Unless there has been terrible abuse, no child wants his or her parents to die. It is a huge loss at any age. It creates a tremendous, unfillable hole. But parents also cast a big shadow for most children. Whether estranged, disengaged, or deeply loving, they set expectations, render judgments, impose their opinions, interfere, and are generally a looming presence for even adult children.
This can be wonderful. It can be annoying.
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It can be destructive. But it is inescapable as long as the parent is alive. Examples abound in life and literature: Lear, the quintessential Jewish mother, the Tiger Mom. And while children can never fully escape this weight even after a parent dies, there is much less pressure to conform to parental expectations and demands after they are gone.
Living parents also occupy the role of head of the family. They make it hard for grown children to become the patriarch or matriarch. When parents routinely live to 95, children must caretake into their own retirement. But there is something even more important than parental shadowing: memories.
How do we want to be remembered by our children and grandchildren? We wish our children to remember us in our prime. Active, vigorous, engaged, animated, astute, enthusiastic, funny, warm, loving. At age 75 we reach that unique, albeit somewhat arbitrarily chosen, moment when we have lived a rich and complete life, and have hopefully imparted the right memories to our children. Yes, with effort our children will be able to recall that great family vacation, that funny scene at Thanksgiving, that embarrassing faux pas at a wedding.
But the most-recent years—the years with progressing disabilities and the need to make caregiving arrangements—will inevitably become the predominant and salient memories. The old joys have to be actively conjured up. They love us and fear the loss that will be created by our death.
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And a loss it will be. A huge loss. But even if we manage not to become burdens to them, our shadowing them until their old age is also a loss. And leaving them—and our grandchildren—with memories framed not by our vivacity but by our frailty is the ultimate tragedy. That is all I want to live. Once I have lived to 75, my approach to my health care will completely change. The momentum of medicine and family means we will almost invariably get it.
My attitude flips this default on its head. 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. 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 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.
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. 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. As for the two policy implications, one relates to using life expectancy as a measure of the quality of health care. Japan has the third-highest life expectancy, at But we should not care about catching up with—or measure ourselves against—Japan. Once a country has a life expectancy past 75 for both men and women, this measure should be ignored. The one exception is increasing the life expectancy of some subgroups, such as black males, who have a life expectancy of just That is dreadful, and should be a major focus of attention.
A second policy implication relates to biomedical research.
Many people, especially those sympathetic to the American immortal, will recoil and reject my view. They will think of every exception, as if these prove that the central theory is wrong. Like my friends, they will think me crazy, posturing—or worse. They might condemn me as being against the elderly.
Again, let me be clear: I am not saying that those who want to live as long as possible are unethical or wrong. I am certainly not scorning or dismissing people who want to live on despite their physical and mental limitations. Indeed, I often advise people in this age group on how to get the best medical care available in the United States for their ailments. That is their choice, and I want to support them. And I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy.
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What I am trying to do is delineate my views for a good life and make my friends and others think about how they want to live as they grow older. I want them to think of an alternative to succumbing to that slow constriction of activities and aspirations imperceptibly imposed by aging. I think the rejection of my view is literally natural. After all, evolution has inculcated in us a drive to live as long as possible. We are programmed to struggle to survive.
Consequently, most people feel there is something vaguely wrong with saying 75 and no more. We are eternally optimistic Americans who chafe at limits, especially limits imposed on our own lives. We are sure we are exceptional. I also think my view conjures up spiritual and existential reasons for people to scorn and reject it. Many of us have suppressed, actively or passively, thinking about God, heaven and hell, and whether we return to the worms. We also avoid constantly thinking about the purpose of our lives and the mark we will leave.
Is making money, chasing the dream, all worth it? Indeed, most of us have found a way to live our lives comfortably without acknowledging, much less answering, these big questions on a regular basis. We have gotten into a productive routine that helps us ignore them. But 75 defines a clear point in time: for me, It removes the fuzziness of trying to live as long as possible. Its specificity forces us to think about the end of our lives and engage with the deepest existential questions and ponder what we want to leave our children and grandchildren, our community, our fellow Americans, the world.
The deadline also forces each of us to ask whether our consumption is worth our contribution. As most of us learned in college during late-night bull sessions, these questions foster deep anxiety and discomfort. The specificity of 75 means we can no longer just continue to ignore them and maintain our easy, socially acceptable agnosticism. For me, 18 more years with which to wade through these questions is preferable to years of trying to hang on to every additional day and forget the psychic pain they bring up, while enduring the physical pain of an elongated dying process. Seventy-five years is all I want to live.
I want to celebrate my life while I am still in my prime. My daughters and dear friends will continue to try to convince me that I am wrong and can live a valuable life much longer. And I retain the right to change my mind and offer a vigorous and reasoned defense of living as long as possible. That, after all, would mean still being creative after Giving out your number may seem fairly innocuous, but it can have big consequences. The commander in chief is impulsive, disdains expertise, and gets his intelligence briefings from Fox News.
What does this mean for those on the front lines? For most of the past two decades, American troops have been deployed all over the world—to about countries. During that time, hundreds of thousands of young men and women have experienced combat, and a generation of officers have come of age dealing with the practical realities of war.
They possess a deep well of knowledge and experience. For the past three years, these highly trained professionals have been commanded by Donald Trump.
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To get a sense of what serving Trump has been like, I interviewed officers up and down the ranks, as well as several present and former civilian Pentagon employees. Next page. There's a problem loading this menu right now. Learn more about Amazon Prime. Get fast, free delivery with Amazon Prime. Books By Richard Rohr. Audible Audiobook. This item will be released on January 21, Other Formats: Audio CD. Yes, and Only 2 left in stock - order soon.
Other Formats: Hardcover. More Information. Anything else? Provide feedback about this page. Back to top. His columns have appeared regularly in numerous print and web publications, including WorldNetDaily, Townhall, and FinancialSense. He resides in Texas with his beautiful wife. His expertise as an financial counselor and thorough knowledge of the products he recommends has attracted an impressive list of individuals and major institutions from across the United States.
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