Saturday, April 26, 2014

Death Before Dementia

It has been a long-running fear of mine.  The fear, the worry, over Alzheimer's.  Or, any ailment of any name, for that matter, in which I could regress towards not knowing where I am and who I am.  A person exists, and yet that person does not exist.  What a tortured "existence" that is.

The logical brain--which is fine now--always reminds me that there is nothing that can be preemptively done.  If it happens, well, shit happens.  I have no idea how the faithful reconcile themselves to such possibilities but at some point they, too, surely recognize that it is all in the luck of the draw.  One can be rich, and one can be poor, but if the neurons go on a work stoppage, that is it.  A blankness sets in on the face.

A couple of hundred years ago, people did not have to worry much about such a state of existence.  How could they when the average life expectancy was no more than forty.  The typical person died well before the neurons could rise up in rebellion.  Now, as we live longer and longer lives, the threat of dementia looms large.  I can run, it seems, but there is no place to hide.

The tsunami of dementia is about to swamp us, writes Michael Kinsley in the New Yorker. (sub. req.) Almost from my first year of graduate school, I have been a fan of Kinsley's.  I loved his writing--the content and the style--in the wonky outlets that I meticulously read.  When he started Slate with Microsoft, in the early years of the web, I became a Slate faithful, which I am even now though Kinsley is long gone.

One of the reasons that Kinsley is long gone--an early onset of Parkinson's.  He was forty-three, and that was twenty years ago.  The fact that twenty years later he is still writing serious content, with that same old phenomenal sense of humor that he had, says a lot about how much Kinsley has been able to stave it off.  An outlier he certainly is.

In the New Yorker piece that is simultaneously hilarious and depressing, Kinsley writes that the ultimate race is this: competitive cognition:
The rules are simple: the winner is whoever dies with more of his or her marbles.
Which, therefore, leads to:
So "Death before dementia" is your rallying cry.  It is also your best strategy, at the moment, since there's no cure for either one.
As Kinsley notes, Parkinson's is not merely a movement disorder. It is not merely about the shakes.
[There] are three categories of Parkinson's symptoms. There are physical symptoms, cognitive ones, and psychiatric ones--depression, anxiety, and so on.
Understanding that Parkinson's is more than a mere movement disorder will generate additional issues:
As we get older, we're all going to lose a few of our marbles.  As the word gets out that Parkinson's disease is not just a movement disorder, there will be people whose careers will be destroyed because, on a particular day at a particular time, they can't recite a seven-digit telephone number backward.  Allowing someone's fate to depend on whether he or she can do well on some stupid test is just the reductio ad absurdum of the meritocratic machinery that has been pretty good to me (and to you, I suspect) over most of a lifetime.
All because we live in a different world from two hundred years ago.  A world in which we live long lives. A world in which the brain is worth more than the brawn.  And a world in which we cherish and reward meritorious accomplishments.

Quite a Faustian bargain we have made.

I am all for my death before dementia!


Ramesh said...

I was wondering what happened - for a dozen posts had gone by without a mention of this subject !

Forget about it Khe - a golden rule in management school was that if there was no solution, there was no problem !

Sriram Khé said...

I was afraid of you, Ramesh ... you had commented that if I blogged about death or dementia you would come all the way here to kick me in my behind ;)
I suppose I do think about these a lot more than the average person does. I would way prefer that the average were a tad higher than where it is now!

Death is not really a problem--either we are dead or we are alive. Dementia is a problem. Big time. Can't quite forget that ... of course, denial will help a lot ;)