Monday, April 25, 2005

Life is a cabaret, old chum--UPDATED

Only a cabaret
April 25, 2005

Like a lot of lazy people, I have a standing joke that I have is my list of people who died while jogging. It's not actually a list, just recollections, starting, of course with James Fixx, the famous marathon runner. If he was sitting on a couch, drinking beer and watching a baseball game, he would have lived longer. He wasn't really a great example, to tell the truth; he was very sick before he started running that day, had every reason to know he was in trouble yet went and ran and died anyhow. Nonetheless, the list--if there was one--is long and honorable, including the former governor of Florida who fell off his treadmill, and Jack Kelly, the brother of Grace Kelly, an Olympic athlete who would scull up the Schuylkill River in the morning and then go running. He dropped dead in front of my office. Then, of course, there was Doug Adams, the wonderful creator of the Hitchhiker books. He died at 49 at a health spa. The saddest story I know was a law professor at Stanford, John Kaplan, one of America's great experts on Constitutional law and a splendid man. He ran marathons, ate nothing that could clog anything under any circumstances, and while he was honing his heart to that of a lion, a tumor was growing in his brain. A friend described him as having the fastest mind he had ever seen. Same brain. He was president of the faculty senate and his colleagues, in respect, let him continue even though he was rapidly becoming incoherent. It was excruciating to witness. There is not a rule that man broke and he was still dead before the age of 50. He jogged until almost the end.

All this rumination is a triggered by a piece by Gina Kolata [$] had in the New York Times a week ago, pointing out that only Americans think they can battle aging and prolong life by their behavior. Most Europeans and Asians know better. Europeans don't read diet books and think our passion for them amusing. This battle with mortality is a peculiarly American trait, part of our charm, I guess. It is not just that Europeans think out fat-battling diets are ridiculous (and they guess, correctly, that none of them actually work for most people) but it is philosophical. Life, they know, is a crap shoot. Your longevity is largely determined by who you are and the genes you got, and then, what you do with them. And when your time comes, your time comes and that too is part of life. What part religion plays in this, I cannot tell, but I'm not sure that it does. We share the same religions they do.

As I approach the age at which my father died--of his third heart attack--I understand this. He would not have died at 67 if he did not smoke for many years and had access to the same medicines I do. My blood pressure is under control (Atenolol) and my cholesterol is at a lovely level, thank you (Pravacol). I have had nothing, praise be, even vaguely resembling a heart attack and the heart disease I do have is minimal. It's being watched and when it is necessary to do something drastic about it we will. Indeed, had my father been around for statins he might have gone on for many more years. Even popping aspirin might have made a difference, but no one knew that then. He lived too early. Bad luck.

I am convinced, as Ms. Kolata wrote, that while you can alter the odds somewhat, it is mostly genetic and karma that determines how old we live. Smoking obviously alters the odds. Working with asbestos radically shifts those odds. So does skiing in avalanche country. Devouring Big Macs and fries clearly is not going to do you any good, and if nothing else, will make you fat. Eating well, exercising and not going bungee jumping, also alters probability, but that's all it does. Mostly it is your genes and luck. I have an uncle who still works three days a week at the age of 93, looks 10 years younger, and except for a few odds and ends, has a fully functioning mind and body. His mother made it to 92, his aunt to 102, his sister (my mother) to 82, and his brother is doing fine in his late 70s. Another brother died of liver cancer in his 40s, and no one can guess why. I'm counting on those genes and hoping to avoid his brother's bad luck.

The problem we all run into (especially medical writers) is that scientists do studies and show that in the aggregate, the odds of living longer are improved by eating carrots, blueberries and kale, and we write stories to that effect (me too). People who exercise live longer than people who don't. In the aggregate. (That people who exercise may feel better than people who don't is not an issue. I concede the point). To an individual, it really doesn't make a hell of a difference. Cancer is a disease of age and every day in every place, I think, some cell is misbehaving. Almost all of the time, our bodies stomp on it and we never notice. And then sometimes, it doesn't. You are either programmed to have heart disease or you are not, and if you are, there are medicines. Indeed, death by heart attack is now a shrinking component of mortality tables thanks to aspirin and statins. I am convinced that only thing switching to a fat-free diet will accomplish is to take flavor out of my meals.

I would advise that we reconsider stories like that. I would, except that Americans still like to read them; editors, therefore like to print them and pay writers to write them, and writers....well, it's hard enough to make a living writing without standing on a useless principle. Maybe we should just not take them too seriously.

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