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Simone's OncOpinion: Eight Decades—The More things Change...

Simone, Joseph V. MD

doi: 10.1097/01.COT.0000455795.16508.dc
Opinion
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It is often said that 80 years of age today is the new 60. Medical improvements, better diets, more exercise, and, mainly, the effectiveness of public health programs such as seat belts, immunizations, and insurance coverage for annual checkups contribute to this advance.

JOSEPH V

JOSEPH V

A death in one's 60s is often viewed today as “too young.” And death in one's 40s or even 50s (not to mention children and young adults) is considered “tragic.” My father died at the age of 64 in 1968; at that time death in one's 60s was not considered “tragic,” except by the immediate family, because it was not unusual.

Similarly, both of my grandfathers and my uncle died in their 60s. My brother died in the early 1940s at nine months of age of “croup” (bronchiolitis), which today is very rarely fatal. My sister died 15 years ago at the age of 60. So my mother buried two of her four children—a blow that I cannot imagine surviving. My mother died at age 92 in 2006, having been a widow for 38 years, four years longer than her marriage.

This litany of family deaths is meant to represent a fairly common tableau in my generation (born in the 1930s amid the Great Depression) as I review my past life and approach the completion of eight decades on this earth. (Actually, I am cheating a bit; soon I will celebrate my 79th birthday, which means I will be one year away from living eight decades).

Approaching 80 seems strange to me. Many if not most 80-year-olds I have known over the years have at least some major health problems and/or seriously limited physical or mental function. For some reason, my wife, who is 18 months younger than me, and I have not yet acquired those problems. We are blessed with good luck so far, but we are well aware that this could change suddenly as soon as today or tomorrow.

In medicine as well the changes are remarkable. I am privileged to have had the opportunity to help develop better therapy, some of it curative, for children with cancer. When I started, virtually all my patients died of the disease or its complications. The new technologies in diagnostics, genetic tracking, minimally invasive procedures, and other advances seem to pop up frequently and, in the process, have changed medical care substantially, mostly for the better.

But before we pat ourselves on the back too vigorously, we should step back and take a broader view. I believe a well-known French proverb is still true today: “plus ça change, plus c'est la même chose,” an 1849 epigram by Jean-Baptiste Alphonse Karr. It is usually translated as “the more things change, the more they stay the same.” This appears to be true when viewed on a global scale even more so than in any individual community or nation.

Of course things change; it happens every day. But in some fundamental ways we often see a repackaged version of the same thing: Large-scale poverty, wars, racism, workplaces that effectively practice slavery and the abuse of minors, epidemics, crooked and dictatorial politicians, ineffective governments, greed and theft by businessmen and business women, and the ever present and inevitable grim reaper that stalks and eventually gets each of us sooner or later.

The 100th anniversary of the start of World War I, which I study, has brought a plethora of books and media reviews of that catastrophe: foolish and arrogant generals who showed unforgivable incompetence in continuing failing tactics in the trenches for years despite repeated failure. As Albert Einstein is thought to have said, “Insanity is doing the same thing over and over and expecting a different result.” The magnitude of that slaughter was monumental, and almost without losing a beat, it eventually led to the even greater slaughter of World War II just two decades later. And we seem to be consistently facing all of the “little” wars that string themselves together eternally in the Middle East, Africa, and elsewhere, like a constant drumbeat.

This view may be pessimistic on a global scale, so we avoid going mad by narrowing the focus of most of our attention on our families, jobs, professions, or neighborhoods. Even in this restricted circle, though, there are many things we cannot control, but we certainly have a better chance of improving our environment than by wringing our hands about the situation in the Ukraine or Palestine, over which we have no power.

This is the approach most of us take. However, we cannot expect to control epidemics, reduce racism, and oust crooked or inept politicians and businessmen if we don't engage ourselves on some level. At the very least, we can take a stand for justice, fairness, and mercy and support those on the front lines who are actually doing something about it.

I am an oncologist and therefore basically an optimist. But it is difficult to see starving immigrant children and families forced to leave their homes to avoid war or famine or epidemics and become permanent refugees all around the world. Contrast that to our insatiable, voracious hunger for material things, non-essential doodads, McMansions, cosmetic surgery, and billions spent on superficial things that often fail to satisfy the buyer.

By now you are probably thinking that I sound like just another curmudgeonly octogenarian. So be it. But I remain optimistic about our ability to change, and that can happen at any age.

© 2014 by Lippincott Williams & Wilkins, Inc.
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