We might never have made it

Lately I’ve been perusing Leon Kass’s book Toward a More Natural Science. Most recently, I read the chapter on prenatal diagnosis which begins with this excerpt:

The chapter you are about to read might never have been written. The same, of course, could be said about any work of writing, for the usual and obvious reasons—not least, because the author might never have been born. But for the present author and the present readers of the present chapter, the accident of our births may now be seen to have been more than usually accidental. Reflect a moment, gentle reader, and take stock of yourself: I suppose that you, too, will discover how fortunate we are to be here. For we were conceived after the discovery of antibiotics yet before amniocentesis, late enough to have benefited from medicine’s ability to prevent and control fatal infectious diseases, yet early enough to have escaped from medicine’s ability to detect, and to prevent us from living to suffer, our genetic diseases. To be sure, my own genetic vices are, as far as I know them, rather modest, taken individually—myopia, asthma and other allergies, bilateral forefoot adduction, bowleggedness, loquacity, and pessimism, plus some four to eight as yet undiagnosed recessive lethal genes in the heterozygous condition—but, taken together, and if diagnosable prenatally, I might never have made it.

After antibiotics and before amniocentesis – this is the in-between we who are alive today straddle.

Kass makes obvious in this paragraph that preventing people from suffering can go so far as to prevent them from living.

Many have a lower threshold for what suffering they will tolerate for others compared to what they could endure themselves. This is something worth bearing in mind whenever we hear words like “intolerable” and “unbearable.” What we ourselves cannot bear or tolerate cannot be the standard for evaluating others’ quality of life.

After all, one of the best qualities of life is the way it continually surprises us.

Prepare to fall

This evening I was speaking with one of my dear friends who is a doctor.

She told me, “I know you’re looking for uplifting stories for your blog, but lately I have been seeing a lot of elderly patients who have had bad falls. Since many of them live alone and are not able to get back up by themselves, sometimes they are not found until the next day or two. When that is the case, the person may be found sitting in their own feces or urine, profoundly helpless, until a support worker or relative comes to visit.”

Of course the best situation is when a vulnerable person can live in a family home so that their presence and wellbeing is continually and naturally monitored by their loved ones. The next best thing for the elderly would be to live in retirement homes where many services are provided and there are attendant nurses. This, however, is quite expensive and not within everyone’s reach.

On hearing about this from my friend, I remembered a recent conversation I had with a senior buddy of mine with whom I have been having weekly phone calls throughout the pandemic.

He and I have never met, but we have sure gotten to know one another through our Wednesday visits.

This gentleman with whom I speak just turned 90-years-old. His wife passed away last year and so he lives alone. Some of his adult children who live in town visit him and each week he brings his 88-year-old sister some shawarma.

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Most Want to Die at Home

Surveys consistently indicate that the majority of people would prefer to die at home instead of in a hospital. However, a minority actually do.

Cicely Saunders International just published You Matter Because You Are You, an action plan better palliative care, in which the charity explores the key challenges faced at the end of life.

The report notes that “Too many people with life-limiting illnesses – as well as those approaching death – spend long periods of time in hospital, in part due to a lack of social or community care. Meanwhile, hospital
admissions are rising to unsustainable levels across the country, something that was made all the more apparent as parts of the NHS risked being overwhelmed during the COVID-19 pandemic.”

Most people want to die at home and most hospital workers would be in favour of much greater home care.

Some of the main obstacles to this include: the weakness of social and familial ties, lack of “coordination and information sharing between health and social care providers”, and inadequate emphasis on professional palliative home care.

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