As some of you are beginning to know, I read a lot. I read as a way of learning about a subject and then I go out into the world to confirm or refute what I’ve learned. Recently I bought a book ( I support all book vendors–Amazon, Barnes and Noble, two local bookstores, and the discount second hand sellers). I spread the wealth. I bought a book titled The Denial of Aging by Muriel Gillick. I thought the book would be about plastic surgery–whether to have it or not, and other issues of cosmetics, eating, and exercise promoted to outwit the aging process for women and an increasing number of men. (My husband has had a face lift; I have not.)

It turns out that the book is a serious discussion of how much medicine should be applied to aging and the aged. Although I would not have bought this book if I’d known its topic, it has explained many important mysteries of the current geriatric medical profession that I had not understood. “Like what?” you may well ask. Here’s an example. I have cancer. It is not a serious, life threatening cancer now. By the time it is, I’ll be dead from something else. So when my doctor told me I had cancer but not to worry this seemed like shooting me and then telling me a joke, or something like that. As I’m reading Gillick’s book (she is a geriatric physician), I now understand that nobody is going to do something about my cancer because what they’d do would hurt a lot, possibly cause serious side effects, and solve not very much. That is the rule of medicine in an over 65 population. How much will it hurt, and how much will it compromise the general health of the patient? If it hurts a lot, but promises greater vigor, then the general rule is to go for it. If it hurts a lot (or the side effects are worse than the procedure), and it doesn’t improve quality of life, then it shouldn’t be done–particularly as we reach the oldest old period of our lives (80+). By the time I’m 80+, and I firmly expect that I will reach this age as my mother and grandmother have done, perhaps my cancer will be an issue. Perhaps not.

In a way this is comforting to me. I want to maintain my interest in life, and my ability to participate for as long as I can. When I am no longer interested, or am unable to participate, I don’t want anyone–doctor, daughter, husband, or sibling–to prolong my life. I’m having a great life, and expect, if my genes are any indication, to have many more years of engagement with my world. When that is no longer possible, I want to be allowed to go as gracefully as possible.