The Long Game

By Kenneth Ring, Ph.D.

As you will know if you've been an assiduous reader of my previous blogs or, more likely, just an occasional casual visitor to them, I don’t spend much time these days watching the news on TV about the virus. Life is dismal enough without being reminded of how much people in the U.S. and around the world are suffering and how many have already died, not that our President ever seems to spend any time mourning them, but then, as we know, he was apparently born without a gene for empathy. Bill Clinton, he ain’t. Never mind, that's not what this blog is about.

What I was going to say is that last night I made an exception and watched The News Hour on PBS. One of the guests on the program was an infectious disease specialist named Michael Osterholm from the University of Minnesota where, it being neither here nor there, I went to graduate school back in the antediluvian epoch. My memories of Minneapolis in those years were of nine months of brutally cold winters followed by ten minutes of spring, but then this isn't what this blog is about either. To begin with, it’s about what I learned from listening to Dr. Osterholm.

This will be one of those good news/bad news tales. Let's start with the bad news. If you’re reading this, you have an excellent chance -- perhaps as much as a 2/3rd probability -- of being infected with the corona virus. The good news, according to Dr. Osterholm, is that you have an 80% chance of winding up only mildly or moderately sick for a few weeks or maybe not even being aware that you've been infected. In that case, you will be laid up for a short time but then you will fully recover and that will be that. Even if you are in the remaining 20%, there's a 50-50 chance that you will not have to be hospitalized and could be successfully treated by your own doctor. And the best news of all -- perhaps only .5 to 1 percent of people who come down with the illness will die. All in all, I'd say that is pretty reassuring news, assuming that Dr. Osterholm's predictions are accurate, but then, who knows? Still, I think we should take heart from these projections, don't you?

Of course, as Dr. Osterholm made clear, nobody knows what the hell will happen over the coming months or years. At this point, it's all guesswork, even if it may be educated guesswork. But Dr. Osterholm went on to tell us some things that were fairly sobering, if they prove to be true.

We don't know whether this virus will act the way the influenza virus behaves, but if it does, we can expect that it will recur and probably more than once over the next year or more. In that case, there will be periods of waves and troughs. We may have a few months when it will abate to a significant degree, but then, perhaps in the late summer or early fall, it may strike again and this time, it could be even worse than it's been. Dr. Osterholm, using a baseball analogy, said where we are now just in the second inning. It will be a long game. Get used to it. If he and other experts are right about this, we are going to be plagued with this virus for quite a while. Nobody knows how long.

And even if COVID-19 does not prove to be as lethal a virus as many had feared, it could still end up ending the lives of many thousands of people. Dr. Osterholm estimates that ultimately it could kill as many as 800,000 people in the U.S. As of this writing, about 50,000 Americans have died from it. That’s obviously not a small number, but it's only a small fraction of those we can expect to perish, again assuming we can trust this projection. We just don’t know, but we have been warned.

Mulling all this over afterward, I naturally thought about all the people who would die. Most of them would be old folks like me. After all, I'm in my mid-eighties now, and though, so far as I know, I don't have any serious illness or "underlying condition" that makes me particularly vulnerable, my odds of surviving aren't good. After all, I am already suffering from an incurable disease -- aging. If the virus doesn’t get me, my decaying telomeres will. But my own life and death is of no particular consequence in the scheme of things -- even if it is to me -- especially when viewed against the enormous level of suffering that billions of people now living are experiencing and will have to continue to endure.

But then I had another thought. Not about myself, but about other old farts like me. I know you will think me callous but it was a big "So what?" So what if many old people were to die from this virus?  I mean, a lot of these people would die, anyway, wouldn’t they, of so called "natural causes." Or if they were living, might well wish they weren't. After all, if you've already lived into your eighties, as I have, you will have learned that the promised "golden years" are a crock of you-know-what.

For years, I have joked about my own version of "a modest proposal." My idea was that people would live under a definite death sentence. If they survived until they had reached their three score and ten, they would be given a pill that would painlessly ease them into death. This, it seems to me, would have many advantages. First of all, it would save billions of dollars since an enormous amount of money has to be spent in the last years of people's lives on providing them health care and hospitalization. Second, it would free up a great deal of money for younger people since no more Social Security payments or pensions would be necessary after a person reached seventy. Third, most people's productive years are over by the time they reach seventy; the rest is mostly just waiting to die and years of illness, decrepitude and senility in store. Is this any way to run a navy? Do you really want to spend your "senior years" shuffling to the shuffleboard area on yet another cruise with elderly folks like yourself or making a sorry spectacle of yourself with your potbelly and ridiculous-looking Bermuda shorts tottering around on some Floridian gulf course? Or worse yet, did you ever dream when young of spending your last years languishing in a nursing home among the demented and utterly forlorn, the truly wretched of the earth? (If you have ever spent time visiting an ancient loved one in one of these places, you will know what I mean.)

Honestly, when you consider all this, wouldn't it really make sense to spare old people this kind of fate? After all, we weren't meant to live to such great ages. Evolutionarily, we were designed to live only so long as to procreate, pass along our genes, and then get off the stage. Dying in one's forties would normally allow us to accomplish all these things. Now more and more of us just hang around, are burdens to our family, and merely take up space while exhausting limited financial resources. What is the point? 

Hell, if I had died when I was seventy, both the world and I would have been better off. I wouldn't have had to suffer the deliberating effects of my spinal stenosis. My hearing would still have been good, my vision, good enough; I still would have been able to hike, to travel, make love, and enjoy life to the fullest. I wouldn’t have to spend days as I do now when I sometimes walk about the house like a wraith, exhausted and weary beyond belief, trapped in a seemingly interminable bardo of ennui hovering between life and death. Instead of often feeling like cashing in my chips, I would have still been in my chips.

Besides, one thing my years of research on near-death experiences has taught me is that death is nothing to be feared, but is to be looked forward to. Dying may be hard, but death is easy.

When I was first researching NDEs forty years ago, I collected testimonies from NDErs about the effects of their experience on their fear of death. Here's a small sampling of what they told me:

"I had been terrified of death before, it [the NDE] left me with a total lack of fear of death."

"Well, I certainly have no fear of death."

"I’m not afraid of death at all."

"I have no fear of death. I don’t to this day."

"If this is what death is like, then I'm not afraid to go... I have absolutely no fear at all."

"I have no fear of death."

"I'm not afraid of dying. I'm really not afraid and I used to be scared to death."

I collected many such quotes from this research (but there is no point in endlessly listing them here) and all other NDE researchers have reported the same findings.

All this, to be sure, doesn't fully address all aspects of our fears about death. Quite apart from the fear of death, what about the fear of dying?

Of course, NDEs don't do anything to diminish that. It’s understandable to fear dying. If, as Bette Davis famously reminded us years ago, old age isn't for sissies, dying is surely not for the craven. Let’s not kid ourselves; no one looks forward to dying (except those in extreme pain or those who are simply weary of life). And who knows what dying will be like for us? Who can say whether when the time comes, we will die "in character?" Elisabeth Kübler-Ross, the great expert on death, apparently had a very difficult time dying and was very angry. Who knows whether Ken Ring, the guy who spent half his life studying NDEs, won't die like Tolstoy’s Ivan Illich by screaming for three days before his death? It’s a crapshoot and you don’t have the chance to load the dice.

And coming back to our current pandemic, the prospect of dying as a result of having extreme difficulty in breathing and effectively suffocating to death is not exactly an enticing prospect, and many of us will, alas, presumably die in this way. But on the other hand, spending one's remaining time on a ventilator is not exactly an alluring future possibility either. And even if ventilators are no longer in short supply, I can't see availing myself of one. Better to stand aside, Ken, and let some younger person take that route. They still have life to live; you've had yours. Make way, old timer.

Anyway, that's how I’m feeling about things after having pondered Dr. Osterholm's commentary. On the whole, I feel encouraged to know that even if the pandemic will be with us for sometime, the great majority of people who really need to live will survive and eventually thrive and those who don’t would probably have died soon enough anyway. The corona virus, bad as it is now, is not strong enough to bring about even a hint of a Malthusian solution to our over-population problem, so the world will continue on with its usual struggles and problems once this crisis has finally passed its acute phase.

It's still a long game, if not for the likes of me. I'm fine with that. Really. Now you will know why.