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Medical interventions or not?

It’s winter, time to go through my checklist of medical appointments/procedures: dermatology, yearly physical, blood work. And my number is up for a colonoscopy, hopefully my last one.

Many of us are going through various issues and tests and interventions, some far more serious than mine: chemo, radiation, surgeries, etc.

All of this is to prolong our lives, help us feel better and improve the quality of what remaining years we have. I am willing to have my blood tested, various lesions burned off my skin from sun damage and have my colon probed to check for cancer. But I’m wondering how far I will go. How many and how drastic of medical interventions will I want to have if things get serious?

I am grateful we have fairly easy medical access here, and some of the specialists are quite good. At other times, I feel there is a certain “medicalization” of older folks, the tendency of the medical community to always suggest a procedure or surgery to solve a problem, potentially exposing us to more and more risks without really solving the problem. Once we get into the medical system, it’s difficult to get out.

Dr. Ezekiel Emanuel, in his groundbreaking article, “Why I Hope To Die at 75” (The Atlantic, October 2014), says:

“At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. ... I will accept only palliative – not curative – treatments if I am suffering pain or other disability.”

His feeling is that living too long is a loss. It renders us to live in a state of deprivation, robs us of our creativity and our ability to contribute to work, society, the world. It transforms how people experience us, relate to us and remember us. He feels that by 75, he will have lived a complete life, have loved and been loved, his kids will be grown, his projects pursued, and he will have made his contributions to the world. He is now 66.

No medical interventions after 75! Wow, I’m already past that and involved in them big time right now. But it’s something to think about. Are we all too obsessed with being healthy, feeling good, the latest diets and supplements, just to prolong the morbidity that is inevitable? Maybe we’re all trying to make that time shorter, and live a more quality life until then, and hope that declining years will be brief.

The bottom line seems to be pain. If we’re in pain, then most of us will do whatever is necessary to escape it, as long as we have hope that this too shall pass. The expectation that I will be fine and well and healthy again is what keeps me going when I have pain. If I didn’t have that, I’m not sure how long I’d want to live constantly suffering. But people do live like this, and for many years.

Will Emanuel’s boundary push back to 80? To 85? I think we all have that line we will not want to cross, where life is just too much and we can’t go on. Who knows where that is, and how long it could be moved further and further into the future.

What is important to us? Letting nature take its course? Preserving our quality of life? Staying true to spiritual beliefs? Living a long life, regardless of quality? Being independent? Being comfortable and pain free? Being free of physical limitations? Being mentally alert and competent? Dying in a short time, rather than lingering? Avoiding expensive care or having loved ones care for us?

All things to think about as we age in this time of many medical advances. It’s sort of like a practice for what is to come. What do we want? What are our choices? How do we see finishing out our years, and the actuality of our deaths? Our path to death depends very much on our preparations and choices we make along the way.

May we all be blessed with good health for as long as possible.

Martha McClellan has lived in Durango since 1993 and has been an educator, consultant and writer. Reach her at mmm@bresnan.net.