|1918 Spanish influenza ward at Camp Funston, Kansas|
A few weeks ago I browsed through a New England Journal of Medicine article by a doctor named Lisa Rosenbaum who recalled asking women who visited a cardiology clinic where she worked: "What do you think is the number-one killer of women?” She was distressed that most answered "breast cancer" instead of the accurate response: "heart disease."
I too would have disappointed Dr. Rosenbaum -- my answer to that query would be "old age."
That's how I grew up -- being told what happened to my older relatives: they aged; their parts wore out; they sometimes sickened and usually shrank and withered; eventually they died. Not a scientific or medical picture, but not a false one either.
I shared what I was reading with my ever-so thoughtful partner and she offered her own slant on it, a passage from the political philosopher Iris Marion Young's Justice and the Politics of Difference. My partner likes to throw this out to her young college students to chew on:
Intriguing, isn't it? Was there really a time when being old was not so associated with disability and immanent demise -- because disability and death were more evenly spread across all ages?
I was interested enough to dig up the essay Young references in an obscure volume, Old Age in a Bureaucratic Society. Thomas Cole argues that "old age", for the rising 19th century US bourgeoisie class, came to signify a dying social order they were overthrowing and to constitute an assault on the value system they were substituting for the former order.
Well, maybe. I instinctively suspect Mr. Cole is stretching his theory a bit beyond his evidence and his short essay does not prove his point to me.
But I do find Young's suggestion that the contemporary shape of agism may well reflect the novel cultural reality that, in well-off countries, most people can expect to live to old age. I'm immediately aware how historically novel this is.
My own grandmother bore five children before 1910; three grew to adulthood and the proportion of survivors was not unusual. When I was in my twenties, I listened to a friend's stories of being a newly graduated nurse working during the influenza pandemic of 1918 which killed 50-100 million people worldwide, 3-5 percent of the world's population. It decimated young adults in particular. My own generation of LGBT folks have seen our male age peers drop in droves in early middle age from HIV related causes; we too don't assume death is only the domain of the old. In the United States we've been spared war's desolation of all ages at home for over a century; not many lands can say that.
As attaining old age has become a reasonable expectation for most US people, do we seek to quarantine most of our fear of decrepitude and death amid elders? This seems likely. Iris Marion Young points to what society loses from agism: old people have (sometimes) accumulated wisdom. Yes, the world changes. But a society that walls off its elders loses the benefit of hard acquired experience.