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"Hope to Die at 75"
Old 09-22-2014, 06:37 AM   #1
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"Hope to Die at 75"

Interesting Read: Why I Hope to Die at 75 - The Atlantic

Setting a personal end-point makes ER even more important:

By the time I reach 75, I will have lived a complete life. I will have loved and been loved. My children will be grown and in the midst of their own rich lives. I will have seen my grandchildren born and beginning their lives. I will have pursued my life’s projects and made whatever contributions, important or not, I am going to make. And hopefully, I will not have too many mental and physical limitations. Dying at 75 will not be a tragedy.

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Old 09-22-2014, 06:54 AM   #2
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Old 09-22-2014, 07:03 AM   #3
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Not me, I will not be done! I am 66 already and there is so much left to experience and enjoy and do. Life is an overflowing bowl of cherries and I want to savor every one of them. If I die before 90, I think it would be tragic (for me, that is; most of the world wouldn't notice).
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Old 09-22-2014, 07:08 AM   #4
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How the author suggests he will proceed.
Let me be clear about my wish. I’m neither asking for more time than is likely nor foreshortening my life. Nor am I talking about waking up one morning 18 years from now and ending my life through euthanasia or suicide.

Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either.

I take guidance from what Sir William Osler wrote in his classic turn-of-the-century medical textbook, The Principles and Practice of Medicine: “Pneumonia may well be called the friend of the aged. Taken off by it in an acute, short, not often painful illness, the old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”

My Osler-inspired philosophy is this: 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. And that good reason is not “It will prolong your life.” I will stop getting any regular preventive tests, screenings, or interventions. I will accept only palliative—not curative—treatments if I am suffering pain or other disability.

This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age. (When a urologist gave me a PSA test even after I said I wasn’t interested and called me with the results, I hung up before he could tell me. He ordered the test for himself, I told him, not for me.) After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.

What about simple stuff? Flu shots are out. Certainly if there were to be a flu pandemic, a younger person who has yet to live a complete life ought to get the vaccine or any antiviral drugs. A big challenge is antibiotics for pneumonia or skin and urinary infections. Antibiotics are cheap and largely effective in curing infections. It is really hard for us to say no. Indeed, even people who are sure they don’t want life-extending treatments find it hard to refuse antibiotics. But, as Osler reminds us, unlike the decays associated with chronic conditions, death from these infections is quick and relatively painless. So, no to antibiotics.

Obviously, a do-not-resuscitate order and a complete advance directive indicating no ventilators, dialysis, surgery, antibiotics, or any other medication—nothing except palliative care even if I am conscious but not mentally competent—have been written and recorded. In short, no life-sustaining interventions. I will die when whatever comes first takes me.
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Old 09-22-2014, 07:20 AM   #5
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This guy says that 75 will come around in 18 years for him. I hate to sound mean, but he doesn't look like a very healthy 57 to me. If I didn't know any better, looking at those pics I'd peg him around late 60's.

I didn't read the whole article to see if he mentions this, but I wonder if he comes from a family that simply doesn't have long-lived genes? In my case, I still have two grandparents who are alive, at 90 and 99. The two that did die, though, both died at 73. Granddad died of lung cancer...but he grew up on a tobacco farm and started smoking around the time he went into kindergarten. Plus, working on a farm, doing mechanic work, etc, lord-knows-what he was exposed to all those years. And my Grandmom who died had some kind of disease where she basically just withered away and expired. Nobody will talk about it though, so I don't know what it was. Apparently it was hereditary, but only affects the women of the family.

I also have a great-aunt who's still kicking at 92. And my grandmother's cousin has planned her own 90th birthday party on October 5. I've also had a few older relatives, mostly women, but a few men, who have made it to 90-ish.

Of course, all that doesn't mean I'm going to make it to 100 or even 90. But because I see enough of it, it does seem to be a realistic possibility.

Still, I figure if I make it to 75 without screwing anything up, I'll figure I've lived a good, long life. But I want to keep going, long after that, as long as I have a few good years left!
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Old 09-22-2014, 07:23 AM   #6
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Easy to say when you are 57. I'd like to hear from him when he is 70 and still in reasonably good health. I'll bet his perspective will be different.
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Old 09-22-2014, 07:39 AM   #7
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I want to be able to celebrate 75 with a triple axel.
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Old 09-22-2014, 07:50 AM   #8
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No way. My dad did well to 85. Mom less so but she had a lifetime smoking habit.

I'm going hiking in a few weeks up a mountain with a bunch of 75 year olds.

Sorry, this guy is nuts, or completely unhealthy already. He's 10 years off in my book.

Now let me tell you about post 85. It hasn't been good for anyone in my extended families. None of them had any quality past 85.
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Old 09-22-2014, 08:10 AM   #9
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75... been there, done that.
A silly article.
Does anyone really know what they would do when the time comes?
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Old 09-22-2014, 08:17 AM   #10
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My father had open-heart surgery (mitral valve repair) when he was 85. He considered the no treatment option, but let me tell you, resigning oneself to wait patiently for death with that kind of heart failure is no picnic. He liked his odds better of either being repaired or dying on the table or shortly afterwards and quickly due to complications.

The good news is that the repair went well and he is now 90 and doing remarkably well - especially cardio-vascular-wise. I can tell you his years from recovery-to-now have be of a MUCH better quality than age 83-surgery.
"Time wounds all heels...." - Groucho Marx
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Old 09-22-2014, 08:18 AM   #11
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Originally Posted by FIRE'd@51 View Post
Easy to say when you are 57. I'd like to hear from him when he is 70 and still in reasonably good health. I'll bet his perspective will be different.
My thoughts exactly.

I once was directed through a thought experiment:

  • Draw a horizontal line on a paper with your pencil.
  • Imagine the line represents your life, then draw a short vertical line where you think you are now (i.e. if you are 40 and expect to live to 80, the short line would be in the middle).
  • Now imagine time passing and you are now just a few crumbs of graphite away from the end of the line.
At that last bullet point, you probably feel a whole lot different about things than when you made the short vertical 'now' mark, right?
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Old 09-22-2014, 08:27 AM   #12
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Originally Posted by FIRE'd@51 View Post
Easy to say when you are 57. I'd like to hear from him when he is 70 and still in reasonably good health. I'll bet his perspective will be different.

Me strongly suspects he won't be buying that one way ticket to Switzerland on his 75th birthday....

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Old 09-22-2014, 08:59 AM   #13
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Originally Posted by FIRE'd@51 View Post
Easy to say when you are 57. I'd like to hear from him when he is 70 and still in reasonably good health. I'll bet his perspective will be different.
Yes, I think our very strong innate, natural survival instincts take over, and many of us just want to keep surviving, no matter what. That's the only explanation I can think of for some of the people I've seen that hang on in very sad shape for so long. I'd prefer to just say. OK, I had my shot at life, it went pretty well, time to go' - but maybe I won't when my time comes?

But I agree, I've seen some pretty active 75 year olds, I would not consider that any sort of hard limit. And even some well into the 90's who seem to be getting along pretty well. But late 80's are getting tough for most people I've known, it would be interesting to see some stats and distribution on this.

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Old 09-22-2014, 09:07 AM   #14
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Yep. Easy for him to say when it's so far away. Maybe not so easy as it approaches.

As the ole country song says...
"Everybody want to go to heaven
But nobody want to go now"
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Old 09-22-2014, 09:35 AM   #15
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Hey, give me a call when you're 74.99.
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Old 09-22-2014, 09:38 AM   #16
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I agree that it is easy to say such things.

My personal experience with people facing death have been that they clung to life regardless of their age, and/or regardless of what they have been saying. In about 1/2 of the cases, at some point, they gave up when pain of living (cancer treatment, terminal illness) became too great. But by then, they had exhausted all medical options to extend their lives.

As a teenager, I could not see myself living past 40 and "promised" to end it all when I reach age 40. My life was pretty sad/bad and I didn't see much motivation extending it beyond 40. Things have gotten much better since and 40 came and went without ending my life. At 53, I am hoping to enjoy healthy retirement as long as I can.
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Old 09-22-2014, 10:19 AM   #17
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Originally Posted by Andre1969 View Post
This guy says that 75 will come around in 18 years for him. I hate to sound mean, but he doesn't look like a very healthy 57 to me. If I didn't know any better, looking at those pics I'd peg him around late 60's.
Agree. Before reading, I thought: "He's aiming for another five years."

Now that I've read it I think: "Hogwash." I've met and seen 75+ triathletes. His comments about protein shakes and exercise and whatnot to prolong life are narrow-minded. Great for him climbing Kilamanjaro, but there are more and more 70- and 80-somethings getting around just fine as people have eaten more healthfully, stopped smoking, and been more active.

While he tries to paint things in a positive light about going out on his own terms and with limited medical care, I can't help but think that he's a cynical, defeatist, pessimist. I get not wanting to go to extraordinary medical means to extend one's life in a lonely nursing home, but at age 57 it seems awfully young to be running around picking ones end.

My dad was diagnosed with cancer at age 78, just 18 months after retiring. Today, at 80, he sounds like his old self, following an 18-month and ongoing battle. His energy is returned, and he's moving around as well as before. It's been a trial, to be certain, but the idea that he should've just given up and died last year like 80% of pancreatic cancer victims is ridiculous. He's got too much to live for.

IMO, this guy's mind will change, maybe when the grandbabies arrive.
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Old 09-22-2014, 10:21 AM   #18
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Well I sort of see his point from one view I don't agree with it. There is/can be a point in time when you do say that I'm not going to worry about preventative care. Our vet did something similar with our old dog. No need for heartworm meds at 14 there is no way the dog will live long enough to get heartworm such it is a problem. I can see doing the same at 75 or 80 do you want to have a colonoscopy if the previous one was negative? There is going to be a point of diminishing returns

OTOH a flu shot is simple and could save you from being really sick (but not dying).
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Old 09-22-2014, 10:25 AM   #19
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Before I moved to HR (where I thought it would be a bad idea), I used to do a little exercise with people to not-so-subliminally plant the idea of ER in them. I would ask them until what age they expected to be able to live a full life. That is, the age before which they would be p----d off if they had some health problem that stopped them from travelling, or doing whatever they planned to do in retirement. Interestingly, the overweight smokers tended to state higher numbers (80-85) than the healthier people (70-75). I would then ask how old they were now, and how many years of service they had (this was an employer where most people had tenure and a DB pension). Then I would show them three things: /a/ how many "good years" they had left (e.g., if they stated 75 and were currently 55, that would be 20; /b/ how much of their life each "one more year" was (e.g., 5%); and /c/ how much they were adding to their pension for each year they stayed (between 2% and 6%, depending on their current age).

A lot of people went rather quiet and asked if they could take the envelope (on the back of which I'd done the calculations) home to talk about it with their partners.

So, while the article cited in the OP is expressed in provocative terms, I think it is worth reflecting on. If he's running half-marathons at 74, he will probably get that colonoscopy. But if he's mostly watching TV and only sees the grandchildren once a year, maybe he won't be blowing the inheritance on experimental chemo.
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Old 09-22-2014, 10:27 AM   #20
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[QUOTE] Why I Hope to Die at 75 - The Atlantic

May your hope come true.

"Expanded polystyrene (made with a blowing agent) releases the blowing agent (gas) when you put it in the toaster. So what you end up with is non-expanded polystyrene!" -- philosopher aja8888
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