All things come to pass
The Rust enjoys a justified reputation for fearless reporting of difficult subjects, amongst which the vicissitudes and inconveniences that attend those of us beyond the first flush of youth can sometimes loom large.
It fell to the English philosopher Thomas Hobbes (1588-1679) to describe the state of mankind as “nasty, brutish and short” – a opinion which, depending upon one’s personal view, can either be regarded as a truism or a possibly these days (given the scientific/medical advances of the last century and a half) a matter for debate.
When my own father, shortly before dying at the age of 94 a couple of years ago, was moved to what the medics call ‘end of life care’ his GP came to see us and explained “The thing is, if something else doesn’t get you first, eventually old age will”.
I found the comment helpfully comforting and in a sense my father’s passing was a relief all round. Certainly it was for him: he hated the process and, from his mid-eighties onwards, never missed an opportunity to tell any new person he met – whether an acquaintance, wine waiter or priest – “Let me give you a word of advice – don’t grow old …”
Mind you, he was somewhat trumped on the occasion when he deployed it at a pre-show dinner we were having at a restaurant close to the Chichester Festival Theatre, to be met with the response from one of our guests “Well, Peter, at least it’s better than the alternative …”
Among the random – and somewhat contra-intuitive – trivia medical facts that have struck me most were, firstly, being told that, although they rarely die of it, a large proportion of men die hosting some degree of prostate cancer; and secondly, more and more of us develop some form of dementia before passing.
As regards the latter, in an echo of the GP’s comment above in my father’s case, ‘back in the day’ people tended to die of something else – even if they were in a population group likely to develop it – before the effects of dementia ever became an issue.
Increasing longevity has plenty to answer for – and two of the accompanying issues are caring for the elderly and how it is paid for.
Yesterday I read a thought-provoking article in The Times by Emma Duncan entitled NHS must start saying ‘no’ if it wants to survive [I would happily have happily provided a link to it for Rusters this morning but for the fact that the newspaper’s “subscription pay wall” prevents me so doing].
In it, as an illustration, Duncan gave a true life example of a gentleman in his mid-eighties with a heart problem who then also developed bowel cancer. A doctor relation counselled against surgery on the basis that – if left to take its course – the cancer would still allow up to two more years of life, whilst the risks of surgery were considerable.
However, the patient insisted on having an operation.
Although the surgery went well, soon thereafter he developed breathing and kidney problems, spent three months in hospital before being discharged, never recovered – and ended by dying of heart failure just three months after that.
The thrust of the article was that operations do not necessarily improve or prolong people’s lives and that many high-risk patients, such as the above-mentioned gent, would have been better off not having had surgery.
The statistical figures are that a quarter of high-risk patients who have operations will need to go back into hospital and a fifth will be dead within a year in any event (they amount to four-fifths of post-surgical deaths).
Duncan’s argument was that the current situation – in which, effectively, a patient has a right to demand surgery, thereby over-ruling medical opinion as to the likely outcome – was wrongly balanced.
Arguably, for the good of both patients and the NHS, doctors should have the final say on whether operations should be carried out.
I can see the sense in that.
My above precis of Duncan’s article is over-simplistic but – at the end of the day, let’s face it – for all living things, life is a finite existence.
I like to maintain that I have a pretty fatalistic approach to life and that, as I awake each day, I am ready to meet my Maker (that is, if he exists at all).
For good or ill, I try to live in the present, subscribing as I do to the quote from Woody Allen – if memory serves, which it may not – from his 1975 movie Love And Death:
“I’m not afraid of death: I just don’t want to be there when it happens …”
