Postponing death by prolonging illness
Everyone dies sometime. But when and how? Those questions become more salient as birthdays roll by. It has been said that wherever old people gather there is an ‘organ recital’ of malfunctioning body organs and parts. I, too, have a recital.
Last year, at age 88, I woke up in a San Francisco hospital room after having my aortic heart valve replaced by one made of a metal spring and some cow tissue (an ‘Edwards Sapien 3 Ultra’). I was glad to be alive, and I was clearly better off than my roommate, an elderly gentleman with a wrinkle-ridden oblong face and no visible hair. Heavily sedated and apparently dying from double pneumonia, he was a convenient roommate: no idle conversation, no moaning in pain, no shouting for nurses, no snoring, no watching late-night TV game-show reruns.
I don’t know what happened to my roommate – I escaped after two days. Back home, my healing went well, ‘for a person my age’, as the doctors routinely reminded me. But it was not entirely good news. My artificial heart valve – by decreasing my chances of dying from heart disease – has increased the likelihood of my dying from something worse (such as pancreatitis or a brain tumour).
Biophysicists have calculated that, with maximal improvement in health care, the biological clock for humans must stop between 120-150 years. Biotechnology firms such as Calico, Biosplice and Celgene are putting this to the test by scrambling to extend our normal lifespan as far as they can. However, a basic problem, at least thus far, is that a sustained quality of life has not been extended to keep up with our expanded longevity.
As people get older, they are not gaining economic security, maintaining their usual level of independence, extending their social relationships, or avoiding chronic illnesses. For instance, about 85 per cent of older adults in the United States have at least one common chronic illness such as diabetes, heart disease, arthritis or Alzheimer’s. Thus, many routine tasks such as bathing, making the bed, doing errands, shopping, picking up items off the floor, or walking without falling cannot be performed without help. In short, as we live longer we are also unwell for longer. [Continue reading…]