Why I Hope Ezekiel Emanuel Grows Old
I have been thinking quite a bit lately about aging.
Three things fuel those ruminations. The first is that I am aging. I have been able to deny it for several decades but my retirement this year coincided with several manifestations of mild and generally innocuous physical decline. The second is my participating with several of my brothers and sisters in being a care-giver for my 89 year old father.
The third was a provocative essay published in the September issue of The Atlantic. The author is a prominent oncologist and medical ethicist named Ezekiel Emanuel. The title of Dr. Emanuel's is largely self-explanatory: "Why I Hope to Die at 75." He has no desire to live past that age, largely because by then his creative contributions to medicine will be over. No longer being socially useful, he would become a burden, a condition he has no desire to bear. He would not directly cause his own death but would indirectly facilitate it by eschewing standard medical treatments such as annual check-ups and colonoscopies.
Emanuel's position runs directly counter to that of the Catholic Church, in two related ways. First, for Christianity, a person's dignity comes not from any aspect of their material conditions but from their being creatures of God and bearers of His spirit. Life is inherently and intrinsically precious and must be safeguarded. Second, therefore, medical care must be available to all and all must take advantage of it. The only exceptions to would occur when medical treatment would not be substantially conducive to health but would be substantially burdensome to the patient.
But something about Dr. Emanuel's position tugs at me.
For many years, I brought the Eucharist to homebound parishioners. I still am moved when I remember the pleas of two old women who said, over and over again, words to the effect of "Why doesn't God let me die?" My mother-in-law spared herself that fate by rejecting dialysis, thus allowing kidney failure to kill her relatively quickly and prematurely. All three women suffered from loneliness. Two suffered from a sense of purposelessness: No one needed them. Their feeling that continued life was an affliction was intelligible to me. I tried to think of an answer to their question about the purpose of continued life, but could think of nothing remotely convincing.
Other experiences, on the other hand, tug in the opposite direction. The most immediate and powerful come from caring for my father. Dad has been a widower for two and a half years and misses Mom terribly. His hands shake from Parkinson's. His left eye is virtually blind; his partial blindness complements his deafness in one ear, a result of his military service in World War II. His memory is shot and he is always losing things. He now is dependent on sons and daughters to manage his finances, to maintain his home, to remind him (repeatedly) to take his medications, to accompany him to his medical appointments and communicate with his doctors, and to remember his schedule.
Despite all that, he continues to live a life worth continuing. He had always been gregarious; that trait now seems more pronounced. He has a regular circuit of restaurants where he takes meals and he is palpably well-loved by the staffs of those places. He visits other diners. Sometimes he knows them but often he just walks up and chats with total strangers. He takes joy either way. On Mondays, he has lunch with several of his children and their spouses, after which all return to his house to watch a movie (preferably a Western or a silly, slapstick-laden comedy). On Thursday nights, he has dinner at the home of one of my brothers along with his extended family. He dines on holidays with one of my sisters. A son and a daughter live with him; between them, they take care of the property, cook meals, and provide companionship. He delights in watching his children banter back and forth and feels a justified pride that they have turned out well.
His relationships with his sons and daughters have altered for the better. He has been re-united with a son from whom he and my mother had been estranged. His feelings for one of my sisters are much warmer than they had ever been. For the first time since I was a child, I told him that I love him; for the first time since I was a child, he told me that he loves me. He expresses his appreciation for us, something he would never have done years ago. He often says, "I don't know what I would do without you kids" and says how fortunate he feels that he and Mom had nine children. That is heartwarming to hear, but only speaks to one side of a reciprocal relationship. We, his offspring, see ourselves as blessed by the opportunity to care for him. It is, after all, our chance to repay him for the hard work he had to do to raise us. But we are experiencing more than the satisfaction of a duty fulfilled. Caring for Dad is fun. In his youth, he had been a formidable man; now, he is a lovable old guy.
So it is tragic that Dr. Emanuel has such a constricted and pessimistic perspective on life in old age. Sometimes old people live lonely, miserable lives, but their experiences are not universal. In other instances, one need not look hard to see God's grace at work.
