Why Would a Perfectly Healthy, Wealthy, and Happy Person Hope to Die?

In the October 2014 issue of The Atlantic magazine, oncologist Ezekiel J. Emanuel published a 5,000-word article with the provocative title “Why I Hope to Die at 75.” The article was accompanied by a photo of the author with a broad grin on his face. He did not look forward to an early death because he was depressed, but rather for some, to my mind, dubious philosophical reasons.

Emanuel predicts that by the time he reaches age 75 he will have lived a complete life. He will have lived to see his children grow to adulthood and have children of their own. He will have made whatever contributions to the world that he is likely to make. He wants to go out while still on top, avoiding the downsides of hanging on too long.

Addressing fellow Americans specifically, Emanuel made several assertions, including:

  • Americans today may live longer than their parents, but they are likely to be more incapacitated.
  • Over the past 50 years, health care hasn’t slowed the aging process so much as it has slowed the dying process.
  • Medical science has been ineffective at countering Alzheimer’s disease and other dementias.
  • Older people become slower, both physically and mentally, and are less creative.
  • Living longer puts a caregiving burden on the next generation.
  • Parents sticking around prevent their offspring from assuming the mantle of the head of the family.
  • Children and grandchildren will remember you as stooped and sluggish, and forgetful and repetitive, rather than active, vigorous, and engaged.

Emanuel looks at the glass and to him it appears to be half empty. I look at the same glass and it is clear to me that it is half full. There is still quite a lot of water in it.

When Emanuel wrote his piece for The Atlantic, his seventy-fifth birthday was 18 years in the future. For me today, my seventy-fifth birthday is less than three years away. From where I stand, his assertions seem to ignore the major strides being made in knowledge of healthy living and in learning the causes of and remedies to the declines caused by aging. Let’s take them one by one.

  • Americans today may live longer than their parents, but they are likely to be more incapacitated.

This does not reflect my experience, or that of many of my contemporaries. Both of my parents were in worse shape than I am now, at a much younger age. They were overweight and sedentary, suffered from high blood pressure, and had heart problems and diabetes. None of those things are true of me.

Both of my parents have now passed on, my father at an age seven years younger than what I am now. Sure, there are some people today who are in worse shape than their parents were at the same age, but I believe they are in the minority. Fewer people are smoking today than was true a generation ago. More people may be obese today than a generation ago, but you will not find among them the people Emanuel derisively calls the American immortals. He is referring to people who exercise, watch their diet, and take nutritional supplements. These people have the biological age and disease profile of people of a significantly younger chronological age. They are not chasing immortality. They are merely working to keep robust health and high functionality for as long as possible, based on current knowledge.

  • Over the past 50 years, health care hasn’t slowed the aging process so much as it has slowed the dying process.

The fallacy with this observation is that medical knowledge and practice of the past 50 years is not the same as the medical knowledge and practice of today. Fifty years ago, twenty-five years ago, even ten years ago, there was no field of study whose object was the halting and reversal of age-related decline. Today, the new field of regenerative medicine is exploding, with major advances being announced on almost a daily basis. The old rules don’t apply any more.  Whereas Western medicine has traditionally relied on drugs to cure disease, now genetic engineering, molecular machines, and other recent technologies are opening entirely new avenues to treat the damage caused by aging and thereby to restore robust good health.

  • Medical science has been ineffective at countering Alzheimer’s disease and other dementias.

The fallacy of this assertion is the same as the previous one. The medical science of the past had no idea what was causing Alzheimer’s disease, so of course was ineffective in countering it. With powerful tools that have recently come on line, researchers are finally figuring out causes, and effective interventions are appearing on the horizon.

  • Older people become slower, both physically and mentally, and are less creative.

This assertion is largely true, but so what! I cannot run as fast or as far as I could when I was 30, but I still run. Perhaps regenerative medicine will someday return me to the physical ability I had at age 30, but even if that does not happen, I expect to be able to continue to engage in many activities that I enjoy. Today, it may take me a little longer to solve a hard sudoku puzzle than it did when I was younger and I may not be as successful at blitz chess as I used to be, but I can still be as competitive as ever at classical chess.

I don’t think I am any less creative than I was at a younger age. I didn’t win any Nobel prizes back then either. I am still writing books and articles and am about as prolific now as I have ever been. I expect that to continue until I am well past age 75. Even Emanuel mentions an eighty-year-old collaborator who was still making major contributions to his field. He dismissed him as an outlier. I suspect that there are a lot more “outliers” than Emanuel imagines, many of them among the American immortals.

  • Living longer puts a caregiving burden on the next generation.

Regardless of whether lives are longer or shorter, a caregiving burden will be placed on the next generation. If lives are longer, the next generation is more mature and better able to handle the responsibility. Not only that, but the caregiving burden is much diminished if it is healthy life that is extended rather than prolonged illness. People who are consciously trying to live longer are doing so by making lifestyle choices that extend healthy life, not just calendar years.

  • Parents sticking around prevent their offspring from assuming the mantle of the head of the family.

This is a pretty weak argument. But at any rate, should not be an issue for most people. My grown children have become the heads of their own households. I didn’t have to die for that to happen. I don’t think my experience is unusual.

  • Children and grandchildren will remember you as stooped and sluggish, and forgetful and repetitive, rather than active, vigorous, and engaged.

This argument is even weaker than the previous one. What people think of me after I am gone is no concern of mine. They will have their own lives to live and they will think what they will think. My legacy will be the things I have done to help people throughout my life. Regardless of that, I don’t believe I am fated to end up stooped and sluggish, forgetful and repetitive. I am working hard to maintain my health and vitality, and as new medical advances are made, I intend to take advantage of them to extend healthy life.

After 5,000 words on why Emanuel does not want to live past age 75, in the last paragraph, he gives himself a golden parachute. He says “And I retain the right to change my mind and offer vigorous and reasoned defense of living as long as possible.”

What a cop out.

My advice to you? “Live long and prosper.”

Lobster Newburg

When you were a kid, did you ever hear anything like this: “Eat everything on your plate! Millions of people are starving in China while you sit there wasting food!” That is something I heard often as a child. My mother grew up during the Depression, and had been taught not to waste anything. She came from good working-class Irish stock, and she learned how to cook from her no-nonsense, meat and potatoes, Irish mother.

I don’t know what experience you might have with Irish cooking, but I’ll tell you what mine was. My grandmother was a master at preparing dinners consisting of roast beef, string beans, and mashed potatoes and gravy.

This was a good thing, because my grandfather LOVED roast beef, string beans, and mashed potatoes and gravy. I figure this must be the official national dinner of Ireland. It seems like every time I visited my grandparents they had roast beef, string beans, and mashed potatoes and gravy for dinner.

So when my mother left home and married my Dad, she knew how to cook one meal: roast beef, string beans, and mashed potatoes and gravy. I have to give my Dad a lot of credit for surviving those early years before she learned how to make meatloaf to serve along with the string beans and mashed potatoes and gravy. At last he had some variety.

After spending my entire youth

eating Gerber’s baby food spinach and Gerber’s baby food squash out of those little jars,

I was really happy the first day I was finally allowed to eat big people’s food.

I thought the string beans and mashed potatoes and gravy were great. The roast beef, however, I chewed and chewed and chewed and chewed into a big wad and then I spit it out.

Mom finally got the idea that a little variety might be good. This was after about five years of nothing but roast beef, string beans, and mashed potatoes and gravy, with an occasional meatloaf thrown in. She talked to one of our Italian neighbors and picked up a new recipe.

She learned how to heat up canned Chef BOYARDEE ravioli. I really liked the ravioli, and it went pretty well with the string beans, and mashed potatoes and gravy. Then she learned how to make spaghetti and meatballs.

They were terrific. Even better, once you filled your plate with spaghetti and meatballs, there was no room left for the string beans and mashed potatoes and gravy.

Flushed with success, she decided to try out even more new meals on her growing family. By this time I had brothers. We all appreciated the spaghetti and meatballs,

the ravioli,

and even the roast beef, string beans and mashed potatoes and gravy,

since we now had it only six nights a week instead of seven like before.

The first new dinner she tried after her spaghetti success was liver and onions with a side of canned lima beans, and of course mashed potatoes and gravy.

This did not go over quite as well with the troops as spaghetti did. However, thanks to Mom and Dad’s Depression-era upbringing, we boys had our plates filled by a parent. Then we were commanded to eat everything on our plates.

It was about this time that my brother Tyson figured out how to upchuck on demand. He would eat a few spoonfuls of mashed potatoes and gravy, look at that liver and onions in front of him, think about how disgusting it was, then put a bite of it in his mouth. Yup. It really was disgusting. Before you knew it, a queasy look would come over his face and BLORRP! He would throw up onto his plate. This of course ruined the rest of his dinner and he would be sent from the table.

The “punishment” of being sent from the table was actually a victory for him. He didn’t have to eat the liver and onions. No such luck for me or for my other brothers. We had to stay at the table until we had eaten every last bite of that liver.

Somehow my mother got the idea that maybe liver and onions might not be the best alternative to roast beef, string beans, and mashed potatoes and gravy. She decided to try something else. Maybe seafood would be more popular. That was when she surprised us all with—Lobster Newburg.

I was surprised all right. The first surprise was the nauseating smell that started wafting from the kitchen about a half hour before dinnertime. The next surprise was the way it looked when I came to the table. I had never been a big fan of casseroles anyway, but this one reached a new low.

A curdled cream sauce, shot through with red speckles, covered lumps of slimy canned white lobster meat. The combination of smells coming from the lobster and the sauce was overpowering. I pinched my nose shut and started breathing through my mouth. Lobster Newburg was the most horrible thing I had ever seen or smelled in my life, let alone put into my mouth.

Not only did I have to see it and smell it—I had to eat it–eat every last bite on my plate. I took a bite and felt the slimy meat quiver in my mouth. I started feeling woooozy. The smell of it and the feel of it in my mouth made my skin crawl. I started to feel faint. At that moment, I knew what Hell must be like. Without even trying, I suddenly understood how Tyson could upchuck on demand. This time I beat him to it.

Mom never served us Lobster Newburg again. And I never complained again about dinners of roast beef, string beans, and mashed potatoes and gravy.