On Old Age and Death VI

The secret to life is meaningless unless you discover it yourself.” 

-W. Somerset Maugham


Nothing you can lose by dying is half as precious as the readiness to die, which is man’s charter of nobility.

-George Santayana


            Decay or deterioration begins early in life. Most people accept that getting old is an inevitable part of life; no one is spared forever. We are born; we grow to become fertile adults; and then our bodies age until we die—the natural round of life. After age 30, people tend to lose lean tissue. Muscles, liver, kidney, and other organs, lose some of their cells. Muscle mass and strength tend to reduce by 30%-50% between the ages of 30 and 80 years. Furthermore, losses in muscular strength occur at an approximate rate of 12%-14% per decade after age 50 years. The biological aging process is not steady and appears to accelerate periodically–with the greatest bursts coming, on average, around ages 34, 60, and 78. The process of muscle loss is atrophy. Bones lose some of their minerals and become less dense–osteopenia in the early stages and osteoporosis in the later stages. By the time people reach their 50s, strength, balance, and endurance are already beginning to wane noticeably–much earlier than previously thought, according to a new study.

Old cells sometimes die because they are programmed to do so. Cells may also be damaged by certain by-products of their own normal activities. These by-products–called free radicals–are given off when cells produce energy.  In some organs, cells die and are not replaced; so, the number of cells decreases. The number of cells in the testes, ovaries, liver, and kidneys, decreases markedly as the body ages. Much of this process is unavoidable. In a sense, our cells are “coded” to die off as time passes. For example, consider the role of telomeres which are protective tips at the end of chromosomes. They play a similar role to the plastic tips on shoelaces. Over time, telomeres shorten, leaving the genetic material of chromosomes more vulnerable to unraveling.

We are constantly under attack from our environment, and our bodies accumulate damage over time. One symptom very commonly associated with aging is wrinkling. After the age of 20, we produce 1% less collagen in the skin each year which results in skin becoming more brittle over time. However, UV rays from the sun are the much more pressing issue, leading to 80% of skin wrinkling over time. Along with losing our chromosomal and cellular ability to divide properly, our immune system becomes less keen over time and loses the ability to decipher the difference between our own cells and enemy cells. In moments of confusion, immune cells may attack one’s own body in a phenomenon called autoimmunity. As we age, our cells begin attacking themselves, observed particularly in the lungs.

As well, when you grow older your cells experience more oxidative stress. That is what happens when free radicals–unstable molecules that can damage DNA—are not balanced by antioxidants in your body. The result is cell damage, which contributes to many of the changes that accompany aging.

Don’t worry about it; there is nothing one can do to change those processes significantly. Several factors influence biological age, including genetics, diet, exercise, biomarkers, and sleep. Aging and lifespan are strongly affected by metabolism.

Old age comes with frailty and disease, or does it? While most older people suffer from severely diminished endurance, there are some who complete marathons and even Ironman events. They are slower, but winning times for 70-year-olds are less than 60% over those of the best athletes aged 30. Today, most scientists think that aging is caused by a complex interplay of different factors, including genetics, programmed physiological changes to our cells, and behavioral, and environmental, influences.

Scientists generally divide the stage of old age into three categories: Young–old [65-84], oldest-old [85- 99], and centenarians [100+] for comparison. These categories are based on the conceptions of aging including: biological, psychological, social, and chronological, differences.

Health Challenges of Aging include: weight gain, sleep problems, nutrition problems, fragile bones, cancer, depression, memory loss, and alcohol tolerance changes. There is a great deal none of us know about the mysteries of aging.


“[Death is] the undiscovered country from whose borders, no travelers returns.”

-Shakespeare, Hamlet


It is better to value death rather than to grieve it. It is also better to prepare for it rather than to fear its coming.


“Cowards die many times before their deaths.

The valiant never taste of death, but once.

Of all the wonders I have yet heard,

It seems to me most strange that men should fear,

Seeing that death, a necessary end,

Will come when it will come.”

-Shakespeare, Julius Caesar

“… Darest thou die?

The sense of death is most in apprehension.”

-Shakespeare, Measure for Measure

“When we die, we lose only the present moment,

For the past has ceased to be, and the future

Has not yet come; so, to comfort ourselves;

We have only to look around and ask, is this moment

Worth keeping?

-Marcus Aurelius

“Death is the sound of distant thunder at a picnic.”

-W.H. Auden [1907-1973]

I chose to use a pseudonym for personal reasons. I’m a retired neurosurgeon living in a rural paradise and am at rest from the turbulent life of my profession. I lived in an era when resident trainees worked 120 hours a week–a form of bondage no longer permitted by law. I served as a Navy Seabee general surgeon during the unpleasantness in Viet Nam, and spent the remainder of my ten-year service as a neurosurgeon in a major naval regional medical center. I’ve lived in every section of the country, saw all the inhumanity of man to man, practiced in private settings large and small, the military, academia, and as a medical humanitarian in the Third World.