“How long do you want to live?”
The answer , most people will say, is easy.
” As long as we still have responsibilities to fulfill, are not a burden on others and are in good health.”
However, when the question posed is ” To what age do you want to live?” the answer doesn’t come as easily. It is very difficult to put a number to the life span we desire. The young may be quick to answer this question because 65 or 70 or 75 seems so far away when one is just twenty-five or thirty but, when the deadline approaches, it seems to come all too soon. At that point, the usual reaction is to want to extend it. ” I’m feeling fine. Another three years is reasonable… maybe even another five… or ten”. It is rare to find a mature person of middle age who says that he wants to live to a certain age and no more.
One such person is Ezekiel J. Emanuel a physician, bio-ethicist and author of ten books who currently is a professor at the University of Pennsylvania and the Wharton School of Business. He comes from a distinguished family. His younger brothers are Rahm Emanuel , Mayor of Chicago and formerly President Obama’s White House Chief of Staff, and Ari Emanuel, a Hollywood talent agent.
In an article in the October 2014 issue of the Atlantic Monthly, Dr. Emanuel, age 57, states that he wants to live to the age of 75.A photo accompanying the article shows him whipcord lean and obviously in great shape. He writes that he is very healthy, with no chronic illnesses, and that he has just climbed Mt. Kilimanjaro with two of his nephews. He then goes onto justify ” Why I Hope To Die At 75″. His main points are:
1. While life expectancy has increased drastically, from 59.7 in 1930 to about 78 today, most of the increase has been achieved by extending the lives of those over 60. In effect, old age is being stretched out and most of our “extra” years are spent in a state of decline. As one researcher put it, improved healthcare has slowed the aging process not so much as it has lengthened the dying process.
2. Human productivity peaks at around age 40 and declines steadily afterwards. This is a statistical truth and, as much as we may want to believe that we are among the outliers, it will almost certainly be true of us also. Our later years will be a waste in respect to our contributions to society.
3.By continuing to hang on to life , we place great burdens on our children and inhibit their growth. We also degrade their memories of us. Do we want to be remembered as active, engaged, vigorous elders or as sluggish, forgetful and repetitive?
4.By setting a definite date for the end our lives, we can make the most of our time on earth. Specificity forces us to think about what we want to accomplish, about what is really important and what we want to leave as our legacy.
Once he reaches 75, Dr.Emanuel intends to stop all except palliative care. In fact, he writes that will refuse colonoscopies and cancer screening tests even earlier. He also feels that biomedical medical research should focus on Alzheimer’s, the growing disabilities of old age and chronic conditions and not on prolonging the dying process.
Dr. Ezekiel’s excellent article is well-reasoned and logical, his conclusions impossible to refute. Based on the article, it seems very likely that he will stick to his guns, that he will not change his mind as his deadline nears. But then he is the exception, not the rule. Most of us lesser beings, the vast majority of humans, cannot think of our approaching dissolution with such equanimity. When I was young, my mother told me of a distant relative, an elderly gentleman who lived with his son and daughter-in-law. He was an expert amateur astrologer and had accurately determined the hour of his death. That morning, he asked his daughter-in-law to phone her husband at work and tell him to return home immediately. He would not give her a reason but something in his earnestness led her to do as he asked. He also requested her to make him a strong cup of coffee and as she complied, he had a shower and dressed himself in his best clothes. She took the coffee to him in his bedroom only to find him lying peacefully in bed, his soul already having departed. They did not even have to prepare the body for the cremation. Few of us have such strength of mind.
Unlike Dr. Emanuel, most of us want to hang in there and enjoy ourselves as much as we can. Yes, we want to be useful, to be contributing members of society, to justify our existence, but we also want to keep on living even when we are not. We do not ask “whether our consumption is worth our contribution.” Unless we are in great pain, we want to cling to life as long as we can. I am reminded of the story of a man being chased a fierce tiger. In his panic, he falls off a cliff but manages to grab on to a bush . He looks down and sees that he is suspended over a river in the middle of which is a crocodile, waiting with jaws wide open. Then his dire situation becomes worse. He feels the bush beginning to give way. As he looks about frantically, he sees a raspberry plant in a fissure on the cliff. It has one ripe red raspberry growing on it and, as he feels himself beginning to fall into the jaws of the crocodile, he makes a last desperate lunge for the raspberry. This story perfectly illustrates the human predicament.
Intellectually I, and most people , may be in full agreement with Dr. Emanuel but, in practice, it is very difficult to follow his path. The experiences of family members stuck in nursing homes have made it abundantly clear that prolonging life with heroic measures is not worth it but, faced with such a choice ourselves, will we have the courage to do any differently.
Asked” To what age do you want to live?” most seniors will probably respond ” Five years more”, an answer that they will repeat next year… and the year after that.. and…