Facing the Ultimate Fact of Life

Aug 24, 2018

Joe Lovell of Amarillo quotes a favorite author, Larry McMurtry. “Woodrow, you just don’t ever get the point – It’s not dyin’ I’m talkin’ about, it’s livin’.” Augustus McCrae to Woodrow Call, in Lonesome Dove.
Credit Joe Lovell - Amarillo, Texas

“Aging.”  That used to be just a word, one not often considered, that I reflexively associated with gaining access to things and experiences previously unavailable to me. 

Now, as I begin my sixth decade, “aging” is a word that reveals itself to me daily – in the aches and stiffness that greet my every morning; in the faces of my siblings, colleagues, and, of course, that sagging, grizzled image in the mirror; in the daily physical challenges of my parents and my wife’s; in the constantly declining memory of my mother-in-law.

Aging is brought home to me by the ever-increasing loss of family, friends and acquaintances.  That used to be a very rare occurrence, most commonly a result of trauma or suicide.  Now it is more common, the result of disease and inevitable frailty.

I find myself at funerals.  Donning my black suit, I arrive at the latest service and eventually slide the program into my pocket, only to discover the program from the last funeral.  My new last departed friend joining the next-to-last. 

Aging is perhaps most starkly and urgently revealed to me in those delightful ever-ticking stopless stop-watches that are my precious grand-daughters.  I better make it count.  It never stops and passes so quickly.

Whether aging is the sad or the delightful, it is and shall ever be.  In the words of a friend learning of his mother’s death while overseas, he was coming home “to face the ultimate fact of life.”

So, what do we do about it?

In his book, “Being Mortal:  Medicine and What Matters in the End,” Dr. Atul Gawande captures and analyzes this mixed bag that is aging and infirmity in America, and does so from the perspective of a physician educated in this country to scientifically treat the body’s symptoms and forestall life’s end.  In his words,

“I am in a profession that has succeeded because of its ability to fix.  If your problem is fixable, we know just what to do.  But if it’s not?  The fact that we have no adequate answers to this question is troubling and has caused callousness, inhumanity, and extraordinary suffering.  This experiment of making mortality a medical experience is just decades old.  It is young.  And the evidence is it is failing.”

In this book, Dr. Gawande takes us on his journey of learning.  Learning about dying and learning about living.  About his learning, from both sides, through experiencing and being a participant in the failures of our nation’s approach to the aging and the dying.  Learning not merely through studies and statistics, but through personal and cultural experiences, including his own, with the slow loss of his father.  He learns that there is so much more to aging, infirmity, and death than simply morbidity and mortality, to use the medical terms. 

How then do we make life worth living when we are no longer able to take care of ourselves?  The studies unequivocally show that Americans generally become happier as we age, even if we cannot do what we used to, because we gain a perspective of death’s inevitability.  “We can fix everything” medicine in America lost its grasp on this fact, though humankind has long known it intuitively.  As ol’ Gus McCrae told Lori,

“The only healthy way to live life is to learn to like all the little everyday things, like a sip of good whiskey in the evening, a soft bed, a glass of buttermilk, or a feisty gentleman like myself.”

Why deny the little everyday things in the name of medicine?

Dr. Gawande’s learning curve passed through some sad and horrible endings, ordeals lengthened by the miracles of modern medicine, but comes out on the side of hope, of Gus – not about dying, but living.

When I first read this book, Dr. Gawande was just another doctor who wrote an interesting and compelling book.  But due to this Nation’s inability to collectively find solutions to our health care delivery system, a trio of billionaires and their companies have undertaken to find their own solutions.  The leaders of J.P. Morgan, Amazon, and Berkshire Hathaway have joined in a venture to innovate health care in America by making it more transparent, affordable, and simple.  And they recently picked Dr. Gawande to lead this innovation.  This book is a window into the mind of a man empowered to shape our health care.  Stay tuned.

Having read this fine book and its message, now facing aging and the ultimate fact of life, I know I need to share it with those important to me.  But, as Dr. Gawande acknowledges, it is not easy to talk about these things for fear of disheartening the very ones you seek to encourage.  I hope I find the courage to share this book with friends and family struggling against disease and aging.  I hope you do too.

For the HPPR Radio Readers Book Club, this is Joe Lovell of Amarillo, Texas.