Dust to Dust — to save the planet

Tree

Why is this not a good idea? Wherever you stand on the “ashes to ashes, dust to dust” business, doesn’t it make sense to quit burying tons of toxic materials in the ground along with our dust and ashes?

Recently an idea for better handling of our dust evolved into the Urban Death Project, a nonprofit that caught this writer’s eye with a Kickstarter campaign some months ago. The campaign having surpassed its designated goal, my “Future Tree” tee shirt is now on its way; and the good idea seems worth sharing.

Urban Death Project founder Katrina Spade is not the first to come up with an alternative to the seriously harmful burial practices of recent centuries – practices that dump unimaginable amounts of contaminating formaldehyde, non-biodegradable metal and concrete into the ground, as if the planet had limitless ground to contaminate.

Natural burial, or “green burial” has been around for at least as long as civilization. The writers of Genesis saw fit to include that “unto dust you shall return” line, and most people found ways to make that happen fairly effectively, with exceptions made for the pharaohs. But somehow, embalming and vaults and caskets crept in, and staving off decay became both profitable and popular. Jessica Mitford’s 1963 The American Way of Death exposed abuses of the funeral home industry – Mitford herself had an inexpensive but memorable ceremony in San Francisco this writer recalls with fondness, and her ashes were scattered at sea. Her wildly popular book, though targeting funeral homes, may also have helped kickstart the search for better alternatives to what had become traditional burial practices in the U.S.

CemeteryJerrigrace Lyons was among the natural burial movement’s pioneers, with the founding of Final Passages in 1995. Lyons sought to “reawaken a choice that our ancestors once held sacred.” Final Passages is “dedicated to the reclaiming of traditional funeral and burial practices,” including green burial. One 65-year-old whose will specifies a green burial puts the issue in plainer terms, declaring he wants “to be part of a tree, part of a flower, go back to being part of the earth.”

Urban Death Project takes green burial to a new level. A three-story cone will form the space into which bodies are gently laid to rest, following a cycles-of-nature ceremony for loved ones. Also within the cone are high-carbon materials which – with the help of “aerobic decomposition and microbial activity” – decompose everything fully into a rich compost

All of which makes perfectly good sense.

It is not easy, however, to give up long-held ideas about dealing with one’s remains after one has presumably gone on to a better place. Family burial plots, oak-shaded cemeteries, columbaria and the scattering of ashes in special places all have great attraction. This writer has long cherished the notion of her children and grandchildren having a couple of lovely parties while they toss her ashes into the Chesapeake and San Francisco bays. This despite knowing that cremation takes high amounts of energy and sends carbon dioxide, mercury vapors and other pollutants into the atmosphere.

EarthBut here is the irrefutable bottom line: the total land surface area of planet earth is 57,308,738 square miles, including 33% desert and 24% mountains to divvy up among more than 7 billion people – all of whom will eventually die.

Turning us into trees to shade the next 7 billion? The Urban Death Project could be onto something.

Fighting off dementia

DementiaAlzheimer’s – already afflicting well over 5 million Americans – is expected to claim more than 16 million of us by 2050 if a cure isn’t found. Today it is at the top of the Bad News list of potential diagnoses for almost anyone over 50. Justifiably so, since the Centers for Disease Control and Prevention reports than one in three seniors now die with Alzheimer’s or other dementia.

That’s the bad news.

The good news, explained recently by Patricia Spilman, M.S. at a sold-out Commonwealth Club event in San Francisco, is that there are things one can to do lower the risk, and perhaps slow the progress of the disease. Spilman, who is Staff Scientist at the Buck Institute’s Bredesen Lab, should know. She has spent more than two decades researching neurodegenerative disease, and has written and spoken extensively on Alzheimer’s and related diseases.

“Forgetting,” Spilman says, by way of reassurance, “is normal. You don’t need to remember where you put the car keys last week, or a doctor’s appointment last month.” And studies – including one by Buck Institute founding President and CEO Dale Bredesen M.D. that is fascinating even for a lay reader – suggest that cognitive decline can be slowed, or in some cases reversed.

Spilman’s prepared remarks consisted largely of useful, realistic advice about how to delay the cognitive decline most of us will experience at some point. The audience, ranging from 20-somethings to more than a few senior citizens, was furiously note-taking throughout (or furiously jotting down questions for the Q&A session to follow.)

Exercise – particularly activities that combine movement and navigation such as tennis or golf – is at the top of the list. “It’s easier if you have a partner,” Spilman suggests, “because this adds the important element of socialization. Walking, plus climbing, is particularly good if you try new routes.” More than a few audience members nodded knowingly when Spilman noted the increasing, widespread dependence on mindless GPS. “Take the opportunity to look at a map,” she said.

Cognitive decline can also be offset by paying attention to the critical need for plenty of sleep. To help with a good night’s sleep, Spilman advises allowing at least several hours between eating and going to bed, and having a dark room. Chronic stress is relieved by a combination of exercise and sleep, along with those other preservatives of gray matter, yoga and mindfulness meditation.

Also good for the brain: almost any sensory stimulation. Music, smells, touch. Spilman cites Oliver Sacks’ Musicophilia: Tales of Music and the Brain, and Norman Cousins’ Anatomy of an Illness, in which Cousins treated himself with comedy as useful reading.

“Do something new every week,” Spilman suggests; “every day. Have goals in later life. Take classes, volunteer, build intergenerational relationships, pursue spirituality, encourage others to change and to grow.”

Computer games can improve cognition also. Spilman did not mention any specific sites, but this writer has enjoyed BrainHQ, and other brainy items from Posit Science’s Karen Merzenich, as well as introductory games on the Lumosity site. Most fascinating of all is the University of California San Francisco (UCSF)’s Brain Health Registry, in which anyone can participate; it’s free, and your brain might wind up helping someone else’s brain one day.

The Q&A segment following Spilman’s talk was fast and full of both personal stories and pertinent questions: “What’s normal decline?” (The difference between not remembering the movie star’s name and not being able to do a job well. You might keep a diary of cognitive function.) “What about genetics – the father-daughter-son factors?” (Yet unproven.) “How about overexposure to electromagnetic fields? (Don’t have unnecessary radiation.) And enough other issues raised for two or three more hours.

No one’s brain, in any event, was idle. Which indicates that everyone in Spilman’s audience was lowering his or her risk of Alzheimer’s.

It was — 1933 — a very good year

Ruth Bader Ginsberg
Ruth Bader Ginsberg

Ruth Bader Ginsberg is too old? Perhaps she should consider stepping down from the Supreme Court?

These suggestions were floated more than once in the Q&A session after a recent Commonwealth Club talk by University of California Hastings Professor of Law Scott Dodson. Dodson is the editor of a newly released collection of essays, The Legacy of Ruth Bader Ginsberg, whose writers suggest nothing of the kind. Contributors to the book, and Dodson himself, focus instead on the significant contributions made thus far by the 82-year-old justice, and the impact she continues to have on jurisprudence and on life in the U.S.

Dodson was drawn to write about Ginsberg because he “kept encountering her clear and consistent opinions” and wanted to create an objective view of her legacy – notably including gender discrimination, as in the case that ended Virginia Military Institute’s male-only admission policy, and racial discrimination, as in the voting rights case Shelby County v Holder. In the latter case, Ginsberg famously wrote that throwing out an anti-discriminatory measure as no longer needed “is like throwing away your umbrella in a rainstorm because you are not getting wet.”

As New York Times columnist Gail Collins wrote several months ago: Ruth Bader Ginsberg has no interest in retiring.

Carol_Burnett_1958
Carol Burnett in 1958

Several days before the Dodson talk, David McCullough, 82, spoke at another San Francisco event in conjunction with his most recent book, The Wright Brothers. McCullough did not go into detail about his next project, but gives every indication that he is a writer with no interest in retiring.

Meanwhile in Texas, Willie Nelson, 82, has another concert coming up, and the next show planned by Carol Burnett, 82, is almost sold out.

This writer may not have anything else in common with Ruth, David, Carol and Willie, but we take what we can get. 1933 wasn’t a bad year to be born.

 

Death, Dying & the Grey Zone

clouds

Death-and-dying usually goes with I-don’t-want-to-talk about-it.

Katy Butler wants us to talk about it. She worries, though, about the culture of death-denial, and about the lack of language when we do try to talk. How, for instance, do you say “I don’t want any more surgeries,” without its sounding like “I’m giving up”? Or how do you say “She doesn’t want that treatment” without its seeming you don’t want to keep Mom around? Especially when you know what Mom wants, but the doctors don’t?

Butler, author of the acclaimed 2013 memoir of her parents’ dying years Knocking on Heaven’s Door, spoke at a recent meeting of the San Francisco Bay Area Network for End-of-Life Care. Network members – physicians, teachers, counselors and individuals associated with a wide variety of end-of-life organizations – were clearly in tune with the message: death comes, but few acknowledge or prepare for it. It’s that vast majority, those who don’t want to talk about it, who concern Butler and her audience, including this writer.

Knocking on Heaven’s Door details, in graceful prose, how Butler’s highly educated, physically active, devoted parents managed to get caught up in the brutal reality of dying in the U.S. Her father, a decorated veteran of World War II, suffered years of gradual descent, including having a pacemaker put in when that was mainly a cruel prolongation of suffering; her mother suffered in parallel but very different ways as his caregiver. It is all, Butler fervently believes, unnecessary suffering. She quotes her father as he declined:

“I don’t know who I am any more.” Another year or so later: “I’m not going to get better.” And still later, “I’m living too long.”

Butler speaks of this in terms of “the Grey Zone.” Whereas most of us want simple, black-and-white answers – “This pill will fix everything;” “you can expect to live another four to six months” – in truth, the time before dying is the Grey Zone. And whereas the Grey Zone used to be short and swift, today – thanks to modern medicine and technology – it is forever expanding.

ER

Everyone will enter the Grey Zone sooner or later. You, reader of these words, and I, writer. You may ski into a tree, or get hit by a truck tomorrow, causing your Grey Zone to be little more than a blur; I could have a major stroke or aneurism and be at the crematorium tomorrow. But in all probability, our Grey Zones will come in bits and pieces, and will extend for many months or years. They are likely to include a few hospital stays for broken bones or debilitating illnesses, chemotherapy for cancer, possible time on a ventilator, multiple medications with occasional unpleasant side effects, outpatient and inpatient experiences with doctors we have never seen before and encounters with medical technology yet to come.

Butler advocates shifting our Grey Zones away from the relentless need to prolong life at all costs to the consideration of what really makes life worth living. We would do well, she says, to be aware of when “that space between active living and dying” should shift from Cure to Care: to easing our way from good life into good death.

Butler’s understanding of these issues come from witnessing her father’s long, anguished journey through a Grey Zone of many years and her mother’s steadfast refusal to allow a similar prolonged struggle to mark the end of her own life.

Quite apart from the expanding battles to legalize medically hastened dying, the need to acknowledge the Grey Zone is equally urgent. Most of us would opt to shorten that space between active living and dying, or at the very least to move gracefully from good life into good death.

It can happen, but not without paying attention. Reading Butler’s book, with an eye to how you would like to knock on heaven’s door yourself, is a good way to start.

Because looking realistically ahead makes infinitely more sense than zoning out.

Danger Zone in End-of-Life Talk

carved ice dove

A suicide pill for everyone over 85? Not the wisest plan to suggest right now. But it is, in fact, a possibility put forth by Joyce Appleby, Professor Emerita of History at the University of California, Los Angeles.

In a letter published in the New York Times on November 13, Appleby notes a recent anti-longevity article by Ezekiel Emmanuel and a new book on end-of-life care by Atul Gawande (both physicians,) and says,

“Perhaps the moment is right for broaching the idea of what we might call prophylactic suicide: the decision of an elderly person to pre-empt the grim reaper and avoid the disabilities of extended life.”

Appleby goes on to note that organizations such as Compassion & Choices, with which this writer has worked closely for well over a decade, “are campaigning for dignified terminations of life for those with incurable diseases” but writes, “What I propose goes a step further, extending the right to people before they face terminal or debilitating illnesses.”

Not surprisingly, Appleby’s letter – one of The Times’ regular “Invitations to Dialog” – drew more than 300 responses. Nine were selected to appear either in print or online; this writer’s is among those online and is as follows:

“I strongly support the right of a terminally ill, mentally competent adult to choose aid-in-dying, now legal in five states, but Ms. Appleby does a disservice to the cause by suggesting “a step further” — prophylactic suicide. The latter bears no relation to the former.

“We would be far better served to fight unwanted medical treatment, so often futile and excruciatingly painful at the end of life, and to enforce individual advance directives. My own directives (I’m 81) stipulate that no medication other than pain relief be given should I become unable to speak for myself, and stress that I do not wish to be fed if unable to feed myself. More important, all of my children and close friends understand these wishes because we’ve had the conversation.

“Let’s work toward those sane measures, and leave “suicide” out of it.”

Because the Death With Dignity movement is so important, and informed dialog about it so critical, it is both tragic and dangerous to have misinformation and misperception spread. There’s been enough of both over the decade+ in which the movement has slowly gained strength. To set the record straight:

Death With Dignity – the right of a terminally ill, mentally competent adult to ask a physician for aid in dying – is now legal in five states (Appleby left out New Mexico) and the movement is fast gaining ground in half a dozen others. This is partly because people increasingly understand that Death With Dignity is not suicide – and is certainly no kin to “euthanasia,” as Emmanuel would have us believe. Under Death With Dignity laws, death comes because of a disease. Every death certificate for those who have considered or used DWD laws lists the cause of death as the disease; it is not caused by suicide. Euthanasia would never be allowed under DWD laws.

But the movement is also gaining strength because it has been carefully thought out and tested. Because it is rational and safe. DWD laws are designed to promote individual autonomy, and incorporate safeguards against abuse.

Much of the opposition (as evidenced in several of the letters in The Times) comes from misunderstandings which are advanced by Emmanuel’s and others’ misuse of the word “suicide” and by fears that the elderly will be encouraged to get out of the way as Appleby’s notion suggests. Both writers muddy the waters and undermine an important cause.

Death With Dignity is a safety zone. Irresponsible words throw it into a danger zone.

 

Smarter Scams, New Victims Every Day

frowny face

My “grandson” and I talked for a full several minutes before I determined he was no one I knew. Despite a few clues – my grandchildren don’t call me “Grandma,” his voice could have been the 21-year-old I hadn’t seen in nearly a year, but it wasn’t perfect – I found the caller convincing enough to trade three or four questions and answers before I hung up the phone.

“Grandson” never got around to the pitch. I want to believe I would never have fallen for a story that would separate me from several thousand dollars, but I surely could have. Today’s scammers – especially those preying on seniors or the socially isolated – are incredibly skilled.

One very smart senior in the San Francisco Bay Area was recently taken in by a call from a fake grandson – and had the courage to tell the story to the local newspaper. Retired physician/author Walter Bortz, who has a real and well-loved grandson, listened with shock and sorrow to an entirely plausible tale that wound up costing him $5,000. The “grandson” told of having had too much drink the night before, of drugs found in the cab he unfortunately took, going to jail, getting beaten up and having his nose broken. Then he gave the phone to a “police officer” who explained how bail could be arranged……..

Elements of the scam – eloquently told to local reporters by the victim – are widely used. The “relative” is often caught up in an arrest involving drugs and/or guns (through no fault of his or her own) and often in another state or country. The need is always urgent, to avoid some terrible consequence like jail time or to cover medical expenses. Transactions are made through prepaid cards available almost everywhere today. Once cashed, the money is impossible to trace.

It’s the meanness of these scams that is almost as bad as the financial loss. Rose, a young businesswoman, tells of her own grandmother getting a call from someone pretending to be Rose and spilling out a tale of disaster that had her grandmother frightened and sobbing. Long after the ruse was uncovered and explained – “I was calling my grandmother, saying, ‘Look! I’m here at my desk. I’m sending you a photo! ’” – the targeted victim was still in distress over the fears she had had for her beloved granddaughter.

JoAnn (a pseudonym,) a friend of this writer in Louisiana, fell victim – almost – to one of the oldest scams around. It began with an official-looking notice of her having won a Canadian lottery. JoAnn lives alone and has withdrawn from friends – but she plays the lottery; she thought one of her tickets had paid off. The notification included a “Certified check” for her seven-figure winnings. All she had to do was deposit the check, wire $1,279 to cover out-of-state taxes, and live in luxury. JoAnn was saved by an alert teller who had not seen her come into the local bank for a long time. The teller began asking questions about the sender, and JoAnn finally told her about winning the lottery. “If you don’t mind,” the teller said, “let me see if this check clears before you do anything further.”

My friend suffered not from financial loss but from the embarrassment factor. JoAnn was in tears by the time she got through telling the story over the phone. “How foolish did I look?” she said. “Suppose word gets around that I fell for such a thing. I have a PhD, for heaven’s sake.” The teller turned everything over to federal agents and it’s highly unlikely that word got around.

But word should get around. Bortz deserves high praise for going public, proving that no one is exempt from the possibility of being scammed. “I like to think that I am worldly wise,” he told The Almanac, “(and yet) I got snookered into this one. But I guess it shows that I’m a nice grandfather.”

Nice grandfathers, and grandmothers, and gentle people everywhere, are being targeted today. The Federal Trade Commission has a fairly complete list of current scams, and how to deal with them, on its Consumer Information page.

The schemes are old, the twists are new, the advice is age-old and two-fold: (a) Keep asking questions; and (b) If it seems too good (or even bad) to be true, it probably is.

Do We REALLY Want to Live Forever?

Is immortality just around the corner?

Say you could live, maybe not forever, but to 150 or so; would you exercise that option? The immortalists, notably including British biomedical gerontologist Aubrey de Grey, unquestionably would. Immortalist thinking is that we should be “conquering death” (by rearranging genomes and other scientific maneuvers) so we can set about living into infinity. De Grey’s goal is to develop a “cure” for human aging.

Immortalism — OK, it’s not in the dictionary, but may be there any day now — the notion that humans should be able to live forever, has been around for a while itself. In the late 1920s, after an “otherworldly experience in the Utah desert,” aviation pioneer Charles Lindbergh enlisted Nobel laureate scientist Alexis Carrel in an immortality project that never went much of anywhere. And that was fortunate, since it had more than a smattering of facism and anti-semitism. Several years ago, David Freidman wrote about that project in The Immortalists: Charles Lindbergh, Dr. Alexis Carrel and Their Daring Quest to Live Forever.

And now comes another daring quest. It’s led by super-scientist de Grey and is detailed in another, new book by Jonathan Weiner, Long for This World: The Strange Science of Immortality. No offense to Jonathan Weiner, who is a remarkably gifted writer with one Pulitzer Prize and a great deal more literary honors more than this writer, but I think I’ll pass on Long for This World. I did read a fine review of it by Abraham Verghese in the New York Times Book Review of August 1 (and was pleased to have my letter about it published a couple of weeks later.) Verghese pointed out that the Immortalists miss the point: “that simply living a full life span is a laudable goal,” and that we could end up “simply extend(ing) the years of infirmity and suffering.”

There’s also a finite amount of space on the planet, and just now we’re not doing a great job of sharing that space. This small piece of cyberspace believes the quest for better life — say, health and wellbeing — might make more sense than the attempt to “conquer death.”