Not Fade Away

Sorry for the abrupt change in seriousness, but I just read a somber, eye-opening article about health care for the very old. Everybody needs to read it immediately.

It was written by a geriatric physician Jerald Winakur. He's an expert in the field. He knows too well what the future holds for his ailing and dementia-addled father of 85. All of the options are ultimately fruitless, extremely painful for the family, and expensive. He knows the numbers and the bleak reality of managed care. He is even haunted by the unthinkable:

Often, in fitful sleep, I dream that when the time comes, I go to my father's bed, quietly fill a syringe with morphine and stroke his arm as I tie the tourniquet.

Given the astronomical numbers of elderly that we will face as a society over the next 20-30 years, given the double-edged sword of advancing treatment and prolonged life expectancy - and given the fact that (if we are lucky) - we will all pass this way sooner or later, this is an issue that needs to be discussed without partisanship.

It's an uncomfortable topic. But by avoiding any active decision, as a society, we have handed the process over to institutions and the adult children of the aged - who are usually too wracked by grief to think clearly. I am not one of those who instinctively hiss at the shadow of every health care company - any reasonable policy must utilize them. But citizens and their representatives need to have a serious discussion. Winakur points out:

Our parents will become our children if they live long enough. Perhaps if we looked on our elderly in this way, we would be kinder to them.

The Baby Boomers are about 60 now, and they are all headed towards the precipice en masse. My generation, "Generation X" is now collectively around 35. We will be the adult generation on duty when that time comes. It might be a peculiar legacy - but what if we could help agree upon a dignified, reasonable, and humane way to spend our final days?

UPDATE: The full article by Dr. Winakur can be found here.