Never Say Die, by Susan Jacoby

Susan Jacoby is an important truth teller who, in a series of books, has addressed key critical issues in our society. She brings great candor and moral passion to her accessible, journalistic narrative writing, which combines careful research, anecdotal material and her own experience. In this book she takes up the social construction of old age. The core idea, developed in many directions, is that old age is real and inescapable, that for many people it is dreadful and that it cannot be resisted by the illusions of our society.

Jacoby contends that our society is engaged in willful denial about old age. Relying on narrative accounts of unusual persons, we characterize old age as a time that offers the prospect of well-being, happiness and an extended season of fulfilled, satisfied living, but it is not that way for most people. Jacoby’s book penetrates the illusion and honestly addresses the dismal prospects of aging people—prospects that have important policy implications.

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Her particular target is the boomer population, which she divides between “early boomers” and the “later boomers,” who have different agendas. The boomers feel entitled, she argues, not only to get it all and to get it all now, but to continue with uninterrupted flourishing and well-being into old age. Such a prospect is a myth that is enhanced and reinforced by the marketing of products that are said to fend off the erosions of old age.

According to marketers, those who have the right diet, the right exercise, the right clothes and the right cosmetics (and no doubt the right surgery) will not get old in debilitating ways:

We’re going to be just like the actress Betty White, hosting Saturday Night Live at age eighty-eight. We’ll be paying our own way, overwhelmed with job offers, and in good enough health to work as hard as we always did. We’ll be perfectly able to take care of ourselves.

A self-declared atheist, Jacoby allows no spiritual palliatives. She is unflinching about the bodily reality of aging that will not be changed by manipulative strategies because the body will not and cannot be sustained forever in health. We belong, she insists, to the animal kingdom, and we share the future of that regime.

Jacoby exegetes boomer self-deception in five essays that are relatively independent discussions but nonetheless overlap. First, she discusses Alzheimer’s as a “neurobiological catastrophe,” a widespread and still spreading social reality for which there is currently no remedy, no prevention, not even a slowing down. Jacoby is highly critical of “junk thought” that imagines that Alzheimer’s can be conquered and that continues to offer false hope and reassuring possibility for which there currently is no basis. Given that reality, she urges the deployment of government resources that would provide the palliative care that families without adequate resources urgently need.

Second, Jacoby offers an incisive discussion concerning the fact that the problem of old age is particularly acute for women, both because women live longer than men and because in a patriarchal society, they are often left without adequate resources. Women in general are poorer than men, and racial and ethnic minority women are even more so. With reference to her own mother, grandmother and great-grandmother, Jacoby comments on the acute “social loneliness” that is faced by women who are left behind. She observes that such women are expected not to “let themselves go,” so they must attend to make-up, hair and clothes so they can “age gracefully,” all of which requires a lot of effort and expense.

Third, she explores the economic status of old people, many of whom have insufficient resources. The stereotype of wealthy “old geezers” misrepresents the true state of affairs:

The American penchant for instant gratification, coupled with opposition to higher taxes that would create a larger government-financed social safety net, spells huge long-term economic trouble for the old—particularly the oldest old—in our society.

Jacoby draws a compelling contrast between the social safety net of European society and the inordinate individualism that precludes such social protection for the old in the United States.

Fourth, in a discussion that borders on cynical, she refutes the common claim that old people are wise: “There is as much proof of the wisdom of old age as there is of the medical efficacy of holy water from Lourdes.” She judges that there is continuity as people grow old. People who were wise early may continue to be so, and those who were not, will not be. Here is a comment that exemplifies the realism with which Jacoby refuses any romantic palaver to the contrary:

People who live with ardor, integrity, and wisdom continue to do so as long as their brains remain intact. Those whose lives have been defined by boredom, dishonesty, and intellectual laziness also continue their earlier course.

Never Say Die culminates with two reflections, one on dying and one on public policy. First, death is inevitable, so it requires careful planning and intentionality, including a living will. Beyond that, Jacoby speaks a good word for suicide in specific cases. She laments the legal requirement that people be kept alive when they wisely and knowingly consider death a preferable alternative. Concerning social policy, Jacoby judges that longevity is no unmitigated gain because extended life is as likely to be a burden as a freedom to be enjoyed. Long-term retirement may eventually become “a passport to boredom and purposelessness for many old men and women who like to work and are healthy enough to do so.”

The book finishes with a shrewd reflection on the politics of health care and the growing tension between the political will of old people and the rising self-assertion of younger people who may or may not be committed to guarantees for the old:

Both the liberal and conservative economic nonsense about old age—a self-serving combination of wishful thinking and politically motivated lying—must be jettisoned if we are ever to begin a meaningful, reality-based discussion about intergenerational responsibility and the lives of old people not only today but in the future.

Though without illusion, this book exhibits great empathy for old people, whom Jacoby wants to be treated with care and for whom she wants to see humane policy. She stays focused on the denial of aging and does not probe the way in which it is a subset of the more systemic denial that pervades our socioeconomic system, all in the service of an uncriticized market ideology. Still, this is a book to which attention must be paid. It reads like a summons, calling truth tellers to tell their truth.