Friday, June 27, 2008

Live shorter and still prosper

Recently released life expectancy figures for 2006 show a new record high in the United States; 78.1 years of age. While much of the rise in life expectancy during US history is attributed to advances in childhood medicine and better public sanitation, more recent upward trends point at the “miracles of modern medicine” giving people the tools needed to treat diseases associated with aging. On the surface this looks like great news; yea! We’re living longer. But life expectancy figures measure only age and do not take into account the physical condition of people on the upper ends of the age spectrum and the quality of life that they lead. There is a fine line between saving a life and artificially prolonging one. What are we sacrificing to tack on a few extra years at the end of our lives?

How do we define life? Is it simply a beating heart or is it the ability to think, enjoy, love, worship, or laugh? Some argue that life is so precious that all means should be taken to keep a person breathing. This mindset keeps people fighting for the physical lives of their family when the person and everything they cherished about their life is already gone. We lose focus of what makes a life, things like happiness and joy, and instead trudge through existence just breathing, not living. As one of our nation’s greatest leaders, Abraham Lincoln, once said; “And in the end, it's not the years in your life that count. It's the life in your years.” The wisdom and power of those words from centuries past are timeless.

This shift towards unhappiness is characterized in movies and television as an unavoidable rite of passage to old age. Ever wonder why people often turn into bitter “curmudgeons?” Perhaps it is because they are told they cannot eat, drink, or do anything that actually made them enjoy life in the first place! Maybe they didn't grow up dreaming about living their last decades in a nursing home where the highlight of their day is penny bingo after their chopped liver lunch. I feel for the sick, the old and the dying who are told they can’t have something they really want because it is bad for their health or because the doctor said so. Battle old age all you want, it is always going to win. If someone makes it 80, 90, or 100 years old they should be rewarded with all the red meat, fried chicken, and booze they want. Watch your diet when you’re young and it actually matters, by 90 who the hell cares? If dying wishes include an ice cream sundae it is really not the time to be worrying about glucose readings; have your cake and eat it too, literally. I have a verbal pact (which I guess will be written here now) with my husband; if I cannot eat, talk, laugh or kiss him, my favorite things in the world to do, then please just pull the plug.

The United States leads the world in the amount of money spent on healthcare in a person’s final year of life. Doctors are in the business of saving lives, and this includes performing “medical heroics” that all too often extend a person’s calendar years with little consideration to the kind of life the person can lead afterwards. People with long-term, debilitating, incurable illnesses are given a battery of surgeries, medicines and procedures to keep them alive but are so rarely reminded that the choice to continue fighting is ultimately theirs and their families. Sometimes years pass where a person is alive but without any signs of life, and with medical advances this is going to happen more and more frequently.

When it comes to heroics, the only thing more courageous than choosing to battle a disease is the courage it takes to realize the disease won and concede the fight. After people decide to stop medical treatments and take a chance with whatever comes after this world, doctors, with their lifesaving possibilities behind them, often step aside and let the end of life experts take charge; nurses. Hospice and Palliative nurses deliver physical, psychosocial, emotional, and spiritual care to the terminally ill and their families. These Nurses prepare patients and their families for the final days through education, comfort, and compassion. I can think of no other career path that requires such opposing capabilities; the strength to watch people die and the compassion to help them and their families through the pain and loss. I consider myself incredibly blessed to work with nurses almost everyday, women and men who teach very valuable lessons on navigating the rivers of life (if you are willing to listen!). The work they do serves as a reminder of lessons learned from family and friends who made the most of their time on earth; live life to the fullest, enjoy every day, and to take better care of yourself when you’re young so the years added are actually healthy ones.

This is dedicated to my Father-in-law John, who realized he was losing his battle against kidney failure and said enough; living out his last days in the comfort and care of a hospice nurse team. Thank you to the nurses who took care of him, who have ever cared for me and my family, and who I am blessed to have as friends and co-workers; you are truly special people for choosing a profession that requires so much skill and compassion.


LucyinStLou said...

You raise some wonderful points. I've often thought the same thing. In fact, even now, although I eat quite healthfully and exercise, I will not give up things I really love because it may or may not extend my life. I've known many people at the peak of health who have died suddenly and those who lived a life to make the AMA shudder who survived to a ripe old age. Genetics and luck play as much of a role in our lifespan as good behavior. Live while you can, I say!

I am sorry for the lose of your father-in-law.

Claire said...

VERY well-written!

I know I need to make some improvements, it just takes me some time to get to them...Having said that, I'm not about to totally give up the things I enjoy so that I might live longer. I guess I need to work on "moderation" (as I sit here eating cheese popcorn). I've known too many people that aren't enjoying their life because they want to live forever. No thanks.

I'm sorry for the loss of your father-in-law, but I applaud his courage. That's a tough call to make.

Explosive Bombchelle said...

Moderation is the most difficult of lessons to master; it is just so much easier to live to one extreme or the other. I am often conflicted on how to manage taking care of myself while still enjoying everything I love about life; good food, fine wine, late nights with friends. Adding to this conflict is my career in the health and wellness nurse and coaching services area. I try to practice what we preach but my passions in life make it so difficult.

On a somewhat related note, I sat next to a doctor on a flight one time and we had a very interesting conversation regarding longevity. He challenged government and private nutrition campaigns and anti-smoking programs as short-sighted in addressing medical costs. His research led to some very convincing figures that these vices might cost a lot to treat in the short-term but ultimately led to people dying earlier and becoming less of a burden on the social security system. Interesting to ponder...

Nursedude said...

Hi Chelle, I am really, really sorry for yours and Wade's loss.

As usual, you bring up a lot to comment in with your writing. I guess you can look at the results of that study and ask yourself if the glass-in this case healthcare- is half full or half empty in the US. My concern is with the growing levels of obesity-along with correlating illnesses like heart disease and diabetes, along with epidemic levels of asthma, allergies and obesity with American kids, that 78 year life expectency might be a HIGH WATER mark for the next few years.

I agree 100% about QUALITY of life and not just years. If you are having to be warehoused somewhere for the last decade or so of your life, that is not living.

Oh yeah, there are also 30 countries that have higher life expectency than we do in the US...

John said...

One of my favorite sequences in the movie "Grumpier Old Men" captures this perfectly when John (Jack Lemmon) discusses diet with his father (Burgess Meredith):

Grandpa: What the... what the hell is this?
John: That's lite beer.
Grandpa: Gee, I weigh ninety goddamn pounds, and you bring me this sloppin' foam?
John: Ariel's got me on a diet because the doc said my cholestorol's a little too high.
Grandpa: Well let me tell you something now, Johnny. Last Thursday, I turned 95 years old. And I never exercised a day in my life. Every morning, I wake up, and I smoke a cigarette. And then I eat five strips of bacon. And for lunch, I eat a bacon sandwich. And for a midday snack?
John: Bacon.
Grandpa: Bacon! A whole damn plate! And I usually drink my dinner. Now according to all of them flat-belly experts, I should've took a dirt nap like thirty years ago. But each year comes and goes, and I'm still here. Ha! And they keep dyin'. You know? Sometimes I wonder if God forgot about me. Just goes to show you, huh?
John: What?
Grandpa: Huh?
John: Goes to show you what?
Grandpa: Well it just goes... what the hell are you talkin' about?
John: Well you said you drink beer, you eat bacon and you smoke cigarettes, and you outlive most of the experts.
Grandpa: Yeah?
John: I thought maybe there was a moral.
Grandpa: No, there ain't no moral. I just like that story. That's all. Like that story.

Nursedude said...

Gotta love the late Burgess Meredith....