by Michael Kessler
My maternal great grandfather, Beryl Litwin, and known to us as the ‘old Zayde,’ died at 109 or 106, depending on whose records you accept. It doesn’t matter much; his newspaper obituary, which I have, describes him as the oldest person in Montreal. More remarkable than just his longevity was that he lived alone until about six months before his death and died only after falling at home, at night, in the dark, because he stubbornly refused to turn on a light on Shabbat. Also remarkable is that he was a chain smoker. His long white beard was stained yellow from nicotine. The old Zayde’s daily routine was to walk to his synagogue in the morning, schmooze with his cronies after services—in the synagogue in winter and in the nearby park in the warmer months—- buy his groceries for the day and prepare his own meals. The old Zayde had no known disease or illness, rarely if ever saw a doctor prior to his fateful fall, and to our knowledge took no medicines. We know he prayed a lot. Maybe he also treated himself with old world remedies, like concoctions he could prepare himself, but this is speculation on my part.
My maternal grandfather, Afroim Litwin, or Zayde, lived until 98. Notably, he died eight to eleven years younger than his father, Beryl. Zayde was also religious, but he had adopted a little more of the modern lifestyle. He did not live alone in his later years. At various times he lived with us (my mother was his daughter), with my aunt, his other daughter, and maybe from time to time with his other children. Zayde was a diabetic; I remember watching him shoot himself up with insulin. But other than this, I am not aware that he suffered from any other illness or disease. Like his father Beryl, Zayde never went to doctors, to my knowledge took no medications except his insulin, and was never sick enough to spend a day in a hospital or even in bed at home. I don’t know where he got his insulin, but I guess it was from the local pharmacist or maybe a clinic.
Next in line came my mother, the granddaughter of Beryl and daughter of Afroim. My mother died at 86. Again, notably, approximately ten years younger than her father and twenty years younger than her grandfather. My mother aged in an era when modern medical care took off, the 1970s and 80s. She went to doctors; she was diagnosed with illnesses or “conditions”; she was prescribed medications; and she experienced a couple of hospital visits. She took pills for a heart condition, high blood pressure, a diabetes pill to treat what she described as a mild sugar problem, and also a sleep medication. Maybe there was more I was not aware of. Despite the medical care, diagnoses, and pills, she died of her heart condition ten and twenty years younger than her predecessors, who had no such care or medicines.
So, now I turn to me. I will be 77 soon. If I live to that birthday, I will have lived to at least nine years younger than my mother at her death, twenty-one years younger than my grandfather at his death, and approximately thirty years younger than my great grandfather at his death. Do you see a pattern here? Interestingly, the pattern seems to be continuing in a straight downward line in other ways. Until about age 60, I rarely visited a doctor, took no medications other than about two Tylenols a year, and I was in excellent physical shape. I regularly jogged, worked out aggressively in the gym, skied at almost every opportunity, and was active in other ways. My weight was also always under control. Around age 60 I started going to doctors, at first just for an annual physical exam. I took pleasure in hearing the doctor tell me I was in excellent shape. But gradually there were diagnoses, referrals to specialists, prescriptions for medications, and more. I began to feel I was tumbling into an abyss, although every report was similar, like “you’re doing fine,” “keep up your exercise routine, watch your diet and take the prescribed pills.” Lipitor for high cholesterol and another pill to improve the good cholesterol, a blood-pressure med, a baby aspirin, a diagnosis of an elevated sugar problem, not serious, probably just pre-diabetes and controllable, but take Metformin every day, and then a diagnosis of atrial fibrillation, or A-Fib as it is often described, resulting in a cardiologist prescribing a couple of pills for that condition. “Don’t worry,” she said. “If I arbitrarily pulled ten men your age off the street, four would have A-Fib. They just don’t know it. And also come in twice a year for an exam and EKG, resting and stress.” There are also a couple of other things the doctors “watch,” especially my insomnia, which has plagued me for years. And, of course, I have a regular five-year colonoscopy and endoscopy.
The more care those on my maternal ladder have had, the earlier they have died. Does this mean I should follow the data and stop seeing doctors and stop taking the meds? Most people, especially my doctors, would say that would be a crazy decision. If I listen to the doctors and continue taking the meds, should I thereby conclude that if Beryl saw doctors and took meds he would have lived to 120 or 130? Not likely. If Afroim saw doctors and took meds, would he have lived to 110? The odds were not in his favor. If I look at it in a different way, did the doctors and meds extend my mother’s life? Will they extend mine? I have no way of knowing. It’s easiest to simply shrug my shoulders, do what they say, and continue going to the gym. And, of course, I must worry that maybe I am more genetically related to my paternal ladder. Oh no! That would would make it too complicated.
With all this I now want to look at myself from another angle. I recently read an article reporting on the results of President Biden’s annual physical exam. The article describes him as being in very good health for a 78-year-old man. My curiosity drew me to the internet where I was able to find the actual six-page report by the physician to the president. I was, and am, somewhat struck by how similar are our medical conditions. Like me the president has A-Fib, and we are treated with the same medication. His doctor says he remains stable with no other cardiac complications while on the medication. Just like me. He takes Crestor for cholesterol; I take the competitive drug, Lipitor. He has acid reflux and takes a medication for it, just like me. He exercises regularly and so do I. And so on. The only major difference is that the president’s report says his blood sugar is normal without medication; mine is normal with medication. The report also says he has a stiffened gait, not serious. So far, I have escaped that one. At the end of the report his doctor says, “President Biden remains a healthy, vigorous, 78 year old male, who is fit to successfully execute the duties of the presidency….” Can I say I am fit to successfully execute the duties of the presidency? No. The president has one advantage on me that qualifies him for the presidency. He was born in the U.S. I was not.
March 3, 2023