Zeke Emanuel attracted widespread attention with his piece, “Why I hope to die at 75.” I wrote a response to Zeke’s piece at the Washington Post here. My stepmother Arlene had a better response, part of which was published in the Atlantic Monthly as well. They edited for reasons of space. I believe her response is worth including in-full:
People like us, octogenarians, who despite an onslaught of medical issues requiring ultra frequent medical appointments, frequent procedures, tests for suspected problems, and all sorts of treatments to manage the aforesaid, are moving along, having grown more understanding of our fellow elderly, more grateful for the love and companionship of our mates, more determined to remain deeply involved in the lives of each and every family member, and determined to set an example, as far as possible, for our children and grandchildren of how to age in such a way that we don’t leave our loved ones with a dread of incapacity, a horror of diminishment of vitality. If we were to suddenly fall off the face of the Earth, after withdrawing from their lives and obsessing about our states of health, they would never be prepared for their own late lives. That would be not only cruel, but irresponsible as well.
We live in an area where almost all the people we see or meet or call friends have had to adopt this sort of philosophy as they deal daily with hearing aids, dental devices, crutches, walkers, braces, and cosmetic and aesthetic adjustments. Most come to incorporate these inconveniences and move on, attending to keeping muscles and intellect optimally functioning. Their children and grandchildren then adjust to these changes as well. In this way, we all can live with an understanding that life is a matter of loving, sharing, living to the fullest. It’s a legacy, a gift that is worth far more than sums of money or great public and personal achievement.
I understand that we cannot anticipate what will befall us, how we may not be able to fulfill this goal, but having this positive philosophy brings a certain peace of mind, allaying debilitating terror that incapacitates and hardens us so that we withdraw from those who need us in so many ways.
Just a beautiful piece of writing. She leaves both Zeke and IÂ me in the dust on this one.
Agreed. Having observed and been a part of the decline and death of both my parents, and now my father-in-law's long-term aging and decline, I have come to value the profound lessons they have taught me about how to live through these processes, with their attendant suffering, gracefully and while remaining connected to those around them. I would not have missed it for the world and will certainly remember them when my time comes. On a much more mundane note, please, it's "…leave Zeke and ME in the dust…"
Not so much for me. I had the bad luck to see my father stricken with a brain tumor that destroyed his ability to calculate or communicate, and then watch the shell of what he was persist for several more years, visibly frustrated and angry much of the time until his brain function deteriorated to an infantile level. I've also been blessed with friends and relatives who remained themselves through most of their declines, but that's not guaranteed.
So much depends on what's important to a person. If being physically active in the world is their thing, then losing that — even if cognition remains — is losing life. If cognition is the thing, similarly.
Emanuel's essay strikes me as provocative headline tacked on to a very conventional life plan. His only real stated intention (he emphatically disavows suicide) is to direct restrained use of life-prolonging treatment that would leave him in a severely limited condition. But no more so, as far as I can tell as innumerable others (myself included) who most definitely do not "hope to die" at 75, or even 85 or 95. Why that drives his family and friends crazy is unclear. Maybe what he tells them is actually different from what he has told us. Or it could be that they are just tired of him nattering about "hoping to die" just to be provocative, when he clearly doesn't mean it.
It is interesting reading this post along with KH's on decision rules. Arlene Pollack may well be the full house exception to the rule.
I just got back from Thanksgiving meal with a sister whom I adore and our late 80s parents, who have become increasingly addled (though not demented) over the years. In addition, my mother and previously her now dead older sisters, feel increasingly free with age to give full voice to their anger and displeasure with anything and everything; and to hold who ever is present responsible for displeasing them. I cannot count on the digits of two hands and two feet the number of family occasions that each has insisted on being included in and then gone on to wreck for no good reason. The lesson that I have learned from watching my relatives is that I should try to die before filling my own adult children with the apprehension (dread is probably too strong) the apprehension that I feel about seeing my parents. Not only is it not a pleasure, it is painful, because the only function that visits seem to serve is an outlet for destructive emotion on their parts. My sisters get it worse than I since they live in the same city as my parents, while I live several hours away.
I have long thought — both for reasons related to the previous paragraph as well as others — along the lines that Emmanuel articulated, but I had stated it to myself with neither his clarity nor the precise steps that he laid out; I realized merely that suicide is to be avoided if only for the destructive consequences on the survivors. Some elders — Arlene Pollack comes to mind — serve as paragons to be followed; others are to be avoided, and to the extent that many of us are likely to fall in the latter category, Emmanuel suggests one way to avoid that outcome while it remains within our grasp.