The magnolias are in glorious bloom in Back Bay, but for the first time in years my friend Ed won’t be traveling from the North Shore for our annual magnolia stroll.
Out of an “abundance of caution” — as the phrase of the moment goes — he will stay in his world and I in mine.
“Because,” he explained, “I know if I catch the virus and land in the hospital, there won’t be a ventilator for me.”
Now keep in mind, Ed sits on the board of his local hospital — and this was a couple of weeks before state health officials issued the latest guidelines for dealing with the expected surge of critically ill patients and a potential shortage of essential equipment, like ventilators.
Now in his late 70s, Ed is a realist. It won’t matter to doctors facing life-and-death decisions that Ed’s a brilliant economist and a quite good amateur painter. It won’t even matter that he’s on the hospital’s board and has given so much back to the community. It matters only, in the words of the state protocol, that, “To the extent resources become scarce, the maximizing benefit will involve attempting to maximize life years saved, not only attempting to save the most lives.”
The good news is that race, ethnicity, ability to pay won’t count, but a host of health-related issues —those “underlying conditions” that are part of the now frequent COVID-19-related obituaries — will.
We will all be assigned a score based on our chances of long-term survival.
And in what sounds like the intro to some weird new game show, in the event two patients with the same score end up vying for the same ventilator, “life-cycle considerations should be used as a tiebreaker, with priority going to younger patients (first priority age 0-17; second priority age 18-49; third priority age 50-65; fourth priority age 65-80; fifth priority age > 80).”
Ed was so right. We’re toast. No doctor will want to know that I’ve got an official letter from the Globe’s lawyer testifying to the “essential” nature of my work or that I could run five miles without a second thought.
To hell with all those birthday card cliches that “you’re only as old as you feel” or “age is only a number.” The latter, of course, turns out to be true in an ironic sort of way.
It’s what former Boston University president John Silber said during his 1990 race for governor (and, yes, we of the “at-risk” generation are old enough to remember that), in what was considered yet another “Silber shocker” at the time. Paraphrasing “King Lear,” he said, "When you’ve had a long life and you’re ripe, then it’s time to go.”
Governor Charlie Baker put it this way, "It’s hard to believe we’re in a period where hospitals might have to make difficult decisions about how to distribute resources like ventilators, but that’s the worst-case scenario, and we must plan for it.”
If that doesn’t scare baby boomers into giving up that trip to the grocery store just because you’ve run out of chips and onion dip, nothing will.
“The ethical justification for using the life cycle principle as a tiebreaker is that it is a valuable goal to give individuals equal opportunity to pass through the stages of life — childhood, young adulthood, middle age, and old age,” the protocol states.
Yep, we get that. COVID-19 is now that mythical ice floe on which elders might be called upon to set sail into the sunset.
Those of us with children or grandchildren we’d do anything to save and protect can’t imagine it any other way. Give up a ventilator? Heck yes!
But facing our own mortality is never easy. We’ve worked longer, played harder, run more marathons, and gone on more diets than past generations just to stay in denial. Now some wretched virus threatens to shatter that illusion. Unless it isn’t just an illusion, and we actually are the resilient and smart old coots we’ve pretended to be.
Rachelle G. Cohen can be reached at Rachelle.firstname.lastname@example.org.