Wednesday, September 09, 2009

Of health, death and disease and bodies breaking piece by piece

Grandma fractured her hip Tuesday at dawn. She is at least 94 years old. I say at least because officially she is 97, but circumstantial dubious evidence (a handwritten note scribbled by her father on the blank first page of an old book) points towards the former. At any rate, she is roughly 20 years past her life expectancy, and it shows. If you'd just seen her 20 years ago, dolled up and sharp as a tack, you wouldn't recognize her today. My grandma, who was once hailed as the most beautiful woman in Damascus, is a dried up, shriveled, shrunken remnant of her former magnificent self. Her brain scan testifies strongly to that effect, as does a two-minute conversation with the woman who once knew five thousand arabic poetry verses by heart. But why is it that things have to turn this bitter while one is still alive and reasonably healthy? Is aging and all the dismemberment it brings a state of physiologic degeneration? a systemic apoptosis of sorts? Nothing I perceive in my grandma's physical and mental faculties seems normal to me. Nothing. And yet, one can seamlessly attribute it all to old age. Senility. A state of generalized deterioration that inevitably leads to death. Much like cancer. Or SLE. Or amyotrophic lateral sclerosis. Much like a serious, fatal disease. So where does one draw the line? What is normal and what isn't? The medical profession has long treated death as a disease. But is it not as intuitive and as natural as life itself? if that be the case, I can now claim, without much qualm, that cancer, or for that matter any biologic state that leads to death, is nothing but a normal, physiologic variant, with a normal, natural, expected state as outcome. Numbers don't do much to contradict this premise. Consider the following. During any person's lifetime, their chance of developing a malignancy is 20%, a number I consider astonishing. Consider another, similar statistic. A woman's lifetime risk of developing breast cancer is close to 12%. A little bit like being left-handed. But one is considered disease, while the other isn't, solely based on the outcome, an outcome that is natural, expected, and most importantly, normal. Which grants me a reasonable, albeit counterintuitive answer. What is happening to my grandma is not disease. In a sense, there's no such a thing as disease. It is but a natural state whose outcome we so desperately try to postpone, short of dismissing and eliminating it altogether. Our quest, as humans, and especially as medical doctors, does not seem to be one against disease, but one against death. One towards our biggest and most persistent obsession, immortality. 


Blogger cathryn said...

Or maybe our quest is against the pain and suffering of death...not death itself.

9:15 AM  
Blogger Joumana said...

There is a very old Greek myth that speaks of the consequences of seeking eternal life while forgetting, or being unable to, acquire eternal youth as well.
Some cultures however are still today less degenerate in their dealing with death than the western world is, accepting it and welcoming it at the end of a well-spent life.
That said, nobody can be expected to watch a loved one's physical envelope wither away without emotion, but remember it doesn't speak for their inner life. The few years of senility we have to endure are but a blink of the eye...

1:33 AM  
Anonymous Anonymous said...

You have a big fan Fouad. I was not sure it was you, but as I read along, my hunch was confirmed.

Pretty impressive of me right? recognizing your style before looking at your username. Some call this a 6th sense, I call it a good observation.

I hope to see you soon, interesting bastard.

The Crystal

2:08 AM  
Blogger Fouad said...

Who are you, Crystal? :)

5:17 AM  

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