The Fallacy of 'Giving Up'

[bemildred]

Death, the last taboo.

At 30 years old, a person's brain weighs about three pounds. In its capaciousness it wears the skull like a well-tailored suit. So notes Harvard professor and surgeon Atul Gawande in his most recent book Being Mortal—only to contrast that with the fact that by age 70, there is usually about an inch of space between the brain and the skull. And that's not because the skull is expanding. From just a glance at a CT scan of a person's brain, a radiologist could venture a pretty good approximation of the person's age.

That's not to say that loss of brain volume means that most people don't retain enough grey matter to remain brilliant in old age. (Over the last 20,000 years, the average human brain has gotten smaller by about the size of a tennis ball, which doesn't mean we've gotten dumber.) Instead it's—like the recession of gums from teeth and the exhaustion of the stem cells that give hair its pigment—a vivid example of the normal aging of the human body.

Together these changes illustrate, Gawande writes, that the end process is often really not the body wearing down so much as gradually shutting down. It's a process that doctors are trained to resist and "fight," leading a patient into "battle" with disease. Though, the analogy falls apart in that a battle with death can't be won; Philip Roth once said that old age is less a battle than a massacre. And, as Gawande notes, a good general is not one who leads an army to the point of total annihilation.

Being Mortal, which was published in October, is ostensibly about the struggle to cope with the constraints imposed by flesh-and-bone biology—and the failure of medical science to acknowledge that any ability to push back is finite. Gawande's ultimate message, that death in America is not often enough discussed, and that patients suffer at the hands of well-meaning doctors because of it, has been generally celebrated, though not for breaking particularly new ground. His is the basic message for which the late surgeon Sherwin Nuland's How We Die won a National Book Award 20 years ago; and it's the message of another book released last week, The Conversation, by another Harvard physician, Angelo Volandes. It's a message that has grown extremely loud inside of the health-professional echo chamber, but is somehow still only faintly reverberating into broader culture.

http://www.theatlantic.com/health/archive/2015/01/dying-better/384626/

[SheilaT]

1. Thanks.

A few years ago I read something that said based on typical usage of various body parts, we are designed to wear out at around age 82. I can't assess the validity of that statement, but it makes sense.

I am currently 66, in very good health, and I actually have plans for my 97th birthday -- there's a total eclipse of the sun I want to see. I personally have a very strong belief in an afterlife, and so while I'm in no hurry whatsoever to leave this life, as far as I'm concerned there will be something after. But even if I believed there was absolutely nothing, I still recognize that this physical life will come to an end.

I'm also greatly disturbed by those who are confident we'll be able to prolong human livespan by hundreds, maybe thousands of years. I see lots of problems if that actually comes about. First is simple overpopulation. The second is that for human society and culture to progress, it needs new members.

[bemildred]

2. My pleasure Sheila.

I will be 70 this year, so have given this some thought too. It becomes so pertinent when you get old.

I have no idea what comes next, any more than I know where I was before my parents started me, but I'm pretty sure I don't need to worry about it. As the process goes on there are things I want to try to do something about and others I prefer to let go. You have to exercise some judgement, you can't control everything.