- Richard A. Chapman/Sun-Times Media
- Ezekiel Emanuel, pictured here with brother Rahm, says he knows when to say when.
Last Wednesday’s Tribune found columnist Mary Schmich remembering her mother’s death. “She was stooped and attached to an oxygen machine, her fingers so gnarled she could barely hold a coffee cup much less play her beloved piano.” And yet—”until very close to the end, she took pleasure in her day. . . . What I took from her is that the diminished life . . . can still be worth living.”
We have the mayor’s brother to thank for Schmich’s turn of thought. Ezekiel Emanuel, a physician and bioethicist, published an essay in the latest Atlantic provocatively titled “Why I Hope to Die at 75.” It’s not that he promises to end his life at that age, Emanuel explains; but he will do nothing to prevent it from ending, even though modern medicine has quite a bag of tricks. “By 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us.” He doesn’t want to be remembered as very old people are remembered, as “feeble, ineffectual, even pathetic” at the end. He might have added what to an Emanuel is probably the most dreadful diminishment of all: as someone no longer engaged with the world around him.
Zeke Emanuel is 18 years away from 75, and we can snicker, if we wish, at his pronouncement that “this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to stop.” No more tests, no more treatments, he vows. Not even flu shots! We shake our heads. If he’s a robust 75 the flu won’t kill him, so why should he spend a miserable week in bed? As for the idea that the last stage of a life is its most indelible—come on! I remember my mother at 91, all right, but I also remember the time when she was 41 and her back went out as she called a strike umping our sandlot baseball game, and the time she showed up for parents’ weekend my freshman year a 46-year-old redhead!
Zeke Emanuel’s essay has attracted plenty of attention. Cory Franklin, in a Trib op-ed, thought he was nuts. Franklin compiled a long, familiar list (Michelangelo, Churchill) of people over 75 who did big things and wrapped it up by repeating something Bertrand Russell wrote when he was 87: “This is one of those views which are so absurd that only very learned men could possibly adopt them.” Rahm Emanuel’s office issued a statement making it known that the mayor “personally disagrees with his brother’s view on dying at 75.”
Schmich, however, was less interested in arguing with Zeke Emanuel’s essay than in bringing it to our attention. It “will make you talk and think,” she wrote, “not just about death but about how you want to live.” She didn’t exactly give Emanuel’s views the benefit of the doubt, but neither did she set out to put him in his place. I’ll give him the benefit of the doubt. I don’t think Emanuel was writing off old age. I think he has an audacious idea about how to approach it. But understand that my thoughts about his essay are colored by the book I just finished.
Man’s Search for Meaning, by the late Viennese psychiatrist Viktor Frankl, was first published in English in 1959. I read it at the time of life when a young man decides he needs to get serious, and I just read it again because the book group I’m in chose it as our latest project. Most of us are now close to the age when Zeke Emanuel suggests calling it a day, and if life is still full of meaning it’s elusive. A year ago I was waiting for a new liver, uncomfortably aware that if the transplant team judged me too far past my prime I wouldn’t get one. I made the cut but I think it was a close call. Thank God I’d decided not to retire.
Frankl’s book is short, simple, and wise. He survived Auschwitz and other Nazi camps, and that experience shaped what he would call logotherapy, an approach to psychiatry based on the belief that what every person ultimately desires most from life is not pleasure or power but meaning. If ever a place was designed to eradicate meaning it was Auschwitz, where inmates were reduced to numbers, suffered the torments of filth, starvation, brutality, and disease, and at some future point that could be neither predicted nor evaded were further reduced to smoke coming from a chimney. Death came when it came—Frankl in his book offers a version of the “appointment in Samarra” parable, in which a servant, threatened by Death, flees to a place where death won’t find him. Why did you threaten my servant? the man’s master asks Death. I didn’t, says Death. It was a start of surprise. I was astonished to run into him here, as I had an appointment with him tonight in Samarra.
Frankl expected to die in the camps. Anyone who survived them would survive by sheer happenstance. And he asked himself, “Has all this suffering, this dying around us, a meaning?” He understood that if there was meaning, it was up to the inmates to impose it.
He remembers lying in the dark at the end of a particularly difficult day speaking softly to the inmates around him. He told them his chances of surviving were one in 20, but “in spite of this, I had no intention of losing hope and giving up.” For if their struggle was hopeless, that “did not detract from its dignity and its meaning.” He asked them to suppose someone dear was looking down—a friend, a wife, or God. “He would hope to find us suffering proudly—not miserably—knowing how to die.”
Frankl’s book gives us two ways to think about Zeke Emanuel’s essay. “There is no reason to pity old people. Instead, young people should envy them . . .” Frankl writes. “Instead of possibilities in the future, they have realities in the past.” Their accomplishments are set in stone. And Emanuel clearly understands that. But if old age offers no possibilities, why bother with it? If somebody young wants to envy his past realities, fine! But they won’t need him around for that. So we can accuse Emanuel of shrinking from old age as some inmates shrank from Auschwitz, so terrified of its rigors and cruelties that even now, long before he sets foot there, he has capitulated.
But actually, all Emanuel has prescribed for himself is the sort of fatalistic life all old people lived before doctors had a bag of tricks to tempt us with. He could be terrified of becoming the kind of deadly old bore who has only one thing on his mind—eking out a little more time in Samarra.
Frankl was a doctor in the camps. Other inmates counted on him. Late in the war, a friend hatched an escape plan and drew Frankl into it. Noting Frankl’s distraction, a patient guessed what was on his mind, and Frankl, denying it, felt accused and ashamed. “Suddenly I decided to take fate into my own hands for once,” he writes. He ran to his friend and told him he’d decided to stay with his patients. “I did not know what the following days would bring, but I had gained an inward peace that I had never experienced before.”
I prefer to think Zeke Emanuel simply made the same choice. When he turns 75 he wants to live as Frankl that day chose to live—unencumbered by his mortality. I prefer to think Emanuel’s actual desire, despite his essay’s title, is not to be dead at 75 but to be fully alive.