Things Fall Apart

The greatest failure in America is the failure to stay young. It is a failure of imagination, the inability to grasp the alternatives offered by surgery, cosmetology, and pharmacology. It is a failure of will, the indiscipline that results in flagging energies, flabby bodies, and clogged arteries.
It is a failure of financial planning, the incapacity to amass the resources needed to deploy the full panoply of anti-aging techniques and technologies. Most basic of all, it is a failure of genetic foresight, the prenatal indolence that passively accepts a poisoned lineage of physical and mental infirmities, moral laxness, and hereditary balding.
The only room for old men and women in this country is in separate bathtubs atop a cliff, holding hands as they watch the sunset and wait for the antidote to flaccidity to kick in so they can frolic in the same tub; or, in the case of a failure to achieve liftoff, throwing themselves in the sea, in a watery version of suttee.
For me, the nightfall of old age is particularly upsetting. I tried hard to seize and hold the day. I was born to healthy, middle-class parents in a good neighborhood. Except for college, the office Christmas party, and that weekend in Las Vegas, I drank moderately. I exercised regularly and completed several marathons. I had regular checkups and took care of my teeth. I’ve enjoyed a reasonably successful career, a happy marriage and a retirement undimmed by fear of living in a cardboard box and subsisting on the kindness of strangers.
Some changes were only to be expected. At thirty, I faced up to male pattern baldness. At forty, I purchased my first pair of reading glasses. At fifty, I added Metamucil to my orange juice. At sixty, I started blood-pressure medication and did my best to eschew meat and order whatever fish was on the menu
Despite hard work, sound planning, lifestyle adjustments, and unusually well-behaved Irish genes, I find myself–to paraphrase the poet Yeats– “where all the ladders” end, “in the foul rag and bone shop” of encroaching decrepitude.
One day I had hearing as good as a rabbit’s. The next I suffered “sudden onset hearing loss.” In a flash, I went deaf in my left ear. At cocktail parties, I can no longer distinguish conversation from background noise (not that it matters much). Going out to dinner requires several minutes of configuring the seating to compensate for my auditory deficiency.
I developed epilepsy. I was sitting down for a television interview when, bang, I suffered a grand seizure that left me unconscious (so I’m told), writhing on the floor. I’ve had several since, the last of which resulted in a head injury that required several stitches. As a result, I can no longer drive, ride a bike, swim alone or–not that I had ever had the desire–swing on a trapeze.
After 50 years of running, my knees resemble the coil springs on a rusted ’56 Chevy. Two weeks ago, something snapped in my upper arm while doing my morning pushups. I can’t lift my right arm above my shoulder. Last week, while jogging, I wrenched my back so badly I can’t walk right. I recently had surgery for thyroid cancer. My medicine cabinet resembles the pickup window at the local pharmacy.
My powers of recall are showing signs of wear and tear. I open cabinets and drawers and instantly forget what I’m looking for. The ability to attach names to the faces of friends and acquaintances is becoming one of life’s small triumphs.
“The wages of sin,” wrote St. Paul, “are death.” Either he forgot to mention or deliberately left out that so are the wages of virtue. We’re all inching or hurtling toward the egress, and we Baby Boomers are elbowing our way to the head of the line. For us, keeping the Grim Reaper at bay looms as an increasingly expensive proposition.
According to the Medicare Newsgroup, an independent source for coverage of Medicare-related issues, end-of-life care continues to be characterized by highly aggressive medical intervention and runaway costs. Medicare spending in 2011 totaled more than $550 billion. Of that, $178 billion, or 20%, was spent on patients’ last six months of life.
It’s true you can’t take it with you. It’s also true that we members of the over-sixty-five set will suck up a disproportionate share of the country’s medical resources in order to make incremental additions to life spans already longer than those enjoyed by 99% of our ancestors.
There are plenty of seniors with the energy and strength to lead productive lives for years, maybe decades to come. But, in the words of Daniel Callahan, president emeritus of The Hastings Institute, “no matter how (many) medical treatments we get, it’s never good enough because people eventually die … We’re not in a winnable war against death.”
The inevitability of the final curtain doesn’t make it easier to accept. I’m as reluctant and fearful as anyone else to face the end. But, sooner or later, it’s all right to think about making room instead of taking it up. A degree of resignation and acceptance isn’t a bad thing.
We can claw and cry for a day or two more, and spend whatever it takes. We can rage against the dying of the light and resent it as a violation of an imagined right to live forever. Or we can enjoy what we’re still capable of enjoying and exit, if not laughing, then with a smile of gratitude for the miracle of existence we’ve been privileged to share.