In her book Reconstructing Illness: Studies in Pathography, Anne Hunsaker Hawkins proposes that the modern pathography is replacing the accounts of religious conversion that were popular in earlier eras. What is a pathography? One definition that I found is “the study of the life of an individual or the history of a community with regard to the influence of a particular disease or psychological disorder.” Reconstructing Illness is an extensive study of this genre, how individuals deal with a diagnosis of a serious illness, and its broader role for medical caregivers and society.
One thing that I was wondering about while reading this is whether there are any pathographies of aging. There is no shortage of pathographies about cancer, HIV/AIDS, dementia (etc.) but I was curious if anyone had ever considered writing about the individual experience of the aging process and its inevitable outcome, death. Hawkins’s book has a very useful list of pathographies organized by disease. Perusing this list provides one with a good understanding of which kind of pathographies are popular but I failed to find even one title that explicitly concerns aging. Similarly, a search on “pathography of aging” on the internet did not produce any results. Sure, there are many books about facing death (or dealing with the death of a loved one) or the challenges and opportunities associated with growing older. But I am not aware of any account that treats the aging process in a format that is remotely similar to the descriptions of disease we meet in the pathography, let alone one where the aging process is described as a battle to be undertaken.
This should not be surprising. For most of us, disease is an abnormal condition that is defined relative to the normal aging process. Although a lot of disease is closely associated with aging, most people hesitate to call the aging process itself a disease because it would render the conventional use of the word disease problematic. There are diseases that are characterized by rapid aging in children, such as progeria, but we do call such conditions a disease because the pace at which these children grow older is not normal. In fact, pathographies of accelerated aging diseases might be the closest thing that approaches a pathography of aging.
Regardless of one’s perspective on the causes or mechanisms of aging, if we look at aging at the molecular level we will find a progressive accumulation of damage as we grow older. Whatever we mean by “aging gracefully,” this accumulation of damage stops for no one and ultimately results in death. Because aging is normal, and no one is being diagnosed with aging, there is not a clear, identifiable, moment in life that triggers the experience and events that are documented in the typical pathography. In fact, the universal nature of human aging and our propensity to react more strongly to unexpected events strongly biases humans to respond to specific diseases and not the aging process itself. What we seem to care about is abnormal deterioration and death, not the deterioration and death that is universal and foreseeable.
Not all people react in such a passive manner to aging. Not anymore. To some of us the relatively slow pace of physiological deterioration is a source of anxiety and the fact that it is a universal phenomenon does not provide solace, especially when medical technologies to halt or reverse aging can be envisioned and pursued. What sets humans apart from other animals is that we can recognize a universal condition and not be satisfied with it. Aging is an undeniable source of suffering and loss of dignity, sets the stage for separation and death, and favors short-term thinking over long-term responsibilities. It will only be a matter of time before the first pathographies of those who succumbed to the process while consciously fighting it will reach us.
Originally published as a column (Quod incepimus conficiemus) in Cryonics magazine 2012-6