Dr. Menlo, eclectic fellow, dragged in a bit from the Times Literary Supplement [I could use a literary supplement, the fortune I spend on vitamins hasn't done squat for my writing] about a newly pieced together poem of Sappho. The article in the TLS cast into my mind the weirdest metaphor for our relationship with death and healthcare: Tithonus, given eternal life but not eternal youth...just rotting away like so much human cordwood piled in a nursing home, doing nothing, listening to Fox News, waiting, waiting, waiting and waiting for a turn taking that last ambulance ride. But the turn never comes because we are more afraid of death than all the senescence and lost capacities that are its prelude. We the society, if not we as patients, have a doctor who we will pay well not to let us quite die even if we have to steal the money. We have research funds to hunt down the last mysteries of disease and wring the last hour of life from our bodies when, with no mystery at all, children grow stunted and starved for want of far less funds. And we don't now and certainly won't have the funds to share what the research finds; all pay, some benefit.
If our attachment to life were a bit more rational, we would devote more resources to keeping healthy those whose lives could yet be full than to keeping alive those who now cling to life. If we weren't, as a society, in a state of vague denial of death, we would not shut the old and dying away in the company only of machines and doctors trying to do the impossible. A dysfunction of our civilization is that these aged, with their savings, constitute the lucrative market. Another is that we have a keen focus on whether or not you are dead; forestalling that inevitable second of transition when the single binary digit representing your existence goes from one to zero. But we have less interest in the many and messy dimensions of whether or not you are fully alive. The poor doctor can't save your life, he can just add some days to its length. Your students, friends, lovers and family save your life from being a mere existence.
You cannot cure age but you can cure neglect and the life style that hastens aging.
There would be a bonus: ask people in nursing homes which they resent more: their infirmities or the dearth of visitors. Those who are literally at death's door are an uninteresting constituency, they don't vote much and except for a few diseases, aren't calling on their congressman to fund stem cell research. They are out of sight even more than the homeless. Isn't it funny that a politician who had a program to benefit everyone who was going to die would have 100% of the population as a constituency? Ah, but that wouldn't be politics would it? That would be religion.
The executioner, being a bit past ripe, is not the least bit unaware that he will age and die. He calls here for hospice, not heroics when his time comes.
If we focused on being alive rather than staying alive, we would succeed at both rather than failing at the one and cheapening our success at the other.
It is more likely arthritis that prompted Sappho's poem than the expectation that 2600 years hence, it would be seed to a reverie on immortality gone wrong. But we take our inspirations where we can find them so thanks, Dr. Menlo, for that bit of news.
The standard of care ought to be the time we spend with all who ail as much as the money we spend so others will tend them. [Are my age and guilt showing? Good! That is the best example I can set.]