Old Enough To Die
What is the age at which one is old enough to die? The military says eighteen qualifies someone to be put in harm's way. At what age do obituaries simply fall back on “Natural Causes” as sufficient enough explanation? At what stage, if ever, does one viscerally accept the Stoic’s injunction of Memento Mori, the reminder that no one gets out of here alive?
Though the term Memento Mori never appears in our focus piece, the sentiment echoes throughout, as the author makes the case against excessive medical screenings and tests (click: Giving Up On Preventive Care). She explains why, at age 76, she decided to give up on screenings and tests for medical conditions common to old age and instead let Nature take its course. “I reject the torment of a medicalized death, I refuse to accept a medicalized life. As the time that remains to me shrinks, each day becomes too precious to spend in windowless rooms under the cold scrutiny of machines.”
So one might ask who made her God to decide she was “old enough to die”? A deeper reading reveals a more nuanced take as she weighs the relative costs and benefits. She allows that medical care is still the preferred option for some urgent problem, by which she presumably means having clear symptoms, but draws the line at problems that otherwise remain undetectable to her.
But what about peace of mind? Or the early detection of an abnormality? The cost/benefit ratio shifts with age just as the ratio may be applied to different tests e.g. PSA, mammograms, the CT scans as the finer resolution making the detection of something/anything inevitable. Her questioning the need for later-age bone density scans was triggered by her finding that the diagnosis of osteopenia was shared by most women over the age of 35. And then there is the issue with over-diagnosis and false positives. Do your own due diligence but certain “heroic recoveries” from cancer turned out to have stemmed from an initial false positive reading.
Health care decisions, of course, are deeply personal and there is a sizable contingent that speaks of dying in hushed tones and subscribes to “rage, rage against the dying of the light” – with an immense preventive care and medical industry there to accommodate.
By the same token, medicine seems to have shifted somewhat to acknowledge and accept mortality, most evident in palliative care. Reflecting on mortality allows one to prioritize what matters and to act with less ego through the lens of “if today were my last day how would I choose to spend it?”
In any event, the mortality-awareness lens is worthy of consideration at any age to the extent it sharpens one’s risk-benefit calculus and reduces the prospect of “endless escalation” of testing and treatment that adds little to meaningful time or well-being.
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