Better than discovering the solution to a problem is to at last see clearly what the problem really is.

The attitude toward aging and mortality have dramatically changed since World War II.  The signs have been evident for years: upon reading Atul Gawande’s book “Being Mortal”, they are expressed with great clarity.

The crux of this paradigm shift is that we have transformed from a society that used to dignify age to one that values the ‘independent self’.   It used to be that the elder would choose how they wanted to live and it was the family’s responsibility to make this happen.  Now, families generally operate independent of one another – even the elder is traveling or working at a second career.  The children pursue their own path, and often the parents aren’t sorry to see them leave the nest.  Even in emerging societies, the way forward for the youth is to function independently of their traditional family unit.

Certain scientific changes have greatly contributed to the cultural shift:

  • Elders used to represent 2% of the population – now it’s 14% and rising. Old age isn’t as rare as it once was
  • It used to be common for an elder to die younger and suddenly; now the norm is more old age with slow decline
  • Whereas we used to highly value an elder’s knowledge and experience; now we Google the topic and get answers instantly
  • It’s easier to be youthful longer with supplements, nutrition and surgeries. Now we’re working on the genetic possibilities of extending age
  • Information processing moves at the speed of light and grandpa just can’t keep up with the technology

As doctors have moved from generalists to specialists, they have become adept at fixing one broken part at a time. Older patients baffle most doctors because there are often multiple conditions present.  Not enough care is given to the impact of one treatment on another health condition which further complicates a problem.

Dr. Gawande’s story is poignant and revealing as he confronts the complicity of the medical community in not properly caring for the aged.  Death is not a failure to cure, but an inevitability for all of us.  Sometimes the best quality of life is found in managing a condition rather than curing it.   It is important to decide what is truly important to us and to embrace it fully.


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