Monday, March 4, 2019

Meditations on Mortality

"How are you really? You haven't had a heart attack or stroke or anything...have you?"

It was the voice of Pam Cresant, a my long-time friend from my youth at 'TEEN Magazine. We hadn't talked on the phone or in person since my move to Arizona nine years ago. However, we've stayed in touch by mail and social media.

I laughed and said that I was fine. 

Pam told me that she had recently called another friend, had a delightful conversation, and then had found out shortly afterwards that her friend died suddenly, not long after their phone visit. "And I had this sudden urge to call you, to hear your voice and see if you're okay," she said. "I realized that we too often put off visits and conversations with friends who are so dear. I don't want it to be too late."

I sighed, knowing what she meant. Too many friends have passed away recently.

Mortality is on our minds as we age...past our parents' lifetimes, past the point when the fact that we are, at least chronologically, old is undeniable.

"My brother asked me the other day how long I thought I might live," my lifelong friend Pat Hill, a classmate from kindergarten through high school, emailed me the other day. "I told him I expect to live another 30 years. How about you? How long do you imagine that you'll live?"

I stopped, surprised by her question. I feel mortal -- and grateful to be alive-- every day. Everyone in the older generation of my family, on both sides, has succumbed to sudden cardiac death --some, like my parents who both died at 66, at much younger ages than I am now.

"I have hopes but not expectations," I told her. "I'd like to live in good or good enough health for some years to come. But I've made peace with the fact that I could die tomorrow."

How am I right now? I'm fine. There are some indications of age. My knees are intermittently painful, especially during cold, rainy weather. My hearing is impaired and I started wearing hearing aids some years ago. I never needed glasses until I was in my forties and now I can't do without them. But I'm strong. I can swim laps for an hour without a break. I'm intellectually engaged and writing better than ever. I exercise regularly and eat reasonably. Overall, I'm healthy, active and energetic. And filled with gratitude for my good health.

It's a time of life when health is, to a certain extent, a matter of luck. But personal responsibility seems to play a larger role as well when we're older. There isn't as much physical forgiveness for bad habits -- whether it's weight gain over a small treat or something much worse. Sometimes genes, old habits and bad luck converge to create a health crisis. There are people with strong constitutions and good genes who can thrive for years despite unhealthy lifestyles. And sometimes our own choices can determine whether we live more of our lives in good health or whether we spend years in uneasy decline.

My cousin Caron has been healthy, active and beautiful all her life. She didn't slow down after retirement, walking every day, studying Hawaiian dancing and delighting in shooting hoops with her grandsons. She has a loving marriage that is a true inspiration and has cultivated wonderful lifelong friendships. She has always cooked and eaten healthy food. Through the years, Caron only had one bad habit: smoking. She finally quit as she neared 70. But the impact of years of tobacco use led to COPD which has made life after 70 difficult for her. She is limited in what she can do, increasingly dependent on Bud, her loving husband of 60 years and is tethered to an oxygen tank 24/7. She shakes her head in frustration when she remembers all of the health-promoting behaviors she had and how her health was destroyed by her one vice. She is an avid anti-smoking activist and is forever reminding me to urge my sister, a lifelong smoker, to quit now before anything bad happens.

A neighbor I'll call Paula smoked for more than 30 years, ate red meat at most meals, drank mostly sugar-filled sodas and never exercised beyond pulling the levers at local casino slot machines. She had colon cancer and kidney failure during the last decade of her life. But, even as her health declined, she didn't step up to engage actively in fighting for her own health. When she would experience yet another health crisis, she'd storm to her doctor's office and say "I don't feel good. Fix it!" When she went on kidney dialysis and received an information sheet on foods to avoid -- with chocolate and sodas heading the list -- she continued to consume chocolate bars and colas throughout each day. "They can fix it," she'd say with a shrug. "I'll just take more binders." Even as she visibly declined, Paula refused to take steps to help herself. She died two years ago at 79 -- amazing everyone that she had lasted as long as she did. She probably had good genes: her mother lived to be 103 and her sister is thriving well into her eighties. 

It's a strange time of life. It's a time when you may be fine one moment and not at all fine the next. "How was it that I was running through Dublin Airport one day and then, four days later, had a heart attack and was diagnosed with heart failure?" a dear college friend of mine asked recently. Her life has changed from one of active travel, volunteer work and expansive engagement with the community and her large extended family to a quieter lifestyle where she is cared for by a wonderfully loving spouse.

So we live with the specter not only of mortality, but also of painful, frustrating physical decline. Many of us who live in gratitude for our health work constantly to safeguard what we still have. We eat healthy meals and focus on getting to and maintaining a healthy weight. We exercise daily and work on building core strength and good balance to avoid falls. We meditate and seek balance in the daily routines of our lives. The overall goal of all these efforts is, quite often, not to pursue the illusion of living to be 120, but to live whatever years that are left to us in reasonably good health

And yet there are no guarantees.

My friend Pat just emailed me again, in response to my comment to her that I've made peace with the fact that I'm healthy now but could die tomorrow: "I've enjoyed knowing you...." she wrote.

Yes. It has been a pleasure, I replied, adding that I hope we have many more opportunities to say "goodbye" and "hello" to each other in years that may come.

These days it's important to say what we want and need to say to beloved friends and family, to greet each day with gratitude and to do all we can to enhance our own lives and the lives of loved ones, both in good health and in illness.

That said,  I'm headed to the gym.

4 comments:

  1. Such insight and wisdom as always. This was particularly poignant as my aunt is dying at the age of 70 and it is such a shock.

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  2. Hi Dr Kathy, I have followed your blog a long time without commenting. Always interesting posts. Thanks.

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  3. Dear Kathy, your ability to weave a shawl of compassion and wisdom based on your own life and the lives of your long-time friends is always inspiring. Thank you for this posting, Kathy, The sentence of yours that epitomizes where I am with all this is "The overall goal of all these efforts is, quite often, not to pursue the illusion of living to be 120, but to live whatever years that are left to us in reasonably good health." That is my hope.

    What I've discovered is that 40 years of being a vegetarian (no red meat, pork, chicken, fish) and years first of riding a bicycle for 10 miles a day and then many more years of walking 3-4 miles a day and eating so nutritiously couldn't outweigh the effect of being a taskmaster to myself with regard to work. Being a workaholic led to all sorts of illness. Now I'm going down a new road of kindness to my body. Peace.

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  4. This one is hitting home right now. Rick is in a pretty big funk after his fall on the ice (this from a guy who has had multiple skull fractures and closed head injuries and MRSA), worried about the blood clots (DVTs) and concerned about upcoming surgery for his leg. Are his cycling days over? Will he race or do mega-mile bike hikes again? What if his recovery is like his friend's who died following leg surgery? Apart from being as reassuring as possible without going over the line, there is little I can do but listen and remind him -- as someone once reminded me -- that our parent's or friend's prognosis or fate is not necessarily ours. But it does hit home -- none of us are any younger and anything can happen at any time. Makes me want to be certain to grab every good day I can!

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