Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. And in stories, endings matter.
Technological society has forgotten what scholars call the “dying role” and its importance to people as life approaches its end. People want to share memories, pass on wisdoms and keepsakes, settle relationships, establish their legacies, make peace with God, and ensure that those who are left behind will be okay.
When my father met her, he was surprised to learn she lived by herself. He was a urologist, which meant he saw many elderly patients, and it always bothered him to find them living alone. The way he saw it, if they didn’t already have serious needs, they were bound to develop them, and coming from India he felt it was the family’s responsibility to take the aged in, give them company, and look after them.
Death is the enemy. But the enemy has superior forces. Eventually, it wins.
Much of our work today has entered its own B-17 phase. Substantial parts of what software designers, financial managers, firefighters, police officers, lawyers, and most certainly clinicians do are now too complex for them to carry out reliably from memory alone. Multiple fields, in other words, have become too much airplane for one person to fly. Yet it is far from obvious that something as simple as a checklist could be of substantial help.
The simpler way to say it is that perspective matters.
And the reason is increasingly evident: the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.
To become a doctor, you spend so much time in the tunnels of preparation – head down, trying not to screw up, just going from one day to the next – that it is a shock to find yourself at the other end, with someone shaking your hand and offering you a job. But the day comes.
The seemingly easiest and most sensible rule for a doctor to follow is: Always Fight. Always look for what more you could do.
Each year, about 350,000 Americans fall and break a hip. Of those, 40 percent end up in a nursing home, and 20 percent are never able to walk again.
Modernization did not demote the elderly. It demoted the family.
Somehow, instead of holding on to the lifelong identity that was slipping away from him, he managed to redefine it. He moved his line in the sand. This is what it means to have autonomy – you may not control life’s circumstances, but getting to be the author of your life means getting to control what you do with them.
We want autonomy for ourselves and safety for those we love.
The risk of a fatal car crash with a driver who’s eighty-five or older is more than three times higher than it is with a teenage driver.
Whereas today people often understate their age to census takers, studies of past censuses have revealed that they used to overstate it.
Three Plagues of nursing home existence: boredom, loneliness, and helplessness.
The power of checklists is limited, Boorman emphasized. They can help experts remember how to manage a complex process or configure a complex machine. They can make priorities clearer and prompt people to function better as a team. By themselves, however, checklists cannot make anyone follow them. I.
You do not imagine that a mere matter of etiquette could foil you. But the social dimension turns out to be as essential as the scientific – matters of how casual you should be, how formal, how reticent, how forthright. Also: how apologetic, how self-confident, how money-minded.
No, the more familiar and widely dangerous issue is a kind of silent disengagement, the consequence of specialized technicians sticking narrowly to their domains. “That’s not my problem” is possibly the worst thing people can think, whether they are starting an operation, taxiing an airplane full of passengers down a runway, or building a thousand-foot-tall skyscraper.
The problem is that the wise course is so frequently unclear. For a long while, I thought that this was simply because of uncertainty. When it is hard to know what will happen, it is hard to know what to do. But the challenge, I’ve come to see, is more fundamental than that. One has to decide whether one’s fears or one’s hopes are what should matter most.