We really only live once

You only live once, but you also only die once

Death comes later. Before that, you can still puzzle in the old people's home about how to catch a hundred budgies that have been delivered without a cage and are buzzing through the beauty salon on the ground floor. You can watch the unconventional - and overwhelmed team of the care facility through the glass doors as it chugs after the birds. That sounds like a lot of fun. Aging is anything but funny. And anyway, most people prefer to push the thought of their own mortality far away from themselves. It almost seems like we're world champions at ignoring death. Dying does not fit into the modern, young world, in which something exciting happens every second, in your own life or in the Facebook and Twitter world of others.

In addition, medicine is constantly finding new therapies for those who wear out a bit, who may have exaggerated life a little. Life expectancy increases continuously. 70 is the new 50. So why bother with dying? Until you get that far yourself, there is certainly a remedy for it. Besides, you only live once: it has to be savored. Carpe diem et cetera.

Atul Gawande thought similarly. He studied medicine and now works as a surgeon at a clinic in Boston. He's the one who mends what has broken apart. One who cuts away what has grown annoyingly. But at some point it became clear to him that there won't be a remedy for every symptom of old age. That aging is not a disease and that at some point it will go downhill for everyone.

You only live once - but you also only die once. As a surgeon, Atul Gawande has seen many people die. He has witnessed her helplessness in the last months, weeks and days, the bewilderment of the relatives. Dying has never let go of him. He wanted to know why the phase at the end of life is often so terrible today and what actually counts at the end of life. Gawande is looking for a way to make old age and the inevitable death more humane. Gawande ended up in the home with the parakeets. And he has seen how aging works in foreign cultures.

We have forgotten how to age, Gawandes notes. He illustrates this with the example of his grandfather. An Indian who, with discipline and rigor, had acquired large estates, recognition and wisdom. Sitaram Gawande tilled fields, got rich, married three women and had 13 children. He was the head of an extended family. It was his old age insurance.

At some point he heard badly. Important things were shouted at him through an ear tube. His eyesight faded. Siblings, daughters and sons, nieces and nephews and grandchildren then read everything to the old man. When at some point he could no longer ride the boundaries of his fields alone on the back of a horse, they got him a small, safe pony and rode out with him. When his legs became rickety, he was supported. He was asked for advice on important questions, as before, his word was still valid even in old age. He took pride of place at the table and was the first to be served. Gawande's grandfather lived to be over a hundred years old. He did not die of the many small and large weaknesses in his body, or of old age, but in an accident. His family had made up for his age.

The physician Atul Gawande relentlessly tells how the human body gets weaker with age. The eyes slacken, the muscles weaken, the skeleton and the joints lose their suppleness. The brain shrinks and is no longer well and tightly packed in the brain shell. Physical health declines, cartilage and joints wear out. Thoughts flow more slowly and rarely do brilliant capers. Social life is also decreasing. Old people have fewer friends because the old have died - but also because their time is apparently so precious to them that they don't want to spend it with superficial acquaintances.

But the process of becoming less is omnipresent today. Old age is no longer anything special in the West. In 1790, Gawande points out, "In America, people of sixty-five or more made up less than two percent of the population; today there are 14, in Germany, Italy and Japan even more than 20 percent ”. But in Western society there is no large family that can absorb the effects of old age. Many societies are built on children leaving their parents to work where there is work. The family's shackles have loosened.

In addition, the wisdom and knowledge of old age would no longer be needed today. “Once we may have turned to an old person to explain the world to us,” writes Atul Gawande. "Today we turn to Google and if we have problems with the computer we ask a teenager."

But what do you do with old age? Atul Gawande interviewed many people who were over 80, 90 or 100. He has identified two poles: security and independence.

Normally, people without a large family are at risk of getting old in retirement or nursing homes. The most important thing here is patient safety. Relatives and carers usually want the aging people not to get into dangerous situations as far as possible. If your legs become wobbly, a wheelchair is a good idea. If you can no longer swallow well, porridge or infusions are a practical alternative.

Many old people, however, do not want to give up their individuality, their independence. You don't want to be woken up at 7.30 a.m., eat the standard porridge at 8 a.m., or be pushed out of your room at 10 a.m. to be swept through by a cleaning crew. Some really want to grow old with their furniture, their memories, their rituals. For others, it is enough if they can watch sports broadcasts on television fairly undisturbed - or take care of a budgie.