Funny how things happen sometimes... Lately, I've been brightening my time on the walking pad (wonderful, but incredibly boring exercise) by re-watching movies from my fairly extensive DVD collection. Every day... I'm not even choosing them - just going in the order my collection is organized: European arthouse, American Classics, American arthouse, etc. And so, believe it or not, on the very day I popped in John Cassavetes's "Gloria" (1980), starring his wife Gena Rowlands, their son Nick Cassavetes publicly announced that Ms. Rowlands (now 94) has been living with Alzheimer's disease for the past five years... Heartbreaking...
We hear a lot of that lately, don't we? More and more people live well into their 90s nowadays: Mel Brooks is 97, William Shatner - 94, Lee Grant - 98, Clint Eastwood - 94, Jimmy Carter is an astonishing 99... And it's not just celebrities. From Scarsdale to Hong Kong, I know people who lived to see their great-great-grandchildren born... Some of them keep their wits about them just fine, but quite a few fall victims to the age-driven degenerative tendencies of the neurons in the human brains; the ones that force the elderly to develop various conditions leading to dementia... Just like poor Gena Rowlands...
Do you ever think about the reasons behind this trend? I do. In fact, I'm so paranoid about the conditions of people's brains, I've been thinking about this since I was in my 30s. And the way I see it, one of the main underlying causes is the profound disparity between the advances in cardiology vs. neuroscience.
Nowadays, people get their heart valves repaired and replaced, their damaged and destroyed arteries bypassed in triple and quadruple ways, their entire dying hearts transplanted straight into the medical waste and exchanged for the healthy ones obtained off of some unfortunate (but robust, nevertheless) recently departed individual. And all these marvelous procedures end up regenerating cardiovascular wellbeing, rejuvenating the throbbing engines by decades... 80 and 90-year-olds run around with tickers as vigorous as those of the well-fit 50-year-old youngsters.
On the other hand, the Brains... I don't think they can 3D-print them even in the most secretive of all evil laboratories in the world. (To the best of my knowledge and research, you know.) And so, very frequently these healthy hearts end up beating for people who can't recognize their children, can't take care of their basic needs, have no clue who and where they are. Did you know that people may live with Alzheimer's for as long as 25 years? It's been 5 years for Gena Rowlands, but poor Joanne Woodward, now also 1994, has been living with that diagnosis since 2007.
For me personally (and I absolutely mean it): I would not want anything working properly in my body, let alone having a heart capacity to last for any extra number of years, if I couldn't know my daughter sitting in front of me. Fuck that shit! And I was seriously concerned when ten years ago my father, then turning 80, was going for his second stent placement... But his memory and mental faculties were above par for his age and nobody even asked me to contribute my opinion... He was desperate to get rid of the pain in his chest and the shortness of breathe... And I felt terrible even having those thoughts in my head...
Thankfully, I knew that I weren't alone and that there were other people who also came to experience such concerns - and not just on a speculatively statistical level, but in a very tangible, first-hand way: Two years prior, in May of 2012, I've read Michael Wolff's cover article he wrote for New York Magazine: A Life Worth Ending - an incredibly intimate account of his and his siblings' journey through the ordeal of caring for their mother whose heart, through prior surgical intervention, was much younger than her brain. Granted, the article was focused on the healthcare costs associated with such parental conundrum as well as already familiar to me by then subject of Long-Term Care insurance policies... Still, Mr. Wolff's is a master of narrative nonfiction and his account of this familial ordeal was deeply emotional and relatable.
I am a very private person who rarely shares (or even communicates - to be honest) with other people. And so that article was basically the first confirmation to me that I weren't crazy or sinister to be thinking about these matters. That there were other people who agreed that we should be acutely guarded against all those frivolous heart repairs for elderly. That it would be not just prudent, but ultimately humane to be considerate of the possibility that these surgeries may destroy, not improve, the quality of their future lives - if the dementia comes knocking.
Universally speaking - I would even say, on the politic0-scientific scale of the matter - we can move in two directions towards a kinder, more reasonable, and, in the long run, beneficial for everyone concerned resolution of this, unfortunately very frequently occurring, predicament.
On one hand, we can attempt to make it compulsory for cardiologists to be more responsible when it comes to recommending surgical interventions for people over certain age and more holistic in their patient care with consideration of conditions beyond their direct specialties. Even more important, we (the elderly and their caretakers as the unified interest group) can insist on being provided with the full disclosure regarding the scope of future possibilities, including the one of the longer life marred by mental incapacity.
But here we have finally arrived at the fiscal side of the issue at hand. (I hope you didn't really think I've forgotten about it.) The cardiovascular mending is the biggest cash cow of the medical industrial complex. Heart conditions are #1 most expensive group of chronic diseases. It's literally impossible nowadays to find a relatively recent statistics on anything, but in 2016 adult cardiovascular spending came to a sweet little sum of $320 billion! Of which 54% was covered by public insurance, i.e. Medicaid and Medicare, and 37% by private insurance. That's 91%, or $291 billion of automatically collectable funds. It's hard to imagine the hospital systems, particularly their boards and investors, giving up any portion of that income - humaneness be damned!
Yet, there is an alternative route of action: to finally start bearing down on this stumbling block of the aging Brain and attempt to, at the very least, match its longitivtiy of the repaired hearts. And I'm not talking about some sci-fi scenarios here either. Researchers working in the stem-cells limitless field of opportunities already made significant inroads into the possibilities of treating a broad spectrum of neurological conditions, including the ones leading to dementia.
Unfortunately, this area of science is suffering from the - really unimaginable in our "enlightened" times - plaque of "ethical" debates, particularly around the matters of embryonic stem cells. And it is an undeniable reality that entirely baseless, anti-scientific, purely political positions still prevail, thus influencing the legal landscape around the matter; slowing down - instead of spearheading - the advancement towards the younger brains. And, just like with the reproductive rights, the antis here are preoccupied with the status of embryos.
Actually, whether it deals with embryos or not, officially stem cell research is legal in the United States. However, it's subject to state-specific laws and federal funding restrictions. And even the embryonic stem cell research is not technically illegal. But! The federal funding (the source responsible for over 50% of all American academic R&D) is categorically prohibited for both the creation of new embryos - reproductive (remember Dolly?) or therapeutic (the creation of stem cells entirely independent of the fertilized eggs) alike - as well as for the distraction of embryos. The latter is especially significant as it includes the process of obtaining stem cells from the existing human embryos - unused and donated by their creators through the fertility banks. In other words, as it frequently happens with our government, everything is dumped into the same suppressive bucket, regardless of the source and purpose.
Believe you me: I'm as much in opposition of the reproductive cloning as the most reactionary conservatives from the heart of Arkansas. I mean, let's leave the artificial creation of multiple identical offsprings in the realms of science fiction. Nobody is that special and we truly already have too many people on this planet. And cloned sustenance - no, thank you!
But the therapeutic cloning with hopes to eliminate dementia?! What's wrong with that? Why do these strange people keep caring more about never to be born embryos than about the living, breathing, and suffering humans. Many of them quite accomplished individuals. Please, let the scientist use those donated bits of cells! Please, give them grants to hurry this shit up! Aren't you afraid that these terrible neurological tragedies may befall you?
And it's so fiscally nearsighted too! Cause imagine the billing volume that can be generated by curative methodologies directed at not just dementia, but also paralysis, multiple sclerosis, Parkinson's decease... Leukemia, lymphoma, neuroblastoma... Etc., etc., etc. - virtually no limitation to the scope of the applications. Including the heart failure!
But I guess, on the Capitol Hill religious lobbying trumps even HMO lobbying... And so, we remain stuck between the cardiologists who can make you ticking like a fucking clock for decades and the helpless neurologists absolutely unequipped to deal with the sad state of the Brains.