Ezekiel J. Emanuel produced a rather interesting article
recently in The Atlantic: Why I Hope to Die at 75. His
title is a bit misleading; he does not actually wish to die at 75; rather, he
believes that at that age he should not take measures to extend his life. From his view, at age 57, life at 75 would be
sufficiently degraded that it would no longer be worth the effort to take measures
that might extend his life.
“But here is a simple truth that
many of us seem to resist: living too long is also a loss. It renders many of
us, if not disabled, then faltering and declining, a state that may not be
worse than death but is nonetheless deprived. It robs us of our creativity and
ability to contribute to work, society, the world. It transforms how people
experience us, relate to us, and, most important, remember us. We are no longer
remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.”
This logic and his conclusion was rather surprising to
those of us who are approaching or have already moved past that target
age. In Aging: Why Would a 57-Year-Old Man Want to Die at 75? a counter
argument was presented that pointed out that those who he described as “feeble,
ineffectual, and even pathetic” seemed to believe that those years he didn’t
wish to live were actually the most contented of their lives.
What is of interest here is Emanuel’s statement that
aging “robs us of our creativity and ability to contribute to work.” He makes these claims:
“Even if we aren’t demented, our mental functioning deteriorates as we grow
older. Age-associated declines in mental-processing speed, working and
long-term memory, and problem-solving are well established. Conversely,
distractibility increases. We cannot focus and stay with a project as well as
we could when we were young. As we move slower with age, we also think slower.”
“It is not just mental slowing. We literally lose our creativity.”
“….the fact is that by 75,
creativity, originality, and productivity are pretty much gone for the vast,
vast majority of us.”
He then seems to insult his academic colleagues who spend
more time mentoring students in the latter years of their careers instead of focusing
on their individual efforts. The
implication is that this occurs because of an age-related decrease in
capability, rather than as a logical career choice.
“Mentorship is hugely important. It lets us transmit our collective memory
and draw on the wisdom of elders. It is too often undervalued, dismissed as a
way to occupy seniors who refuse to retire and who keep repeating the same
stories. But it also illuminates a key issue with aging: the constricting of
our ambitions and expectations.”
“We accommodate our physical and mental limitations. Our expectations
shrink. Aware of our diminishing capacities, we choose ever more restricted
activities and projects, to ensure we can fulfill them.”
To support his
contentions, Emanuel presents this chart attributed to Dean Keith Simonton a
psychology professor at the University of California at Davis.
Simonton does
seem to be the preeminent scholar when it comes to understanding the aging and
productivity of people who have demonstrated a significant degree of
creativity. Let us see what he actually
has to say on the subject. Simonton
produced a short summary of relevant conclusions in bullet form here.
A copy of one of his articles is provided in concise but slightly longer
form here. The latter source will be used in the present
article.
Simonton tells
us that we should be careful in interpreting charts such as the one utilized by
Emanuel. They consist of averages over
many types of activities, some of which have quite different time
histories. He also suggests that using
chronological age as the variable is misleading because it is the career itself
that has a time dependence of its own.
People who choose to pursue a particular creative activity starting
later in life will follow a similar curve, but it will be shifted along the age
axis.
“….we introduce a central finding of the recent empirical literature: The
generalized age curve is not a function of chronological age but rather it is
determined by career age….People
differ tremendously on when they manage to launch themselves in their creative
activities. Whereas those who get off to
an exceptionally early start may….find themselves peaking out early in life,
others who qualify as veritable ‘late bloomers’ will not get into full stride
until they attain ages at which others are leaving the race.”
This
introduces the notion of a career trajectory that is more a function of career
duration than physical age. The
shape of this productivity dependence on career duration varies considerably
from one creative activity to another.
“The occurrence of such interdisciplinary contrasts endorses the conjecture
that the career course is decided more by the intrinsic needs of the creative
process than by generic extrinsic forces, whether physical illness, family
commitments, or administrative responsibilities.”
Simonton
provides some examples of differing productivity histories for various creative
disciplines.
“Especially noteworthy is the realization that the expected age decrement
in creativity in some disciplines is so minuscule that we can hardly talk of a
decline at all. Although in certain
creative activities, such as pure mathematics and lyric poetry, the peak may
appear relatively early in life, sometimes even in the late 20s and early 30s,
with a rapid drop afterwards, in other activities, such as geology and
scholarship, the age optimum may occur appreciably later, in the 50s even, with
a gentle, even undetectable decrease in productivity later.”
Presumably,
Emanuel would categorize himself as an academic scholar. If he had read Simonton carefully, he might
have concluded that as such he had a right to expect a long and productive life
rather than assume that the death of his creativity was imminent.
Simonton
provides us with another insight into age and productivity: even though less is
produced at later stages of a career, the “quality ratio” is undiminished.
“….if one calculates the ratio of creative products to the total number of
offerings at each age interval, one finds that this ‘quality ratio’ exhibits no
systematic change with age. As a
consequence, the success rate is the same for the senior colleague as it is for
the young whippersnapper. Older creators
may indeed be producing fewer hits, but they are equally producing fewer misses
as well.”
This allows
Simonton to suggest this startling conclusion:
“This probabilistic connection between quantity and quality, which has been
styled the ‘constant probability of success’ principle….strongly implies that
an individual’s creative powers remain intact throughout the life span.”
In other
words, the decrease in creative output as a career progresses can be caused by
many factors other than age. Perhaps a
professor at a university will choose to spend more time with students later in
his career. That is, after all, what
professors are supposed to do. Others
may find a new creative outlet and gradually transition to a new discipline. Artists may try to improve their “quality
ratio” by investing more time and effort into each piece.
Simonton
finishes with this conclusion:
“….the career trajectory reflects not the inexorable progression of an
aging process tied extrinsically to chronological age, but rather entails the
intrinsic working out of a person’s creative potential by successive acts of
self-actualization.”
Damn! We might as well live as long as we can.
Ezekiel Emanuel is
director of the Clinical Bioethics Department at the U.S. National Institutes
of Health and heads the Department of Medical Ethics & Health Policy at the
University of Pennsylvania.
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