Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise — not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and — just as important at a certain age — how we choose to spend the time that remains to us. … In giving up on preventative care, I’m just taking this line of thinking a step further: Not only do I reject the torment of a medicalized death, but I refuse to accept a medicalized life, and my determination only deepens with age. As the time that remains to me shrinks, each month and day becomes too precious to spend in windowless waiting rooms and under the cold scrutiny of machines. Being old enough to die is an achievement, not a defeat, and the freedom it brings is worth celebrating.
~ Barbara Ehrenreich
(Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer)
A year after my cancer surgery it seems like a good time to mention a book that tumbled into my life at just the right moment. After my brush with a life-threatening illness, the ideas set forth in Barbara Ehrenreich’s book, Natural Causes, make a whole lot of sense to me.
I spent many years carting my mother-in-law, my aunt and my father around to those “windowless waiting rooms,” getting test after test, some of them downright painful. My aunt finally put her foot down and proclaimed, “Whatever I’ve got, I’m taking it with me.”
She lived to be 103 in spite of refusing all the standard tests recommended for her in the last years of her life. When she died, it was from an infection. After accepting treatment for a day or two, she finally refused treatment for that, too.
Nothing ever came of those countless tests.
In my own case, because my mother died of breast cancer, I have submitted to many “required” mammograms and wound up with three false positives, causing weeks of anxiety. Now I refused to have any more. At this point in my life I am old enough to die, and if I wake up one morning and feel a lump in my breast, so be it.
The endometrial cancer I wound up getting? Well, there is no screening for it. Irony.
Fortunately I’ve found a general practitioner who understands my feelings and treats my “urgent problems” without pushing me into a “medicalized life.” Barbara Ehrenreich’s book has all the facts and figures I needed to convince me that as a culture, we are indeed killing ourselves, or at least making ourselves miserable, in order to live longer. All these expensive, invasive tests have not increased our lifespans.
Therefore, I have chosen to enjoy spending whatever time I have left to me without borrowing trouble.
Hi Barbara, This is very interesting. One of my biggest fears is that of becoming a patient, especially if something is found that won’t kill me, but will lead me into the black hole of the medical-industrial complex. I hadn’t heard of this book but it sounds worthwhile.
Hi Susan, I do highly recommend this book. Sadly, your fears are well founded. Death use to be viewed as a natural part of life but as a culture we’ve become too obsessed with avoiding it at all costs. The price we pay is too high. We need to learn better how to balance quality of life and quantity of life…
Thank you for this wisdom this morning. Something to ponder indeed. I am headed more fully into the western medical establishment world next week and will keep this in mind. I honor your stand here.
Thank you, Kathy. I wasn’t sure how people would take this so my sharing was tentative. I hope your coming journey into the western medical establishment goes well and that you are much feeling better than you were last year.
I have had this book on my reading list for a while, and was unable to find a copy of it locally. I might have to order it. I’m contemplating my 60th birthday “gift” that I should have arranged for by now (the colonoscopy), wondering if I want to put myself through it. I know all the arguments in favor and don’t totally disagree, but I also have other issues to deal with and the cleansing part of the procedure might be tough going (more so than usual).
Thank you for this thought-provoking post. Quality of life, it seems to me, is so much more important than quantity.
I have the book on my Kindle ~ I still get a kick out of carrying a library around in my handbag.
I hear you about the colonoscopy. I had one when I was 50 and skipped the one at 60. (I’ll be 62 in January.) I still cringe when I remember the hell my frail 90-year-old father went through preparing for his last colonoscopy. Looking back, I regret all the needless suffering he endured.
It’s hard to know when enough is enough. That’s why I appreciate Ehrenreich’s stressing that giving up on preventative care (or painful screenings) should be a personal decision. Wishing you well as you determine which way to go.
I understand completely, Barbara. You have to do whatever you feel makes life good for you – however good a life or however long a life you’re able to have.
Personally, I’ve refused most of the so-called ‘preventative’ tests because of the possibility of false-positives of which I gather there are many. I wouldn’t be able to cope with them as I get incredibly anxious and find that more difficult to cope with than most physical conditions. That’s not to say that I wouldn’t have treatment – I’d have to consider it at the time, but I suspect I’d avoid things that are likely to make me feel worse.
Yes, we seem to have a similar approach to health care. Last year I decided to go ahead with radiation after weighing the risks vs. the probable benefits. It was painless with months of fatigue following the only side effect I noticed. But there are some treatments I would very likely refuse. One never knows, until the time comes, which course one will take. The older we get the more our perspective changes. I think I decided all this subconsciously a few years ago but it’s a relief to say it out loud and make it “official,” so to speak. Thanks so much for stopping by, Val, and sharing your thoughts.