Okay, fair warning. If you are an incurable optimist, if you suffer from irrational exuberance and are a true believer that age is "just a state of mind," you probably won't like what Susan Jacoby has to say.
"In real old age, as opposed to fantasyland, most people who live beyond their mid-eighties can expect a period of extended frailty and disability before they die ... The common boomer fantasy of dropping dead of a heart attack while making love at age 95 bears about as much relationship to the reality of old age as the earlier boomer fantasy of painless childbirth without drugs bore to the reality of labor as experienced by most women."
Jacoby is an experienced journalist with a long career covering such diverse topics as law, religion, medicine, aging and women's rights. In "Never Say Die," she targets the prevailing myths and attitudes toward aging in America and, like a champion dart thrower, systematically punctures them one after another.
While Jacoby's tone makes her sound at times like the pessimist's pessimist, she is not trying to rub our noses in our own human frailty and mortality. Quite the opposite. "I hope this book about the genuine battles of growing old will provide support for all who draw their strength and courage from reality, however daunting that reality may be, rather than from platitudes about 'defying old age.'" In short, the author is trying to wake us up to a fact: that many of the ideas and beliefs we cling to about what life will be like as we age are not supported by fact. A flood of false information from mainstream media, advertisers and policy makers paint a too-rosy picture of old age, in effect, telling us what we want to hear rather than what we need to know.
The passion the author displays for her subject is palpable throughout the book, as it should be for someone who has experienced the loss of several close family members to old age, infirmity and disease. "This commonly used phrase [defying old age] fills me with rage, because the proximity of old age to death is not only undefiable (sic) but undeniable." Jacoby certainly does not wish ill health on anyone. She merely feels one cannot age with dignity if one denies the most basic truths and statistical facts about reaching one's eighth, ninth or even tenth decade of life.
The most poignant passages
in the book relate to American attitudes toward diseases such as Alzheimer's, even quoting Susan Sontag: "Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick." Jacoby adds to this, observing that the "statement applies to dementia even more than it does to the other scourges in the kingdom of the sick, because Alzheimer's imposes not just 'a spell' of suffering but a life sentence -- or rather, a death-in-life sentence."
The statistics Jacoby quotes are daunting to say the least. Not only do half of those over 85 currently suffer from some form of dementia, but the "prevalence of Alzheimer's doubles in every five-year period over age sixty-five." Here again, the author's intent is not to harp on the depressing, but rather to raise people's awareness of a very real and pressing societal problem -- one that is currently not even being acknowledged, much less addressed.
"Never" reserves its sharpest and most telling darts, however, for the myths surrounding the economics of aging: "Social Security payments account for more than 80 percent of the income of half the Americans over age 65 who live on less than $19,000 a year. And when one considers the Congressional Research Service's finding that three-fourths of Americans over 65 have annual incomes under $34,000, it is obvious that Social Security is desperately needed by everyone but the small minority of the super-rich." The recent Congressional debate on the future of Social Security and Medicare makes this book incredibly timely. In fact, given attempts by Republicans such as Rep. Paul Ryan of Wisconsin to implement draconian cuts in social spending, Jacoby's writing seems at times almost prescient. And while the author does not specifically focus on the issue of homelessness, her conclusions about the financial implications of growing old are equally applicable to both the poor and middle class alike.
Jacoby's craft at writing, her effortless prose with just the right mix of humor, seriousness and documentation, make this book an easy read. And while the subject matter may not be joyous, for those who are looking for a frank discussion of what old age will really be like -- particularly for those such as baby boomers who are about to experience it -- this book is worth reading.
If you can afford Botox injections, erection pills and increasingly expensive, invasive medical procedures designed to keep you alive, by all means carry on. For the rest of us, it's time to wake up, stop guzzling the snake-oil-flavored Kool-Aid and start altering our state of mind to reflect a more realistic picture of what our final days will be like.