The Living End (Reflections)

I just devoured a book called The Living End, by Guy Brown. It was a well-written account of how the circumstances of death have changed drastically in the past 100 or so years. In the old days, something like 40% of humanity never made it to their 5th birthday. Life expectancy was still low even for those who made it past 5--they were most likely to die in their 30s or 40s from acute causes like infectious disease, famine, violence, complications from childbirth, etc.

Nowadays, in an age of good sanitation and antibiotics, people live a lot longer but tend to die of chronic conditions like heart disease, cancer, respiratory disease, and dementia, often after at least a decade of poor health. Even fatal heart attacks have become less common (when you think about it, that would be a good way to go--it's quick). Now, instead, people live with congestive heart failure, or a fragile, jerry-rigged heart, kept going by technology and drugs.

The first third or so of the book, as you might imagine, was a bit of a downer. There is no evidence, he says, that a good diet, exercise, supplements, etc. slow down our aging rate at all. Yeah, you'll be healthier, but a 65-year-old in 2010 is just as physically aged as a 65-year-old in 1510. So all of this increase in life expectancy isn't front-loaded onto youth; it just adds years onto the end, when you're less functional.

The cool part of the book was the discussion about how death has changed from a "digital" (1 you're fully alive, 0 you're fully dead, with no gray in-between) to an "analog" event (more like a dimmer switch). From the book:

The digital theory of death is dying. We can no longer think of ourselves as suddenly going from being fully alive (1) to fully dead (0). In the same way we have accepted that we do not jump from being non-existent (0) to fully alive (1) at birth. Becoming a full human being is a process. We grow into it over a period of years and decades, but then we grow out of it. That does not mean that aging is growing up in reverse. They are obviously completely different processes: an extremely old person is not the same mentally or physically as a new-born baby. But growing up and growing old could be thought of as growing into and growing out of life. This would give us an analogue theory of life and death: there is a continuum between life and death. Life is not all-or-nothing, there are degrees of life; at some times in our life we are more alive than at other times. We’d all agree that at some times of the day (or night) we are more alive than others. But to assert that some people are more alive than others is a political bombshell. However, whether we like or not, the future reality where the majority of us die demented or cognitively impaired will force new concepts of life and death upon us.

Later in the book, he applies this analog theory to the concept of self. Our cells, organs, etc. are constantly dying off and being regenerated over a lifetime, like a wave that is made up of different water molecules as it advances. In our culture, we've always thought of the "self" as a kind of unchanging spiritual essence that stays constant throughout life and survives in eternity in some sort of afterlife. His theory suggests that the self is just as fluid and ever-changing as the body or the degree of being alive.

All of the memories of every experience we've ever had affects the chemistry of our brains, wiring them differently for each individual. Neurons die or get pruned constantly--there's no way we could remember everything that's ever happened to us. The very act of calling up a memory changes the neural pathway where it's stored. The life experiences/memories that make you unique are therefore constantly changing--it's just usually so gradual you don't notice it.

Are you really the same self at 80 as you were as a baby? This makes sense to me, but seeing it spelled out like that made me sort of uncomfortable. The "self" is such a big deal in our culture. Paul has read the book too, and we're trying to figure out what actually constitutes the "self."