Variations on an End-of-Life Theme

Really fascinating comments by Mike Darwin about what amounts to variations on end-of-life themes.

I think it’s a reality that the human body is programmed to deteriorate in time, probably led by brain function, anatomically and physiologically. It’s been said that this deterioration is universal and expected and so it’s incumbent on us to do what we can in the limited time we have. I have patients in their 60s that suffer dementia outside of the usual etiology of diabetes, hypertension and multiple stroke.  I routinely see 50 year old guys that look and act like they’re 80. I have had guys stroke big time in their 30s. Some have multi-organ disease, some don’t.  I knew guys that were old men in high school.

But the variation in brain function as the body deteriorates is very remarkable. My mother is 93 years and her body has just about hit the terminal skids. She’s deaf as a post, now wheelchair bound from generalized osteoarthritis. She weighs about 70 pounds now.  But she instantly recognizes me, asks about my family, knows all their names, remembers fine points of the past and I bring her big print books and crossword puzzles that she devours using a big magnifying glass.  My father died at age 90, the day before he had a mild stroke he was wandering around town in a sport jacket shopping for books to read. He was not hypertensive and never took a single medicine in his entire life. He died of anesthesia complications after an emergency operation for strangulated hernia (I suspect).  My paternal grandmother was dating much younger men in her late 60’s, advising them she was 50 and getting away with it. My German professor in college was 93.

Mike and I differ in that I look at life span very fatalistically. I’m acutely aware that I have been graciously given a finite amount of time on this earth and there will be limits to want to get done. And there is little in anything I can do about that. As I age, I find that I can do less and less of what I was able to do when I was 20 or even 40.  It just is what it is, and the benchmark is how much you can do in the time allotted.

Most of my friends who work with the brain are “scientists” who ponder about how the brain “works”. They poke and prod and measure things trying to find out what it means when an impulse moves from one place to another through various neurotransmitters.  Personally, I don’t think any of this matters because it won’t lead to an understanding of what and why we are.  Where the rubber meets the road is what makes us cognitive humans, not collections of neuron circuits. I think the ultimate explanation, if there is one, lies in the realm of philosophy. I try to understand it using a common sense filter.

I suspect there are aspects of the brain that are very computer-like.  Hawking said there is no after-life because when the computer is shut off, it’s function totally vanishes in a volatile fashion. But I’m not so sure.  The human soul is what differs us from dogs and cats, and does not necessarily depend on computer function to exist.  Whether the seat of the soul will be the ghost in the computer is a much more interesting and elusive concept.  It could be argued that person-hood probably has some storage area. Maybe not, but let’s argue that it is unlikely to exist in the ethereal mist. Everything that makes David Crippen or Mike Darwin a “person” is possibly contained in the transfer-RNA of those parts of his brain reserved for memory and storage of experience.  The technology for unlocking this resource and transferring the information to a super-computer does not currently exist but it will in the future, as the development curve for computer power is almost vertical. It’s only a matter of time. As far as that goes, it’s only a matter of time before computers become “self aware” as in the “Terminator” sense, but I digress.

If this information can be uploaded, there is no technical reason why it cannot be downloaded back into another storage area (super-computer?) or (why not?) another brain wiped clean of information. There are people that think this is possible, or will be in the future.  But, does that make David Crippen the same guy that now tutors doctors, drives exotic sports cars, ogles gorgeous blondes, plays in a rock band and tours the world on two wheels?  Technically, it’s possible but I suspect not. The information held in the portion of the brain that serves as the repository of the person of David Crippen is not all there is. I suspect the person-hood of David Crippen is more than the sum of his parts. It is the interaction of the sum of the parts that would not necessarily occur outside the delicate balance in its original setting, even though all the parts were present. Like cutting up a camel and then putting him back together. All the parts would fit but they would not necessarily work the way they did before.

Mike wants a chance to come back and live another lifetime, maybe an infinite number of lifetimes. The potential to do that is unlikely but possible. I’m not sure at all that I would want to do that as the same person that I am now. I have managed to pack a lot into my life and plan to pack in a lot more before age incapacitates me. But I think I will be happy with what I can do in a “lifetime”, for a lot of reasons.

I think if my brain were reconstituted from it’s current iteration by transferring all my t-RNA (constituting my memories) into a super-computer and then downloading it into a wiped clean brain, there is no guarantee that I would emerge as me.  My memories are not necessarily my soul, and there is no guarantee that my soul can be localized, accessed and reproduced. I am a creature of my present, an integral part of my present. There is no guarantee that I would not find a future to be like an LSD experience, an untenable psychosis in which I would not be able to participate. It has been my experience that many people I have known welcome death at an advanced age. They did what they did and the time came.

On the basis of my family history, I suspect I will live to my 90s.  I’ll probably dance on Darwin’s grave. If I do, I think I will accept the inevitable deterioration in my persona and do what I can with what I have to work with. It isn’t out of the question that someday I may reside in a personal care home for no other reason that I won’t be able to take care of myself. I’ll hang photos of glory days on the wall and hope my vision and hearing will allow a laptop that I can keep an eye on what’s happening in a world I can no longer participate in. I think I would be happy with that deal, all things considered. I don’t think I would be capable of starting over. I had my shot at it, I took it and when the time comes, it must be given up gracefully, ever thankful for the opportunity.

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