Book Reviews
We’re All Going to Die - Dr Leah Kaminsky (HarperCollins 293 pp)
A Long Time Coming - Melanie Joosten (Scribe 232 pp)
Reviewed by Robin Osborne
Mirroring the demographics of our society, books about ageing, end-of-life-care and death have become increasingly frequent and these works from two well-regarded Australian authors are valuable additions to the burgeoning field.*
Both are well written, brimming with empathy for their subjects, and sharply analytical about the barriers and prejudices faced by Australians as we age.
While commenting on covers may be superficial, I would note the coincidence of both depicting butterflies - do they signify old age, and if so, how? - although in the case of the Kaminsky book an heirloom butterfly brooch makes an appearance.
Dr Kaminsky, a GP, observes that, “During thirty years of practice you get to see a wide range of ailments, a veritable litany of woes. Always at the back of my mind has been a rumbling sense of dread, loosely disguised by a morbid curiosity to know where and when I am going to die.
“Which disease number will come up? Until now, it’s all been a bit of a crapshoot trying to predict, and hence prevent, whatever disease might have my name written on it.”
While contemplating her own mortality, she recognises that while “we all have to die one day… if we strive to surround ourselves with life and meaning, we only have to die once.”
In the meantime, then, we should seek the best life possible, a philosophy highlighted by the story of 90-year-old Julia, a patient with a multiplicity of conditions who seeks medical approval to contest a 50-metre swim in the over-75s class at the Senior Olympics.
Fearing an adverse outcome, Kaminsky hesitates, but after a checkup gives the go-ahead.
“Maybe I was worried that her family might sue me if something went wrong, or perhaps I was simply being ageist.”
Some time later, Julia returns, proudly waving a gold medal from the event. As it turned out, she was the only one in the race.
Kaminsky cites psychiatrist and Holocaust survivor Victor Frankl who said we can only make peace with our mortality by finding meaning in our own lives.
As the author puts it, “Rather than dreaming of having better sex, bungee jumping off a cliff or meeting Elton John, living a life in which we are true to ourselves is far more rewarding than merely walking along the treadmill of existence.”
Focus subjects include end-of-life directives, the pathological fear of childbirth, and the importance of those working with the dead, truly “the oldest profession in the world.”
The long road to death in various social and cultural contexts is the focus of the eight ‘essays on old age’ by Melanie Joosten whose acclaimed novel Berlin Syndrome is now being made as a film.
With a masters in social work, she is accustomed to meeting older people, and focused her interviews for this book more on the present and future than the past, discovering that “a failure of our bodies and their constituent parts is only the most obvious facet of getting older.”
Less obvious but more concerning, she writes, is how society “orchestrates our gradual exit from public life as we age, recasting us from lead players with individual agency to burdensome detritus.”
This book also pulls no punches, making it another valuable contribution to the debate we need to have.
She continues, “Too often the only public conversation about ageing revolves around the question of euthanasia, discounting the possibility that as we as a society figure out how to live our later lives with dignity, perhaps we are in no position to jump to conclusions about how to end our lives with dignity.”
Addressing the current ‘positive-ageing agenda’, Joosten worries about the expectation that all older people should be fit and healthy, and positively engaged with life, with an inability to do so being often framed as a personal failure - not all nonagenarians can swim competitively!
This pressure, bolstered by superannuation ads and health promotion materials, ignores not only wider systemic causes but the fact that some things, such as the inevitability of death, cannot be treated or cured.
Yet this agenda “posits that a person’s best self is their young self - before the onset of any age-related concerns - and sees old age as a corruption of the natural way of things rather than a continuation.”
Equally concerning is that with almost two-thirds of over-85s being female, does the treatment of older people as “second-class citizens” result from their being mainly women?
Many questions are raised in this thoughtful work by a writer whose social work commitment arose from “a feeling of obligation towards those who do not have the opportunities I have had.”
The answers may be obvious but are proving hard to achieve: we need better end-of-life dignity, ideally at home, and a greatly enhanced aged-care and services environment, which she dubs “the biggest challenge of our ageing population”.
Mirroring Kaminsky, Joosten emphasizes the importance of living the most meaningful life while this is still possible.
“How we feel about leaving this world is influenced by how we live in this world - even as we are dying… we must properly consider the needs of our ageing population both as individuals and as a cohort, to discourage the presumption of burden and to embrace the ever-changing nature of a long life.”
Both books are valuable contributions to this ongoing discussion.
*The same trend is apparent in other developed countries, with one forthcoming title of note being Aging Wisely by contemporary philosopher Martha Nussbaum and Harvard law colleague Saul Levmore.
According to The New Yorker the pair investigates the ‘unknown country’ of old age, examining the moral, legal, and economic dilemmas: “The book is structured as a dialogue between two aging scholars, analyzing the way that old age affects love, friendship, inequality, and the ability to cede control.
“They both reject the idea that getting old is a form of renunciation.
“Nussbaum critiques the tendency in literature to “assign a ‘comeuppance’ ” to aging women who fail to display proper levels of resignation and shame. She calls for an “informal social movement akin to the feminist Our Bodies movement: a movement against self-disgust” for the aging.
“She promotes Walt Whitman’s “anti-disgust” world view, his celebration of the “lung-sponges, the stomach-sac, the bowels sweet and clean. . . . The thin red jellies within you or within me. . . . O I say these are not the parts and poems of the body only, but of the soul.”
