Longevity… Why?

Even before I became a doctor, I’d always thought to myself that I didn’t want to live very long. 

Till now, I cannot imagine my life beyond the age of 70. It is not because I don’t know that 70 years is not a very long time. I am well past the time dilation of early childhood. A couple of years ago in fact, I was shocked to my foundation to discover that I had not lived up to 1 billion seconds. So all the vibe, the jive, the colour and passion of youth, the confusion of adolescence and the challenges of adulthood had passed by so quickly. If there was a giant metronome droning away at 1 beat per second, it would not have recorded one billion hits and I had already grown from infant to child to adolescent to adult, already trained and qualified to deliver babies and treat sick people. Had already exchanged body fluids with dozens of people, probably shuttled a hundred different strains of microbes back and forth in the process. All this under the billion seconds mark. Incredible!

Perhaps to reinforce this feeling, I am working in healthcare- as if I needed any reminding of the frailty of human life. For a considerable part of my postgraduate training, I have treated men and women in the twilight of their lifespan. I have come up close and personal with the “devastating” effects of age and disease on the human body. 

At this very moment, I have a patient in my care, who reminds me particularly of why longevity does not appeal to me so much. He is 67 years of age. A whole 3 years shy of what I thought was the “safe berth” of 70. But he has an aggressive type of prostate cancer that is really eating him up. What is even sadder is that he is still mentally sharp and very much about his wits. Usually, prostate cancer progresses indolently and by the time the end is inevitable, the patient is either already used to being a shadow of their former self or can no longer even tell the difference.

In this case, my patient was completely sound in mind and body until less than a year ago. The disease is tearing away at his body faster than his mind can decline. He simply cannot fathom the rate of his degeneration. He is now paraplegic, incontinent of urine and feces and cachectic to mention just a few. There’s also a couple of pathologic fractures and persistently low blood levels. 

This afternoon, while setting up yet another blood transfusion for him, he started asking a barrage of probing questions.  

“Why am I still so pale, even after taking so many pints of blood?”

I calmly explain that we will check his blood levels again after this transfusion is done. So that we can have an objective measure of how much improvement he has made as against what we expect. 

That is running around the question, sincerely speaking, but he seems satisfied with the answer. 

He goes ahead to talk about how he can’t understand why he is weak all the time, is practically bedridden and nursing a bedsore over his lower back or what the vague, nonspecific pain he feels in his abdomen is.

At one point he blurts out: “Doctor, take a look at me, just look at me”

Ironically, that is the point where it became hardest to keep my eyes on his face or any other part of him for that matter.

It is sad, just sad. I try my best to stop imagining myself in his shoes. Every bit as independent-minded, headstrong, obstinate and set in my ways, yet physically incapable of walking to where I want, wearing what I want, indulging in my hobbies. I shake off the horror of sitting still and being fed, being clothed, peeing and pooping on myself and worse still, being cleaned off by another person, no matter whom. 

It is even more horrifying to think that all these terrible things I had associated with old age and longevity and for which I had chosen the safe sanctuary of 70; where one could not be considered to have died a young man, but not old enough to be “useless” could occur even before that age. 

This is funny because I am part of a clan of long-lived men. My grandfather’s brother died recently at the age of 104 years. He easily had another 5 years in him. Till he died, he was ambulant, relatively independent, still recognized and remembered the little details about pretty much everyone. Granted, his eyesight wasn’t what it used to be and his hands were quite shaky, but apart from hollow cheeks, missing teeth and wrinkled skin, he was quite OK. 

My own grandfather is in his early 90s and is still fit as a fiddle. One would think that being part of this kind of family, I’d be less squeamish about growing old, but even if my worst fears never come true, I’d probably be really bored with life then… 

But then again, try as much as I can, I cannot shake these fears off. They lurk beneath the surface and from time to time, they leak out and reinforce my dislike for longevity even more.  Maybe I should cut my expected life span to less than 70 in the light of what I have now in front of me. But then, I might as well die now- there’s another patient in another ward, who is 21 years of age and battling End Stage Renal Disease…

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