Why Prolonging Life

Delays Happiness
An argument that preventive health care is not always
worth the sacrifice

J E R E M Y V. L Y N N

OCTOBER 2015 ISSUE

Timi
Gustafson

______________________________________________________________________________

DISTRESSED YET SURVIVING.

That is the state in which I find most patients. Whether alone at home, scared in
an ambulance, or secure under the watch of a doctor, human beings show their
unyielding drive to survive when emergency medical situations arise.
I discovered this fact soon after beginning my Emergency Medical Technician
(EMT) training this past summer. I signed up for the course with the intention of

gaining experience in the medical field. But I didnt realize the experience
would yield lessons reaching beyond blood pressure cuffs and CPR. My first
hours working on the ambulance exposed me to the very core of human nature,
and exemplified the fundamental desires of human beings.
My first call working in the back of an ambulance was in response to a sick
woman. Ambulance calls are ranked in priority, one being the most urgent and
three being the least. This particular call was a two. However, as I walked into
the home of my first patient, I couldnt imagine what circumstances warranted a
priority one. I tried not to imagine a situation more severe than the one at hand.
The woman could hardly turn over on her bed to face me as I approached. Her
skin was cold to the touch yet she was sweating. Her body continued to shiver,
even under the two comforters that she lied beneath. She didnt even have the
strength or focus necessary to talk. However, I didnt need her to explain the
situation; I could piece the puzzle together. The prescription bottles on the
kitchen counter provided more than enough information to my now trained eye.

My first hours working on the

ambulance exposed me to the very core
of human nature, and exemplified the
fundamental desires of human beings.
The prescriptions were anti nausea, fatigue, and infection drugs. The womans
suffering was the result of 3 concurrent days of chemotherapy, a rigorous yet
typical cycle for lung cancer patients electing treatment. While all people react
to treatment differently, most cancer patients receiving chemotherapy can expect
hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased
chance of infections, bruising, bleeding both internal and external, and fatigue,
just to name a few of the common side-effects. The risk of sepsis, a potentially

life-threatening complication of infection, also looms in the dark. Life altering

side effects simply come with the treatment.
As my partner and I stood in the room witnessing sepsis first hand, I couldnt
help but feel slightly depressed. I couldnt understand why anyone should have
to go through the sufferingalmost torturethat is chemotherapy. But the
emergency medical profession allows no time for such feelings. The womens
moans and struggled movements demonstrated her unyielding will to survive.
And our job as EMTs was to facilitate just that: survival. My partner and I
proceeded to stabilize the patient, load her into the ambulance, and transport her
to the hospital as quickly as possible.

Robert
Vincent

everal weeks later, a similar call brought this experience back to mind. As I
again struggled with the ethics behind such torment and anguish, a confounding

realization clouded my thoughts: pursuing treatment was a choice. No

one forced these patients to receive chemotherapy treatment. No doctor
had placed IV lines in their arms against their will, or forced drugs down
their throats. The aforementioned patients, along with the millions of other
cancer patients receiving chemotherapy, had willingly given up any health
remaining at the time of diagnosis and sacrificed immediate happiness. In fact,
the level of discomfort these patients were now experiencing had been
explained to them in great detail before hand. But they proceeded to sign away
their direct happiness in hopes of future prosperity. Now of course I understand
the horrible realty of cancer. I am also aware of the highly successful treatments
that have saved millions from this deadly disease. But while some cancer
treatments boast higher success rates than others, no treatment comes with
guarantees. The choice to receive treatment and set aside current comfort
therefore remains a gamble, and patients are never forced to play such odds.
However, most patients do elect treatment, and I cant help but wonder what
universal circumstances lead people to this pointthe point of welcoming
physical and mental decay as opposed to living out a natural and potentially
pain-free life. Is this the result of our innate drive to survive that was implanted
in us through millions of years of evolution? Does this motivation for survival
fuel the fear that often accompanies death? We are animals selected to survive,
and when death is looming, we naturally pursue avenues of rebirth. This makes
total sense. But why are healthy people now willingly to sacrifice immediate
pleasures in attempt to prevent our inevitable fate? Are such efforts effecting
change?
According to the United States Census Bureau, the average life expectancy has
indeed increased over the past 40 years. Between 1970 and 2007, the average
life expectancy for males and females increased by 8.3 years and 5.7 years,
respectively. An extra 2-year increase is expected for both males and females by
2020. These statistics are somewhat unexpected considering the United States
Department of Health and Human Services reported a 10 percent increase in the
incidence of cancer over the same time frame. Perhaps the coinciding 18 percent
rise in 5-year survival rate following diagnosis fills the gaps in this story.

Based on these statistics, we have indeed made strides towards the revered idea
of immortality. But we still have a long ways to go. Luckily the United States
populous has welcomed this challenge with enthusiasm and perseverance, in
more ways than one. Americans are currently obsessed with following strict
diets and exercise regiments, and show no restraint when it comes to
prescription, vitamin, and supplement use. High tech scans and diagnostic tools
extend regimented medical check-ups far beyond tried and true dental care and
flu shots, and now allow doctors to monitor patient health at the cellular level.
According to a 2013 Mayo Clinic news release, modern ultrasound, CT scans
and MRIs are known to detect cellular irregularities that dont necessarily
warrant treatment. Is finding such benign health abnormalities the consequence
or the goal? Either way, large healthcare organizations have done their part in
this quest. For example, the BeWell program at Ball State University offers $50
cash to those who meet with their physician, receive age-appropriate physicals
and scans, and complete a personal life health assessment each year. This
obsession with prevention has become woven into American culture.

Why are healthy people now willingly

to sacrifice immediate pleasures in
attempt to prevent our inevitable fate?
My own regimented exercise schedule seemingly reflects this culture. I lift
weights, play basketball, or golf almost every day and believe strongly in the
importance of physical activity. According to the Mayo Clinic, exercising helps
increase the production of our bodies feel-good neurotransmitters, called
endorphins. Exercise also helps reduce stress and anxiety, and leads to improved
sleep cycles at night. But make no mistake about it. I have not been consumed
by the recent obsession with preventative healthcare. The benefits of exercise
are primarily short-lived, and so are my reasons for staying active: immediate
enjoyment and wellness. For that reason, I do not subject my body to potential

overuse injuries from extreme exercise plans, nor do I believe I should. The
nationally funded Lets Move program recommends 60 minutes of enjoyable
exercise per day for a reason. Exercise becomes destructive when driven by an
irrational desire for immortality. And those hours invested in preparing for the
future are not guaranteed a return. According to the American Cancer Society,
22.83% of men will die from cancer, and overly rigorous exercise does not
provide immunity from such odds. The clock is always ticking, and with lost
time comes lost opportunity for personal enjoyment and content.
Dieting, too, should be a moderated endeavor. The United States Department of
Agriculture recommends a balanced meal of protein, grains, fruits, vegetables,
and dairy products. However, fad-diets, high protein/low-carb diets, food-group
elimination diets, and one-food diets seem to be gaining popularity in this age of
prevention. Such regimes are frequently founded on notions of selective mineral
avoidance as means of disease prevention. Increased amounts of the mineral
elements sodium and potassium are believed to cause diseases such as
hypertension and Alzheimers. But without overwhelming research backing
such claims, how can people justify such an eccentric way of eatingor
thinking? In fact, the well-documented research suggests just the opposite. The
Mayo Clinic suggests high protein/low-carb diets increase the risk of heart
disease and often times deteriorate kidney function over time. Moderation is
more beneficial to maintaining health than religiously committing to an extreme
diet. After all, who doesnt enjoy a burger for dinner every once in awhile, or
even a little dessert?

N. Maffulli

long with Americas cultural effort to prevent death has evolved a

preoccupation to predict it. This makes sense. Those obsessing over an
elongated lifespan ought to know whether their efforts are working.
Websites such as ePrognosis and RealAge market their ability to predict
individual lifespans through complex analysis of a users current health
condition and habitual risk factors. The health and risk factors analyzed include
weight, mobility, and current health disorders, among many other things.
Developers of ePrognosis claim their product helps aging adults plan their
healthcare as well as properly execute financial savings and decisions. These
websites essentially offer a cheap, easy estimate of how old you really are for
personal comparison to the now obsolete biological age. However, these online
fortune-tellers offer no insurance policy for those who prematurely donate all of
their savings, or discontinue medical treatment at inopportune times. The
programming behind these websites is not qualified to make predictions with
such hefty consequences. And perhaps these predictions are better left untold,
anyways.
I fear that if these sites could provide reliable data, the resulting ethical
questions would be center for serious debate. Some may foresee a death-day
countdown being useful. However, those captivated by immortality will be
starkly awoken when their end date is set. In the words of Bioethicist Dena
Davis, emerging biomarkers that hope to someday predict the development of
diseases such as Alzheimers are essentially providing an opportunity for
people to schedule their suicide. The enchanting nature of these websites is
removed the instant they gain proven validity. At that point, nothing remains but
the unchangeable facts. And will someday knowing these facts actually allow
for added happiness or satisfaction in life? I am not convinced. The knowledge
of an approaching terminal disease doesnt exactly equate to optimism. This

seems definite, but one question remains. Will knowing these facts halt the
current obsession with preventative healthcare? If so, I believe this decrease in
preoccupation will facilitate an increase in everyday happiness. I guess only
time will tell.
As for now, luckily, the biomarker companies have no reason to publish suicide
schedules. But that does not mean death predictions are nonexistent. Consider
lung cancer victims again. According to the Mayo clinic, only 52 percent of
lung cancer patients live more than 5 years past diagnosis. That leaves 48
percent of lung cancer patients with essentially scheduled deaths. In this case,
the chance for prevention has passed. Nonetheless, the opportunity for treatment
remains. Is aggressive treatment justified in this situation? I believe the
instinctive answer is a resounding yes. The probability of surviving increases by
over 50 percent when aggressive treatment is pursued. But this decision ought
not be impulsive. The 50 percent chance at survival must be weighed against the
100 percent certainty of immediate suffering. As exemplified previously,
chemotherapy and other aggressive cancer treatments have significantly
devastating effects on the human body. Let me also reiterate that the sacrifice of
ones immediate condition, however healthful or degraded that condition may
be, is not required.

I personally believe a more wholesome

life lies hidden in the shadows of our
unyielding attempts to prolong it.
All people are born with unique characteristics. As we grow and mature, we
possess the right to think uniquely and make decisions independently. We also
age differently. A variance in lifestyle choices among the American populous
should therefore be expected. Let me be clear. I am in no way trying to belittle
the importance of proven preventative healthcare techniques or dismiss the
success of modern medicine. Denying such successes would be foolish.

However, allowing preventative healthcare or medical treatment to overshadow

day-to-day happiness is also foolish. Our culture harbors extremes, and the
recent obsession with preventative healthcare is no exception. So where is the
line between justified and extreme? When should we stop harping over lifespan
predicitons and instead enjoy the pleasures of the present? Is an increased
lifespan ever worth a temporary decrease in quality of life? These questions
must be answered on an individual basis.
I personally believe a more wholesome life lies hidden in the shadows of our
unyielding attempts to prolong it.
ABOUT THE AUTHOR
JEREMY V. LYNN is an EMT and undergraduate student at the University of
Michigan. He is actively involved in medical research, focusing on breast
cancer and head/neck cancer.