Mortality

“Getting older isn’t easy for a lot of us. Neither is living; neither is dying. We struggle against the inevitable, and we all suffer because of it. We have to find another way to look at the whole process of being born, growing old, changing, and dying, some kind of perspective that might allow us to deal with what we perceive as big obstacles without having to be dragged through the drama.” – Ram Dass, Still Here (©2000)

Back when I was younger, I used to laugh at my aunt Ingrid's reactions to the news that someone had died. If the decedent was older than her, she'd sound relieved. Yep, he's dead, but, heck he was two years, five years, ten years or more older so it was no surprise the old dude had bought the farm. Yeah, he's dead, but he was ancient; I've got lots of time left. On the other hand, if the dead person was younger there'd be a kind of surprised, almost fearful response: but she was so young! This is such a shock! Even if the age difference wasn't great, like if she was 70 at the time and the decedent was only 69, she'd start looking worried. Time was obviously running out. 

Well, now I'm in my 60s reading obits and seeing life spans shorter than mine -- and I'm starting to have a similar reaction. Oh, shit. I'm not going to live forever after all. It's one thing to recognize that fact intellectually when you're in your 30s or 40s, but it feels a little different once you start wondering if you really should buy those green bananas. You start to hope you're one of the lucky bastards who drops dead unexpectedly and inspires bad jokes (hit the ball, drag Harry) and not one of the poor saps tethered to an oxygen bottle at the nursing home. 

Most of the time I don't think about it much, but this was one of those months where I wound up having conversations with my primary care physician about glucose levels, cholesterol, weight, and all the other things health care providers love to fret about. My blood glucose was a number that is now considered too high: they moved the goal posts a few years ago, so what was perfectly okay a decade ago is now Ohmigod-you-need-to-take-metformin. Ditto the cholesterol. The numbers haven't changed in years, they always hover right around just over the line, but every time my PCP sees them it's ohmigod-you-need-to-take-Lipitor. 

Why? Am I going to live longer? Well, no. Lots of studies have been done showing that if you're one of those just over the line people treating a condition that's borderline doesn't do a thing to increase your life span. Will it reduce risk of heart attacks or strokes? Ah. . . no. There isn't a statistically significant difference in outcomes for people whose cholesterol falls in that just over the line area. Well, what about quality of life? Are they going to make me more physically fit, help with aching joints, make it a little less scary scrambling up step ladders or easier to get up if for some reason I've decided to kneel on the floor? Nope, not at all. The only thing that helps with activities of daily life is exercise to retain mobility and flexibility.  

In fact, there are no good answers that justify taking drugs for a borderline condition, at least not for me. You go from knowing your total cholesterol is just over 200 to knowing it's just under while at the same time enjoying all the fun side effects, like gas that practically makes you jet propelled, diarrhea that has you wishing you owned stock in Kimberly-Clark, and giving up foods you like because they can interact in a bad way with the drugs. You haven't actually gained any years; it's just going to feel a lot longer because you're miserable. The line between "you're okay" and OMG is a fairly arbitrary one; it had to drawn somewhere, but that area on either side of it is a fairly fuzzy one. 

I can understand why physicians and other health care providers are reluctant to face the truth and admit that the stuff they're prescribing might not actually do much: they're dedicated to saving lives. It sucks that they can't offer their patients immortality (or even a comfortable old age). Handing a patient a prescription lets them feel like they've done something even if they really haven't. I don't know if I'll bother arguing with my PCP about this or not; I might just let her write the prescriptions and then not get them filled. She's talking about leaving L'Anse anyway (the winters are pushing her away). Odds are that a year from now I'll be dealing with someone new so the current PCP will never know how thoroughly I ignored her advice. 

I figure that at my current age, if all goes well, I've got a 50% chance of making it to 86. If the odds are only 50/50, I think I'd prefer to spend that time enjoying a decent qualify of life instead of shuffling pill bottles and wondering if I should invest in some Butterfly Body Liners. After all, nobody lives forever.