Living Well

I’ve been thinking about mortality lately. This was spurred by a feeling of being a little bit “off” — an elevated heart rate, chest tightness, something not quite right. Net is I’m fine: I’m thankful to have a clean bill of health. Nevertheless, a health scare — like other close calls such as surviving a car crash, experiencing a natural disaster, or living through a deadly pandemic — is an important reminder that this precious life we live is fragile and finite.

I recently watched the beautiful movie musical Tick, Tick…Boom!, which tells the story of composer Jonathan Larson who feels the pressure of seconds ticking by as he struggles to write an epic Broadway show. Larson does in fact write the award-winning musical Rent, but tragically dies of an aortic dissection at age 35, the day of Rent’s first Off-Broadway performance.

Tick, Tick…Boom!’s director Lin-Manuel Miranda also recounted the life of Alexander Hamilton, who likewise died young. The cast of Hamilton sings, “Why do you write like you’re running out of time? Write day and night like you’re running out of time? Ev’ry day you fight, like you’re running out of time.” Hamilton died at age 47 of a gunshot wound from a duel with Aaron Burr, after having been a commander of a battalion in the American Revolutionary War, the author of 51 Federalist Paper essays, and the first Secretary of the Treasury.

Far too many others have also been struck down in the prime of their lives — friends and family members, colleagues and celebrities. Neuroscientist Nadia Chaudhri died this fall at age 43 of ovarian cancer. Actor and playwright Chadwick Boseman passed away last year at age 43 from colon cancer. Michael Duffy died at age 29 in the terrorist attacks at the World Trade Center on 9/11. My IBM colleague Seth Erlebacher died at age 46 of a sudden heart attack. Jamie Guttenberg died at age 14 from a school shooting. Computer Science Professor Randy Pausch of the inspiring Last Lecture died at age 47 from pancreatic cancer. My brilliant college friend attorney Lisa Kramer passed away at age 44 from brain cancer. Neurosurgeon Paul Kalanithi — author of the poignant memoir When Breath Becomes Air — died at age 38 from lung cancer. Broadway star Nick Cordero died at age 41 from complications of COVID-19.

Each of these individuals made extraordinary contributions in their short lives. All had family and friends that loved them and felt their loss acutely. And we can only imagine what more they could have accomplished and experienced if they were blessed with more time.

Life expectancy at birth — which tells us how long a newborn will likely live — has been steadily increasing. Globally it was just 57 back in 1950, and it’s over 73 today. Life expectancy is higher for women than men, and it varies across the world — from a low of 54 (in the Central African Republic) to a high of 85 (in Hong Kong and Japan). Healthcare improvements have contributed to this trend, particularly reductions in child mortality. For individuals who survive to adulthood, their life expectancy becomes higher than it was at birth. Consider that today in the United States, a female’s life expectancy at birth is 81; by 40 years old, her life expectancy is 83; at 65 years old, it becomes 86; and if she makes it to 80, her life expectancy is 90. The oldest person ever recorded lived to age 122, part of an exclusive faction of age-110+ supercentenarians. Unfortunately, the COVID-19 pandemic has increased mortality and premature death rates.

So, how much time is enough? Prolific composer and lyricist Stephen Sondheim’s passing last week at the age of 91 sent tremors through the musical theater community, who mourned the loss of their beloved icon. So too when Ruth Bader Ginsburg passed last year at age 87, there was an outpouring of despair at the loss of this trailblazing Supreme Court justice. Sondheim and Ginsburg led long, full, and impactful lives, but even so their deaths created a void. How many more Broadway musicals did Sondheim have in him? How many more seminal decisions for Ginsburg?

My own mother died at age 69 — too early to meet her youngest grandchild or to witness her oldest graduate high school or to see her daughter become the IBM CIO. What I regret most is not being able to talk to her about the little everyday moments — to recount a funny story, commiserate about the state of the world, have a sounding board when times are tough. But I also appreciate the legacy she has left, the undeniable influence she had on me, our family, and the others she touched during her lifetime.

I’m rapidly approaching 50, which feels like a daunting milestone in this journey of life. The Wait But Why website illustrates poignantly how each of us is gifted with a countable number of lifetime moments. Imagine I am lucky enough to live to 90. That means I have roughly 40 more Thanksgivings to celebrate, 10 more presidential elections to vote in, and only two more cicada broods to witness (okay, I could do without the swarms of noisy insects).

With such limited time and the varied risks that threaten to cut our time short, it’s easy to understand why some might want to hide away, feeling vulnerable and holding their loved ones close. Believe me, if I could swaddle my kids in bubble wrap to keep them safe, I’d be tempted to do so. Sometimes it feels like an act of immense courage to let my teenager get behind the wheel of a car or play a contact sport like hockey.

But — life is for living, and living well means experiencing all it has to offer. For me, that includes helping my children grow and thrive, connecting with family and friends, contributing in some meaningful way to the lives of others. Here are some reflections on what we can do to take care of ourselves and each other and to be intentional about how we use our limited time.

1. FORTIFY: Fuel Up
How can we expect our body to sustain us for a century or more if we don’t take care of it? That means putting high quality fuel in the tank: a healthy diet coupled with sufficient exercise and rest. For me, this means drinking more water and less caffeine, eating more fruits and vegetables and fewer carbs. A plant-based diet is both healthful and sustainable, when coupled with limited red meat and processed foods. Exercise and sleep are essential — and I need to get more of both. Thirty minutes of moderate physical activity daily is recommended for adults, along with 7 to 9 hours of sleep each night, without which our mind and body don’t properly recharge. Heathy habits also means avoiding harmful vices like cigarette smoking, which shortens life expectancy by at least 10 years.

2. PROTECT: Safeguard Ourselves and Others
There are a host of things we can do to mitigate risks and give ourselves (and others!) the best chance at a long and healthy life. Wear a seat belt in a car, a helmet on a bike, a mask indoors during a pandemic. Install smoke and carbon monoxide detectors in your home and change the batteries regularly. Keep firearms unloaded and locked away. Get vaccinated — this protects you and helps prevent community disease spread. The COVID-19 pandemic has certainly reminded us how interdependent we all are, the world over, and the responsibility we all have to promote wellness and support public health.

3. DETECT: Early Diagnosis is Key
The odds of effective treatment, cure, and survival are directly tied to how early we detect an illness. This requires us to be proactive in getting checkups and screenings — like annual exams, blood tests, mammograms, and colonoscopies. When cervical cancer is detected via pap smear screening before it has spread, the 5-year survival rate is 92%; if detected at a later stage, the survival rate is just 15%. Similar is true for early detection of lung cancer, breast cancer, heart disease, and more. In the hustle and bustle of our busy lives, it’s easy to put off preventive care appointments. Let’s commit to prioritizing the time.

4. PREPARE: Plan for Any Eventuality
Despite the best laid plans, there are things we cannot guard against. Bad things happen even when we’re careful, even if we’re vaccinated, even if we’re wearing a helmet. So go ahead and prepare just in case. Run evacuation drills at home. Discuss a plan to help your kids out of an uncomfortable or dangerous situation. Make sure loved ones know your desires about treatment and organ donation, should you become incapacitated. Create a will, identify guardians for your children, and invest in life insurance. Tell family and friends how much they mean to you.

5. FIND JOY: Look After Our Mental Health
There sure are plenty of things to get stressed over these days — macro things like politics, gun violence, climate change, and COVID-19; personal things like relationship worries, work demands, dirty dishes, and of course our health (and all those screening appointments we need to make! and how about meeting with a lawyer about a will? and don’t forget to get a booster shot!). So sometimes it takes an overt effort to find joy and look after our mental health. Some people find practicing mindfulness or meditation restorative. For me, it is seeking people and activities that bring me joy. Curling up on the couch with a good book. Playing board games with my kids. Going out to dinner with my husband. Taking a walk through the woods with my dog. Laughing with a friend. Expressing gratitude is also associated with greater happiness and better relationships. Even prior to the pandemic, depressive and anxiety disorders were the leading causes of disability worldwide; since COVID-19, there has been increased prevalence across the lifespan. Seek help — which might include therapy, medication, or both — if symptoms worsen or impact daily activities. Pay special attention to others who are suffering and get them the help and support they need.

Everyone generally knows we should do all these things…but if you’re anything like me, you’ve likely put them off, focusing on urgent tasks or what others ask of you. Now is as good a time as any — and far better than next week, next month, or next year — to re-commit to prioritizing our own personal well-being so we can continue to live well for years to come.