Thursday, August 8, 2013

A Decade of Life

The Pew Research Center just released the results of a recent survey that has everyone abuzz. It turns out that many Americans would prefer not to live past 100 and many would even settle for a number of years earlier. These results have spurred much debate about the consequences of extending the longevity of an already burgeoning elderly population. Many of the commentaries cite statistics about how our life expectancy has climbed from around 50 at the turn of the twentieth century until 79, the current expectation. While on average, human beings are living longer, living past 79 is nothing new to homo sapiens.

Since at least the Bronze Age, or 3,500 BC, a fair share of Sardinians have lived past 100. Hippocrates, who lived around 500 BC, is said to have lived between 87 and 110 years. The Greek philosophers are believed to have lived into their 90s. Michelangelo lived to 87. None of these humans relied on major technological advances for their longevity. Instead, they respected their bodies, understood the relationship of food to their health, stayed physically active, and dealt effectively with their stress. They also valued family and social connections above all else.

Abraham Lincoln once said that its not the years of life that matter but the life in your years that do. Rather than focus on what chronological age we live to, the emphasis should be on what we do with that time. As a physician who often asks patients during their first visit, "Why do you want to live?," I can tell you that answers vary from, "I don't want to die" to very specific reasons to live. Based on these answers, I help people prioritize what is important to them and make decisions accordingly. They begin to understand, some for the first time in their lives after many decades, the consequences of their health related choices and their reason(s) to keep living.

The sustaining of life merely to add candles to a birthday cake is meaningless. The true value of longevity is predicated on living a life with meaning and purpose. Although what is meaningful and purposeful can only be decided on an individual basis, when such a foundation exists, there is no reason not to keep living. However, the absence of such meaning and purpose makes life intolerable at any age.

As Henry David Thorough wrote in Walden Pond, “The mass of men lead lives of quiet desperation. What is called resignation is confirmed desperation...Alas for those that never sing, But die with all their music in them."

Let's focus our energies not on extending life, but on improving. It really is quality, not quantity that counts. The first step is striving to live in a healthy body, free of infirmity. For the most part, this is a choice, one predicated on lifestyle.  The six biggies are food, physical activity, stress, sleep, engagement, and social. I've already written about all of these ad nauseum so I will leave it to you to peruse my previous blogs.  The bottom line is that good choices often mean good results.  No one, including me, can promise you how long you will live or exactly what kind of life it will be.  But please don't live your life with blinders on to the consequences of obvious bad choices like regularly eating french fries and drinking coke or hardly getting off the couch.; please don't predicate your life on the belief that avoiding such foods or activity somehow makes life less worth living; please don't trust that medical care somehow fixes you--it usually doesn't. I know it's a personal choice  and I also know that neither I nor anyone else can tell you how to live your life.  But choices really do have consequences.  Good choices take effort; exert yourself. Scientists now believe that a healthy lifestyle is worth up to a decade of life. What's a decade of life worth to you?

As you ponder your answer, please consider for a moment the words of Luigi Cornaro, an Italian senior citizen from the 16th century who wrote in his book, The Art of Living Long, that "Men [and women] are as a rule, very sensual and intemperate, and wish to gratify their appetites and give themselves up to the commission of innumerable diseases. When, seeing that they cannot escape suffering the unavoidable consequence of such intemperance as often as they are guilty of it, they say—by way of excuse—that it is preferable to live ten years less and enjoy one’s life.  They do not pause to consider what immense importance ten years more of life, and especially of healthy life, possess when we have reached mature age, the time, indeed, at which men [and women] appear to the best advantage in learning and virtue—two things which can never reach their perfection except with time."  This is as true today as it was some five hundred plus years ago.

Nevertheless, I write and care for those who value their health and are looking for guidance to live more good years. Sometimes I think it is a Sisyphean struggle to get people to focus on protecting their health, but I wouldn't give it up for anything.

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