Being Ill

For most people, getting sick is no big deal, a minor inconvenience.  But when you get to my age, every sniffle, wheeze, intestinal pain or unexpected ache is interrogated like tea leaves for signs of the end times.

My father was famous in our family for refusing to admit it when he was sick.  Nothing put him in bed, neither cold nor flu, or even a bad hangover.  Then in his 70's he had two heart attacks in quick succession.  Thereafter, the word of the doctor was law.  He surrounded himself with medication and measured the doses religiously.  Late onset asthma and emphysema required oxygen tanks in the house, but he was too embarrassed to resume his daily walks at the mall with his buddies carrying his tank behind him.  He lived until he was 83, a grand old age, but his final years were lived in a medicalized haze.

Life, of course, is terminal; there are no guarantees.  When all goes well under the sheltering tree of good health, we can ignore this simple truth.  The obliviousness of the young to their impending doom, however, is a red flag to elders who are obsessed with vital signs, insurance claims and doctor appointments. The generation gap is never so large as when it divides those youth who are more obsessed with body image than with the body's pains from the geriatric set on the banks of the River Styx awaiting their demise.

Nan has had a cough for weeks and refused all offers of medication. When we flew back home from our trip to Korea, my head filled up like a balloon with mucous and I could barely breathe.  So I immediately sought remedies in the bags of pills we keep in a bathroom drawer.  My sinuses were screaming and pain spread under one cheekbone.  A trip to the emergency room at the hospital up the street confirmed my diagnosis and I got an antibiotic for the infection along with a decongestant, and medicine I've only found in Thailand, Mucosolvan, to clean out the airways.

My worst fear is not being able to breathe.  I recall bending over in our North Carolina home when I was seven, struggling for every breath.  The asthma attacks began when we moved south from Ohio. They took me to the hospital where I was put in an oxygen tent and given a shot of adrenaline to kickstart the faulty fight-or-flight response back into normal action. I was given a back scratch test to determine allergies and found I was sensitive to everything, particularly milk, tobacco and cat hair.  At Duke Hospital in Durham I was a guinea pig for a new treatment that never worked.  Eventually various prescribed epinephrine sprays kept the attacks in check.

My brother is a canary in the mine of disease and fatal conditions.  He has undergone a multitude of tests, at considerable expense, for all of the recently discovered illnesses, and learned he has not a few of them.  The internet has opened up a treasure trove for those ailing mysteriously and has enabled many to find symptoms that fit and a diagnosis that brings comfort in a world out to kill its population off.  My son, not yet fifty, considers my medical problems as early warning signs delivered by bad genes and imagines the dire consequences of not falling far from the tree.

When I came to Thailand five years ago, I abandoned the Statin drugs that presumably had kept my cholesterol in check and stopped using the corticosteroid spray I was told to inhale daily to prevent asthma attacks.  And I resolved to no longer monitor my PSA level to see if the prostrate cancer I'd lived with for six years was spreading.  With the image of my father's declining years in mind, I did not want to constantly watch for signs of decay.  Old people discussing their illnesses are exceedingly boring.

My reluctance to get periodic checkups was mystifying to friends.  One of my closest, who has had several heart attacks and a pacemaker installed, shook his head at my stubbornness.  Medical care in Thailand is approximately half that back in the states, but it is something I consider a needless luxury on my limited retirement income.  Aging skin is prone to all manner of strange growths, but I no longer get a regular skin scan to detect horrors like melanoma, which killed my friend Corb.  My hearing sucks, my eyesight is failing, a degenerative knee hurts when I walk, and I need a tooth pulled, but most of me works just fine so I put off all possible bodily renovations and reconstructions.  If life is ultimately fatal, why try to postpone the inevitable?

Illness comes in many flavors.  On the one hand, my head feels as if it's filled with cotton, raspy throat cords have lowered my voice an octave, and my coughing resembles the crackling roar of an avalanche.  On the other, my muscle tone has diminished considerably, stairs are a constant challenge, getting up in the morning requires unimaginable fortitude, and I spend much meditative time at the toilet because of an enlarged prostate.  Germs and viruses, along with accidental injuries, can make life miserable for everyone, but the debilitation of aging solely troubles those of us who have survived for at lease sixty years.  Only the former can be called "sick."  They're categorically distinct conditions.

When I drove my car drunk into a candy store at the age of 18 and broke my femur, the hospital was my refuge.  I loved the care and attention I received during the two months I lay in traction.  Even the instructors on their rounds with nurse trainees gave me pleasure.  First the girls practiced with a hypodermic needle on a defenseless orange and then they experimented on my butt.  Years later I looked upon that time with nostalgia and thought of doctors and hospitals positively as sources of healing.  What bothered me most was to seek medical help for some ailment only to be told it was nothing to worry about.  Being diagnosed with cancer put that to rest.

Some signals cannot be ignored.  A year ago Christmas, when Nan was away, I felt bad enough to go -- twice -- to the hospital.  The second time I was admitted with pneumonia after a neat device that fits on a finger detected the oxygen level in my blood dangerous low.  I stayed for three days until my vital signs normalized.  And I was convinced that a daily corticosteroid spray was necessary to avoid a repeat performance. Now, after two weeks, my sinus infection is cured but the cold lingers; another fact of aging is that recovery takes longer.

Illness and injury are transient and aging is a permanent, and rapidly escalating, decline of the physique.   Somewhere in the middle are the multifarious malfunctions of the body, like heart disease and cancer, which one day may be confirmed as the result of poor lifestyle choices, or the consequences of pernicious changes in the environment determined by corporate greed.  Total health is an illusive and short-lived goal.

My prescription for life is Deuteronomic and Nitzschean.  In the Biblical book of Deuteronomy, God told the Israelites: "I have set before you life and death, blessing and cursing: therefore choose life, that both thou and thy seed may live." Constantly watching the body, its health and  its prospects of longevity, is for me to choose death.  Our task is to live here now, as fully as we are capable.  Nietzsche was plagued with migraines and eventually died from syphllis, but a joy for life shines through his most pessimistic philosophy. In his strange yet central idea of eternal return, he advised that we should live our life in such a way that we could relive it forever, a "Groundhog Day" of the will.  I'm damned if I want to relive my life in a doctor's office or a hospital emergency room.