Ruminations on demise

Maybe I need a tattoo?

Aweh dearly beloved fellow Ruminants & Groupies in day 570 of Re-Modified Lock Down Level 1 and with alcohol.

Period as a semi-retired pensioner: 191 days

This week I am going to press the pause button on discussing humanity’s response to climate change, but it is no doubt a topic I will come back to.

In keeping with my self-diagnosed narcissistic personality disorder, I wish to engage in some woe is me navel gazing. I am going to stare into the abyss and contemplate my own demise as well as the demise of those around me.

I am 60 years old and although I’m generally in good health I am conscious of my age and my increasing decrepitude. After eye surgery my ability to read fine print in low light conditions is poor. I have done numerous hearing tests and although my hearing is deemed fine, I do have “age appropriate” hearing loss in the higher frequency ranges. Nerine, my wife, is convinced my hearing is very poor but I confess that listening rather than hearing is the likely culprit.

In the last month I have lost two friends of my approximate age who both died suddenly and unexpectedly of heart failure not related to Covid. They did not yet suffer significantly from cognitive decline which is part of the ageing process. It is not only athletes whose performance declines, but also mental performance suffers with age. In the mild form this just manifests itself as forgetfulness and senior moments. I was forgetful as a youth and now cannot live without constant reminders many of which I graciously (and sometimes not so graciously) receive from Nerine.

My father is 81 and suffers from senile dementia possibly Alzheimer’s disease. Positive diagnosis is difficult. He is cared for by my 79-year-old mother and this is an extremely demanding task for her. Senile dementia is a very cruel disease which slowly robs a person of their very identity and being. It tests your conception of what it means to be alive.

Is Alzheimer’s disease in my or my brother and sister’s future? Current science says family history is not necessary for an individual to develop Alzheimer’s. However, research shows that those who have a parent or sibling with Alzheimer’s are more likely to develop the disease than those who do not have a first-degree relative with Alzheimer’s. Alzheimer’s is ultimately terminal and, in the end, robs you of your consciousness and your identity.

What does it mean to be alive?  Not in the sense that a tree is alive but in the sense of being alive as a human. I suggest that this is not an issue that we deal with very well as a species. You have those who try to argue that life begins at conception, and this is often associated with an anti-abortion stance. Even some scientists try to argue life begins at conception to support their anti-abortion stance. https://dailyfriend.co.za/2021/10/10/the-most-dishonest-debate-of-all-abortion/.  The notion that a fertilised egg is alive does not do justice to what it means to be alive as a human. Why limit yourself to the moment of conception? Why should we not consider every egg and every sperm to be alive? This was wonderfully satirised by the Monty Python song chorus:

Every sperm is sacred
Every sperm is great
If a sperm is wasted,
God gets quite irate

Many lawyers, doctors, scientists, and people in general like to think of life as binary. You are either dead or alive but perhaps the reality is not as simple as that. What does it mean to alive as a human?  I suggest that a more sensible definition has to do with consciousness. If you are not conscious you are not meaningfully alive as a human. Foetuses and babies gradually become conscious as they develop. It is not a binary event, not alive at one moment and then alive at the next.

If you are temporarily unconscious while sleeping, being anaesthetised or in a reversible coma then you are also alive although temporarily indisposed. If you are brain dead and, in a coma, and being kept alive by a machine with no possibility of becoming conscious again then you are not really alive. Lawyers and some doctors might classify you as alive but really?  Of course, the judgement call as to whether it might be possible to resuscitate you from a coma becomes a very difficult one.

Although death can be sudden you can also die slowly. Just look up what severe late-stage Alzheimer’s entails and make up your own mind.

The march of technology and the ability to keep patients alive almost indefinitely is creating problems for hospitals. When Tinslee Lewis was ten months old, doctors said that the treatment keeping her alive was causing her pain and should cease. Born with grave heart and lung conditions that surgery could not ease, she had no prospect of getting better, they said. Her family disagreed.

Nearly two years and several court judgments later, Tinslee remains on life support in a hospital in Texas. In April the hospital, requesting that a court’s final ruling, expected in January, should be brought forward, described how the child’s body had been “ravaged” by invasive treatments. Her mother countered that the two-year-old, who is heavily sedated but conscious, had shown some signs of improvement. Texas Right to Life, a pro-life group that is funding the Lewises’ legal fight, hopes it will result in the overturning of a state law designed to protect doctors’ right to withhold what is known as “futile” or “non-beneficial” care. Tinslee’s care, paid for by Medicaid, has cost more than $24m, according to the hospital’s most recent court filing. https://www.economist.com/united-states/2021/08/26/improved-technology-collides-with-religious-beliefs-at-the-icu

Quality of life matters a lot. My suggested reading for contemplating your mortality and those around you is, “Being Mortal” by Atul Gawande. https://www.goodreads.com/book/show/20696006-being-mortal. Facing the fact that we are all going to die is certainly not a fun notion, but neither is believing we can extend our so-called lives indefinitely. There really is such a thing as quality of life, and probably should be a thing called quality of death as well.

According to actuarial tables I have 21 more years to live but it could be more or less and some of those years I could suffer ill heath and have poor quality of life. So, what remains for me?

I have this blog and my devoted groupies and there is much to blog about. I have my wonderful family and my sons who will hopefully outlive me. I can be a grumpy old, opinionated man propagating micro aggressions to the woke younger generation. I will continue to run the Rosebank chess club and serve on community organisations while I can. That is enough.

Thank you for your contributions and comments. Please keep them coming.

Regards

Bruce