‘It was the best of times, it was
the worst of times, it was the age of wisdom, it was the age of foolishness, it
was the epoch of belief, it was the epoch of incredulity, it was the season of
Light, it was the season of Darkness, it was the spring of hope, it was the
winter of despair, we had everything before us we had nothing before us, we
were all going to Heaven, we were all going direct the other way – in short,
the period was so far like the present period, that some of its noisiest authorities
insisted on its being received, for good or for evil in the superlative degree
of comparison only.’
Apart from the fact that my English
teacher would have smacked her ruler across my knuckles for using a sentence
with 119 words in it, the sentiments conveyed in Dickens’ words resonate with
where I think we are today, some 161 years later. I’m sure I’m not the only one
who spends some time thinking about what life was like pre-Covid; the plans we
had that had to be abandoned; the things we did then that we are not doing now
and the continuing uncertainty of what the future will bring.
Paul Cosford is someone having to
deal with the certainty of his uncertain future. You can read his story here
(and please do as its message is both poignant and powerful). Paul is a doctor,
who for many years has worked in public health. He is also living with terminal
lung cancer. Writing in the British Medical Journal last week, he used his experience
to raise the issue of assistive dying. As I say it is a very powerful and
personal narrative. One of the things that struck me about his account was that
he was, wherever possible, making the most of every moment he might have left. He
knows that the remorseless march of the cancer will eventually incapacitate him
to the extent that he will become dependent upon others to meet most of his
needs. But until those days arrive, he is determined to spend as much time as
he can with those he loves and doing as many of the things he loves doing as he
can.
There was a second aspect to his
story that also struck a chord. This was the notion of permanence. Whilst previously
he was a long distance cyclist, these days he walks. Sitting on a bench to catch his breath, he
draws upon his view of a river or the undulations of the hills, which may not
have changed much in hundreds of years to bring perspective, and through that,
comfort, in thinking about the fragility of his existence here on earth. I wish
him well as he steadfastly continues to live with something that will
eventually kill him.
The other story that caught my
attention last week was a research report from Finland. Like Paul’s story, this
was a research project that took life expectancy as its focus. It is clear that
people, on average, are living longer. The Finnish study however was not so concerned
with how long a person lived for, but the quality of the life lived. Way back
in 2001, the Word Health Organisation (WHO) added the concept of health-span to
the way life expectancy could be measured. Health-span is the measure of the quality
of life than someone experiences rather than the quantity of life lived.
The study was undertaken at the
University of Jyvaskyla (a lovely place name, pronounced U-vas-kla). It was
unique as there are few studies in the world that have been able to compare the
way older people of the same age manage in their daily lives, but in different historical
times. The study looked at two cohorts of participants (aged 75 - 85) born 30
years apart. The study compared the physical and cognitive performance of each
group. Perhaps not surprisingly given the changes in the lifestyle choices
people have been able to make over the past 3 or 4 decades, many improvements
were noted in the later-born group. In terms of their physical performance, their
walking speed was faster, grip strength stronger, lung function measurements nearly
50% better – they also performed better across most of the cognitive performance
tests. The results give me hope. They should also give a certain other older
man hope too.
Donald Trump, President of the US,
tested positive for Covid19 - on Friday. He is a 74-year old man (two of the strongest
risk factors) and is clinically obese (a third risk factor). Research shows
that those aged 65- 74 have a five times higher risk of hospital admission than
other groups and a 90% higher risk of death. Not a great place to find yourself
in. However, like many of those in the Finnish study the golden-haired one doesn’t
appear to have any underlying chronic health conditions, and is reasonably
active. He plays a lot of golf and appears to walk quickly between shots. Clearly
the outcome for anyone in Trump’s situation depends upon many factors, some of
which are unmeasurable, so there will always be some degree of uncertainty.
Our friend Dickens. He would have
hated the pandemic, and the notion of a lockdown would have been almost too
much for him to contemplate. He famously visited the Lake District because of
his restlessness and the need to be on the move – it’s also alleged that it
gave him an opportunity to spend time with his mistress, but it’s not for me to
judge. These days I visit the Lakes with my fiancée, young J. We like walking
on hills that have been there for millennia. The seasons change, but those
hills change much more slowly. Permanence, or maybe the illusion of certainty.
The day before Dickens died, he
cashed a cheque for £22 (about £5,000 in today’ money) in the pub across the road from
his house. History says that it was intended to be a gift for his mistress. I think
in Dickens’ mind, on that sunny morning 161 years ago, it was almost certain he would have thought that
life would be going on just as it always had. Its certain that we will all
live with uncertainty.
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