It's About Time

The Quality of Life by Suzanne M. Schweikert M.D. Copyright 2003 All Rights Reserved Comments, thoughts, and personal experiences on time related topics are welcome. Email: Dr.Schweikert@WritersMonthly.com

Time Is Irrelevant: Short vs. long lives…

As a doctor, I’m all about saving lives. In fact, I like to start when they’re young, as that has the potential for the greatest number of YPLLS (pronounced yipples = years of potential life lost) and QUOLYS (pronounced kwallys = quality of life years saved). These terms were coined by the bright and calculator wielding epidemiologists who help us make all sorts of decisions about what to eat, what to drive, the oil industry, and how to spend our health care dollars, all based on huge numbers of people dying of various causes.

But this counting, while it helps determine the impact on society of, for example, head injuries caused by driving while talking on cell phones (DALYS = Disability Adjusted Life Years), can all too easily translate into the belief that, the longer you live, the more quality your life has had. Much to my own surprise, I have found this NOT to be the case. It seems that those who die young often have a quality of life that the death counters either cannot, or will not, measure.

While I once thought that saving young lives would somehow mean that all these little people would be given (and therefore use wisely) a "new lease on life," nothing could be farther from the truth. In fact, those who actually end up dying seem to be the only ones ever given a "new lease." Most of us just renew the same old lease over and over. Which is only fair, I suppose. Ever since we evolved from single cell organisms, we haven’t learned much of anything by osmosis. But we don’t die when submersed in salt water, so I guess it’s a fair tradeoff.

Lately, it has come to my attention that many of the infants I’ve "saved," i.e. those who miraculously survive their own births, go on to live nightmares of sickness, self-abuse, abuse by others, and so on. Some die a slow and prolonged death in childhood, while others are wiped out in their teens, in the wink of a speeding bullet. And for the rest of us who live into our adulthoods, we die slowly or quickly, depending on the circumstances. But we don’t contribute nearly as much to the QUOLY’s and YPLL’s, since by the time we’re twenty, we have less of these left anyways.

But contrary to these quantifications of the so-called value of life, I’ve found that being around terminally ill people (the slow and prolonged group) gives one even more insight (despite a natural resistance to these things) into the real lessons of life. And the younger a person is when he or she is dying, it seems the more profound their lesson is.

This is not to say that deaths of children are beautiful things. They are not. There is anger, suffering, deep and unrelenting sadness, and eventual holes left in the world that cannot be filled. And for those children who die violent or unexpected deaths, we wonder if there was time for them to be aware of their passing, or to learn anything from it. In fact, sometimes we even hope that they were unaware, that it all happened "too fast."

And yet, I have come to believe that awareness of death is something we all need more of. It would be ideal if we were all given at least a few seconds each day in which to face our mortality. For a slowly dying person, there is often a layer of truth and honesty that washes over them, making every moment on earth a meaningful one. Sometimes this an understanding about who they love and why, and other times it has more to do with letting go of who and what they love. For the very young, who cannot communicate what they learn as they face death, I have no way of knowing exactly what is grasped. However, in watching them die, I always feel that they know something I do not. Which, I’m sure, they do.

And this is never going to change. I will always be under the impression that I can take care of something tomorrow, next week, or next year. And, until I see my own mortality face to face, I will always believe that I have a little more time to accomplish what I need to. And in a way, I am always right. Until the one day that I am wrong. And whether I have two seconds, two months, or two years left, at the moment when I become aware I am surely dying, I am certain that I will then be in touch with something profound and amazing — something that I do not currently know.

And the funny thing is, no matter what age we are when we walk up to death’s door, we will all be like children, scared and excited by our hopes and dreams of what is to come. At that moment, we might even realize that the QUOLY’s and YPLL’s, or even years and months, are incapable instruments when it comes to measuring the quality of our lives.

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