The Last Well Person
May 19, 2006
I’m reading a book that is going to get me in all sorts of trouble with my doctors. It’s The Last Well Person: How to Stay Well Despite the Health-Care System by Dr. Nortin Hadler, Professor of Medicine and Microbiology/Immunology at the University of North Carolina at Chapel Hill. He says we are being presented an image of the “baby boom” generation living forever. “Fear not,” he says, “The death rate is one per person. The only uncertainties in that regard are when, how it will happen, and what the journey was like.”
He says there seems to be “a fixed longevity for our species, set around eighty-five years of age. …anything beyond is a bonus and even a statistical oddity.” He takes a very dim view of what medicine can do to alter that fact. He also has little good to say about some of the current hot medical interventions. Near the beginning of the book, he says:
I, for one, do not care how many diseases I harbour on my eighty-fifth birthday, though I prefer not to know that they are creeping up on me. Neither do I care which of these diseases carries me off, as long as the leaving is gentle and the epilogue meaningful. Perhaps the best we can reasonably hope for is eighty or so years of life free of morbidities that overwhelm our wherewithal to cope, and to die in our sleep on our eighty-fifth birthday. …When high-functioning octogenarians decline, it is because their time is approaching. When death supervenes, it is because it is their time. That is the real proximate cause of death. It does not matter how many diseases are vying for the coup de grace - only that the journey was as gratifying as possible.
Now, that makes a heap of sense to me.
Part One of the book is titled THE METHUSELAH COMPLEX, with chapter titles like “Interventional Cardiology and Kindred Delusions.” Part Two is WORRIED SICK, including chapters titled “Medicalization of the ‘Worried Well,’ and “Turning Aging into a Disease. ”
As I read through this little black book, you can probably expect a few wierd articles in the Orlop over the next few weeks.
Dave, who doesn’t know what’s creeping up on him but has no doubt about the epilogue.
Comments
3 Responses to “The Last Well Person”
Got something to say?
……unless you are like my 92 year old, very active and acute Mother who makes complaints to her doctor that her legs just don’t work like they should. His reply is “there are no studies on 90 year olds to give us any data on this” to which she replies “Don’t tell me it is just because I’m over 90. I just want you to fix it.”
I get a kick out of the old folks who come to the GP I transcribe for complaining of fatigue. They’re in their 80s and 90s and can’t figure out why they’re so tired. The docs are kind and do the blood work but will say to me and not to them… uh… they’re old…and tired. Keeps the lab techs employed, the tests usually come back negative. They should praise the Lord that’s all that’s wrong with them! Sounds like an interesting book. Hope I die peacefully in my sleep when my times comes, but I’ve got a few more good kicks left.
Oblivious: I think I would be delighted to be active at 92 regardless of legs that don’t work well. Bless her heart! The “I wnat you to fix it” idea is still strong in many of us at any age.
Linda: You definitely must read this book! I don’t know whether you will like it or hate it, but I’d like to find out. My problem is that the writer’s vocabulary is a bit beyond me, but you would probably not have any trouble with it.
One of his themes is that when we decide we can’t cope with a hurt and go to the doctor, the hurt automagically becomes a disease and we become a patient, which, he says, is usually not a good thing. He calls it the medicalization of a (often normal) pain.