but they are a vanishing species. The medical homepractice is the ideal replacement of the future but it may disappear along with PCP's if Congress isn't careful.

  • Did you ever try comparing TV today with TV from 25+ years ago.  The editing today is absurd. 
  • Has our attention span gotten so short that we lose interest if we're not seeing a new frame every half second?
Good points, Deron. I will treat these questions as rhetorical.
In my case I pay so little attention to commercial television that except for C-SPAN and the evening news I rarely sit through a whole program. I watch the news is by using the "back" button on the remote, alternating one of the alphabet channels with a PBS report on another channel during the commercials.

Senator Kennedy's death, like all deaths, is a reminder of everyone's mortality  All political persuasions will end in death. None is exempt. Thanks to science, if you don't want to die or let someone go, a persistent vegetative state may be available for years, but even that eventually ends with death. At some level everyone knows this, which may explain why Ms. Palin's imaginative locution of death panels drew such a visceral response. And seeing how effectively that line worked to frighten old people, opponents of reform grabbed it like a bloody shirt to advance the emotional appeal of their cause.

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