Today is my 64th birthday. That's a number shockingly old to me. For a year or so I've been telling folks that I'm already 64, to soften the blow when it does come. Usually the folk I've told that to is Julie. She's said that I'm not yet 64, and there's no sense rushing it. Tomorrow, she won't say that anymore.
If I'm lucky, she'll also refrain from singing the Beatles' "When I'm Sixty-Four" when we're in public. I've never liked the song, even when I was 62 or 63. It trivializes the pain and perverse joys of old age. Paul McCartney wrote it when he was 16, an age when 64 must have seemed impossibly old. It was only impossibly old for his fellow Beatles, John Lennon and George Harrison.
Anyway, McCartney has achieved the age of impossibility, and so have I. While I'm happily unworried about who will need or feed me, I do worry about sanity and humor in the face of old age. In October's Atlantic—the one with the geriatric skateboarder on the cover—Ezekiel Emanuel writes that he hopes to live only to 75. He's 57 now, and in good health, but thinks 75 years is enough time. He thinks Americans spend too much money and effort on length of life rather than on quality of life.
Having watched both my parents die bereft of movement, sanity and dignity, I agree with him. Neither of my parents wanted to die the way they did—they made that clear in conversations with me when they were younger than I am now—but they were part of a health care system that, if it wasn't invented by Satan, was invented by one of His hospital managers or health insurance executives.
My parents got sucked in, step by irreversible step, until the ends of their lives could be characterized as hopeless unremitting torture. Our health care system, for them at least, replaced dying with dying piece-by-piece.
I don't want to go through anything remotely similar to what my mother or father did. Neither does Ezekiel Emanuel. He says that after age 75 he's done with routine check-ups, antibiotics, cardiac stress tests and flu shots. He'll refuse cancer treatment except for palliative care. No pacemaker, heart bypass operation, PSA test, colonoscopy, ventilator, dialysis or surgery. No resuscitation.
I'm well aware that for me, age 75 is only 11 years away. But I tend to agree with Emanuel's prescription for the horrors of aging. You don't want to subject your loved ones to them, and you don't want to undergo them yourself. You especially don't want to get demented, which will confront your caregivers with a body with no one in it, whose thought and selfhood have been reduced to grotesque reflex.
I know people who are much older than 75 who still have their wits, who still brighten the world and the lives of the people around them. But I like the idea of letting God and grace choose the manner and time of my own exit. I'm tempted to start on Emanuel's program now, given its simplicity and lack of waiting rooms. You may prefer to go with the health care system, which is fine, but don't expect to find God and grace listed on your itemized bill, and don't expect that you won't beg for them eventually.
You may think I've forgotten the perverse joy portion of this discussion. I haven't. Two weeks ago Julie and I did our own stress test. We went into the Sawtooths for three days, climbing through the swamps and deadfall of Fishhook Canyon to the base of Baron Peak. We climbed Baron, which is a walk-up if you don't mind now and then walking on all fours, and we wrote our names in the summit register. We noted that we had last written our names there in 1999, 15 years ago, on a day hike from Redfish Lake to the Grandjean trailhead. We climb Baron every 15 years, whether we need it or not, I wrote. I realized that in another 15 years I'd be 79, at which point a day hike to Grandjean might take more than three days. And it would be dangerous in a wheelchair, especially with Julie at the controls.
That night I awoke with a deep pain in the center of my back, extending through my chest and down my left arm. "I'm having a heart attack," I thought to myself, and struggled to a sitting position in the tent, wondering if I should wake Julie and ask her if we'd donated to Life Flight this year.
It was the long night of the eclipse, and the full moon was half-bloody through the mosquito netting. I got out of the tent to see what sort of omen it was, and the pain started going away. I realized it was the result of too many hours on the cold hard ground, after a day of climbing and bouldering and scrambling over logs. I walked around for a bit and started feeling pretty resuscitated for a dying man.
The next morning I sat on the edge of a stilled deep-green lake, drinking coffee and eating naproxen—palliative care—in slanted October sunlight. Julie sat down beside me.
"You going to live?" she asked. I'd told her about my blood-moon panic. She had said that if I really had been dying of a heart attack, it would have been a long and sad walk out to the car.
"I'm going to live," I said. "For the moment."
"The moment is all we've got," she said. "Why would anybody want anything more?"