Sunday, October 5, 2014

Zeke Emanuel guesses how he'll feel in 2032

Dr. Ezekiel Emanuel

    Attempting to explain the impenetrability of Richard M. Daley, I coined the phrase: "Trying to get to know him is like trying to peel a ball bearing with your thumbs." Maybe some people can, maybe the man has friends who understand exactly what he's all about. God I hope so. But to the rest of us, it's a smooth, slippery, sealed mystery. I don't believe Daley himself has a clue about who he really is or why. 
    Though not quite as murky, Rahm Emanuel is similar enigma. He talks more than Daley did, true, but in a sense he's just as unknowable but for opposite reasons. If Daley's a silent sphinx, Rahm's a babbling brook, a Twitter feed, an endless gush of spin and pronouncements and self-congratulation. It's hard to find a few nuggets of reality floating in all that.  He reflects himself, but a funhouse mirror version, with the good distorted, and the negative shrunk down to nothing.
     One indispensable guide to Daley was his younger brother, Bill. Rich might never say anything of substance if he could avoid it—he'd cough up a wet furball of mangled syntax and consider the topic closed—but Bill liked to talk, and sometimes he would cast a wan ray of light down the pitch dark well of his brother's soul. 
     As with Daley, Rahm's older brother Ezekiel Emanuel provides a valuable perspective on the unknowable. His book about growing up with Rahm and Ari, the youngest boy, Brothers Emanuel: A Memoir of an American Family painted a surprisingly candid—read "stark"—view of their lives, with a pediatrician father who had a tendency to bring stray foster kids home to live, and a driven, occasionally unhinged mother who dragooned her children to picket their neighbors' homes and forced them to attend rallies for causes they could barely understand. It explained a lot. The parents drilled into the boys the need to compete, and the three siblings tried to top each other in a semitic North Shore version of the Kennedys.
     Reading it, and assuming that the truth was a derivation or two worse, you have sympathy for Rahm. Of course he'd be the way he is, the poor bugger, a driven little machine of achievement, running after the next prize. To the public, he's rich and powerful. To him, no doubt, he's never rich or powerful enough. 
     Now Zeke has written an essay in the current Atlantic magazine, "Why I hope to Die at 75," that is causing conversation for what it says about aging, the suggestion that rather than clawing at the curtains of life, one should reach moderate old age and resign yourself to a hoped-for swift death. An interesting premise, though I'm more fascinated by what it tells us about  the general Emanual worldview. 
      A doctor and bioethicist, Emanuel argues, correctly, that as we age our bodies decline and our minds become less free-ranging.
     "We literally lose our creativity," he writes.  "But the fact is that by 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us."
      That's enough for Emanuel, 57, to announce that he'll be happy to go at 75, to avoid the gentle slide into non-productivity. He won't kill himself, he hastens to add, without quite explaining why not. He'll just refuse all life-saving medical care at that point. He seems to think he's making a bold declaration though I couldn't have been the only reader who felt the nearly two decades between this promise and the fulfillment render pretty much everything he insists he'll do or believe essentially meaningless. If I told you what type of tea I'll prefer in 2032, you'd look at me askance, and rightly so. 
      Still, it's the measure he uses to value life that I find fascinating. Forget 75. I hate to be Debbie Downer here, but the truth is, at 65, or 45, or 25, most of us, the vast majority,  aren't winning any prizes in the creativity, originality, or productivity departments. So the decline of whatever scant prowess we may have once had isn't the biggest loss, to us or anybody else. Certainly no reason to step away from the one life we've ever had. The Atlantic piece reflects the mindset of man who is blind to anything that isn't success, the morality gleaned from sneaker commercials and stockbroker ads, that postulate a nation or Iron Man Tri-athletes (like Rahm) where nobody retires to potter in a garden and do the crossword puzzle, a doom that Zeke Emanuel in essence mocks. 
   And then, as walking becomes harder and the pain of arthritis limits the fingers’ mobility, life comes to center around sitting in the den reading or listening to books on tape and doing crossword puzzles. And then …
    Emanuel immediately kicks open an escape hatch. "Maybe this is too dismissive" he quickly adds, lest anyone latch onto his implication that if you aren't writing Infinite Jest you might as well be dead. But that is what he is saying. The idea that life is, itself, a joy, a unique gift that can be savored even on the most limited terms, never seems to occur to Zeke Emanuel. That waking up, making a cup of coffee, assessing the sky and beginning another day, alive, where one can talk to friends, read books, walk the dog, whatever one can, is enough to live on, despite the pain, indignity and decline of age, is unimaginable. He charts the average age men win the Nobel Prize: 48. Well, we all better get on the stick then.
     Emanuel never mentions that plenty of adults lead lives that are diminished, by general standards, from day one. By his measure, they shouldn't give flu shots at Misericordia, because the sooner those folk die, well, the better for them and everyone else. Yet they do, and those of us whose lives barely register on the Emanuel Scale resist writing lengthy pieces in The Atlantic (are there any other kind?) eagerly anticipating our rendezvous with death.
     Emanuel mentions that his parents are both alive, his father 87, has "slowed tremendously" and isn't churning out professional successes anymore.
     "Despite this, he also said he is happy," Emanuel notes, dubiously.
     I have an arthritic hip, a balky memory, and am in desperate need of bifocals, my eyes weakened no doubt from staring hard at the horizon, waiting for a ship that never came in. Yet I truly can say I enjoy life more back when I was 25 and all my neurons were on line and firing properly.     
    Emanuel doesn't perceive it, but his parents being alive skews his judgment here, because he theorizes their decline will blot out the good memories he has of them.
     "Yes, with effort our children will be able to recall that great family vacation, that funny scene at Thanksgiving, that embarrassing faux pas at a wedding," he writes. "But the most-recent years—the years with progressing disabilities and the need to make caregiving arrangements—will inevitably become the predominant and salient memories."
     At times perhaps. But my impression is that difficult declines are kept in a separate category for most people. My parents are 82 and 78, and while they are not hiking glaciers in Colorado the way they used to, they just got back from taking the Queen Mary up to Nova Scotia, and if you asked them, they would say they have their good and bad days, but all told they do not wish they had died years earlier. Nor do I wish they had. I talk to my mother on the phone almost daily, and she manifests her distinct personality quite well—sometimes too well—despite being three years past Zeke Emanuel's sell-by date. And my father, well, the passing years have filed off some sharp edges, and I have to say that the version circa 2014 is in some ways preferable to the 1984 model. We argue less.
     That is meaningless in Zeke Emanuel's world. To him, if you're not rocking your profession back on its heels, well, the grave calls. He wants the last image that his kids have of him as vibrantly climbing Mount Kilimanjaro, not leaning on a cane and feeding pigeons. The fact that his own kids vehemently disagree with this gets waved off, several times. Respecting the opinion of others, giving it weight and significance, is not an Emanuel survival skill.
     Whatever life holds in store for my parents, I'm not worried it's going to efface the memory of Hanukkah 1967. I now this because my wife's parents are both gone, sadly. Both went through difficult, painful deaths which, despite Emanuel's postulation otherwise, did not wipe out the decades of happy memories for their children. Nobody liked seeing them suffer, but nobody was rooting for them to nip out earlier either, including themselves. They had a toughness that has nothing to do with running a marathon. There's a creepy, detached, inhuman quality to Emanuel's argument, but that can't come as a surprise to anyone living in his brother's city.
      Achievement is a great thing; I'm big on it myself. But it can have a monstrousness, and it vibrates under his argument. When Emanuel writes "It is much more difficult for older people to learn new languages," you wish a more practical, human person, grounded in quotidian life, had pointed out to him that, luckily old people seldom need to learn new languages. Whatever the remaining years of my life holds, mastering Mandarin isn't part of the program, and I'm okay with that. 
      Being an Emanuel, he lards his essay with enough caveats and escape clauses that nobody can really be offended by it, and Emanuel allows himself freedom to renounce the whole idea as he approaches 75.
      "I retain the right to change my mind and offer a vigorous and reasoned defense of living as long as possible," he writes, lest Atlantic subscribers show up to his East Coast home with torches in 2032.
      I don't want to criticize Emanuel too harshly. I'm glad he wrote the piece, as our aging society will demand a re-thinking of how we approach medical care at the end of life, and what he calls "a tsunami of dementia" will become a problem we can't avoid, assuming it isn't already. Our ethics and approach to health care lag tragically beyond our technical medical capabilities, and change must happen. It is too easy to slip into the protracted, technology-ridden death alone in a hospital ward that nobody wants for themselves or their loved ones.
      It can be very difficult to talk to parents about these issues—he discusses that—and we need to create a world where doing so is essential.
      So this sort of article is helpful, as part of a conversation we should all be having. But it also confirmed what I know about the mechanistic, Energizer Bunny of endless action that Chicago has for a mayor. I'm not complaining—I think he's doing a good job, in the main, and perhaps a regular human being wouldn't take it on, never mind perform it as well. But there's a mystery to Rahm, and this helps us make out its contours in the darkness. If there seems a disconnect, a gulf of incomprehension between Rahm Emanuel and the 2.7 million flesh-and-blood people he leads, or tries to, well, it obviously runs in the family.





10 comments:

  1. Sure we should discuss end of life medical care. But it should be the choice of the patient and family--not decided for them by others. As you correctly say, for some of us, just sitting and reading a book can be a worthwhile day of life even when we can't walk, etc.

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  2. I'd wanted to read the Atlantic article when 1st reported, but it's not available from a library through Zinio, so was glad to read a recent précis in the S-T. My immediate thought was, here comes the GOP claiming death panels. My overriding thought was, if it's OK for Down's children to just be happy, why can't the elderly. Several over-80s in my senior center book club have very insightful observations. Myself, I want to hang around because I'm always interested in what's new on the horizon: I won't be creating it, but I like to know it occurs. Janet Fendrych

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  3. Cheeseburger JonesOctober 5, 2014 at 8:28 AM

    Gratuitous shot at the Atlantic aside, a great analysis of the man who leads Chicago, though I'm not sure if he loves or even likes the city. Just another task on his way to....?

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  4. But isn't 75 the new 55? All kidding aside, when I first read Zeke's essay it left me unsatisfied, with more questions than answers about his view on aging. I wondered why he came across a bit cold, and I think you've answered my questions nicely.

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  5. "Neither the sun nor death can be looked at steadily." La Rouchfoucold.

    You're right in ending your excellent joint exposition of the book and the Atlantic article with a recognition that Zeke Manuel should be commended for taking on the most unpopular subject imaginable, even if he advances a proposition almost no one will agree with. It is true that few people are creative and productive at advanced ages, but the few exceptions might adequately compensate for the rest of us. If Verdi had croaked at 75 we wouldn't have Otello and Falstaff, his two greatest works. I myself would hope to pass from the scene (in my sleep, of course) before becoming an economic burden and a pain in the ass to those obliged to care for me, but would even then be reluctant to let go of a lot of simple pleasures. Like posting on your blog. And I recognize that when the time comes I might well, to quote another famous Frenchy addressing her executioner, plead for "encore un moment, monsieur."

    On the enigmatic verbal offerings of the former mayor, my favorite, although I can't exactly say why, was his comment on low voter registration: "Everybody's worried about apathy."

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  6. Despite the short space, this is a trenchant analysis of the brothers. In response to Mr Jones, above, I think Rahm is looking to be the first Jewish president.

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  7. For every superstar there have to be hundreds, thousands, perhaps millions of fans, who are by definition less than super. I guess it hurts to fall from the heights, but it might be instructive to think how the rest of the world puts up with being mediocre.

    John

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  8. A wonderful post, Neil. So many finely-wrought observations and phrases that it would take a 3-paragraph comment just to reference them. But I feel like the crux of the matter is that, as you write: "...the vast majority, aren't winning any prizes in the creativity, originality, or productivity departments" to begin with. Maybe the quotidian pleasures of life don't hold much appeal for Emanuel at this point, but I kinda think that his perspective may well change as he actually approaches his self-selected expiration date. A discussion of the many issues that will become more urgent with regard to the aging population in the country is certainly warranted, but this "pick an age to call it quits, whatever one's capabilities might be at the time" approach seems to me like a rather odd argument for a bioethicist to be promoting.

    Oh, and unlike many observers, I've always believed that Daley and Rahm care a lot about the city, not that it's always evident. I'm no particular fan of either, but I would never have wanted to be in their shoes, trying to effectively manage this city, for all the corned beef at Manny's...

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  9. In the spirit of levity regarding aging I would recommend Christopher Buckley's twisted tale called Boomsday paired with this You Tube song. www.youtube.com/watch?v=Zrv2FuajJZ8



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  10. "...lest anyone latch onto his implication that if you aren't writing Infinite Jest you might as well be dead." Sadly, the fellow who wrote Infinite Jest decided that even if you _had_ written Infinite Jest, you might as well be dead.

    The thing that struck me about the Atlantic article was Emanuel's fear of pretty much _every_ type of decline. Why would he accept stasis or constant improvement as the only life worth living, and why would he ask others to accept the same view? One of the joys of being human is the ability to come to terms with a wide range of situations, and to thrive in them. Why write off this ability? And why not even give consideration to the joys of companionship and cameraderie, to pursuing interests, to helping others, to simple pleasure? So he might not be a scholarly rock star at 75 -- why doesn't he see that other avenues will present themselves?

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