Juicy bits:
"I do not believe in an immortal soul independent of the human body, because I do not believe in God or any form of supernaturalism. Nor do I argue, as some psychologists and philosophers do, that there is a mind or consciousness independent of the intractable materials mass of gray matter that is the human brain. To contend that consciousness (like spirituality) is a phenomenon separate from or greater than the brain itself strikes me as just another refusal to acknowledge that homo sapiens, with the most sophisticated brain of all species on earth, nevertheless belongs to the animal kingdom. What others call the mind or the spirit is the literally marvelous result of what the brain, a physical organ, has made of its encounters with stimuli over a lifetime."
Notes undertreatment of pain in Alzheimer patients because they can't express their circumstances clearly.
"One of the most frequent promises that husbands an wives makes to each other is that neither will put the other in a nursing home." So you'd think we'd judge the avail drugs by their ability to keep people out of institutions. They do nothing - merely palliative. Give us the sense we're doing something. The drugs given are palliative."
Old age is a woman's issue. Decries the
puffery about the wisdom of old to identify a purpose for the longer lives lived today.
"I do not know whether any death can truly be called good, decent, or dignified. For me the physical reality of the end, the flickering out, whether slow or fast, of brain neurons that have communicated with one another so brilliantly to form the life experience of one member of our species - one beloved member - overwhelms everything else. To an atheist, death -whether it comes as a thief in the night or through sudden. violent confrontation - is no more and no less than he fate all humans share. Take away supernatural hopes and one is left with nature, which is neither decent not indecent. The difference between "do everything" and "do everything - but stop when there is no more to be done" lies not in any spurious distinction between the "unnatural" (ventilators and tubes) and the "natural" (palliative care at home or in a hospice) but in the recognition that human intelligence itself is a part of and not the master of nature. Acceptance of the point at which intelligence and its inventions can no longer battle the ultimate natural master, death, is a true affirmation of what it means to be human."
"The issue is not whether it is morally wrong to want to live longer but whether it makes sense for a society to assume the costs that will inevitably be associated with a longer period of old age for more of its members. ....as long as Americans continue to believe in the myth that each of us possesses the power to create our own economy, we will be paralyzed, as a society, in our effort to meet the huge challenges to our institutions posed by the impending old age, and old old age, of the boomers."
"The central emotional challenge of advanced old age, as distinct from financial issues, is the establishment of a livable balance between autonomy and dependence."
"Laying claim to the right to feel rotten about what is happening can free up energy for the fight to live as well as possible through whatever life hands us as we grow older."
"The case against the propagation of [the myth and marketing of young old age] is much clearer when considering large social issues in an aging society, because faith in the future victory of science over old age and its discontents is bound to divert energy and money from the urgent task of devising new institutions and strategies to meet the needs of the old as they are now. But it is more difficult to make the case, on an individual basis, against the [xxx] of hope for a new old age....Even if there is little fact based justification [can it be no more deleterious to adults than he myth of Santa Claus to children?] ...adults are not children, even though they are often treated as children. Hope is not incompatible with realism, but it is incompatible with the expectation that things are going to turn out well if we only conduct ourselves well. Inflated expectations about successful aging, if the body imposes a cruel old age, can lead to real despair....
"The myth of the young old age spreads a miasma that obscures the intensity of memory and vision - not wisdom - that is the gift of sentience if one is fortunate enough to remain aware until the end."
