Tag Archives: Mortality

“Drinking Alone in the Rainy Season” by Tao Yuanming [陶渊明] (a.k.a. Táo Qián, or 陶潜]

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Whatever lives must meet its end --
   That is the way it has always been.

If Taoist immortals were once alive,
   Where are they today?

The old man who gave me wine
   Claimed it was the wine of the immortals.

One small cup and a thousand worries vanish;
   Two, and you'll even forget about heaven.

But is heaven really so far away?
   It is best to trust in the Tao.

A crane in the clouds has magic wings
   To cross the earth in a moment.

It's been forty years of struggle 
   Since I first became reclusive.

Now that my body is nearly dead,
   My heart is pure. What more is there to say?

NOTE: This is the translation of Sam Hamill found in The Poetry of Zen (2004); Shambhala Publications: Boston, MA, p.24.

“In this short Life…” (1292) by Emily Dickinson [w/ Audio]

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In this short Life that only lasts an hour
   How much - how little - is within our power

PROMPT: 100-year-old

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Daily writing prompt
Write a letter to your 100-year-old self.
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Dear 100-year-old self,

In the unlikely event that we’re still alive, go play with the wolves. Let them have their meal, meager though it may be. We’ve had a good run, and – unless I miss my guess – are not feeling vigorous of either mind or body. If we are feeling vigorous of mind and body, please disregard until such time as it’s not true anymore. In said case, I’m very curious about what kind of scientific breakthrough occurred (or magic fountain we fell into,) and look forward to learning about that in due time.

Signed,

Your younger self, the one far more afraid of dementia & incontinence than of death-

“Because I Could Not Stop for Death” (479) by Emily Dickinson [w/ Audio]

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Because I could not stop for Death —
   He kindly stopped for me —
 The Carriage held but just Ourselves —
   And Immortality.

We slowly drove — He knew no haste
   And I had put away
 My labour and my leisure too,
   For His Civility —

We passed the School, where Children strove
   At Recess — in the Ring —
 We passed the Fields of Gazing Grain -
   We passed the Setting Sun -

Or rather - He passed us -
   The Dews drew quivering and chill -
 For only Gossamer, my Gown -
   My Tippet - only Tulle -

We paused before a House that seemed 
   A Swelling of the Ground -
 The Roof was scarcely visible -
   The Cornice - in the Ground-

Since then - ‘tis Centuries - and yet
   Feels shorter than the Day
 I first surmised the Horses’ Heads
   Were toward Eternity -

PROMPT: Longevity

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What are your thoughts on the concept of living a very long life?

As long as I’m of sound mind and capable body, I’m fine with it, but not at any cost. I’d rather shuffle off this mortal coil than drag out the suffering of immobility and / or dementia.

I think Atul Gawande’s “Being Mortal” is good required reading. Among other things, he talks about the smoke and mirrors of our species’s increased lifespan. (i.e. increased lifespan, yes, but too often at the cost of diminished quality of life through those additional years.)

5 Melancholic Works of Nonfiction You Should Read

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5.) Man’s Search for Meaning by Viktor Frankl: Deep life lessons learned inside a Nazi death camp.

 

4.) Being Mortal by Atul Gawande: A medical doctor discusses how living longer doesn’t necessarily mean living better, and what that can mean for one’s final years.

 

3.) When Breath Becomes Air by Paul Kalanithi: Contemplations on the meaning of life from a doctor who was dying from a terminal illness, and who succumbed before completion of the book.

 

2.) The Diving-Bell and the Butterfly by Jean-Dominique Bauby: The story of a man who developed Locked-In Syndrome in the wake of a severe stroke and couldn’t move a muscle, save one eyelid.

 

1.) First They Killed My Father by Loung Ung: The title captures the family level tragedy of Pol Pot’s rule, but the book conveys something of the national tragedy as well.

BOOK REVIEW: Being Mortal by Atul Gawande

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Being Mortal: Medicine and What Matters in the EndBeing Mortal: Medicine and What Matters in the End by Atul Gawande
My rating: 5 of 5 stars

Amazon page

 

This may be the scariest, saddest, and most necessary book that I’ve read in some time. In it, Dr. Gawande discusses how medicine has proven increasingly effective at extending life, but—at the same time–we are less able to care for the elderly. The traditional approach, in which the elderly move back in with their families (or live independently near them,) often proves untenable. And it’s not necessarily because people are too busy, lazy, or indifferent to put up with granny, but rather that granny is likely to end up with needs that require a professional caregiver—in some cases for virtually every aspect of her daily life. In short, we’ve done a great job of extending life, but often with a sharp dip in the quality of life at the end.

The nursing home was the solution that the health care community came up with when this problem first became apparent. While the nursing home is both necessary and effective for many, for those of sound mind and sound-ish body, the move can be highly demoralizing. People revert from being independent and autonomous adults into a child-like status in which they have little freedom or privacy. Again, if grandpa has dementia or needs to be tube-fed, there’s no way around this, but if he’s just at risk for a fall that might break his hip, then it can be humiliating.

When it comes down to the end, fear of death has led to an unwillingness to ask important questions or even consider what might be just around the corner. This has led patients to keep asking for that one treatment that just might extend their lives—and doctors have been more than willing to allow this. This may be fine in the early days of a terminal illness, but once one has gone through—say–a couple of courses of chemotherapy, the treatment one is likely to get is some trial phase experiment that is as likely to kill one cruelly as extend one’s life—and to the degree that it does extend one’s life one may suffer a set of complications far more miserably than one would in letting the disease kill one. One of the most intriguing study results cited showed that people who took up hospice palliative care (making one comfortable) were found on average to live a little longer than those who kept seeking whatever treatment they could find.

This all sounds like bad news, but the author devotes much of the book to exploring the options that have been put forth in the face of these problems. One of these is the assisted living facility as an alternative to a traditional nursing home. These facilities work for people who are of sound mind and who aren’t too bad off physically. They allow the individuals to live as they might in a condo or apartment, but there are on-sight caregivers and assistance with all the tasks around the house that might prove too challenging for an older person. The other major solution is hospice care. Not that palliative care is new, but it’s increasingly being show to be a preferable option for all concerned. Another important outcome resulted from a major insurance provider’s decision to allow individuals to pursue palliative care while they were still being treated. [Historically, one only had the option of hospice once one had given up on treatment.] At any rate, the intriguing finding was that the insurance company actually ended up paying less because more people signed up for palliative care and those individuals used expensive health care elements like emergency rooms and intensive care units (ICU) less.

While I can’t say that I enjoyed reading this book, I would recommend it for everyone. It’s very readable. The approach is case-based. Dr. Gawande talks not only about his own patients and the patients and caregivers that he interviewed (his practice is not geriatric in nature, so he spoke with several experts), but also about the end of his own father’s life. It’s a short book of about 300 pages arranged into eight chapters. There are no graphics, and endnotes are the only ancillary matter, but nothing else is necessary for this book.

Read it.

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