By Thomas Lee
Two recent stories in the New York Times caught my attention because they seem to represent the opposite sides of the same coin. Or as we like to call it, the American healthcare system.
In a moving piece in the Sunday Times Magazine, Katy Butler describes how a pacemaker kept her elderly father alive but at a terrible emotional cost to her family. Her father suffered from severe dementia and eventually the family shut off the device:
“My 77-year-old mother found herself on duty more than 80 hours a week,” Butler writes. “Her blood pressure rose and her weight fell. On a routine visit to Dr. Fales, she burst into tears. She was put on sleeping pills and antidepressants.
“My father said he came to believe that she would have been better off if he had died. ‘She’d have weeped the weep of a widow,’ he told me in his garbled, post-stroke speech, on a walk we took together in the fall of 2002. ‘And then she would have been all right.’ It was hard to tell which of them was suffering more.”
In Monday’s Times, healthcare reporter Milt Freudenheim examines how the healthcare system will cope with the inevitable influx of high risk elderly patients that suffer from chronic diseases. Dr. Francis Collins, director of the National Institutes of Health, laments the lack of funding into ways to treat aging diseases and extend life.
“‘The opportunities in aging research are compelling,’ Dr. Collins said. He mentioned a study last year on mice that lived significantly longer after being given rapamycin, a cancer and immunosuppressive drug.
‘”That is turning out to be the most exciting new pathway for extending normal life span that has ever been discovered,’” Dr. Collins said. But he said the opportunities were also compelling in cancer, diabetes, mental illness and autism."
Using completely different tones, the two stories illustrate the unfailing, almost religious faith Americans place in science and technology to treat disease and prolong life. But just because we can, does that mean we should?
It’s a question that no one really wants to ask, because it’s such an explosive issue in a country that prizes the sanctity of life. Remember Terry Schiavo? Or Sarah Palin’s accusations of government run “death panels?”
But if there’s one thing the nasty healthcare debate has taught us, is that the system is broken: We want more and more healthcare, but don’t want to pay for it.
Americans are getting old fast. More than 40 percent of adult patients in acute care hospital beds are 65 or older, according to Freudenheim’s piece. Seventy million Americans will have turned 65 by 2030. And the 85-and-older cohort is the nation’s fastest-growing age group.
I’m not suggesting we let sick, old people die. But it’s certainly worth posing this hypothetical question: If you had X dollars to spend, would you spend it on an 80-year-old or a 12-year-old boy dying of cancer?
In a perfect world, we wouldn’t have to make that choice. In that perfect world, everyone would have a job, housing, food and clean water. Yet we accept there will always be unemployed, homeless, hungry people. We don’t do so well with death.
Butler writes: “Thanks to advanced medical technologies, elderly people now survive repeated health crises that once killed them, and so the ‘oldest old’ have become the nation’s most rapidly growing age group. Nearly a third of Americans over 85 have dementia (a condition whose prevalence rises in direct relationship to longevity). Half need help with at least one practical, life-sustaining activity, like getting dressed or making breakfast.”
Whenever someone tells me their grandmother or elderly father dies, I always say the same thing.
“Well, at least they lived a long life.”
And then I think of my sister Linda, who died of cancer at age 32.
“What could have been,” I say to no one in particular. “Now there’s a damn tragedy.”