There are these signs that time is passing. The increasing stiffness I feel when getting up in the morning (every morning). Median lines are a bit more difficult to navigate at night, especially when it is raining and the only illumination on the road come from the glare of headlights. I am doing weight training three days a week to keep muscle mass up, but it appears to be a losing battle. There are those occasional moments when I suddenly forget what I am about to do next. This can’t be. My brain suggests I am still in my thirties—but the calendar tells me next month I will be 65. I am getting older, but I refuse to acknowledge I may be old. I am not a card-carrying AARP member (okay, I do take advantage of reduced rates at movie theatres).
The latest Time Magazine’s cover article gives hope that regenerative medicine may interrupt aging for an emerging generation, pushing the limits of longevity eventually to 142 and beyond. Recent rodent experiments are encouraging; compounds like rapamycin seem to be slowing aging. Unfortunately, or fortunately, I am in the generation that will probably not have our cells doused with the right genetic ingredients. It’s a little late. Hence, there’s a really good chance my goal of playing tennis at a 4.5 level is probably not going to happen; my court speed is not going to get any faster. Any future injuries will have the same response as the last. When I asked the surgeon how I could have avoided rupturing the Achilles tendon, he impassively responded, “You couldn’t. You’re getting older.”
So recently, to encourage myself, I picked up Atul Gawande’s, Being Mortal. It’s one of those books you can’t put down, but at the same time you ask yourself—“Why am I reading this??!!” Gawande is a medical doctor. I loved his first book, Checklist Manifesto. I can’t say I have loved his latest book, but it is not because it is dull or unreadable. It’s sort of like going to a palm reader who is telling you your future—and if it is true, it is a bit scary. He confronts us with our mortality.
Gawande reminds us that it is no single disease that will be our undoing, but the accumulated crumbling of the body systems. It’s a pleasant thought. Things will soften, while other things will harden. Some muscles will thicken, while others thin. The loss of muscle mass begins at around 40. By 80, half of it is gone. Brains shrink, bowels slow down, glands stop functioning, joints damage, arteries calcify, and the ability to multitask seriously declines. Eventually we wear down until we can’t wear down anymore. (You can see that is a great read for your next vacation—or after you next loss on a court—or when you are feeling generally depressed and need a little adrenaline rush).
One of the greatest fears in all of this is the loss of control—the eventual shift from independent living–to assisted living to a nursing home, where the chances are you will end up being treated like preschool children. What is unnerving is the thought life will be reduced to a bed, a small dresser, a tiny TV, and a half a room with a curtain to separate one’s privacy from the next person. Could it be I will one day live a supervised institutional existence of boredom, loneliness, and helplessness? I am reminded of the woman in our church who entered into her 80’s, going from one “George Bush Sr.” feat after another. Eventually she ended up in a home. Visiting her one day, she thanked me for coming, but let me know that her life no longer mattered. In her mind, she no longer was part of something greater—a family, a community, a society. The medicines and treatments that prolonged her existence did not seem to serve her so well.
If I am reading this right, Gawande lives with the increased tension of his profession—using the latest technology and drugs to sustain lives that often amounts to prolonging death. Medicine exists to fight death and disease. But Gawande has started paying more attention to what awaits his older patients. He writes this book, having ventured more and more beyond his surgical office to follow his patients into their lives. And it has forced him to ask hard questions: When should we try to fix, and when should stop trying to fix? Have we reached the point of actively inflicting harm on patients rather than confronting the subject of mortality? Could it be that people do live longer when we stop forcing them to live longer? Have we become so conditioned to fighting for time? Is there a moment we should fight for other things people value, like being with family or enjoying chocolate ice cream? Are we not facing the reality that death is the enemy and it has superior forces, and it will win—and in a war you can’t win, you don’t want a general who fights to the point of total annihilation? Don’t you want a general (a.k.a. doctor) who knows how to fight for territory that can be won and how to surrender when it can’t?
When dad died last year, we had to take a certain stand against the medical establishment and confront the reality of mortality. It was time to move from a “hospital bed to home in a debilitated state to a hospital bed existence.” It was time for hospice, where dad could truly prepare to transition. Had we followed the advice of the doctor, dad might be still in a prolonged dying state, at great cost to him and everyone else. We could see it was no longer about shortening valued life; it was about prolonging suffering. We could also do this because God has given us the hope of heaven through the blood of Jesus. To live is Christ—to die is gain.
These words from Paul to the believers in Philippi are the most centering words of all. Whatever time we have on this earth is time to live Christ—really live Jesus. Serve Him. Speak for Him. Glorify God. And maybe I have a lot of years left to do this. I still have dreams and endless unfinished projects. But when the time comes—acknowledge that the power of medicine is finite—and always will be. It is really okay to be released, as I hope my family will do for me. It is okay to go home. More than okay—it should be our great anticipation.