The Line Between Life And Death

To get clear on our ability to effect the most important quality of life – and life itself, we must also be clear on where we draw the line between life and death.

For what do we do all of this? By “this”, I mean care about and tend to our health. Why not just take the minimum road that life requires? Our lifespans are at all-time highs, modern conveniences have removed the necessity of much physical labor; why not just enjoy these things and die when we die?

The answer lies in our definition of “death”; and conversely, “life”. We would see the folly of this argument immediately with a simple shift in our definition of one or the other that makes the distinction crystal clear. Once again, we fail ourselves by failing with language.

Remember when you were 10 years old, and you thought that people who were 30 were on death’s door and you couldn’t conjure up any practical reason that they would want to go on living at that age?

Then you hit 30 and you realized that 30 wasn’t so bad after all, but you were pretty sure that 60-year-olds were only hanging around out of denial.

Then you hit 60 and you were having the time of your life. Sure, all the parts weren’t working with the same reliability they once had, but all in all it is a pretty good age.

When we are 10, our internal definition of “dead” is to be 30 years old. When we are 30, our internal definition of “dead” is 60. When we are 60, our internal definition of the word “dead” is when our internal organs cease to function. Are any of those accurate?

For a sociology course I took in college, I conducted a study among visitors to a shopping center located near the campus. My methodology was that this was as close to a cross-section of our culture that I was going to find with a research budget of zero. In my study I interviewed as diverse a group as I could find and asked the following question: would you like to live to the age of 100?

A whopping 73% of my respondents answered in the negative. All by itself, this is revealing of our attitudes about our quality-of-life. The only real reason for a “no” answer would be the presumption of the unacceptably low quality of life someone might expect at age 100. These respondents obviously conjured up their own image of life at 100 (maybe from personal experience, but probably not) and deemed it likely to be the experience that awaited them; and so it was not preferable or no different from the clinical version of death, which would even seem to be, in spite of all of its uncertainty, preferable.

This is telling in that all of those who answered in the negative never realized that they had just admitted that there was another definition of death than the clinical one. The fact that the quality of life that many 100-year-olds are living is far higher than others much younger was apparently unknown or not considered. Also telling is the fact that, as we live our actual lives (not a theoretical one) we don’t seem willing to fight for any threshold of life other than the clinical version.

Clinical death (i.e., a failure of the body’s vital organs) has long been thought to be the line that separates life from death, and just about the only line that humans are not willing to cross without a fight. I’d like to suggest that if you just move that line a little to the left, say to a minimum level of full functionality, it would change everything about your day-to-day behaviors and the things for which you are willing to fight.

Once again, this is evident in the historical perspective: life as it was known always contained – by necessity – a degree of functional capacity. An inability to approach each day with both physical and mental energy – the stuff of survival – was the beginning of the end.

But there was more: life would never have sustained itself without a contribution from the mind; the mind’s desire to push forward and find a better way. This is what we know of as “excitement”.

We can find it even now in the world of other animals. I once had a good friend who was a dog behaviorist. This is simply someone who studies the behavior of dogs and attempts to translate the meaning into human terms. A lot of this material shows up as obedience training methods for getting dogs to do what we want them to do, but it goes much deeper than that. For example, my dog-behaviorist friend was often asked the question, “how do you know when it is time to put an old dog to sleep?” What they were really asking was, “when would the dog prefer death to his current quality of life?”

Isn’t this the same question that we ask ourselves about human quality of life? It is essentially asking, “what is the line between life and death?” The line below which you would not longer want to live. Many people have had to face that question about another human; a loved one with a grave illness, for example.

The answer my friend gave was a wise one that we can all learn from: she would ask them to assess the dog’s quality of life by asking 3 questions, known as “the 3 Fs”. The questions are based on the concepts of Food, Fun, and Follow:
Food = “Does the dog still enjoy its food?”
Fun = “Does the dog still find fun in its life?”
Follow = “Does the dog still follow you around?”

She never said what percentage of answers required a “no” in order to end the dog’s life; the message was only intended to help the person responsible for the decision to pinpoint exactly where that line is drawn for him or her self. It was clear by the question that h/she already knew that waiting around for multiple organ failure was likely not the best plan.

“Do Not Resuscitate” orders are another place this shows up: these orders direct medical personal to avoid resuscitating a patient if they should suffer organ failure even if available procedures could bring them back to this side of the clinical line. Inherent in that decision is the acknowledgment that a certain degree of quality-of-life matters.

It is clear that we understand the value of quality of life in determining the line between life and death; we just don’t apply it to ourselves. And when we don’t apply it to ourselves, we won’t fight for it in our lives. Human nature is that the bottom threshold is the only threshold we will fight for. Set the bar higher, suddenly you’re fighting for things you didn’t use to care about.

Only when the specter of an incapable body becomes just as unacceptable as multiple organ failure will be fight for a higher quality-of-life in our everyday behaviors.

When you acknowledge a certain quality-of-life as the line between life and death, you also acknowledge that the mind cannot create quality-of-life all by itself. Otherwise age would never be a factor as long as you were mentally clear. The truth is that both the mind and the body must contribute. Therefore optimal health – the subject of these writings – is simply your body’s contribution to a higher quality of life.

This new search for greater participation in our own health begins by recognizing that we will never fight for anything that is above that life and death line. When we act as if avoiding massive organ failure is all that matters, we put ourselves on the path to a tragically low quality-of-life while we’re still on this side of the line.

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