Remember you will die
It was January 2020 and I was visiting Philadelphia. For many of us, just the date January 2020 is enough to send a shiver down our spines, but the chill was a lot more literal then, as a cold front engulfed the city. I was relieved when I set foot in the warm Mütter museum. The physical relief I felt was quickly replaced by existential discomfort.
For the uninitiated, the Mütter museum, run by The College of Physicians of Philadelphia, is a showcase of medical specimens, including conjoined skeletons, saponified corpses, presidents’ tumors, and even pieces of Einstein’s brain (It looks like any other brain only smarter!). At the Mütter, Philly native (and magician) Teller explained “We are permitted to confront real, not simulated, artifacts of human suffering, and are, at a gut level, able to appreciate the epic achievements of medicine .”
I felt queasy when I realized that the beautifully drawn 19th century tattoos were still on the jarred skin of a once-living human. I flinched when a cough sound effect played inches from my ear as I sat in a fake bus seat, part of the unfortunately prescient rotating exhibit about the 1918 Spanish flu pandemic. I was oblivious to the fact that Covid was likely already in the United States, about to unleash another pandemic.
I left the museum with an overwhelming awareness of my own mortality, not helped by the weather that met me when I stepped outside — the kind of cold that reminds you of the fragility of the soft flesh that we’re made of. It was an unpleasant feeling that stuck around for weeks.
Like most of us, I am lucky enough not to have to think about my own death regularly, and frankly, I try to avoid it. But I think as a society we have gained an aversion to death that borders on denial.
You can’t help but notice the recent American fixation with living the longest lives we possibly can. We are proclaiming 90 as the new 50, and trying to live not to 100 but 150. We are obsessed with these numbers but not what they mean – we are concerned with the length of our lives more than their quality.
Those preaching the possibility of ultra-long life swear by regimens which typically include preventative care — healthy eating and exercise — things we know are unqualified positive choices. They are intertwined however with less proven ideas: excess genomic testing, dubious supplements, extreme diets, immunosuppressive medicines, vampiric plasma infusions, or penile shock therapy to name a few.
Much of the thrust of anti-aging mania comes from Silicon Valley. This highlights a critical truth about why many of us have lost our techno-optimism. More and more, we are pitting our technological advancements against our humanity. Wars are fought with drones, dating is done with phones, even this article is written by AI (just kidding).
When it comes to healthcare the same is true. We have become obsessed with extending life, often through costly and invasive technologies if they can extend life even slightly. These treatments can eliminate hard earned savings at the expense of quality of life for elderly patients, and of their families who shoulder many of the responsibilities of their care. Instead of chasing the promise of additional years to our lives, perhaps we should be measuring how much life it adds to our years.
None of this is to diminish the great strides we have made with health technology in the last century. We are living longer, better lives with good public health practices, regular screenings, and life-saving medicines like statins. We have awe-inspiring technologies that were science fiction to our grandparents, from PET scans to robots assisting surgery, appendectomies performed through tiny laparoscopic incisions, gamma-ray knifes used to destroy brain tumors, heart valves replaced through cardiac catheters, genomic testing and gene editing, to name but a few.
These technologies have given us the immense privilege of not feeling the sting of death around us nearly as often as our ancestors, whose lives were overwhelmingly touched by loss. Remembering this privilege means remembering death, but the ultra-longevity craze, over-intervention, and sometimes indiscriminate use of medical technology highlights our cultural and institutional aversion to this fundamental part of existence.
In the not-so-distant past, our cultures, religions, and philosophies had no choice but to confront ever-present death. In Southeast Asia, Buddhist monasteries developed forms of meditation that involve contemplating the impermanence of life and the inevitability of death. In West Africa, the Igbo people practiced the Mmanwu masquerade, donning masks that allowed them to literally embody the dead and communicate with the spirits of their ancestors. Europe had the memento mori, a Latin phrase and proverb urging us to “remember you will die.” Memento mori took off in the medieval period, embodied through art forms that highlighted the inevitability of death, with more skulls and skeletons than a Hot Topic.
I’m not advocating that we obsess over our inevitable demise, only that we respect our own history and recognize our mortality. By acknowledging the limits of our time on Earth, we can give so much more meaning to the time we have. The idea of memento mori is powerful and prescient, reminding us to spend our cosmically brief time living well and being human.
In medicine this means continually revisiting what we mean when we pledge to do no harm. Extending life is not the same as enhancing life. It means helping people understand their bodies— how to best keep them healthy and prevent illness. It means encouraging us all to take advantage of the many screening programs that are offered to us. It means helping people understand their illness and their treatment choices, so they get the care most consistent with their own beliefs and preferences. It means resisting the sometimes-perverse economic incentives to do more. It also means not being afraid to engage in honest shared conversations when treatment may be prolonging suffering instead of prolonging life. Together we should resist the allure of technology in favor of our humanity.
It is life’s fleetingness that makes it precious, that fills every second with meaning. Each moment, no matter what we are doing is unique, transient, never to be experienced again. We owe it to ourselves to experience it, aided perhaps, but never superseded by technology — from dating to dying.
Embrace your humanity. Memento mori. And if you’re in Philadelphia, choose to check out the Mütter. https://cpp-college.netlify.app/our-work/mutter-museum
Edited by: Adam Husney
