Never Say Die

Susan Jacoby would have more appropriately titled Never Say Die, her look at aging in America, if she had called it The Worst Years of Our Lives – for that is what she predicts the ninth and tenth decades of life will be for those “fortunate” enough to live very far into them.  (I do want to note that she clarifies the purpose of her book with its subtitle: The Myth and Marketing of the New Old Age.)  She sees few exceptions (and she attributes most of those to class and money) to the rule: those who reach old old age invariably enter a world impacted more by Alzheimer’s, poverty, family neglect, suicide and assisted suicide, and painful disease than by everything that came before. 

To Jacoby, this is a given, and there is no room for debate.  She believes that those who are blind to this truth have been brainwashed by unscrupulous marketers having some dubious product to sell, some magic pill, cream, liquid, book, or surgery that promises to stop aging in its tracks.  As millions of baby boomers reach or approach their 65^th birthdays, it is more and more difficult to avoid these hucksters.  They are everywhere.  We are, after all, easy-sells; we want desperately to believe that the suffering associated with the aging process will be defeated just in time for us to enjoy life well into our nineties, if not beyond. 

As Jacoby points out, it is not that older people become obsessed by death.  Rather, it is that death “becomes a more conscious presence” in their lives as the decades pass.  Losing grandparents is somewhat expected and acceptable; losing parents, less so; and losing siblings, old high school friends, and office mates at a steady clip is what finally hits home – we, too, are going to die soon.  At sixty-five it is still easy for many of us to believe that the “best years of our lives” are still ahead of us but at eighty-five only “a fool or someone who has led an extraordinarily unhappy life can imagine the best years are still to come.”

Never Say Die is a wake-up call, a warning that old age is best handled by preparing oneself for it long before it happens.  Jacoby warns of the generational warfare that is likely to erupt when younger workers can no longer afford to finance the medical costs required to keep their elders alive.  The difficult choices that have been avoided by politicians for decades will finally have to be made.  Those who can afford to save enough to pay their own way in old age need to do just that.  Those who cannot, face a much less clear future because it will be up to politicians to figure a way out of the impending mess.

It is impossible, of course, to avoid politics in any discussion of health care and caring for a rapidly aging population in the future.  Jacoby, however, takes the approach of blaming almost everything bad on conservatives and giving liberals credit for almost everything good.  It is only in the book’s last few pages that she effectively dares to criticize the liberal point-of-view at all.  Jacoby’s criticism of conservatism often can be justified – but the tone of that criticism, as seen below, often lessens its credibility:

“Since we do not euthanize the old when they become too expensive (teabagger fantasies notwithstanding), society winds up paying in the end if government does not require young adults to contribute to the maintenance of a strong public safety net.”  (Surely Jacoby understands the sexual connotation of the term “teabagger,” but she chooses to use it anyway.)

“While I considered John Paul Stevens the wisest member of the Supreme Court before his retirement at age ninety, I shudder to think about the possibility of Antonin Scalia serving on the Court until his late eighties.”  (Agreeing with Jacoby’s political point-of-view earns one a free pass that disagreeing with her politics does not earn.)

“Many of these people are former full-time retirees who were victimized by conservative-backed federal policies that enabled companies to break their pension and health care promises to retired workers.”  (This issue is not as black and white as Jacoby portrays it.)

“The rationally-challenged but cleverly opportunistic fringe was represented by the shameless hustler Sarah Palin, who – blogging away viciously after walking away from her job as governor of Alaska – transformed entirely voluntary consultations into “death panels” that would decide whether old people and children like her son with Down syndrome would continue to receive medical care.”  (Here, in her choice of adjectives, Jacoby shows her own irrational hatred of Sarah Palin and the “fringe” she represents.)

Never Say Die has some important things to say about medicine, aging, long term care of the elderly, and the hucksters trying to make a fast buck from a generation’s wishful thinking.  It is, despite the author’s failure to resist taking a few cheap shots at those who happen to disagree with her, a good addition to the conversation.

Rated at: 3.5