People always ask me what I am reading these days. They want to know if I am up on the latest fiction, the latest book club novel, the most recent New York Times bestseller. I answer vaguely about being busy, reading the paper, mention a few favored periodicals. I do not tell them the truth. I read obsessively about death.
I also read about dying. I include the fear of dying. I read about the economics of health care as it relates to the last six months of life. I’m interested in hospice and palliative care. I’m particularly interested in the plethora of books and articles being written now by people my age and older that reflect their fear of death, either through observations of their parents’ aging, or death, or meditations on their own. Illness has always been a ripe subject for writers. The inevitability of death, the fear of death, the question of an afterlife, the nature of suffering, the question of surrender vs. control, these are all topics that thinkers have pondered for centuries. Only now it seems worse because life isn’t ending as it used to, with a brief illness or some short period of suffering. Life isn’t ending at all; life is petering away in an interminable decline more often than not. That awareness has come to the fore of the collective imagination. It is an ugly thing to watch.
A couple of years ago The New Yorker published a terrific cartoon. It showed a couple sitting at their kitchen table going over a ledger. The caption read: “If we take a late retirement and an early death, we’ll just squeak by.” Or something to that effect. But the point is that we can’t afford our long lives, and the government can’t afford our long lives, and everyone thinks they want to live longer. But I would argue with that. I guess that’s why I read about it so much. It’s research for the next book, it’s partly obsession, and it’s my work. I spend a lot of my time taking care of patients who have outlived their bodies or their minds.
I work with surgeons who happily replace body parts on elderly patients who are never the same afterwards, who will never be able to do the rehab required. They don’t think twice. I don’t know what they tell themselves to justify the surgery. If I ask, they don’t respond well to the question. Maybe it’s a matter of denial. I used to think that the difference between those who like old people and those who are intensely uncomfortable around them is simple: You can handle being around old people under one condition only, and that is if you see yourself in their shoes someday. But now I see more subtlety at work, especially in the medical field.
I had friends and family members who visited my mom and I was struck by the way some infantilized her. I see the same behavior in the hospital all the time—treating the elderly as not quite human, calling them “dear”. I wonder at the people who do this: do they think old age will never happen to them? Old people can make us very uncomfortable because they force us to face our future. I had a lot of trouble with it myself when my mom’s dementia grew worse. I went dutifully to visit and stayed as long as I could stand it. At the same time, I knew that my visits were the best part of her day. But I was looking down the nose of a cannon.
So that’s what I read these days. Julian Barnes’ Nothing to be Frightened Of is an excellent depiction of his fear. An article by William Vollman called A Good Death. It seems nearly every day or every few days I find articles about an adult child caring for a parent, burying a parent, coping with the responsibilities of parenting a parent. There’s so much anger at having to pay for parental care! I wonder if our parents were angry at how much we cost them. Of course, I read those stories too. I search Harper’s and The Atlantic and The New Yorker. I read the New Old Age blog in the New York Times. It is a subject very much on all our minds. And it is costing the country a fortune.