Challenges of a long life
Denis Dragunsky on the problem of "squeezed generations"
"Newspaper.Ru"Once upon a time there was a certain Typhon in ancient Greece.
But not the one who is the scary monster Typhon, but the one who is the handsome Tithonos. The son of the Trojan king Laomedon and the father of the Ethiopian king Memnon. He was so pretty that he became the lover not of some queen, but of the goddess of the dawn herself, the beautiful Eos. Do you remember: "The youngest with purple fingers Eos came out of the darkness of the clouds"? She fell in love with him so much that she rushed to Zeus and begged for immortality for her boyfriend, as for God. Zeus was in a good mood and agreed.
But the frivolous Eos forgot to ask for eternal youth in addition to immortality. Therefore Typhon became an immortal old man. Eos just bit her elbows, but they don't ask Zeus twice.
The handsome Typhon grew old, lost strength, became covered with wrinkles, dried up, his voice became quiet and raspy, and when he completely shrank, the saddened Eos turned him into a cicada. Now he is quietly chirping among the grass. A bird cannot peck him, because he is immortal. He chirps and remembers how in his youth he caressed a beautiful, eternally young goddess. Or he no longer remembers anything – because of senile senility.
Here is such a Greek mythology.
But I want to talk about things that are not so lyrical. On the contrary, about disturbing and sad things. About the fact that a very long life in very many cases – not in all, of course, not in all! we all know active old people who are cheerful in mind and body! – but, I repeat, in many cases it means a long and, alas, extremely difficult, painful, painful old age. It is difficult for a person, for his loved ones and ultimately for the whole society.
I had to read that about a quarter of the amount of health insurance is spent in the last year of a person's life. That is, if you call things by their proper names, not for healing, but for prolonging the torment for a while longer.
And one American doctor told me quite bluntly: "A day of agony costs $ 10-15 thousand." They cost the insurance company, the state budget or the family of the dying person, depending on the patient's insurance status. Not a day of treatment, I repeat, but a day of agony. Although this is called treatment, but doctors and relatives are well aware that there is no talk of recovery or at least stabilization of the condition.
Well, they will ask me, do you think that hopeless patients should be immediately disconnected from the machines? And old people at all – like in a movie about Narayama? Take them to a rocky peak and leave them there to die? So as not to interfere with the young and strong?
No, I don't think so.
Moreover, I am convinced that a doctor should fight for the patient's life until the very last second. Hoping with all my soul that at this very last second the door will suddenly open and a colleague will run into the ward, holding in his hand a newly invented medicine that will save, put the patient on his feet or prolong the life of an old man for a good time. As they say, for an indefinitely long time.
The doctor is here as a soldier who must fight with superior enemy forces to the last cartridge, fervently believing that right now, this minute, he will hear from behind the saving rumble of tanks, the hum of airplanes and a native "hurrah!" – ours are coming!
Of course, this is reckless, stupid, murderously romantic. The sick old man will die. The soldier will be covered by an explosion.
But if we act prudently and soberly, then indeed we will come to the rejection of people who have barely fallen ill or crossed the threshold of old age appointed by society. And if we turn to the military example, we will come to the apology of mass desertion, to surrender after the first long-range shot.
Therefore, romantic and reckless behavior turns out to be the most clear and prudent.
It's not even that sooner or later we will all turn out to be old people, and many of us will turn out to be sick old people. The fact is that in caring for the terminally ill and for the decrepit old people – the key to caring for those who are not yet forty and who have earned mild gastritis. Respect for a person's life, the struggle for his life is indivisible, it cannot depend on his age and the severity of the disease.
I foresee the following question: if you are such an impeccable humanist, why did you start this conversation? To tell us that good is good and evil, on the contrary, is bad? We know that, thank you.
What are you, what are you.
I started this conversation to remind you that the fact that humanity and civility dictates at all costs to take care of the elderly, including the seriously ill, and prolong their lives as much as possible – this problem does not go away. The problem of a huge burden on the family, on society, even on the state budget, it still remains.
An increase in life expectancy is associated with an increase in the age at which people acquire children. The connection here is quite simple: in modern industrial and especially post-industrial society, men and women at the time of their physical and mental heyday are engaged in education, work, professional development, creativity, career, and not family. Only in such conditions is science and technology rapidly developing, which makes it possible to achieve significant breakthroughs in medicine, and simply in the comfort and safety of life.
It comes to family and especially children when people have the opportunity to exhale a little. Something has been done in the work, the desired social level has been achieved, most of the housing debt has been paid. This usually happens by the age of 35-40. Earned yourself a child.
As a result, we get a series of so-called squeezed generations. Squeezed between young children and elderly parents.
A forty-year-old man pushes a baby carriage with his two-year-old child in front of him with one hand, and pulls a wheelchair with his eighty-year-old father with the other hand.
Further, an increase in life expectancy is, as a rule (I emphasize that I am not talking about fine exceptions), means an increase in the duration of old age. Well, or so: in order for an active full-fledged life to last, say, for ten years, for example from 65 to 75, helpless and painful years are extended by at least the same amount.
Of course, these are just my observations and impressions, nothing more. However, it seems to me – both from the biographies of my relatives and acquaintances, and from literature, fiction and memoirs – that in the old days there were many more people who died healthy, so to speak.
Count Kirill Bezukhov was ill for a month or so. The old Prince Bolkonsky died in two days. If they had been ill for years, the plot of the great novel would have been completely different. Pierre would not have become the richest groom in Russia and would not have married the beautiful Helen. And Princess Mary could not have brought Nikolai Rostov such a substantial dowry.
The whole culture and the whole everyday life for thousands of years did not include the situation of long-term (and often expensive) care for helpless old people. The price of a civilized "prolonged dying" sometimes undermines the well-being of entire families.
What in the past could have become an inheritance, passed on to the next generation in the form of money or other property, can now go to pay for medicines, doctors and nurses.
And it would be good if it was only about money or things. Social well-being is changing a lot; sons and daughters who devote themselves to caring for elderly sick parents are happy and unhappy at the same time; tired, often impoverished, torn between the elderly and their own children…
What to do?
Our culture is not yet ready for the challenge of old age, has not mastered it. The contradiction between the humanity that is so necessary for all of us to the decrepit old and the very high, sometimes unaffordable payment for it – this contradiction, it seems to me, is in principle insoluble.
As a contradiction between labor and capital, between rich and poor (people and countries), between biological and social gender. It is impossible to live without these contradictions, they create the energy of development, but they also become a source of endless tragedies.
What to do? Think. Think. Comprehend. To look for a way out – your own, personal, own.
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