Special Diets and American Immortals

One thing (one of many!) that has changed since I was younger is the number of my friends on special diets. Dinner parties have become minefields.  Of course, older people with various ailments are even more likely to be avoiding certain foods than the general population; we are not alone in this, but we are the worst.  It makes entertaining difficult, but challenges us to learn to bake gluten-free, oil-free, sugar-free (and usually taste-free) fare.

I have always enjoyed cooking for other people.  I especially liked making birthday cakes, but – alas! – there is almost no one I can make them for anymore except hapless children.  Having just made a layered sugar extravaganza for visiting grandchildren, I realized how much I missed the joy of baking and consuming such an illicit treat.

I am not criticizing.  My husband and I are not immune.  We have struck things off our diet to lower our cholesterol, keep our weight down, and pamper our stomach linings.  I have terrible teeth, so I avoid nuts, hard candies, and anything else that might crack my very expensive caps.

From my work on old age, it appears that, in earlier times, there was little faith that doctors (fisicien), drugs (drogges), and diets (dyas) could help one avoid old age (elde) and death (deth).  In Langland’s 14^th century Piers Plowman, the protagonist sees that even the doctor falls prey to old age and death, so what is the point?

Lyf leued that lechecraft ∙ lette shulde Elde,

(Life believed that medicine would delay old age)

And dryuen awey Deth ∙ with dyas and drogges.

 (And drive away Death with drugs and prescriptions.)

And Elde auntred hym on Lyf ∙ and at the last he hitte

(And Old Age ventured against Life, and he hit at the last)

A fisicien with a forred hood ∙ that he fel in a palsye,

(A physician in a furred hood so that he fell in a palsy,)

And there deyed that doctour ∙ ar thre dayes after.

(And there the doctor died before three days were passed.)

‘Now I see,’ seyde Lyf ∙ ‘that surgerye ne fysike

(‘Now I see,’ said Life, ‘that surgery and medicine)

May nought a myte auaille ∙ to medle aghein Elde.’

(Cannot do good at all [might avail] against Old Age.’)   (XX: 172-178, translated by E. Talbot Donaldson)

Langland is right – nothing much does “avail” against the onset of old age.  But, of course, medicine and nutrition have helped us live longer in old age.  But now, regardless of all our drugs and diets, life expectancy in the United States (and in much of the world) is falling, probably for the first time since the Black Death.

Ah, but you say, now we have better drugs and diets and doctors.  Yes.  And we can sometimes delay the inevitable.  But I do wonder a little about making life a war against old age and death.  In 1968, life expectancy was 68 years, in 2019, 41 years later, it had increased almost 20% to 79 (no wonder social security is in trouble).  However, by 2021, it had decreased to 76.  Part of the loss was due to Covid – but not all of it.  There were also increases in fatal drug overdoses, accidents, gun deaths, and suicides.   On the other hand we are keeping people with Alzheimer’s and most chronic conditions alive longer.  Women still live longer than men, white people live longer than black or brown people, and rich people live longer than poor people.

My own parents died at 77 and 89; my maternal grandparents died at 76 and 82.  They, of course, ate cheesecake and had their cocktails until the end.  Will I live longer than my parents?  And, of course, in making life expectancy predictions, one must also consider the life expectancy of the planet.  Enough said.

A few years back (2014), Ezekiel Emanuel (noted oncologist and bioethicist who was recently appointed to Biden’s Covid team and whose brothers are Rahm and Ari) wrote a much-discussed article in The Atlantic entitled “Why I Hope to Die at 75.”  The title is misleading; Emanuel does not necessarily hope to die in his mid-seventies.  But he has decided that by age 75 he will give up all measures to make him live into a very long but perhaps debilitated old age.  He is clearly against euthanasia and physician-assisted suicide, but:

I am talking about how long I want to live and the kind and amount of health care I will consent to after 75.  Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible.  This has become so pervasive that it now defines a cultural type: what I call the American immortal.

I wrote about Dr. Emanuel in a blog a few years ago, but I recently looked to see if he had changed his stance as he was almost ten years closer to 75. (He is now 65).  He has not completely reneged, but he has softened his stance. I think we all soften our stance as we get older.  Death is a scary foe, but not as scary (for me) as prolonged dementia or debilitating illness.

But back to special diets and what Dr. Emanuel calls the aspiring “American immortal.”  I have learned to give tofu some flavor, to cook with flax and applesauce rather than oil, and to live without red meat.  I am part of the trend, willing to cater to those who are trying more extreme measures – to a point.  I do think that we need to spend more time thinking about what we are saving those extra years for, and what we might be giving up as we look for the magic bullet.

I once wrote a story about how food can sometimes make us feel better, even though it might not make us last longer.  “A Spoonful of Sugar” ends with these lines: “Gabriella couldn’t figure out death today. But she would think about it again. Meanwhile, she would make more cookies.”  More cookies please.