The Great Leveler

A piece in the Sunday Review in today’s New York Times deconstructs the condition that will overtake us all, not an illness but the inevitable process of ageing. Anne Karpf writes of the unyielding negative caste a youthful culture in America puts on those guilty of aging. “Ageism is simply prejudice against one’s future self,” Karpf observes. That attitude is shortsighted and ignores one inevitable fact of our mutual existence.
It is reminiscent of a 1984 speech, in which Gov. Richard Lamm of Colorado said elderly people who are terminally ill have a ”duty to die and get out of the way” instead of trying to prolong their lives by artificial means. I am hardly the first to suggest that America is cruel to the elderly among us. If we are fortunate enough to live to attain senior citizen status, we will inherit this delightful narrow-mindedness of the youngest generation in the history of the United States.
People like us need to be particularly sensitive to this rhetorical dead-end street. Chronic conditions are tied to Aging. By 2030, according to the CDC, the number of U.S. adults aged 65 or older will more than double to about 71 million. More than eighty percent of us will live with a chronic illness, fifty percent with two. Welcome to our future. Battling enemies within us is daunting enough. We have to take on the entire population.? We need to undergo one giant attitude check. Maybe a candidate for President will take on this issue. I doubt it.

Two in one day. I must be bored.

31 Responses to The Great Leveler

  1. KG January 4, 2015 at 4:08 pm #

    The irony in this is this younger generation is the first generation predicted to NOT live as long as their parents’ generation. They won’t have to worry about aging when they die from diseases related to inactivity and staring at cell phones for decades.

    • Richard M. Cohen January 4, 2015 at 8:11 pm #

      I hope you are wrong.


  2. Christopher January 5, 2015 at 3:03 am #

    I was pretty young at the time, but I remember that quote from Gov. Lamm. What a peach. He must have been a fan of the NSDAP’s Action T4 program.

    I personally don’t think the population of the future will be so insular as to wish the elderly or the infirm to the cornfield. Yes, people are cruel… and I certainly get the feeling I am resented as beingin the wayin many situations. But perhaps by the time the population has changed so enormously, science will have passed a few big hurdles from its own hubris and come to provide more insight on how to mitigate age related medical issues so that they become more of a singular enterprise. I also believe future societies will be more enlightened than they are now. Seems to happen regularly every few generations.

    As far as ‘death by Nintendo’ or iphone microwaved brain… those would just be way too weird for epidemics, but who’s to say.

    • Richard M. Cohen January 5, 2015 at 6:46 am #

      Trouble is the changing demographics are happening fast. The boomers are the population bulge, and we are aging. We are in the process of putting a incallcuable strain on resources and institutions. I fear the safety net will have a giant hole in it.


  3. M January 5, 2015 at 1:11 pm #

    Being a Millennial born near the height of the Echo-Boom (in 1988), I resent a lot of what I read by columnists and journalists who are Baby Boomers themselves – ESPECIALLY when they talk about the Millennial generation (aka, their offspring).

    I understand that every generation has its struggles. That is obvious and not worth discussing. But (some) Boomers talk all about how self centered and crappy Millennials are, and how the government/economy/everything is going to fall apart when the Boomers age and die. But guess what? You’re doing the talking, you’re making predictions, you’re maybe being jerky parents. We will have to live through it as we transition to the “adults running the show,” caring for you (which we will do with love), but struggling nonetheless. Any tips on how to fix this mess that we (you) got us into?

    I find this article to succinctly sum up all the relevant points, although it certainly is not from a publication like the NYTimes. However, it doesn’t discuss income inequality which is just another problem to add to the plate.

    Also just a final thought – who invented those cell phones anyway? What if Millennials are a reflection of the Baby Boomers and what the Boomers contributed to society. But unfortunately it seems that the Boomers don’t like what they are seeing in the mirror.

    • Richard M. Cohen January 5, 2015 at 2:05 pm #

      I am not sure I get your point. I do think your generation is going to get screwed because mine and my parent’s never had the guts or political will to fix the system well ahead of any crisis. Social Security, Medicare and Medicaid are in trouble. But also aging boomers are going to strain the healthcare system beyond endurance. Not certain who to blame there. Generational hubris is amusing. I see it in my kids who are your age. They think theyu have the answers. So did we.


    • KG January 5, 2015 at 8:59 pm #

      M, great article with a lot of valid points made. Thank you for your insight into the life of a Millennial. The one good thing about being terminally ill is that I don’t have to worry about any of these social issues. M, live your life with the fervor and spunk you presented in this blog post and you’ll be fine.

  4. M January 5, 2015 at 3:14 pm #

    Hmm – I don’t think I had a point, actually. Sometimes spewing words and trying to be tough is the point. Mostly I was just mad about the comment KG said about cell phones. If mass extinction happens from cell phone use, I will blame the people who invented cell phones (Boomers). Ha!

    Yet…I find blame to be pointless in these kinds of situations, because life is as we found it when we were born – right? It is a collection of millions of years of evolution, and thousands of years of human civilization. Is generational hubris amusing? I think it is immature (yes, I just admitted I am immature – it’s ok). Maybe it is because everyone resents their parents at some point in their lives, along the likes of “You’re just so embarrassing, Mom/Dad!!” – simply because you are their parent. No other reason.

    I am annoyed at the situation we’re in because of what others have done in the past, but there is still a twisted love for the previous generation because I wouldn’t be here without them. In fact, I find that Millennials and Boomers had similar experiences in their coming of age years – war, economic difficulties, energy crises, etc. I like my parents and their friends. I even like their stinking music. I used to dance/jump too close to the record player growing up, and was often scolded for making the needle jump (“You’ll scratch the record!!!!”).

    R – I know you don’t use the word “caregiver” for your personal situation in dealing with chronic illness, but I think the scary thing for Millennials is that a lot of us will have to (or currently do) care for our parents without any help because of those broken government systems. And a lot of us have also helped our parents care for our grandparents, so we’ll do it twice in a lifetime. And that’s painful and scary, I suppose. As for an image-obsessed culture that is afraid of aging…I do point to the media for that one, which last time I checked is still being run by Boomers (!). Remember who primarily votes at The Academy…mostly old white men. How charming. Maybe they just want to see young people on the screens (particularly women) because they are afraid of their own reflection. Or because sex sells. Or some other stupid shit that I frankly don’t care about. TV is over-rated, and good people should leave that business (RE: your b-day tweet to your wife – so nice, so true! She’s too good for TV!). Films want to attract only the male audience 18-35. Screw it all.

    So how does that relate to hope and your future book? Maybe it doesn’t and it is just food for thought. Have you remembered to read the story of Pandora’s box in regards to hope?

    • Richard M. Cohen January 6, 2015 at 12:42 pm #


      You sound like a free sprit spreading your social gospel with a shotgun. Man. Duck!


  5. Louise January 5, 2015 at 4:38 pm #

    Yes, every generation thinks it has it all figured out but the Boomers ( I am at the tail end of that) have had the tyranny of the majority factor all of their lives. People over sixty five will be a powerful voting block as well as cultural force. The boomers have never done anything quietly, and I will be very surprised if aging is an exception.

    • Richard M. Cohen January 6, 2015 at 12:44 pm #

      I have no intention to go quietly.


  6. Christopher January 6, 2015 at 2:34 am #

    I agree with you, Louise. As a child of Boomer parents, both of whom are gone now, I am a witness to that “tyranny of the majority” (though not through my parents).

    @M, you sound incredibly cynical for a young person (albeit probably not much younger than me). As far as Greek myth and hope… Elpis was the only spirit not to be loosed from the box (jar) and plague all humans. Instead, the spirit of hope remained to comfort all humanity. It’s ironic that Elpis was also the goddess of fame.

    • Richard M. Cohen January 6, 2015 at 12:46 pm #

      Have you ever seen an angel dance on a pin?


  7. Christopher J. Torri January 7, 2015 at 3:44 am #

    No. I guess that would just be a waste of time.

  8. Jan January 7, 2015 at 7:45 pm #

    Gee, aging is inevitable, for everyone: rich, poor, famous, ordinary. I think we just think about it more when we are not so young anymore (physically, not necessarily mentally).

    Which reminds me, I spent a week going through “stuff” in most rooms in my house in Dec. (Very liberating, actually). I came across some notes taken during a Mayo dr. appt. early in my nearly 10-year course of MS. Know what they said? That likely the single most important thing I can do with MS is to have a positive attitude.

    So there you have it. Not just rhetoric. I choose to make my friendships two-way streets. Not, “what can I learn from this, or get,” but, “How can I help this other person?” …insight, an ear, empathy, listening. What I am dealing with is certainly not fun, but I do have enjoyment–mostly when I get out of the box and be of help in some way to another, however small as it may seem.

    And about those teens who are slaves to all things electronic–well, that’s another topic!

    • Richard January 7, 2015 at 7:54 pm #

      I thought more of Mayo. Apparently BS stands for more than Bachelor of Science.


      • Jan January 8, 2015 at 11:16 am #

        Oh, Richard. I hope I did not offend there. And I really was talking more about my personal philosophy. (Some may call it “denial”). I think I truly do “get” your responding comment. Easy for them to say, right? And do they follow up with me now and then as I’d do my clients? (No). No manpower for that kind of concierge service in the medical realm without specific cause. I get that.

        I haven’t seen a neurologist in a couple of years. As I see it, why? Without meds, I see no need to track lesions. I know what I feel and see in myself empirically. I know it is progressing in certain ways. I do not need to be reminded (and pay a lot for it). Ignorant? Maybe. I am usually in pain of some sort and in varying degrees.

        But for me, there was pain of another sort in 10 years of dealing with all of this. (But I had to walk and crawl through it: no flying from point A to point B). I still do deal with it; still search; still explore; still try stuff. (Your “stuff” seems to be stem cells. With braving a stem cell approach, of course monitoring is important, and I respect that).

        It’s just that I feel that I’m just doing a better job these days of “living in day-tight compartments” (phrase coined by Dale Carnegie, if I recall correctly).

        MS is so varied; truly, I do not mean to be glib. It is not easy. And believe me, I have had MANY difficult times with it. More than I let on with most. It’s just that I have a mindset that remains rather firm, regardless. (Again, that is simply not always possible, nor am I always able to do that).

        Two friends in my former neighborhood lost husbands to cancer. My sister’s husband left her last spring (with no explanation) two weeks prior to their 36th anniversary. I cannot work full-time as planned to help with college. There are people all around me with such challenges; a world around me, literally. MS stinks. It’s just that if I cannot really control something, I’m doing my best to not just survive (although it can feel that way a lot), but to thrive in other ways in which I am able. It’s about my mindset in the face of adversity.

        You, I think, are thriving in providing your blog. Does it take away your MS issues (no). But does it give meaning, purpose to you? (Likely). We’re all here on earth. Often, not in the ways we’d prefer. Life is difficult, often. (I’ve quoted the opening line of “The Road Less Traveled” for far too long and am finally reading it through. A good read).

        So yeah, I think that my Mayo person would readily admit that there is likely more they don’t know about MS than what they do know. So I’m not seeing a huge benefit from a degree related to this now, really.

        On another topic, today’s WSJ had a good article about whether or not a 4-year degree will actually pay off. Pay off. Or really benefit others. Sometimes. Hmm. Good food for thought. As with MS, it seems very individualized, varied.

  9. Elizabeth January 8, 2015 at 11:52 am #

    I’m not being snarky, but that just reminded me of my mid-diagnosis of fibromyalgia when I was 32. The rheumatologist said now remember, even though you are feeling pain you are not actually in pain so don’t reduce your physical activity. Huh??

    I understood that he was explaining to me that my body would not decline or be harmed by activity but that was one of the most dumb-ass comments I have ever heard. He said it’s like phantom pain. It was people like him that made me go another ten years just dealing with my symptoms and not finding out what was causing them.

    Just keep swimming.

    • Jan January 8, 2015 at 1:09 pm #

      Elizabeth, I have a friend who sometimes quotes “Finding Nemo:” “keep swimming, keep swimming…” (My friend wasn’t actually talking about swimming per se, but plugging along at whatever. And our “whatevers” have often not been easy by any means).

      I also have either Erythromelalgia or paresthesias (hard to distinquish). It was a rheumatologist (a kind one) who had diagnosed the EM about 5 years ago when my neurologist said it wasn’t MS. That neurologist (Richard will love this) was my first Mayo guy I rather “fired” — he was so helpful at first, truly. But a couple years later, when twice asking what the pain in my toes would be, if not MS and my not having a medical concept of something else and being all in the emotional throes of all of it, eventually said that it is NOT MS, and if I wanted to know more about that, then I should go to medical school. After about 5 seconds that felt like 5 min., the phone line went dead. Can you imagine? Maybe dealing with MS, no cure, and newbie green patients can take its toll. (I have bad days too, but I don’t care where you work, you don’t treat clients that way!) That said, overall I truly do respect Mayo–it’s a well-oiled machine with many kind and caring people.

      Regardless of what it really is, I totally understand what you said! I often do push through pain and can only swim as my exercise (even that can hurt at times).

      If I’m feeling pain, I’m feeling pain. Nothing phantom about that! Yep; easy to say–just try to live it! And my “show must go on” outside demeanor does have lots of stories that I’ve pushed through.

      Sorry, Elizabeth, for your pain. No one but you yourself can tell you how to feel.

      • Jan January 8, 2015 at 1:51 pm #

        P.S. to Elizabeth…

        That word you used, “snarky,” made me smile. I have teens, and I’m sure it can be used in a response sometime! 🙂

    • Richard January 9, 2015 at 9:27 am #

      Jan and Elizabeth-

      Both of you have dealt with and survived some real winners. I think I would just walk away. Who needs high blood pressure, too?


      • Jan January 9, 2015 at 9:51 am #

        Richard, there is actually wisdom in walking away at times. Truly. No one seems to be able to distinguish for me (even the Internet) the difference between EM and paresthesia. I’m finding peace in walking away in that it doesn’t really matter! (No cure for either). I know and feel that my feet burn, so it’s time to move on and do something else and not split hairs over it.

        Also, to all, I tell of my experiences mostly to provide additional insight and possibly shorten a learning curve for some. I wouldn’t tell anyone how to feel; just to possibly consider something (as in things I wish I had known earlier. But then again, maybe we just have to experience life for ourselves).

        Thank you all, meaning Richard too, for your insight and also chuckles.

        Have a good weekend.

  10. Elizabeth January 8, 2015 at 3:56 pm #

    So I don’t want to hijack the post because I was really interested in the initial post because of a few reasons. One is that the 1st day Congress was back in session they start talking about pulling away disability benefits because they have decided most of us are just people who have run out of unemployment and our muscles have atrophied. That’s why we can’t work and there are factories full of Dr.s that are willing to diagnosis us with anything so that we can get benefits. I guess no one told them that it usually takes years to get benefits and the denials letters come first and fast. I do everything anonymously for the fear that someone will realize I have MS and not hire me. If something works long enough for me to feel better and go back to work, trust me this couch and I are no longer friends, nor is the pittance I live on. I used to make a good living, i’ll take it back in a second. There is NO and I mean NO benefit to having this stupid disease. I’ll write my congressman friend after I finish this post.
    But secondly, I have seen my only son turn from a strong kid who is excited and ready to take on the world into a self-dependent, scared 21 year old who is afraid his Mom is not going to be able to get off this couch at all some day. He was blessed to only see his dog die until 2 years ago, never been to a funeral, and in the last year and a half has seen his Mom become disabled, and two grandparents die within a week of each other with a third imminent in the coming weeks. I think many of our kids have not been exposed to mortality until a much older age. I hope that kids our age Richard will change their focus and think about what they can do to change things for everyone. The millenials have a different lens, but also access to see everything. Which will they chose?

    • Richard January 9, 2015 at 9:37 am #

      I think seeing death anddisability are very hard for young people. But they are smart andwill come around. Smart is not a word that applies to too many mem,bers of Congress. Talk about dumb-ass.


    • Richard January 9, 2015 at 9:40 am #


      I think seeing death anddisability are very hard for young people. But they are smart andwill come around. Smart is not a word that applies to too many mem,bers of Congress. Talk about dumb-ass.


  11. Louise January 9, 2015 at 4:01 pm #

    Hey Richard
    Off topic, but I just saw a news release that Biogen is in phase 2 on a drug that may reverse nerve damage in optic neuritis. I know “phase 2” and “might” but I just wanted to make sure you are aware should it be of any use to you. I kind of feel like you’re my friend now.;-)

    • Richard January 11, 2015 at 9:16 pm #


      Thanks. Will check it out. I do not trust Biogen.


  12. Grant January 11, 2015 at 6:08 am #

    The drug is an Anti-LINGO monoclonal antibody (Tysabri is another well known mAb). It targets the LINGO-1 protein, which is present in certain key areas of the central nervous system and supposedly gets in the way of remyelination and regeneration of axons. The drug selectively targets the protein to interrupt its expression. Unfortunately trial results have been mixed. It’s inconclusive as yet whether the drug is effective. Like with other monoclonal antibody drugs there is also the possibility of developing PML. More should be known by the second half of 2015.

    • Richard January 11, 2015 at 9:19 pm #

      I lost vision inan endless process starting 42 years ago. I won’t hold my breath.


  13. henriette January 14, 2015 at 8:42 pm #

    I love your blog. end of story.

    • Richard January 15, 2015 at 6:48 am #