Thursday, July 2, 2009

Choosing (Long) Life

Why is it, do you think, that we have created a society in which, for all most of us spend at least some day every single day contemplating matters relating to our health and pondering our potential longevity, it is still considered slightly tasteless actually to chat with another about death...and especially our own eventual deaths? I suppose the answer is simply that that kind of talk makes us feel vulnerable, uneasy, and defenseless, three sensations none of us enjoys even slightly. We joke about death endlessly, of course, but those jokes are almost always centered on the demises of other people. We go to other people’s funerals all the time, but we still find it inconceivable to imagine our own. And when someone inadvertently, or even not inadvertently, mentions a date in the distant future far beyond what we can reasonable imagine to constitute the outer boundaries of our own natural lifetimes, we generally respond by doing what we can to change the topic as quickly as possible. We talk vaguely about great authors or artists living on through their work, but none of us wants to escape death by being remembered fondly after we’re gone—we want to escape death (as Woody Allen didn’t say first) by not dying. We know no one gets out alive. We just can’t quite believe it.

All that being the case, I was fascinated by the www.livingto100.com website I came across the other day. Run by a Dr. Thomas Perls, the website is an outgrowth of the New England Centenarian Study, itself a project of the Boston University School of Medicine. (You can read all about the study, including some of its tentative findings, at http://www.bumc.bu.edu/centenarian/overview/.) The short version is that a group of professors and medical researchers at B.U. had the idea of identifying people who have managed to survive into their personal second centuries, then trying to figure out what they all have in common. Presumably, whatever it is they’re all doing, we should all be doing too! Nor is it at all clear that whatever these centenarians are doing is what people who live into extreme old age have always done: there are, the study says, over 50,000 Americans today over the age of 100, which is approximately three times as many as there were just three decades ago in 1980. So something has clearly changed, but isolating what exactly that something is—and thus deciding whether we are talking about environmental conditions or personal habits or some combination of the two—is not at all as simple as it might appear at first blush. Perhaps medicine has just become that much more sophisticated and people are simply living past 100 in larger numbers now because they aren’t succumbing to anything else before they get there!

You can consider the results of the study by reading a book authored by Dr. Perls and Dr. Margery H. Silver called Living to 100:Lessons in Living to Your Maximum Potential at Any Age, published by Basic Books and available on-line at all the obvious sites. Or you can go to the www.livingto100.com website, as I did, and take a test that cooks up all the various relevant factors into a reasonable guess at how long you can actually expect to survive. It takes a little courage to sign on. I started three times before I finally pushed myself actually to continue on to the end. The test itself is not at all difficult—there are about forty questions to answer, none of them requiring any research (supposing you know your blood pressure and your cholesterol numbers, although you can also answer by saying that you’re not sure or don’t know)—but it is more than just slightly sobering actually to get started: as you click on that “Take the Calculator” link, you are signing on to allow someone who has devoted his life as physician, geriatrician, and researcher to analyze your data and guess how long you can reasonably expect to live. No wonder it took me a while to buy in! I mean...it’s one thing to sing along with the cantor that it’s written on Rosh Hashanah and sealed on Yom Kippur who will live and who will die (and who at the natural end of his or her days and who not), and another to agree to let someone with a reasonable right to have an opinion actually attempt to calculate how much time you have left.

It took some self-discipline actually to take the test, but I did it. (I’ll tell you the results below.) Mostly, my answers were the “right” ones, or at least not the wrong ones. I’m a married man. I swallow 81mg of aspirin daily. I eat my vegetables. I have a blood relative to lived to be over 95. (This is a big point, twice as meaningful as taking the low-dose aspirin daily. My father’s sister, my Aunt Molly, died at 99.) I go to shul a lot. I play games intended to keep the mind alert “like Scrabble or Soduku.” (I gave that to myself even though I hardly ever play Scrabble and am not entirely sure what Soduku is. Surely writing books and studying Talmud must count.) I don’t eat red meat more than twice a week. I don’t smoke. I don’t use IV drugs. I don’t have unprotected sex with multiple partners. (I heard that! Let’s just move on.) I don’t usually drink more than five cups of coffee a day. I have more than twelve years of formal education. I like nuts.

Mind you, I lost points too. I don’t wear sunscreen as often as I probably should when I’m outdoors. My father had diabetes. (It was a bit shocking to me that the only three diseases they ask about are cancer, heart disease, and diabetes. I lost points on all three.) I generally sleep less than six hours a night. I occasionally feel slightly stressed. I rarely eat five pieces of fruit on any given day. What can you do? I suppose I could eat more fruit or try to worry less about the future of the Jewish people.

The results of the study are very interesting to consider, although it’s hard to know how exactly to interpret some of the data. It doesn’t surprise me that very few people who live to be 100 are smokers. Nor does it strike me as illogical that the siblings of centenarians have a much greater likelihood of attaining extreme old age than other people, although I’m not sure why this should have anything to do with gender, which it apparently does: the male siblings of people who reach 100 are eleven times more likely than other men born around the same time to reach their upper nineties, whereas female siblings appear to be only 8.5 times as likely to reach their one hundredth birthdays. Nor is it at all obvious to me why a woman over age 40 who bears a child naturally simultaneously becomes four times more likely to live to be 100 than other women. These and many more statistics, plus a much fuller picture of the study, are available on the website and in the book, both of which I recommend to you.

In Pirkei Avot, Judah ben Tema is quoted as saying that people who reach the age of one hundred are, at least generally speaking, “as though they were dead, vanished, and gone from the world.” But the centenarians featured on the Living to 100 website at (http://www.bumc.bu.edu/centenarian/meet-centenarians/) don’t seem half dead at all. Just to the contrary! (One of them, at age 102, plays eighteen holes of golf three times a week.) Maybe the world has changed. After all, if there are three times as many American centenarians today as there were a scant 30 years ago, so how many 100-year-olds could Judah ben Tema have actually known in his day? Or maybe we ourselves have changed, or society has. Whatever, there is something satisfying in knowing that, for all our long-term destinies are in God’s hands, our short-term chances of living a long life are not entirely a function solely of good genes and good fortune. We can affect the odds considerably and, in most cases, without too much effort or expense. How much does dental floss cost? (Did I mention that before? People who floss daily live on the average two years longer than people who don’t. It’s hard to imagine why that would be. Maybe people with good dental hygiene are generally people who take care of themselves in other ways as well.)

And now for the results. It took some courage to click the final button, but I did. According to Dr. Perls, I should live to be 98. That would be nice! (I suppose I should revisit that thought when I’m 97. But it feels encouraging now!) The bottom line: eat fruit, don’t smoke, and go to shul! You can’t do much about you family history. But you can still consider carefully what Dr. Perls and his colleagues have discovered and act upon their findings. And the Torah does command us after all to choose life!

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